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Li R, Pan Y, Jing N, Wang T, Shi Y, Hao L, Zhu J, Lua J. Flavonoids from mulberry leaves exhibit sleep-improving effects via regulating GABA and 5-HT receptors. JOURNAL OF ETHNOPHARMACOLOGY 2024:118734. [PMID: 39374877 DOI: 10.1016/j.jep.2024.118734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 08/15/2024] [Accepted: 08/21/2024] [Indexed: 10/09/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Mulberry leaf (Folium Mori) is a dried leaf of the dicotyledonous mulberry tree and is a homologous food and medicine. Treating insomnia with it is a common practice in traditional Chinese medicine. But still, its potential sleep-improving mechanism remains to be elucidated. AIM OF REVIEW Potential bioactive components and mechanisms of the sleep-improving effect of purified flavone from mulberry leaves (MLF) were explored through in vivo experiments, network pharmacology analysis, and molecular experimental validation. MATERIALS AND METHODS The mice model was established by pentobarbital sodium induction to evaluate the sleep-improving effect of MLF. The MLF's chemical composition was identified through a liquid chromatograph quadrupole time-of-flight mass spectrometer (Q-TOF LC/MS) to elucidate its sleep-improving active ingredient. At last, the underlying mechanism of MLF's sleep-improving effect was elucidated through neurotransmitter detection (ELISA), network pharmacology analysis, and molecular experimental validation (quantitative real-time PCR and western blotting). RESULTS MLF could dramatically reduce sleep latency by 35%, prolong sleep duration by 123%, and increase the sleep rate of mice through increasing γ-aminobutyric acid (GABA) and serotonin (5-HT) release in serum, hypothalamus, and hippocampus. Q-TOF LC/MS identified 16 flavonoid components in MLF. Network pharmacological analysis suggested that the key sleep-improving active ingredients in MLF might be quercetin, kaempferol, morin, and delphinidin. The key path for MLF to improve sleep might be the tryptophan metabolism and neuroactive ligand-receptor interaction, and the key targets might be gamma-aminobutyric acid type A receptor subunit alpha2 Gene (GABRA2) and serotonin 1A (5-HT1A) receptors. CONCLUSIONS MLF has shown significant sleep-improving effects in mice and may take effect through regulating the GABA and 5-HT receptors.
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Affiliation(s)
- Rui Li
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China; Food Laboratory of Zhongyuan, Zhengzhou University, Luohe, Henan 462300, China.
| | - Yongkang Pan
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China; Food Laboratory of Zhongyuan, Zhengzhou University, Luohe, Henan 462300, China.
| | - Nannan Jing
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China; Food Laboratory of Zhongyuan, Zhengzhou University, Luohe, Henan 462300, China.
| | - Ting Wang
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China; Food Laboratory of Zhongyuan, Zhengzhou University, Luohe, Henan 462300, China.
| | - Yanling Shi
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China; Food Laboratory of Zhongyuan, Zhengzhou University, Luohe, Henan 462300, China.
| | - Limin Hao
- Systems Engineering Institute, Academy of Military Sciences (AMS), Beijing, 100010, China.
| | - Jiaqing Zhu
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China; Food Laboratory of Zhongyuan, Zhengzhou University, Luohe, Henan 462300, China.
| | - Jike Lua
- Food Laboratory of Zhongyuan, Zhengzhou University, Luohe, Henan 462300, China.
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Zhang F, Zhang X, Peng Q, Tang L. Electroacupuncture of the cymba concha alleviates p-chlorophenylalanine-induced insomnia in mice. Acupunct Med 2023; 41:345-353. [PMID: 37081732 DOI: 10.1177/09645284231160193] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
OBJECTIVE Insomnia is the most common sleep disorder and is often comorbid with mental and physical diseases. The present study was designed to investigate the hypnotic effect of electroacupuncture (EA) of the cymba concha to stimulate the auricular branch of the vagus nerve (ABVN). METHODS Mice were intraperitoneally injected with p-chlorophenylalanine (PCPA, 300 mg/kg·d) for 2 days to induce insomnia and subsequently received EA or manual acupuncture (MA) of the cymba concha for 30 min once daily for 5 consecutive days, or no treatment. The phenobarbital-induced sleep test was used to analyze the hypnotic effects and the open field test was used to analyze the locomotor activities and anxiolytic effects of EA/MA of the cymba concha. In addition, the levels of gamma-aminobutyric acid (GABA) and glutamate (Glu) in the hypothalamus and peripheral blood were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS PCPA injection significantly decreased sleep duration, increased sleep latency and induced anxiety-like behaviors in mice. In PCPA-insulted mice, EA of the cymba concha improved the sleep disturbance by significantly prolonging sleep duration, while no change in sleep latency was observed. Moreover, EA of the cymba concha improved PCPA-induced anxiety-like behaviors without decreasing locomotor activities in the open field test. EA of the cymba concha increased the level of GABA in the hypothalamus and peripheral blood, while Glu concentrations remained unchanged. CONCLUSION These findings indicate that EA of the region innervated by the ABVN upregulates GABA levels in the hypothalamus and ameliorates the symptoms of insomnia and anxiety, suggesting that EA of the cymba concha might have potential value as an intervention for insomnia.
