BACKGROUND:Acupuncture has been reported to enhance muscle strength in several studies using conventional needling techniques. Press tack needles offer a more practical modality; however, their efficacy with respect to leg muscle strength remains unknown. The purpose of this study was to investigate the effect of press tack needle acupuncture on leg muscle strength in sports students. METHODS:A double-blind randomized controlled trial was conducted among 30 male sports students who were randomized into an acupuncture group (n = 15) and a placebo group (n = 15). Press tack needles (0.20 mm × 1.2 mm) were applied bilaterally at ST36 and ST34 in the acupuncture group, while round plasters were applied at the same locations in the placebo group. Leg muscle strength was measured using a leg dynamometer before and 30 min after the intervention. RESULTS:No statistically significant difference between groups was observed in the primary outcome of leg muscle strength post-intervention (81 [67-107] kg vs 62 [50-100] kg; p = 0.066). However, both groups demonstrated significant within-group improvements (p < 0.001 and p = 0.001, respectively) and the mean change (±SD) in leg muscle strength was significantly greater in the acupuncture group than in the placebo group (10.2 ± 6.8 kg vs 5.6 ± 4.1 kg; p = 0.033). CONCLUSION:Press tack needle acupuncture at ST36 and ST34 did not demonstrate significant superiority over placebo on leg muscle strength, although the study appears in retrospect to have been underpowered for this primary outcome. The significant between-group difference for the changes in leg strength (pre- vs post-intervention) among individual participants is encouraging, and further investigation is warranted.
OBJECTIVE:The aim of this pilot study was to examine whether tactile length-memorisation training practised in a single basic posture could improve insertion-depth control across different needling postures. METHODS:In this single-group pre-post pilot study, eight visually impaired acupuncture students at a school for the blind performed needle insertions to a target depth of 15 mm on a prone practice model before and after a 2-week home-based tactile length-memorisation training programme. Insertions were performed at three sites: posterior (midline of the back), right-lateral (right abdominal region) and left-lateral (left abdominal region). The practitioner's working posture naturally differed for each site: upright for the posterior, inclined forward and to the right for the right-lateral, and slightly forward for the left-lateral insertion. The training involved repeated tactile memorisation and reproduction of the residual needle length using the fingertips and was conducted only in the basic posture used for needling the posterior region (upright posture). Before and after the training, we computed the mean absolute error, median absolute deviation and the proportion of trials with errors exceeding 5 mm. Outcomes were assessed using paired statistical tests and effect size metrics. RESULTS:The mean absolute error decreased significantly across all regions after training (from approximately 5-6 mm to 1-2 mm). No errors exceeding 5 mm were observed post-training, and median absolute deviation decreased significantly only in the left-lateral region. CONCLUSION:These preliminary findings suggest that tactile length-memorisation training may enhance insertion-depth precision without visual cues and may be applicable across different needling postures.
BACKGROUND:Acupuncture at different traditional acupuncture point locations activates different autonomic pathways and modulates systemic inflammation. Electroacupuncture preconditioning (EAP) at PC6 or ST36 has been demonstrated to be cardioprotective during acute myocardial ischemia (MI) injury, but the mechanism remains unclear. As inflammation is crucial for repair post-MI, we aimed to investigate whether the protective effect of EAP at PC6 or ST36 is related to the suppression of inflammation and whether autonomic pathways are involved. METHODS:Mice underwent ligation of the left anterior descending (LAD) coronary artery to generate model MI after 3 days of EAP at PC6 or ST36. Echocardiography and triphenyltetrazolium chloride (TTC) staining were used to evaluate cardiac function and myocardial infarction area. Cardiac troponin (cTn)I and norepinephrine (NE) were measured by enzyme-linked immunosorbent assay (ELISA). Flow cytometry was employed to determine macrophage M1/M2 phenotypic polarization, and the levels of pro- and anti-inflammatory cytokines in cardiac tissue were detected by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). In addition, unilateral cervical vagotomy and chemical sympathetic blockade were employed to clarify specific autonomic pathways. RESULTS:EAP at PC6 or ST36 preserved cardiac function, reduced myocardial infarct size, decreased serum cTnI levels, promoted M2 macrophage polarization and decreased the cardiac pro-inflammatory cytokines tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-18 and nucleotide-binding oligomerization domain (NOD)-like receptor protein 3 (NLRP3). Compared to EAP at ST36, EAP at PC6 yielded a better cardioprotective effect and regulated the anti-inflammatory cytokine transforming growth factor (TGF)-β. Moreover, sympathetic nerves were involved in the protective effect of EAP at PC6, while the vagus nerve was necessary for EAP at ST36. CONCLUSION:Our findings suggest that EAP at PC6 or ST36 activates different autonomic pathways and modulates M2 macrophage polarization, resulting in the suppression of myocardial inflammation.
