Selective Vagus Nerve Stimulation as a Therapeutic Approach for the Treatment of ARDS: A Rationale for Neuro-Immunomodulation in COVID-19 Disease.
Selective Vagus Nerve Stimulation as a Therapeutic Approach for the Treatment of ARDS: A Rationale for Neuro-Immunomodulation in COVID-19 Disease.
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DOI：
10.3389/fnins.2021.667036
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发表时间：
2021
影响因子：
4.3
通讯作者：
Holder D
中科院分区：
文献类型：
--
作者：
Mastitskaya S;Thompson N;Holder D
急性呼吸窘迫综合征（ARDS）是急性肺损伤最严重的形式。它是由败血症，吸入和肺炎引起的，包括SARS冠状病毒和人类流感病毒引起的肺炎。ARDS的主要病理生理机制是全身炎症反应。迷走神经刺激（VNS）可以限制脾脏中细胞因子的产生，从而抑制肺和其他器官中的任何全身性炎症和炎症诱导的组织损伤。然而，当应用非选择性VNS时，增加的副交感神经流出到肺的作用可能导致支气管收缩、粘液分泌增加和增强局部肺部炎症活动;这可能超过VNS的有益的全身抗炎作用。器官/功能特异性治疗可以通过对迷走神经内的局部神经束活动进行成像和对所识别的器官特异性神经束进行选择性刺激来实现。这可能能够提供迷走神经内不同通路的选择性神经调节，并提供一种新的手段来改善ARDS的结果。本文就迷走神经刺激的抗炎作用机制、选择性迷走神经刺激技术的研究进展及在急性呼吸窘迫综合征治疗中的应用作一综述。
Acute respiratory distress syndrome (ARDS) is the most severe form of acute lung injury. It is induced by sepsis, aspiration, and pneumonia, including that caused by SARS coronavirus and human influenza viruses. The main pathophysiological mechanism of ARDS is a systemic inflammatory response. Vagus nerve stimulation (VNS) can limit cytokine production in the spleen and thereby dampen any systemic inflammation and inflammation-induced tissue damage in the lungs and other organs. However, the effects of increased parasympathetic outflow to the lungs when non-selective VNS is applied may result in bronchoconstriction, increased mucus secretion and enhance local pulmonary inflammatory activity; this may outweigh the beneficial systemic anti-inflammatory action of VNS. Organ/function-specific therapy can be achieved by imaging of localized fascicle activity within the vagus nerve and selective stimulation of identified organ-specific fascicles. This may be able to provide selective neuromodulation of different pathways within the vagus nerve and offer a novel means to improve outcome in ARDS. This has motivated this review in which we discuss the mechanisms of anti-inflammatory effects of VNS, progress in selective VNS techniques, and a possible application for ARDS.
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影响因子：
25.4
作者：
Guaraldi, Giovanni;Meschiari, Marianna;Mussini, Cristina
通讯作者：
Mussini, Cristina
DOI：
10.1056/nejmra0910061
发表时间：
2010-12-02
期刊：
The New England journal of medicine
影响因子：
--
作者：
Fahy JV;Dickey BF
通讯作者：
Dickey BF
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作者：
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影响因子：
3.5
作者：
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通讯作者：
Pellissier, S.
影响因子：
81.5
作者：
Matthay, Michael A.;Zemans, Rachel L.;Calfee, Carolyn S.
通讯作者：
Calfee, Carolyn S.