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Affiliation(s)
- Fenyan Zhang
- Department of Neurology, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoming Zhang
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
- Sub-Health Institute, Hubei University of Chinese Medicine, Wuhan, China
| | - Qi Peng
- University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Ling Tang
- Department of Neurology, University-Town Hospital of Chongqing Medical University, Chongqing, China
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Lee S, Kim SN. The effects of acupuncture on sleep disorders and its underlying mechanism: a literature review of rodent studies. Front Neurosci 2023; 17:1243029. [PMID: 37614343 PMCID: PMC10442542 DOI: 10.3389/fnins.2023.1243029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/28/2023] [Indexed: 08/25/2023] Open
Abstract
Sleep is a set of physiological processes mainly under neurobiological regulation that affect several physiological systems, and sleep disorders are a condition where normal sleep patterns are disturbed. Clinical studies have confirmed the effects of acupuncture on sleep duration and quality. Although many studies have explored the therapeutic effects of acupuncture on sleep disorders, the mechanisms are unclear. We investigated the mechanism of acupuncture efficacy in a rodent model of sleep disorders and evaluated the therapeutic effects of acupuncture treatment. According to our results, sleep disorders are associated with several brain regions and neurotransmitters. Furthermore, this review showed that neurological processes, such as catecholamine and BDNF signaling pathways, can be regulated by acupuncture, which is a crucial aspect of the acupuncture mechanism in sleep disorders.
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Affiliation(s)
| | - Seung-Nam Kim
- College of Korean Medicine, Dongguk University, Goyang, Republic of Korea
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Influence of warm acupuncture on gut microbiota and metabolites in rats with insomnia induced by PCPA. PLoS One 2022; 17:e0267843. [PMID: 35482778 PMCID: PMC9049555 DOI: 10.1371/journal.pone.0267843] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/14/2022] [Indexed: 01/13/2023] Open
Abstract
Background Insomnia is the most common of the sleep disorders. Current pharmacotherapy treatment options are usually associated with adverse effects and withdrawal phenomena. Therapeutic alternatives with a more favorable safety profile for patients are needed. Mongolian medical warm acupuncture (MMWA) is an emerging therapeutic option for treating insomnia. However, the underlying mechanisms responsible for the anti-insomnia efficacy of the MMWA remain unclear. This study aims to investigate the effect of the MMWA on the alterations of the gut microbiota and serum metabolome in rats with insomnia. Results We found that the relative abundances of gut bacteria and the concentrations of several serum metabolites were obviously altered in PCPA-induced insomnia rats. The MMWA treatment exerted an anti-insomnia effect. In addition, the dysbiosis of the gut microbiota and the serum metabolites were ameliorated by the MMWA. Correlation analysis between the gut microbiota and metabolites suggested that the levels of Amide c18, Benzoyl chloride, Cytosine, and N, n-dimethylarginine were positively correlated with the relative abundance of Clostridium XlVa and Blautia, which characterized the insomnia rats. KEGG enrichment analysis identified the cAMP signaling pathway involving anti-insomnia effect of the MMWA. Moreover, the MMWA intervention significantly increased contents of butyrate in feces, while effectively inhibited the expression level of GAT-1 in brain tissues. Conclusion This study reveals that the MMWA intervention might have a major impact on the modulation of host gut microbiota and metabolites, which in turn have a crucial role in the regulation of the host’s signaling pathways associated with insomnia. The present study could provide useful ideas for the study of the intervention mechanisms of the MMWA in insomnia rat models.
