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Guo R, Shen X, Ealing J, Zhou J, Lu J, Ning Y. Efficacy and safety of acupuncture for cognitive impairment in Alzheimer's disease: a systematic review and meta-analysis. FRONTIERS IN DEMENTIA 2024; 3:1380221. [PMID: 39081600 PMCID: PMC11285646 DOI: 10.3389/frdem.2024.1380221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/22/2024] [Indexed: 08/02/2024]
Abstract
Objective To systematically evaluate the efficacy of acupuncture in the treatment of cognitive impairment in Alzheimer's disease (AD) by meta-analysis, in order to provide evidence-based evidence for the application of acupuncture therapy in the clinical process of AD. Methods From the establishment of the database to December 31, 2022, China Biomedical Literature Database (CBM), China National Knowledge Network (CNKI), VIP database, WanFang Database, Pubmed, Embase and Cochrane Library Database were systematically searched. To collect published randomized controlled clinical trials (RCTS) of acupuncture in the treatment of cognitive impairment in AD. The subjects in the intervention group were given acupuncture alone or combined with other treatments the same as the control group; the control group received conventional Western medicine treatment. The main outcome indicators of the study were cognitive function assessment of subjects, including: Simple Mental State Examination Scale (MMSE), Assessment of daily Living Ability Scale (ADL), Alzheimer's Disease Cognitive Function Assessment Scale (ADAS-Cog), TCM syndrome score (SDSD), Montreal Cognitive Test (MoCA), Secondary outcome indicators were the occurrence of adverse reactions. Literature screening, data extraction, and quality evaluation of the included literature were performed independently by two researchers, according to bias risk assessment tools recommended in the Cochrane manual. Data were analyzed by RevMan5.3 software. Dichotomous variables were represented by risk ratio (OR) and 95% CI, and continuity variables were represented by mean difference (MD) and 95% CI. For heterogeneity analysis, when P > 0.1 and I 2 ≤ 50%, fixed effect model was applied. When P ≤ 0.1 and I 2 > 50%, the random effects model is applied. Results A total of 1,172 eligible subjects were included in 18 RCTS, including 595 in the intervention group and 577 in the control group. The results of meta-analysis are as follows: acupuncture intervention group improved MMSE [MD = 1.67, 95% CI (0.94, 2.41), P < 0.00001], ADL [MD = -1.18, 95% CI (-3.09, 0.72), P = 0.22], ADAS-Cog [MD = 3.31, 95% CI (5.84, 0.78), P = 0.01], SDSD [MD = 2.40, 95% CI (3.53, 1.26), P < 0.0001], MoCA [MD = 4.80, 95% CI (3.74, 5.86), P = 0.04] were better than the control group. No serious adverse reactions related to acupuncture were observed in the intervention group, and the incidence and severity of adverse reactions were lower than those in the control group, with statistical significance [OR = 0.17, 95% CI (0.04, 0.67), P = 0.01]. Conclusion Existing data show that acupuncture therapy has certain advantages in improving cognitive dysfunction and improving self-care ability of patients with Alzheimer's disease. However, due to the small number of RCTS and cases evaluating the efficacy of acupuncture, and the possibility of measurement bias and selectivity bias in included studies, it is still unable to conduct high-intensity demonstration on its effectiveness. Further large-scale, high-quality randomized, double-blind controlled trials are needed to evaluate its efficacy. Systematic Review Registration https://inplasy.com/inplasy-2021-12-0125/, identifier: INPLASY2021120125.
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Affiliation(s)
- Ruyue Guo
- Department of Encephalopathy, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, China
| | - Xiaoming Shen
- The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, China
| | - John Ealing
- Salford Royal Hospital, Salford, United Kingdom
| | - Jiao Zhou
- Department of Encephalopathy, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, China
| | - Jin Lu
- Department of Encephalopathy, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, China
| | - Yunfan Ning
- Department of Encephalopathy, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, China
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Chen YC, Chen JH, Tsai CF, Wu CY, Chang CN, Wu CT, Yeh WL. Protective effects of paeonol against cognitive impairment in lung diseases. J Pharmacol Sci 2024; 155:101-112. [PMID: 38797534 DOI: 10.1016/j.jphs.2024.04.006] [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: 02/16/2024] [Revised: 04/14/2024] [Accepted: 04/30/2024] [Indexed: 05/29/2024] Open
Abstract
Pulmonary inflammation may lead to neuroinflammation resulting in neurological dysfunction, and it is associated with a variety of acute and chronic lung diseases. Paeonol is a herbal phenolic compound with anti-inflammatory and anti-oxidative properties. The aim of this study is to understand the beneficial effects of paeonol on cognitive impairment, pulmonary inflammation and its underlying mechanisms. Pulmonary inflammation-associated cognitive deficit was observed in TNFα-stimulated mice, and paeonol mitigated the cognitive impairment by reducing the expressions of interleukin (IL)-1β, IL-6, and NOD-like receptor family pyrin domain-containing 3 (NLRP3) in hippocampus. Moreover, elevated plasma miR-34c-5p in lung-inflamed mice was also reduced by paeonol. Pulmonary inflammation induced by intratracheal instillation of TNFα in mice resulted in immune cells infiltration in bronchoalveolar lavage fluid, pulmonary edema, and acute fibrosis, and these inflammatory responses were alleviated by paeonol orally. In MH-S alveolar macrophages, tumor necrosis factor (TNF) α- and phorbol myristate acetate (PMA)-induced inflammasome activation was ameliorated by paeonol. In addition, the expressions of antioxidants were elevated by paeonol, and reactive oxygen species production was reduced. In this study, paeonol demonstrates protective effects against cognitive deficits and pulmonary inflammation by exerting anti-inflammatory and anti-oxidative properties, suggesting a powerful benefit as a potential therapeutic agent.
