Pulses over Pills? Tests Show Implantable Bioelectronic Device Inhibits TNF Production in RA Patients

Kevin J. Tracey, MD, is extremely confident in a new study: “I believe this study will change the way we see modern medicine, helping us understand that our nerves can, with a little help, make the drugs that we need to help our body heal itself.” He’s referring to “Vagus nerve stimulation inhibits cytokine production and attenuates disease severity in rheumatoid arthritis,” which he co-authored, now published in Proceedings of the Natural Academy of Sciences.

The study, a first of its kind, followed 17 rheumatoid arthritis (RA) patients who underwent the surgical implantation of bioelectronic devices on their vagus nerves. The hope was that stimulation of this nerve would inhibit the production of cytokines, key inflammatory agents in diseases like RA, most specifically tumor necrosis factor (TNF). The results, it seems, are very encouraging.

In advance of testing, baseline blood samples were collected, and following a two week recovery period after implanting the devices, the researchers began to monitor TNF production as it related to nerve stimulation. After increasing levels of stimulation over the first six weeks of the study, corresponding with decreases in TNF production, the device was turned off for two weeks, during which TNF levels rebounded significantly. From day 56, when the device was turned back on and electronic stimulation resumed, until day 84, the final day of the study, production was again seen to decrease.

By monitoring the presence of RA-associated cytokines and symptoms with this on-off-on method, the researchers were able to correlate the vagus nerve stimulation from their implanted device with the drop in TNF production, ruling against outside forces.

Significant symptom improvement was reported by many of the patients whose RA had been previously unresponsive to other RA treatments like methotrexate. No serious side effects were noted across the study. Because RA is a widespread condition, impacting over a million Americans and representing at least $19 billion in annual medical costs, this fascinating breakthrough could be of great importance. Its developments may span outside arthritic treatment, with the press release noting it could be of use someday to those suffering Crohn’s, Parkinson’s, or even Alzheimer’s.

Important to note, however, is the short-term nature of the study. While the results were extremely encouraging over the roughly-three month period that it ran, the article itself notes that it “was not designed or powered to evaluate the relationship between specific electrical current dose—response and clinical outcomes or the longer-term durability of therapeutic benefit, and the effects of under- or overstimulation of the inflammatory reflex are also an important area for future study.”