Frontiers in Medicine published a review (accepted 12 May 2026) by researchers at Dalian Medical University and Qilu Hospital arguing that sepsis‑associated gastrointestinal dysfunction (SAGD) reflects coordinated inflammatory, barrier and neuroimmune failure and that vagus‑nerve‑targeted neuromodulation—notably transcutaneous auricular vagus nerve stimulation (taVNS)—warrants clinical study.
The authors synthesize preclinical and clinical literature linking pro‑inflammatory cytokines (tumor necrosis factor, interleukin‑1β, interleukin‑6) to epithelial injury, tight‑junction disruption and impaired gastrointestinal neuromuscular function. They also highlight microcirculatory disturbances and tissue hypoxia as contributors to barrier breakdown. Alterations in the gut–brain axis and autonomic imbalance are presented as mechanisms that can worsen motility and suppress the cholinergic anti‑inflammatory pathway.
Current clinical management of SAGD is described as largely supportive and not targeted to these underlying processes. As a central regulator of both immune responses and gut motility, the vagus nerve is proposed as a logical target. The review points to non‑invasive approaches such as taVNS as a practical way to modulate vagal pathways and autonomic balance without surgical implants.
The authors note that direct clinical evidence specifically testing vagal neuromodulation in SAGD remains limited. They stop short of asserting efficacy but argue the biological rationale justifies controlled trials and translational work to define stimulation parameters, timing, and patient selection.
The paper is open access under a CC BY license and frames SAGD as a disorder at the intersection of systemic inflammation, barrier failure and neuroimmune dysregulation, rather than solely a gastrointestinal or circulatory complication of sepsis.
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Tags: sepsis-associated gastrointestinal dysfunction, vagus nerve stimulation, transcutaneous auricular VNS, gut–brain axis, neuroimmune
Topics: Vagus nerve & taVNS, Neuromodulation, Non-invasive brain stimulation