Advancing the Understanding of Acupoint Sensitization and Plasticity Through Cutaneous C-Nociceptors

Inflammatory pain and electroacupuncture: how the P2X3 receptor can help modulate inflammation-a review of current literature

AIM

Inflammatory pain arises from tissue stress or injury and is initiated by signaling molecules that stimulate the immune and nervous systems. Evidence suggests that purinergic signaling pathways can modulate pain and inflammation through the activation of P1 and P2 purinergic receptors, such as the P2X3 receptor, which are stimulated by extracellular molecules like adenosine triphosphate (ATP). Electroacupuncture (EA) exhibits precise mechanisms that modulate inflammatory pain through the activation of the P2X3 receptor.

OBJECTIVE

This review analyzed evidence regarding the role of electroacupuncture and the purinergic system, particularly the P2X3 receptor, in modulating inflammation and pain.

MATERIALS AND METHODS

A search for the most relevant articles available in the SciVerse Scopus and MEDLINE/PubMed databases was conducted for publications from 1995 to 2024. Articles were initially selected by reading the title, abstract, and main text, respectively.

RESULTS

It was found that the P2X3 receptor, as well as the molecules activating purinergic receptors, such as ATP and adenosine, have the potential to regulate pain and inflammation. Additionally, EA can modulate the purinergic system in an anti-inflammatory response. EA may stimulate analgesia mainly through the conversion of ATP to adenosine, a crucial molecule in pain control.

CONCLUSION

The purinergic system directly influences inflammatory pain and controls inflammation. In this context, EA has the potential to orchestrate this system to control pain and inflammation.

Therapeutic components of acupuncture stimulation based on characteristics of sensory nerve and nervous signaling pathway

Acupuncture, a therapeutic practice rooted in traditional Chinese medicine and integrated with modern neuroscience, achieves its effects by stimulating sensory nerves at specific anatomical points known as acupoints. This review systematically explores the therapeutic components of acupuncture, emphasizing the interplay between sensory nerve characteristics and neural signaling pathways. Key factors such as acupoint location, needling depth, stimulation intensity, retention time, and the induction of sensations (e.g., Deqi) are analyzed for their roles in neural activation and clinical outcomes. The review highlights how variations in spinal segment targeting, tissue-specific receptor activation, and stimulation modalities (e.g., manual acupuncture, electroacupuncture, moxibustion) influence therapeutic effects. Emerging evidence underscores the significance of ion channels, dermatomes, myotomes, and gene-specific pathways in mediating systemic effects. Additionally, the differential roles of mechanical, thermal and nociceptive stimuli and the temporal dynamics of sensory and immune responses are addressed. While insights from animal models have advanced our understanding, their translation to clinical practice requires further investigation. This comprehensive review identifies critical parameters for optimizing acupuncture therapy, advocating for individualized treatment strategies informed by neuroanatomical and neurophysiological principles, ultimately enhancing its precision and efficacy in modern medicine. Please cite this article as: Wie HS, Kim SN. Therapeutic components of acupuncture stimulation based on characteristics of sensory nerve and nervous signaling pathway. J Integr Med. 2025; 23(2): 106-112.

The Effect of Laser Biostimulation at Sensitized Acupoints on Chronic Pelvic Pain and Quality of Life in Women with Pelvic Inflammatory Disease: A Randomized Controlled Trial

