A study of acupoint specificity and mechanism of electroacupuncture intervention on chronic colitis in rats based on PI3K/AKT/mTOR signaling pathway

Objective:This study aimed to elucidate the differences in effects and mechanisms of action of electric-needle therapy at Tian Shu(ST25),Da Chang Shu(BL25),Zu San Li(ST36)and Shang Ju Xu(ST37)acupoints on chronic experimental colitis in rats through the PI3K/AKT/mTOR signaling pathway.Methods:Sixty pathogen-free SD rats were randomly assigned to six groups:the normal,model,Tian Shu(ST25),Da Chang Shu(BL25),Zu San Li(ST36)and Shang Ju Xu(ST37)groups,each with 10 rats.Chronic colitis was induced in rats by combining immunization and local stimulation.After model establishment,electrical needle intervention combined with dispersing wave of 2 Hz/50 Hz with a current intensity of 2 mA once daily for 20 min was applied on acupoints of each group.Subsequently,the inflammation of colonic mucosa and serum levels of inflammatory factors(IL-23,IL-17,IL-10)were observed;ELISA was used to detect mRNA expressions of PI3K,Akt and mTOR in colitic tissues by RT-PCR as well as protein content of p-PI3k/PI3K,p-Akt/Akt,and p-mTOR/mTOR in colitic tissues by Western blotting.Result:Compared with the normal group,the model rats showed a poor general condition,serious damage to the colonic mucosa with a large number of inflammatory cells infiltration.The serum IL-23 and IL-17 expressions were significantly increased(P<0.01),while the serum IL-10 expression was significantly decreased(P<0.01);the mRNA and protein expressions of PI3K,Akt,mTOR and p-PI3K,p-Akt and p-mTOR were significantly increased(P<0.05,P<0.01).Compared with the model group,the pathological slices of rats in each acupoints intervention group showed obvious improvement of colitis inflammatory reaction and tissue damage;the serological levels of IL-23 and IL-17 were significantly reduced(P<0.01),while the serology level of IL-10 was significantly increased(P<0.01);the expressions of PI3K,Akt,mTOR mRNA and p-PI3K,p-Akt,p-mTOR proteins were significantly decreased(P<0.05,P<0.01).Compared with Tian Shu(ST25),Da Chang Shu(BL25),Zu San Li(ST36)groups,the recovery degree of mucosa layers in Shang Ju Xu(ST37)group was closer to that of normal group,and the curative effect was relatively the best;in terms of serological levels of IL-23 and IL-17,the Shang Ju Xu(ST37)group was significantly lower(P<0.05),while the level of IL-10 was significantly higher(P<0.01);the expressions of PI3K,Akt,mTOR mRNA and p-PI3K,p-Akt,p-mTOR proteins were significantly decreased(P<0.05,P<0.01).Conclusion:Results indicate that electrical acupuncture at Tian Shu(ST25),Da Chang Shu(BL25),Zu San Li(ST36)and Shang Ju Xu(ST37)show similar effects in relieving the colitis-induced damage in the mucosa of chronic colitis rats,as well as inflammatory response.Among them,Shang Ju Xu(ST25)has a superior overall effect in treating chronic colitis compared to Tian Shu(ST25),Da Chang Shu(BL25)and Zu San Li(ST36).The mechanism may be related to inhibition of PI3K/Akt/mTOR signaling pathway.

Cerebral functional imaging of Waiguan (SJ 5) acupoint specificity using single-photon emission computed tomography

The action of needling in acupoint therapy has to first be regulated and integrated by the brain, and then it affects the target organ and manifests its therapeutic effects, which is dependent on the specificity of the acupoints. The authors put forward the hypothesis of the ＂acupoint-related brain＂. Single-photon emission computed tomography was used to explore the activation of brain regions following true needling in true acupoint Waiguan （SJ 5）, sham needling in true acupoint Waiguan, true needling in a sham point, and sham needling in a sham point. The relative specificity of Waiguan in normal persons was analyzed by observing changes in regional cerebral blood flow. Compared with the sham needling in true acupoint group and sham needling in the sham point group, acupuncture at Waiguan can activate brain regions controlling movement. Compared with true needling in the sham point group, acupuncture at Waiguan can also activate brain regions controlling movement. The results suggest that the specificity of needling at an acupoint is related to certain activated cerebral functional regions, which are associated with the clinical application of the acupoint.

Cluster Analysis for Acupoint Specificity of Acupuncture Effect Based on Cerebral Infarction Rat Model