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Affiliation(s)
- Yen-Chang Chen
- Institute of New Drug Development, China Medical University, No.91 Hsueh-Shih Road, Taichung, 404333, Taiwan
| | - Jia-Hong Chen
- Department of General Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 88, Sec. 1, Fengxing Road, Taichung, 427213, Taiwan
| | - Cheng-Fang Tsai
- Department of Medical Laboratory Science and Biotechnology, Asia University, No.500 Lioufeng Road, Taichung, 413305, Taiwan
| | - Chen-Yun Wu
- Institute of New Drug Development, China Medical University, No.91 Hsueh-Shih Road, Taichung, 404333, Taiwan
| | - Chen-Ni Chang
- Institute of New Drug Development, China Medical University, No.91 Hsueh-Shih Road, Taichung, 404333, Taiwan
| | - Chen-Teng Wu
- Department of Surgery, China Medical University Hospital, No. 2, Yude Road, Taichung, 404332, Taiwan
| | - Wei-Lan Yeh
- Institute of New Drug Development, China Medical University, No.91 Hsueh-Shih Road, Taichung, 404333, Taiwan; Department of Biochemistry, School of Medicine, China Medical University, No.91 Hsueh-Shih Road, Taichung, 404333, Taiwan.
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Chen Y, Li Y, Wu M, Li Z. Electroacupuncture improves cognitive function in APP/PS1 mice by inhibiting oxidative stress related hippocampal neuronal ferroptosis. Brain Res 2024; 1831:148744. [PMID: 38163562 DOI: 10.1016/j.brainres.2023.148744] [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: 09/22/2023] [Revised: 12/03/2023] [Accepted: 12/29/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Electroacupuncture, recognized as a crucial non-pharmacological therapeutic approach, has demonstrated notable efficacy in enhancing cognitive function among Alzheimer's disease (AD) patients. This study aimed to investigate the neuroprotective properties of electroacupuncture in APP/PS1 mice with AD. METHODS A total of thirty APP/PS1 mice were randomly assigned to three groups: the Alzheimer's disease group (AD), the electroacupuncture treatment group (EA), and the ferroptosis inhibitor deferasirox treatment group (DFX). Additionally, ten C57BL/6 mice were included as a control group (Control). In the EA group, mice underwent flat needling at Baihui and Yintang, as well as point needling at Renzhong, once daily for 15 min each time. In the DFX group, mice received intraperitoneal injections of deferasirox at a dosage of 100 mg/kg/day. Following the 28-day treatment period, behavioral evaluation, morphological observation of neurons, and detection of neuronal ferroptosis were conducted. RESULTS The electroacupuncture treatment demonstrated a significant improvement in spatial learning, memory ability, and neuronal damage in mice with AD. Analysis of neuronal ferroptosis markers indicated that electroacupuncture interventions reduced the elevated levels of malondialdehyde, iron, and ptgs2 expression, while also increasing superoxide dismutase activity, Ferroportin 1 and glutathione peroxidase 4 expression. Moreover, the regulatory impact of electroacupuncture on ferroptosis may be attributed to its ability to enhance the expression and nuclear translocation of Nrf2. CONCLUSIONS This study suggested that electroacupuncture could inhibit the neuronal ferroptosis by activating the antioxidant function in neurons through p62/Keap1/Nrf2 signal pathway, thereby improve the cognitive function of AD mice by the neuronal protection effect.
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Affiliation(s)
- Yu Chen
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yitong Li
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Meng Wu
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Zhigang Li
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China.
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Yi N, Xing D, Xie J, Cheng Z. Different acupuncture and moxibustion therapies for mild cognitive impairment: a network meta-analysis. Arch Gerontol Geriatr 2024; 120:105328. [PMID: 38237376 DOI: 10.1016/j.archger.2024.105328] [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: 10/16/2023] [Revised: 01/02/2024] [Accepted: 01/09/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To investigate the effectiveness of different acupuncture and moxibustion therapies in improving cognitive function in patients with mild cognitive impairment (MCI) to determine the optimal approach. This study aims to provide insights into the treatment of MCI patients for future randomized controlled trials (RCTs) and clinical decision-making. MATERIALS AND METHODS RCT studies were retrieved from databases including PubMed, Embase, Cochrane Library, Web of Science, CNKI, WANFANG, VIP, and SinoMed. The Cochrane risk of bias tool was used to assess the risk of bias for eligible trials. Bayesian network meta-analysis was conducted using R4.2.3 software. RESULTS A total of 46 RCTs with 3641 participants were included. The network meta-analysis showed that acupoint pressing + cognitive training + auricular point sticking, massage + western medicine treatment, and electroacupuncture + western medicine treatment ranked first, second, and third in improving MMSE score, respectively. Acupoint pressing + cognitive training, cognitive training + scalp acupuncture, and cognitive training + moxibustion ranked first, second, and third in improving MoCA score, respectively. CONCLUSION This study showed that acupoint pressing alone or acupoint pressing + auricular point sticking may improve cognitive function in MCI patients and possibly be the most effective acupuncture interventions for the treatment of MCI.
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Affiliation(s)
- Na Yi
- School of Acupuncture and Massage, Liaoning University of Traditional Chinese Medicine, Shenyang Liaoning 110847, China
| | - Dajiang Xing
- Department of Neurology, Liaoning Provincial People's Hospital, Shenyang Liaoning 110015, China
| | - Jingru Xie
- Preventive Treatment of Disease Centre, The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang Liaoning 110034, China
| | - Zedong Cheng
- Department of Science and Technology, Liaoning University of Traditional Chinese Medicine, Shenyang Liaoning 110847, China.