Background and Objectives: Chronic pelvic pain (CPP) is a common complication of pelvic inflammatory disease (PID). Although acupuncture has been increasingly used for the management of CPP, there is insufficient research to support the use of laser stimulation of sensitized acupoints. This study aimed to investigate the effects of laser on sensitized acupoints on pelvic pain perception and quality of life in women with pelvic inflammatory disease. Materials and Methods: Thirty-six women with CPP caused by chronic pelvic inflammatory disease were randomly divided into two equal groups. Both groups received non-steroidal anti-inflammatory drugs, while the study group also received a low-level laser at sensitized acupoints for 6 weeks. All the patients were evaluated before and after the intervention. The 12-item Short-Form Health Survey (SF-12) was used to measure the quality of life, while a pressure algometer and visual analog scale for pain (VAS-P) were used to measure pain sensitivity and intensity, respectively. A mixed MANOVA was used to investigate the effects of the treatment. Results: A mixed MANOVA on VAS, SF-12, and PPT scores revealed significant interaction effects of treatment and time (F = 38.34, p = 0.001, partial η2 = 0.96) and main effects of treatment (F = 9.74, p = 0.001) and time (F = 110.1, p = 0.001). Post-treatment, the study group showed greater reductions in VAS (MD = -1.00, p = 0.001), improvements in SF-12 (MD = 9.11, p = 0.001), and increased Pressure Pain Thresholds (PPT) at multiple anatomical points (p = 0.001-0.01). Conclusions: Laser biostimulation of neurogenic-sensitized acupoints significantly improves pain perception, intensity, and quality of life in women with CPP. suggested that the utilization of laser therapy at sensitized acupoints should be considered a potential component of a rehabilitation program for females suffering from chronic pelvic pain resulting from pelvic inflammatory disease. (Clinicaltrials.gov identifier: NCT05537207; Date of registration: 13 September 2022).

Efficacy of Transcutaneous Electrical Acupoint Stimulation on Modulating Upper Extremity Sympathetic Skin Response in Alleviating Cancer Survivors With Chemotherapy-Induced Peripheral Neuropathy: A Propensity Score-Matched Cohort Study

Objective

 Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of chemotherapy and it is currently intractable We compared the efficacy of transcutaneous electrical acupoint stimulation (TEAS) against non-TEAS groups and investigated the variables that predict effective relief of upper extremity pain in cancer survivors with CIPN.

Methods

We retrospectively collected data of cancer survivors who developed CIPN between May 2017 to March 2022. All eligible CIPN patients were divided into TEAS group (received TEAS) and non-TEAS group (did not receive TEAS) in our department. A 1:1 ratio propensity score matching (PSM) was used to balance the baseline features. The change of numerical rating scale (NRS), Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2), and sympathetic skin response (SSR) parameters are all assessed after treatment. The procedure was considered a clinically effective relief if the patients' NRS scores were reduced by 50% or more, and overall patients with effective relief were all counted after treatment. Furthermore, a multivariable logistic regression model was utilized to evaluate the predictors of effective relief following CIPN treatment.

Results 

A total of 102 cancer survivors with CIPN were analyzed after PSM (51 in each group). The change of NRS, SF-MPQ-2, SSR latency and SSR amplitude in TEAS group were significantly higher than those in non-TEAS group at 3 weeks after therapy (all P<0.01). In addition, the effective relief rate was significantly higher in TEAS group than in non-TEAS group (P=0.026). Multivariate logistic regression on the total study cohort showed that TEAS group (OR 2.783, P = 0.025) and the baseline SSR amplitude of the upper extremity <1265 µV (OR 12.191, P = 0.000) were independent predictive factors for the clinical efficacy.

Conclusions 

TEAS significantly decreased the severity of CIPN. TEAS group and baseline SSR amplitude of the upper extremity <1265 µV were the independent predictive factors for the clinical efficacy after treatment.

Mechanisms of acupuncture at Zusanli (ST36) and its combinational acupoints for stress gastric ulcer based on the correlation between Zang-fu and acupoints

