---
title: VNS and Asthma | Knowledge Hub | Byond Healthcare
description: In chronic asthma, structural remodeling ensues, causing thickening of airway walls, bronchial hyper-responsiveness, and mucous hypersecretion. How can VNS help?
---

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# How does VNS help with Asthma?

In chronic asthma, structural remodeling ensues, causing thickening of airway walls, bronchial hyper-responsiveness, and mucous hypersecretion.

There are two primary mechanisms the body employs to maintain airway caliber and control airway smooth muscle tone, namely the **neural networks and inflammatory mediators**.

The parasympathetic innervation dominates the regulation of lower respiratory airway smooth muscles and secretion. The postganglionic cholinergic nerves of the parasympathetic nervous system mediate muscle contraction through the acetylcholine-associated pathways.

The sympathetic nervous system indirectly regulates airway smooth muscle tone through the activation of adrenal medullary cortex (epinephrine release) and surface b2 receptors (b2AR) on airway muscles. 

Cross-talk between muscarinic AChR and b2AR in airway smooth muscles determines the lung function.

In addition, non-adrenergic non-cholinergic nerves mediate muscle relaxation through nitric oxide  or the neuropeptide vasoactive intestinal peptide. The muscarinic (M3) receptors on smooth muscle are pro-inflammatory and play a profound role in airway constriction and glandular secretion.

**Low-voltage VNS induced a modest rise** in the plasma epinephrine and norepinephrine Levels. Cervical VNS has demonstrated an acute bronchodilatory effect possibly through the adrenergic system or other central mechanism.  [(Yuan and Silberstein, 2016c)](https://pubmed.ncbi.nlm.nih.gov/26364805/)

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