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Kataoka J, Olsson M, Lindgren E, Larsson I, Schmidt J, Benrick A, Stener-Victorin E. Effects of weight loss intervention on anxiety, depression and quality of life in women with severe obesity and polycystic ovary syndrome. Sci Rep 2024; 14:13495. [PMID: 38866860 PMCID: PMC11169487 DOI: 10.1038/s41598-024-63166-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 05/26/2024] [Indexed: 06/14/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women that is associated with an increased risk of anxiety and depression and with a lower health-related quality of life (HRQoL). PCOS is closely associated with obesity, which per se can lead to symptoms of anxiety and depression and lower HRQoL. The first-line treatment for PCOS is weight loss through lifestyle intervention, which has been shown to improve all symptoms of the syndrome. The aim of this study was to investigate symptoms of anxiety and depression and HRQoL in women with severe obesity (BMI ≥ 35) with and without PCOS, and to evaluate the effect of a one-year structured weight loss intervention. A total of 246 women with severe obesity (PCOS n = 63, non-PCOS n = 183) were included. The comprehensive psychopathological rating scale self-rating scale for affective symptoms (CPRS-S-A) and the short form-36 (SF-36) were used to assess symptoms of anxiety and depression and HRQoL. In total 72 women of the 246 women with severe obesity completed a one-year weight loss programme and were followed up and compared with baseline data. In women with severe obesity, there were no differences in symptoms of anxiety and depression and HRQoL between women with and without PCOS at baseline. Clinically relevant anxiety symptoms were present in 71.3% (PCOS) and 65.6% (non-PCOS), and depression symptoms were present in 56.4% (PCOS) and 52.2% (non-PCOS). Significant weight loss improved physical HRQoL in all women, but reduced symptoms of anxiety and depression only in women without PCOS. There were no differences when comparing the changes between the groups. Women with severe obesity are severely affected by symptoms of anxiety and depression, independent of PCOS. Weight loss improved symptoms of anxiety and depression in women without PCOS, but there were no differences between groups in change from baseline to follow-up.Trial registration number: Clinical trial.gov: NCT01319162, March 18, 2011. Date of registration and enrolment of the first subject September 2011.
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Affiliation(s)
- Josefin Kataoka
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 430, 405 30, Gothenburg, Sweden
- Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Marie Olsson
- Department of Physiology and Pharmacology, Karolinska Institute, Biomedicum, B5, 171 77, Stockholm, Sweden
| | - Eva Lindgren
- Department of Physiology and Pharmacology, Karolinska Institute, Biomedicum, B5, 171 77, Stockholm, Sweden
| | - Ingrid Larsson
- Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 428, 405 30, Gothenburg, Sweden
| | - Johanna Schmidt
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 416 85, Gothenburg, Sweden
| | - Anna Benrick
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 430, 405 30, Gothenburg, Sweden
- Institute of Health Sciences, University of Skövde, Box 408, 541 28, Skövde, Sweden
| | - Elisabet Stener-Victorin
- Department of Physiology and Pharmacology, Karolinska Institute, Biomedicum, B5, 171 77, Stockholm, Sweden.
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Huang S, Yu C, Hu M, Wen Q, Wen X, Li S, Li K, Ma H. Electroacupuncture ameliorates hepatic defects in a rat model of polycystic ovary syndrome induced by letrozole and a high-fat diet. Acupunct Med 2024; 42:87-99. [PMID: 38044823 DOI: 10.1177/09645284231207863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
BACKGROUND This study was designed to evaluate the effects of low-frequency electroacupuncture (EA) on glucose and lipid disturbances in a rat model of polycystic ovary syndrome (PCOS) characterized by insulin resistance (IR) and hepatic steatosis. METHODS The PCOS rat model was induced by continuous administration of letrozole (LET) combined with a high-fat diet (HFD). Female Sprague-Dawley rats were divided into the following four groups: control, control + EA, LET + HFD and LET + HFD + EA. EA was administered five or six times a week with a maximum of 20 treatment sessions. Body weight, estrous cyclicity, hormonal status, glucose and insulin tolerance, lipid profiles, liver inflammation factors, liver morphology and changes in the phosphatidylinositol 3-kinase (PI3-K)/Akt (protein kinase B) pathway were evaluated. RESULTS The rat model presented anovulatory cycles, increased body weight, elevated testosterone, abnormal glucose and lipid metabolism, IR, liver inflammation, hepatic steatosis and dysregulation of the insulin-mediated PI3-K/Akt signaling axis. EA reduced fasting blood glucose, fasting insulin, area under the curve for glucose, homeostasis model assessment of IR indices, triglycerides and free fatty acids, and alleviated hepatic steatosis. Furthermore, low-frequency EA downregulated mRNA expression of tumor necrosis factor (TNF)-α and interleukin (IL)-6, upregulated mRNA expression of peroxisome proliferator-activated receptor (PPAR)-α, increased protein expression of phosphorylated (p)-Akt (Ser473), p-glycogen synthase kinase (GSK) 3β (Ser9) and glucose transporter 4 (GLUT4), increased the ratio of p-GSK3β to GSK3β and downregulated protein expression of GSK3β. CONCLUSION An obese PCOS rat model with IR and hepatic steatosis was successfully established by the combination of LET and HFD. EA improved dysfunctional glucose and lipid metabolism in this PCOS-IR rat model, and the molecular mechanism appeared to involve regulation of the expression of key molecules of the PI3-K/Akt insulin signaling pathway in the liver.
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Affiliation(s)
- Shiya Huang
- The Third Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chuyi Yu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Min Hu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qidan Wen
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaohui Wen
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shuna Li
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Kunyin Li
- The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hongxia Ma
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Wang MN, Zhai MX, Wang YT, Dai QF, Liu L, Zhao LP, Xia QY, Li S, Li B. Mechanism of Acupuncture in Treating Obesity: Advances and Prospects. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2024; 52:1-33. [PMID: 38351701 DOI: 10.1142/s0192415x24500010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Obesity is a common metabolic syndrome that causes a significant burden on individuals and society. Conventional therapies include lifestyle interventions, bariatric surgery, and pharmacological therapies, which are not effective and have a high risk of adverse events. Acupuncture is an effective alternative for obesity, it modulates the hypothalamus, sympathetic activity and parasympathetic activity, obesity-related hormones (leptin, ghrelin, insulin, and CCK), the brain-gut axis, inflammatory status, adipose tissue browning, muscle blood flow, hypoxia, and reactive oxygen species (ROS) to influence metabolism, eating behavior, motivation, cognition, and the reward system. However, hypothalamic regulation by acupuncture should be further demonstrated in human studies using novel techniques, such as functional MRI (fMRI), positron emission tomography (PET), electroencephalogram (EEG), and magnetoencephalography (MEG). Moreover, a longer follow-up phase of clinical trials is required to detect the long-term effects of acupuncture. Also, future studies should investigate the optimal acupuncture therapeutic option for obesity. This review aims to consolidate the recent improvements in the mechanism of acupuncture for obesity as well as discuss the future research prospects and potential of acupuncture for obesity.
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Affiliation(s)
- Mi-Na Wang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
- School of Traditional Chinese Medicine, School of Life Science, Beijing University of Chinese Medicine, Beijing 100029, P. R. China
| | - Miao-Xin Zhai
- Yinghai Hospital, Daxing District, Beijing 100163, P. R. China
| | - Yi-Tong Wang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
- School of Traditional Chinese Medicine, School of Life Science, Beijing University of Chinese Medicine, Beijing 100029, P. R. China
| | - Qiu-Fu Dai
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
| | - Lu Liu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
| | - Luo-Peng Zhao
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
| | - Qiu-Yu Xia
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
| | - Shen Li
- Department of Emergency, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, P. R. China
| | - Bin Li
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
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Qin H, Feng J, Wu X. Effects and mechanisms of acupuncture on women related health. Front Med 2024; 18:46-67. [PMID: 38151668 DOI: 10.1007/s11684-023-1051-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/30/2023] [Indexed: 12/29/2023]
Abstract
Globally, public health interventions have resulted in a 30-year increase in women's life expectancy. However, women's health has not increased when socioeconomic status is ignored. Women's health has become a major public health concern, for those women from developing countries are still struggling with infectious and labor-related diseases, and their counterparts in developed countries are suffering from physical and psychological disorders. In recent years, complementary and alternative medicine has attracted wide attentions with regards to maintaining women's health. Acupuncture, a crucial component of traditional Chinese medicine, has been used to treat many obstetric and gynecological diseases for thousands of years due to its analgesic and anti-inflammatory effects and its effects on stimulating the sympathetic/parasympathetic nervous system. To fully understand the mechanism through which acupuncture exerts its effects in these diseases would significantly extend the list of available interventions and would allow for more reasonable advice to be given to general practitioners. Therefore, by searching PubMed and CNKI regarding the use of acupuncture in treating obstetric and gynecological diseases, we aimed to summarize the proven evidence of using acupuncture in maintaining women's health by considering both its effectiveness and the underlying mechanisms behind its effects.