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5
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Gao J, Zhou N, Lu M, Wang Q, Zhao C, Wang J, Zhou M, Xu Y. Effects of electroacupuncture on urinary metabolome and microbiota in presenilin1/2 conditional double knockout mice. Front Microbiol 2023; 13:1047121. [PMID: 36762099 PMCID: PMC9904445 DOI: 10.3389/fmicb.2022.1047121] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 12/23/2022] [Indexed: 01/25/2023] Open
Abstract
Aim The treatment of Alzheimer's disease (AD) is still a worldwide problem due to the unclear pathogenesis and lack of effective therapeutic targets. In recent years, metabolomic and gut microbiome changes in patients with AD have received increasing attention, and the microbiome-gut-brain (MGB) axis has been proposed as a new hypothesis for its etiology. Considering that electroacupuncture (EA) efficiently moderates cognitive deficits in AD and its mechanisms remain poorly understood, especially regarding its effects on the gut microbiota, we performed urinary metabolomic and microbial community profiling on EA-treated AD model mice, presenilin 1/2 conditional double knockout (PS cDKO) mice, to observe the effect of EA treatment on the gut microbiota in AD and find the connection between affected gut microbiota and metabolites. Materials and methods After 30 days of EA treatment, the recognition memory ability of PS cDKO mice was evaluated by the Y maze and the novel object recognition task. Urinary metabolomic profiling was conducted with the untargeted GC-MS method, and 16S rRNA sequence analysis was applied to analyze the microbial community. In addition, the association between differential urinary metabolites and gut microbiota was clarified by Spearman's correlation coefficient analysis. Key findings In addition to reversed cognitive deficits, the urinary metabolome and gut microbiota of PS cDKO mice were altered as a result of EA treatment. Notably, the increased level of isovalerylglycine and the decreased levels of glycine and threonic acid in the urine of PS cDKO mice were reversed by EA treatment, which is involved in glyoxylate and dicarboxylate metabolism, as well as glycine, serine, and threonine metabolism. In addition to significantly enhancing the diversity and richness of the microbial community, EA treatment significantly increased the abundance of the genus Mucispirillum, while displaying no remarkable effect on the other major altered gut microbiota in PS cDKO mice, norank_f_Muribaculaceae, Lactobacillus, and Lachnospiraceae_NK4A136 group. There was a significant correlation between differential urinary metabolites and differential gut microbiota. Significance Electroacupuncture alleviates cognitive deficits in AD by modulating gut microbiota and metabolites. Mucispirillum might play an important role in the underlying mechanism of EA treatment. Our study provides a reference for future treatment of AD from the MGB axis.
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Affiliation(s)
- Jie Gao
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Department of Rehabilitation Medicine, Affiliated Hospital of Nantong University, Nantong, China
| | - Nian Zhou
- Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Tongji University Cancer Center, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Mengna Lu
- Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China,School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qixue Wang
- Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chenyi Zhao
- Department of Physiology, School of Basic Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jian Wang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China,*Correspondence: Jian Wang,
| | - Mingmei Zhou
- Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Mingmei Zhou, ; orcid.org/0000-0002-2552-4754
| | - Ying Xu
- Department of Physiology, School of Basic Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Ying Xu, ; orcid.org/0000-0003-3563-4233
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Zhang Z, Chen L, Guo Y, Li D, Zhang J, Liu L, Fan W, Guo T, Qin S, Zhao Y, Xu Z, Chen Z. The neuroprotective and neural circuit mechanisms of acupoint stimulation for cognitive impairment. Chin Med 2023; 18:8. [PMID: 36670425 PMCID: PMC9863122 DOI: 10.1186/s13020-023-00707-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 12/30/2022] [Indexed: 01/21/2023] Open
Abstract
Cognitive impairment is a prevalent neurological disorder that burdens families and the healthcare system. Current conventional therapies for cognitive impairment, such as cholinesterase inhibitors and N-methyl-d-aspartate receptor antagonists, are unable to completely stop or reverse the progression of the disease. Also, these medicines may cause serious problems with the digestive system, cardiovascular system, and sleep. Clinically, stimulation of acupoints has the potential to ameliorate the common symptoms of a variety of cognitive disorders, such as memory deficit, language dysfunction, executive dysfunction, reduced ability to live independently, etc. There are common acupoint stimulation mechanisms for treating various types of cognitive impairment, but few systematic analyses of the underlying mechanisms in this domain have been performed. This study comprehensively reviewed the basic research from the last 20 years and found that acupoint stimulation can effectively improve the spatial learning and memory of animals. The common mechanism may be that acupoint stimulation protects hippocampal neurons by preventing apoptosis and scavenging toxic proteins. Additionally, acupoint stimulation has antioxidant and anti-inflammatory effects, promoting neural regeneration, regulating synaptic plasticity, and normalizing neural circuits by restoring brain functional activity and connectivity. Acupoint stimulation also inhibits the production of amyloid β-peptide and the phosphorylation of Tau protein, suggesting that it may protect neurons by promoting correct protein folding and regulating the degradation of toxic proteins via the autophagy-lysosomal pathway. However, the benefits of acupoint stimulation still need to be further explored in more high-quality studies in the future.
