RESUMEN
BACKGROUND: Hyperbaric oxygenation (HBO) therapy can improve locomotor dysfunction following spinal cord injury (SCI). Emerging evidence has demonstrated that sirtuin1 (SIRT1) exerts protective effects on neurons. However, whether HBO alleviates locomotor dysfunction by regulating SIRT1 is unclear. METHODS: The traumatic SCI animal model was performed on the adult Sprague-Dawley rats. The Basso, Beattie Bresnahan (BBB) locomotor rating scale was used to evaluate the open-field locomotor function. Western blot, real-time quantitative reverse transcription polymerase chain reaction, SIRT1 activity assay, and enzyme-linked immunosorbent assays were performed to explore the molecular mechanisms. RESULTS: We found that series HBO therapy significantly improved locomotor dysfunction and ameliorated the decreased mRNA, protein, and activity of spinal cord SIRT1 induced by traumatic SCI injury in rats. In addition, intraperitoneal injection of SIRT1 inhibitor EX-527 abolished the beneficial effects of series HBO treatment on locomotor deficits. Importantly, series HBO treatment following the traumatic SCI injury inhibited the inflammatory cascade and apoptosis-related protein, which was retained by EX-527 and enhanced by SRT1720. Furthermore, EX-527 blocked the enhanced induction of autophagy series with the HBO application. CONCLUSION: These findings demonstrated a new mechanism for series HBO therapy involving activation of SIRT1 and subsequent modulation of the inflammatory cascade, apoptosis, and autophagy, which contributed to the recovery of motor dysfunction.
RESUMEN
BACKGROUND: Irritable bowel syndrome is a chronic functional gastrointestinal disease, of which diarrhea-predominant irritable bowel syndrome (IBS-D) is a common subtype. In China, acupoint application therapy is currently widely used as an effective complementary therapy for IBS-D. In the clinical management of IBS-D, acupoint application is usually combined with other therapies, including acupuncture, moxibustion, and Chinese herbal and Western medicine. However, at present, evidence regarding the most effective options for treating IBS-D is insufficient. Therefore, this protocol proposes a systematic review and network meta-analysis for evaluating the effectiveness of acupoint application and its combination therapies in treating IBS-D, and for identifying the acupoint application-related treatments with the highest probability of being the best intervention. METHODS: Six English electronic databases (PubMed, Ovid MEDLINE, Scopus, Web of Science, the Cochrane Library, and EMBASE), four Chinese electronic databases [China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (CQVIP), WanFang, and SinoMed), and one Japanese medical database (Citation Information by National Institute of Informatics (CiNii)] will be searched for eligible randomized controlled trials from their inception to June 1, 2022. The efficacy and safety of acupoint application therapy and its combination therapies for patients with IBS-D will be evaluated. The STATA 14.0 (StataCorp, USA) software package will be used for the meta-analysis. A Bayesian network meta-analysis (NMA) will be performed using R (version 4.0.2) and Aggregate Data Drug Information System (ADDIS, version 1.16.8) software packages. Bias risk will be assessed using the Cochrane Collaboration's risk of bias tool; specifically, publication bias will be evaluated using Egger's test and funnel plots. The rank probabilities of various outcomes for each intervention will be calculated, clustered, and ranked using the cumulative ranking curve method. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method will be employed to assess the certainty of evidence for NMA outcomes. CONCLUSIONS: This study will aim to determine the clinical efficacy of acupoint application therapy and its combined therapy in the treatment of IBS-D and provide an evidence-based foundation for identifying the best acupoint application program.