Abstract

Background: Vascular dementia (VD) is the second most common type of dementia after Alzheimer’s disease, but there is a lack of definitive treatment for VD. Acupuncture treatment is effective in improving the cognitive impairment and behavioral capacity of patients with VD. In recent years, more studies indicated that peripheral inflammation and abnormal peripheral immune function may aggravate neuroinflammation and cognitive dysfunction. However, there are few studies about the acupuncture and the abnormal peripheral immune function of VD. Also, few studies concern the regulating effect of acupuncture on peripheral immunity of patients with VD.Objective: The aim of this study was to explore the effect of the “sanjiao” acupuncture method on peripheral immunity of patients with mild to moderate VD.Methods: A total of 30 patients with VD were involved in the acupuncture group (AG), which was treated with the “sanjiao” acupuncture method once a day for six times a week and lasted for 12 weeks, and 30 healthy elderly people were assigned to the normal group (NG), which had no treatment. The distribution of lymphocyte subsets and the levels of some inflammatory cytokines in the peripheral blood of subjects were evaluated using the flow cytometry (FCM) and the enzyme-linked immunosorbent assay (ELISA).Results: A total of 60 subjects were involved in this study, while 58 subjects completed the entire trial. Before treatment, the levels of CD3+ T, CD4+ T cells, CD4+/CD8+, Tregs, B cells, IFN-γ, and IL-10 in patients with VD were significantly decreased compared with the normal group (all P < 0.05 or P < 0.01). The level of TNF-α in peripheral blood of patients with VD was significantly increased (P < 0.01). After acupuncture treatment, the levels of CD3+ T, CD4+ T cells, and IFN-γ were significantly increased (all P < 0.05 or P < 0.01). The level of TNF-α was significantly decreased (P < 0.01). The proportion of Tregs was increased (P < 0.01), but it was still lower than that of the normal group (P < 0.05).Conclusion: The acupuncture method can increase the proportion of CD3+, CD4+ T cells, and Tregs in peripheral blood of patients with VD. And, it reduces the levels of pro-inflammatory factor TNF-α, which achieves the anti-inflammatory effects and immunostimulation. It suggests that acupuncture can improve the peripheral immune dysfunction of patients with VD by regulating the distribution of lymphocyte subsets and the levels of inflammatory cytokines.Clinical Trial Registration: [www.chictr.org.cn], identifier [ChiCTR-IOR-17012052].

Highlights

  • Vascular dementia (VD) is the general term of dementia syndrome caused by the injury of brain tissue resulting from a series of cerebral vascular diseases

  • During the course of this study, the cognitive function of patients with VD was improved after the acupuncture treatment, and they had no significantly related adverse reactions except for the minor bleeding caused by needle acupuncture, which suggested that acupuncture treatment for VD was safe and effective

  • This study further investigated the regulatory effect of acupuncture treatment on the peripheral immune function of patients with VD and confirmed that the “sanjiao” acupuncture method could increase the proportion of CD3+, CD4+ T cells, and Tregs in the peripheral blood of patients with VD

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Summary

Introduction

Vascular dementia (VD) is the general term of dementia syndrome caused by the injury of brain tissue resulting from a series of cerebral vascular diseases. The microglial cells are activated and release the proinflammatory factors, chemokines, and reactive oxygen species, which can damage the neuron. These inflammatory mediators further promote the activation of microglial cells, which aggravate the inflammatory reaction. Monocytes and macrophages are activated, and the pro-inflammatory factors are increased All of these affect the immune function of patients with VD. The immune cells such as neutrophils, monocyte, and macrophages in the peripheral blood and the pro-inflammatory factors that they released invade into brain parenchyma via damaged blood-brain barrier (BBB), further promoting the activation of microglial cells and aggravating the neuroinflammation which exacerbate the nerve injury. Few studies concern the regulating effect of acupuncture on peripheral immunity of patients with VD

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