The idea that nerve problems and arthritis go hand in hand has been evolving in the research literature for the last decade or more. However, this is not something you often hear about as a patient with arthritis. Now a new study sheds some interesting light on how nerve stimulation may one day help rheumatoid arthritis (RA) patients.
We’ve talked before about the problems in treating rheumatoid arthritis, partly because it is so different from osteoarthritis. In rheumatoid arthritis (RA), which is an autoimmune inflammatory disease, the joints are attacked by the body itself. RA becomes progressively worse over time; it’s incurable and typically is about as painful and disabling as osteoarthritis.
Because it’s an autoimmune condition, and science doesn’t know where else to turn, RA patients are often treated with toxic drugs. These drugs heavily suppress the body’s immune response, not only to its own joints, but also to the foreign invaders it is meant to protect against, like viruses, bacteria, and parasites. In fact, one of my best friends died of common pneumonia because he was being treated with one of the drugs.
Besides these toxic biologic drugs, there are few traditional alternatives to treating RA. Now, there may be research to show that the symptoms and the inflammatory markers of RA can be improved with another approach that doesn’t involve dangerous drugs.
The Vagus Nerve: The Wanderer
The vagus nerve is the most complex and the longest of the cranial nerves. It starts in the brain and travels down into the abdomen. In fact, it’s Latin name means “the wanderer”, likely because of the original anatomists found it in so many cavities like the cranial, neck, thorax, and abdominal!
In the study we’ll be reviewing, researchers had the hypothesis that the nerve is involved in the immune response. They hoped that by stimulating it, an anti-inflammatory reflex can be set off to suppress the body’s immune system without harming the ability to fight off infection (like toxic drugs do). If this worked and could be controlled, it would be game-changing for the lives of many RA patients.
For their study, the researchers implanted their device (the microregulator) along the vagus nerve of 14 patients with RA who had unsuccessfully been treated with at least two different types of medications for their condition. The participants were divided into three groups.
• 60 seconds of stimulation once daily
• 60 seconds of stimulation four times daily
• Placebo (sham) treatment
After three months of treatment, 50% of participants in the stimulation groups were shown to have a clinically meaningful response. Two patients achieved remission. There was, overall, no response in the placebo group of participants. Those receiving once-daily stimulation had better results than those receiving stimulation four times per day. In the participants receiving stimulation, there was also more than a 30% drop in levels of inflammatory markers (interleukin (IL)-1-beta, IL-6, and TNF-alpha).
The upshot? This is a big deal if these results hold up! While this would be very bad for pharma companies making biologic immune suppressant drugs, the idea that an RA patient could get a nerve stimulator and get off of the drugs would be life-altering for many!