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Benrick A, Kokosar M, Hu M, Larsson M, Maliqueo M, Marcondes RR, Soligo M, Protto V, Jerlhag E, Sazonova A, Behre CJ, Højlund K, Thorén P, Stener-Victorin E. Autonomic nervous system activation mediates the increase in whole-body glucose uptake in response to electroacupuncture. FASEB J 2017; 31:3288-3297. [PMID: 28404742 DOI: 10.1096/fj.201601381r] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/27/2017] [Indexed: 12/15/2022]
Abstract
A single bout of low-frequency electroacupuncture (EA) causing muscle contractions increases whole-body glucose uptake in insulin-resistant rats. We explored the underlying mechanism of this finding and whether it can be translated into clinical settings. Changes in glucose infusion rate (GIR) were measured by euglycemic-hyperinsulinemic clamp during and after 45 min of low-frequency EA in 21 overweight/obese women with polycystic ovary syndrome (PCOS) and 21 controls matched for age, weight, and body mass index (experiment 1) and in rats receiving autonomic receptor blockers (experiment 2). GIR was higher after EA in controls and women with PCOS. Plasma serotonin levels and homovanillic acid, markers of vagal activity, decreased in both controls and patients with PCOS. Adipose tissue expression of pro-nerve growth factor (proNGF) decreased, and the mature NGF/proNGF ratio increased after EA in PCOS, but not in controls, suggesting increased sympathetic-driven adipose tissue metabolism. Administration of α-/β-adrenergic receptor blockers in rats blocked the increase in GIR in response to EA. Muscarinic and dopamine receptor antagonist also blocked the response but with slower onset. In conclusion, a single bout of EA increases whole-body glucose uptake by activation of the sympathetic and partly the parasympathetic nervous systems, which could have important clinical implications for the treatment of insulin resistance.-Benrick, A., Kokosar, M., Hu, M., Larsson, M., Maliqueo, M., Marcondes, R. R., Soligo, M., Protto, V., Jerlhag, E., Sazonova, A., Behre, C. J., Højlund, K., Thorén, P., Stener-Victorin, E. Autonomic nervous system activation mediates the increase in whole-body glucose uptake in response to electroacupuncture.
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Affiliation(s)
- Anna Benrick
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,School of Health and Education, University of Skövde, Skövde, Sweden
| | - Milana Kokosar
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Min Hu
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Martin Larsson
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Manuel Maliqueo
- Endocrinology and Metabolism Laboratory, West Division, School of Medicine, University of Chile, Santiago, Chile
| | - Rodrigo Rodrigues Marcondes
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.,Disciplina de Ginecologia, Laboratório de Ginecologia Estrutural e Molecular (LIM 58), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marzia Soligo
- Institute of Translational Pharmacology, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - Virginia Protto
- Institute of Translational Pharmacology, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - Elisabet Jerlhag
- Department of Pharmacology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Antonina Sazonova
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Carl Johan Behre
- Department of Cardiology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kurt Højlund
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Peter Thorén
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Somatoautonomic reflexes in acupuncture therapy: A review. Auton Neurosci 2016; 203:1-8. [PMID: 27876359 DOI: 10.1016/j.autneu.2016.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 10/21/2016] [Accepted: 11/15/2016] [Indexed: 02/06/2023]
Abstract
Oriental therapies such as acupuncture, moxibustion, or Anma, have been used to treat visceral disorders since ancient times. In each of these therapies, stimulation of the skin or underlying muscles leads to excitation of afferent nerves. The sensory information is carried to the central nervous system, where it is transferred to autonomic efferents, thus affecting visceral functions. This neuronal pathway, known as the "somatoautonomic reflex", has been systematically studied by Sato and his colleagues for over a half century. Nearly all their studies were conducted in anesthetized animals, whereas human patients are conscious. Responses in patients or the events following therapeutic somatic stimulation may differ from those observed in anesthetized animals. In fact, it is increasingly apparent that the responses in patients and animals are not always coincident, and the differences have been difficult for clinicians to reconcile. We review the mechanism of the "somatoautonomic reflex" as described in anesthetized animals and then discuss how it can be applied clinically.
