Vagus Nerve Stimulation Blocks Cytokine Storm of Swine Flu

Nicotine has an anti-inflammatory effect via the vagus nerve, which is useful against many diseases, and perhaps may block the cytokine storm of the H1N1 swine flu.

Nicotine stimulates the cholinergic anti-inflammatory pathway. At the end of this pathway are immune cells that produce anti-inflammatory cytokines that block inflammation. Thus, nicotine, although one of the most addictive chemicals, can have beneficial effects on inflammatory diseases, such as arthritis, asthma, cancer, inflammatory bowel diseases and perhaps, H1N1.

Tobacco Smoke Is Toxic but also Anti-Inflammatory

Paradoxically tobacco smoke contains hundreds of toxic and carcinogenic chemicals that produce inflammatory reactions and numerous degenerative diseases, but it also contains nicotine that is anti-inflammatory. Smokers assault their bodies, but moderate and obscure the inflammatory degeneration and disease, until they stop the nicotine exposure.

Nicotine Withdrawal Is Inflammatory

The anti-inflammatory benefits of nicotine reveal the inflammatory basis of many unexpected diseases. Nicotine withdrawal is severe, partly because it leads to rebound release of inflammatory cytokines, inflammation and inflammatory disease symptoms that include depression and obesity. Smoking cessation may contribute to more severe symptoms of H1N1 infections.

Nicotine Acts via the Vagus Nerve

Attempts to augment bypass surgery for weight reduction have encountered the anti-inflammatory benefits of stimulating the vagus nerve. Vagus nerve stimulation via an electrode attached to the left branch in the neck by a device implanted behind the clavicle, reduces inflammatory cytokine production and is an effective treatment for obesity. Other types of vagus stimulation are being tested for efficacy in treatment of numerous inflammatory diseases, including arthritis, allergy, asthma, Alzheimer's, etc.

Nicotine Blocks Cytokine Storms

Cytokine storms are a deadly consequence of inflammation that is out of control. These exaggerated host responses are targets for bioterrorism, because it takes very little toxin or a very minimal infection to be lethal, if it produces a cytokine storm. In mice, the ricin toxin, a bioterrorism agent, induces a cytokine storm that kills by multiple organ failure. Ricin-treated mice can be protected by nicotine prior or after the cytokine storm begins.

H1N1 May Kill by Cytokine Storm Similar to Spanish Flu of 1918

The rapid high temperature produced by Mexican H1N1 suggest that some of the deaths have resulted from cytokine storms. As more information becomes available on existing cases, it will become more clear how similar the current H1N1 strain is to the virus that caused the Spanish flu pandemic of 1918.

Block H1N1 Cytokine Storms with Nicotine

It may be possible to reduce lethality by blocking the cytokine storm with nicotine. There are numerous means of administering nicotine and research will need to be done to determine which if any of these approaches is effective in the treatment of severe cases of the current H1N1 flu. Smoking as a source of nicotine is probably unwise, because the other toxic components compromise the immune system and make it more vulnerable to flu infection.

Additional information on H1N1 virulence evolution in response to use of antiviral drugs and isolation is available here.


Mabley JG, Pacher P, Szabo C. 'Activation of the cholinergic anti-inflammatory pathway reduces ricin-induced mortality and organ failure in mice'. Mol Med. 2009 Feb 11. [Epub ahead of print]

Gwilt CR, Donnelly LE, Rogers DF. 'The non-neuronal cholinergic system in the airways: an unappreciated regulatory role in pulmonary inflammation?' Pharmacol Ther. 2007 Aug;115(2):208-22.

Johnston GR, Webster NR. 'Cytokines and the immunomodulatory function of the vagus nerve.' Br J Anaesth. 2009 Apr;102(4):453-62.