Electrical Stimulation at the ST36 Acupoint Protects against Sepsis Lethality and Reduces Serum TNF Levels through Vagus Nerve- and Catecholamine-Dependent Mechanisms.

Albino Villegas-Bastida,Altamirano Gustavo-Acosta,Rafael Torres-Rosas,Lourdes Andrea Arriaga-Pizano,Mario Adan Moreno-Eutimio,Javier Flores-Estrada

doi:10.1155/2014/451674

Abstract

Electrical vagus nerve (VN) stimulation during sepsis attenuates tumor necrosis factor (TNF) production through the cholinergic anti-inflammatory pathway, which depends on the integrity of the VN and catecholamine production. To characterize the effect of electroacupuncture at ST36 (EA-ST36) on serum TNF, IL-6, nitrite, and HMGB1 levels and survival rates, based on VN integrity and catecholamine production, a sepsis model was induced in rats using cecal ligation and puncture (CLP). The septic rats were subsequently treated with EA-ST36 (CLP+ST36), and serum samples were collected and analyzed for cytokines levels. The serum TNF, IL-6, nitrite, and HMGB1 levels in the CLP+ST36 group were significantly lower compared with the group without treatment, the survival rates were significantly higher (P < 0.05), and the acute organ injury induced by CLP was mitigated by EA-ST36; however, when subdiaphragmatic vagotomy was performed, the serum levels of TNF in the CLP+ST36 group did not show a significant difference compared with the group without electrostimulation, and, similarly, no significant difference in serum TNF levels was found under the pharmacological blockade of catecholamines. These results suggest that in rats with CLP sepsis models EA-ST36 reduces serum TNF levels through VN- and atecholamine-dependent mechanisms.

Highlights

Acupuncture has been used for over 4,000 years and has recently experienced widespread use worldwide, with endorsements from the United States National Institutes of Health, the National Center for Complementary and Alternative Medicine, and the World Health Organization
To evaluate the effect of EA at ST36 on serum tumor necrosis factor (TNF), IL-6, nitrite, and HMGB1 levels during sepsis, four groups of rats were formed: one group underwent surgery without cecal ligation and puncture (CLP) (SHAM), and three groups were subjected to CLP, where one of these groups was treated with EA at ST36 (CLP+ST36) or sham acupuncture (CLP+SHAM-EA) after closure and suturing of the abdominal cavity
The rats treated with EA at ST36 showed lower serum TNF levels compared with the rats subjected to CLP alone, and this difference was statistically significant (P < 0.05) (Figure 1(a)) at two hours after the stimulation, and the reduction lasted over 18 hrs

Summary

Introduction

Acupuncture has been used for over 4,000 years and has recently experienced widespread use worldwide, with endorsements from the United States National Institutes of Health, the National Center for Complementary and Alternative Medicine, and the World Health Organization. Acupuncture has been described as a complementary and alternative medicine (CAM) in which filiform needles are inserted at specific points on the body, called acupoints, which can subsequently be stimulated in various ways, such as through electroacupuncture (EA) [1]. Antiinflammatory effects have been reported in mouse models of inflammation associated with EA at the Zusanli acupoint (ST36). Gu et al [3] reported that treatment with EA at ST36 induced a nephroprotective effect associated with decreased levels of TNF-α and interleukin-1 (IL-1) in a lipopolysaccharide-induced model of acute nephritis; Yim et al reported that EA at ST36 decreases the TNF-α and IL-6 levels in a collagen-induced arthritis mouse model [4]; Wang et al confirmed the reduction of TNF-α levels after

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Conclusion