Electroacupuncture Promotes Motor Function Recovery in MCAO/R Rats by Activating Astrocyte-Related PI3K/AKT Pathway.

Background: Electroacupuncture (EA) is a widely used traditional Chinese medicine method to manage various diseases, including cerebral ischemia-reperfusion injury (CIRI). Objectives: We assessed the neuroprotective effects of EA and examined its mechanism in a rat model of the middle cerebral artery occlusion-reperfusion (MCAO/R). The gait analysis was performed to evaluate the neuroprotective effects. Western blot and immunohistochemistry assays were carried out to determine the molecular mechanisms of EA. Methods: Male SD rats were randomly divided into the sham operation group, right MCAO/R group, and EA group. EA was administered every day (4/20 Hz, 10 min/1 d) at the following acupoints: Baihui (DU20), Yintang (EX-HN3), and Zusanli (ST36). Gait and motor function were analyzed from day 8 onward. Results: The plantar support and balance coordination of MCAO/R rats decreased, and the cellular structure of the ischemic penumbra was unclear. EA improved the gait dynamics of the rats, adjusted the cell structure, further activated astrocytes, and increased the expression and phosphorylation of phosphoinositide 3-kinase/protein kinase B (PI3K/PKB or AKT). Conclusion: EA promoted astrocyte-related effects in the rat model. Our findings suggest that the neuroprotective mechanism of EA may be related to the activation of the PI3K/AKT signaling pathway. The intervention enhanced brain protection and improved motor functions.

Traditional Chinese medicine (TCM) collaborative care for patients with axial spondyloarthritis (AcuSpA): protocol for a pragmatic randomized controlled trial.

BACKGROUND: Axial spondyloarthritis (AxSpA) is a chronic disease which results in fatigue, pain, and reduced quality of life (QoL). Traditional Chinese medicine (TCM), especially acupuncture, has shown promise in managing pain. Although a TCM collaborative model of care (TCMCMC) has been studied in cancer, there are no randomized controlled trials investigating TCM in AxSpA. Therefore, we will conduct a pragmatic trial to determine the clinical effectiveness, safety, and cost-effectiveness of TCMCMC for patients with AxSpA. We define TCMCMC as standard TCM history taking and physical examination, acupuncture, and TCM non-pharmacological advice and communications with rheumatologists in addition to usual rheumatologic care. The purpose of this paper is to describe the rationale for and methodology of this trial. METHODS/DESIGN: This pragmatic randomized controlled trial will recruit 160 patients who are diagnosed with AxSpA and have inadequate response to non-steroidal anti-inflammatory drugs (NSAIDs). Simple randomization to usual rheumatologic care or the intervention (TCMCMC) with a 1:1 allocation ratio will be used. Ten 30-min acupuncture sessions will be provided to patients assigned to the TCMCMC arm. All participants will continue to receive usual rheumatologic care. The primary endpoint - spinal pain - will be evaluated at week 6. Secondary endpoints include clinical, quality of life, and economic outcome measures. Patients will be followed up for up to 52 weeks, and adverse events will be documented. DISCUSSION: This trial may provide evidence regarding the clinical effectiveness, safety, and cost-effectiveness of a TCMCMC for patients with AxSpA. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03420404 . Registered on 14 February 2018.