New research suggests that electrical impulses may one day be used to treat rheumatoid 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.
After identifying which of the 80,000-plus fibers in the vagus nerve were responsible for TNF production, Dr. Tracey developed a device to stimulate those fibers, sending a signal to turn off TNF production.
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.
“This shows that we’re targeting the biology [of inflammation], not just the symptoms,” Dr. Tracey says.
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.”