Sympathetic nerves play an important role in the generation and maintenance of pain, and many studies have shown that inflammatory factors play an important role in this process. During tissue inflammation or injury, the interaction between sympathetic nerves and the sensory nervous system may lead to the aggravation of pain. Inflammatory mediators such as tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-1β play a key role in soft tissue injury and complex regional pain syndrome (CRPS) and thus affect the perception and regulation of pain through sympathetic nerve pathways. The efficacy of acupuncture and moxibustion in the treatment of pain disorders has been verified in clinical practice, and significant results have been achieved. As an exogenous nerve stimulation technique, acupuncture can stimulate a variety of anti-inflammatory pathways mediated by sympathetic nerves, to regulate the activity of sympathetic nerves and the release of neurotransmitters, regulate inflammatory cytokines and signaling pathways, and interfere with nerve-immune interaction, thus inducing anti-inflammatory and analgesic effects. In conclusion, acupuncture treatment has shown positive effects in the management of pain caused by sympathetic nerves and soft tissues, and the mechanism may involve the regulation of the nervous system mediated by the modulation of inflammatory factors. These findings provide a scientific basis for the use of acupuncture in pain management and, although the underlying mechanisms remain unclear, suggest new directions for future research. This article explores the pathways underlying acupuncture analgesia and specifically examines the role of sympathetic nerves.
Objective: To describe attitudes towards acupuncture and expectations regarding potential treatment outcomes among women with self-reported primary dysmenorrhoea (PD) residing in Australia.Methods: A cross-sectional, descriptive online survey was conducted to assess attitudes and treatment expectancy using an adapted version of previously published complementary and alternative medicine (CAM) attitude scale and a validated acupuncture expectancy scale (AES). Data were analysed descriptively, with exploratory analysis conducted to support the interpretation of response patterns. Ethical approval was obtained from the Edith Cowan University Human Research Ethics Committee (2023-04471-LIU) and participants provided electronic informed consent.Results: A total of 247 responses were received. Participants were mainly aged 25-30 years and largely from Western Australia. Many reported having experienced PD for more than 6 months and a range of related symptoms. Item-level analysis suggested generally favourable attitudes towards acupuncture, with 81% expressing interest in acupuncture. Treatment expectancy was moderate overall. Sensitivity and exploratory stratified analyses showed broadly comparable descriptive patterns across demographic and clinical subgroups.Conclusion: Women with self-reported PD showed generally favourable attitudes towards acupuncture and moderate expectancy. Of note, this was found to be a self-selected sample with higher educational attainment that was predominantly interested in acupuncture. Findings reflect perceived acceptability rather than clinical effectiveness or population-level perspectives and should not be generalised. As attitudes were assessed using an adapted, non-validated instrument, results should be interpreted cautiously as indicative of response tendencies. Future research is needed among women not interested in acupuncture and those with a lower educational level to further explore the contextual and experiential factors that potentially shape how acupuncture is perceived and utilised.
