Wei Wei, Yang Zhi-Xin, Wang Tian-Yu, Cui Tao-Tao, Chen Jian-Shuang, Zhang Chao, Li Na, Ren Li-Qun
Chengde Medical University, Chengde 067000, Hebei Province, China; Hebei Key Laboratory of Nerve Injury and Repair, Chengde 067000.
Chengde Medical University, Chengde 067000, Hebei Province, China.
Zhongguo Zhen Jiu. 2022 Apr 12;42(4):413-8. doi: 10.13703/j.0255-2930.20210929-k0003.
To observe the effect of moxibustion at oppositely-located points "Mingmen" (GV 4) and "Shenque" (CV 8) on the motor function of the hind limbs and bladder function in rats with neurogenic bladder after suprasacral spinal cord injury (SCI), so as to explore the effect of this therapy on bladder tissue apoptosis mediated by endoplasmic reticulum stress pathway.
Twenty-eight female Wistar rats were randomly divided into a sham-operation group (8 rats) and a model establishment group (20 rats). Using the modified Allen's method, the spinal cord of T segment was injured to establish a neurogenic bladder model in the model establishment group. Sixteen rats were modeled successfully and then divided into a model group (8 rats) and a moxibustion group (8 rats). In the moxibustion group, 2 h after consciousness regaining from modeling anesthesia, moxibustion was exerted at "Shenque" (CV 8) and "Mingmen" (GV 4), 2 cones at each acupoint in one intervention. The intervention was administered once every two days and 5-time intervention was required totally. After intervention, Basso, Beattie and Bresnahan locomotor rating scale (BBB) score for the motor function of the hind limbs, and the urodynamics indexes (maximum bladder capacity, urine leakage pressure and bladder compliance) were compared among groups. HE staining method was adopted to observe the morphological changes of bladder tissue. With Western blot method and real-time PCR assay, the protein and mRNA expressions of the endoplasmic reticulum stress-related genes (glucose- regulated protein 78 [GRP78], activating transcription factor 4 [ATF4] and cysteinyl aspartate specific proteinase-12 [Caspase-12]) were determined.
The transitional epithelial cells were arranged irregularly, the bladder wall was getting thinner, and the cellular vacuolar degeneration and neutrophil infiltration were found in the model group. Whereas, compared with the model group, in the moxibustion group, the arrangement of transitional epithelial cells was clear and continuous in layers, the cellular vacuolar degeneration was mild and the infiltration presented in a small amount of neutrophil granulocytes. Compared with the sham-operation group, in the model group, the BBB score was reduced (<0.01), the maximum bladder capacity and bladder compliance were increased (<0.01), and the protein expression levels of GRP78, ATF4 and Caspase-12, as well as mRNA expressions were all increased (<0.01). In comparison with the model group, in the moxibustion group, BBB score was increased (<0.01), the maximum bladder capacity and bladder compliance were decreased (<0.01), and the protein and mRNA expression levels of GRP78, ATF4 and Caspase-12 were all decreased (<0.01).
Moxibustion at the "oppositely-located points" improves the urination function, alleviate urine retention in neurogenic bladder rats after spinal cord injury. The underlying mechanism may be related to the down-regulation of the expressions of GRP78, ATF4 and Caspase-12 in the endoplasmic reticulum stress pathway of the bladder tissues, and thus to alleviate the apoptosis of bladder tissue.
观察督脉“命门”（GV 4）与任脉“神阙”（CV 8）对骶上脊髓损伤（SCI）后神经源性膀胱大鼠后肢运动功能及膀胱功能的影响，探讨其对膀胱组织内质网应激途径介导的细胞凋亡的作用。
28只雌性Wistar大鼠随机分为假手术组（8只）和造模组（20只）。造模组采用改良Allen法损伤T节段脊髓建立神经源性膀胱模型。16只大鼠建模成功，再分为模型组（8只）和艾灸组（8只）。艾灸组于建模麻醉清醒后2 h，对“神阙”（CV 8）和“命门”（GV 4）进行艾灸，每次每穴灸2壮。每2天干预1次，共干预5次。干预后，比较各组大鼠后肢运动功能的Basso、Beattie和Bresnahan运动评分量表（BBB）评分及尿动力学指标（最大膀胱容量、漏尿点压力和膀胱顺应性）。采用HE染色法观察膀胱组织形态学变化。采用Western blot法和实时荧光定量PCR法测定内质网应激相关基因（葡萄糖调节蛋白78[GRP78]、活化转录因子4[ATF4]和半胱天冬酶-12[Caspase-12]）的蛋白和mRNA表达。
模型组膀胱移行上皮细胞排列不规则，膀胱壁变薄，可见细胞空泡变性及中性粒细胞浸润。与模型组相比，艾灸组膀胱移行上皮细胞排列清晰、连续，细胞空泡变性较轻，中性粒细胞浸润较少。与假手术组相比，模型组BBB评分降低（<0.01），最大膀胱容量和膀胱顺应性增加（<0.01），GRP78、ATF4和Caspase-12蛋白表达水平及mRNA表达均增加（<0.01）。与模型组相比，艾灸组BBB评分升高（<0.01），最大膀胱容量和膀胱顺应性降低（<0.01），GRP78、ATF4和Caspase-12蛋白及mRNA表达水平均降低（<0.01）。
“对穴”艾灸可改善脊髓损伤后神经源性膀胱大鼠的排尿功能，缓解尿潴留。其作用机制可能与下调膀胱组织内质网应激途径中GRP78、ATF4和Caspase-12的表达，从而减轻膀胱组织细胞凋亡有关。