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Affiliation(s)
- Zichen Zhang
- grid.410648.f0000 0001 1816 6218Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617 People’s Republic of China
| | - Liuyi Chen
- grid.410648.f0000 0001 1816 6218Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617 People’s Republic of China ,grid.257143.60000 0004 1772 1285First Clinical College, Hubei University of Chinese Medicine, Wuhan, 430065 People’s Republic of China
| | - Yi Guo
- grid.410648.f0000 0001 1816 6218Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617 People’s Republic of China ,grid.410648.f0000 0001 1816 6218National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381 People’s Republic of China
| | - Dan Li
- grid.410648.f0000 0001 1816 6218Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617 People’s Republic of China ,grid.410648.f0000 0001 1816 6218School of Acupuncture and Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617 People’s Republic of China ,grid.410648.f0000 0001 1816 6218National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381 People’s Republic of China
| | - Jingyu Zhang
- grid.410648.f0000 0001 1816 6218Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617 People’s Republic of China
| | - Ling Liu
- grid.257143.60000 0004 1772 1285First Clinical College, Hubei University of Chinese Medicine, Wuhan, 430065 People’s Republic of China
| | - Wen Fan
- grid.412879.10000 0004 0374 1074Department of Rehabilitation Physical Therapy Course, Faculty of Health Science, Suzuka University of Medical Science, Suzuka City, 5100293 Japan
| | - Tao Guo
- grid.410648.f0000 0001 1816 6218Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617 People’s Republic of China
| | - Siru Qin
- grid.410648.f0000 0001 1816 6218Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617 People’s Republic of China
| | - Yadan Zhao
- grid.410648.f0000 0001 1816 6218Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617 People’s Republic of China
| | - Zhifang Xu
- grid.410648.f0000 0001 1816 6218Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617 People’s Republic of China ,grid.410648.f0000 0001 1816 6218School of Acupuncture and Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617 People’s Republic of China ,grid.410648.f0000 0001 1816 6218National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381 People’s Republic of China
| | - Zelin Chen
- grid.410648.f0000 0001 1816 6218Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617 People’s Republic of China ,grid.410648.f0000 0001 1816 6218School of Acupuncture and Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617 People’s Republic of China ,grid.410648.f0000 0001 1816 6218National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381 People’s Republic of China
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Zhou R, Xiao L, Xiao W, Yi Y, Wen H, Wang H. Bibliometric review of 1992–2022 publications on acupuncture for cognitive impairment. Front Neurol 2022; 13:1006830. [PMID: 36226080 PMCID: PMC9549373 DOI: 10.3389/fneur.2022.1006830] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To explore the development context, research hotspots, and frontiers of acupuncture therapy for cognitive impairment (CI) from 1992 to 2022 by visualization analysis. Methods Articles about acupuncture therapy for cognitive impairment were retrieved from the Web of Science Core Collection (WoSCC) until 1 March 2022. Basic information was collected by Excel 2007, and VOSviewer 1.6.17 was used to analyze the co-occurrence of countries, institutes, and authors. Co-citation maps of authors and references were analyzed by CiteSpace V.5.8.R3. In addition, CiteSpace was used to analyze keyword clusters and forecast research frontiers. Results A total of 279 articles were retrieved, including articles from 19 countries, 334 research institutes, and 101 academic journals. The most published country and institutes were the People's Republic of China (217) and the Fujian University of Traditional Chinese Medicine (40). Ronald C Petersen owned the highest co-citations (56). Keywords and co-cited references cluster showed the main research directions in this area, including “ischemic stroke,” “cerebral ischemia/reperfusion,” “mild cognitive impairment,” “Alzheimer's disease,” “vascular dementia,” “vascular cognitive impairment with no dementia,” “multi-infarct dementia,” “synaptic injury,” “functional MRI,” “glucose metabolism,” “NMDA,” “nuclear factor-kappa b pathway,” “neurotrophic factor,” “matrix metalloproteinase-2 (MMP-2),” “tumor necrosis factor-alpha,” “Bax,” “Caspase-3,” and “Noxa”. Trending keywords may indicate frontier topics, such as “randomized controlled trial,” “rat model,” and “meta-analysis.” Conclusion This research provides valuable information for the study of acupuncture. Diseases focus on mild cognitive impairment (MCI), Alzheimer's disease (AD), and vascular dementia (VaD). Tauopathies with hyperphosphorylation of Tau protein as the main lesions also need to be paid attention to. The development of functional magnetic resonance imaging (fMRI) will better explain the therapeutic effect of acupuncture treatment. The effect of acupuncture on a single point is more convincing, and acupuncture on Baihui (GV20) may be needed in the future. Finally, the implementation of high-quality multicenter randomized controlled trials (RCTs) requires increased collaboration among experts from multiple fields and countries.
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Affiliation(s)
- Runjin Zhou
- Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lu Xiao
- Ganzhou Cancer Hospital, Ganzhou, China
- *Correspondence: Lu Xiao
| | - Wei Xiao
- Ganzhou Cancer Hospital, Ganzhou, China
| | - Yanfei Yi
- Ganzhou Cancer Hospital, Ganzhou, China
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Fu QH, Pei J, Zhou HG, Wang T, Zhan YJ, Tao L, Xu J, Zhou Q, Wang LY. Effect of acupuncture with donepezil based on syndrome differentiation on cognitive function in patients with mild-to-moderate Alzheimer’s disease: a study protocol for a multicenter randomized controlled trial. Trials 2022; 23:695. [PMID: 35986297 PMCID: PMC9389745 DOI: 10.1186/s13063-022-06532-1] [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: 07/18/2021] [Accepted: 07/08/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
There has been a rapid increase in the worldwide prevalence of Alzheimer’s disease (AD). Previous studies have shown that acupuncture can improve neurological and cognitive function; however, the utility of applying acupuncture in patients with AD remains unclear. This study protocol describes a clinical trial for evaluating the efficacy and safety of acupuncture based on syndrome differentiation with donepezil hydrochloride on cognitive function in patients with AD.
Methods/design
This multicenter randomized controlled trial commenced on February 1, 2019, at the Shanghai Longhua Hospital of TCM, Shanghai Huashan Hospital of Fudan University, and Shanghai Mental Health Center, and will conclude on June 30, 2022. The study will recruit 184 patients randomly divided into an acupuncture group or a control group at a 1:1 ratio. All participants will receive donepezil hydrochloride (5 mg/day), and those in the acupuncture group will receive acupuncture based on syndrome differentiation with donepezil for 12 weeks. The primary outcome will be the post-treatment change in the Alzheimer’s Disease Assessment Scale-cognition score at 12 weeks. The secondary outcomes will be the efficacy scores of the Minimum Mental State Examination, Alzheimer’s Disease Cooperative Research Activity-Daily Life, and Quality of Life-Alzheimer’s Disease. All assessments will be performed at baseline, after treatment (week 12), and at follow-up (weeks 24 and 36).
Discussion
This trial may provide high-quality evidence for the efficacy of acupuncture in the treatment of AD. The results of this study will be published in peer-reviewed journals.