OBJECTIVE:Patients with ankylosing spondylitis (AS), who suffer from inflammatory back pain, spend about two times more on healthcare than the general population. However, current treatments are unsatisfactory. The aim of this single-armed pilot study was to assess the feasibility of using electroacupuncture (EA) to manage AS pain that is not adequately controlled by analgesics. We hypothesized that, after 6 weeks of treatment, at least 10% of the subjects would experience a 30% reduction in their pain severity numerical rating scale (NRS) score when compared to baseline. METHODS:Twenty AS subjects who were experiencing moderate to severe pain despite usual care were recruited between March 2016 and August 2017 in Hong Kong, with two patients ultimately dropping out. Semi-standardized EA was performed on the 20 subjects twice a week for 6-10 weeks. Outcome measures were mainly examined at baseline and at weeks 6, 10 and 18. These measures included: pain severity NRS, medication use, Bath ankylosing spondylitis functional index, Bath ankylosing spondylitis disease activity index, Bath ankylosing spondylitis global index, short-form 36, Bath ankylosing spondylitis metrology index, chest expansion, swollen and painful joint count, C-reactive protein and erythrocyte sedimentation rate. RESULTS:A one-sided exact binomial test showed that at least 10% of the subjects achieved a 30% pain reduction at week 6 (p = 0.002). CONCLUSION:AS pain was decreased after 6 weeks of EA treatment. However, a randomized controlled trial with an adequate sample size is needed to confirm this finding. TRIAL REGISTRATION NUMBER:NCT02697968 (ClinicalTrials.gov).
BACKGROUND:Postherpetic neuralgia (PHN) is a prevalent and painful complication following herpes zoster infection, impacting patient quality of life and posing significant treatment challenges. Current pharmacological approaches often result in adverse effects. The aim of this study was to develop a clinical prediction model for selecting PHN patients for electroacupuncture (EA) treatment and to determine the prognostic outcomes after two sessions. METHODS:We conducted a retrospective observational cohort analysis on adults diagnosed with PHN between 2010 and 2017. All participants had undergone at least two acupuncture sessions. Data analysis included demographic, clinical and treatment variables to identify predictors of treatment outcomes. Treatment success was defined using the numeric rating scale (NRS), with failure characterized by an NRS score >3. Predictive modeling and internal validation employed bootstrap resampling. RESULTS:Among 243 patients included in the study, the treatment failure rate was 20.6%. Key predictive factors for treatment outcome were the presence of diabetes mellitus, use of carbamazepine and high initial NRS scores. The accuracy of the prediction model was reflected by an area under the receiver operating characteristic (ROC) curve of 0.80 after the first session and 0.88 following the third session, indicating a robust predictive capability. CONCLUSION:In this study, we successfully developed and internally validated a clinical prediction model for EA in PHN patients. We anticipate that this model may guide clinicians in personalized patient care, optimizing the selection process for EA treatment, and predicting treatment response early in the treatment cycle.
OBJECTIVE:To explore the effectiveness and safety of electroacupuncture (EA) as an adjunct to conventional rehabilitation (CR) in patients with upper limb spasticity after brain injury. METHODS:This study was a single-blind, prospective, two-group parallel randomized controlled trial. Eligible patients were randomly divided into an intervention group and a control group. Participants in the control group received CR only, whereas those in the intervention group received CR supplemented with EA, administered five times weekly for 2 weeks. Modified Ashworth scale (MAS), shear modulus of biceps brachii muscle (BBM), Fugl-Meyer motor scale (FMMS), Barthel index (BI) and safety were assessed at baseline and after 2 weeks of treatment. RESULTS:A total of 64 patients were randomized, with 58 included in the final (per protocol) analysis. The baseline data of the two groups were comparable. Following the 2-week treatment period, improvements were observed in both groups compared to baseline. However, no significant differences were noted between the two groups in MAS (Z = -1.692, p = 0.091), BBM shear modulus short axis of 0° elbow flexion (mean difference (MD) -1.079, 95% confidence interval (CI) -2.786 to 0.628), long axis of 0° elbow flexion (MD -0.499, 95% CI -1.699 to 0.700), short axis of 90° elbow flexion (MD -0.005, 95% CI -0.933 to 0.923), long axis of 90° elbow flexion (MD -0.845, 95% CI -1.355 to 1.113), FMMS (MD -0.890, 95% CI -2.243 to 0.462) or BI (MD 0.024, 95% CI -2.955 to 3.002) scores. One participant reported an itchy sensation at the acupuncture site, with no other adverse events observed during or after the trial. CONCLUSION:EA was not effective when added to CR as a 2-week intervention for upper limb spasticity after brain injury, but appears to be a safe intervention in this population. TRIAL REGISTRATION NUMBER:ChiCTR2200060819 (Chinese Clinical Trial Registry).