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Catalogna M, Fishman S, Halpern Z, Ben-Shlomo S, Nevo U, Ben-Jacob E. Regulation of glucose dynamics by noninvasive peripheral electrical stimulation in normal and insulin-resistant rats. Metabolism 2016; 65:863-73. [PMID: 27173465 DOI: 10.1016/j.metabol.2016.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 02/25/2016] [Accepted: 03/09/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND The epidemic nature of type 2 diabetes mellitus (T2DM), along with the downsides of current treatments, has raised the need for therapeutic alternatives. METHODS We studied normo-glycemic and high-fat diet (HFD), induced insulin-resistant Wistar Han rats for 2 to 3weeks. Rats received peripheral electrical stimulation (PES) treatment (2Hz/16Hz bursts, 10mA) in their hind limbs for 3min, 3 times per week. Glucose tolerance was evaluated by using a glucose tolerance test at the beginning and again at the end of the study. The effect of an acute PES treatment on metabolic rates of glucose appearance and turnover was measured by using the hyperinsulinemic-euglycemic clamp (HEGC) test. RESULTS Repeated PES treatment significantly inhibited the progression of glucose intolerance in normal and insulin-resistant rats and prevented HFD-induced gains in body weight and fat mass. Acute treatment induced a prolonged effect on glucose turnover, as evaluated by the HEGC test. Increased hepatic glucose output was observed during the basal state (P<0.005). Under hyperinsulinemic conditions, PES improved tissue sensitivity to insulin (41.1%, P<0.01), improved suppression of hepatic glucose production (58.9±4.4% vs. 87.1±4.4%, P<0.02) and significantly elevated the rate of glycogenesis (P<0.01), compared with controls. CONCLUSIONS The present study indicates that a noninvasive PES treatment of very short duration is sufficiently potent to stimulate glucose utilization and improve hepatic insulin sensitivity in rats. Repeated PES treatment may have a beneficial effect on HFD-induced adiposity and control of body weight.
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Affiliation(s)
- Merav Catalogna
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Israel
| | - Sigal Fishman
- Research Center for Digestive Tract and Liver Diseases, Tel Aviv Sourasky Medical Center, Israel, Affiliated with the Sackler School of Medicine, Tel Aviv, Israel
| | - Zamir Halpern
- Research Center for Digestive Tract and Liver Diseases, Tel Aviv Sourasky Medical Center, Israel, Affiliated with the Sackler School of Medicine, Tel Aviv, Israel
| | - Shani Ben-Shlomo
- Research Center for Digestive Tract and Liver Diseases, Tel Aviv Sourasky Medical Center, Israel, Affiliated with the Sackler School of Medicine, Tel Aviv, Israel
| | - Uri Nevo
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Israel.
| | - Eshel Ben-Jacob
- School of Physics and Astronomy, Raymond & Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Israel; Center for Theoretical Biological Physics, Rice University, Houston, TX, USA
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Acupoint-specific, frequency-dependent, and improved insulin sensitivity hypoglycemic effect of electroacupuncture applied to drug-combined therapy studied by a randomized control clinical trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:371475. [PMID: 25024728 PMCID: PMC4082841 DOI: 10.1155/2014/371475] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 04/28/2014] [Accepted: 05/06/2014] [Indexed: 01/22/2023]
Abstract
The application of electroacupuncture (EA) to specific acupoints can induce a hypoglycemic effect in streptozotocin-induced rats, normal rats, and rats with steroid-induced insulin resistance. EA combined with the oral insulin sensitizer rosiglitazone improved insulin sensitivity in rats and humans with type II diabetes mellitus (DM). There are different hypoglycemic mechanisms between Zhongwan and Zusanli acupoints by EA stimulation. On low-frequency (2 Hz) stimulation at bilateral Zusanli acupoints, serotonin was involved in the hypoglycemic effect in normal rats. Moreover, after 15 Hz EA stimulation at the bilateral Zusanli acupoints, although enhanced insulin activity mainly acts on the insulin-sensitive target organs, the muscles must be considered. In addition, 15 Hz EA stimulation at the bilateral Zusanli acupoints has the combined effect of enhancing cholinergic nerve activity and increasing nitric oxide synthase (NOS) activity to enhance insulin activity. Despite the well-documented effect of pain control by EA in many systemic diseases, there are few high-quality long-term clinical trials on the hypoglycemic effect of EA in DM. Combination treatment with EA and other medications seems to be an alternative treatment to achieve better therapeutic goals that merit future investigation.
