Electroacupuncture at Lower He-Sea and Front-Mu Acupoints Ameliorates Insulin Resistance in Type 2 Diabetes Mellitus by Regulating the Intestinal Flora and Gut Barrier

Abstract

Introduction The study objective was to investigate the effects of electroacupuncture performed at the he-sea and front-mu acupoints on the intestinal microflora and intestinal barrier in db/db mice and to explore the related mechanism in type 2 diabetes mellitus. Methods Db/m mice in the normal control group (NOC), electroacupuncture group (EA), metformin group (MET) and T2DM group (T2DM) were used as model controls, and db/db mice were used in all three groups, with 8 mice in each group. The treatment period was 2 weeks. Fasting blood glucose (FBG) and triglyceride (TG) levels were measured. Lipopolysaccharide (LPS) and tumor necrosis factor-α (TNF-α) levels were detected by enzyme-linked immune sorbent assay (ELISA). The ileal tissue was stained with hematoxylin-eosin staining (H & E), and histopathological changes were observed under a light microscope. Illumina sequencing was used to analyze the V4 region of the 16S rRNA gene to evaluate the effect of EA on the intestinal flora. Results Our results suggest that EA treatment can reduce the expression of diabetes-related markers, with an effect similar to that of metformin. After EA intervention, the abundance of Firmicutes and the ratio of Firmicutes to Bacteroidetes increased, while the abundances of Bacteroidetes and Eubacterium decreased. In addition, the serum levels of LPS and TNF-α in the electroacupuncture group were downregulated, and ileal tissue damage was alleviated under an electron microscope. Conclusion EA combined with acupoints can restore the intestinal flora structure, decrease the blood LPS level, reduce levels of inflammation, maintain the integrity of the intestinal barrier, and play a therapeutic role in the treatment of T2DM, mainly by increasing the abundance of Firmicutes and the ratio of Firmicutes to Bacteroidetes and decreasing the abundances of Bacteroidetes and Eubacterium.

Primordial Drivers of Diabetes Heart Disease: Comprehensive Insights into Insulin Resistance

“…In the future, as a research methodology, different signaling pathways of physiological effects of insulin Diabetes Metab J 2024;48:19-36 https://e-dmj.org can be used as mainline modules, and the interrelationships between each module and the upstream and downstream of different pathways can be analyzed to further clarify the specific pathological mechanisms of insulin resistance to DHD. In addition, the link between intestine dysbiosis and insulin resistance has gained attention [141]. Researchers found that the intake of probiotics in rats significantly improved insulin resistance caused by high sugar diets, reduced low-level chronic inflammation and oxidative stress, and regulated the body's energy metabolism [142].…”

Acupuncture influences multiple diseases by regulating gut microbiota

“…Following electroacupuncture treatment (with a 3Hz expansion wave, current of 1mA), the abundance of Firmicutes increased, whereas that of Bacteroides decreased in patients with T2DM. Additionally, the proportion of Firmicutes/Bacteroides increased, leading to a decrease in LPS and TNF-α levels in the electroacupuncture group ( Wang et al., 2022a ). It is speculated that electroacupuncture has the potential to enhance overall inflammatory status and ultimately mitigate insulin resistance.…”

Acupuncture as multi-targeted therapy for the multifactorial disease obesity: a complex neuro-endocrine-immune interplay

“…In a more recent study, EA for 21 days in high-fat DIO mice rescued dysbiosis of the gut microbiota in the cecum ( 179 ). Moreover, acupuncture treatment has been linked to inhibition of gut dysbiosis in various animal models, including in male mice models for IBS ( 180 ) chronic colitis ( 181 ), T2DM ( 44 ), Parkinson’s disease ( 176 ) and insomnia ( 177 ). In male rat models with post-inflammatory irritable bowel syndrome, acupuncture and moxibustion treatment were independently associated with changed gut microbiota ( 178 , 182 ).…”

“…Recent research in both animal models and humans has focused on the possible role of the gut microbiota in acupuncture, as acupuncture can potentially regulate the neuroendocrine-immune system of the body and improve the intestinal microenvironment. Several animal studies suggest that acupuncture may affect the gut microbiota, and this may play a role in the effectiveness of acupuncture (43)(44)(45)(176)(177)(178)(179). In obese male rats, EA decreased the Firmicutes-to-Bacteroidetes ratio compared to obese rats who did not undergo acupuncture (43).…”