Gastric ulcer (GU) is a common digestive system disease. Acupuncture, as one of the external treatments of traditional Chinese medicine (TCM), has the characteristics of multi-target, multi-pathway and multi-level action in the treatment of GU. The relationship between meridian points and Zang-fu is an important part of the theory of TCM, which is crucial for the diagnosis and treatment of diseases. There is an external and internal link between acupoints and Zang-fu. The pathological reaction of Zang-fu can manifest as acupoint sensitization, while stimulation of acupoints can play a therapeutic role in the internal Zang-fu. Therefore, the acupoint has the functions of reflecting and treating diseases. This review explores the tender points on the body surface of patients with GU and the rules of acupoint selection. In addition, Zusanli (ST36), as one of the most used acupoints of the stomach meridian, was selected to show the mechanisms behind acupoint stimulation in the treatment of GU in greater detail, specifically in the well-studied model of the stress GU (SGU). Hence, the mechanisms of acupuncture at ST36 and points commonly used in combination with ST36 to treat SGU are discussed further. Treatment effects can be achieved through anti-inflammatory and antioxidant activities, gastric mucosal injury repair, and interaction with the brain-gut axis. In summary, this review provides evidence for a comprehensive understanding of the phenomena and mechanism of acupoint functions for GU. Please cite this article as: He M, Lim XY, Li J, Li L, Zhang T. Mechanisms of acupuncture at Zusanli (ST36) and its combinational acupoints for stress gastric ulcer based on the correlation between Zang-fu and acupoints. J Integr Med. 2025; 23(1): 1-11.

Parkinson's Disease Bradykinesia, Forward Posture, and Drug-Induced Pisa Syndrome Alleviated With Traditional Japanese Acupuncture: A Case Report

Parkinson's disease (PD) is a common progressive neurodegenerative disease. The management of PD including Pisa syndrome (PS), a postural deformity in PD characterized by reversible lateral bending of the trunk on the side, is often challenging. Recently, acupuncture has been a recognized intervention for treating motor or non-motor symptoms in PD management. However, very few of these studies or cases have been reported from Japan. A 58-year-old man with a four-year history of PD (Hoehn and Yahr Scale: Stage 2) presented to the acupuncture department of our hospital with dysphasia, bradykinesia, forward posture, and newly appeared right-side bending of the trunk after he increased the dose of rotigotine delivered via skin patches six months earlier. There was no change in the right-sided bending of the trunk two months after the withdrawal of the dopaminergic agents. A traditional Japanese acupuncture and moxibustion treatment, Hokushin-kai, was started. According to the Oriental medical diagnosis, he was categorized with "liver depression," "kidney deficiency," and "dampness" patterns. The treatment was administered once a week, and only one or two needles were used. The acupoints, such as Ququan (LR8) or Houxi (SI3), were selected according to the Oriental medical diagnosis and the findings of the acupoint examination. At first, the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) score was 34 points, and the Parkinson's Disease Questionnaire (PDQ-39) score was 42 points; the Cobb angle was 45°. After 10 weeks, he could walk smoothly and almost upright. MDS-UPDRS-3 and PDQ-39 scores improved to 12 points and 34 points, respectively, while the Cobb angle improved to 32°. Changes (improvements) in his gait and posture are shown in the videos included in this case report. We present a case of PD bradykinesia, forward posture, and drug-induced PS alleviated with traditional Japanese acupuncture. This case report suggests that acupuncture using this Japanese method would achieve similar efficacies to those achieved in conventional case reports or clinical trials, and it could be one of the optional treatments available for PD. Further studies, such as the long-term effect of acupuncture on PD patients or improved outcomes of PD patients with early-phase intervention, are required.