OBJECTIVE:Nausea, vomiting and pain are common postoperative complications. The aim of this study was to evaluate the effects of ondansetron combined with acupuncture at bilateral PC6 during the intraoperative period on the incidence of postoperative nausea and vomiting (PONV), severity of nausea/pain and the need for rescue antiemetics in patients undergoing elective one- or two-level lumbar disc herniation (LDH) surgery. METHODS:In this double-blind randomized controlled trial, 92 patients with American Society of Anesthesiologists (ASA) physical status I-II who were scheduled for elective LDH surgery under general anesthesia were randomized into two groups: the acupuncture group (group A) and the control group (group C). Group A received PC6 acupuncture bilaterally plus ondansetron; group C received ondansetron only. PONV was defined as nausea with a visual analog scale (VAS) score ⩾4, vomiting or need for rescue medication. Persistent nausea (>20 min), unchanged score or repeated vomiting prompted administration of 4 mg intravenous (IV) ondansetron. Pain scores ⩾4 were treated with IV dexketoprofen. RESULTS:Data on 79 patients (n = 40 in group A and n = 39 in group C) were analyzed. The incidence of PONV within 24 h (primary outcome) did not significantly differ in group A versus group C (15.0% vs 33.3%, p = 0.057). However, nausea incidence at 0-24 h, as well as PONV incidence and rescue antiemetic use at 0-2 h, were significantly lower in group A (p < 0.05). Nausea and pain severity were also significantly lower in group A at 0-2 and 2-4 h (p < 0.05). A moderate positive correlation was found between pain and nausea severity over 24 h (p < 0.001). CONCLUSION:Although this study was negative in its primary endpoint, multiple significant secondary findings suggest that acupuncture with standard antiemetic therapy was associated with lower early PONV and reduced rescue antiemetic use. TRIAL REGISTRATION NUMBER:NCT06669676 (ClinicalTrials.gov).
BACKGROUND:Acupuncture may alleviate both the motor and depressive symptoms of Parkinson's disease (PD); however, the underlying mechanism has not yet been elucidated. In this study, on the basis of previous findings that acupuncture improves depressive behaviors in a rat model of depression in Parkinson's disease (DPD), we investigated whether manual acupuncture (MA) has a modulatory effect on the phosphatidylinositol-3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) pathway, autophagy and prefrontal cortical synaptic repair proteins in a rat model of DPD. METHODS:We screened 6-hydroxydopamine (6-OHDA)-induced DPD model rats and divided them into four groups: DPD group, DPD + MA group, DPD + PI3K group and DPD + MA + PI3K group. The latter two groups were injected with the PI3K inhibitor LY294002. A sham group injected with normal saline was also included. Twenty-eight days after the end of treatment, the expression of phosphorylated (p)-PI3K, p-Akt, p-mTOR, p-p70S6K (70 kDa ribosomal protein S6 kinase), p-4E-BP-1 (4E binding protein 1), p62, Beclin-1, Synapsin I and postsynaptic density protein (PSD)95 in the prefrontal cortex was determined by Western blotting. We used transmission electron microscopy (TEM) to study neuronal damage and evaluate the effect of MA on neurons and autophagy in the prefrontal cortex of DPD model rats. RESULTS:MA upregulated the expression of p-PI3K, p-Akt, p-mTOR, p-p70S6K, p-4E-BP-1, p62, Synapsin I and PSD95, and decreased expression levels of Beclin-1, in the prefrontal cortex of DPD model rats. Acupuncture attenuated neuronal damage and reduced the number of autophagosomes in the prefrontal cortex of DPD model rats. CONCLUSION:Acupuncture may serve as a treatment for DPD by activating the PI3K/Akt/mTOR pathway to inhibit the process of autophagy and repair damaged synapses.
