Abstract
Electroacupuncture (EA) can effectively relieve hyperglycemia and gastric emptying disorders in diabetic gastroparesis (DGP). However, the effect of EA on type 2 diabetes mellitus (T2DM) gastroparesis and its mechanism in the enteric nervous system (ENS) are rarely studied. We investigated the therapeutic effect of EA at ST36 and its effect on the main inhibitory and excitatory neurotransmitters in the ENS in DGP rats. Male Sprague-Dawley (SD) rats were fed a high-fat diet for 2 weeks and injected with streptozotocin (STZ) at 35 mg/kg to induce T2DM. T2DM rats were divided into the diabetic mellitus (DM) group and the EA group. The control (CON) group comprised normal rats without any intervention. EA treatment was started 6 weeks after the induction of DM and continued for 5 weeks. The body weight and food intake of the rats were recorded every week. Blood glucose, insulin, glucose tolerance, gastric emptying, and antral motility were measured after treatment. The expression of protein gene product 9.5 (PGP9.5), neuronal nitric oxide synthase (nNOS), and choline acetyltransferase (ChAT) in gastric antrum were quantified by western blotting and quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). The T2DM gastroparesis model was successfully established. EA treatment reduced the body weight, food intake, and blood glucose; improved glucose intolerance and insulin resistance; increased the gastric emptying rate, the mean antral pressure, and the amplitude of antral motility; and decreased the frequency of antral motility compared with those in the DM group. EA treatment increased the expression level of nNOS, ChAT, and PGP9.5 proteins, and nNOS and ChAT mRNA. The results suggested that EA at ST36 could ameliorate DGP, partly restore the damage to general neurons, and increase nNOS and ChAT in the gastric antrum. EA improved DGP partly via reducing the loss of inhibitory and excitatory neurotransmitters in the ENS.
Highlights
Gastroparesis is defined as a syndrome of delayed gastric emptying without mechanical obstruction. e main symptoms include early satiety, postprandial fullness, nausea, vomiting, abdominal distension, and abdominal pain [1]
DGP seems to be more common in type 1 diabetes mellitus (T1DM) than in type 2 diabetes mellitus (T2DM), the increased prevalence of T2DM leads to a greater number of patients with type 2 diabetic gastroparesis [1]
Blood glucose was measured using a portable glucometer (Roche, Indianapolis, IN, USA). e animals with a nonfasting blood glucose (NFBG) level > 16.7 mmol/L were determined as having T2DM [12]
Summary
Gastroparesis is defined as a syndrome of delayed gastric emptying without mechanical obstruction. e main symptoms include early satiety, postprandial fullness, nausea, vomiting, abdominal distension, and abdominal pain [1]. Gastroparesis is defined as a syndrome of delayed gastric emptying without mechanical obstruction. Diabetic gastroenteropathy is the most common complication in patients with long-term DM. E most common complication of diabetes in the gastrointestinal tract is delayed gastric emptying, which is defined as DGP [2]. DGP seems to be more common in type 1 diabetes mellitus (T1DM) than in T2DM, the increased prevalence of T2DM leads to a greater number of patients with type 2 diabetic gastroparesis [1]. Conventional western medicine treats gastroparesis using prokinetic drugs, gastric pacemaker, and surgery; the side effects, such as extravertebral symptoms, arrhythmia, infection, and malnutrition, are difficult to avoid. Acupuncture, as a complementary and alternative treatment technology, can effectively improve gastrointestinal peristalsis and accelerate gastric emptying [3]. Acupuncture can improve gastrointestinal symptoms in patients
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