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Electroacupuncture improves glucose tolerance through cholinergic nerve and nitric oxide synthase effects in rats. Neurosci Lett 2011; 494:114-8. [PMID: 21376780 DOI: 10.1016/j.neulet.2011.02.071] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2010] [Revised: 02/19/2011] [Accepted: 02/25/2011] [Indexed: 11/20/2022]
Abstract
The purpose of this investigation was to evaluate the effect and mechanisms of electroacupuncture (EA) at the bilateral Zusanli acupoints (ST-36) on glucose tolerance in normal rats. Intravenous glucose tolerance test (IVGTT) was performed to examine the effects of electroacupuncture (EA) on glucose tolerance in rats. The EA group underwent EA at the ST-36, with settings of 15 Hz, 10 mA, and 60 min; the control group underwent the same treatments, but without EA. Atropine, hemicholinium-3 (HC-3) or NG-nitro-L-arginine methyl ester (L-NAME) were injected into the rats alone or simultaneously and EA was performed to investigate differences in plasma glucose levels compared to the control group. Plasma samples were obtained for assaying plasma glucose and free fatty acid (FFA) levels. Western blot was done to determine the insulin signal protein and nNOS to exam the correlation between EA and improvement in glucose tolerance. The EA group had significantly lower plasma glucose levels compared to the control group. Plasma glucose levels differed significantly between the EA and control groups after the administration of L-NAME, atropine, or HC-3 treatments alone, but there were no significant differences in plasma glucose with combined treatment of L-NAME and atropine or L-NAME and HC-3. EA decreased FFA levels and enhanced insulin signal protein (IRS1) and nNOS activities in skeletal muscle during IVGTT. In summary, EA stimulated cholinergic nerves and nitric oxide synthase for lowering plasma FFA levels to improve glucose tolerance.
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Figueiredo LM, Silva AH, Prado Neto AXD, Hissa MN, Vasconcelos PRLD, Guimarães SB. Electroacupuncture stimulation using different frequencies (10 and 100 Hz) changes the energy metabolism in induced hyperglycemic rats. Acta Cir Bras 2011; 26 Suppl 1:47-52. [DOI: 10.1590/s0102-86502011000700010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
PURPOSE: To investigate the effect of 10 and 100 Hz peripheral electro-estimulation (electroacupuncture, EAc) at Zusanli (ST-36) and Zhongwan (CV-12) acupoints on blood glucose and lactate levels and tissue (liver and kidney) concentrations of lactate in hyperglycemic induced anesthetized rats. METHODS: Thirty-six rats were randomly assigned to 3 groups (n=12): G1: basal (anesthesia: ketamine (90mg kg-1 body weight)+ xylazine (10mg/kg-1 body weight, i.p.); G2: anesthesia+EA10Hz EAc and G3: anesthesia+EA100Hz EAc). EAc stimulation was delivered for 30 min at 10 mA at selected acupoints. Blood and tissue (kidney, liver) samples were collected at the end of the EAc application (n=6, T30) and 30 minutes later (n=6, T60) for biochemical analysis. G1 samples were collected at the same timepoints. ANOVA followed by Tukey's Multiple Comparison Test was used for statistical analyses. RESULTS: Glycemia decreased significantly (p<0.001) in G2/G3 rats in all timepoints. Kidney and liver lactate concentrations decreased significantly (p>0.001) in G2/G3 rats at T-60 and at T30 timepoints in G2 compared with G1 rats. Lactacedemia decreased significantly at T30 timepoint in G2 compared with G1 rats. G1/G3 tissue lactate levels were not different. CONCLUSIONS: Electroacupuncture (10 Hz) applied to St-36 and CV-12 acupoints decreases glycemia and lactacedemia and liver and kidney lactate concentrations. We hypothesize that the decrease in lactate levels may be related to greater energy production due to enhanced lactate to pyruvate conversion. Higher frequency (100 Hz) failed to promote the same effect.
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Johansson J, Feng Y, Shao R, Lönn M, Billig H, Stener-Victorin E. Intense electroacupuncture normalizes insulin sensitivity, increases muscle GLUT4 content, and improves lipid profile in a rat model of polycystic ovary syndrome. Am J Physiol Endocrinol Metab 2010; 299:E551-9. [PMID: 20663984 DOI: 10.1152/ajpendo.00323.2010] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Polycystic ovary syndrome (PCOS) is associated with hyperandrogenism and insulin resistance, possibly reflecting defects in skeletal muscle and adipocyte insulin signaling. Low-frequency (2 Hz) electroacupuncture (EA) increases insulin sensitivity in female rats with dihydrotestosterone (DHT)-induced PCOS, but the mechanism is unclear. We hypothesized that low-frequency EA regulates mediators involved in skeletal muscle glucose uptake and metabolism and alters the lipid profile in rats with DHT-induced PCOS. To test this hypothesis, we implanted in prepubescent female rats 90-day continuous-release pellets containing DHT (PCOS). At 70 days of age, the rats were randomly subdivided into two groups: one received low-frequency EA (evoking muscle twitches) for 20-25 min five times/wk for 4-5 wk; the other did not. Controls were implanted with pellets containing vehicle only. All three groups were otherwise handled similarly. Lipid profile was measured in fasting blood samples. Insulin sensitivity was determined by euglycemic hyperinsulinemic clamp, soleus muscle protein expression of glucose transporter 4 (GLUT4), and phosphorylated and nonphosphorylated Akt, and Akt substrate of 160 kDa was determined by Western blot analysis and GLUT4 location by immunofluorescence staining. PCOS EA rats had normalized insulin sensitivity, lower levels of total high-density lipoprotein and low-density lipoprotein cholesterol, and increased expression of GLUT4 in different compartments of skeletal muscle compared with PCOS rats. Total weight and body composition did not differ in the groups. Thus, in rats with DHT-induced PCOS, low-frequency EA has systemic and local effects involving intracellular signaling pathways in muscle that may, at least in part, account for the marked improved insulin sensitivity.