OBJECTIVE:This study investigated the effects of auriculotherapy on early postoperative rehabilitation after total knee arthroplasty (TKA). METHODS:A prospective cohort study was conducted from March to September 2024 at Peking Union Medical College Hospital and its affiliated consortium. Patients receiving auriculotherapy postoperatively were compared with a matched non-exposed group (selected by propensity score matching). The primary outcome was the change in knee joint active range of motion (AROM) from postoperative day (POD) 1 to POD 4 (Δ AROM). Secondary outcomes included Hospital for Special Surgery (HSS) scale, patient-controlled analgesia (PCA) use, facial visual analog scale (F-VAS) and Tampa scale of kinesiophobia (TSK) scores, plus swelling measurements. RESULTS:Data from a total of 110 patients was collected in this study, with 84 (42 matched pairs) included in the final analysis. Compared with the non-exposed group, the auriculotherapy group showed significantly greater improvements in Δ AROM (40.60 ± 11.69° vs 29.41 ± 13.64°, p < 0.001) and HSS scores (p = 0.004). The auriculotherapy group also pressed their PCA button fewer times (p = 0.047) and exhibited reduced supplemental analgesic use (p = 0.004) and lower TSK scores (p < 0.001). Knee circumference and swelling were significantly reduced in the auriculotherapy group (p < 0.05). Trend analysis indicated significant between-group differences and interaction effects for AROM and kinesiophobia (p < 0.001). CONCLUSION:Based on the findings of this observational study, auriculotherapy is associated with better early functional outcomes in early postoperative rehabilitation of patients after TKA. Randomized controlled trials are necessary to explore its potential effectiveness and underlying mechanisms.
OBJECTIVE:The aim of this study was to investigate the effects of acupuncture on a rat model of chronic migraine (CM) and explore the underlying mechanism of action from the perspective of the gut-brain axis. METHODS:A total of 24 male Sprague-Dawley (SD) rats were randomly allocated into control, model and acupuncture groups (n = 8 each). The CM model was established by intraperitoneal injection of nitroglycerin (NTG). Acupuncture was administered at GV20 and bilateral PC6/LR3/ST36 for rats in the acupuncture group once a day for 9 days. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of 5-hydroxytryptamine (5-HT), calcitonin gene-related peptide (CGRP) and vasoactive intestinal peptide (VIP) in plasma. A combination of 16S rDNA sequencing and liquid chromatography-mass spectrometry (LC-MS) metabolomics was adopted to investigate the role of the gut-brain axis in migraine chronification and the effect of acupuncture on CM. RESULTS:Acupuncture treatment significantly attenuated hyperalgesia in CM model rats and regulated serum levels of brain-gut peptides, including 5-HT, CGRP and VIP. Furthermore, the gut microbial community structure and metabolic profile changed in CM rats and acupuncture impacted the changes. Notably, acupuncture modulated 10 gut microbial genera and 13 fecal metabolites. CONCLUSION:These findings suggest that the gut-brain axis may play an important role in the chronification of migraine, and the regulation of gut microbiota and metabolites may be one of the mechanisms underlying the analgesic effect of acupuncture in CM.
