Seldom do I ever have a “WOW” moment when reading about advances in medicine, but it happened last week, reading an article in the January issue of Nature Medicine titled, Vagus Nerve Mediated Neuro-Immune Modulation for Rheumatoid Arthritis. That is doctor talk for shocking a nerve in the neck that improves rheumatoid arthritis when all other medications have failed. Bear with me while I explain the characters in this too-good-to-be-true medical moment.
First, the vagus nerve is one of 12 nerve pairs that leave the brain passing to the body without going through the spinal cord. It has several actions in the body, including slowing the heart rate and controlling digestion by stimulating contractions of the stomach and gut, as well as the secretion of stomach acid and pancreatic enzymes. Lately, it’s been found that the vagus nerve also controls the release of chemical factors from the spleen, which, in turn, increases inflammation, both beneficial and harmful.
The second main character in the story involves small proteins called cytokines, which are released by white blood cells and generally increase inflammation, which helps the body fight infection. However, the system may go awry, with cytokines being released that attack healthy tissue. This is the culprit in rheumatoid arthritis (RA), as these cytokines destroy the healthy joint linings. The best medicines we have today for RA counteract this rogue cytokine action, but, unfortunately, they are ineffective 40 to 50% of the time. The patient lives in pain.
Now, back to the plot of the story. The article mentioned above described stimulating the vagus nerve with a small electrical generator about the size of a kidney bean surgically placed in the neck. It was programmed to deliver a small one-minute electrical shock every 24 hours. This electrical shock passes down the vagus nerve to the spleen, causing it to tell the white cells to quit making these misbehaving cytokines.
The result was phenomenal. 50% of the patients got relief from their rheumatoid arthritis. Not only were expensive medicines avoided, but pain and joint function also improved. Scientists are now looking at this technique to treat other autoimmune conditions, such as lupus, ulcerative colitis, and Crohn’s disease.
In summary, an electrical shock (which should have nothing to do with controlling autoimmune diseases) delivered to a nerve that controls digestion improved a horribly painful arthritis. That is my “WOW” moment.
Dr. Charlie Barnett is a contributor to KnoxTNToday, where he writes a weekly column, DocTalk, sharing his expertise on health and wellness management.
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