Acupoint Sensitivity in Health and Disease: A Systematic Review

Introduction: The concept of acupoints is a key defining feature of acupuncture, yet the scientific basis of acupoints remains unclear. In recent years, there has been an emerging body of animal studies demonstrating an association between cutaneous sensitivity and visceral pathophysiology, through which acupoints over the skin are sensitized in pathologic conditions. Several studies with humans have also been conducted to assess whether the sensitivity of acupoints is distinct in healthy versus clinical populations. However, no systematic review has been conducted to collate and synthesize the status and quality of human studies on this topic. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). Literature search was performed by combining variations of search terms related to acupoints and pain sensitivity in PubMed, EMBASE, and Alt HealthWatch (EBSCOHost). Screening of titles and abstracts and review of full-text articles for eligibility were performed by two independent investigators. Using a predefined template, information on subject characteristics, pathologic conditions, names of assessed acupoints, and relevant main findings were extracted from the included studies. The methodological quality of included studies was assessed using a modified Newcastle-Ottawa Scale (NOS) for case-control studies. A quality assessment checklist was also developed by the present authors to examine the quality of reporting of experimental variables that were considered important for evaluating acupoint sensitivity. Results: A total of 3453 studies were identified from the database search, of which 11 met the eligibility criteria to be included in this review. Six studies examined the mechanical sensitivity of body acupoints, and the remaining five studies examined the mechanical sensitivity of auricular points. Overall, findings suggest that the sensitivity of acupoints may be distinct in healthy versus clinical populations. However, there were various potential sources of bias and substantial heterogeneity across included studies in clinical conditions and acupoints. Conclusion: There is at present insufficient evidence to support or refute that acupoints in humans are sensitized in pathologic conditions. There were various methodological issues, including small sample size and poor reporting of experimental design and variables, which limit the ability to draw a definitive conclusion on this topic. It is also largely unclear whether it is the general body regions rather than specific acupoints that may be sensitized, as most studies did not include nonacupoint location(s) for comparison. Thus, further rigorous research is warranted.

Neuregulin4-ErbB4 signalling pathway is driven by electroacupuncture stimulation to remodel brown adipose tissue innervation

AIM

To show that electroacupuncture stimulation (ES) remodels sympathetic innervation in brown adipose tissue (BAT) via the bone morphogenic protein 8B (BMP8B)-neuregulin 4 (NRG4)-ErbB4 axis, with somatotopic dependence.

MATERIALS AND METHODS

We established a high-fat diet (HFD) model with C57BL/6J mice to measure the thermogenesis and metabolism of BAT. In addition, the sympathetic nerve activity (SNA) was measured with the electrophysiological technique, and the immunostaining of c-Fos was used to detect the central nervous system sources of sympathetic outflows. Finally, the key role of the BMP8B-NRG4-ErbB4 axis was verified by peripheral specific antagonism of ErbB4.

RESULTS

ES at the forelimb and abdomen regions significantly up-regulate SNA, whereas ES at the hindlimb region has a limited regulatory effect on SNA but still partially restores HFD-induced BAT dysfunction. Mechanistically, ES at the forelimb and abdomen regions driving catecholaminergic signals in brown adipocytes depends on neural activities projected from the ventromedial nucleus of the hypothalamus (VMH) to the spinal cord intermediolateral column (IML). Notably, the peripheral suppression of ErbB4 in BAT inhibits the thermogenesis and metabolic function of BAT, as well as significantly hindering the SNA activation and metabolic benefits induced by ES.

CONCLUSION

These results suggest that ES appears to be an effective approach for remodeling sympathetic innervation in BAT, which is closely related to neuronal activity in the VMH and the NRG4-ErbB4 signaling pathway.

Exploratory Study of Biomechanical Properties and Pain Sensitivity at Back-Shu Points

OBJECTIVES

Hypersensitive acupoints in specific body areas are associated with corresponding internal or visceral disorders. Back-shu points are clinically significant for the diagnosis of visceral organ disease, according to the biomechanical characteristics of the acupoints. In this study, we assessed the biomechanical characteristics and pain sensitivities of five back-shu points linked to five visceral organs in healthy participants.

METHODS

The study included 48 volunteer participants. A myotonometry was used to assess muscle tone and muscle stiffness at five back-shu points associated with visceral organs. Pressure was monitored using a microcontroller and a force sensor. Pain sensitivity was assessed in response to deep pressure pain produced by a constant force.

