Vagus-brain communication in atherosclerosis-related inflammation: A neuroimmunomodulation perspective of CAD

Yori Gidron, Nina Kupper, Martijn Kwaijtaal, Jobst Winter, Johan Denollet

Research output: Contribution to journalReview articlepeer-review


The current understanding of the pathophysiology of atherosclerosis leading to coronary artery disease (CAD) emphasizes the role of inflammatory mediators. Given the bidirectional communication between the immune and central nervous systems, an important question is whether the brain can be "informed" about and modulate CAD-related inflammation. A candidate communicator and modulator is the vagus nerve. Until now, the vagus nerve has received attention in cardiology mainly due to its role in the parasympathetic cardiovascular response. However, the vagus nerve can also "inform" the brain about peripheral inflammation since its paraganglia have receptors for interleukin-1. Furthermore, its efferent branch has a local anti-inflammatory effect. These effects have not been considered in research on the vagus nerve in CAD or in vagus nerve stimulation trials in CAD. In addition, various behavioural interventions, including relaxation, may influence CAD prognosis by affecting vagal activity. Based on this converging evidence, we propose a neuroimmunomodulation approach to atherogenesis. In this model, the vagus nerve "informs" the brain about CAD-related cytokines; in turn, activation of the vagus (via vagus nerve stimulation, vagomimetic drugs or relaxation) induces an anti-inflammatory response that can slow down the chronic process of atherogenesis.

Original languageEnglish
Pages (from-to)e1-e9
Issue number2
StatePublished - Dec 2007
Externally publishedYes

Bibliographical note

Funding Information:
This work was supported by a VICI grant from the Netherlands Organisation for Scientific Research (NWO; grant no. 453-04-004).


  • Atherosclerosis
  • Autonomic nervous system
  • Coronary artery disease
  • Inflammation
  • Vagus nerve

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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