Department of General Surgery, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin 300052, China.
Department of General Surgery, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin 300052, China; Department of Minimally Invasive Surgery, Characteristics Medical Center of Chinese People Armed Police Force, Tianjin 300162, China.
Biomed Pharmacother. 2024 Apr;173:116387. doi: 10.1016/j.biopha.2024.116387. Epub 2024 Mar 11.
BACKGROUND: The induction of intestinal inflammation as a result of abdominal surgery is an essential factor in postoperative ileus (POI) development. Electroacupuncture (EA) at ST36 has been demonstrated to relieve intestinal inflammation and restore gastrointestinal dysmotility in POI. This study aims to elucidate the neuroimmune pathway involved in the anti-inflammatory properties of EA in POI. METHODS: After intestinal manipulation (IM) was performed to induce POI, intestinal inflammation and motility were assessed 24 h post-IM, by evaluating gastrointestinal transit (GIT), cytokines expression, and leukocyte infiltration. Experimental surgery, pharmacological intervention, and genetic knockout mice were used to elucidate the neuroimmune mechanisms of EA. RESULTS: EA at ST36 significantly improved GIT and reduced the expression of pro-inflammatory cytokines and leukocyte infiltration in the intestinal muscularis following IM in mice. The anti-inflammatory effectiveness of EA treatment was abolished by sub-diaphragmatic vagotomy, whereas splenectomy did not hinder the anti-inflammatory benefits of EA treatment. The hexamethonium chloride (HEX) administration contributes to a notable reduction in the EA capacity to suppress inflammation and enhance motility dysfunction, and EA is ineffective in α7 nicotinic acetylcholine receptor (α7nAChR) knockout mice. CONCLUSIONS: EA at ST36 prevents intestinal inflammation and dysmotility through a neural circuit that requires vagal innervation but is independent of the spleen. Further findings revealed that the process involves enteric neurons mediating the vagal signal and requires the presence of α7nAChR. These findings suggest that utilizing EA at ST36 may represent a possible therapeutic approach for POI and other immune-related gastrointestinal diseases.
背景:腹部手术引起的肠道炎症是术后肠梗阻(POI)发展的一个重要因素。电针(EA)刺激足三里穴已被证明可减轻 POI 中的肠道炎症并恢复胃肠道动力障碍。本研究旨在阐明 EA 在 POI 中抗炎作用所涉及的神经免疫途径。
方法:在进行肠道操作(IM)以诱导 POI 后,通过评估胃肠道转运(GIT)、细胞因子表达和白细胞浸润来评估 IM 后 24 小时的肠道炎症和运动情况。实验性手术、药理学干预和基因敲除小鼠被用于阐明 EA 的神经免疫机制。
结果:EA 刺激足三里穴可显著改善 GIT,并降低 IM 后肠道肌层中促炎细胞因子的表达和白细胞浸润。膈下迷走神经切断术可消除 EA 治疗的抗炎作用,而脾切除术并不妨碍 EA 治疗的抗炎益处。六烃季铵(HEX)给药可显著降低 EA 抑制炎症和增强运动功能障碍的能力,并且 EA 在α7 型烟碱型乙酰胆碱受体(α7nAChR)敲除小鼠中无效。
结论:EA 刺激足三里穴通过需要迷走神经支配但不依赖脾脏的神经回路来预防肠道炎症和运动障碍。进一步的研究结果表明,该过程涉及介导迷走神经信号的肠神经元,并且需要存在α7nAChR。这些发现表明,使用 ST36 处的 EA 可能代表 POI 和其他免疫相关胃肠道疾病的一种潜在治疗方法。
World J Gastrointest Surg. 2025-2-27