Modulation of Neurally Mediated Vasodepression and Bradycardia by Electroacupuncture through Opioids in Nucleus Tractus Solitarius

Tjen‐A‐Looi, Stephanie C.; Fu, Liang‐Wu; Guo, Zhi‐Ling; Longhurst, John C.

doi:10.1038/s41598-018-19672-9

Cited by 13 publications

(10 citation statements)

References 56 publications

(109 reference statements)

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“…In addition, stimulation with EA at P5-6 or ST36-37 acupoints inhibits sympathoexcitatory blood pressure responses (Tjen-A-Looi et al, 2004; Zhou et al, 2005a) while current data show the inability of EA-inhibition at G37-39. EA modulates also reflex hypotension and bradycardia with point specific actions (Tjen-A-Looi et al, 2018) suggesting that EA influences both cardiovascular inhibitory and excitatory reflex responses. Collectively, these observations suggest that both moxibustion and EA modify excitatory as well as inhibitory reflex responses by stimulation at specific acupoints.…”

Section: Discussionmentioning

confidence: 99%

RETRACTED: Moxibustion Modulates Sympathoexcitatory Cardiovascular Reflex Responses Through Paraventricular Nucleus

et al. 2019

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Electroacupuncture (EA) point specific (ST36-37) stimulation decreases cardiovascular reflex responses through supraspinal regions such as the hypothalamic paraventricular nucleus (PVN) while mechanical stimulation of acupoints decreases pressor responses through peripheral thermal transient receptor potential vanilloid type-1 (TRPV1). Moxibustion generating heat applied at acupoint in combination with antihypertensive drugs decreases elevated blood pressure. We hypothesized that moxibustion modulates sympathoexcitatory cardiovascular responses through the hypothalamic PVN and peripheral heat sensitive TRPV1 in the absence of antihypertensive drugs. Rats were anesthetized, ventilated, and heart rate and mean blood pressure were monitored. Gastric distention induced consistent pressor reflex responses every 10-min. Thirty-minutes of bilateral moxibustion at the acupoint ST36, overlying the deep peroneal nerves, reduced the gastric distention evoked elevation in blood pressure. Blood pressure reflex responses were not reduced by both EA and moxibustion at G39. The moxibustion inhibition but not EA inhibition of the cardiovascular responses was reversed with blockade of local heat sensitive TRPV1 at ST36. Accordingly, activation of thermal TRPV1 by moxibustion at an average of 44.2°C in contrast to 40°C reduced the pressor responses. Naloxone, an opioid receptor antagonist, microinjected into PVN inhibited transiently the effect of moxibustion. Thus, activation of peripheral heat sensitive TRPV1 mediated the moxibustion-inhibition, but not EA-inhibition, of sympathoexcitatory cardiovascular reflex responses through hypothalamic PVN opioid system.

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Section: Discussionmentioning

confidence: 99%

RETRACTED: Moxibustion Modulates Sympathoexcitatory Cardiovascular Reflex Responses Through Paraventricular Nucleus

et al. 2019

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“…The mechanism of effect of TEAS on HRV and serum hs-cTnT is still unclear. Stimulation of P5-6 reduced vagally evoked activity of cardiovascular NTS cells31 and improved cardiac function by increasing left ventricular diastolic and systolic function in rat myocardial cells 32. In addition, stimulation of PC6 could also improve the blood flow of coronary artery33 and increase Gs-alpha protein in cardiomyocytes 34.…”

Section: Discussionmentioning

confidence: 92%

<p>Cardioprotective effect of transcutaneous electrical acupuncture point stimulation on perioperative elderly patients with coronary heart disease: a prospective, randomized, controlled clinical trial</p>

Li¹,

Wu²,

Yan³

et al. 2019

CIA

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PurposeThe purpose of this study was to evaluate the effects of transcutaneous electrical acupoint stimulation (TEAS) on postoperative autonomic nervous system function and serum biomarkers in the elderly.Patients and methodsA total of 122 American Society of Anesthesiologists class II or III patients with coronary heart disease undergoing spinal surgery were randomly divided into two groups: TEAS (received TEAS at Neiguan [PC6] and Ximen [PC4] for 30 minutes before anesthesia induction until the end of surgery) and control (received electrode plate at the same acupuncture points without any electrical stimulation). Serum was isolated for the measurement of concentration of high-sensitive troponin T (hs-cTnT), CRP, and CK. Heart rate (HR) and heart rate variability (HRV) including: total power (TP), low-frequency (LF) power, high-frequency (HF) power, and LF/HF ratio were used to assess autonomic nervous system function. The primary outcome was to evaluate whether TEAS changed the postoperative serum hs-cTnT. The secondary outcomes were to observe the effects of TEAS on HRV, circulating CK and CRP after surgery.ResultsHs-cTnT, CRP, and CK concentrations were significantly higher on first, third and fifth day after surgery than those before anesthesia induction in both groups. Hs-cTnT concentration was significantly lower on the first and third day after surgery in TEAS group than in control group. Compared with 1 day before surgery, TP, LF, and HF decreased significantly and HR, LF/HF increased significantly on first, third, and fifth day after surgery in control group. Compared with control group, HR was significantly lower on the first, third, and fifth day after surgery, LF/HF decreased and TP, LF, HF were significantly higher on the first day after surgery in TEAS group.ConclusionTEAS at PC6 and PC4 could reduce postoperative serum hs-cTnT concentration and change HRV index to improve autonomic nervous system activity.

