The effect of acupuncture on high blood pressure of patients using antihypertensive drugs.

Blood pressure control is an important component of cardiovascular disease prevention. Despite the advances in the treatment of hypertension; effective management remains poor. The combined use of multiple drug strategies fail to regulate blood pressure and chronic use of those agents cause severe side-effects. New strategies are required to control high blood pressure. We aim in our study to research the effects of acupuncture treatment on blood pressure of hypertensive patients who have already been exposed to antihypertensive drug therapy for at least 24 months. Each patient was using 1-3 antihypertensive drug of a heterogeneous pharmacological group ranging from ACE inhibitors, diuretics, and beta blockers and the most common complaint of those patients were fatigue, dizziness, weakness, headache and joint pain, sleeping problems, cold hands and feet, edema, depression. We did not alter patients' diet (salt intake), physical activity or use of antihypertensive drugs. The study includes 24 male and 10 female patients. Ki 3 (Taixi), Liv 3 (Taichong), Sp 9 (Yinlingquan), L.I. 4 (Hegu), Ht 7 (Shenmen), St 36 (Zusanli), Sp 6 (Sanyinjiao), Ki 7 (Fulio), Lu 9 acupuncture points were needled. After being treated with acupuncture for one month in every two days for a total of 15 sessions, we found significant reductions (p ? 001) in both systolic (from 163.14 +/- 19.33 to 129.49 +/- 18.52) and diastolic (from 94.37 +/- 19.70 to 79.31 +/- 7.87) blood pressures of these patients. The aim here is not to compare the effectiveness of acupuncture and drug therapy on blood pressure, but to simply report that on patients currently using antihypertensive medication, acupuncture facilitated a significant reduction in blood pressure and reduced the patients complaints. We therefore conclude that our data strongly suggest that acupuncture should be in the hypertension treatment guidelines and widely used for blood pressure regulation.

Treatment of nocturia symptoms with acupuncture.

Nocturia is a common symptom in the elderly. It causes sleeping disorders and is also associated with a higher risk of falling and increased mortality. The majority of nocturia patients prescribed desmopressin although it may cause significant hyponatremia which is a serious life threatening side effect. There is a need to use safer alternative treatment strategies specialy for older nocturia patients. We aim to examine the effect of acupuncture treatment on nocturia patients as a safe alternative treatment option. 35 nocturia patients have been joined to our study aged between 28 to 72. Among those patients in the study, 23 were female while 12 were male. Acupuncture treatment were applied in every 2 days totaling 10 sessions and each treatment session has lasted for 20 minutes. Nocturia frequency of the patients were recorded 1 to 6 before acupuncture treatment sessions. We have observed that nocturia symptoms recovered completely in 60% of the patients at the end of 10 sessions of the treatment while nocturia frequency were reduced to one per night in 37% of the patients. On the other hand nocturia sypmtoms in 2.8% of the patients were not changed at all. As a result 97% of the patients have responded to acupuncture treatment positively which applied bilaterally to Yintang point, Ki 3, Liv 3, Sp 9, L.I. 4, Ht 7, Sp 6, Lu 9, Sp 3, P 6 points. According to our results we conclude that acupuncture treatment should be widely used in nocturia patients of older ages as well as relatively younger adults.

Oxytocin or social housing alleviates local burn injury in rats.

BACKGROUND: Thermal injury may cause distant organ inflammation and multiorgan failure. Oxytocin (OT), a nonapeptide, modulates the immune and inflammatory processes. MATERIALS AND METHODS: To investigate the effects of oxytocin on burn-induced tissue injury, Sprague-Dawley rats were subjected to a partial thickness burn. Immediately after burn, half of the burned rats were placed single in the cages, while others were caged in groups. All the rats then were treated with either OT (5 microg/kg, s.c) or saline twice daily for 5 d. The control rats had no burn injury and received no treatments. On day 5, the rats were decapitated, tissue and serum samples were obtained to score the severity of damage and to assay TNF-alpha levels. RESULTS: Burn trauma resulted in oxidative ileal damage, as evidenced by increased apoptotic rate, increased neutrophil recruitment, and enhanced lipid peroxidation. OT treatment depressed the TNF-alpha level and alleviated dermal degeneration, while attenuating ileal damage. Although a higher degree of skin damage was observed in the animals kept isolated following burn injury, keeping the rats in groups did not affect the level of TNF-alpha or the severity of dermal or ileal injury, but abolished the burn-induced elevations in ileal lipid peroxidation and myeloperoxidase activity. Moreover, OT treatment reduced the ileal apoptosis when applied to rats housed in groups, while the treatment did not alter apoptotic ratio in the isolated rats. CONCLUSION: Oxytocin can be considered as a potential agent in treating burn-induced distant organ injury.

