Cholinergic anti-inflammatory pathways are potently activated by electrical VNS, as demonstrated in previous studies that prevented the release of pro-inflammatory cytokines such as TNF-⍺, IL-1β, IL-6, and IL-18 during endotoxemia [11], and in patients receiving tragus stimulus following acute MI [129]. This evidence concerns the gene IL1B and serum lipopolysaccharide activity.