Bonaz · Frontiers in neuroscience 2018 · narrative review · n=?

The Vagus Nerve at the Interface of the Microbiota-Gut-Brain Axis.

Cited 1350 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review outlining physiological mechanisms without original empirical data or systematic search methods.

PubMed 29467611 · doi:10.3389/fnins.2018.00049 · record verified 2026-08-27

What was done

This narrative review describes the anatomical and functional pathways through which the vagus nerve participates in bidirectional microbiota-gut-brain axis communication, including metabolite sensing, autonomic central integration, and the cholinergic anti-inflammatory pathway.

What was found

The abstract presents no quantitative experimental data or clinical effect sizes. It details that the vagus nerve is composed of 80% afferent and 20% efferent fibers. Afferents sense microbiota metabolites and relay signals to the central autonomic network, while efferent fibers drive a cholinergic anti-inflammatory pathway that reduces peripheral inflammation and intestinal permeability. Low vagal tone and stress-mediated vagal inhibition are noted in irritable bowel syndrome and inflammatory bowel disease.

Why it matters

This review outlines the physiological pathways connecting the autonomic nervous system to gut homeostasis, identifying vagal modulation and vagus nerve stimulation as mechanistic targets for inflammatory and functional gastrointestinal disorders.

Limits

As a narrative review, it presents no primary data, patient sample sizes, or systematic search protocols. Hypothesized clinical benefits of vagus nerve stimulation are based entirely on mechanistic reasoning without trial outcome data in the abstract.

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