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Affiliation(s)
- Huichao Qin
- Department of Reproductive Medicine, Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, 150036, China
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Jiaxing Feng
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Xiaoke Wu
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China.
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Yang N, Ma K, Liu W, Zhang N, Shi Z, Ren J, Xu W, Li Y, Su R, Liang Y, Wang S, Li X. Serum metabolomics probes the molecular mechanism of action of acupuncture on metabolic pathways related to glucose metabolism in patients with polycystic ovary syndrome-related obesity. Biomed Chromatogr 2023; 37:e5710. [PMID: 37593801 DOI: 10.1002/bmc.5710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/03/2023] [Accepted: 07/17/2023] [Indexed: 08/19/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine syndrome, and obesity is the most common clinical manifestation. Acupuncture is effective in treating PCOS, but the differences in the biological mechanisms of acupuncture therapy and Western medicine treatment have not been determined. Thus, the purpose of this study was to find glucose metabolism-related pathways in acupuncture treatment and differentiate them from Western medical treatment. Sixty patients with PCOS-related obesity were randomly distributed into three groups: patients receiving (1) acupuncture treatment alone, (2) conventional Western medicine treatment, and (3) acupuncture combined with Western medicine treatment. A targeted metabolomics approach was used to identify small molecules and metabolites related to glucose metabolism in the serum of each group, and ultra-high-performance liquid chromatography-tandem mass spectrometry was used to analyze different metabolic fractions. The results showed acupuncture treatment modulates the activity of citric and succinic acids in the tricarboxylic acid cycle, regulates glycolytic and gluconeogenesis pathways, and improves the levels of sex hormones and energy metabolism. The intervention effects on the metabolic pathways were different between patients receiving combination therapy and patients receiving acupuncture therapy alone, suggesting that the dominant modulatory effect of Western drugs may largely conceal the efficacy of acupuncture intervention.
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Affiliation(s)
- Nan Yang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Ke Ma
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Weidong Liu
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Ning Zhang
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Zhouhua Shi
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jian Ren
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Wanli Xu
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Yuqiu Li
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Riliang Su
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Yanbo Liang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Shijun Wang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Xiuyang Li
- Postdoctoral Station, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
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Landgraaf RG, Bloem MN, Fumagalli M, Benninga MA, de Lorijn F, Nieuwdorp M. Acupuncture as multi-targeted therapy for the multifactorial disease obesity: a complex neuro-endocrine-immune interplay. Front Endocrinol (Lausanne) 2023; 14:1236370. [PMID: 37795371 PMCID: PMC10545882 DOI: 10.3389/fendo.2023.1236370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/29/2023] [Indexed: 10/06/2023] Open
Abstract
The prevalence of obesity has reached pandemic dimensions. It is associated with multiple comorbidities and is becoming a clinical and public health threat. Obesity is a multifactorial disease with a complex pathophysiology and interplay of various systems. A strong interplay exists between the neuro-endocrine system, the immune system with systemic chronic low-grade inflammation, and microbiome dysbiosis that can lead to the development of obesity, which in turn can exacerbate each of these factors, hence creating a vicious cycle. The conventional treatment with lifestyle modifications such as diet, physical exercise, pharmacotherapy, and bariatric surgery does not always result in sufficient weight control thus paving the way for other strategies. As one such strategy, acupuncture is increasingly used worldwide to treat obesity. This narrative review outlines the evidence for this neuro-endocrine-immune interplay in the pathophysiology of obesity. Furthermore, the existing experimental and clinical evidence of acupuncture as a multi-targeted therapy for obesity is explained and future research perspectives are discussed.
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Affiliation(s)
- Raymond Guy Landgraaf
- Department of Internal and Vascular Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands
- Sinomedica Gui Sheng Tang, Scientific Department, Lugano, Switzerland
| | - Michelle Nicté Bloem
- Emma Children’s Hospital, Amsterdam University Medical Center (UMC), Pediatric Gastroenterology, University of Amsterdam, Amsterdam, Netherlands
| | - Massimo Fumagalli
- Sinomedica Gui Sheng Tang, Scientific Department, Lugano, Switzerland
| | - Marc Alexander Benninga
- Emma Children’s Hospital, Amsterdam University Medical Center (UMC), Pediatric Gastroenterology, University of Amsterdam, Amsterdam, Netherlands
| | - Fleur de Lorijn
- Emma Children’s Hospital, Amsterdam University Medical Center (UMC), Pediatric Gastroenterology, University of Amsterdam, Amsterdam, Netherlands
| | - Max Nieuwdorp
- Department of Internal and Vascular Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands
- Department of Experimental Vascular Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands
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Zhao H, Zhang J, Cheng X, Nie X, He B. Insulin resistance in polycystic ovary syndrome across various tissues: an updated review of pathogenesis, evaluation, and treatment. J Ovarian Res 2023; 16:9. [PMID: 36631836 PMCID: PMC9832677 DOI: 10.1186/s13048-022-01091-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/26/2022] [Indexed: 01/12/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by chronic ovulation dysfunction and overabundance of androgens; it affects 6-20% of women of reproductive age. PCOS involves various pathophysiological factors, and affected women usually have significant insulin resistance (IR), which is a major cause of PCOS. IR and compensatory hyperinsulinaemia have differing pathogeneses in various tissues, and IR varies among different PCOS phenotypes. Genetic and epigenetic changes, hyperandrogenaemia, and obesity aggravate IR. Insulin sensitization drugs are a new treatment modality for PCOS. We searched PubMed, Google Scholar, Elsevier, and UpToDate databases in this review, and focused on the pathogenesis of IR in women with PCOS and the pathophysiology of IR in various tissues. In addition, the review provides a comprehensive overview of the current progress in the efficacy of insulin sensitization therapy in the management of PCOS, providing the latest evidence for the clinical treatment of women with PCOS and IR.
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Affiliation(s)
- Han Zhao
- grid.412467.20000 0004 1806 3501Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning 110000 People’s Republic of China
| | - Jiaqi Zhang
- grid.412467.20000 0004 1806 3501Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning 110000 People’s Republic of China
| | - Xiangyi Cheng
- grid.412467.20000 0004 1806 3501Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning 110000 People’s Republic of China
| | - Xiaozhao Nie
- grid.412467.20000 0004 1806 3501Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning 110000 People’s Republic of China
| | - Bing He
- Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, 110000, People's Republic of China.
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Liu Y, Sun N, Xiong J, Zhou Y, Ye X, Jiang H, Guo H, Zhi N, Lu J, He P, Yang H, Li Q, Sun R, He J. Modulation of cerebral cortex activity by acupuncture in patients with prolonged disorder of consciousness: An fNIRS study. Front Neurosci 2022; 16:1043133. [PMID: 36523434 PMCID: PMC9744766 DOI: 10.3389/fnins.2022.1043133] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/07/2022] [Indexed: 12/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Acupuncture is a promising non-pharmacological therapy for patients with prolonged disorder of consciousness (PDOC); however, its underlying mechanism remains uncertain. This study aimed to reveal the modulatory effects of acupuncture on the cerebral cortex activity among patients with PDOC. MATERIALS AND METHODS Twenty-eight PDOC patients were randomly assigned to the treatment (n = 14) or control (n = 14) group. The treatment group received one session of acupuncture, while the control group received one session of sham acupuncture. All patients underwent evaluation of the functional connectivity and activation response of the dorsolateral prefrontal cortex (DLPFC), primary motor cortex (M1), and primary somatosensory cortex (S1) via functional near-infrared spectroscopy. We further explored the potential correlation of the consciousness level and activation response/functional connectivity with acupuncture. RESULTS Compared to the control group, a single session of acupuncture significantly tended to enhance resting-state functional connectivity (rsFC) in DLPFC-M1, DLPFC-M1, and S1-S1. And the activation level of the DLPFC (both sides) in the acupuncture group is significantly higher than those in sham acupuncture group. However, no significant correlation was found between the consciousness level and activation response/functional connectivity. CONCLUSION One session of acupuncture has a significant modulation of rsFC and activation in the DLPFC, M1, and S1 with PDOC patients. Acupuncture-evoked effect may have some functional significance in PDOC patients. This is an important step toward exploring the acupuncture effects on PDOC patients.
