The Role of the Vagus Nerve in Rheumatoid Arthritis

Faize Elif BAHADIRa

aBahçeşehir University Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, İstanbul, Türkiye

ABSTRACT
Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting primary the joints, with an autoimmune etiology. Despite the availability of new generation antirheumatic drugs offering diverse treatment options, a subset of patients may remain unresponsive to these interventions or have contraindications. In the last few decades, the understanding that the vagus nerve (VN) provides bidirectional communication between the nervous system and immune cells has led to exploration of vagus nerve stimulation (VNS) as a potential therapy option for relieving RA symptoms. However, numerous animal and human studies have produced varying results regarding the efficacy of VNS. This inconsistency may stem from the complexity of the underlying pathogenesis of the disease in humans, as well as the lack of standardization in treatment protocols. This highlights the necessity for further research to establish the safety, efficacy, and long-term viability of VNS as a therapeutic option for RA. This review aims to evaluate the role of the VN in RA pathogenesis and therapeutic management, taking into account the complex nature of the disease and the uncertainties surrounding the mechanisms underlying VNS action in RA.
Keywords: Rheumatoid arthritis; vagus nerve stimulation; inflammatory reflex; autonomic imbalance

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