Could a Pacemaker-Like Implant Be the Next Rheumatoid Arthritis Treatment?

Researchers believe they have found an electrical implant similar to a pacemaker that can control the body's neural circuits to alleviate the symptoms of diseases such as rheumatoid arthritis and Crohn's disease.

This electrical implant could provide numerous patients an alternative way to treat and manage their illnesses without having to take pills, which is a daunting task for many.

An electrical implant like a pacemaker has been invented by researchers to alleviate the symptoms of diseases such as Crohn’s disease and rheumatoid arthritis by controlling the body’s neural circuits. With this device, patients would no longer need to take any pills. It works by stimulating the vagus nerve, which is actually a bundle of nerve fibers that runs to the abdomen and various organs, relaying messages between the brain and other body parts. The pacemaker-like device can be implanted in the left collarbone, connecting the wires from the implant to the vagus nerve in the neck. When other treatments are unsuccessful, this technology can be used to treat various disorders. According to researchers, controlling the neural circuits will help alleviate the symptoms by tapping into the circuits that connect the brain to the immune system, which researchers believe can bring some relief. A promising study was done by Dr. Tracy and his colleagues in 2016 on this technology and its benefits. In one participant, it was observed that the pain and swelling completely disappeared within six weeks of receiving the implant. She could even take part in physical activities.

Bioelectronics, like the name implies, combines electronics with biology. This novel technology manipulates the neural circuits that deal with the release of certain problematic molecules. Tracy and his team discovered an inflammatory reflex, wherein the vagus nerve sends information to the brain whenever there is damage and inflammation and, in turn, the brain sends messages to the body’s organs in order to dampen the inflammation response. It was previously believed that the brain did not have any influence or control over the immune system, but medical professionals now know otherwise. The tumor necrosis factor (TNF) is one of the keys to tackle inflammatory diseases. TNF is released by macrophages, which are found in various parts of the body. Popular drugs are used to bind to TNF and inhibit or completely block its activity. However, these medications may not always be effective and are associated with a cancer risk as well.

Stimulation of the vagus nerve has been made possible through the bioelectronic approach. With it, researchers are able to turn off the release of TNF. They believe that by activating the communication of vagus nerves to spleen nerves, it is possible to increase neurotransmitter production and release, which will have a direct effect on T-cells as well as increase the production of certain substances that will reduce the release of TNF. According to one researcher, Kox, it is the neurotransmitters, rather than the vagus nerve itself, that directly affect macrophages. However, this pathway is extremely complex and requires further research. Rheumatoid arthritis patients typically have a higher heart rate, and research has revealed that the vagus nerve plays a major role in controlling this as well. A small implant was created by Dr. Tracey and his colleagues that sits on the vagus nerve and is controlled by a tablet computer. Instead of completely blocking the TNF, bioelectronics can reduce its levels, which avoids complications of immunosuppression, which are very common in patients receiving TNF-blocking medications.