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Affiliation(s)
- Yiwei Liu
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China
| | - Ning Sun
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China
| | - Jing Xiong
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China
| | - Yuanfang Zhou
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xiangyin Ye
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Hua Jiang
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China
| | - Hua Guo
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China
| | - Na Zhi
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jingkang Lu
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China
| | - Peijue He
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China
| | - Huilin Yang
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China
| | - Qingbin Li
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China
| | - Ruirui Sun
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jing He
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China
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Acupuncture for polycystic ovary syndrome – A cross-sectional survey of clinical practice amongst acupuncturists trained in reproductive medicine. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Wang J, Xia Q, Zhu F, Huang W, Meng Y, Wang Y, Liu Y, Liu X, Li H, Sun B. Effects of Acupuncture on Adverse Events in Colonoscopy: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Pain Ther 2022; 11:1095-1112. [PMID: 35922617 PMCID: PMC9633895 DOI: 10.1007/s40122-022-00415-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/07/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Acupuncture has gradually penetrated into many disciplines in clinical medicine, such as surgery, anesthesia, and outpatient examinations. Although a number of clinical trials have investigated the effects of acupuncture on colonoscopy, the results were inconsistent. In this meta-analysis, we analyzed the effects of acupuncture on colonoscopy to provide evidence for subsequent research and clinical application of acupuncture in colonoscopy. METHODS This meta-analysis was performed using Review Manager version 5.4 and Stata version 16 software. The primary outcome was the incidence of adverse events, and the secondary outcomes included patients' anxiety score before colonoscopy, time to insert the colonoscope, total detection time, propofol consumption, patients' pain score, and patient satisfaction rate. RESULTS The results showed that the incidence of adverse events (odds ratio [OR] 0.27, 95% confidence interval [CI] 0.16-0.43, P = 0.00, I2 = 25%), patients' pain score (mean difference [MD] - 1.03, 95% CI - 1.45 to - 0.62, P = 0.00, I2 = 94%), and time to insert the colonoscope (MD = - 2.54, 95% CI - 4.96 to - 0.13, P = 0.04, I2 = 0%) were significantly lower in the treatment group than in the control group. Compared with the control group, the satisfaction rate of patients (OR 2.53, 95% CI 1.56-4.10, P = 0.00, I2 = 47%) in the treatment group was significantly improved. There was no significant between-group difference in patients' anxiety score, the total detection time, and propofol dosage. CONCLUSIONS During colonoscopy, acupuncture can significantly reduce the incidence of adverse events, relieve patients' pain, and improve patient satisfaction. REGISTRATION PROSPERO registration number CRD42022324428.
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Affiliation(s)
- Jing Wang
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China
| | - Qing Xia
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Fangyi Zhu
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China
| | - Wei Huang
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China
| | - Yanting Meng
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China
| | - Yanping Wang
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China
| | - Yumei Liu
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China
| | - Xijun Liu
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China
| | - Hulun Li
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China. .,The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, People's Republic of China.
| | - Bo Sun
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China.
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11
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Wen Q, Hu M, Lai M, Li J, Hu Z, Quan K, Liu J, Liu H, Meng Y, Wang S, Wen X, Yu C, Li S, Huang S, Zheng Y, Lin H, Liang X, Lu L, Mai Z, Zhang C, Wu T, Ng EHY, Stener-Victorin E, Ma H. Effect of acupuncture and metformin on insulin sensitivity in women with polycystic ovary syndrome and insulin resistance: a three-armed randomized controlled trial. Hum Reprod 2022; 37:542-552. [PMID: 34907435 PMCID: PMC8888993 DOI: 10.1093/humrep/deab272] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 11/15/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Does acupuncture improve insulin sensitivity more effectively than metformin or sham acupuncture in women with polycystic ovary syndrome (PCOS) and insulin resistance (IR)? SUMMARY ANSWER Among women with PCOS and IR, acupuncture was not more effective than metformin or sham acupuncture in improving insulin sensitivity. WHAT IS KNOWN ALREADY Uncontrolled trials have shown that acupuncture improved insulin sensitivity with fewer side effects compared with metformin in women with PCOS and IR. However, data from randomized trials between acupuncture and metformin or sham acupuncture are lacking. STUDY DESIGN, SIZE, DURATION This was a three-armed randomized controlled trial enrolling a total of 342 women with PCOS and IR from three hospitals between November 2015 and February 2018, with a 3-month follow-up until October 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS Women aged from 18 to 40 years with PCOS and homeostasis model assessment of insulin resistance (HOMA-IR) ≥2.14 were randomly assigned (n = 114 per group) to receive true acupuncture plus placebo (true acupuncture), metformin plus sham acupuncture (metformin, 0.5 g three times daily) or sham acupuncture plus placebo (sham acupuncture) for 4 months, with an additional 3-month follow-up. True or sham acupuncture was given three times per week, and 0.5 g metformin or placebo was given three times daily. The primary outcome was change in HOMA-IR from baseline to 4 months after baseline visit. Secondary outcomes included changes in the glucose AUC during an oral glucose tolerance test, BMI and side effects at 4 months after baseline visit. MAIN RESULTS AND THE ROLE OF CHANCE After 4 months of treatment, the changes of HOMA-IR were -0.5 (decreased 14.7%) in the true acupuncture group, -1.0 (decreased 25.0%) in the metformin group and -0.3 (decreased 8.6%) in the sham acupuncture group, when compared with baseline. True acupuncture is not as effective as metformin in improving HOMA-IR at 4 months after baseline visit (difference, 0.6; 95% CI, 0.1-1.1). No significant difference was found in change in HOMA-IR between true and sham acupuncture groups at 4 months after baseline visit (difference, -0.2; 95% CI, -0.7 to 0.3). During the 4 months of treatment, gastrointestinal side effects were more frequent in the metformin group, including diarrhea, nausea, loss of appetite, fatigue, vomiting and stomach discomfort (31.6%, 13.2%, 11.4%, 8.8%, 14.0% and 8.8%, respectively). Bruising was more common in the true acupuncture group (14.9%). LIMITATIONS, REASONS FOR CAUTION This study might have underestimated the sample size in the true acupuncture group with 4 months of treatment to enable detection of statistically significant changes in HOMA-IR with fixed acupuncture (i.e. a non-personalized protocol). Participants who withdrew because of pregnancy did not have further blood tests and this can introduce bias. WIDER IMPLICATIONS OF THE FINDINGS True acupuncture did not improve insulin sensitivity as effectively as metformin in women with PCOS and IR, but it is better than metformin in improving glucose metabolism (which might reduce the risk of type 2 diabetes) and has less side effects. Metformin had a higher incidence of gastrointestinal adverse effects than acupuncture groups, and thus acupuncture might be a non-pharmacological treatment with low risk for women with PCOS. Further studies are needed to evaluate the effect of acupuncture combined with metformin on insulin sensitivity in these women. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by grants 2017A020213004 and 2014A020221060 from the Science and Technology Planning Project of Guangdong Province. The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER Clinicaltrials.gov number: NCT02491333. TRIAL REGISTRATION DATE 8 July 2015. DATE OF FIRST PATIENT’S ENROLLMENT 11 November 2015.
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Affiliation(s)
- Qidan Wen
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Min Hu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Maohua Lai
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Juan Li
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhenxing Hu
- Department of Gynecology, Xuzhou Maternity and Child Health Care Hospital, Xuzhou, Jiangsu, China
| | - Kewei Quan
- Department of Obstetrics and Gynecology, Dongguan Hospital of Traditional Chinese Medicine, Dongguan, Guangdong, China
| | - Jia Liu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hua Liu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yanbing Meng
- Department of Traditional Chinese Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Suling Wang
- Department of Traditional Chinese Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiaohui Wen
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Chuyi Yu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shuna Li
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shiya Huang
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yanhua Zheng
- Department of Traditional Chinese Medicine, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Han Lin
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xingyan Liang
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Lingjing Lu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhefen Mai
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Chunren Zhang
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Taixiang Wu
- Chinese Clinical Trial Registry, Shenzhen, China
| | - Ernest H Y Ng
- Department of Obstetrics and Gynecology, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Elisabet Stener-Victorin
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Hongxia Ma
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
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12
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Ye Y, Zhou CC, Hu HQ, Fukuzawa I, Zhang HL. Underlying mechanisms of acupuncture therapy on polycystic ovary syndrome: Evidences from animal and clinical studies. Front Endocrinol (Lausanne) 2022; 13:1035929. [PMID: 36353235 PMCID: PMC9637827 DOI: 10.3389/fendo.2022.1035929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder among women of reproductive age. Current standard treatment includes lifestyle change, oral pharmacological agents, and surgical modalities. However, the efficacy of current therapies is less than satisfactory. Clinical evidence has shown that acupuncture is effective for regulating hormone levels, promoting ovulation, and attenuating insulin resistance in patients with PCOS. Acupuncture may affect the production of β-endorphin, which may lead to gonadotropin-releasing hormone secretion and then affect ovulation, menstrual cycle, and fertility. The mechanism of acupuncture for patients with PCOS has not been comprehensively reviewed so far. Better understanding of the mechanisms of acupuncture would help popularize the use of acupuncture therapy for patients with PCOS. In this narrative review, we aimed to overview the potential mechanisms and evidence-based data of acupuncture on PCOS, and analyze the most frequently used acupoints based on animal and clinical studies. The results of this study will contribute to a better understanding of the current situation in this field.
