Graduate School, Wannan Medical College, Wuhu, China.
Department of Anesthesiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Front Immunol. 2022 Feb 10;13:832432. doi: 10.3389/fimmu.2022.832432. eCollection 2022.
Acute respiratory distress syndrome (ARDS) is an uncontrollable, progressive pulmonary inflammatory disease, and as a common clinical critical disease, there is no effective treatment available. Electroacupuncture (EA) therapy is a type of traditional Chinese medicine physiotherapy that can alleviate the inflammatory response. However, the potential mechanism of EA in the treatment of ARDS is not yet clear. Ferroptosis is a new type of programmed cell death characterized by intracellular iron accumulation and lipid peroxidation. Recently, emerging evidence has shown that ferroptosis is closely related to the occurrence and development of ARDS caused by various pathological factors. Here, we further investigated whether EA-mediated inhibition of ferroptosis in lung tissue could attenuate lipopolysaccharide (LPS)-induced ARDS and explored its underlying mechanisms. In this study, mice were administered LPS intraperitoneally to establish a model of LPS-induced ARDS. We found that EA stimulation could not only reduce the exudation of inflammatory cells and proteins in the alveolar lumen but also significantly alleviate the pathological changes of lung tissue, inhibit the production of proinflammatory cytokines and improve the survival rate of mice. Concurrently, we also found that ferroptosis events occurred in the lung tissue of LPS-induced ARDS mice, manifested by elevated iron levels, ROS production and lipid peroxidation. Intriguingly, our results showed that EA stimulation at the Zusanli (ST36) acupoint activated α7 nicotinic acetylcholine receptor (α7nAchR) in lung tissue mainly through the sciatic nerve and cervical vagus nerve, thus exerting anti-ferroptosis and pulmonary protective effects. Additionally, these effects were eliminated by methyllycaconitine (MLA), a selective antagonist of α7nAchR. experiments, activation of α7nAchR protected alveolar epithelial cells from LPS-induced ferroptosis. Furthermore, our experiments showed that the pulmonary protective effects of EA stimulation were effectively reversed by erastin, a ferroptosis activator. Collectively, we demonstrated that EA stimulation could alleviate LPS-induced ARDS by activating α7nAchR to inhibit LPS-induced ferroptosis in alveolar epithelial cells. Targeting and regulating ferroptosis in alveolar epithelial cells may be a potential intervention approach for the treatment of LPS-induced ALI/ARDS in the future.
急性呼吸窘迫综合征(ARDS)是一种不可控的、进行性的肺部炎症性疾病,作为一种常见的临床危重病,目前尚无有效的治疗方法。电针(EA)疗法是一种传统的中医物理疗法,可以减轻炎症反应。然而,EA 治疗 ARDS 的潜在机制尚不清楚。铁死亡是一种新型的程序性细胞死亡,其特征是细胞内铁积累和脂质过氧化。最近,新出现的证据表明,铁死亡与各种病理因素引起的 ARDS 的发生和发展密切相关。在这里,我们进一步研究了 EA 是否通过抑制肺组织中的铁死亡来减轻脂多糖(LPS)诱导的 ARDS,并探讨了其潜在机制。在这项研究中,我们通过腹腔内注射 LPS 来建立 LPS 诱导的 ARDS 模型。我们发现,EA 刺激不仅可以减少肺泡腔中炎症细胞和蛋白质的渗出,还可以显著减轻肺组织的病理变化,抑制促炎细胞因子的产生,提高小鼠的存活率。同时,我们还发现 LPS 诱导的 ARDS 小鼠的肺组织中发生了铁死亡事件,表现为铁水平升高、ROS 产生和脂质过氧化。有趣的是,我们的结果表明,EA 刺激足三里(ST36)穴位主要通过坐骨神经和颈迷走神经激活肺组织中的α7 烟碱型乙酰胆碱受体(α7nAchR),从而发挥抗铁死亡和肺保护作用。此外,这些作用被 α7nAchR 的选择性拮抗剂甲基lycaconitine(MLA)消除。在进一步的实验中,激活α7nAchR 可保护肺泡上皮细胞免受 LPS 诱导的铁死亡。此外,我们的实验表明,EA 刺激通过激活α7nAchR 来减轻 LPS 诱导的 ARDS 的肺保护作用,而铁死亡激活剂 erastin 可有效逆转 EA 刺激的肺保护作用。总之,我们证明 EA 刺激通过激活α7nAchR 抑制 LPS 诱导的肺泡上皮细胞铁死亡来减轻 LPS 诱导的 ARDS。靶向和调节肺泡上皮细胞中的铁死亡可能是未来治疗 LPS 诱导的 ALI/ARDS 的一种潜在干预方法。