title: Bioelectrical Stimulation for the Reduction of Inflammation in Inflammatory Bowel Disease.
abstract: Crohn's disease and ulcerative colitis are the primary inflammatory bowel diseases (IBDs) affecting the gastrointestinal tract. The current therapy aims at decreasing inflammation and reducing symptoms. This typically requires immune suppression by steroids, thiopurines, methotrexate, or tumor necrosis factor inhibitors. Patients may be unreceptive to medical therapy, and some may discontinue the treatment due to adverse effects. Noninvasive, transcutaneous vagus nerve stimulation (VNS) is currently used as a treatment for depression and epilepsy, and it is being investigated for the treatment of conditions such as multiple sclerosis, migraines, and Alzheimer's disease. Recent studies have demonstrated the importance of splenic and vagus nerve functions in the inflammatory process through the production of certain cytokines. We hypothesize that using transcutaneous VNS via the auricular afferent branch could achieve a selective anti-inflammatory effect on the intestinal wall. This review examines the possibility of using vagal stimulators as a therapy for IBD. This could open the door to novel treatments for numerous vagally mediated diseases characterized by poor responses to current therapies.
authors.affiliation: School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Marshall
authors.affiliation: School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Ian
authors.initials: I
authors.lastname: Taylor
authors.affiliation: Department of Surgery, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Lahr
authors.affiliation: Division of Gastroenterology, GI Motility Clinic, University of Louisville, Louisville, KY, USA.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Abell
authors.affiliation: Department of Biochemistry, University of Mississippi Medical Center, Jackson, MS, USA. ; Cancer Institute, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Espinoza
authors.affiliation: Division of Gastroenterology, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Nitin K
authors.initials: NK
authors.lastname: Gupta
authors.affiliation: Cancer Institute, University of Mississippi Medical Center, Jackson, MS, USA. ; Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA. ; Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Christian R
authors.initials: CR
authors.lastname: Gomez
keywords: Crohn’s disease; inflammation; inflammatory bowel disease; noninvasive; transcutaneous electrical stimulation; ulcerative colitis; vagus nerve stimulation