Evidence map›Paper›PMID 42169167›Full record

ArticleBiology direct2026

Transcutaneous auricular vagus nerve stimulation alleviates chronic heart failure by targeting cathepsin K/p53-mediated ferroptosis.

Lulu Zhao, Yanzhou Lu, Yuchi Hu, Songyuan Dai, Xing Wang, Xi Zhai, Lijin Pu, Baotong Hua, Jing Wang, Ling Zhao

Abstract read
In one paragraph

Article in Biology direct, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Lulu Zhao *Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Xichang Road, Kunming, Yunnan, 650032, China.
Yanzhou Lu *Department of Psychology, University of South Dakota, Vermillion, USA.
Yuchi HuDepartment of Cardiology, The First Affiliated Hospital of Kunming Medical University, Xichang Road, Kunming, Yunnan, 650032, China.
Songyuan DaiDepartment of Cardiology, The First Affiliated Hospital of Kunming Medical University, Xichang Road, Kunming, Yunnan, 650032, China.
Xing WangDepartment of Cardiology, The First Affiliated Hospital of Kunming Medical University, Xichang Road, Kunming, Yunnan, 650032, China.
Xi ZhaiDepartment of Cardiology, The First Affiliated Hospital of Kunming Medical University, Xichang Road, Kunming, Yunnan, 650032, China.
Lijin PuDepartment of Cardiology, The First Affiliated Hospital of Kunming Medical University, Xichang Road, Kunming, Yunnan, 650032, China.
Baotong HuaDepartment of Cardiology, The First Affiliated Hospital of Kunming Medical University, Xichang Road, Kunming, Yunnan, 650032, China.
Jing WangDepartment of Cardiology, The First Affiliated Hospital of Kunming Medical University, Xichang Road, Kunming, Yunnan, 650032, China. wangjing@ydyy.cn.
Ling ZhaoDepartment of Cardiology, The First Affiliated Hospital of Kunming Medical University, Xichang Road, Kunming, Yunnan, 650032, China. zhaoling580@126.com.

Funding

Basic research project of Yunnan Provincial Department of Science and Technology 202101AY070001-131Kunming Medical University 2024 Graduate Education Innovation Fund 2024S044National Natural Science Foundation 82160080Yunnan Province Revitalizing Yunnan Talents Support Plan Project YNWR-MY-2020-011
6 · The paper itself

Abstract

backgroundHeart failure remains a major global health challenge, with ferroptosis implicated in its pathogenesis. Transcutaneous auricular vagus nerve stimulation (taVNS) has shown therapeutic potential for heart failure, but its regulatory mechanism underlying myocardial ferroptosis remains unclear.

methodsIsoproterenol-induced chronic heart failure (CHF) rats received taVNS for 2 weeks. Cardiac function was assessed by echocardiography, while myocardial pathology was analyzed using histological staining. Ferroptosis was evaluated via flow cytometry, transmission electron microscopy, and detection of ferroptosis markers. In vitro, Ang II-stimulated H9C2 cells were treated with Ach or subjected to cathepsin K knockdown.

resultsThe taVNS treatment improved LVEF and reduced LVIDd/LVIDs in CHF rats, accompanied by attenuated hypertrophy and fibrosis as well as decreased NT-proBNP, TNF-α, and IL-6 levels. Additionally, taVNS suppressed ferroptosis in cardiac tissues of CHF rats, as evidenced by reduced ROS and Fe²⁺ levels, decreased iron deposition, and upregulated SLC7A11 and GPX4 expression. However, the mAChR and α7-nAChR antagonists (atropine and MLA) abolished these benefits of taVNS. Moreover, taVNS inhibited cathepsin K/p53 pathway to suppress ferroptosis in CHF rat cardiac tissues, rescuing SLC7A11 and GPX4 expression and reducing ROS and Fe²⁺ levels. Acetylcholine replicated taVNS effects in vitro, reversing Erastin-induced ferroptosis and suppressing cathepsin K/p53 pathway.

conclusionThe taVNS treatment modulated cholinergic receptor activation to suppress cathepsin K/p53-mediated ferroptosis, ameliorating cardiac dysfunction in CHF. These findings revealed the specific mechanism by which taVNS exerted cardioprotection via cholinergic receptors, offering a novel therapeutic strategy for CHF.

Indexed as

Cathepsin KFerroptosisHeart FailureTranscutaneous Electric Nerve StimulationTumor Suppressor Protein p53Vagus Nerve StimulationAnimalsChronic DiseaseMaleRatsRats, Sprague-DawleyCathepsin KCtsk protein, ratTumor Suppressor Protein p53Cathepsin KCholinergic receptorsChronic heart failureFerroptosisTranscutaneous auricular vagus nerve stimulation

Identifiers

PMID42169167
PMCPMC13361866

What Socratic holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.