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The recently identified syndrome known as Long COVID (LC) is characterized by a constellation of debilitating conditions that impair both physical and cognitive functions, thus reducing the quality of life and increasing the risk of developing the most common age-related diseases. These conditions are linked to the presence of symptoms of autonomic dysfunction, in association with low cortisol levels, suggestive of reduced hypothalamic-pituitary-adrenal (HPA) axis activity, and with increased pro-inflammatory condition. Alterations of dopamine and serotonin neurotransmitter levels were also recently observed in LC. Interestingly, at least some of the proposed mechanisms of LC development overlap with mechanisms of Autonomic Nervous System (ANS) imbalance, previously detailed in the framework of the aging process. ANS imbalance is characterized by a proinflammatory sympathetic overdrive, and a concomitant decreased anti-inflammatory vagal parasympathetic activity, associated with reduced anti-inflammatory effects of the HPA axis and cholinergic anti-inflammatory pathway (CAP). These neuro-immune-endocrine system imbalanced activities fuel the vicious circle of chronic inflammation, i.e. inflammaging. Here, we refine our original hypothesis that ANS dysfunction fuels inflammaging and propose that biomarkers of ANS imbalance could also be considered biomarkers of inflammaging, recognized as the main risk factor for developing age-related diseases and the sequelae of viral infections, i.e. LC.
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http://dx.doi.org/10.1016/j.mad.2024.111915 | DOI Listing |
Curr Hypertens Rep
July 2025
Department of Medicine, Duke University Medical Center, Durham, NC, USA.
Purpose Of Review: Heart failure (HF) is characterized by a significant imbalance of the autonomic nervous system (ANS), with chronic sympathetic nervous system (SNS) overactivity leading to maladaptive cardiac remodeling, arrhythmia, and hemodynamic instability. In this review, we aim to discuss current and emerging therapies and the potential path forward for developing future novel neuromodulatory therapies in HF.
Recent Findings: Neuromodulatory therapies including splanchnic nerve modulation (SNM), vagal nerve stimulation (VNS), baroreflex activation therapy (BAT), and renal denervation (RDN) reduce sympathetic output in individuals with HF, leading to improved cardiac function, neurohormonal regulation, and vascular resistance.
Front Physiol
June 2025
School of Sports, Shaanxi Normal University, Xi'an, China.
Objectives: This study aimed to examine the acute regulatory effects of three different incremental load treadmill exercise protocols on autonomic nervous system (ANS) function in healthy college students. The ultimate goal was to inform evidence-based training strategies and enhance cardiopulmonary function assessment in this population.
Methods: Forty healthy male college students were recruited to complete three incremental treadmill protocols: Ellestad A, Ellestad B, and Bruce.
Cytokine Growth Factor Rev
August 2025
Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy; Advanced Technology Center for Aging Research and Geriatric Mouse Clinic, IRCCS INRCA, Ancona, Italy.
Long COVID is a chronic condition that arises after SARS-CoV-2 infection and is characterized by persistent and often debilitating symptoms, such as fatigue, cognitive dysfunction ("brain fog"), dyspnea, and autonomic disturbances. Increasing evidence suggests that Long COVID shares key immunopathological mechanisms with autoimmune diseases, primarily sustained immune dysregulation. In individuals with genetic or immunological susceptibility, SARS-CoV-2 infection can trigger the production of autoantibodies targeting cytokines, membrane receptors, and components of the autonomic nervous system (ANS), thereby disrupting neuroimmune homeostasis.
View Article and Find Full Text PDFBr J Anaesth
September 2025
Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China; Neuroscience Research Institute, Zhengzhou University Academy of Medical Sciences, Zhengzhou, Henan, China. Electronic address:
The autonomic nervous system (ANS) is essential for maintaining physiological homeostasis. Autonomic nervous system imbalance, characterised by sympathetic hyperactivation and low parasympathetic tone, can occur during the perioperative period. These changes drive systemic stress responses, cardiovascular instability, impaired tissue repair, and immunosuppression, which in turn increase infection risk, neurocognitive decline, and multiorgan dysfunction.
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May 2025
The First Clinical Medical College of China Three Gorges University, Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, Yichang Central People's Hospital Yichang 443000, Hubei, China.
Non-alcoholic fatty liver disease (NAFLD) has emerged as a global health challenge due to its rising prevalence and strong association with metabolic syndrome. Recent studies highlight the critical role of the gut-brain axis (GBA)-a bidirectional communication system between the gut, brain, and liver-in NAFLD pathogenesis. Dysregulation of this axis can worsen metabolic dysfunction, inflammation, and liver injury.
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