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Affiliation(s)
- Yang Ye
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Cong-Cong Zhou
- School of Global Public Health, New York University, New York, NY, United States
| | - Hang-Qi Hu
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Ii Fukuzawa
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Hao-Lin Zhang
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
- *Correspondence: Hao-Lin Zhang,
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13
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Wang W, Wang J, Lv J, Yu C, Shao C, Tang Y, Guo Y, Bian Z, Du H, Yang L, Millwood IY, Walters RG, Chen Y, Chang L, Fan L, Chen J, Chen Z, Huang T, Li L. Association of heart rate and diabetes among 0.5 million adults in the China Kadoorie biobank: Results from observational and Mendelian randomization analyses. Nutr Metab Cardiovasc Dis 2021; 31:2328-2337. [PMID: 34052074 DOI: 10.1016/j.numecd.2021.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/06/2021] [Accepted: 04/16/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Observational studies have associated resting heart rate with incident diabetes. Whether the associations are causal remains unclear. We aimed to examine the shape and strength of the associations and assessed the causal relevance of such associations in Chinese adults. METHODS AND RESULTS The China Kadoorie Biobank enrolled 512,891 adults in China. Cox proportional hazard regression models was conducted to estimate hazard ratios (HRs) for the associations of resting heart rate with type 2 diabetes and total diabetes. Among 92,724 participants, 36 single-nucleotide polymorphisms (SNPs) related to resting heart rate were used to construct genetic risk score. We used Mendelian randomization analyses to make the causal inferences. During a median follow-up of 9 years, 7872 incident type 2 diabetes and 13,349 incident total diabetes were documented. After regression dilution bias adjustment, each 10 bpm higher heart rate was associated with about a 26% higher risk of type 2 diabetes (HR, 1.26 [95% CI, 1.23, 1.29]) and 23% higher risk of total diabetes (HR, 1.23 [95% CI, 1.20, 1.26]). Instrumental variable analyses showed participants at top quintile compared with those at bottom quintile had 30% higher risk for type 2 diabetes (HR, 1.30 [95% CI, 1.17, 1.43]), and 10% higher risk for total diabetes (HR, 1.10 [95% CI, 1.02, 1.20]). CONCLUSIONS This study provides evidence that resting heart rate is an important risk factor for diabetes risk. The results suggest that novel treatment approaches targeting reduction of high heart rate for incidence of diabetes may be worth further investigation.
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Affiliation(s)
- Wenxiu Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jingjia Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China; Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Chunli Shao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yida Tang
- Department of Cardiology, Peking University Third Hospital, Beijing, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom; Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom; Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Iona Y Millwood
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Robin G Walters
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom; Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Liang Chang
- NCDs Prevention and Control Department, Henan CDC, Henan, China
| | - Lei Fan
- NCDs Prevention and Control Department, Henan CDC, Henan, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Tao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China.
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China.
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14
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Morgalla MH, Fritschle H, Vosseler A, Benkendorff C, Lamprinou A, Heni M, Fritsche A. Influence of Spinal Cord Stimulation on Insulin Sensitivity in Chronic Pain Patients. Exp Clin Endocrinol Diabetes 2021; 130:17-21. [PMID: 34255321 DOI: 10.1055/a-1525-3339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND OBJECTIVE This prospective, sham-controlled, randomized, cross-over study (NCT03637075), was designed to test the hypothesis that spinal cord stimulation (SCS) for the treatment of pain can also improve glucose metabolism and insulin sensitivity when compared to sham stimulation. METHODS Ten non-diabetic participants (5 females, mean age 48.8 years) who had an SCS system implanted for the treatment of chronic neuropathic pain were studied. Whilst applying a hyperinsulinemic-euglycemic clamp, sham-stimulation and tonic stimulation were performed for 45 min (n=4) or 60 min (n=6) in each case randomly. The insulin sensitivity index and pain levels were determined. A second investigation, BurstDR stimulation was also conducted and the result was compared to that of sham stimulation (cross-over design). RESULTS The insulin sensitivity improved significantly under the tonic stimulation when compared to the sham stimulation (p=0.037). BurstDR stimulation independently did not lead to a significantly improved insulin sensitivity compared to that after sham stimulation (p=0.16). We also examined the pain during the test and found no significant difference between sham and tonic stimulation (p=0.687). CONCLUSION The results of this study show that tonic stimulation used for the treatment of pain could also improve glucose metabolism and insulin sensitivity. Further investigations are required to investigate the clinical relevance of the role of glucose metabolism in diabetic chronic pain participants and its underlying mechanisms.
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Affiliation(s)
| | | | - Andreas Vosseler
- Medical Clinic IV, University of Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | | | - Apostolia Lamprinou
- Medical Clinic IV, University of Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Martin Heni
- Medical Clinic IV, University of Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Andreas Fritsche
- Medical Clinic IV, University of Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
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15
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Interactive regulation of laryngeal cancer and neuroscience. Biochim Biophys Acta Rev Cancer 2021; 1876:188580. [PMID: 34129916 DOI: 10.1016/j.bbcan.2021.188580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 06/10/2021] [Accepted: 06/10/2021] [Indexed: 01/11/2023]
Abstract
Nerve fibres are distributed throughout the body along with blood and lymphatic vessels. The intrinsic morphological characteristics of nerves and the general characteristics of secretions in the tumour microenvironment provide a solid theoretical basis for exploring how neuronal tissue can influence the progression of laryngeal cancer (LC). The central nervous system (CNS) and the peripheral nervous system (PNS) jointly control many aspects of cancer and have attracted widespread attention in the study of the progression, invasion and metastasis of tumour tissue banks. Stress activates the neuroendocrine response of the human hypothalamus-pituitary-adrenal (HPA) axis. LC cells induce nerve growth in the microenvironment by releasing neurotrophic factors (NTFs), and they can also stimulate neurite formation by secreting axons and axon guides. Conversely, nerve endings secrete factors that attract LC cells; this is known as perineural invasion (PNI) and promotes the progression of the associated cancer. In this paper, we summarize the systematic understanding of the role of neuroregulation in the LC tumour microenvironment (TME) and ways in which the TME accelerates nerve growth, which is closely related to the occurrence of LC.
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16
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Lin Y, Wang X, Li XB, Wu BQ, Zhang ZH, Guo WH, Wu CC, Chen X, Chen ML, Dai Z, Chen FY, Zhu R, Liang CX, Tian YP, Yang G, Yan CQ, Lu J, Wang HY, Li JL, Tu JF, Li HW, Yang DD, Yu FT, Wang Y, Yang JW, Shi GX, Yan SY, Wang LQ, Liu CZ. Acupuncture for persistent atrial fibrillation after catheter ablation: study protocol for a pilot randomized controlled trial. Trials 2021; 22:35. [PMID: 33413569 PMCID: PMC7792186 DOI: 10.1186/s13063-020-04967-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 12/11/2020] [Indexed: 12/17/2022] Open
Abstract
Background Atrial fibrillation (AF) is a common arrhythmia, which is closely related to cardiovascular morbidity and mortality. Although acupuncture is used in the treatment of AF, the evidence is insufficient. The objective of this pilot trial is to evaluate the feasibility, preliminary efficacy, and safety of acupuncture in reducing AF burden for persistent AF after catheter ablation (CA). Methods and design This will be a multi-center, 3-arm, pilot randomized controlled trial in China. Sixty patients in total will be randomly assigned to the specific acupoints group, the non-specific acupoints group, or the non-acupoints group in a 1:1:1 ratio. The whole study period is 6 months, including a 3-month treatment period and a 3-month follow-up period. All patients will receive 18 sessions of acupuncture over 12 weeks after CA and appropriate post-ablation routine treatment. The primary outcome is AF burden at 6 months after CA measured by electrocardiography patch that can carry out a 7-day continuous ambulatory electrocardiographic monitoring. The secondary outcomes include AF burden at 3 months after CA, recurrence of AF, quality of life, etc. The adverse events will also be recorded. Discussion This pilot study will contribute to evaluating the feasibility, preliminary efficacy, and safety of acupuncture in reducing AF burden for persistent AF after CA. The results will be used for the sample size calculation of a subsequent large-scale trial. Trial registration Chinese Clinical Trial Registry ChiCTR2000030576. Registered on 7 March 2020. Supplementary information Supplementary information accompanies this paper at 10.1186/s13063-020-04967-y.