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Affiliation(s)
- Julia Johansson
- Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Higashimura Y, Shimoju R, Maruyama H, Kurosawa M. Electro-acupuncture improves responsiveness to insulin via excitation of somatic afferent fibers in diabetic rats. Auton Neurosci 2009; 150:100-3. [PMID: 19556171 DOI: 10.1016/j.autneu.2009.06.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Revised: 06/01/2009] [Accepted: 06/05/2009] [Indexed: 11/19/2022]
Abstract
The effects of electro-acupuncture (EA) on plasma concentration of glucose and on responsiveness to insulin were examined in an animal model of diabetes, the streptozotocin-treated rat. Two weeks after treatment with streptozotocin, rats were anesthetized with urethane-chloralose and subjected to the EA for 10 min delivered to the tibialis anterior muscle of one side. The stimulation produced no significant changes in plasma glucose concentration. In contrast, EA increased the response of plasma glucose to insulin (0.2 U kg(-1)). The effect of EA on the responsiveness to insulin was abolished by section of both sciatic and femoral nerves ipsilateral to the side of the EA. These results show that EA in diabetic rats has no effect on plasma glucose concentration while it augments the responsiveness to insulin, and we show that this occurs via a mechanism that involves the somatic afferent nerves.
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Affiliation(s)
- Yukie Higashimura
- Center for Medical Science, International University of Health and Welfare, Otawara, Tochigi, Japan
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Effect of Zusanli (ST.36) Electroacupuncture at Two Frequencies on the Bioavailability of 99mTc-Sodium Pertechnetate and on Labeling of Blood Constituents in Rats. J Acupunct Meridian Stud 2009; 2:135-46. [DOI: 10.1016/s2005-2901(09)60046-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Chang SL, Lin KJ, Lin RT, Hung PH, Lin JG, Cheng JT. Enhanced insulin sensitivity using electroacupuncture on bilateral Zusanli acupoints (ST 36) in rats. Life Sci 2006; 79:967-71. [PMID: 16762373 DOI: 10.1016/j.lfs.2006.05.005] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2005] [Revised: 03/10/2006] [Accepted: 05/06/2006] [Indexed: 10/24/2022]
Abstract
In this study, intravenous glucose tolerance test (ivGTT) and insulin challenge test (ICT) were applied to evaluate the influence of electroacupuncture (EA) on insulin sensitivity in rats. Firstly, hypoglycemic activity was confirmed on normal Wistar rats (36+/-12%) and streptozotocin (STZ)-induced diabetic rats (13+/-8%) after 60 min of 15 Hz EA on bilateral Zusanli acupoints. The rats were divided into the experiment group (EG) and control group (CG) randomly. After fasting, plasma glucose and insulin levels were assayed in the normal Wistar rats undergoing ivGTT. Plasma glucose levels and hypoglycemic activity were also evaluated in the normal Wistar rats and STZ diabetic rats during ICT. As the data showed, EA improved the glucose tolerance from 15 to 90 min (p<0.005 compared with the plasma glucose levels of the CG) during ivGTT. In addition, significant improvement in the Homeostasis Model Assessment (HOMA) index was found in the EG from 15 to 90 min (p<0.005 compared with the CG). More hypoglycemic activity was achieved in normal Wistar and STZ diabetic rats in the EG than in the CG (from 30 to 60 min) during ICT. In conclusion, the results suggest that 15 Hz EA at bilateral Zusanli acupoints improved glucose tolerance. Thus, EA should be considered as an alternative method for improving insulin sensitivity and/or increase insulin-hypoglycemic activity in rats.
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Affiliation(s)
- Shih-Liang Chang
- Graduate Institute of Integration of Chinese and Western Medicine, China Medical University, Taichung City, Taiwan, ROC.
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