Trial registration
ClinicalTrials.govNCT03810794. Registered on 17 January 2019.
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Pei W, Meng F, Deng Q, Zhang B, Gu Y, Jiao B, Xu H, Tan J, Zhou X, Li Z, He G, Ruan J, Ding Y. Electroacupuncture promotes the survival and synaptic plasticity of hippocampal neurons and improvement of sleep deprivation-induced spatial memory impairment. CNS Neurosci Ther 2021; 27:1472-1482. [PMID: 34623740 PMCID: PMC8611786 DOI: 10.1111/cns.13722] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 12/11/2022] Open
Abstract
Aims This study aimed to investigate whether electroacupuncture (EA) promotes the survival and synaptic plasticity of hippocampal neurons by activating brain‐derived neurotrophic factor (BDNF)/tyrosine receptor kinase (TrkB)/extracellular signal‐regulated kinase (Erk) signaling, thereby improving spatial memory deficits in rats under SD. Methods In vivo, Morris water maze (MWM) was used to detect the effect of EA on learning and memory, at the same time Western blotting (WB), immunofluorescence (IF), and transmission electron microscopy (TEM) were used to explore the plasticity of hippocampal neurons and synapses, and the expression of BDNF/TrkB/Erk signaling. In vitro, cultured hippocampal neurons were treated with exogenous BDNF and the TrkB inhibitor K252a to confirm the relationship between BDNF/TrkB/Erk signaling and synaptic plasticity. Results Our results showed that EA mitigated the loss of hippocampal neurons and synapses, stimulated hippocampal neurogenesis, and improved learning and memory of rats under SD accompanied by upregulation of BDNF and increased phosphorylation of TrkB and Erk. In cultured hippocampal neurons, exogenous BDNF enhanced the expression of synaptic proteins, the frequency of the postsynaptic currents, and the phosphorylation of TrkB and Erk; these effects were reversed by treatment with K252a. Conclusions Electroacupuncture alleviates SD‐induced spatial memory impairment by promoting hippocampal neurogenesis and synaptic plasticity via activation of BDNF/TrkB/Erk signaling, which provided evidence for EA as a therapeutic strategy for countering the adverse effects of SD on cognition.
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Affiliation(s)
- Wenya Pei
- Department of Acupuncture, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Fanqi Meng
- Department of Acupuncture, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qingwen Deng
- Department of Histology and Embryology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Baobao Zhang
- Department of Histology and Embryology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Yuan Gu
- Guangzhou Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Boyu Jiao
- Department of Acupuncture, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haoyu Xu
- Department of Histology and Embryology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Jiuqing Tan
- Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Xin Zhou
- Department of Acupuncture, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhiling Li
- Department of Traditional Chinese Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Guanheng He
- Department of Acupuncture, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jingwen Ruan
- Department of Acupuncture, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ying Ding
- Department of Histology and Embryology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
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10
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Yin W, Lv G, Li C, Sun J. Acupuncture therapy for Alzheimer's disease: The effectiveness and potential mechanisms. Anat Rec (Hoboken) 2021; 304:2397-2411. [PMID: 34623030 DOI: 10.1002/ar.24780] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/22/2021] [Accepted: 08/28/2021] [Indexed: 12/18/2022]
Abstract
Alzheimer's disease (AD) is a common neurodegenerative disease that accounts for approximately 70% of dementia. Following the global escalation of the aging process, the morbidity of AD is increasing rapidly. The current treatment for AD is mainly limited to medications, such as acetylcholinesterase inhibitors. However, the efficacy of acetylcholinesterase inhibitors in improving memory and cognitive functions is not satisfactory. It is a challenge to find an effective alternative therapy for ameliorating AD symptoms. As an important therapeutic technique in traditional Chinese medicine, acupuncture has been proved effective in treating many neurologic diseases including AD. The efficacy of acupuncture is also acknowledged by the National Institutes of Health of the United States. Here, we summarized the effectiveness of acupuncture for treating AD. Especially, the role of acupuncture at certain acupuncture points in modulating the brain function through meridians activity based on Chinese meridian theory is discussed. How acupuncture at a certain acupoint can improve AD symptoms is also described. Furthermore, the possible molecular mechanisms of acupuncture for AD are reviewed, and the role of acupuncture in modulating signaling molecules in neural protection and homeostasis is highlighted. This study may help to understand the theoretical basis and potential molecular mechanisms of acupuncture therapy for AD.
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Affiliation(s)
- Wei Yin
- Department of Anatomy, School of Basic Medical Sciences, Shandong University, Jinan, China
| | - Guoying Lv
- Department of Anesthesiology, The Second Hospital of Shandong University, Jinan, China
| | - Chuangang Li
- Department of Anesthesiology, The Second Hospital of Shandong University, Jinan, China
| | - Jinhao Sun
- Department of Anatomy, School of Basic Medical Sciences, Shandong University, Jinan, China
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11
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Xu A, Tang Y, Zeng Q, Wang X, Tian H, Zhou Y, Li Z. Electroacupuncture Enhances Cognition by Promoting Brain Glucose Metabolism and Inhibiting Inflammation in the APP/PS1 Mouse Model of Alzheimer's Disease: A Pilot Study. J Alzheimers Dis 2021; 77:387-400. [PMID: 32741819 DOI: 10.3233/jad-200242] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is a neurodegenerative disease, yet there is no effective treatment. Electroacupuncture (EA) is a complementary alternative medicine approach. In clinical and animal studies, EA promotes cognition in AD and vascular dementia. It has been previously reported that cognitive decline in AD might be closely related to reduced glucose intake in the brain. It is worth mentioning that the regions of glucose hypometabolism are usually found to be associated with neuroinflammation. OBJECTIVE This study is to explore whether the protective mechanism of EA on cognition is related to the regulation of glucose metabolism and neuroinflammation. METHODS APP/PS1 mice were randomly divided into AD group and the treatment (AD + EA) group. In the AD + EA group, EA was applied on Baihui (GV20) and Yintang (GV29) for 20 min and then pricked at Shuigou (GV26), once every alternate day for 4 weeks. Morris water maze (MWM) tests were performed to evaluate the effects of EA treatment on cognitive functions. 18F-FDG PET, immunofluorescence, and western blot were used to examine the mechanisms underlying EA effects. RESULTS From MWM tests, EA treatment significantly improved cognition of APP/PS1 mice. From the 18F-FDG PET, the levels of uptake rate of glucose in frontal lobe were higher than the AD group after EA. From immunofluorescence and western blot, amyloid-β (Aβ) and neuroinflammation were reduced after EA. CONCLUSION These results suggest that EA may prevent cognitive decline in AD mouse models by enhancing glucose metabolism and inhibiting inflammation-mediated Aβ deposition in the frontal lobe.
