The results of a pilot study, presented at the European Annual Congress of Rheumatology, suggest that electrostimulation of the vagus nerve could constitute a new approach in the treatment of rheumatoid arthritis.
The vagus nerve is one of the nerves that connects the brain to the rest of the body. It is the longest and most complex nerve of the 12 cranial nerves which originate in the brain and extend to the neck, chest and abdomen.
Recent advances in the fields of neuroscience and immunology have made it possible to map brain circuits regulating immune responses. In one of these circuits, called the inflammatory reflex, signals are transmitted via the vagus nerve to prevent the release of cytokines such as tumor necrosis factor (TNF), an inflammatory molecule considered to be a major therapeutic target in the treatment of polyarthritis rheumatoid.
The basic idea ofa new study, recently presented at the European Annual Congress of Rheumatologyis that by stimulating the activity of the inflammatory reflex, natural immune reactions can be modulated without producing significant immunosuppression.
For the study, a miniature neuro-stimulator (called MicroRegulator) was implanted in 14 patients with rheumatoid arthritis and on whom at least two biological or oral tests had already failed. These patients were divided into three groups: a placebo group, a group with daily stimulation and another with four daily stimulations.
Hope for rheumatoid arthritis and other chronic inflammatory diseases
After twelve days of the study, patients who received daily stimulation showed better results than the group with four daily stimulations, with two-thirds of patients meeting the criteria for “good” or “moderate” response to treatment, described by Congress. European Annual of Rheumatology.
The results also show that the levels of cytokines, which are proteins essential to the functioning of cell signaling, had for some of them fallen by up to 30% in the groups with electrostimulation.
“This breakthrough is really exciting. For many patients with rheumatoid arthritis, current treatments do not work or are not tolerated, explains Professor Thomas Dörner, Chairman of the Scientific Committee of the Annual European Congress of Rheumatology. These results open the door to a new treatment approach for both rheumatoid arthritis and other chronic inflammatory diseases.”
Chronic inflammatory joint disease
Rheumatoid arthritis is a chronic inflammatory disease of the joints that progresses in flare-ups. It is an autoimmune disease, but several immunological, genetic, hormonal or environmental factors are necessary for it to trigger.
Without treatment, the disease gradually spreads to new joints and leads to the progressive deformation or destruction of the affected joints (often those of the hands and feet). In some rarer forms of the disease, extra-articular manifestations appear, affecting other organs. In France, rheumatoid arthritis affects 0.3 to 0.8% of the adult population, or about 200,000 people. It is two to three times more common in women than in men.
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