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The VN is also believed to activate splenic sympathetic nerves via a vagal-sympathetic reflex, releasing NE that binds to splenic lymphocytes, promoting the release of ACh, which in turn inhibits the secretion of pro-inflammatory cytokines from splenic macrophages through a negative feedback loop, thereby exerting anti-inflammatory effects via the splenic sympathetic nerve pathway (103, 104)

This is likely to involve feeling the muscle and gently moving the leg

Common side effects, if any, are mild and transient, including abdominal cramping, bloating, and loose stools

Shigella sonnei meningitis due to interleukin-1 receptor-associated kinase-4 deficiency: First association with a primary immune deficiency