Abstract

Transcutaneous electrical acupoint stimulation (TEAS) has been consistently used clinically for its ease of operation, non-invasiveness and painlessness, in contrast to the characteristics of inserted needles. However, the mechanism remains unknown. The aim of this study was to investigate the local response of TEAS at Hegu acupoint (LI4). Immunohistochemistry was used to measure the expression of tryptase-positive mast cells, neuropeptides of the calcitonin gene-related peptide (CGRP) and substance P (SP) in LI4. Mast cells were also labelled with serotonin (5-HT), neurokinin-1 receptor (NK-1R) and toluidine blue. The results showed that cutaneous CGRP and SP immune-positive (CGRP-IP or SP-IP) nerve fibres in LI4 were more highly expressed. There were high degrees of mast cell aggregation and degranulation with release of 5-HT near the CGRP-IP or SP-IP nerve fibres and blood vessels after TEAS. The degranulation of mast cells (MCs) was accompanied by expression of NK-1R after TEAS. Either mast cell membrane stabilizer (Disodium cromoglycate) or NK-1R antagonist (RP 67580) diminished the accumulation and degranulation of MCs induced by TEAS. Taken together, the findings demonstrated that TEAS induced sensory nerve fibres to express CGRP and SP, which then bound to the NK-1R on MCs, after which MCs degranulated and released 5-HT, resulting in TEAS-initiated acupuncture-like signals.

Highlights

  • Transcutaneous electrical acupoint stimulation (TEAS) combines the transcutaneous electrical stimulation of physical therapy with acupoint therapy but less invasive than MA5

  • We hypothesized that TEAS activated cutaneous sensory nerve fibres to express sensory calcitonin gene-related peptide (CGRP) and substance P (SP), and that SP bonded to neurokinin-1 receptor (NK-1R) situated in mast cells (MCs) to initiate MC release of tryptase and 5-HT

  • TEAS induced both CGRP and SP immune-positive nerve fibres highly expressed in the epidermis and dermis of acupoint LI4

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Summary

Introduction

Transcutaneous electrical acupoint stimulation (TEAS) combines the transcutaneous electrical stimulation of physical therapy with acupoint therapy but less invasive than MA5. Transcutaneous electrical nerve stimulation (TENS) or TEAS instead of MA or EA is becoming a trend for they had same effect on antinociception and shares common neural mechanisms[10]. Our previous study demonstrated that local cutaneous nerve terminals and mast cells (MCs) responded to MA. MA at acupoint LI411 induces higher expression of neuropeptides of calcitonin gene-related peptide (CGRP) and substance P (SP) in subepidermal nerve fibres to activate MCs. Whether nerve-mast cell cross-talk contributes to the effects of TEAS remains unclear. We hypothesized that TEAS activated cutaneous sensory nerve fibres to express sensory CGRP and SP, and that SP bonded to neurokinin-1 receptor (NK-1R) situated in MCs to initiate MC release of tryptase and 5-HT

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