NaHCO3 as an activator of a vagal anti-inflammatory response in autoimmune diseases

Amazing paper especially about this discovery:

"Taken together, our data indicate a previously unrecognized function of the mesothelium to mediate splenic anti-
inflammatory responses via cholinergic signalling to the splenic
capsule. Such a mechanism may resolve much of the current
controversy regarding how vagal stimulation alters splenic function, suggesting cholinergic signals may be transmitted to the
splenic capsule not by vagal efferent nerves but by the mesothe-
lium. Our findings are consistent with a recent report by Mihara
et al. (45) who found that stimulation of the a-7 nicotinic
acetylcholine receptor on rat intestinal mesothelial cells blunted
the inflammatory response of these cells to LPS. Interestingly,
these investigators also reported that enteric nerves (presumed to
be vagal efferents) adhered to the mesothelial cells of the ileal
serosa, leading the authors to speculate that the anti-inflammatory
effects of the mesothelium in the ileum may be stimulated by
autonomic nerves (45). To our knowledge, our data are the first evidence that mesothelial cells may have a “neuronal-like” func-
tion innervating the splenic capsule. Although our histological
findings provide an explanation for our immunological data, our
finding of neuronal-like function in mesothelial cells is unprece-
dented and raises a number of important questions. Although we are unable to address these questions in the current study, further
studies are warranted, as similar innervation by mesothelial cells
in other organs could represent a previously unrecognized path-
way of biological communication."

Oral NaHCO3 Activates a Splenic Anti-Inflammatory Pathway: Evidence That Cholinergic Signals Are Transmitted via Mesothelial Cells

Sarah C. Ray, Babak Baban, Matthew A. Tucker, Alec J. Seaton, Kyu Chul Chang, Elinor C. Mannon, Jingping Sun, Bansari Patel, Katie Wilson, Jacqueline B. Musall, Hiram Ocasio, Debra Irsik, Jessica A. Filosa, Jennifer C. Sullivan, Brendan Marshall, Ryan A. Harris and Paul M. O’Connor

J Immunol April 16, 2018, ji1701605; DOI: https://doi.org/10.4049/jimmunol.1701605

https://medicalxpress.com/news/2018-04-soda-inexpensive-safe-combat-autoimmune.html


My clinical experience about the importance of sodium bicarbonate perfusion in CKD patients who are scheduled to a contrast imaging or therapeutic procedure is very clear. If you hydrate and alkalinize your patient at the very least during the procedure and after, even when two procedures (for instance AngioCT and very fast an endovascular procedure) are mandatory, you will not have any problem and I never used acute dialysis in this setting. The limit is CKD with CHF because the patient could be in trouble with the volume load.