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Affiliation(s)
- Ying Lin
- Acupuncture Research Center, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Xian Wang
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing University Cardiology Research Institute of Traditional Chinese Medicine, Beijing, 100700, China
| | - Xue-Bin Li
- Department of Cardiology, Peking University People's Hospital, Beijing, 100044, China
| | - Bang-Qi Wu
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Zhao-Hui Zhang
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Wei-Hua Guo
- Department of Cardiology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Cun-Cao Wu
- Department of Cardiology, Peking University People's Hospital, Beijing, 100044, China
| | - Xin Chen
- Department of Cardiology, Tianjin First Center Hospital, Tianjin, 300192, China
| | - Ming-Long Chen
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Zhong Dai
- Department of Traditional Chinese Medicine, Peking University People's Hospital, Beijing, 100044, China
| | - Fu-Yan Chen
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Rui Zhu
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Chu-Xi Liang
- Department of Traditional Chinese Medicine, Peking University People's Hospital, Beijing, 100044, China
| | - Yun-Peng Tian
- Department of Cardiology, Tianjin First Center Hospital, Tianjin, 300192, China
| | - Gang Yang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Chao-Qun Yan
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Jing Lu
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Hai-Ying Wang
- Department of Cardiology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Jin-Ling Li
- Acupuncture Research Center, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Jian-Feng Tu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, 100010, China
| | - He-Wen Li
- Acupuncture Research Center, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Dan-Dan Yang
- Department of Cardiology, Peking University People's Hospital, Beijing, 100044, China
| | - Fang-Ting Yu
- Acupuncture Research Center, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Yu Wang
- Acupuncture Research Center, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Jing-Wen Yang
- Acupuncture Research Center, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Guang-Xia Shi
- Acupuncture Research Center, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Shi-Yan Yan
- Acupuncture Research Center, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Li-Qiong Wang
- Acupuncture Research Center, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China.
| | - Cun-Zhi Liu
- Acupuncture Research Center, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
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Peng Y, Yang X, Luo X, Liu C, Cao X, Wang H, Guo L. Novel mechanisms underlying anti-polycystic ovary like syndrome effects of electroacupuncture in rats: suppressing SREBP1 to mitigate insulin resistance, mitochondrial dysfunction and oxidative stress. Biol Res 2020; 53:50. [PMID: 33109277 PMCID: PMC7590702 DOI: 10.1186/s40659-020-00317-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 10/15/2020] [Indexed: 12/23/2022] Open
Abstract
Background Acupuncture, a therapy of traditional Chinese medicine, is confirmed to exert the therapeutic action on polycystic ovary syndrome (PCOS). However, the detailed therapeutic mechanisms of acupuncture in PCOS remain ambiguous. In this study, we further investigated whether electroacupuncture (EA) alleviated PCOS-like symptoms in rats via regulating a metabolic regulator, sterol regulatory element binding protein-1 (SREBP1). Methods The PCOS-like rat model was built by hypodermic injection with dehydroepiandrosterone (DHEA). The rats were subjected to EA intervention (ST29 and SP6 acupuncture points) for 5 weeks. Primary granulosa cells were isolated from control and PCOS-like rats for evaluating insulin resistance, mitochondrial dysfunction and oxidative stress in vitro. Results The expression of SREBP1 was increased in PCOS-like rats, which was suppressed by EA treatment. In addition, lentivirus-mediated overexpression of SREBP1 restrained EA treatment-induced improvement in pathological changes, serum hormone levels and insulin resistance in rats. In addition, overexpression of SREBP1 repressed insulin-stimulated phosphorylation of insulin receptor β (IR) and AKT in primary granulosa cells. Moreover, upregulation of SREBP1 further exacerbated mitochondrial dysfunction and oxidative stress in granulosa cells isolated from PCOS-like rats. Mechanically, EA treatment suppressed SREBP1 expression through inducing the activation of AMP-activated protein kinase (AMPK) signaling pathway in PCOS-like rats. Conclusion EA intervention alleviated PCOS-like symptoms in rats via improving IR, mitochondrial dysfunction and oxidative stress through regulating SREBP1, a lipid metabolism regulator. Our findings illuminate the novel protective mechanisms of EA in the treatment of PCOS.
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Affiliation(s)
- Yan Peng
- Disease Prevention Center, The First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, People's Republic of China
| | - Xinming Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, People's Republic of China
| | - Xi Luo
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, People's Republic of China
| | - Chunhong Liu
- College of Basic Medicine Sciences, Heilongjiang University of Chinese Medicine, Harbin, 150040, People's Republic of China
| | - Xia Cao
- Document Retrival Center, Heilongjiang University of Chinese Medicine, Harbin, 150040, People's Republic of China
| | - Hongyan Wang
- Department of Gynecological Oncology, Cancer Hospital of Harbin Medical University, Harbin, 150081, People's Republic of China
| | - Liyuan Guo
- Department of Gynecological Oncology, Cancer Hospital of Harbin Medical University, Harbin, 150081, People's Republic of China.
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18
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Peng Y, Guo L, Gu A, Shi B, Ren Y, Cong J, Yang X. Electroacupuncture alleviates polycystic ovary syndrome-like symptoms through improving insulin resistance, mitochondrial dysfunction, and endoplasmic reticulum stress via enhancing autophagy in rats. Mol Med 2020; 26:73. [PMID: 32698821 PMCID: PMC7374902 DOI: 10.1186/s10020-020-00198-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/13/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Electroacupuncture (EA), a treatment derived from traditional Chinese medicine, can effectively improve hyperandrogenism and insulin resistance in patients with polycystic ovary syndrome (PCOS), however, its underlying mechanisms remain obscure. This study aimed to investigate whether EA could mitigate PCOS-like symptoms in rats by regulating autophagy. METHODS A rat model of PCOS-like symptoms was established by subcutaneous injection with dehydroepiandrosterone (DHEA), and then EA treatment at acupoints (ST29 and SP6) was carried out for 5 weeks. To inhibit autophagy in rats, intraperitoneal injection with 0.5 mg/kg 3-MA (an autophagy inhibitor) was performed at 30 min before each EA treatment. RESULTS EA intervention alleviated PCOS-like symptoms in rats, which was partly counteracted by the combination with 3-MA. Moreover, DHEA-exposure-induced deficient autophagy in skeletal muscle was improved by EA treatment. EA-mediated improvements in insulin resistance, mitochondrial dysfunction, and endoplasmic reticulum (ER) stress in PCOS-like rats were counteracted by 3-MA pretreatment. Mechanically, EA attenuated autophagy deficiency-mediated insulin resistance in PCOS-like rats via inactivating mTOR/4E-BP1 signaling pathway. CONCLUSIONS Taken together, our findings indicate that EA treatment ameliorates insulin resistance, mitochondrial dysfunction, and ER stress through enhancing autophagy in a PCOS-like rat model. Our study provides novel insight into the mechanisms underlying the treatment of EA in PCOS, which offers more theoretic foundation for its clinical application.
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Affiliation(s)
- Yan Peng
- Disease Prevention Center, The First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, People's Republic of China
| | - Liyuan Guo
- Department of Gynecological Oncology, Cancer Hospital of Harbin Medical University, Harbin, 150081, People's Republic of China
| | - Anxin Gu
- Department of Radiation oncology, Cancer Hospital of Harbin Medical University, Harbin, 150081, People's Republic of China
| | - Beibei Shi
- Graduate School, Heilongjiang University of Chinese Medicine, Harbin, 150040, People's Republic of China
| | - Yukun Ren
- Graduate School, Heilongjiang University of Chinese Medicine, Harbin, 150040, People's Republic of China
| | - Jing Cong
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, People's Republic of China
| | - Xinming Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, People's Republic of China.
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19
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Huhtaniemi IT. Electroacupuncture Mimics Exercise in Affecting Gene Expression of Skeletal Muscle. J Clin Endocrinol Metab 2020; 105:5840706. [PMID: 32428230 DOI: 10.1210/clinem/dgaa283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 05/13/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Ilpo T Huhtaniemi
- Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, Hammersmith Hospital Campus, London, UK
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20
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Benrick A, Pillon NJ, Nilsson E, Lindgren E, Krook A, Ling C, Stener-Victorin E. Electroacupuncture Mimics Exercise-Induced Changes in Skeletal Muscle Gene Expression in Women With Polycystic Ovary Syndrome. J Clin Endocrinol Metab 2020; 105:5813905. [PMID: 32232327 PMCID: PMC7185955 DOI: 10.1210/clinem/dgaa165] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 03/27/2020] [Indexed: 12/29/2022]
Abstract
CONTEXT Autonomic nervous system activation mediates the increase in whole-body glucose uptake in response to electroacupuncture but the mechanisms are largely unknown. OBJECTIVE To identify the molecular mechanisms underlying electroacupuncture-induced glucose uptake in skeletal muscle in insulin-resistant overweight/obese women with and without polycystic ovary syndrome (PCOS). DESIGN/PARTICIPANTS In a case-control study, skeletal muscle biopsies were collected from 15 women with PCOS and 14 controls before and after electroacupuncture. Gene expression and methylation was analyzed using Illumina BeadChips arrays. RESULTS A single bout of electroacupuncture restores metabolic and transcriptional alterations and induces epigenetic changes in skeletal muscle. Transcriptomic analysis revealed 180 unique genes (q < 0.05) whose expression was changed by electroacupuncture, with 95% of the changes towards a healthier phenotype. We identified DNA methylation changes at 304 unique sites (q < 0.20), and these changes correlated with altered expression of 101 genes (P < 0.05). Among the 50 most upregulated genes in response to electroacupuncture, 38% were also upregulated in response to exercise. We identified a subset of genes that were selectively altered by electroacupuncture in women with PCOS. For example, MSX1 and SRNX1 were decreased in muscle tissue of women with PCOS and were increased by electroacupuncture and exercise. siRNA-mediated silencing of these 2 genes in cultured myotubes decreased glycogen synthesis, supporting a role for these genes in glucose homeostasis. CONCLUSION Our findings provide evidence that electroacupuncture normalizes gene expression in skeletal muscle in a manner similar to acute exercise. Electroacupuncture might therefore be a useful way of assisting those who have difficulties performing exercise.
