Abstract

our previous study found that acupuncture with low frequency electrical stimulation (Acu/LFES) can prevent muscle atrophy by increasing muscle protein anabolism in mouse models of chronic kidney disease and diabetes. Previous other studies have found that Acu/LFES decreases urinary albumin secretion and improves renal blood flow and GFR in nephropathy patients and animals. We hypothesized that Acu/LFES has benefits on both skeletal muscle and kidney. Normal C56BL6 mice were awake without any anesthesia and appeared to be comfortable throughout the Acu/LFES. Acupuncture points selected were according to the WHO Standard Acupuncture guidelines. The mice were treated with Acu/LFES (anode: Yang Ling Quan, GB34 and cathode: Zu San Li, ST36) daily for 15 days. Renal plasma flow was measured by p-Aminohippuric acid infusion (PAH Colorimetric Assay Kit, BioVision Inc.). Glomerular filtration rate was determined using inulin infusion and measured with a FIT-GFR kit (BioPhysics Assay Lab, Inc.). Muscle function was measured using a mouse grip strength meter. Exosomes were isolated by serial centrifugations. A miR deep sequencing assay and qPCR were used to identify microRNA expression in exosomes. Skeletal muscle function and protein anabolic markers were increased after Acu/LFES treatment. Interestingly, PAH clearance was increased by 45% in the mice after 15 minutes of Acu/LFES versus mice with sham Acu/LFES (sham 6.1 ± 1.3 vs. Acu/LFES 8.9 ± 2.7 ml/min/g BW, P = 0.009, n=8/group). In additional, inulin clearance was increased 39.8% (sham 65.9 ± 16.3 vs. Acu/LFES108.9 ± 19.7 ul/min/BW, P = 0.014). We found that Acu/LFES increases serum exosome abundance (Figure 1). When exosome secretion was blocked using GW4869, the Acu/LFES-induced increase in renal blood flow and GFR were limited. To identify how exosomes regulate renal blood flow, we performed microRNA deep sequencing of exosomes isolated from mouse serum and found that 34 microRNAs were altered by Acu/LFES. Notably, miR-181d-5p, a microRNA that is involved in regulating translation of renin, was significantly increased in the serum exosomes of Acu/LFES treated mice. Using a luciferase reporter assay, we demonstrated that miR-181 directly inhibits angiotensinogen, which provides potential evidence of Acu/LFES regulation of renal blood flow. Acu/LFES not only improves muscle function, but also increases miR-181 in serum exosomes and increases renal blood flow, suggesting that miR181 may regulate renal blood flow possibly by influencing the renin-angiotensin system. This study provides new insights about the mechanism(s) of muscle-organ cross talk through exosome-derived microRNA.

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