The effect of sildenafil, a phosphodiesterase-5 inhibitor, on acetic acid-induced colonic inflammation in the rat.

BACKGROUND AND AIM: Sildenafil, a selective and potent inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase (PDE)5, has a relaxant effect on the smooth muscle cells of the arterioles supplying the human corpus cavernosum acting via nitric oxide (NO)-dependent mechanism. This study aimed to investigate the possible protective effect of sildenafil citrate on the extent of tissue integrity, oxidant-antioxidant status and neutrophil infiltration to the inflamed organ in a rat model of acetic acid-induced colitis. METHODS: Colitis was induced by intrarectal administration of 1 mL of 5% acetic acid to Sprague-Dawley rats (200-250 g; n = 7-8/group). Control rats received an equal volume of saline intrarectally. In treatment groups, the rats were treated with either sildenafil citrate (5 mg/kg/day; subcutaneously) or saline for 3 days. After decapitation, distal colon was weighed and scored macroscopically and microscopically. Tissue samples were used for the measurement of malondialdehyde (MDA) and glutathione (GSH) levels, myeloperoxidase (MPO) activity, and oxidant production. Trunk blood was collected for the assessment of serum tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta levels. RESULTS: In the colitis group, the colonic tissue was characterized by lesions, increased lipid peroxidation with a concomitant reduction in GSH content, increased MPO activity and oxidant production. Serum TNF-alpha and IL-1beta levels were higher in the colitis group compared to control values. Sildenafil reversed these inflammatory parameters nearly back to control values. CONCLUSIONS: Sildenafil citrate administration to rats with acetic acid-induced colitis seems to be beneficial via prevention of lipid peroxidation, oxidant generation, cytokine production and neutrophil accumulation.

Protective role of adrenomedullin in burn-induced remote organ damage in the rat.

Clinical and experimental research findings suggest that a local burn insult produces oxidant-induced organ changes as evidenced by increased lipid peroxidation in lung, liver and gut. Adrenomedullin (AM), a potent vasodilator, was originally isolated from pheochromocytoma cells, and has been identified in other tissues. In this study, we investigated the potential role of AM in burn-induced remote organ damage in rats. Sprague-Dawley rats (250-300 g) were treated with either AM (100 ng/kg, subcutaneously) or saline 10 min before burn insult which covers 30% of total body surface area and were decapitated 24 h after the burn insult. Trunk blood was collected and analyzed for liver and kidney functions and for determination of TNF-alpha levels. The liver, lung and kidney samples were taken for histologic evaluation and for measurement of malondialdehyde (MDA) level, myeloperoxidase (MPO) activity and chemiluminescence levels. The data revealed that AM treatment resulted in a significant protection in tissues tested against burn injury via suppression of lipid peroxidation, tissue neutrophil infiltration, oxidant generation and via decreasing circulating levels of the pro-inflammatory cytokine TNF-alpha. AM treatment was also effective in attenuating hepatic and kidney dysfunction due to burn injury, suggesting that peripherally AM administration may protect the tissues against burn-induced injury.

Ghrelin alleviates biliary obstruction-induced chronic hepatic injury in rats.

BACKGROUND: Reactive oxygen species and oxidative stress are implicated in hepatic stellate cell activation and liver fibrosis, which are initiated by recruitment of inflammatory cells and by activation of cytokines. OBJECTIVE: The possible anti-oxidant and anti-inflammatory effects of ghrelin were evaluated in a hepatic fibrosis model in rats with bile duct ligation (BDL). METHODS: Under anesthesia, bile ducts of Sprague Dawley rats were ligated, and half of the rats were subcutaneously administered with ghrelin (10 ng/kg/day) and the rest with saline for 28 days. Sham-operated control groups were administered saline or ghrelin. On the 28th day of the study, rats were decapitated and malondialdehyde (MDA) content--an index of lipid peroxidation, and myeloperoxidase (MPO) activity--an index of neutrophil infiltration--were determined in the liver tissues. Oxidant-induced tissue fibrosis was determined by collagen contents, while the hepatic injury was analyzed microscopically. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) levels and lactate dehydrogenase (LDH) levels were determined to assess liver function and tissue damage, respectively. Pro-inflammatory cytokines; TNF-alpha, IL-1beta and IL-6 were also assayed in plasma samples. RESULTS: In the saline-treated BDL group, hepatic MDA levels, MPO activity and collagen content were increased (p<0.001), suggesting oxidative organ damage, as confirmed histologically. In the ghrelin-treated BDL group, however, all of the oxidant responses were reversed significantly (p<0.05-p<0.001). Serum AST, ALT, LDH levels, and cytokines were elevated in the BDL group as compared to the control group, while this increase was significantly decreased by ghrelin treatment. CONCLUSION: Owing to the anti-inflammatory and anti-oxidant effect as demonstrated in our study, it is possible to speculate that exogenously administered ghrelin may possess an antifibrotic effect against biliary obstruction-induced liver fibrosis. Thus, it seems likely that ghrelin may be of potential therapeutic value in protecting the liver fibrosis and oxidative injury due to biliary obstruction.

