{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T20:44:21Z","timestamp":1786481061975,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T00:00:00Z","timestamp":1651104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014899","name":"American Neurogastroenterology and Motility Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014899","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Intestinal barrier dysfunction is the likely initiating event in multiple human diseases. Currently, there are limited therapeutic strategies to address its dysfunction. Animal studies suggest that vagal nerve stimulation may improve intestinal barrier function, but this has not been evaluated in humans. This study aimed to determine the effect of vagal nerve stimulation on intestinal permeability in adults administered a bolus dose of intravenous corticotropin releasing hormone (CRH) which has been shown to increase small intestinal permeability in healthy human subjects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a cross\u2010over study, 16 volunteers (median age 34\u00a0years, 11 female) were randomized to receive auricular transcutaneous vagal nerve or sham stimulation (10\u00a0minutes each side) after intravenous administration of 100\u00a0\u00b5g of CRH. Intestinal barrier function was measured before and 2\u00a0h after each intervention with dual\u2010sugar urine testing (lactulose:mannitol ratio) and intestinal fatty\u2010acid binding protein (I\u2010FABP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Exposure to CRH increased I\u2010FABP concentrations by a median of 49 (IQR 4\u201071)% (<jats:italic>p<\/jats:italic> = 0.009). Lactulose:mannitol ratios were 0.029 (0.025\u20100.050) following vagal stimulation compared with 0.062 (0.032\u20100.170) following sham stimulation (<jats:italic>p<\/jats:italic> = 0.0092), representing a fall of 53 (22\u201071)%. I\u2010FABP concentrations did not change (<jats:italic>p<\/jats:italic> = 0.90).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Brief non\u2010invasive vagal nerve stimulation consistently reduces paracellular permeability of the small intestine after CRH administration, but does not entirely mitigate I\u2010FABP release from the epithelium. Studies of vagal nerve stimulation in disease states are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14382","type":"journal-article","created":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T10:38:58Z","timestamp":1651142338000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Transcutaneous vagal nerve stimulation protects against stress\u2010induced intestinal barrier dysfunction in healthy adults"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8954-2978","authenticated-orcid":false,"given":"Tamara","family":"Mogilevski","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Monash University and Alfred Health  Melbourne Australia"},{"name":"Barts Health NHS trust  London UK"},{"name":"Centre for Neuroscience Surgery and Trauma Blizard Institute Wingate Institute of Neurogastroenterology Barts and the London School of Medicine and Dentistry 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