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Wang MN, Zhai MX, Wang YT, Dai QF, Liu L, Zhao LP, Xia QY, Li S, Li B. Mechanism of Acupuncture in Treating Obesity: Advances and Prospects. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2024; 52:1-33. [PMID: 38351701 DOI: 10.1142/s0192415x24500010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Obesity is a common metabolic syndrome that causes a significant burden on individuals and society. Conventional therapies include lifestyle interventions, bariatric surgery, and pharmacological therapies, which are not effective and have a high risk of adverse events. Acupuncture is an effective alternative for obesity, it modulates the hypothalamus, sympathetic activity and parasympathetic activity, obesity-related hormones (leptin, ghrelin, insulin, and CCK), the brain-gut axis, inflammatory status, adipose tissue browning, muscle blood flow, hypoxia, and reactive oxygen species (ROS) to influence metabolism, eating behavior, motivation, cognition, and the reward system. However, hypothalamic regulation by acupuncture should be further demonstrated in human studies using novel techniques, such as functional MRI (fMRI), positron emission tomography (PET), electroencephalogram (EEG), and magnetoencephalography (MEG). Moreover, a longer follow-up phase of clinical trials is required to detect the long-term effects of acupuncture. Also, future studies should investigate the optimal acupuncture therapeutic option for obesity. This review aims to consolidate the recent improvements in the mechanism of acupuncture for obesity as well as discuss the future research prospects and potential of acupuncture for obesity.
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Affiliation(s)
- Mi-Na Wang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
- School of Traditional Chinese Medicine, School of Life Science, Beijing University of Chinese Medicine, Beijing 100029, P. R. China
| | - Miao-Xin Zhai
- Yinghai Hospital, Daxing District, Beijing 100163, P. R. China
| | - Yi-Tong Wang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
- School of Traditional Chinese Medicine, School of Life Science, Beijing University of Chinese Medicine, Beijing 100029, P. R. China
| | - Qiu-Fu Dai
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
| | - Lu Liu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
| | - Luo-Peng Zhao
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
| | - Qiu-Yu Xia
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
| | - Shen Li
- Department of Emergency, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, P. R. China
| | - Bin Li
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
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Landgraaf RG, Bloem MN, Fumagalli M, Benninga MA, de Lorijn F, Nieuwdorp M. Acupuncture as multi-targeted therapy for the multifactorial disease obesity: a complex neuro-endocrine-immune interplay. Front Endocrinol (Lausanne) 2023; 14:1236370. [PMID: 37795371 PMCID: PMC10545882 DOI: 10.3389/fendo.2023.1236370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/29/2023] [Indexed: 10/06/2023] Open
Abstract
The prevalence of obesity has reached pandemic dimensions. It is associated with multiple comorbidities and is becoming a clinical and public health threat. Obesity is a multifactorial disease with a complex pathophysiology and interplay of various systems. A strong interplay exists between the neuro-endocrine system, the immune system with systemic chronic low-grade inflammation, and microbiome dysbiosis that can lead to the development of obesity, which in turn can exacerbate each of these factors, hence creating a vicious cycle. The conventional treatment with lifestyle modifications such as diet, physical exercise, pharmacotherapy, and bariatric surgery does not always result in sufficient weight control thus paving the way for other strategies. As one such strategy, acupuncture is increasingly used worldwide to treat obesity. This narrative review outlines the evidence for this neuro-endocrine-immune interplay in the pathophysiology of obesity. Furthermore, the existing experimental and clinical evidence of acupuncture as a multi-targeted therapy for obesity is explained and future research perspectives are discussed.
