Vagus Nerve Research: Implications for Autoimmune Disease
On January 28, 2026 neurosurgeon and bioelectronic medicine pioneer Kevin J. Tracey joined cardiologist and science communicator Eric Topol for a live Substack conversation centered on Tracey’s book The Great Nerve: The New Science of the Vagus Nerve and How to Harness Its Healing Reflexes.
Tracey’s work has been instrumental in defining how the vagus nerve regulates immune responses via the “inflammatory reflex”, a neural circuit that can turn off excessive inflammation.
This concept forms the scientific foundation for bioelectronic medicine, therapies that modulate nerve activity to treat inflammatory and autoimmune diseases. Multiple clinical trials of vagus nerve stimulation for rheumatoid arthritis, systemic lupus erythematosus (SLE), postural orthostatic tachycardia syndrome (POTS), Crohn’s disease, ulcerative colitis, multiple sclerosis, Sjögren’s syndrome, juvenile idiopathic arthritis, and chronic inflammatory demyelinating polyneuropathy are completed, ongoing, or currently recruiting, reflecting sustained scientific interest in this technology.
The discussion underscored growing scientific interest in the neuro-immune interface, where vagus nerve pathways are being explored as a means to alter immune activity without conventional drugs. Recent research, including trials of implantable vagus nerve stimulators in those with rheumatoid arthritis, suggests that daily stimulation can produce measurable improvements in disease activity scores compared with sham controls, highlighting the potential for non-pharmacologic autoimmune therapies.
Topol also connected Tracey’s work to a broader shift in how scientists think about the body. Rather than viewing the brain, immune system, and organs as separate systems, researchers now understand them as closely linked and constantly communicating. In this view, chronic inflammation and autoimmune disease are shaped not only by immune cells, but also by signals traveling through nerves. Studies show that changes in activity within specific nerve pathways can influence levels of inflammatory molecules in the body, helping to explain how the nervous system can modulate inflammation.
Citations
Koopman, F. A., Chavan, S. S., Miljko, S., Grazio, S., Sokolovic, S., Schuurman, P. R., Mehta, A. D., Levine, Y. A., Faltys, M., Zitnik, R., Tracey, K. J., & Tak, P. P. (2016). Vagus nerve stimulation inhibits cytokine production and attenuates disease severity in rheumatoid arthritis. Proceedings of the National Academy of Sciences of the United States of America, 113(29), 8284–8289. https://doi.org/10.1073/pnas.1605635113
Pavlov, V. A., & Tracey, K. J. (2012). The vagus nerve and the inflammatory reflex–linking immunity and metabolism. Nature reviews. Endocrinology, 8(12), 743–754. https://doi.org/10.1038/nrendo.2012.189
Olofsson, P. S., & Tracey, K. J. (2017). Bioelectronic medicine: technology targeting molecular mechanisms for therapy. Journal of internal medicine, 282(1), 3–4. https://doi.org/10.1111/joim.12624