{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T01:15:29Z","timestamp":1790385329415,"version":"4.1.0"},"reference-count":63,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T00:00:00Z","timestamp":1765670400000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Systemic autoimmune conditions are characterized by increased inflammation and high disease burden. Vagus nerve stimulation (VNS) is known to activate the cholinergic anti\u2010inflammatory pathway and can serve as a potential therapeutic modality for autoimmune conditions. This study aimed to conduct a preregistered systematic review to determine the effect of VNS on inflammation in autoimmune conditions, according to Preferred Reporting Items for Systematic reviews and Meta\u2010Analyses (PRISMA) guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The databases of Medline\/PubMed, Web of Science, Scopus, and CENTRAL were searched until September 2, 2024. Data pertaining to changes in inflammatory blood biomarkers and clinical outcomes in patients with autoimmune conditions receiving VNS were extracted. Studies were included if they provided measurements of peripheral blood biomarkers and clinical outcomes. Study screenings and full\u2010text article reviews were conducted in duplicate. The design of the included studies was assessed using the National Health Lung and Blood Institute guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve clinical trials studying the effect of VNS on rheumatoid arthritis, Crohn disease, polymyalgia rheumatica, psoriatic arthritis, ankylosing spondylitis, systemic lupus erythematous, and systemic sclerosis were reviewed. We found that &gt;50% of studies found a reduction in the mean difference of pro\u2010inflammatory cytokine levels before and after VNS (C\u2010reactive protein decreased in 6 of 9 studies; tumor necrosis factor \u03b1 decreased in 4 of 8 studies) with the most consistent reduction in IL\u20106 levels (6 of 7 studies).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although it can be suggested that VNS can decrease markers of pro\u2010inflammation in autoimmune diseases, more clinical studies with robust design and quality are needed to more confidently support VNS as a therapeutic option for autoimmune conditions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr2.70137","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T07:41:28Z","timestamp":1765784488000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Vagus Nerve Stimulation in Autoimmune Conditions: A Systematic Review"],"prefix":"10.1002","volume":"7","author":[{"given":"Lina E.","family":"Lombo","sequence":"first","affiliation":[{"name":"Schulich School of Medicine and Dentistry University of Western Ontario  London Ontario Canada"},{"name":"Department of Psychiatry Massachusetts General Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5972-771X","authenticated-orcid":false,"given":"Jorman H.","family":"Tejada\u2010Perdomo","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Faculty of Health Sciences Universidad Surcolombiana  Neiva Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge A.","family":"Ramos\u2010Castaneda","sequence":"additional","affiliation":[{"name":"Research Group Innovaci\u00f3n y Cuidado, Faculty of Nursing Universidad Antonio Nari\u00f1o  Neiva Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8325-9944","authenticated-orcid":false,"given":"Ronald G.","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Massachusetts General Hospital and Harvard Medical School  Boston Massachusetts"},{"name":"School of Medicine Universidad de Santander  Bucaramanga Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2012.02.001"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41214"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.coi.2022.102266"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/0253-7613.103235"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp050514"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.4110\/in.2022.22.e9"},{"issue":"12","key":"e_1_2_6_8_1","first-page":"656","article-title":"Etiology and management of lack or loss of response to anti\u2010tumor necrosis factor therapy in patients with inflammatory bowel disease","volume":"15","author":"Fine S","year":"2019","journal-title":"Gastroenterol Hepatol (N Y)"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.62.1.15"},{"key":"e_1_2_6_10_1","article-title":"Global autoimmune spending 2011\u20102023","author":"Milkulic M.","year":"2023","journal-title":"Statista"},{"key":"e_1_2_6_11_1","unstructured":"CostelloAH.Cyberonics Inc; premarket approval of neurocybernetic prosthesis (NCP) system \u2013 action. 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