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Affiliation(s)
- Raymond Guy Landgraaf
- Department of Internal and Vascular Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands
- Sinomedica Gui Sheng Tang, Scientific Department, Lugano, Switzerland
| | - Michelle Nicté Bloem
- Emma Children’s Hospital, Amsterdam University Medical Center (UMC), Pediatric Gastroenterology, University of Amsterdam, Amsterdam, Netherlands
| | - Massimo Fumagalli
- Sinomedica Gui Sheng Tang, Scientific Department, Lugano, Switzerland
| | - Marc Alexander Benninga
- Emma Children’s Hospital, Amsterdam University Medical Center (UMC), Pediatric Gastroenterology, University of Amsterdam, Amsterdam, Netherlands
| | - Fleur de Lorijn
- Emma Children’s Hospital, Amsterdam University Medical Center (UMC), Pediatric Gastroenterology, University of Amsterdam, Amsterdam, Netherlands
| | - Max Nieuwdorp
- Department of Internal and Vascular Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands
- Department of Experimental Vascular Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands
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Yao J, Yan X, Xiao X, You X, Li Y, Yang Y, Zhang W, Li Y. Electroacupuncture induces weight loss by regulating tuberous sclerosis complex 1-mammalian target of rapamycin methylation and hypothalamic autophagy in high-fat diet-induced obese rats. Front Pharmacol 2022; 13:1015784. [PMID: 36313328 PMCID: PMC9596966 DOI: 10.3389/fphar.2022.1015784] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Obesity can be caused by abnormalities of hypothalamic autophagy, which is closely regulated by the epigenetic modification of TSC1-mTOR. However, whether the weight-reducing effect of EA may relate to the modification of TSC1-mTOR methylation and hypothalamic autophagy remain unclear. This study was conducted to reveal the possible mechanism by which EA reduces BW by measuring the levels of TSC1-mTOR methylation and hypothalamic autophagy-related components.Methods: The weight-reducing effect of EA was investigated in high-fat diet (HFD)-induced obese (DIO) rats by monitoring the BW, food consumption, and epididymal white adipose tissue (eWAT)/BW ratio. Hematoxylin and eosin staining was performed for morphological evaluation of eWAT. Immunofluorescence was utilized to observe the localization of LC3 in the hypothalamus. The expressions of autophagy components (Beclin-1, LC3, and p62) and mTOR signaling (mTOR, p-mTOR, p70S6K, and p-p70S6K) were assessed by western blot. The methylation rate of the TSC1 promoter was detected by bisulfite genomic sequencing.Results: Treatment with EA significantly reduced the BW, food consumption, and eWAT/BW ratio; attenuated the morphological alternations in the adipocytes of DIO rats. While HFD downregulated the expression levels of Beclin-1 and LC3 and upregulated those of p62, these changes were normalized by EA treatment. EA markedly decreased the methylation rate of the TSC1 gene promoter and suppressed the protein expressions of mTOR, p-mTOR, p70S6K, and p-p70S6K in the hypothalamus.Conclusion: EA could reduce BW and fat accumulation in DIO rats. This ameliorative effect of EA may be associated with its demethylation effect on TSC1-mTOR and regulation of autophagy in the hypothalamus.
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Affiliation(s)
- Junpeng Yao
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiangyun Yan
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xianjun Xiao
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xi You
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yanqiu Li
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuqing Yang
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wei Zhang
- Academic Affairs Office, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ying Li
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Ying Li,
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Lima IGD, Silva JRTD, Silva AGD, Andrade ADS, Sousa LD. Electroacupuncture reduces weight, skinfold thickness and waist circumference and increases skin temperature of the abdominal region in women: a randomized controlled trial. Acupunct Med 2022; 40:425-433. [PMID: 35437025 DOI: 10.1177/09645284221077111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Acupuncture, as a complementary and alternative medical treatment, has shown some promise as a therapeutic option for obesity and weight control. The aim of the current study was to investigate the effects of electroacupuncture (EA) on body weight, body mass index (BMI), skin fold thickness, waist circumference and skin temperature of the abdominal region in non-obese women with excessive abdominal subcutaneous fat. METHODS A total of 50 women with excessive abdominal subcutaneous fat (and average BMI of 22) were randomly assigned to one of two groups: an EA group (n = 25) receiving 10 EA sessions (insertion of needles connected to an electrical stimulator at a frequency of 40 Hz for 40 min) and a control group (n = 25) that received no treatment. Outcome measures evaluated included waist circumference, supra-iliac and abdominal skinfolds, body composition and superficial skin temperature (measured by cutaneous thermography) before and after treatment. RESULTS Compared with the untreated group, women in the EA group exhibited decreased supra-iliac and abdominal skin folds (p < 0.001), waist circumference (p < 0.001), percentage body fat (p = 0.001) and percentage abdominal fat (p < 0.001). In addition, the EA group showed an elevated skin temperature at the site of the treatment. However, EA did not significantly impact body weight (p = 0.01) or BMI (p = 0.2). CONCLUSION EA promoted a reduction in abdominal waist circumference, supra-iliac and abdominal skin folds, and percentage body and abdominal fat in women of normal BMI with excessive abdominal subcutaneous fat, as well as an increase in the superficial skin temperature of the abdominal region. TRIAL REGISTRATION NUMBER RBR-9tsmpp (Brazilian Registry of Clinical Trials).
