Li Haixia, Yin Jieyun, Zhang Zhaohui, Sallam Hanaa S, Chen Jiande D Z
Division of Gastroenterology, Department of Internal Medicine, University of Texas Medical Branch at Galveston, TX, USA.
Transtimulation Research Inc., Oklahoma City, OK, USA.
J Transl Gastroenterol. 2024 Jul-Sep;2(3):139-149. doi: 10.14218/jtg.2024.00026. Epub 2024 Sep 25.
Gastrointestinal dysmotility commonly follows thermal injuries, such as burns. This study aimed to investigate the effects and mechanisms of electroacupuncture (EA) on burn-induced gastric dysmotility in rats.
Sprague-Dawley rats were divided into sham and thermal injury groups subjected to a 60% scald burn. Antagonists, including β-blockade (propranolol), α-blockade (phentolamine), or a selective cyclooxygenase (COX)-2 inhibitor (nimsulide), were administered to verify the pathways involved. Six hours after the burn, the animals were evaluated for gastric emptying and heart rate variability. Blood and gastric tissues were collected for assays of cytokines, hormones, and COX-2 levels. EA was performed at bilateral ST36 (Zusanli) acupoints for 45 m.
Burn injury delayed gastric emptying by 61% ( < 0.01), which was normalized by nimsulide or propranolol but not by phentolamine. EA improved gastric emptying by 87% ( = 0.03) in burned rats. Heart rate variability and plasma hormone (noradrenaline and pancreatic polypeptide) analyses indicated sympathetic hyperactivity in burned rats; EA improved burn-induced sympathovagal imbalance by enhancing vagal activity. Protein and mRNA expressions of COX-2 in the gastric fundus and antrum increased with burn but were normalized by propranolol. EA reduced the burn-induced increase in COX-2 expression in the gastric fundus but not in the antrum. EA also decreased burn-induced elevations in plasma interleukin (IL)-6 and IL-10. Negative correlations were found between gastric emptying and plasma IL-6 levels, as well as between gastric emptying and COX-2 mRNA levels.
These findings suggest that burn-induced gastric dysmotility is mediated via autonomic-COX-2 pathways. EA at acupoint ST36 improves burn-induced delays in gastric emptying by down-regulating COX-2 and pro-inflammatory cytokines through the autonomic nervous pathway.
胃肠道动力障碍常继发于热损伤,如烧伤。本研究旨在探讨电针(EA)对大鼠烧伤所致胃动力障碍的影响及其机制。
将Sprague-Dawley大鼠分为假手术组和60%烫伤的热损伤组。给予拮抗剂,包括β受体阻滞剂(普萘洛尔)、α受体阻滞剂(酚妥拉明)或选择性环氧化酶(COX)-2抑制剂(尼美舒利),以验证其中涉及的途径。烧伤后6小时,评估动物的胃排空和心率变异性。采集血液和胃组织,检测细胞因子、激素和COX-2水平。在双侧足三里(ST36)穴位进行45分钟的电针治疗。
烧伤损伤使胃排空延迟61%(P<0.01),尼美舒利或普萘洛尔可使其恢复正常,但酚妥拉明不能。电针使烧伤大鼠的胃排空改善了87%(P=0.03)。心率变异性和血浆激素(去甲肾上腺素和胰多肽)分析表明,烧伤大鼠存在交感神经过度活跃;电针通过增强迷走神经活动改善烧伤引起的交感-迷走失衡。胃底和胃窦中COX-2的蛋白和mRNA表达随烧伤而增加,但普萘洛尔可使其恢复正常。电针降低了烧伤引起的胃底COX-2表达增加,但对胃窦无此作用。电针还降低了烧伤引起的血浆白细胞介素(IL)-6和IL-10升高。胃排空与血浆IL-6水平之间以及胃排空与COX-2 mRNA水平之间存在负相关。
这些发现表明,烧伤所致胃动力障碍是通过自主神经-COX-2途径介导的。足三里穴位电针通过自主神经途径下调COX-2和促炎细胞因子,改善烧伤引起的胃排空延迟。