Future Rheumatoid Arthritis Therapy: Nerve Stimulation

New research suggests that electrical impulses may one day be used to treatrheumatoid arthritis (RA).

Neurosurgeon Kevin J. Tracey, MD, president and CEO of the Feinstein Institute for Medical Research in Manhasset, N.Y., discovered that stimulating the vagus nerve, which extends from the brain stem to the stomach, could control the inflammation that is central to RA.

In healthy people, the nervous system, including the vagus nerve, maintains key bodily functions within a safe zone. One of the vagus nerve’s jobs is to control the production of tumor necrosis factor (TNF), a molecule that triggers inflammation. But in people with RA, the vagus nerve doesn’t keep TNF levels within the safe zone.

在确定了迷走神经中的8万多根纤维中,哪一根与TNF产生有关后,特蕾西博士开发了一种装置,刺激这些纤维,发出信号,阻止TNF产生。

The silver dollar-sized device is implanted into the chest and delivers electrical signals (via an electrode that runs up to the neck) that in essence tells the immune system “enough inflammation already!”

Clinical trials for the device began in 2009. To date, 24 RA patients have signed on to test the device, and the initial results are promising. The majority of patients experienced significant reductions in pain, swelling, joint tenderness and reduced levels of C-reactive protein, which increase with inflammation.

特雷西博士说:“这表明我们正在瞄准[炎症的]生物学,而不仅仅是症状。”

He believes it could be available in Europe as early as 2017 and in the U.S. after that.

“We’re at the stage of technology development where we can target nerve circuits for therapeutic benefit,” he says. “It’s the future of treatment.”

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