Stimulating the vagus nerve with electrical signals significantly improves disease severity of rheumatoid arthritis (RA), according to a new study, “Vagus nerve stimulation inhibits cytokine production and attenuates disease severity in rheumatoid arthritis,” published in Proceedings of the National Academy of Sciences (PNAS).
So-called bioelectronic medicine may help treat diseases such as rheumatoid arthritis, which are traditionally treated with relatively expensive drugs, without any reported side effects.
“This is the first study to evaluate whether stimulating the inflammatory reflex directly with an implanted electronic device can treat RA in humans,” Prof. Paul-Peter Tak, of the Division of Clinical Immunology & Rheumatology of the Academic Medical Center at the University of Amsterdam, and the principal investigator and lead author of the study, said in a press release.
Researchers implanted a small stimulating device on the vagus nerve of 17 rheumatoid arthritis patients, several of whom had failed to respond to multiple therapies, including biological agents with different mechanisms of action.
The vagus nerve extends from the brain stem to the abdomen, going through several organs such as the heart, esophagus, and lungs. Its role is to keep the heart rate constant and control food digestion.
The researchers used a set schedule of activation and de-activation of the nerve and measured the response over 84 days. At day 42, they analyzed the number of tender and swollen joints, disease activity as measured by the patients themselves and the physicians, and C-reactive protein levels in the blood, which is a protein produced by the liver in response to inflammation.
Several patients reported significant improvements in disease severity without any side effects.
In previous in vitro and animal studies, the same team had shown that targeting the inflammatory reflex reduces inflammation through the inhibition of cytokines such as tumor necrosis factor (TNF). It had not been proven until this study that electrical stimulation of the vagus nerve can inhibit cytokine production and reduce inflammation in patients.
“This is a real breakthrough in our ability to help people suffering from inflammatory diseases,” said Dr. Kevin J. Tracey, co-author of the study and president and CEO of the Feinstein Institute for Medical Research, and co-founder of SetPoint Medical that developed the implanted device.
“Our findings suggest a new approach to fighting diseases with bioelectronic medicines, which use electrical pulses to treat diseases currently treated with potent and relatively expensive drugs,” added SetPoint Medical CEO Anthony Arnold.
“These results support our ongoing development of bioelectronic medicines designed to improve the lives of people suffering from chronic inflammatory diseases and give healthcare providers new and potentially safer treatment alternatives at a much lower total cost for the healthcare system,” he said.