Zhao Luopeng, Liu Lu, Xu Xiaobai, Qu Zhengyang, Zhu Yupu, Li Zhijuan, Zhao Jingxia, Wang Linpeng, Jing Xianghong, Li Bin
Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People's Republic of China.
Beijing Key Laboratory of Clinic and Basic Research with Traditional Chinese Medicine on Psoriasis, Beijing Institute of Traditional Chinese Medicine, Beijing, People's Republic of China.
J Pain Res. 2020 Jan 13;13:75-86. doi: 10.2147/JPR.S225431. eCollection 2020.
Acupuncture has a therapeutic effect similar to that of prophylactic drugs and can be considered a treatment option for migraineurs. However, the mechanism of acupuncture treatment's effect on migraine is uncertain. An approach based on anti-inflammatory effects is an important treatment strategy for migraine because non-steroidal anti-inflammatory drugs (NSAIDs) are usually used during migraine attacks. Meningeal inflammation is thought to be responsible for the activation of the trigeminovascular system. Our previous study found that electroacupuncture (EA) decreased neurogenic inflammation mediator expression in the trigeminal ganglion (TG) and alleviated hyperalgesia. The present study examined whether EA would inhibit hyperalgesia by alleviating neurogenic inflammatory factors.
A rat model of migraine was established using dural electrical stimulation (DES). Five groups were analyzed in this study. The Model group received DES three times to mimic migraine attacks, a Control group had sham DES, and three groups received electroacupuncture after DES: a Non-Acu group at a non-acupuncture point, a GB20 group at GB20, and a GB20/34 group at GB20 and GB34 acupuncture points. We evaluated mechanical hyperalgesia using an electronic von Frey esthesiometer in the awake state. After sacrifice, the dura mater was analyzed using immunofluorescence. Serum calcitonin gene-related peptide, cyclooxygenase-2, brain-derived neurotrophic factor, IL-1β, IL-6, and TNF levels were determined using enzyme-linked immunosorbent assays to evaluate the anti-inflammatory effect of acupuncture.
After repeated DES, we observed facial and hind paw mechanical hyperalgesia, which was inhibited by electroacupuncture. Electrical stimulation increased the number of mast cells and macrophages and serum levels of inflammatory factors. GB20 and GB20/34 electroacupuncture significantly decreased the number of mast cells and macrophages and serum levels of inflammatory factors. Moreover, electroacupuncture at GB20/34 was superior to that at GB20 alone in inhibiting hyperalgesia and alleviating inflammatory factors.
Electroacupuncture inhibits DES-induced hyperalgesia by alleviating inflammatory factors. Inhibition of dural mast cells, macrophages, and serum inflammatory factors may be one of the mechanisms involved in acupuncture treatment's effect on migraine.
针刺具有与预防性药物相似的治疗效果,可被视为偏头痛患者的一种治疗选择。然而,针刺治疗偏头痛的作用机制尚不清楚。基于抗炎作用的方法是偏头痛的重要治疗策略,因为在偏头痛发作期间通常使用非甾体抗炎药(NSAIDs)。脑膜炎症被认为是三叉神经血管系统激活的原因。我们之前的研究发现,电针(EA)可降低三叉神经节(TG)中神经源性炎症介质的表达并减轻痛觉过敏。本研究探讨EA是否通过减轻神经源性炎症因子来抑制痛觉过敏。
采用硬脑膜电刺激(DES)建立大鼠偏头痛模型。本研究分析了五组。模型组接受三次DES以模拟偏头痛发作,对照组进行假DES,三组在DES后接受电针治疗:非穴位组在非穴位处,GB20组在GB20穴位,GB20/34组在GB20和GB34穴位。我们在清醒状态下使用电子von Frey触觉仪评估机械性痛觉过敏。处死动物后,使用免疫荧光法分析硬脑膜。使用酶联免疫吸附测定法测定血清降钙素基因相关肽、环氧化酶-2、脑源性神经营养因子、IL-1β、IL-6和TNF水平,以评估针刺的抗炎作用。
重复DES后,我们观察到面部和后爪的机械性痛觉过敏,电针可抑制这种痛觉过敏。电刺激增加了肥大细胞和巨噬细胞的数量以及炎症因子的血清水平。GB20和GB20/34电针显著减少了肥大细胞和巨噬细胞的数量以及炎症因子的血清水平。此外,GB20/34电针在抑制痛觉过敏和减轻炎症因子方面优于单独的GB20电针。
电针通过减轻炎症因子来抑制DES诱导的痛觉过敏。抑制硬脑膜肥大细胞、巨噬细胞和血清炎症因子可能是针刺治疗偏头痛作用机制之一。