Electroacupuncture Inhibits Atherosclerosis through Regulating Intestinal Flora and Host Metabolites in Rabbit

Targeting Trimethylamine N-Oxide: A New Therapeutic Strategy for Alleviating Atherosclerosis

Atherosclerosis (AS) is one of the most common cardiovascular diseases (CVDs), and there is currently no effective drug to reverse its pathogenesis. Trimethylamine N-oxide (TMAO) is a metabolite of the gut flora with the potential to act as a new risk factor for CVD. Many studies have shown that TMAO is involved in the occurrence and development of atherosclerotic diseases through various mechanisms; however, the targeted therapy for TMAO remains controversial. This article summarizes the vital progress made in relation to evaluations on TMAO and AS in recent years and highlights novel probable approaches for the prevention and treatment of AS.

Additional Acupuncture Confers a Favorable Long-Term Prognosis for Elderly Hypertensive Patients with Carotid Atherosclerosis after Atorvastatin Treatment

Objective

The purpose of the study is to investigate the clinical efficacy and long-term prognosis of acupuncture (AP) combined with atorvastatin (ATO) in treating senile essential hypertension (EH) complicated with carotid atherosclerosis (CA).

Methods

108 elderly EH patients with CA admitted to our hospital between January 2018 and September 2018 were enrolled into the study, consisting of 67 patients who received treatment of AP with ATO (AP + ATO group) and 41 patients who received treatment of ATO alone (ATO group). Comparative outcomes included clinical efficacy, blood pressure (BP), the levels of blood lipids and inflammatory factors, carotid intima-media thickness (IMT), the number of unstable carotid intima plaques, the carotid plaque area, and the incidence of adverse reactions. All patients were followed up for 3 years to evaluate their quality of life and the recurrence rate of CA.

Results

The AP + ATO group presented a higher efficacy, a declined BP, and lower posttreatment levels of blood lipids and inflammatory factors than the ATO group (P < 0.05). Reductions were observed in IMT, number of plaques, and plaque area in both groups after treatment, with more significant improvements in the AP + ATO group (P < 0.05). No difference was observed in the incidence of adverse reactions between two groups after treatment (P > 0.05). The follow-up analysis demonstrated a higher SF-36 score and a lower recurrence rate of CA in the AP + ATO group than the ATO group (P < 0.05).

Conclusion

The findings suggested that, for elderly EH patients with CA, treatment of AP with ATO offers better clinical efficacy and safety, which not only can decline the BP, but also can reduce blood lipids and plaque formation, and improve quality of life.

Comparative efficacy of different types of acupuncture as adjuvant therapy on carotid atherosclerosis: a protocol for systematic review and network meta-analysis

INTRODUCTION

Carotid atherosclerosis (CAS) is a disease of the aorta caused by lipid metabolism disorders and local inflammation. Acupuncture combined with traditional western medicine (such as aspirin or atorvastatin) for the treatment of CAS has been widely applied in clinical practice, but there is still a lack of supporting evidence for its efficacy and safety on CAS. Therefore, this systematic review and network meta-analysis (NMA) will summarise the effects of different types of acupuncture treatments on CAS, and a ranking of the therapeutic classes will also be presented, aiming to provide evidence-based medicine for its extensive clinical application.

METHODS AND ANALYSIS

Systematic and NMA searches will be conducted in seven electronic databases: PubMed, EMBASE, Medline, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang Database and Chongqing VIP databases. The search time is from their inception to December 2020, regardless of language and publication type. Randomised controlled trials and controlled clinical trials that include patients with CAS receiving acupuncture therapy compared with a control group will be considered eligible. The primary outcomes include the carotid intima-media thickness and vessel plaque quantification; the secondary outcomes include the carotid plaque Crouse score, greyscale median, lipid levels, the incidence of cardiovascular events, safety and adverse events. The selection of studies, data extraction, quality assessment and risk of bias assessment will be conducted by two independent reviewers. The NMA will be analysed with Stata V.15.0, RevMan V.5.3 software and WinBUGS V.1.4.3.

ETHICS AND DISSEMINATION

Ethical approval will not be required for this study as it will be based on de-identified, aggregated published data. We will publish the findings in a peer-reviewed journal.