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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 Sciences, University of Skövde, Skövde, Sweden
- Correspondence and Reprint Requests: Anna Benrick, University of Gothenburg, Institute of Neuroscience and Physiology, Department of Physiology, Box 423, 405 30 Gothenburg, Sweden. E-mail: ; Elisabet Stener-Victorin- reprint requests, Karolinska Institutet, Department of Physiology and Pharmacology, Biomedicum, B5, Solnavägen 9, 171 77 Stockholm, Sweden. E-mail:
| | - Nicolas J Pillon
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Emma Nilsson
- Epigenetics and Diabetes Unit, Department of Clinical Sciences, Lund University Diabetes Centre, Lund University, Scania University Hospital, Malmö, Sweden
| | - Eva Lindgren
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Anna Krook
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Charlotte Ling
- Epigenetics and Diabetes Unit, Department of Clinical Sciences, Lund University Diabetes Centre, Lund University, Scania University Hospital, Malmö, Sweden
| | - Elisabet Stener-Victorin
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
- Correspondence and Reprint Requests: Anna Benrick, University of Gothenburg, Institute of Neuroscience and Physiology, Department of Physiology, Box 423, 405 30 Gothenburg, Sweden. E-mail: ; Elisabet Stener-Victorin- reprint requests, Karolinska Institutet, Department of Physiology and Pharmacology, Biomedicum, B5, Solnavägen 9, 171 77 Stockholm, Sweden. E-mail:
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21
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Li J, Wu W, Stener-Victorin E, Ng EHY, Li RHW, Li M, Liu H, Lai M, Meng Y, Zheng Y, Xia Y, Ma H. A prospective pilot study of the effect of acupuncture on insulin sensitivity in women with polycystic ovary syndrome and insulin resistance. Acupunct Med 2020; 38:310-318. [PMID: 32249617 DOI: 10.1177/0964528420902144] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To test the hypothesis that acupuncture improves insulin sensitivity in women with polycystic ovary syndrome (PCOS) and insulin resistance (IR). DESIGN Prospective pilot study. SETTING Guangzhou, China, 2014-2016. PARTICIPANTS Eighty women with PCOS aged 18-40 years with body mass index (BMI) above 18.5 kg/m2 and with homeostatic model assessment for insulin resistance (HOMA-IR) index ⩾2.14. INTERVENTIONS Subjects received acupuncture with combined manual and low-frequency electrical stimulation of the needles three times per week for 6 months. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the change in HOMA-IR after 6 months of acupuncture relative to baseline. Secondary outcomes included changes after 6 months of acupuncture and at 3 months of follow-up (both relative to baseline) in oral glucose tolerance test (OGTT) parameters (glucose and insulin levels), anthropometric measurements, and circulating metabolic and endocrine variables. RESULTS HOMA-IR and fasting plasma glucose and insulin levels were significantly decreased after 6 months of acupuncture, and both HOMA-IR and fasting insulin remained significantly decreased at 3 months of follow-up. In a subgroup analysis of normal-weight and overweight/obese women, HOMA-IR was reduced after 6 months of acupuncture in both subgroups, but there was no significant difference between the two groups. CONCLUSIONS Acupuncture treatment in Chinese women with PCOS and IR was associated with an encouraging improvement in insulin sensitivity. Further randomized controlled studies are required to confirm the efficacy of acupuncture for this indication.
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Affiliation(s)
- Juan Li
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wanting Wu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Sci-tech Industrial Park, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Elisabet Stener-Victorin
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Ernest Hung Yu Ng
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong Special Administrative Region, China.,Key Laboratory of Fertility Regulation, Department of Obstetrics and Gynaecology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Raymond Hang Wun Li
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong Special Administrative Region, China.,Key Laboratory of Fertility Regulation, Department of Obstetrics and Gynaecology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Meifang Li
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hua Liu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Maohua Lai
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yanbing Meng
- Department of Traditional Chinese Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yanhua Zheng
- Department of Traditional Chinese Medicine, The Fourth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yang Xia
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hongxia Ma
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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22
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Huang S, Hu M, Ng EHY, Stener-Victorin E, Zheng Y, Wen Q, Wang C, Lai M, Li J, Gao X, Wang X, Hu Z, Xia T, Hu R, Liu J, Wen X, Li S, Quan K, Liang X, Shang H, Ma H, Qiao J. A multicenter randomized trial of personalized acupuncture, fixed acupuncture, letrozole, and placebo letrozole on live birth in infertile women with polycystic ovary syndrome. Trials 2020; 21:239. [PMID: 32131886 PMCID: PMC7057514 DOI: 10.1186/s13063-020-4154-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 02/10/2020] [Indexed: 11/25/2022] Open
Abstract
Background Traditional Chinese medicine (TCM) usually involves syndrome differentiation and treatment. Acupuncture, one form of TCM, requires the selection of appropriate acupoints and needling techniques, but many clinical trials on acupuncture have used fixed acupuncture protocols without accounting for individual patient differences. We have designed a multicenter randomized controlled trial (RCT) to evaluate whether personalized or fixed acupuncture increases the likelihood of live births in infertile women with polycystic ovary syndrome (PCOS) compared with letrozole or placebo letrozole. We hypothesize that letrozole is more effective than personalized acupuncture, which in turn is more effective than fixed acupuncture, and that placebo letrozole is the least effective intervention. Moreover, we hypothesize that personalized acupuncture is more likely to reduce the miscarriage rate and the risk of pregnancy complications compared with letrozole. Methods/design The study is designed as an assessor-blinded RCT. A total of 1100 infertile women with PCOS will be recruited from 28 hospitals and randomly allocated to 4 groups: personalized acupuncture, fixed acupuncture, letrozole, or placebo letrozole. They will receive treatment for 16 weeks, and the primary outcome is live birth. Secondary outcomes include ovulation rate, conception rate, pregnancy rate, pregnancy loss rate, changes in hormonal and metabolic parameters, and changes in quality of life scores. Adverse events will be recorded throughout the trial. All statistical analyses will be performed using IBM SPSS Statistics version 21.0 software (IBM Corp., Armonk, NY, USA), and a P value < 0.05 will be considered statistically significant. Discussion This study will be the first multicenter RCT to compare the effect of personalized or fixed acupuncture with letrozole or placebo letrozole on live birth in infertile women with PCOS. The findings will inform whether personalized acupuncture therapy can be considered an alternative treatment to improve the live birth rate in infertile women with PCOS. Trial registration ClinicalTrials.gov, NCT03625531. Registered on July 13, 2018. Chinese Clinical Trial Registry, ChiCTR1800017304. Registered on July 23, 2018.
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Affiliation(s)
- Shiya Huang
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Min Hu
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Ernest Hung Yu Ng
- Department of Obstetrics and Gynecology, University of Hong Kong, Hong Kong, Special Administrative Region, China
| | - Elisabet Stener-Victorin
- Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China.,Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Yanhua Zheng
- Department of Traditional Chinese Medicine, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Qidan Wen
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Cong Wang
- Department of Traditional Therapy, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Maohua Lai
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Juan Li
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xingcheng Gao
- Department of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xinhua Wang
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhenxing Hu
- Department of Gynecology, Xuzhou Maternity and Child Health Care Hospital, Xuzhou, Jiangsu, China
| | - Tian Xia
- Center for Reproductive Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Rongkui Hu
- Department of Reproductive Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jianping Liu
- Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China.,Centre for Evidence Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaohui Wen
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shuna Li
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Kewei Quan
- Department of Obstetrics and Gynecology, Dongguan Hospital of Traditional Chinese Medicine, Dongguan, Guangdong, China
| | - Xingyan Liang
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hongcai Shang
- Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China.,Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Hongxia Ma
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China. .,Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China.
| | - Jie Qiao
- Department of Obstetrics and Gynecology, Third Hospital, Peking University, Beijing, China.