OBJECTIVE:To investigate the role and mechanism of the dorsal motor nucleus of the vagus nerve (DMV) in the effects of electroacupuncture (EA) at HT7 in a mouse model of chronic heart failure (CHF). METHODS:A CHF model was established in male C57 mice by ligating the anterior descended branch of the left coronary artery. In part I of the experiment, mice were randomly divided into Control, untreated model (CHF) and EA-treated model (CHF + EA) groups (n = 6 each). In part II, mice were randomly divided into the following groups (n = 6 each): EA-treated model group (CHF + EA); EA-treated model group receiving cholinergic neuron promoter chemogenetic activating virus encoding human M4 muscarinic (hM4) receptor (hM4D) and clozapine-N-oxide (CNO) (CHF + hM4D + CNO + EA); EA-treated model group additionally receiving "empty" virus encoding enhanced green fluorescence protein (EGFP) and CNO (CHF + EFGP + CNO + EA); EA-treated model group receiving hM4D only (CHF + hM4D + EA); and EA-treated model group receiving CNO only (CHF + CNO + EA). All mice except those in the Control and CHF groups were treated with bilateral EA at HT7 (frequency 2 Hz, intensity 2mA, pulse width 0.2 ms ± 20%) once a day (20 min each time) for 7 days. Left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), scar area and serum inflammatory factor levels were evaluated using a Doppler ultrasound imaging system, Masson staining, ELISA and other methods. RESULTS:Compared with the Control group, LVEF/LVFS in the CHF group decreased (p < 0.001), the scar area was larger, atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and interleukin (IL)-6 levels increased significantly, and acetylcholine (ACh) decreased significantly (p < 0.001) in the CHF group. Compared with the CHF group, LVEF/LVFS increased (p < 0.001), scar area was smaller, ANP, BNP and IL-6 decreased significantly and ACh increased significantly (p < 0.001) in the CHF + EA group. Compared with the CHF + EA group, the CHF + hM4D + CNO + EA group exhibited a decrease in LVEF/LVFS (p < 0.001), a larger scar area, a significant increase in ANP, BNP and IL-6, and a significant decrease in ACh (p < 0.001),while there was no significant difference in each index between the CHF + CNO + EA and CHF + hM4D + EA groups (p > 0.05). Compared with the CHF + hM4D + CNO + EA group, the CHF + EGFP + CNO + EA exhibited an increase in LVEF/LVFS (p < 0.001), a smaller scar area, a significant decrease in ANP, BNP and IL-6, and a significant increase in ACh (p < 0.001). CONCLUSION:Electroacupuncture at (HT7) may activate DMVAch and reduce myocardial fibrosis, thereby improving CHF, in a mouse model.
OBJECTIVE:Intestinal inflammatory responses are a key pathological feature of inflammatory bowel disease (IBD) and the nucleotide oligomerization domain (NOD)-like receptor protein 3/cysteine aspartate protease-1/apoptosis-associated speck-like protein (NLRP3/caspase-1/ASC) signaling pathway plays a key role in mediating these responses. The aim of this study was to investigate how electroacupuncture (EA) affects inflammation-related protein levels, including NLRP3, caspase-1 and ASC, in a mouse model of IBD and explore the underlying mechanisms of action. METHODS:Forty-eight mice were randomly assigned to control, model, EA and NLRP3 inhibitor groups. IBD was induced using dextran sodium sulfate (DSS). After 1 week of EA treatment, fecal occult blood tests were performed and disease activity index (DAI) scores were recorded. In addition, hematoxylin-eosin staining was performed to evaluate the histopathological changes in the colon. Serum interleukin (IL)-1β, IL-18 and tumor necrosis factor (TNF)-α levels were measured using enzyme-linked immunosorbent assay, and protein expression of NLRP3, caspase-1, ASC, gasdermin D (GSDMD), N-terminal GSDMD (N-GSDMD), IL-1β and IL-18 in colonic tissues was assessed using Western blotting. RESULTS:IBD resulted in alterations in general condition and colonic morphology, a significant increase in serum IL-1β, IL-18 and TNF-α levels, and a significant increase in protein expression of NLRP3, caspase-1, ASC, GSDMD, N-GSDMD, IL-1β and IL-18 in the colonic tissues (p < 0.01 or p < 0.001). EA and NLRP3 inhibition reversed these pathological changes and reduced the expression of inflammatory proteins induced by intestinal inflammatory responses (p < 0.05 or p < 0.01). CONCLUSION:The NLRP3/caspase-1/ASC signaling pathway appears to play a role in mediating the therapeutic effects of EA in IBD.