Oxytocin ameliorates skin damage and oxidant gastric injury in rats with thermal trauma.

Transient splanchnic vasoconstriction following major burns causes oxidative and/or nitrosative damage in gastrointestinal tissues due to ischemia, which is followed by reperfusion injury. Oxytocin (OT), a hypothalamic nonapeptide, possesses antisecretory and antiulcer effects, facilitates wound healing and is involved in immune and inflammatory processes. To assess the possible protective effect of oxytocin (OT) against burn-induced gastric injury, Sprague-Dawley rats (250-300g) were randomly divided into three groups as control (n=8), OT-treated burn (n=8) and saline-treated burn (n=8) groups. Under anesthesia, the shaved dorsal skin of rats was exposed to 90 degrees C water for 10s to induce burn injury covering 30% of total body surface area in a standardized manner. Either oxytocin (5microg/kg) or saline was administered subcutaneously immediately after and at 24h following burn, and the rats were decapitated at 48h. Serum samples were assayed for TNF-alpha, and stomach was taken for the determination of malondialdehyde (MDA), myeloperoxidase (MPO) activity, DNA fragmentation rate (%) and histopathological examination. MDA and MPO were assayed for products of lipid peroxidation and as an index of tissue neutrophil infiltration, respectively. When compared to control group, burn caused significant increases in gastric MDA and MPO activity and increased microscopic damage scores at 48h (p<0.001). Oxytocin treatment reversed the burn-induced elevations in MDA and MPO levels and reduced the gastric damage scores (p<0.001, p<0.01), while TNF-alpha levels, which were increased significantly at 48thh after injury (p<0.001), were abolished with OT treatment (p<0.001). The results of this study suggest that oxytocin may provide a therapeutic benefit in diminishing burn-induced gastric inflammation by depressing tissue neutrophil infiltration and decreasing the release of inflammatory cytokines, but requires further investigation as a potential therapeutic agent in ameliorating the systemic effects of severe burn.

Ghrelin ameliorates pancreaticobiliary inflammation and associated remote organ injury in rats.

The present study was designed to evaluate whether ghrelin could reduce organ injury and systemic inflammation induced by pancreaticobiliary obstruction. In Sprague-Dawley rats, either the bile duct (BDL) or common pancreaticobiliary duct (PBDL) was ligated or a sham operation was applied. BDL or PBDL rats received either ghrelin (10ng/kg) or saline intraperitoneally immediately before the surgery and once a day until the rats were decapitated at 72h. The pancreas, liver, lung and kidney were removed for the histological analysis, and for the determination of malondialdehyde (MDA), glutathione (GSH) levels and myeloperoxidase activity (MPO). MDA and MPO levels in all the tissues, which were elevated in PBDL group (p<0.05-0.001), were reversed back to control levels in ghrelin-treated rats. In BDL group, elevations in hepatic MDA and MPO levels (p<0.001) were also abolished by ghrelin treatment. In contrast to saline-treated group with severe pancreatic damage, ghrelin-treated rats demonstrated a moderate pancreatic and hepatic destruction accompanied with reduced pulmonary and renal damages. The results illustrate that ghrelin protects the hepatic and pancreatic tissues, as well as remote organs against oxidative injury, by a neutrophil-dependent mechanism.

Oxytocin ameliorates oxidative colonic inflammation by a neutrophil-dependent mechanism.

