Targeting autonomic-immune regulation with neuromodulation in the perioperative period

Autonomic neuroscience explores the complexities of the autonomic nervous system, which is essential for maintaining homeostasis and generating adaptive responses to physiological and pathophysiological challenges. The autonomic nervous system regulates numerous vital functions, including heart rate, blood pressure, temperature, and digestion, and interacts closely with the immune system. The perioperative period represents a well-defined model of acute autonomic and immune perturbation, providing a unique opportunity to investigate autonomic regulation and its modulation in a controlled clinical setting.This field is continually evolving, particularly with respect to autonomic–immune interactions under physiological stress. Recent research has highlighted the potential for autonomic neuromodulatory strategies, such as vagal stimulation, to influence immune responses and support recovery following surgical procedures. Despite promising findings suggesting possible benefits of neuromodulation during the perioperative period, challenges remain due to limitations in study design, sample size, and methodological consistency. Further exploration is therefore essential to draw definitive conclusions and advance understanding of these interconnected regulatory systems.This Research Topic aims to evaluate high-quality autonomic neuromodulation strategies in the perioperative setting, with the objective of reducing complications and improving patient recovery. A central focus is on elucidating the biological mechanisms underlying these effects, particularly the interplay between autonomic regulation and immune responses. Addressing these aims requires rigorous study designs, including randomized and crossover trials, with pre-registered protocols, appropriate power calculations, and transparent reporting. Such approaches will support robust future analyses and enhance the reliability and clinical relevance of findings.To gather further insights into perioperative autonomic neuromodulation, we welcome articles addressing, but not limited to, the following themes:Randomized and crossover neuromodulation trials focusing on perioperative autonomic and clinical outcomesMechanisms linking autonomic regulation and immune system interactionsUse of biomarkers (e.g., IL-6, CRP, TNF-α) in assessing neuromodulation efficacyAutonomic readouts such as heart rate variability and baroreflex sensitivity in clinical trialsClinically meaningful endpoints, including quality-of-recovery scores and analgesic consumption, interpreted in relation to autonomic regulationPotential complications and patient-specific factors influencing autonomic neuromodulation efficacyComparative analysis of different autonomic neuromodulation techniquesAdvanced methodologies that improve study design and interpretation in autonomic neuromodulation researchSubmissions should provide in-depth insights into autonomic function, its interaction with immune regulation, and adaptive responses to physiological stress, supporting the goals of Sustainable Development Goal 3: Good Health and Well-being. Topic editors: Susan M Barman, Stefanos Zafeiropoulos, Mikkel Frandsen, Nicole Thompson Source: https://www.frontiersin.org/research-topics/80971/targeting-autonomic-immune-regulation-with-neuromodulation-in-the-perioperative-period