BACKGROUND:Electroacupuncture (EA) has shown efficacy in the treatment of chronic obstructive pulmonary disease (COPD), but the underlying mechanism of action remains unclear. Oxidative stress is a main pathological process in COPD. This aim of this study was to explore the anti-oxidant effect of EA in a COPD rat model. METHODS:Rats were divided into control, model, EA, sham acupuncture (SA) and N-acetylcysteine (NAC) groups. All rats except those in the control group were exposed to cigarette smoke combined with repeated bacterial infection to induce a COPD rat model. Rats in the EA group received EA at GV14 and bilateral BL13/BL23 for a further 8 weeks, while rats in SA group were given manual acupuncture at sites 5 mm from the traditional acupuncture point locations (without electrical stimulation) as a negative control. NAC (54 mg/kg/d) was used in the NAC group as a positive control. Lung function was assessed by whole body plethysmography, and tissue structure was assessed by histology. mRNA and protein levels of oxidative indicators and nuclear factor E2-related factor (Nrf2) signaling were measured by qPCR and immunohistochemistry or Western blotting, respectively. RESULTS:After EA treatment, lung function and pathological features were improved. Total antioxidant capacity (T-AOC) and total superoxide dismutase (T-SOD) in serum, as well as SOD1 and heme oxygenase (HO)-1 in lung tissue, were increased, while markers of oxidative stress-lipid peroxidation (LPO) and malonaldehyde activity (MDA)-were decreased. Nrf2 protein in the nucleus of lung tissue, as well as HO-1 and γ-glutamylcysteine synthetase (γ-GCS) mRNA and protein, were improved. NAC, as an antioxidant, was better than EA at increasing the expression of HO-1 protein and γ-GCS mRNA. CONCLUSIONS:EA was beneficial for the treatment of COPD in this rat model and exerted antioxidant effects via mechanisms potentially related to Nrf2 signaling.
BACKGROUND:In the treatment of post-stroke depression (PSD), acupuncture has emerged as a therapeutic option; however, the exact mechanisms underlying its efficacy remain unclear. Prior research suggests acupuncture may improve PSD symptoms by regulating M1/M2 microglial polarization, reducing the release of inflammatory factors and inflammatory-associated damage. OBJECTIVE:The aim of the present study was to explore whether manual acupuncture (MA) can mediate microglial polarization via the silence information regulator/nuclear factor κB (Sirt1/NF-κB) pathway, thereby reducing inflammatory responses in the brains of rats exhibiting PSD and improving depressive behavior. METHODS:Thirty male rats were divided into a middle cerebral artery occlusion (MCAO) group, PSD group, PSD + MA group, PSD + MA + Sirt1 inhibitor group, and PSD + MA + NS (normal saline) group. Acupuncture was applied 6 days a week for 4 weeks at GV26, GV20 and bilateral PC6 and SP6. In the PSD + MA + Sirt1 inhibitor group, nicotinamide (NAM), a specific inhibitor of Sirt1, was slowly injected into the frontal lobe with a stereotactic injector 1 h before acupuncture. Behavioral tests were conducted after modeling and intervention, including the sucrose preference test (SPT) and open field test (OFT), and body weight was monitored. Following the tests, specimens of the dorsolateral frontal lobe were taken to evaluate molecular markers. Immunofluorescence staining was employed to determine the expression levels of M1 microglial markers CD16/Iba1 and M2 microglial markers CD206/Iba1 in the dorsolateral prefrontal cortex. mRNA expression of CD16/intrinsic nitric oxide synthase (iNOS) and CD206/arginase (Arg)-1 was detected by q-RT-PCR. Western blot analysis was used to quantify protein expression of Sirt1, total p65 and phosphorylated p65 (p-p65) proteins. Interleukin (IL)-1β, IL-6, IL-10 and tumor necrosis factor (TNF)-α levels were quantified using ELISA. RESULTS:Depression-like behavior of PSD model rats was reduced by MA. Acupuncture promoted transformation of microglia from M1 to M2 in the prefrontal lobe, thereby decreasing expression of pro-inflammatory factors (IL-1β, IL-6 and TNF-α) and increasing expression of anti-inflammatory IL-10 after PSD. In addition, expression of Sirt1 in the prefrontal lobe increased following MA, while expression of p65/p-p65 was reduced, indicating activation of the Sirt1/NF-κB pathway. These findings suggest that M1 to M2 microglial polarization was closely related to Sirt1/NF-κB pathway activation following MA. CONCLUSION:MA promoted the transformation of microglia from M1 to M2 in the prefrontal lobe of PSD rats, reduces the inflammatory response and improves depression-like behavior in rats. These effects were associated with activation of the Sirt/NF-κB pathway.
