Electroacupuncture stimulates remodeling of extracellular matrix by inhibiting apoptosis in a rabbit model of disc degeneration.

The present study was designed to determine whether EA stimulates remodeling of extracellular matrix by inhibiting apoptosis in degenerated disc. 40 rabbits were randomly assigned to one of the four groups. Animal model was established by a loading device. Magnetic resonance imaging and Pfirrmann's classification were obtained to evaluate both the model and the EA treatment on disc degeneration. The ultrastructure of discs was observed by TEM. Apoptosis involvement was determined with TUNEL staining and western blot for the protein expression of Bax and Bcl-2. The results indicated that EA intervention decreased the MRI grades. TEM analysis showed an apparent remodeling and rearrangement of disc ECM after EA intervention for 28 days. The number of TUNEL-positive cells in the EA group was significantly lower than that in the compression group. The protein expression demonstrated an antiapoptosis effect mediated by EA. Increased expression of Bcl-2 proteins and reduced Bax protein expression were detected after 28 days treatment. It was concluded that antiapoptosis pathway probably participates in the mechanism of EA stimulating the remodeling of ECM in disc degeneration.

The effect of electroacupuncture on the extracellular matrix synthesis and degradation in a rabbit model of disc degeneration.

The present study was aimed at determining if the electroacupuncture (EA) is able to protect degenerated disc in vivo. New Zealand white rabbits (n = 40) were used for the study. The rabbits were randomly assigned to four groups. EA intervention was applied to one of the four groups. Magnetic resonance imaging and Pfirrmann's classification were obtained for each group to evaluate EA treatment on the intervertebral disc degeneration. Discs were analyzed using immunofluorescence for the labeling of collagens 1 and 2, bone morphogenetic protein-2 (BMP-2), matrix metalloproteinase-13 (MMP-13), and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1). For protein expression analysis, western blot was used for biglycan and decorin. Outcomes indicated that EA intervention decreased the grades compared with the compressed disc. Immunofluorescence analysis showed a significant increase of collagens 1 and 2, TIMP-1, and BMP-2 positive cells, in contrast to MMP-13 after EA treatment for 28 days. The protein expression showed a sign of regeneration that decorin and biglycan were upregulated. It was concluded that EA contributed to the extracellular matrix (ECM) anabolic processes and increased the ECM components. MMPs and their inhibitors involved in the mechanism of EA intervention on ECM decreased disc. It kept a dynamic balance between ECM synthesis and degradation.

[Effects of electroacupuncture stimulation of "Jiaji" (EX-B 2) on expression of matrix metalloproteinase-13 and tissue inhibitor of metalloproteinase-1 in intervertebral disc tissue in rabbits with lumbar intervertebral disc degeneration].

OBJECTIVE: To observe the effect of electroacupuncture(EA) stimulation of "Jiaji" (EX-B 2) on the expression of matrix metalloproteinase-13 (MMP-13) and tissue inhibitor of metalloproteinase-1 (TIMP-1) proteins in the lumbar disc in rabbits with lumbar intervertebral disc degeneration so as to explore its mechanism in relieving intervertebral disc degeneration. METHODS: A total of 36 New Zealand rabbits were randomly divided into normal, sham operation (sham), model, and EA groups, with 9 rabbits in each group. The lumbar intervertebral disc degeneration model was established by using a custom-made external loading device to axially compress the lumbar discs (L4, L5) for 28 days in reference to Kroeber and colleagues' methods. After modeling, EA stimulation (2 Hz/15 Hz, 1-2 mA) was applied to bilateral "Jiaji" (EX-B 2) areas for 20 min, once daily for 28 days. The expression levels of MMP-13 and TIMP-1 proteins of the lumbar intervertebral disc (L4-L5) tissues were assayed by Western blot and immunoflorescence methods, separately. RESULTS: Compared to the normal and sham groups, MMP-13 expression levels at the time-points of day 28 in the model group, on day 28 (pre-EA) in the EA group were significantly up-regulated (P < 0.01); and TIMP-1 expression levels on day 28 in both model and EA groups were significantly decreased (P < 0.01). Following EA treatment, the expression level of MMP-13 was notably lower in the EA group than in the model group, and that of TIMP-1 was remarkably higher in the EA group than in the model group (P < 0.01). No significant differences were found in the expression levels of MMP-13 and TIMP-1 from day 1 to day 56 in the same one group of both normal and sham groups, and between these two groups (P > 0.05). CONCLUSION: Electroacupuncture at "Jiaji" (EX-B 2) can effectively suppress intervertebral disc degeneration induced up-regulation of MMP-13 protein and down-regulation of TIMP-1 protein in the disc tissue in rabbits, which may contribute to its effect in bettering lumbago in clinic.

[Advances in the studies of refractory erectile dysfunction].

Erectile dysfunction (ED) is a common problem, for which PDE5 inhibitors (PDE5I) represent the first line therapy at present and have a success rate of approximately 80%. Refractory ED, which refers to ED in some patients with chronic diseases such as diabetes mellitus and cardiovascular diseases or in those treated by radical prostatectomy, receives little benefit from PDE5I alone. Apart from the NO-cGMP pathway, the processes of erection and ED involve several signaling pathways, such as RhoA/Rho kinase, H2S, CO, etc. The complicated signaling network contributes to the pathogenesis of refractory ED. PDE5I-based alternative therapy and combined therapy may increase the success rate of its treatment. This article outlines the advances in the studies of refractory ED that fails to respond to PDE5I.