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23
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Shu Q, Chen L, Wu S, Li J, Liu J, Xiao L, Chen R, Liang F. Acupuncture Targeting SIRT1 in the Hypothalamic Arcuate Nucleus Can Improve Obesity in High-Fat-Diet-Induced Rats with Insulin Resistance via an Anorectic Effect. Obes Facts 2020; 13:40-57. [PMID: 31935731 PMCID: PMC7105640 DOI: 10.1159/000503752] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 09/26/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To investigate the anorexigenic and anti-obesity effectiveness of electroacupuncture (EA) on high-fat-diet-induced (HFDI) obese rats with insulin resistance (IR) and to reveal the possible mechanisms of EA affecting SIRT1 (silent mating type information regulation 2 homolog 1) in the central nervous system (CNS). METHODS We divided 60 rats into 6 groups. All interventions, including EA and intracerebroventricular administration, were performed after 8 weeks of model establishment. We tested obesity phenotypes like body weight (BW) gain; food intake; and IR levels including glucose infusion rate, intraperitoneal insulin tolerance test (IPITT), and intraperitoneal glucose tolerance test (IPGTT) during treatment. We detected protein expression and microscopic locations in hypothalamic SIRT1, the transcription factor FOXO1 (forkhead box protein O1), acetylated FOXO1 (Ac-FOXO1), pro-opiomelanocortin (POMC), and neuropeptide Y (NPY) via Western blotting and immunofluorescence, and monitored gene expression by real-time polymerase chain reaction. RESULTS Like the SIRT1 agonist, EA suppressed BW gain and IR levels in obese rats, but this was only partially blocked by the SIRT1 antagonist. EA could upregulate protein expression of hypothalamic SIRT1 and downregulate the acetylation level of FOXO1 in the hypothalamic arcuate nucleus (ARC), which decreased gene expression of NPY and increased that of POMC. The agonist targeted the hypothalamic SIRT1 gene, unlike EA, which targeted posttranscriptional regulation. CONCLUSION EA could improve obesity in HFDI rats with IR via its anorectic effect. This effect targeted posttranscriptional regulation of the SIRT1 gene, which induced upregulation of ARC FOXO1 deacetylation and mediated the gene expression of POMC and NPY.
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Affiliation(s)
- Qing Shu
- Department of Rehabilitation, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
- Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, China
| | - Li Chen
- College of Acupuncture, Moxibustion and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
- Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, China
| | - Song Wu
- College of Acupuncture, Moxibustion and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
- Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, China
| | - Jia Li
- College of Acupuncture, Moxibustion and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
- Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, China
| | - Jianmin Liu
- College of Acupuncture, Moxibustion and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
- Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, China
| | - Ling Xiao
- Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, China
- School of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Rui Chen
- Department of Traditional Chinese Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fengxia Liang
- College of Acupuncture, Moxibustion and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
- Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, China
- *Fengxia Liang, Hubei University of Chinese Medicine, 1 Tanhualin, Wuchang District, Wuhan, Hubei 430061 (China), E-Mail , Rui Chen, Department of Traditional Chinese Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Street, Wuhan, Hubei 430022 (China), E-Mail
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24
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Jo BG, Kim NH, Namgung U. Sympathetic Nervous Activity is Involved in the Anti-Inflammatory Effects by Electroacupuncture Stimulation. ACTA ACUST UNITED AC 2019. [DOI: 10.14406/acu.2019.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Byung Gon Jo
- Department of Korean Medicine, Daejeon University
| | - Nam Hoon Kim
- Department of Korean Medicine, Daejeon University
| | - Uk Namgung
- Department of Korean Medicine, Daejeon University
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25
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Vázquez-Martínez ER, Gómez-Viais YI, García-Gómez E, Reyes-Mayoral C, Reyes-Muñoz E, Camacho-Arroyo I, Cerbón M. DNA methylation in the pathogenesis of polycystic ovary syndrome. Reproduction 2019; 158:R27-R40. [DOI: 10.1530/rep-18-0449] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 04/08/2019] [Indexed: 12/12/2022]
Abstract
Polycystic ovary syndrome (PCOS) is the leading endocrine and metabolic disorder in premenopausal women characterized by hyperandrogenism and abnormal development of ovarian follicles. To date, the PCOS etiology remains unclear and has been related to insulin resistance, obesity, type 2 diabetes mellitus, cardiovascular disease and infertility, among other morbidities. Substantial evidence illustrates the impact of genetic, intrauterine and environmental factors on the PCOS etiology. Lately, epigenetic factors have garnered considerable attention in the pathogenesis of PCOS considering that changes in the content of DNA methylation, histone acetylation and noncoding RNAs have been reported in various tissues of women with this disease. DNA methylation is changed in the peripheral and umbilical cord blood, as well as in ovarian and adipose tissue of women with PCOS, suggesting the involvement of this epigenetic modification in the pathogenesis of the disease. Perhaps, these defects in DNA methylation promote the deregulation of genes involved in inflammation, hormone synthesis and signaling and glucose and lipid metabolism. Research on the role of DNA methylation in the pathogenesis of PCOS is just beginning, and several issues await investigation. This review aims to provide an overview of current research focused on DNA methylation and PCOS, as well as discuss the perspectives regarding this topic.
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26
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Abstract
Objective: To confirm that acupuncture applied to patients would improve the clinical curative effect and accelerate the patient's recovery by introducing the application of acupuncture in pre-operation, during operation, and post-operation. Data sources: Literature cited in this review was retrieved from PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) and was primarily published in English or Chinese from 2010 to 2018, with keywords of “acupuncture,” “electroacupuncture,” “perioperative period,” “sedation,” “analgesia,” and “recovery.” Relevant citations in the retrieved articles were also screened to include more data. Study selection: All retrieved literature was scrutinized, most typical articles related on perioperative acupuncture application in clinical study were reviewed. Results: Acupuncture could relieve anxiety and stress during the preoperative stage. It reduces the usage of narcotics and stress response, and maintains the respiratory stability and homeostasis during surgery. It also exerts a protective effect on vital organs, and during the postoperative stages, enhances the recovery while effectively alleviating the postoperative pain. This phenomenon prevents common postoperative discomforts such as nausea and vomiting. In addition, it might improve the patients’ long-term prognosis. Conclusions: The novel concept “perioperative acupuncture medicine” is to focus on the optimal treatment in the perioperative period of surgical patients. The review reveals the important role of acupuncture in enhancing rapid recovery of patients during the perioperative period.
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27
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Lu SF, Tang YX, Zhang T, Fu SP, Hong H, Cheng Y, Xu HX, Jing XY, Yu ML, Zhu BM. Electroacupuncture Reduces Body Weight by Regulating Fat Browning-Related Proteins of Adipose Tissue in HFD-Induced Obese Mice. Front Psychiatry 2019; 10:353. [PMID: 31244685 PMCID: PMC6580183 DOI: 10.3389/fpsyt.2019.00353] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 05/03/2019] [Indexed: 02/05/2023] Open
Abstract
Objective: This study investigated the influence of electroacupuncture (EA) and its potential underlying mechanisms on adipose tissue in obese mice. Methods: Three-week-old male C56BL/6 mice were randomly divided to feed or not to feed high-fat diet (HFD), named HFD group and chow diet (CD) group, respectively. After 12 weeks, CD and HFD mice were randomly divided into two groups, respectively, to receive or not receive EA for 4 weeks. Body weight (BW) was monitored. Intraperitoneal glucose tolerance test and metabolic chamber recordings were performed. Blood samples and adipose tissue were collected for the analysis of leptin, triglyceride levels, and fat browning-related proteins. Results: EA significantly reduced food intake, BW, and white adipose tissue (WAT)/BW ratio; decreased the adipocyte size and serum concentrations of triglyceride (TG) and cholesterol; and increased oxygen consumption in HFD mice. Compared with the CD mice, the HFD mice had elevated fasting serum glucose level and impaired glucose tolerance; however, these parameters were decreased by EA treatment. Meanwhile, EA promoted the protein and mRNA expressions of UCP1, PRDM16, and PGC-1α in adipose tissue, and activated sympathetic nerves via p-TH, A2AR, and β3AR in white adipose tissue. Conclusions: EA reduced food intake, BW, TG, and cholesterol, and improved glucose tolerance in HFD mice. This ameliorative effect of EA on obesity-related symptoms associated with its promoted adipose tissue plasticity via activating sympathetic nerves.