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Affiliation(s)
- Anping Xu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yinshan Tang
- Department of Rehabilitation and Traditional Chinese Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Qingtao Zeng
- Information Engineering Institute, Beijing Institute of Graphic Communication, Beijing, China
| | - Xin Wang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Huiling Tian
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - You Zhou
- Department of Rehabilitation and Traditional Chinese Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhigang Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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12
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Effects of Acupuncture on Oxidative Stress Amelioration via Nrf2/ARE-Related Pathways in Alzheimer and Parkinson Diseases. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6624976. [PMID: 33995547 PMCID: PMC8096560 DOI: 10.1155/2021/6624976] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/06/2021] [Accepted: 04/16/2021] [Indexed: 12/17/2022]
Abstract
Oxidative stress is responsible for the pathogeneses of various diseases. Mitochondrial dysfunction, impaired DNA repair, and cellular damage followed by oxidative stress contribute to neurodegenerative diseases, such as Alzheimer disease (AD) and Parkinson disease (PD). Acupuncture is a traditional therapy that has been practiced for >3000 years in Asia. Many studies have demonstrated that acupuncture has notable antioxidative, anti-inflammatory, and antiapoptotic effects. However, the exact mechanism remains unclear. Nuclear factor erythroid 2-related factor (Nrf2) is crucial in regulating the redox equilibrium. Activated Nfr2 translocates into the nucleus, binds to the antioxidant response element (ARE), and initiates antioxidative enzyme transcription. In this review, we demonstrated the effects of acupuncture on oxidative stress amelioration in AD and PD animal models through Nrf2/ARE pathway activation and Nrf2/ARE-related pathway regulation. Thus, acupuncture could be a therapeutic option for AD and PD.
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13
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The Role of Acupuncture Improving Cognitive Deficits due to Alzheimer's Disease or Vascular Diseases through Regulating Neuroplasticity. Neural Plast 2021; 2021:8868447. [PMID: 33505460 PMCID: PMC7815402 DOI: 10.1155/2021/8868447] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/29/2020] [Accepted: 12/15/2020] [Indexed: 02/06/2023] Open
Abstract
Dementia affects millions of elderly worldwide causing remarkable costs to society, but effective treatment is still lacking. Acupuncture is one of the complementary therapies that has been applied to cognitive deficits such as Alzheimer's disease (AD) and vascular cognitive impairment (VCI), while the underlying mechanisms of its therapeutic efficiency remain elusive. Neuroplasticity is defined as the ability of the nervous system to adapt to internal and external environmental changes, which may support some data to clarify mechanisms how acupuncture improves cognitive impairments. This review summarizes the up-to-date and comprehensive information on the effectiveness of acupuncture treatment on neurogenesis and gliogenesis, synaptic plasticity, related regulatory factors, and signaling pathways, as well as brain network connectivity, to lay ground for fully elucidating the potential mechanism of acupuncture on the regulation of neuroplasticity and promoting its clinical application as a complementary therapy for AD and VCI.
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14
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Yu CC, Du YJ, Wang SQ, Liu LB, Shen F, Wang L, Lin YF, Kong LH. Experimental Evidence of the Benefits of Acupuncture for Alzheimer's Disease: An Updated Review. Front Neurosci 2021; 14:549772. [PMID: 33408601 PMCID: PMC7779610 DOI: 10.3389/fnins.2020.549772] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 11/18/2020] [Indexed: 12/15/2022] Open
Abstract
As the global population ages, the prevalence of Alzheimer's disease (AD), the most common form of dementia, is also increasing. At present, there are no widely recognized drugs able to ameliorate the cognitive dysfunction caused by AD. The failure of several promising clinical trials in recent years has highlighted the urgent need for novel strategies to both prevent and treat AD. Notably, a growing body of literature supports the efficacy of acupuncture for AD. In this review, we summarize the previously reported mechanisms of acupuncture's beneficial effects in AD, including the ability of acupuncture to modulate Aβ metabolism, tau phosphorylation, neurotransmitters, neurogenesis, synapse and neuron function, autophagy, neuronal apoptosis, neuroinflammation, cerebral glucose metabolism, and brain responses. Taken together, these findings suggest that acupuncture provides therapeutic effects for AD.