UNLABELLED: Oxytocin (OT), a nonapeptide produced in the paraventricular and the supraoptical nuclei in the hypothalamus has a wide range of effects in the body. However, the role of OT on the gastrointestinal (GI) tract has to be settled. OT may participate in the regulation of motility, secretion, blood flow, cell turnover and release of neurotransmitters and/or peptides in the GI tract, possesses antisecretory and antiulcer effects, facilitates wound healing and is involved in the modulation of immune and inflammatory processes. The present work was conducted to assess the possible therapeutic effects of OT against the acetic acid-induced colonic injury in the rat. METHODS: Colitis was induced by intracolonic administration of acetic acid (5%) in Sprague-Dawley rats (200-250 g). Either saline or OT (0.5 mg/kg) was injected subcutaneously, immediately after the induction of colitis and repeated two times a day for 4 days. On the 4th day, rats were decapitated and distal 8 cm of the colon were removed for the macroscopic and microscopic damage scoring, determination of tissue wet weight index (WI), malondialdehyde (MDA) levels, an end product of lipid peroxidation; glutathione (GSH) levels, a key antioxidant; and myeloperoxidase (MPO) activity, as an indirect index of neutrophil infiltration. Colonic collagen content, as a fibrosis marker was also determined. Lactate dehydrogenase (LDH) and tumor necrosis factor-alpha (TNF-alpha) levels were assayed in serum samples. In the acetic acid-induced colitis, macroscopic and microscopic damage scores, WI, MDA and MPO levels were significantly increased, while GSH levels were decreased when compared to control group (p <0.05-<0.001). Treatment with OT abolished the colitis-induced elevations in damage scores, WI, MDA and MPO levels and restored the GSH levels (p <0.05-0.001). Similarly, acetic acid increased the collagen content of colonic tissues and OT-treatment reduced this value to the level of the control group. Serum LDH and TNF-alpha levels were also elevated in the acetic acid-induced colitis group as compared to control group, while this increase was significantly decreased by OT treatment. The results suggest that OT, which improves the antioxidative state of the colonic tissue and ameliorates oxidative colonic injury via a neutrophil-dependent mechanism, requires further investigation as a potential therapeutic agent in colonic inflammation.

Effective chronic low back pain and knee pain treatment with acupuncture in geriatric patients.

BACKGROUND: The most common disease of the older age group in Turkey is degenerative articular disease and pain associated with the disease. Analgesics and physical therapy are preferred treatment for geriatric chronic pain but suffering from multiple medical and nutritional problems in old ages can limit treatment options with analgesics due to an increased risk of adverse effects and drug interactions. OBJECTIVES: We aim to show the effect of acupuncture on back-pain and knee-pain treatment of elderly people. METHODS: The study includes 34 patients, 24 female and 8 male. The mean age was 69.0417 ± 8.95 years for females and 73.12 ± 8.95.24 years for males. Every two days for a total of 10 sessions acupuncture treatment to Yintang, Ht 7 (Shenmen), LI 4 (Hegu), Ki 3 (Taixi) and Ki 6 were found to significantly reduce pain scores of patients. RESULTS: Mean back pain scores (8.8696 ± 1.546) and mean knee pain scores (9.1304 ± 1.4239) of patients were reduced significantly to 2.1739 ± 1.466 and 1.455 ± 0.7; p< 0.001 respectively after the acupuncture treatment. CONCLUSION: These are important results as they give rationale to use acupuncture treatment widely in chronic low back pain and knee pain in the geriatric group of patients to reduce the side effects of polypharmacy in elderly.

Oxytocin protects against sepsis-induced multiple organ damage: role of neutrophils.

BACKGROUND: Sepsis, commonly associated with enhanced generation of reactive oxygen metabolites, leads to multiple organ dysfunctions. The neurohypophyseal hormone oxytocin (OT), released during social contact, was recently shown to modulate the immune and inflammatory processes. We investigated the protective role of OT against sepsis-induced pelvic inflammation. MATERIALS AND METHODS: Under anesthesia, sepsis was induced in female Sprague-Dawley rats (200-250 g) by cecal ligation and perforation method. Sham-operated rats served as controls. Either saline or OT (1 mg/kg) was given subcutaneously immediately after and at the 16th hour, and rats were decapitated at the 24th hour of sepsis induction. Colon, uterus, and liver samples were obtained for the histopathological analysis of damage and for the measurement of myeloperoxidase (MPO) activity, indicating neutrophil infiltration, malondialdehyde (MDA), indicating lipid peroxidation, and glutathione (GSH), a key antioxidant, levels. RESULTS: Colonic, uterine and liver MDA levels in the sepsis group were significantly increased (P < 0.01-P < 0.001), while colonic and uterine GSH levels were decreased (P < 0.05-P < 0.01) when compared to the control group. OT treatment reversed the MDA and GSH levels back to the control levels, while hepatic GSH levels were not altered. MPO activity in the colon and liver was increased by sepsis (P < 0.05-P < 0.001) while OT treatment abolished the elevated MPO activity. Collagen levels in the uterus and liver were increased by sepsis (P < 0.01) and OT treatment reduced the collagen levels in both tissues (P < 0.01-P < 0.05). Serum TNF-alpha levels were significantly increased by sepsis (P < 0.001) and OT treatment abolished the sepsis-induced increase in TNF-alpha levels. CONCLUSIONS: OT protects against sepsis-induced oxidative damage by acting as an antioxidant agent and its protective effect in the colon and liver appears to be dependent on its inhibitory effect on neutrophil infiltration. Our results suggest that OT may have a therapeutic value in limiting sepsis-associated multiple organ damage.