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Affiliation(s)
- Sheng-Feng Lu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yue-Xia Tang
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China.,Huai'an Hospital of Traditional Chinese Medicine, Huaian, China
| | - Tao Zhang
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Shu-Ping Fu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Hao Hong
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yu Cheng
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Hou-Xi Xu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xing-Yue Jing
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Mei-Ling Yu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Bing-Mei Zhu
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China
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Park JY, Namgung U. Electroacupuncture therapy in inflammation regulation: current perspectives. J Inflamm Res 2018; 11:227-237. [PMID: 29844696 PMCID: PMC5963483 DOI: 10.2147/jir.s141198] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Although acupuncture therapy is increasingly used to treat diverse symptoms and disorders in humans, its underlying mechanism is not known well. Only recently have experimental studies begun to provide insights into how acupuncture stimulation generates and relates to pathophysiological responsiveness. Acupuncture intervention is frequently used to control pathologic symptoms in several visceral organs, and a growing number of studies using experimental animal models suggest that acupuncture stimulation may be involved in inducing anti-inflammatory responses. The vagus nerve, a principal parasympathetic nerve connecting neurons in the central nervous system to cardiovascular systems and a majority of visceral organs, is known to modulate neuroimmune communication and anti-inflammatory responses in target organs. Here, we review a broad range of experimental studies demonstrating anti-inflammatory effects of electroacupuncture in pathologic animal models of cardiovascular and visceral organs and also ischemic brains. Then, we provide recent progress on the role of autonomic nerve activity in anti-inflammation mediated by electroacupuncture. We also discuss a perspective on the role of sensory signals generated by acupuncture stimulation, which may induce a neural code unique to acupuncture in the central nervous system.
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Affiliation(s)
- Ji-Yeun Park
- Department of Oriental Medicine, Daejeon University, Daejeon, South Korea
| | - Uk Namgung
- Department of Oriental Medicine, Daejeon University, Daejeon, South Korea
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29
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Meng JB, Jiao YN, Xu XJ, Lai ZZ, Zhang G, Ji CL, Hu MH. Electro-acupuncture attenuates inflammatory responses and intraabdominal pressure in septic patients: A randomized controlled trial. Medicine (Baltimore) 2018; 97:e0555. [PMID: 29703040 PMCID: PMC5944568 DOI: 10.1097/md.0000000000010555] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 04/04/2018] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND A pathological increase in intraabdominal pressure (IAP) and inflammatory responses have negative effects on splanchnic, respiratory, cardiovascular, renal, and neurological function in septic patients with intestinal dysfunction. Electro-acupuncture (EA) has been evidenced to have a bidirectional neuron-endocrine-immune system regulating effect in patients with intestinal dysfunction. The purpose of current study was to evaluate the effects of EA at "Zusanli" (ST36) and "Shangjuxu" (ST37) on inflammatory responses and IAP in septic patients with intestinal dysfunction manifested syndrome of obstruction of the bowels Qi. METHODS Eighty-two septic patients with intestinal dysfunction manifested syndrome of obstruction of the bowels Qi were randomly assigned to control group (n = 41) and EA group (n = 41). Patients in control group were given conventional therapies including fluid resuscitation, antiinfection, vasoactive agents, mechanical ventilation (MV), supply of enteral nutrition, and glutamine as soon as possible. In addition to conventional therapies, patients in EA group underwent 20-minutes of EA at ST36-ST37 twice a day for 5 days. At baseline, posttreatment 1, 3, and 7 days, serum levels of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) and IAP levels, were measured, respectively. And days on MV, length of stay in intensive care unit (ICU) and 28 days mortality were recorded. RESULTS The serum levels of TNF-α and IL-1β and IAP levels at posttreatment 1, 3, and 7 days were lower significantly in the EA group compared with the control group (mean [SD]; 61.03 [20.39] vs 79.28 [20.69]; P < .005, mean [SD]; 35.34 [18.75] vs 66.53 [30.43]; P < .005 and mean [SD]; 20.32 [11.30] vs 32.99 [20.62]; P = .001, respectively, TNF-α. Mean [SD]; 14.11 [5.21] vs 16.72 [5.59]; P = .032, mean [SD]; 9.02 [3.62] vs 12.10 [4.13]; P = .001 and mean [SD]; 5.11 [1.79] vs 8.19 [2.99]; P < .005, respectively, IL-1β. Mean [SD]; 14.83 [5.58] vs 17.55 [3.37]; P = .009, mean [SD]; 11.20 [2.57] vs 14.85 [3.01]; P < .005 and mean [SD]; 8.62 [2.55] vs 11.25 [2.72]; P < .005, respectively, IAP). There were no significant differences in the duration of MV, length of stay in ICU, and 28d mortality between the groups. CONCLUSION EA at ST36-ST37 attenuated inflammatory responses through reduction in serum levels of TNF-α and IL-1β and IAP in septic patients with intestinal dysfunction manifested syndrome of obstruction of the bowels Qi.
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Affiliation(s)
- Jian-biao Meng
- Intensive Care Unit, Tongde Hospital of Zhejiang Province
| | - Yan-na Jiao
- Intensive Care Unit, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xiu-juan Xu
- Intensive Care Unit, Tongde Hospital of Zhejiang Province
| | - Zhi-zhen Lai
- Intensive Care Unit, Tongde Hospital of Zhejiang Province
| | - Geng Zhang
- Intensive Care Unit, Tongde Hospital of Zhejiang Province
| | - Chun-lian Ji
- Intensive Care Unit, Tongde Hospital of Zhejiang Province
| | - Ma-hong Hu
- Intensive Care Unit, Tongde Hospital of Zhejiang Province
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30
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Huang X, Chen L, Xia YB, Xie M, Sun Q, Yao B. Effects of electroacupuncture on luteal regression and steroidogenesis in ovarian hyperstimulation syndrome model rat. Life Sci 2018; 197:1-9. [DOI: 10.1016/j.lfs.2018.01.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 01/14/2018] [Accepted: 01/23/2018] [Indexed: 01/26/2023]
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31
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Shorakae S, Abell SK, Hiam DS, Lambert EA, Eikelis N, Jona E, Sari CI, Stepto NK, Lambert GW, de Courten B, Teede HJ. High-molecular-weight adiponectin is inversely associated with sympathetic activity in polycystic ovary syndrome. Fertil Steril 2018; 109:532-539. [DOI: 10.1016/j.fertnstert.2017.11.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 11/15/2017] [Accepted: 11/15/2017] [Indexed: 01/22/2023]
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32
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Kokosar M, Benrick A, Perfilyev A, Nilsson E, Källman T, Ohlsson C, Ling C, Stener-Victorin E. A Single Bout of Electroacupuncture Remodels Epigenetic and Transcriptional Changes in Adipose Tissue in Polycystic Ovary Syndrome. Sci Rep 2018; 8:1878. [PMID: 29382850 PMCID: PMC5790004 DOI: 10.1038/s41598-017-17919-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 12/04/2017] [Indexed: 12/13/2022] Open
Abstract
A single bout of electroacupuncture results in muscle contractions and increased whole body glucose uptake in women with polycystic ovary syndrome (PCOS). Women with PCOS have transcriptional and epigenetic alterations in the adipose tissue and we hypothesized that electroacupuncture induces epigenetic and transcriptional changes to restore metabolic alterations. Twenty-one women with PCOS received a single bout of electroacupuncture, which increased the whole body glucose uptake. In subcutaneous adipose tissue biopsies, we identified treatment-induced expression changes of 2369 genes (Q < 0.05) and DNA methylation changes of 7055 individual genes (Q = 0.11). The largest increase in expression was observed for FOSB (2405%), and the largest decrease for LOC100128899 (54%). The most enriched pathways included Acute phase response signaling and LXR/RXR activation. The DNA methylation changes ranged from 1-16%, and 407 methylation sites correlated with gene expression. Among genes known to be differentially expressed in PCOS, electroacupuncture reversed the expression of 80 genes, including PPARγ and ADIPOR2. Changes in the expression of Nr4a2 and Junb are reversed by adrenergic blockers in rats demonstrating that changes in gene expression, in part, is due to activation of the sympathetic nervous system. In conclusion, low-frequency electroacupuncture with muscle contractions remodels epigenetic and transcriptional changes that elicit metabolic improvement.
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Affiliation(s)
- Milana Kokosar
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - 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
| | - Alexander Perfilyev
- Epigenetics and Diabetes, Department of Clinical Sciences, Lund University Diabetes Centre, Lund University, Clinical Research Centre, Scania University Hospital, Malmö, Sweden
| | - Emma Nilsson
- Epigenetics and Diabetes, Department of Clinical Sciences, Lund University Diabetes Centre, Lund University, Clinical Research Centre, Scania University Hospital, Malmö, Sweden
| | - Thomas Källman
- Department of Medical Biochemistry and Microbiology, NBIS - National Bioinformatics Infrastructure Sweden, SciLifeLab, Uppsala University, Uppsala, Sweden
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Charlotte Ling
- Epigenetics and Diabetes, Department of Clinical Sciences, Lund University Diabetes Centre, Lund University, Clinical Research Centre, Scania University Hospital, Malmö, Sweden
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