Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Biomedical Engineering, Ben-Gurion University of the Negev, Beer Sheva, Israel; The Division of Cardiovascular and Thoracic Surgery, Rabin Medical Center, Petach-Tikva, Israel.
Transpl Immunol. 2024 Oct;86:102105. doi: 10.1016/j.trim.2024.102105. Epub 2024 Aug 10.
Allograft rejection, accompanied by a rise in proinflammatory cytokines, is a leading cause of morbidity and mortality after lung transplantation. Immunosuppressive treatments are routinely employed as an effective way to prevent rejection, however, there is still an unmet need to develop new strategies to reduce the damage caused to transplanted organs by innate inflammatory responses. Recent research has shown that activating the vagus nerve's efferent arm regulates cytokine production and improves survival in experimental conditions of cytokine excess, such as sepsis, hemorrhagic shock, ischemia-reperfusion injury, among others. The cholinergic anti-inflammatory pathway can provide a localized, fast, and discrete response to inflammation by controlling the neuroimmune response and preventing excessive inflammation. This review intends to assess and discuss, the influence of noninvasive vagal nerve stimulation for prophylactic measures and supporting treatment in patients undergoing organ transplantation rejection with a prominent T-cell mediated immune response as a means of attenuating inflammation and leukocyte infiltration of the graft vessels.
同种异体移植排斥反应伴随着促炎细胞因子的升高,是肺移植后发病率和死亡率升高的主要原因。免疫抑制治疗通常被用作预防排斥反应的有效方法,但仍需要开发新的策略来减少固有炎症反应对移植器官造成的损害。最近的研究表明,激活迷走神经的传出臂可以调节细胞因子的产生,并改善细胞因子过多(如败血症、失血性休克、缺血再灌注损伤等)的实验条件下的存活率。胆碱能抗炎途径可以通过控制神经免疫反应和防止过度炎症来提供局部、快速和离散的炎症反应。本综述旨在评估和讨论非侵入性迷走神经刺激对器官移植排斥反应患者的预防措施和支持治疗的影响,这些患者具有明显的 T 细胞介导的免疫反应,作为减轻炎症和白细胞浸润移植物血管的一种手段。