The brain-gut axis, inflammatory bowel disease, and bioelectronic medicine

Author: Michael Eberhardson1,2,3, Yaakov A Levine2,4, Laura Tarnawski2, Peder S Olofsson2,5
1 Department of Gastroenterology and Hepatology, University Hospital of Linköping, 581 91 Linköping, Sweden.
2 Department of Medicine, Center for Bioelectronic Medicine, Bioclinicum, Karolinska Institutet, 171 64 Stockholm, Sweden.
3 Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden.
4 SetPoint Medical, Valencia, California 91355, USA.
5 Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, New York, USA.
Conference/Journal: Int Immunol
Date published: 2021 Apr 29
Other: Special Notes: doi: 10.1093/intimm/dxab018. , Word Count: 177

The hallmark of inflammatory bowel diseases (IBD) is chronic intestinal inflammation with typical onset in adolescents and young adults. An abundance of neutrophils are seen in the inflammatory lesions, but adaptive immunity is also an important player in the chronicity of the disease. There is an unmet need for new treatment options since modern medicines such as biological therapy with anti-cytokine antibodies still leave a substantial number of patients with persisting disease activity. The role of the central nervous system and its interaction with the gut in the pathophysiology of IBD has been brought to attention both in animal models and in humans after the discovery of the inflammatory reflex. The suggested control of gut immunity by the brain-gut axis represents a novel therapeutic target suitable for bioelectronic intervention. In this review, we discuss the role of the inflammatory reflex in gut inflammation and the recent advances in the treatment of IBD by intervening with the brain-gut axis through bioelectronic devices.

Keywords: Crohn’s disease; inflammation; inflammatory reflex; ulcerative colitis; vagus nerve stimulation.

PMID: 33912906 DOI: 10.1093/intimm/dxab018