迷走神经刺激的脑-肠轴机制研究现状

Current research status on the mechanism of vagus nerve stimulation in the brain-gut axis

迷走神经刺激最早用于治疗难治性癫痫和抑郁症,近年来其适应证不断扩大。脑-肠轴是连接于肠道与大脑的双向通讯网络通路,维持着肠道微生物的稳态平衡并塑造大脑功能。迷走神经在神经系统疾病的脑-肠轴机制中扮演着重要的角色,这可能是迷走神经刺激治疗相关疾病的重要依据。最近的研究表明迷走神经刺激能调节肠道微环境及肠道菌群,但是这种改变的具体机制还需要进一步研究。粪菌移植或口服益生菌联合迷走神经刺激在未来可能成为重要的治疗手段,尤其是提高迷走神经刺激对癫痫的疗效;肠道菌群也可能成为迷走神经刺激治疗癫痫疗效的预测靶点。

Vagus nerve stimulation was first used in the treatment of refractory epilepsy and depression,and its indications have expanded in recent years.The brain-gut axis is a bidirectional communication network pathway connecting the gut to the brain,maintaining homeostatic balance of the gut microbiota and shaping brain function.The vagus nerve plays an important role in brain-gut axis mechanisms in neurological disorders,which may be an important rationale for vagus nerve stimulation in the treatment of related diseases.Recent studies have shown that vagus nerve stimulation modulates the intestinal microenvironment and the intestinal microbiota,but the specific mechanisms of this alteration need further investigation.Fecal transplants or oral probiotics combined with vagus nerve stimulation may become an important therapeutic tool in the future,especially to improve the efficacy of vagus nerve stimulation for epilepsy;the gut microbiota may also be a predictive target for the efficacy of vagus nerve stimulation for epilepsy.