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Affiliation(s)
- Isabella Gomes de Lima
- Physiotherapy Course, Institute of Motricity Sciences, Federal University of Alfenas (UNIFAL), Alfenas, Brazil
| | - Josie Resende Torres da Silva
- Physiotherapy Course, Institute of Motricity Sciences, Federal University of Alfenas (UNIFAL), Alfenas, Brazil.,Program of Biosciences Applied to Health, Federal University of Alfenas, Alfenas, Brazil
| | - Amanda Godoy da Silva
- Program of Rehabilitation Sciences, Institute of Motricity Sciences, Federal University of Alfenas, Alfenas, Brazil
| | - Alice de Sousa Andrade
- Program of Rehabilitation Sciences, Institute of Motricity Sciences, Federal University of Alfenas, Alfenas, Brazil
| | - Ligia de Sousa
- Physiotherapy Course, Institute of Motricity Sciences, Federal University of Alfenas (UNIFAL), Alfenas, Brazil.,Program of Rehabilitation Sciences, Institute of Motricity Sciences, Federal University of Alfenas, Alfenas, Brazil
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The efficacy and safety of auriculotherapy for weight loss: A systematic review and meta-analysis. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2021.101402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Obesity Animal Models for Acupuncture and Related Therapy Research Studies. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6663397. [PMID: 34630614 PMCID: PMC8497105 DOI: 10.1155/2021/6663397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 09/02/2021] [Indexed: 11/17/2022]
Abstract
Obesity and related diseases are considered as pandemic representing a worldwide threat for health. Animal models are critical to validate the effects and understand the mechanisms related to classical or innovative preventive and therapeutic strategies. It is, therefore, important to identify the best animal models for translational research, using different evaluation criteria such as the face, construct, and predictive validity. Because the pharmacological treatments and surgical interventions currently used for treating obesity often present many undesirable side effects, relatively high relapse probabilities, acupuncture, electroacupuncture (EA), and related therapies have gained more popularity and attention. Many kinds of experimental animal models have been used for obesity research studies, but in the context of acupuncture, most of the studies were performed in rodent obesity models. Though, are these obesity rodent models really the best for acupuncture or related therapies research studies? In this study, we review different obesity animal models that have been used over the past 10 years for acupuncture and EA research studies. We present their respective advantages, disadvantages, and specific constraints. With the development of research on acupuncture and EA and the increasing interest regarding these approaches, proper animal models are critical for preclinical studies aiming at developing future clinical trials in the human. The aim of the present study is to provide researchers with information and guidance related to the preclinical models that are currently available to investigate the outcomes of acupuncture and related therapies.
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The Beneficial Effects of Moxibustion on Overweight Adolescent Girls. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:1943181. [PMID: 34055002 PMCID: PMC8131142 DOI: 10.1155/2021/1943181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 11/15/2020] [Accepted: 04/24/2021] [Indexed: 12/11/2022]
Abstract
Among adolescent girls, overweight or obesity has both physical and psychological involvement. We conducted a randomized controlled trial of moxibustion using a moxa burner. Fifty-four eligible girls aged 15-18 years with a body mass index (BMI) greater than 25.3 were enrolled in the study. The girls were randomly allocated to the treatment (n = 27) and control (n = 27) groups. The girls underwent treatment three times per week for 8 weeks (24 treatments). Moxibustion was applied to the RN12, RN6, ST25, ST36, and SP6 acupoints. Physical assessments were BMI, waist-to-hip ratio (WHR), and body fat ratio (BFR). Psychological outcomes were measured using the Rosenberg Self-Esteem Scale (RSE). Data were collected at the beginning of the study (baseline), week 4, and week 8. Of the 54 participants, 46 completed the trial. The difference in mean BMI from baseline between the two groups was 0.097 (p=0.655) at week 4 and -0.794 (p=0.001) at week 8. The mean WHR of the treatment group was significantly reduced compared with baseline, with a -0.011 (p=0.017) and -0.035 (p < 0.001) mean change at weeks 4 and 8, respectively. The mean BFR was slightly reduced (-0.253;p=0.474 ) at week 4 compared with baseline in the treatment group. At week 8, it was significantly reduced (-2.068; p < 0.001) from baseline in the treatment group. The mean RSE in the treatment group showed no significant increase from baseline at week 4 (0.155 points, p=0.803), but it improved significantly from baseline at week 8 (1.606 points, p=0.021) compared to that in the control group. No obvious adverse effect was reported during this study. Moxibustion using a moxa burner may be an effective and safe intervention for overweight adolescent girls, having both physical and psychological benefits.