Objectives： To study the acupoint specificity through the comprehensive evaluation of the acupuncture effect on rat model with the middle cerebral artery occlusion （MCAO）. Methods： Duplicated MCAO model by Zea-longa＇s thread ligation was assessed by Zausinger＇s six-point method, and rats with 1-3 scores were chosen to be grouped. According to the randomized and controlled principle, rats were divided into 6 basic control groups （including normal group, sham group, model control group, model group without intervention, Nimodipine group, lateral-to-Renzhong group） and 6 acupuncture groups [including Neiguan （PC6） group, Weizhong （BL40） group, Chize （LU5） group, Sanyinjiao （SP6） group, Renzhong （DU6） group and non-acupoint group]; in each acupoint or non-acupoint 9 different parameter combinations were respectively set by orthogonal intersection method. There were in total 60 groups, and each group had 12 rats. The rats were treated by acupuncture with the lifting-thrusting manipulation every 12 h, in total 6 times. Indices of neurobehavioral scores, cerebral blood flow, infarction rate, microcirculation, and light microscope, etc. were measured. In order to comprehensively evaluate the acupuncture effect to research the specificity of acupoint, a cluster analysis was made with SPSS17.0 for the comprehensive effect scores of the samples computed according to the comprehensive evaluation models, and then sorting and classification were made for the comprehensive effect scores. Results： In the acupuncture groups every acupoint had different therapeutic effect due to different acupuncture parameter combinations; among the acupuncture groups the orders of curative effect were as followings： Neiguan group was of exceptional result, Weizhong group and Sanyinjiao group were of valid results in upper level, Chize group and Renzhong group were of valid results in lower level, and non-acupoint group was of invalid result; the therapeutic result of acupoint group was superior to non-acupoint group; and the curative effect of acupuncture group was also superior to basic control group. Conclusion： The acupoint has the specificity of acupuncture effect, and the acupoint specificity is relative.

Positron emission tomography study of the specificity of Waiguan (SJ 5) acupoint

Functional brain imaging studies of the specificity of acupoint stimulation have revealed that needling at particular acupoints can induce activation of corresponding brain areas, examined in physiological and pathological states. The present study examined Waiguan （SJ 5） as the acupoint of interest. We tested five conditions： a true needling at true acupoint group, a sham needling at true acupoint group, a true needling at sham acupoint group, a sham needling at sham acupoint group, and a healthy control group. We examined changes in glucose metabolism in different functional cortical regions to determine the specific brain activation elicited by acupuncture at Waiguan. The results revealed that true and sham acupuncture at the same acupoint activated different brain regions. In addition, applying acupuncture at a genuine acupoint and a neighboring sham acupoint activated different brain regions. These findings suggest that acupuncture at Waiguan causes activation in some brain regions.

Editor's Choice—Specificity of acupuncture acupoints:observation by functional magnetic resonance imaging

Acupuncture at certain acupoints （specific sites for needle insertion） can induce the activation of specific regions of the brain. This activated brain region influences the target organ or tissue in order to treat the disease. Acupoint specificity is the basis of acupuncture therapy.

Acupuncture at the Taixi(KI3) acupoint activates cerebral neurons in elderly patients with mild cognitive impairment

Our previous ifndings have demonstrated that acupuncture at the Taixi （KI3） acupoint in healthy youths can activate neurons in cognitive-related cerebral cortex. Here, we investigated whether acupuncture at this acupoint in elderly patients with mild cognitive impairment can also activate neurons in these regions. Resting state and task-related functional magnetic resonance imaging showed that the pinprick senstation of acupuncture at the Taixi acupoint differed signiifcantly between elderly patients with mild cognitive impairment and healthy elderly controls. Results showed that 20 brain regions were activated in both groups of participants, including the bi-lateral anterior cingulate gyrus （Brodmann areas [BA] 32, 24）, left medial frontal cortex （BA 9, 10, 11）, left cuneus （BA 19）, left middle frontal gyrus （BA 11）, left lingual gyrus （BA 18）, right medial frontal gyrus （BA 11）, bilateral inferior frontal gyrus （BA 47）, left superior frontal gyrus （BA11）, right cuneus （BA 19, 18）, right superior temporal gyrus （BA 38）, left subcallosal gyrus （BA 47）, bilateral precuneus （BA 19）, right medial frontal gyrus （BA 10）, right superior frontal （BA 11）, left cingulate gyrus （BA 32）, left precentral gyrus （BA 6）, and right fusiform gyrus （BA 19）. These results suggest that acupuncture at the Taixi acupoint in elderly patients with mild cogni-tive impairment can also activate some brain regions.

Specific cerebral activation following true and sham Waiguan(SJ 5) needling Functional magnetic resonance imaging evidence

Positive activation and negative activation of glucose metabolism can be detected in different brain regions under acupuncture conditions using functional magnetic resonance imaging （fMRI） which reveals acupoint function and location-acupoint specificity. This study observed the regional cerebral activation of the Waiguan （SJ 5） acupoint following true needling at the true Waiguan acupoint, sham needling at the true Waiguan acupoint and true needling at a sham point using fMRI. The fMRI results demonstrated that compared with sham needling, true needling at Waiguan activated the BA8 area and left cerebellum. Compared with needling at the sham point, needling at Waiguan activated the BA2 area, the left cerebellum and the right inferior semilunar lobule. Thus the activated brain areas caused by needling Waiguan may be the basis for treatment of certain diseases.

