Electrical Stimulation at the ST36 Acupoint Protects against Sepsis Lethality and Reduces Serum TNF Levels through Vagus Nerve‐ and Catecholamine‐Dependent Mechanisms

Abstract

Electrical vagus nerve (VN) stimulation during sepsis attenuates tumor necrosis factor (TNF) production through the cholinergic anti-inflammatory pathway, which depends on the integrity of the VN and catecholamine production. To characterize the effect of electroacupuncture at ST36 (EA-ST36) on serum TNF, IL-6, nitrite, and HMGB1 levels and survival rates, based on VN integrity and catecholamine production, a sepsis model was induced in rats using cecal ligation and puncture (CLP). The septic rats were subsequently treated with EA-ST36 (CLP+ST36), and serum samples were collected and analyzed for cytokines levels. The serum TNF, IL-6, nitrite, and HMGB1 levels in the CLP+ST36 group were significantly lower compared with the group without treatment, the survival rates were significantly higher (P < 0.05), and the acute organ injury induced by CLP was mitigated by EA-ST36; however, when subdiaphragmatic vagotomy was performed, the serum levels of TNF in the CLP+ST36 group did not show a significant difference compared with the group without electrostimulation, and, similarly, no significant difference in serum TNF levels was found under the pharmacological blockade of catecholamines. These results suggest that in rats with CLP sepsis models EA-ST36 reduces serum TNF levels through VN- and atecholamine-dependent mechanisms.

Electroacupuncture treatment partly promotes the recovery time of postoperative ileus by activating the vagus nerve but not regulating local inflammation

“…Here, we introduced it for POI treatment because a growing body evidence indicates that EA regulates the GI function by exciting vagus nerve system and might produce anti-inflammatory effect5253. If EA could activate vagus nerve system before surgery, it might prevent POI via the cholinergic anti-inflammatory pathway such as previous study.…”

Acupuncture at Zusanli (ST36) for Experimental Sepsis: A Systematic Review

“…Only 6 studies [51,52,61,64,75,77] reported using adult animals, 16 studies [30,34,38,40,49,50,53,57,62,65,68,69,73,[78][79][80] had no statement about animals' age, and the remaining 33 studies reported the specific age of the animals.…”

“…Urethane [30, 31, 34-38, 40, 42-45, 47-50] was used in 16 studies to induce anesthesia, pentobarbital [41, 63, 65, 66, 72-74, 76, 77, 80, 81] was used in 11 studies, ketamine [32,57,58,62] was used in 4 studies, chloral hydrate [29,78] was used in 2 studies, and xylazine hydrochloride [33] and isoflurane [64] were used in 1 study, respectively. Ketamine combined with Suxinmian [54-56, 59-61, 79], midazolam [67,70,71], xylazine [21,69], and urethane [39,46] were used in 7, 3, 2, and 2 studies, respectively. While the remaining 5 studies [51-53, 68, 75] had no statement about anesthetics.…”

Essential Neuroscience in Immunology

“…Electrical stimulation of the sciatic nerve significantly reduced circulating levels of cytokine in a murine endotoxemia model in a vagus nerve dependent manner. Blocking of vagus nerve activity with either pharmacological antagonists or surgical ablation suppressed the inhibitory effects of electrical stimulation (51–53). In a collagen-induced arthritis model, electrical stimulation of the sciatic nerve significantly reduced arthritis incidence, attenuated inflammatory cytokine levels, and prevented joint destruction (54).…”