Abstract
Background/AimsGastric dysmotility is a frequent complication among patients with diabetes mellitus. Electroacupuncture (EA) has been empirically used to relieve gastrointestinal symptoms. The aims of this study were to investigate the effects of EA on gastric contraction and the mechanisms of interstitial cells of Cajal (ICC) involved.Materials and MethodsMale Sprague–Dawley rats were randomized into the normal control, diabetes (DM), diabetic and sham EA (DM + SEA), diabetic and low-frequency EA (DM + LEA), and diabetic and high-frequency EA (DM + HEA) groups. Diabetic models were established and then treated with EA for 8 weeks. Body weight and blood glucose were recorded every 2 weeks. The spontaneous contractions of distal gastric strips were analyzed. Immunostaining and RT-PCR were used to test the apoptotic ICC, IGF-1/IGF-1R, and Nrf2/HO-1 pathways.ResultsThe body weight in the DM + LEA and DM + HEA groups were increased compared with that of the DM group, though there was no effect on the blood glucose. The gastric contractions were obviously disordered in the DM group, but EA could regularize the contractions. The number of apoptotic ICC was dramatically increased in the DM group, but reduced with EA treatment. Meanwhile, the IGF-1/IGF-1R pathway was verified to be significantly altered in diabetic rats. The Nrf2/HO-1 pathway was not significantly increased in the DM group. EA with different frequencies efficiently improved the expression of IGF-1/IGF-1R signaling and activated the Nrf2/HO-1 pathway.ConclusionEA could improve gastric motility dysfunction and attenuate ICC apoptosis possibly through the regulation of IGF-1/IGF-1R and Nrf2/HO-1 pathways. EA may be a potential therapeutic method for diabetic gastric motility dysfunction.
Highlights
Acupuncture is a common alternative medicine empirically practiced for more than 2,500 years to treat different diseases
These results revealed that EA could protect ICC from apoptosis to alleviate the contraction of gastric antrum, partly through the Insulin-like growth factor 1 (IGF-1)/IGF-1R and Nuclear factor erythroid 2-related factor (Nrf2)/HO1 pathway
We found that the expression of the Nrf2/Heme oxygenase-1 (HO-1) pathway was not increased in diabetic rats, and EA significantly improved the expression of the Nrf2/HO-1 pathway, meaning that EA may take effects on the Nrf2/HO-1 pathway to reduce ICC apoptosis in diabetic gastroparesis rats
Summary
Acupuncture is a common alternative medicine empirically practiced for more than 2,500 years to treat different diseases (van den Berg-Wolf and Burgoon, 2017). As a form of traditional Chinese medicine, the efficacy of EA in pain relief was accepted by the United States and other Western countries (Ju et al, 2017). According to traditional Chinese medicine, Zusanli acupoint (ST36) is commonly used to treat gastrointestinal disorders, such as motor dysfunction, visceral pain, and secretion (Chen et al, 2018; Song et al, 2019; Guo et al, 2020). Numerous studies have manifested that EA at ST36 has been widely accepted to treat diabetic patients with symptoms such as vomiting, nausea, abdominal bloating, and abdominal pain (Wang, 2004; Liu et al, 2012; Pan et al, 2017). The underlying mechanisms of EA at ST36 on diabetic gastric motility dysfunction have not yet been elucidated
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