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“…Electroacupuncture (EA), a form of somatic afferent stimulation with low current and low frequency (2-4 mA, 2 Hz, 0.5 ms), reduces sympathetic over-excitation and elevated blood pressure involving the medulla and hypothalamus region PVN (Tjen-A- Looi et al, 2003Looi et al, , 2007Looi et al, , 2016bLi et al, 2016). We also have shown that PBG-induced vasodepression and bradycardia can be reduced by EA through actions in the medullary nuclei NTS and nucleus ambiguus (Tjen-A- Looi et al, , 2018. The current study investigates if the hypothalamic region PVN also participates in the EA-inhibition of the reflex responses vasodepression and bradycardia.…”

Section: Introductionmentioning

confidence: 99%

“…In this regard, the negative chronotropic response following PBG administration results from excitation of cardiac parasympathetic neurons in the nucleus ambiguus ( McAllen and Spyer, 1976 ; Verberne and Guyenet, 1992 ; Wang et al, 2000 ; Tjen-A-Looi et al, 2012 ). A number of other medullary regions, such as the rostral and caudal ventrolateral medulla (rVLM and cVLM) and nucleus tractus solitarius (NTS; Verberne and Guyenet, 1992 ; Barman et al, 2005 ; Jeggo et al, 2005 ; Tjen-A-Looi et al, 2018 ), process the inhibitory hemodynamic response.…”

Section: Introductionmentioning

confidence: 99%

Neurogenic Hypotension and Bradycardia Modulated by Electroacupuncture in Hypothalamic Paraventricular Nucleus

Tjen‐A‐Looi

Fu²,

Guo³

et al. 2022

Front. Neurosci.

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Electroacupuncture (EA) stimulates somatic median afferents underlying P5-6 acupoints and modulates parasympathoexcitatory reflex responses through central processing in the brainstem. Although decreases in blood pressure and heart rate by the neural-mediated Bezold-Jarisch reflex responses are modulated by EA through opioid actions in the nucleus tractus solitarius and nucleus ambiguus, the role of the hypothalamus is unclear. The hypothalamic paraventricular nucleus (PVN) is activated by sympathetic afferents and regulates sympathetic outflow and sympathoexcitatory cardiovascular responses. In addition, the PVN is activated by vagal afferents, but little is known about its regulation of cardiopulmonary inhibitory hemodynamic responses. We hypothesized that the PVN participates in the Bezold-Jarisch reflex responses and EA inhibits these cardiopulmonary responses through the PVN opioid system. Rats were anesthetized and ventilated, and their heart rate and blood pressures were monitored. Application of phenylbiguanide every 10 min close to the right atrium induced consistent depressor and bradycardia reflex responses. Unilateral microinjection of the depolarization blockade agent kainic acid or glutamate receptor antagonist kynurenic acid in the PVN reduced these reflex responses. In at least 70% of the rats, 30 min of bilateral EA at P5-6 acupoints reduced the depressor and bradycardia responses for at least 60 min. Blockade of the CCK-1 receptors converted the non-responders into EA-responders. Unilateral PVN-microinjection with naloxone reversed the EA inhibition. Vagal-evoked activity of the PVN cardiovascular neurons was reduced by 30 min EA (P5-6) through opioid receptor activation. These data indicate that PVN processes inhibitory cardiopulmonary reflexes and participates in EA-modulation of the neural-mediated vasodepression and bradycardia.

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Modulation of Neurally Mediated Vasodepression and Bradycardia by Electroacupuncture through Opioids in Nucleus Tractus Solitarius

Cited by 13 publications

References 56 publications

RETRACTED: Moxibustion Modulates Sympathoexcitatory Cardiovascular Reflex Responses Through Paraventricular Nucleus

RETRACTED: Moxibustion Modulates Sympathoexcitatory Cardiovascular Reflex Responses Through Paraventricular Nucleus

<p>Cardioprotective effect of transcutaneous electrical acupuncture point stimulation on perioperative elderly patients with coronary heart disease: a prospective, randomized, controlled clinical trial</p>

Neurogenic Hypotension and Bradycardia Modulated by Electroacupuncture in Hypothalamic Paraventricular Nucleus

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