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Affiliation(s)
- Chao-Chao Yu
- Department of Tuina, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.,The Fourth Clinical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Yan-Jun Du
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
| | - Shu-Qin Wang
- Department of Tuina, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.,The Fourth Clinical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Le-Bin Liu
- Department of Rehabilitation Medicine, Hubei Rongjun Hospital, Wuhan, China
| | - Feng Shen
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
| | - Li Wang
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
| | - Yuan-Fang Lin
- Department of Tuina, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.,The Fourth Clinical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Li-Hong Kong
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
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15
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Yu CC, He C, Du YJ, Gao S, Lin YF, Wang SQ, Wang L, Wang J, Wang XS, Jiang T, Kong LH. Preventive electroacupuncture reduces cognitive deficits in a rat model of D-galactose-induced aging. Neural Regen Res 2021; 16:916-923. [PMID: 33229729 PMCID: PMC8178792 DOI: 10.4103/1673-5374.297090] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Acupuncture can reduce cognitive deficits in Alzheimer’s disease. However, whether electroacupuncture can prevent or alleviate the cognitive deficits in animal models of aging remains poorly understood. Studies have shown that disordered epigenetic modifications play a critical role in age-related cognitive decline. Therefore, we hypothesized that preventive electroacupuncture might improve cognitive functions during aging by regulating epigenetic modifications. A rat model of aging was produced by intraperitoneal injection of 120 mg/kg D-galactose for 8 weeks. Baihui and Shenshu acupoints were stimulated by electroacupuncture for 8 weeks from the first day of D-galactose administration. Preventive electroacupuncture alleviated memory impairment, decreased tau hyperphosphorylation, and reduced glycogen synthase kinase-3β protein and mRNA expression levels in the brainstem dorsal raphe nucleus, where intracellular neurofibrillary tangle lesions first occur. In addition, the DNA methylation level in the promoter region of the glycogen synthase kinase-3β gene was increased. The effects of preventive electroacupuncture were stronger than those of preventive acupuncture. Intraperitoneal injection of 0.4 mg/kg 5-aza-2′-deoxycytidine, an inhibitor of DNA methyltransferase that blocks epigenetic modifications, antagonized the effects of preventive electroacupuncture. Our results suggest that preventive electroacupuncture treatment alleviates cognitive impairment in aging rats probably by affecting the epigenetic modification of the glycogen synthase kinase-3β gene in the dorsal raphe nucleus. This study was approved by the Animal Ethics Committee of Hubei University of Chinese Medicine, China (approval No. HUCMS201712001) on November 28, 2017.
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Affiliation(s)
- Chao-Chao Yu
- Department of Tuina, Shenzhen Traditional Chinese Medicine Hospital; The 4th Clinical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong Province, China
| | - Chuan He
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, Hubei Province, China
| | - Yan-Jun Du
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, Hubei Province, China
| | - Shan Gao
- Department of Acupuncture & Moxibustion, Wuhan Hospital of Integrated Chinese & Western Medicine, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China
| | - Yuan-Fang Lin
- Department of Tuina, Shenzhen Traditional Chinese Medicine Hospital; The 4th Clinical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong Province, China
| | - Shu-Qin Wang
- Department of Tuina, Shenzhen Traditional Chinese Medicine Hospital; The 4th Clinical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong Province, China
| | - Li Wang
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, Hubei Province, China
| | - Jia Wang
- Department of Acupuncture & Moxibustion, Wuhan Hospital of Integrated Chinese & Western Medicine, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China
| | - Xue-Song Wang
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, Hubei Province, China
| | - Tao Jiang
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, Hubei Province, China
| | - Li-Hong Kong
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, Hubei Province, China
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16
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Xu A, Zeng Q, Tang Y, Wang X, Yuan X, Zhou Y, Li Z. Electroacupuncture Protects Cognition by Regulating Tau Phosphorylation and Glucose Metabolism via the AKT/GSK3β Signaling Pathway in Alzheimer's Disease Model Mice. Front Neurosci 2020; 14:585476. [PMID: 33328854 PMCID: PMC7714768 DOI: 10.3389/fnins.2020.585476] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/26/2020] [Indexed: 12/22/2022] Open
Abstract
Background Alzheimer’s disease (AD) is mainly manifested as a continuous and progressive decline in cognitive ability. Neurofibrillary tangles (NFTs) are pathological hallmarks of AD and due to accumulated phosphorylated Tau. Glycogen synthase kinase-3β (GSK3β), as a major Tau kinase and a downstream target of the serine protein kinase B (AKT) signaling pathway, can regulate Tau phosphorylation in AD. Importantly, the AKT/GSK3β signaling pathway is involved in glucose metabolism, and abnormal glucose metabolism is found in the AD brain. Numerous studies have shown that electroacupuncture (EA), which is thought to be a potential complementary therapeutic approach for AD, can protect cognitive ability to a certain extent. Objective The purpose of this experiment was to investigate whether the protective and beneficial mechanism of EA on cognition was mediated by the AKT/GSK3β signaling pathway, thereby improving glucose metabolism and Tau phosphorylation in the brain. Methods EA was applied to the Baihui (GV20) and Yintang (GV29) acupoints of 6-month-old amyloid precursor protein (APP)/presenilin-1 (PS1) mice for 20 min, and then quickly prick Shuigou (GV26) acupoint. The intervention was performed once every other day for 28 days. The Morris water maze (MWM) test was performed on C57BL/6N (Non-Tg) mice, APP/PS1 (Tg) mice and EA-treated Tg (Tg + EA) mice to evaluate the effect of EA therapy on cognitive function. 18F-FDG positron emission tomography (PET), immunohistochemistry, and western blotting (WB) were used to investigate the possible mechanism underlying the effect of EA on AD. Results EA treatment significantly improved the cognition of APP/PS1 mice and the glucose uptake rate in the hippocampus. Furthermore, EA inhibited the phosphorylation of Tau (Ser199 and Ser202) proteins by inducing AKT (Ser473) and GSK3β (Ser9) phosphorylation. Conclusion These results demonstrate that EA intervention protects cognition by enhancing glucose metabolism and inhibiting abnormal phosphorylation of Tau protein in the AD model mice, and the AKT/GSK3β pathway might play an irreplaceable role in the regulation process.
