The vagal nerve as a link between the nervous and immune system in the instance of polymicrobial sepsis |
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Authors: | Wolfram Kessler Tobias Traeger Alexandra Westerholt Friederike Neher Marlene Mikulcak Antje Müller Stefan Maier Claus-Dieter Heidecke |
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Institution: | 1. Department of Surgery, Abteilung für Allgemeine Chirurgie, Visceral-Thorax- und Gef?sschirurgie, Universit?tsklinikum Greifswald der Ernst-Moritz-Arndt-Universit?t, Friedrich-Loeffler-Strasse 23b, 17475, Greifswald, Germany
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Abstract: | Background The role of the vagal nerve in the autonomic nervous system is widely well known. Recently, an additional function was revealed
serving as a connector between the nervous and immune system. This connection is called the “cholinergic inflammatory pathway.”
Through stimulation of the acetylcholine receptors located upon the macrophages, the “unspecific” immune system can be directly
influenced.
Methods The vagal nerve was completely transected directly posterior to its passage through the diaphragm. The effect of complete
vagotomy was analyzed using a murine model of polymicrobial peritonitis (colon ascendens stent peritonitis, CASP). Survival
and clinical course of vagotomized or sham-operated mice were analyzed in the CASP model.
Results After CASP surgery, vagotomy led to a significantly increased mortality (64.7%) in comparison to sham-vagotomized animals
(34%). No difference in the bacterial load of various tissues (lung, liver, spleen, blood, lavage fluid, and kidney) from
septic animals with or without vagotomy was observed. Vagotomized animals reveal elevated serum cytokine levels (TNF, IL-6,
IL-10, and MCP-1) 20 h after the induction of polymicrobial peritonitis.
Conclusion The vagal nerve is therefore an important modulator of the immune system.
W. Kessler and T. Traeger contributed equally to this work
Best of Forum Papers presented at the Annual Meeting of the German Society of Surgery, 2–5 May 2006, Berlin, Germany |
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Keywords: | CASP Cytokines Sepsis Inflammation Vagotomy |
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