PROSPERO REGISTRATION NUMBER

CRD42020207260.

Analysis of Gut Microbiota in Patients with Coronary Artery Disease and Hypertension

Cardiovascular and cerebrovascular diseases are characterized by high rates of morbidity and mortality. Microbiota is closely associated with cardiovascular disease. We aimed to comprehensively analyze the microbiotas of 300 healthy controls, 300 patients with high blood pressure (HBP), and 300 patients with coronary heart disease (CHD). The results indicated no significant difference in microbiota diversity among the three groups (P > 0.05). However, differences in microbiota richness among the three groups were significant (P < 0.05). Bacteroidetes and Bacteroidia were the dominant bacteria in the CHD group, Enterobacteriales and Escherichia-shigella in the HBP group, and Acidaminococcaceae and Phascolarctobacterium in the healthy control group. The prediction results of the random forest model indicated that the population with CHD displayed prominent features with high sensitivity, indicating that microbiota detection might become a novel clinical indicator to predict and monitor the risk of cardiovascular events. The prediction of microbiota function suggested differences in oxygen supply and chronic inflammation between populations with HBP/CHD and healthy populations. Although there is no difference in gut microbiota diversity among the three groups, each group has its dominant microbiota in terms of richness.

Effects of swimming on the development of atherosclerosis in mice

OBJECTIVE

To investigate the effects of swimming on the formation of atherosclerotic lesions and the corresponding mechanism.

METHODS

20 ApoE-deficient young male mice of SFP grade were assigned equally into two groups: atherosclerosis group and swimming group. Atherosclerosis models were established by feeding with high cholesterol diet. Swimming exercise was performed at a frequency of 90 min per day, 6 days per weeks for 10 weeks. The weight index, histologic changes of aorta area, blood lipid levels, expression levels of eNOS, tNOS and iNOS, expression levels of MMP-9 and MMP-14, inflammatory factor levels, and oxidative stress status were compared between the two groups.

RESULTS

Compared to the atherosclerosis group, the plaque area, plaque rupture rates, and vulnerable index in the aorta of the swimming group were significantly less and the fibrous cap thickness was greater. The weight of mice and serum lipid levels in the swimming group were superior. In addition, in contrast to atherosclerosis group, mRNA expression levels of eNOS, tNOS, iNOS, and SOD in the swimming group were signifiantly elevated, while the levels of MMP-9, MMP-14 and MDA, and serum levels of IL-6, Lp-PLA2, and TNF-α were significantly decreased.

CONCLUSION

Swimming exercise significantly decreases the development of atherosclerotic plaque in ApoE-deficient mice, possibly due to a reduction in the expression of blood lipid, MMP-9, MMP-14, MDA, IL-6, Lp-PLA2, and TNF-α and elevation in the expression of eNOS, tNOS, iNOS, and SOD.

Personalized treatment interventions: nonpharmacological and natural treatment strategies in Alzheimer's disease

Introduction: Alzheimer's disease (AD) is a slow, irreversible, progressive, complex, and fatal neurodegenerative disorder. Available pharmacological treatment, known for almost two decades, does not cure the disease, but only alleviates the symptoms, with various efficacy and different side effects. Therefore, there is an unmet need to find other person-centered or personalized approaches to treat AD.Areas covered: This article describes the application of precision medicine-like approaches utilizing nonpharmacological treatment strategies and the use of natural products in personalized care for patients with AD.Expert opinion: Due to the heterogeneity of disease symptoms, somatic conditions, and patient preferences, there is definitely no "one size fits all" intervention. Therefore, individualized treatment choice is based on dementia stage, medical and psychiatric comorbidity, leading symptoms, patient preferences, and remaining capacity of the patient. In the absence of disease-modifying agents, a patient-centered, multidisciplinary team approach appears to be the best option to alleviate the heavy symptomatic burden in this unfortunate population. Hence, appropriate interventions can be offered along the AD continuum, while a better understanding of personal characteristics might help in establishing optimal individualized treatment, as well as its duration and intensity, to deliver interventions in the most effective ways.