Progress of Research on Specificity of Meridian Acupoint Efficacy

Acupuncture point specificity is the theoretical basis for meridian and acupuncture theory. Also it is the key factor for the efficacy of acupuncture treatment. Studies on acupoint specificity have aroused wide interest in scholars both at home and abroad. Some researchers abroad do not support acupoint specificity. Chinese scholars have, after years of research, preliminarily confirmed the existence of acupoint specificity. However, there is still no conclusive evidence to support acupoint specificity in terms of its specific physiological foundation, underlying mechanism and laws. This paper summarizes and analyzes basic and clinical researches on acupoint specificity in biological structure, physiology and acupoint effect, provides clues for further studies and develops the theoretical basis for acupont specificity.

针灸治疗功能性消化不良的穴位组方随机对照试验数据挖掘

Background:The aim of the study was to explore the regularity of acupoints combination in the treatment of functional dyspepsia(FD)by means of data mining technology.Methods:We conducted a systematic search of nine databases from their inception to December 2022 to identify eligible randomized controlled trials(RCTs).The acupoints prescriptions in the treatment of FD were extracted and analyzed based on association rule mining and network analysis.Furthermore,the acupoints prescribed for irritability symptom of FD were quantified by forward inference,reverse inference and Bayes factor(BF)correction.Results:A total of 45 RCTs on 30 acupoints were included,involving 172 times the total application frequency.Analysis of acupoints prescriptions covered 29 meridian acupoints and one extra-ordinary point,disturbing in 10 meridians.The top three acupoints in application frequency were Zusanli(ST36,19.77%),Neiguan(PC6,16.86%),Zhongwan(CV12,12.21%).The most involved meridian was the foot yangming stomach meridian(34 times).The most frequently used acupoints combinations were PC6 and ST36.The core prescriptions were ST36,PC6,Tianshu(ST25),CV12.The specificities of acupoints selection for FD with dysphoria as follows:using the forward inference,PC6,Taichong(LR3),Qimen(LR14),CV12,Danzhong(CV17),ST25,ST36 were selected.Using the reverse inference and BF correction,PC6,CV12,CV17,Sanyinjiao(SP6),ST25,ST36 were selected.

An infrared thermographic analysis of the sensitization acupoints of women with primary dysmenorrhea

OBJECTIVE:To explore the sensitization acupoints of women with primary dysmenorrhea(PD)by comparing infrared radiation temperatures between acupoints and non-acupoints.METHODS:We tested 10 acupoints of every woman with PD and healthy subjects on premenstrual,menstrual,and postmenstrual days using an infrared imaging device.The primary outcome was the absolute value of body surface temperature difference(AVTD)between the left and right sides of the same testing point.RESULTS:A total of 58 PD patients and 57 healthy volunteers completed the test from May 2016 to May 2017.Compared with the healthy group,we observed a significant reduction and increase in the AVTD in Taichong(LR3)and Sanyinjiao(SP6),respectively,during menstrual days in the PD group(P=0.01;P=0.04);while during postmenstrual days,all AVTDs of Shuiquan(KI5),Diji(SP8),and Xuehai(SP10)were diminished in the PD group(P=0.01;P=0.03;P=0.01,respectively).No significant differences in AVTD were detected at any other points or testing times.CONCLUSIONS:Compared with the healthy group,the AVTDs of Taichong(LR3),Sanyinjiao(SP6),Shuiquan(KI5),Diji(SP8),and Xuehai(SP10)at menstruationrelevant points of PD patients were sensitized,providing a reference for the selection of acupoints in the treatment of PD.

Is Sham Acupuncture as Effective as Traditional Chinese Acupuncture? It's too Early to Say

Many clinical trials and experimental studies claim that sham acupuncture is as effective as traditional Chinese acupuncture. However, these studies have no standard sham acupuncture control and many other factors can affect the clinical effect. These factors include needle retention time, treatment frequency, and the total number of treatments needed for satisfactory results, and all can change the clinical effect. The majority of existing acupuncture treatment studies do not consider these factors and lack standard dosage criteria. Therefore, it is still too early to conclude that sham acupuncture is as effective as traditional Chinese acupuncture. This article investigates the factors that influence the curative effect of acupuncture as to help set a standard for acupuncture studies in the future.

穴位刺激调控自主神经系统的区域异质性

Acupoints on the different parts of the body surface vary in regulating the autonomic nervous system(ANS),exhibiting differences in the acupoint specificity in terms of the distributing directions of sympathetic and parasympathetic branches.The paper introduces the rules of acupoints on the corresponding body surfaces in modulating ANS based on their location at four limbs,abdomen,sacrum,head and face,suboccipital and lateral cervical region and auricle(concha).The fundamental rule of acupoint heterogeneity in ANS regulation is that:all acupoints can induce somatic-sympathetic reflex.The regional heterogeneity of acupoints in ANS is shown:by the fact that stimulation beyond a certain intensity can induce systemic autonomic effects.The acupoints on the abdomen act on the sympathetic nervous system,those at concha on the vagal system and those on the sacral region on the sacral parasymathetic system.The heterogeneity of acupoints in regulating ANS refers to co-effects of acupoints specific effect(within segments) and its systemic effect(whole body),which embodies the specificity of acupoints structure.The acupoints on the same body surface regions display the homogeneity of modulation.Mastering the heterogeneous characteristics of acupoints in modulating ANS is particularly conductive to constructing the theoretical basis of acupoints in clinical acupuncture treatment for systemic diseases.