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Wang L, Yu CC, Li J, Tian Q, Du YJ. Mechanism of Action of Acupuncture in Obesity: A Perspective From the Hypothalamus. Front Endocrinol (Lausanne) 2021; 12:632324. [PMID: 33868169 PMCID: PMC8050351 DOI: 10.3389/fendo.2021.632324] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/16/2021] [Indexed: 01/22/2023] Open
Abstract
Obesity is a prevalent metabolic disease caused by an imbalance in food intake and energy expenditure. Although acupuncture is widely used in the treatment of obesity in a clinical setting, its mechanism has not been adequately elucidated. As the key pivot of appetite signals, the hypothalamus receives afferent and efferent signals from the brainstem and peripheral tissue, leading to the formation of a complex appetite regulation circuit, thereby effectively regulating food intake and energy homeostasis. This review mainly discusses the relationship between the hypothalamic nuclei, related neuropeptides, brainstem, peripheral signals, and obesity, as well as mechanisms of acupuncture on obesity from the perspective of the hypothalamus, exploring the current evidence and therapeutic targets for mechanism of action of acupuncture in obesity.
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Affiliation(s)
- Li Wang
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
| | - Chao-Chao Yu
- Department of Tuina, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
- The Fourth Clinical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Jia Li
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
| | - Qing Tian
- Department of Pathology and Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan-Jun Du
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
- *Correspondence: Yan-Jun Du,
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Electroacupuncture Prevents Osteoarthritis of High-Fat Diet-Induced Obese Rats. BIOMED RESEARCH INTERNATIONAL 2020; 2020:9380965. [PMID: 32724821 PMCID: PMC7366230 DOI: 10.1155/2020/9380965] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/22/2020] [Accepted: 06/16/2020] [Indexed: 01/09/2023]
Abstract
The effects of acupuncture on osteoarthritis (OA) pathogenesis have been demonstrated in vitro and in animal models. However, the potential for acupuncture to mediate protective effects on obese-induced OA has not been examined. Here, we investigated the effects of different acupuncture patterns on OA pathogenesis in high-fat diet- (HFD-) induced obese rats. After 12-week diet-induced obesity, obese rats were treated with three acupuncture protocols for 2 weeks, including ST36, GB34, and ST36+GB34. The results showed that the three acupuncture protocols both prevented obesity-induced cartilage matrix degradation and MMP expression and mitigated obesity-induced systemic and local inflammation but had different regulatory effects on lipid metabolism and gut microbiota disorder of obese-induced OA rats. Furthermore, the three acupuncture protocols increased the microbial diversity and altered the structure of community of feces in obese rats. We found that ST36 and GB34 could inhibit proinflammatory shift in the gut microbiome with an increase in the ratio of Bacteroidetes/Firmicutes and promote the recovery of relative abundance of Clostridium, Akkermansia, Butyricimonas, and Lactococcus. Although both ST36 and GB34 had an anti-inflammatory effect on serum inflammatory mediators, only the acupuncture protocol with both ST36 and GB34 could effectively inhibit LPS-mediated joint inflammation in obesity rats. Therefore, relieving obesity-related chronic inflammation, lipid metabolism disorder, and gut microbiota disorder may be an important mechanism for acupuncture with ST36 and GB34 to promote OA recovery.
