Page 52 - MI-1-2

Microbes & Immunity

PERSPECTIVE ARTICLE
Is vagus nerve-mediated regulation of immunity

an etiological target for therapeutic intervention
in endometriosis?

Claire-Marie Rangon 1,2† * , Shaoyuan Li , Peter S. Staats 2,4† , Alba Boluda-Nicola ,
3
5,6
and Jérôme Bouaziz 5,6
1 Department of Pediatrics, One Clinic, Paris, France
2 Vagus Nerve Society, Atlantic Beach, Florida, United States of America
3 Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing,
China
4 National Spine and Pain Centers, Atlantic Beach, Florida, United States of America
5 Department of Gynecology and Obstetrics, One Clinic, Paris, France
6 Department of Research, One Clinic, Paris, France
(This article belongs to the Special Issue: Recent Advances in Immune Regulation by the Vagus
Nerve)

Abstract
† These authors contributed equally Endometriosis is a complex chronic neuro-inflammatory disorder, affecting
to this work.
roughly 10% of reproductive-age women. It is characterized by the presence of
*Corresponding author: endometrial-like tissue outside the uterus, which induces a chronic inflammatory
Claire-Marie Rangon
(dr.clairemarierangon@one.fr) reaction. This disease can present a wide range of symptoms, including chronic pain
and infertility. Despite extensive research, the exact pathogenesis of endometriosis
Citation: Rangon C, Li S, remains incompletely understood. New strategies and paradigms on pathogenesis
Staats PS, Boluda-Nicola A,
Bouaziz J. Is vagus nerve-mediated and treatment are needed. Schematic factors contributing to the development
regulation of immunity an etiological of endometriosis lesions include genetic, hormonal, and immunological factors.
target for therapeutic intervention Although genetics may contribute to the epidemiologically suggested heritability
in endometriosis? Microbes &
Immunity. 2024;1(2):46-56. of endometriosis, epigenetics has gained an increasing consideration in research.
doi: 10.36922/mi.4389 Remarkably, microbiota dysbiosis, acting as a catalyst for the main acknowledged
Received: July 31, 2024 epigenetic etiologies (locally produced estradiol, pro-inflammatory cytokines,
and hypoxic stress) demands further attention. Indeed, over the past 10 years, it
Accepted: September 19, 2024
has become clear that the vagus nerve, the fastest component of the microbiota-
Published Online: October 15, gut-brain axis, can efficiently control inflammation through the cholinergic anti-
2024 inflammatory pathway. Therefore, stimulation of the vagus nerve could be a
Copyright: © 2024 Author(s). good candidate for modulating the severity of endometriosis. The detrimental
This is an Open-Access article consequences of microbiome dysbiosis and the estrobolome activity on the
distributed under the terms of the
Creative Commons Attribution initiation of the disease as well as counterpart dysfunctions in the central nervous
License, permitting distribution, system will be focused on, both supporting a key role of the vagus nerve since the
and reproduction in any medium, early stage of endometriosis. Consequently, the rationale for using non-invasive
provided the original work is
properly cited. vagus nerve stimulation will be discussed, introducing a fruitful shift of paradigm in
this still enigmatic disease.
Publisher’s Note: AccScience
Publishing remains neutral with
regard to jurisdictional claims in
published maps and institutional Keywords: Endometriosis; Pathophysiology; Epigenetics; Immunity; Microbiota-gut-
affiliations. brain axis; Non-invasive vagus nerve stimulation

Volume 1 Issue 2 (2024) 46 doi: 10.36922/mi.4389