Chan Eubi, Mani Ali R
Network Physiology Laboratory, UCL Division of Medicine, London, UK.
School of Medicine, Brighton and Sussex Medical School, Brighton, UK.
Physiol Rep. 2025 Feb;13(3):e70230. doi: 10.14814/phy2.70230.
Emerging evidence suggests that the vagus nerve can modulate the immune system in experimental settings. Vagus nerve stimulation (VNS), initially developed for managing epilepsy, is now being explored as a treatment for autoimmune diseases due to its potential immunomodulatory effects. This systematic review evaluates the therapeutic potential of VNS in autoimmune diseases by critically appraising findings from human clinical studies. This systematic review was conducted in accordance with the PRISMA guideline, with a comprehensive literature search performed in Ovid, Cochrane, and PubMed databases up to July 2024. Studies focusing on VNS in patients with autoimmune diseases were eligible, and the quality of study was assessed using the QualSyst tool. Of the 53 papers identified for full-text assessment, 19 studies met the eligibility criteria. Findings suggest that VNS is a promising adjunctive therapy for Crohn's disease and rheumatoid arthritis, showing potential to alleviate symptoms and modulate immune responses. The efficacy and safety of VNS vary widely across studies, highlighting the complex nature of autoimmune diseases and the diverse mechanisms of VNS action. Future research should prioritize large-scale, randomized controlled trials with standardized protocols to further elucidate the efficacy, long-term safety, and optimal parameters of VNS across various autoimmune conditions.
新出现的证据表明,在实验环境中迷走神经可以调节免疫系统。迷走神经刺激(VNS)最初是为治疗癫痫而开发的,由于其潜在的免疫调节作用,目前正被探索用于治疗自身免疫性疾病。本系统评价通过严格评估人类临床研究的结果,评估VNS在自身免疫性疾病中的治疗潜力。本系统评价按照PRISMA指南进行,截至2024年7月,在Ovid、Cochrane和PubMed数据库中进行了全面的文献检索。纳入关注自身免疫性疾病患者VNS的研究,使用QualSyst工具评估研究质量。在确定进行全文评估的53篇论文中,有19项研究符合纳入标准。研究结果表明,VNS是克罗恩病和类风湿关节炎一种有前景的辅助治疗方法,显示出缓解症状和调节免疫反应的潜力。VNS的疗效和安全性在不同研究中差异很大,凸显了自身免疫性疾病的复杂性以及VNS作用机制的多样性。未来的研究应优先开展大规模、标准化方案的随机对照试验,以进一步阐明VNS在各种自身免疫性疾病中的疗效、长期安全性和最佳参数。