Northwell Health - Feinstein Institute for Medical Research

BIOELECTRONIC MEDICINE AND BLOOD PRESSURE: Making a Connection A new study, led by scientists from the Feinstein Institute and Karolinska Institutet, shows that T cells capable of producing the neurotransmitter acetylcholine can regulate blood pressure. These T cells are white blood cells that contain the enzyme choline acetyltransferase (ChAT), which is responsible for producing acetylcholine. Scientists from the Feinstein Institute; Karolinska Institutet in Stockholm, Sweden; University Health Network in Toronto; and York University in Toronto collaborated in making this discovery and recently published the results in Nature Biotechnology. Having identified ChAT cells' role and already knowing the enzyme responds to vagus nerve stimulation, Feinstein Institute researchers will explore the use of bioelectronic medicine to treat blood pressure and hypertension. "Studies conducted at the Feinstein Institute found that immune function could be controlled by neural mechanisms through the spleen," said Kevin J. Tracey, MD, president and chief executive officer of the Feinstein Institute and one of the lead authors of the Nature Biotechnology paper. "In this study, we were looking to identify triggers that could reach deeper into the smaller arteries to aid with conditions such as high blood pressure. We found what we were looking for and will develop this finding into new research that we hope will pave the way to new therapies that will improve the lives of millions." Researchers at the Feinstein Institute have partnered with the Karolinska Institutet for the past 10 years. Peder S. Olofsson, MD, PhD, worked at the Feinstein Institute between 2009 and 2015 and has since returned to the Karolinska Institutet as founding director of its Center for Bioelectronic Medicine. "Interdisciplinary collaborations in bioelectronic medicine offer an opportunity to improve understanding of physiological mechanisms. This study, which focused on blood pressure regulation, represents one such advance," said Dr. Olofsson, corresponding author of the Nature Biotechnology paper. Bioelectronic medicine is possible because every organ in the body is innervated. By modulating the nerves, researchers can deliver treatment through the body's neural circuitry. Here's how they used neurostimulation of the vagus nerve to treat RA. – Patients with RA were surgically implanted with a vagus nerve- stimulating device. – The device delivered electrical current directly to the vagus nerve and inhibited the production of TNF, a molecule that causes inflammation and other inflammation-producing cytokines. – As TNF production declined, so did the severity of RA symptoms. How It Works One out of three American adults has high blood pressure, a condition in which the long-term force of blood against artery walls is high enough to potentially cause health problems such as hypertension and heart disease. FeinsteinInstitute.org 5 Innovation

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