Department of Critical Care Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, Shandong 266035, China.
Department of Pathology, School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, 210023 Nanjing, China; Key Laboratory of Cell Differentiation and Apoptosis of Chinese Ministry of Education, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Biomed Pharmacother. 2023 Jun;162:114600. doi: 10.1016/j.biopha.2023.114600. Epub 2023 Mar 28.
Previous studies proved the benefits of electroacupuncture (EA) on heart in ischemia reperfusion injury and chronic heart failure. However, the role of EA on sepsis-induced cardiac dysfunction has rarely been elucidated before. In this study, we aimed to investigate the effects of EA on cardiac dysfunction in a rat model of sepsis and to speculate the underlying mechanisms.
Sepsis was induced by cecum ligation and puncture in anesthetized rats. EA at the acupoint "Neiguan (PC6)" was applied 0.5 h after the induction of sepsis for 20 min. Heart rate variability was obtained immediately after EA to evaluate autonomic balance. Echocardiography was performed at 6 h and 24 h after sepsis induction in vivo. Measurements of hemodynamics, blood gases, cytokines and biochemistry were collected at 24 h. Cardiac tissue underwent immunofluorescence staining to determine the expression of α7 nicotinic acetylcholine receptor (α7nAChR) on macrophages.
EA increased vagus nerve activity, prevented the development of hyperlactatemia, attenuated the decline of left ventricle ejection fraction, suppressed systemic and cardiac inflammation and alleviated the histopathological manifestations of heart in sepsis rats. Furthermore, the cardiac tissue from EA treated rats showed increased expressions of α7nAChR on macrophages. The cardio-protective and anti-inflammatory effects of EA were partly or completely prevented in rats with vagotomy.
EA at PC6 attenuates left ventricle dysfunction and decreases inflammation in sepsis-induced cardiac dysfunction. The cardio-protective effects of EA are mediated through vagus nerve mediated cholinergic pathway.
先前的研究证明了电针（EA）在缺血再灌注损伤和慢性心力衰竭中的心脏益处。然而，EA 在脓毒症引起的心脏功能障碍中的作用以前很少被阐明。在这项研究中，我们旨在研究 EA 在脓毒症大鼠模型中心律失常的作用，并推测其潜在机制。
在麻醉大鼠中通过盲肠结扎和穿刺诱导脓毒症。在脓毒症诱导后 0.5 小时给予 EA 穴位“内关（PC6）”，持续 20 分钟。EA 后立即进行心率变异性以评估自主平衡。在体内诱导脓毒症后 6 小时和 24 小时进行超声心动图检查。在 24 小时时收集血液动力学，血气，细胞因子和生化指标的测量值。进行心脏组织免疫荧光染色以确定巨噬细胞上α7 烟碱型乙酰胆碱受体（α7nAChR）的表达。
EA 增加了迷走神经活动，防止了高乳酸血症的发展，减轻了左心室射血分数的下降，抑制了全身和心脏炎症，并减轻了脓毒症大鼠心脏的组织病理学表现。此外，接受 EA 治疗的大鼠心脏组织中的巨噬细胞上α7nAChR 的表达增加。迷走神经切断术大鼠的 EA 的心脏保护和抗炎作用部分或完全被阻止。
PC6 的 EA 可减轻左心室功能障碍并降低脓毒症引起的心脏功能障碍中的炎症。EA 的心脏保护作用是通过迷走神经介导的胆碱能途径介导的。