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Determination of Electroacupuncture Effects on circRNAs in Plasma Exosomes in Diabetic Mice: An RNA-Sequencing Approach. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:7543049. [PMID: 31662781 PMCID: PMC6778869 DOI: 10.1155/2019/7543049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/05/2019] [Accepted: 07/29/2019] [Indexed: 01/22/2023]
Abstract
circRNAs are involved in diabetes mellitus pathogenesis. Electroacupuncture (EA) is an effective therapeutic strategy for diabetes mellitus. However, whether the mechanism of action of EA on diabetes mellitus is related to altered circRNAs is unclear. The aim of this study was to reveal the effect of EA on circRNA expression in plasma exosomes and the underlying signaling pathway in mice with type 2 diabetes mellitus (T2DM). In total, 10 mice were randomly categorized into a normal group and 20 mice were used for the T2DM model preparation and randomly divided into the model and model + EA groups. Mice in the model + EA group were administered EA treatment. Changes in the fasting blood glucose (FBG) level and islet structure were evaluated. Plasma exosomes were subjected to RNA sequencing, and then bioinformatics analysis and real-time quantitative PCR (qPCR) verification were performed. EA treatment reduced the FBG level, preserved the islet structure, and reduced the islet β cell apoptotic rate in T2DM mice. After EA treatment, 165 differentially expressed circRNAs were found. GO and KEGG analyses revealed that thyroid hormone signaling was actively regulated by EA. circRNA/miRNA interaction analysis revealed mmu-mir-7092-3p to be closely associated with circINPP4B, suggesting that the phosphatidylinositol signaling pathway may be affected by EA. qPCR confirmed that 12 circRNAs had significant differences. These findings suggested that EA intervention can significantly protect islet function and improve the FBG level in T2DM, possibly via regulation of thyroid hormone and phosphatidylinositol signaling.
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11
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Samodien E, Pheiffer C, Erasmus M, Mabasa L, Louw J, Johnson R. Diet-induced DNA methylation within the hypothalamic arcuate nucleus and dysregulated leptin and insulin signaling in the pathophysiology of obesity. Food Sci Nutr 2019; 7:3131-3145. [PMID: 31660128 PMCID: PMC6804761 DOI: 10.1002/fsn3.1169] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/18/2019] [Accepted: 07/24/2019] [Indexed: 12/24/2022] Open
Abstract
Obesity rates continue to rise in an unprecedented manner in what could be the most rapid population‐scale shift in human phenotype ever to occur. Increased consumption of unhealthy, calorie‐dense foods, coupled with sedentary lifestyles, is the main factor contributing to a positive energy balance and the development of obesity. Leptin and insulin are key hormones implicated in pathogenesis of this disorder and are crucial for controlling whole‐body energy homeostasis. Their respective function is mediated by the counterbalance of anorexigenic and orexigenic neurons located within the hypothalamic arcuate nucleus. Dysregulation of leptin and insulin signaling pathways within this brain region may contribute not only to the development of obesity, but also systemically affect the peripheral organs, thereby manifesting as metabolic diseases. Although the exact mechanisms detailing how these hypothalamic nuclei contribute to disease pathology are still unclear, increasing evidence suggests that altered DNA methylation may be involved. This review evaluates animal studies that have demonstrated diet‐induced DNA methylation changes in genes that regulate energy homeostasis within the arcuate nucleus, and elucidates possible mechanisms causing hypothalamic leptin and insulin resistance leading to the development of obesity and metabolic diseases.