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Affiliation(s)
- Anping Xu
- School of Acupuncture-moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Qingtao Zeng
- Information Engineering Institute, Beijing Institute of Graphic Communication, Beijing, China
| | - Yinshan Tang
- Department of Rehabilitation and Traditional Chinese Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xin Wang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Xiaochen Yuan
- Key Laboratory of Microcirculation, Ministry of Health, Institute of Microcirculation, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - You Zhou
- Department of Rehabilitation and Traditional Chinese Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zhigang Li
- School of Acupuncture-moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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17
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Mechanisms of Electroacupuncture on Alzheimer’s Disease: A Review of Animal Studies. Chin J Integr Med 2020; 26:473-480. [DOI: 10.1007/s11655-020-3092-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2019] [Indexed: 12/22/2022]
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18
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Qi B, Yang Y, Cheng Y, Sun D, Wang X, Khanna R, Ju W. Nasal delivery of a CRMP2-derived CBD3 adenovirus improves cognitive function and pathology in APP/PS1 transgenic mice. Mol Brain 2020; 13:58. [PMID: 32272942 PMCID: PMC7144060 DOI: 10.1186/s13041-020-00596-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 03/23/2020] [Indexed: 12/12/2022] Open
Abstract
Calcium dysregulation is a key pathological event in Alzheimer's disease (AD). In studying approaches to mitigate this calcium overload, we identified the collapsin response mediator protein 2 (CRMP2), an axonal guidance protein that participates in synapse dynamics by interacting with and regulating activity of N-methyl-D-aspartate receptors (NMDARs). We further identified a 15 amino acid peptide from CRMP2 (designated CBD3, for calcium-binding domain 3), that reduced NMDAR-mediated Ca2+ influx in cultured neurons and post-synaptic NMDAR-mediated currents in cortical slices. Whether targeting CRMP2 could be therapeutically beneficial in AD is unknown. Here, using CBD3, we tested the utility of this approach. Employing the APP/PS1 mouse model of AD which demonstrates robust pathophysiology including Aβ1-42 deposition, altered tau levels, and diminished cognitive functions, we asked if overexpression of CBD3 could rescue these events. CBD3 was engineered into an adeno-associated vector and nasally delivered into APP/PS1 mice and then biochemical (immunohistochemistry, immunoblotting), cellular (TUNEL apoptosis assays), and behavioral (Morris water maze test) assessments were performed. APP/PS1 mice administered adeno-associated virus (AAV, serotype 2) harboring CBD3 demonstrated: (i) reduced levels of Aβ1-42 and phosphorylated-tau (a marker of AD progression), (ii) reduced apoptosis in the hippocampus, and (iii) reduced cognitive decline compared with APP/PS1 mice or APP/PS1 administered a control virus. These results provide an instructive example of utilizing a peptide-based approach to unravel protein-protein interactions that are necessary for AD pathology and demonstrate the therapeutic potential of CRMP2 as a novel protein player in AD.
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Affiliation(s)
- Baochang Qi
- Department of Orthopedic Traumatology, The First Hospital of Jilin University, Changchun, 130021, Jilin Province, China
| | - Yu Yang
- Department of Neurology and neuroscience center, The First Hospital of Jilin University, No.1 Xinmin Street, Chaoyang District, Changchun, 130021, Jilin Province, China
| | - Yingying Cheng
- Department of Neurology and neuroscience center, The First Hospital of Jilin University, No.1 Xinmin Street, Chaoyang District, Changchun, 130021, Jilin Province, China
| | - Di Sun
- Department of Colorectal and Anal Surgery, The First Hospital of Jilin University, Changchun, 130021, Jilin Province, China
| | - Xu Wang
- Department of Neurology and neuroscience center, The First Hospital of Jilin University, No.1 Xinmin Street, Chaoyang District, Changchun, 130021, Jilin Province, China
| | - Rajesh Khanna
- Department of Pharmacology, College of Medicine, The University of Arizona, Tucson, AZ, 85718, USA.
- Center for Innovation in Brain Sciences, University of Arizona, Tucson, AZ, 85721, USA.
| | - Weina Ju
- Department of Neurology and neuroscience center, The First Hospital of Jilin University, No.1 Xinmin Street, Chaoyang District, Changchun, 130021, Jilin Province, China.
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19
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Tang Y, Xu A, Shao S, Zhou Y, Xiong B, Li Z. Electroacupuncture Ameliorates Cognitive Impairment by Inhibiting the JNK Signaling Pathway in a Mouse Model of Alzheimer's Disease. Front Aging Neurosci 2020; 12:23. [PMID: 32116652 PMCID: PMC7016202 DOI: 10.3389/fnagi.2020.00023] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/22/2020] [Indexed: 12/14/2022] Open
Abstract
Electroacupuncture (EA) has become popular for its adjustable strength and frequency and easy quantification in the clinic and has demonstrated therapeutic potential for Alzheimer’s disease (AD). However, the mechanism remains unknown. Abnormally activated c-Jun N-terminal kinase (JNK) has been closely related to the pathological process of AD. The aim of this study was to investigate the effect of EA on cognitive impairment and the role of the JNK signaling pathway in AD model amyloid precursor protein (APP)/presenilin 1 (PS1) mice. The memory and learning ability of each group was assessed using the Morris Water Maze (MWM). Immunofluorescence, immunohistochemistry and Western blot were performed to measure the expression of APP, JNK, phosphorylated (P-)JNK, mitogen-activated protein kinase 4 (MKK4), MKK7, c-Jun and caspase-3 in hippocampal tissue samples in APP/PS1 mice after EA intervention. Obvious cognitive deficits were observed in the AD model APP/PS1 mice in the MWM test and were associated with JNK signaling pathway activation and APP upregulation. Four weeks of EA significantly ameliorated the cognitive impairments and inhibited JNK signaling pathway activation and APP upregulation. Taken together, the findings demonstrated that EA can reverse cognitive deficits and substantially lower the burden of APP in AD model APP/PS1 mice, at least partially through inhibiting the JNK signaling pathway and regulating apoptosis signals. Therefore, EA may offer an effective alternative therapeutic approach for AD.
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Affiliation(s)
- Yinshan Tang
- Department of Rehabilitation and Traditional Chinese Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Anping Xu
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Shujun Shao
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - You Zhou
- Department of Rehabilitation and Traditional Chinese Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Bing Xiong
- Department of Rehabilitation and Traditional Chinese Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zhigang Li
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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