Vagal nerve stimulation potential therapeutic benefits in acute lung rejection and transplantation

• Published in: Transplant immunology Vol. 86; p. 102105
• Main Authors: Edalati, Shaun, Meyer, J. Sam, Aravot, Dan, Barac, Yaron D.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2024
• Subjects: Acute lung rejection; Immune response; Lung transplantation; Therapeutic benefits; Vagal nerve stimulation; Immune response; Acute lung rejection; Vagal nerve stimulation; Therapeutic benefits; Lung transplantation
• ISSN: 0966-3274; 1878-5492; 1878-5492
• DOI: 10.1016/j.trim.2024.102105

Allograft rejection, accompanied by a rise in proinflammatory cytokines, is a leading cause of morbidity and mortality after lung transplantation. Immunosuppressive treatments are routinely employed as an effective way to prevent rejection, however, there is still an unmet need to develop new strategies to reduce the damage caused to transplanted organs by innate inflammatory responses. Recent research has shown that activating the vagus nerve's efferent arm regulates cytokine production and improves survival in experimental conditions of cytokine excess, such as sepsis, hemorrhagic shock, ischemia-reperfusion injury, among others. The cholinergic anti-inflammatory pathway can provide a localized, fast, and discrete response to inflammation by controlling the neuroimmune response and preventing excessive inflammation. This review intends to assess and discuss, the influence of noninvasive vagal nerve stimulation for prophylactic measures and supporting treatment in patients undergoing organ transplantation rejection with a prominent T-cell mediated immune response as a means of attenuating inflammation and leukocyte infiltration of the graft vessels. •VNS may reduce inflammation in organ transplantation.•VNS activates the cholinergic anti-inflammatory pathway to lower cytokine levels.•VNS could supplement immunosuppressive therapies in transplantation.•VNS showed reduced inflammation in brain-dead donor organs, improving graft function.•Exploring VNS for transplant rejection could lead to fewer complications and longer organ survival.