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Zhu Y, Zhu X, Chen Z, Cao X, Wang L, Zang L, Cao W, Sun T, Bai X. The Efficacy of Needle-Warming Moxibustion Combined with Hyperbaric Oxygen Therapy for Ischemic Stroke and Its Effect on Neurological Function. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2204981. [PMID: 35237338 PMCID: PMC8885239 DOI: 10.1155/2022/2204981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/20/2022] [Accepted: 01/26/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To elucidate the therapeutic efficacy of needle-warming moxibustion (NWM) combined with hyperbaric oxygen therapy (HBOT) in the treatment of patients with ischemic stroke and its effect on neurological function. METHODS One hundred patients with ischemic stroke admitted to the Xuzhou Medical University Affiliated Hospital of Lianyungang from January 2019 to July 2021 were enrolled. Among them, 45 patients treated with NWM were set as the control group, and the rest 55 patients treated by NWM combined with HBOT were included in the research group. The curative effect, neurological deficit score, activity of daily living (ADL), balance ability, and the levels of serum proinflammatory factors in both groups were observed and recorded. Of them, the neurological deficit of patients was evaluated by the National Institutes of Health Stroke Scale (NHISS), the ADL ability was determined by the Barthel index score, and the balance ability was assessed by the Berg balance scale. RESULTS The total effective rate of the research group was higher than that of the control group. Better ADL and balance ability and milder neurologic impairment were determined in the research group compared with the control group. After treatment, the secretion levels of proinflammatory factors such as C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-8 (IL-8) in the serum of patients in the research group were statistically lower than those before treatment and the control group. CONCLUSIONS NWM combined with HBOT is effective in the treatment of patients with ischemic stroke, which can not only improve patients' neurological function, ADL, and balance ability but also inhibit serum inflammatory reactions.
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Affiliation(s)
- Yonggang Zhu
- Neurorehabilitation Department, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The First People's Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, 222002 Jiangsu Province, China
| | - Xiuhua Zhu
- Neurorehabilitation Department, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The First People's Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, 222002 Jiangsu Province, China
| | - Zhitian Chen
- Neurorehabilitation Department, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The First People's Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, 222002 Jiangsu Province, China
| | - Xueli Cao
- Neurorehabilitation Department, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The First People's Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, 222002 Jiangsu Province, China
| | - Lu Wang
- Neurorehabilitation Department, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The First People's Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, 222002 Jiangsu Province, China
| | - Lin Zang
- Neurorehabilitation Department, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The First People's Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, 222002 Jiangsu Province, China
| | - Weiwei Cao
- Neurorehabilitation Department, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The First People's Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, 222002 Jiangsu Province, China
| | - Tian Sun
- Neurorehabilitation Department, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The First People's Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, 222002 Jiangsu Province, China
| | - Xinyu Bai
- Acupuncture and Massage Department, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The First People's Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, 222002 Jiangsu Province, China
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Shao G, Xie W, Jia X, Bade R, Xie Y, Qi R, Gong K, Bai H, Si L, Chen Y, Sun K, Bo A. Overview of Traditional Mongolian Medical Warm Acupuncture. Aging Dis 2022; 13:1030-1041. [PMID: 35855342 PMCID: PMC9286911 DOI: 10.14336/ad.2022.0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/07/2022] [Indexed: 11/09/2022] Open
Abstract
Mongolian medical warm acupuncture is a traditional therapy of Mongolian medicine and was developed by people living on the Mongolian Plateau. This kind of traditional oriental medicine has a long history. The main characteristics of Mongolian medical warm acupuncture are the acupoints and the needles used. Its theory is based on the human anatomical structure and the distinct local culture. Mongolian medical warm acupuncture has been practiced for centuries and proved to be very effective in the treatment of age-related diseases, including the musculoskeletal and nervous diseases. This paper aims to briefly introduce the history and scope of Mongolian medical warm acupuncture, with a particular focus on age-related diseases, where Mongolian medical warm acupuncture has shown significant beneficial effects.
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Affiliation(s)
- Guo Shao
- Center for Translational Medicine and Department of Laboratory Medicine, the Third People’s Hospital of Longgang District Shenzhen, Shenzhen, China.
- Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China.
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
- Correspondence should be addressed to: Dr. Guo Shao (), Dr. Kai Sun (), and Dr. Agula Bo (), Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China
| | - Wei Xie
- Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China.
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Xiaoe Jia
- Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China.
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Rengui Bade
- Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China.
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Yabing Xie
- Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China.
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Ruifang Qi
- Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China.
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Kerui Gong
- Department of Oral and Maxillofacial Surgery, University of California San Francisco, San Francisco, USA.
| | - Haihua Bai
- Inner Mongolia Minzu University, Tongliao, China.
| | - Lengge Si
- Inner Mongolia Minzu University, Tongliao, China.
| | | | - Kai Sun
- Center for Translational Medicine and Department of Laboratory Medicine, the Third People’s Hospital of Longgang District Shenzhen, Shenzhen, China.