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Affiliation(s)
- Ebrahim Samodien
- Biomedical Research and Innovation Platform South African Medical Research Council. Tygerberg Cape Town South Africa
| | - Carmen Pheiffer
- Biomedical Research and Innovation Platform South African Medical Research Council. Tygerberg Cape Town South Africa.,Department of Medical Physiology Stellenbosch University Tygerberg South Africa
| | - Melisse Erasmus
- Biomedical Research and Innovation Platform South African Medical Research Council. Tygerberg Cape Town South Africa.,Department of Medical Physiology Stellenbosch University Tygerberg South Africa
| | - Lawrence Mabasa
- Biomedical Research and Innovation Platform South African Medical Research Council. Tygerberg Cape Town South Africa
| | - Johan Louw
- Biomedical Research and Innovation Platform South African Medical Research Council. Tygerberg Cape Town South Africa.,Department of Biochemistry and Microbiology University of Zululand KwaDlangezwa South Africa
| | - Rabia Johnson
- Biomedical Research and Innovation Platform South African Medical Research Council. Tygerberg Cape Town South Africa.,Department of Medical Physiology Stellenbosch University Tygerberg South Africa
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Yao J, He Z, Chen Y, Xu M, Shi Y, Zhang L, Li Y. Acupuncture and weight loss in Asians: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e16815. [PMID: 31415397 PMCID: PMC6831107 DOI: 10.1097/md.0000000000016815] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Acupuncture is effective for reducing body weight; however, evidence in Asian populations is lacking. We performed a systematic review and meta-analysis to evaluate the efficacy of acupuncture for body weight reduction in Asians. METHODS The Medline, Embase, Cochrane library, and Chinese databases were searched for relevant studies through October 20, 2018. Publications describing randomized controlled trials (RCTs) comparing acupuncture with other treatments for the reduction of body weight were compiled. Reviewers assessed bias and collected data on trial characteristics and outcomes. The study was conducted based on the reporting items of the guidelines for systematic evaluation and meta-analysis (PRISMA). Review Manager 5.2 software was used to calculate weight mean difference (WMD) and 95% confidence intervals (CIs). RESULTS Twelve RCTs involving 1151 subjects were included. Compared with the control groups, the acupuncture groups exhibited significantly greater reductions of body mass index (BMI)(WMD -1.20kg/m2; 95% CI -1.91, -0.48)and waist circumference (WMD -1.85 cm; 95% CI -3.20, -0.49) In the subgroup analyses, significant differences in the reduction of BMI was observed between the acupuncture and sham acupuncture groups, the acupuncture plus diet and exercise, and the diet and exercise groups, and the acupuncture and no intervention groups, but not between the acupuncture plus exercise and exercise groups [corrected]. CONCLUSIONS Our study demonstrates that acupuncture is effective in the intervention of overweight/obesity in Asians; however, compared with exercise alone, acupuncture combined with exercise had no effect on the BMI or waist circumstance in the short term. Long-term studies are needed to evaluate the efficacy of acupuncture in weight reduction in Asians.
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Affiliation(s)
- Junpeng Yao
- Chengdu University of Traditional Chinese Medicine
| | - Zhiqiong He
- The Third Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Diabetes Mellitus Prevention and Control Center of Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Ying Chen
- Chengdu University of Traditional Chinese Medicine
| | - Mingmin Xu
- Chengdu University of Traditional Chinese Medicine
| | - Yunzhou Shi
- Chengdu University of Traditional Chinese Medicine
| | - Lin Zhang
- The Third Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Diabetes Mellitus Prevention and Control Center of Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Ying Li
- Chengdu University of Traditional Chinese Medicine
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Wang LH, Huang W, Wei D, Ding DG, Liu YR, Wang JJ, Zhou ZY. Mechanisms of Acupuncture Therapy for Simple Obesity: An Evidence-Based Review of Clinical and Animal Studies on Simple Obesity. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:5796381. [PMID: 30854010 PMCID: PMC6378065 DOI: 10.1155/2019/5796381] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/25/2018] [Indexed: 12/15/2022]
Abstract
Simple obesity is a worldwide epidemic associated with rapidly growing morbidity and mortality which imposes an enormous burden on individual and public health. As a part of Traditional Chinese Medicine (TCM), acupuncture has shown the positive efficacy in the management of simple obesity. In this article, we comprehensively review the clinical and animal studies that demonstrated the potential mechanisms of acupuncture treatment for simple obesity. Clinical studies suggested that acupuncture regulates endocrine system, promotes digestion, attenuates oxidative stress, and modulates relevant molecules of metabolism in patients of simple obesity. Evidence from laboratory indicated that acupuncture regulates lipid metabolism, modulates inflammatory responses, and promotes white adipose tissue browning. Acupuncture also suppresses appetite through regulating appetite regulatory hormones and the downstream signaling pathway. The evidence from clinical and animal studies indicates that acupuncture induces multifaceted regulation through complex mechanisms and moreover a single factor may not be enough to explain the beneficial effects against simple obesity.
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Affiliation(s)
- Li-Hua Wang
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, China
| | - Wei Huang
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, China
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Dan Wei
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - De-Guang Ding
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Yi-Ran Liu
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Jia-Jie Wang
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Zhong-Yu Zhou
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| |
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