- Correspondence should be addressed to: Dr. Guo Shao (), Dr. Kai Sun (), and Dr. Agula Bo (), Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China
| | - Agula Bo
- Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China.
- Correspondence should be addressed to: Dr. Guo Shao (), Dr. Kai Sun (), and Dr. Agula Bo (), Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China
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Queen bee larva consumption improves sleep disorder and regulates gut microbiota in mice with PCPA-induced insomnia. FOOD BIOSCI 2021. [DOI: 10.1016/j.fbio.2021.101256] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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iTRAQ-based proteomics analysis on insomnia rats treated with Mongolian medical warm acupuncture. Biosci Rep 2021; 40:222577. [PMID: 32249904 PMCID: PMC7953503 DOI: 10.1042/bsr20191517] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 02/17/2020] [Accepted: 03/09/2020] [Indexed: 01/20/2023] Open
Abstract
Objective: To explore the proteomic changes in the hypothalamus of rats treated with Mongolian medical warm acupuncture for insomnia therapy based proteomics. Method: We used an iTRAQ-based quantitative proteomic approach to identify proteins that potential molecular mechanisms involved in the treatment of insomnia by Mongolian medical warm acupuncture. Result: In total, 7477 proteins were identified, of which 36 proteins showed increased levels and 45 proteins showed decreased levels in insomnia model group (M) compared with healthy control group (C), 72 proteins showed increased levels and 44 proteins showed decreased levels from the warm acupuncture treated insomnia group (W) compared with healthy controls (C), 28 proteins showed increased levels and 17 proteins showed decreased levels from the warm acupuncture-treated insomnia group (W) compared with insomnia model group (M). Compared with healthy control groups, warm acupuncture-treated insomnia group showed obvious recovered. Bioinformatics analysis indicated that up-regulation of neuroactive ligand–receptor interaction and oxytocin signaling was the most significantly elevated regulate process of Mongolian medical warm acupuncture treatment for insomnia. Proteins showed that increased/decreased expression in the warm acupuncture-treated insomnia group included Prolargin (PRELP), NMDA receptor synaptonuclear-signaling and neuronal migration factor (NSMF), Transmembrane protein 41B (TMEM41B) and Microtubule-associated protein 1B (MAP1B) to adjust insomnia. Conclusion: A combination of findings in the present study suggest that warm acupuncture treatment is efficacious in improving sleep by regulating the protein expression process in an experimental rat model and may be of potential benefit in treating insomnia patients with the added advantage with no adverse effects.
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Effects of Acupuncture Treatment in Reducing Sleep Disorder and Gut Microbiota Alterations in PCPA-Induced Insomnia Mice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:3626120. [PMID: 33178314 PMCID: PMC7647758 DOI: 10.1155/2020/3626120] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 08/07/2020] [Accepted: 10/15/2020] [Indexed: 12/21/2022]
Abstract
Chronic insomnia without intervention will do harm to people's physical and psychological health as well as the quality of life. While ensuring efficacy, traditional Chinese medicine therapy, such as acupuncture, overcomes the side effects of drugs. However, the molecular mechanism of traditional medicine is unclear and it encounters many obstacles in repetitiveness and popularization. On the other side, the placebo effects also need to be eliminated during the intervention. In this study, a number of indicators such as duration of sleep latency, serum markers, pineal gland immunohistochemistry, and gut microbes were detected in the PCPA-induced insomnia mice to compare the effects between acupuncture and hypnotic drug treatments. Although the food intake and weight were not changed, the results show that serum maker and gut microbiota alterations were mediated by concurrent changes in sleep disorder induced by PCPA in mice. Compared with the PCPA-induced insomnia group, dopamine, 5-hydroxytryptamine, and norepinephrine were reduced in serum, and the melatonin was increased in the pineal gland of the acupuncture group as well as zopiclone drug group. Moreover, the analysis results from 16S tag sequencing of the gut microbiome bacterial rRNA hypervariable region show the same improvement effects between the two medical intervention groups. A co-occurrence network analysis showed that blank and acupuncture networks exhibited higher similarity than sham and zopiclone networks and the sham network possessed the highest complexity of microbial communities. Taken together, the gut microbiome will likely be a new target for improving sleep disorders, and taking into account the side effects of hypnotic drugs, nonpharmacological interventions such as acupuncture may be an effective means and have greater clinical benefits.
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