RESULTS

Substantial differences in muscle tone and stiffness were observed at the five back-shu points; muscle tone was highest at BL15, whereas muscle tone and muscle stiffness were lowest at BL23. Moreover, pain sensitivity was significantly different among the acupoints; pain sensitivity was highest at BL23. There was a significant negative correlation between muscle tone and pain sensitivity.

CONCLUSIONS

We found significant differences in muscle tone, muscle stiffness, and pain sensitivity among five back-shu points associated with visceral organs, which may be attributable to anatomical variations at each point. Our findings suggest that differences at back-shu points should be considered to ensure the accurate diagnosis of visceral disease.

Neural circuit mechanisms of acupuncture effect: where are we now?

Recently, there has been increasing attention on the impact of acupuncture on the dysregulated neural circuits in different disease. This has led to new understandings of how acupuncture works. This review presents a comprehensive analysis of research that have examined the impact of acupuncture on abnormal neural circuits associated with pain, anxiety, Parkinson's disease, addiction disorders, cognitive problems, and gastrointestinal disorders. These studies have shown that acupuncture's therapeutic effects are mediated by specific brain areas and neurons involved in neural circuit mechanisms, emphasising its wide-ranging influence. The positive impacts of acupuncture can be ascribed to its ability to modify the functioning of neurocircuits in various physiological conditions. Nevertheless, contemporary studies on acupuncture neural circuits frequently overlook the comprehensive circuit mechanism including the periphery, central nervous system, and target organ. Additionally, the scope of diseases studied is restricted. Future study should focus on broadening the range of diseases studied and exploring the neural circuit mechanisms of these diseases in depth in order to enhance our understanding of acupuncture's neurobiological impacts.

Anatomical Exploration of the KI1 Acupoint: Implications for Medial and Lateral Plantar Nerve Stimulation

Background and Objectives: This study aims to identify the precise anatomical location and therapeutic mechanisms of the KI1 acupoint (Yongquan) in relation to foot muscles and nerves, known for treating neurological disorders and pain. Materials and Methods: Dissection of six cadavers at Chungnam National University College of Medicine examined KI1's relation to the foot's four-layer structure. Results: The KI1 acupoint was located in the superficial and deep layers of the plantar foot, adjacent to significant nerves like the medial and lateral plantar nerves. Differences in the acupoint's exact location between genders were noted, reflecting variances in foot morphology. KI1 acupuncture was found to stimulate the muscle spindles and nerve fibers essential for balance and bipedal locomotion. This stimulation may enhance sensory feedback, potentially improving cognitive functions and balance control. Conclusions: This anatomical insight into KI1 acupuncture underpins its potential in neurological therapies and pain management.

Deep electroacupuncture of neurogenic spots attenuates immobilization stress-induced acute hypertension in rats

Background

Our previous studies proved that neurogenic inflammatory spots (or neurogenic spots) have the same physiological features as acupuncture points and that neurogenic spot stimulation generates therapeutic effects in various animal models. However, it is unclear how deeply the neurogenic spots should be stimulated to generate therapeutic effects.

Methods

The effects of acupuncture at various needle depths below the neurogenic spot were examined in a rat immobilization stress-induced hypertension (IMH) model. Electroacupuncture was applied to a neurogenic spot at depths of 1, 2, or 3 mm using a concentric bipolar electrode.

Results

Electrical stimulation of the neurogenic spot at a 3-mm depth most effectively lowered blood pressure compared with controls and stimulation at 1- and 2-mm depths, which was inhibited by pretreatment with a local anesthetic lidocaine. Electrical stimulation of the neurogenic spot or injection of substance P (SP) at a 3-mm depth significantly excited the rostral ventrolateral medulla (rVLM) compared with superficial stimulation. Electrical stimulation applied at a 3-mm depth on neurogenic spots dominantly caused c-fos expression from rVLM and ventrolateral periaqueductal gray (vlPAG) in IMH rats. Pretreatment with resiniferatoxin (RTX) injection into the neurogenic spot to ablate SP or calcitonin gene-related peptide (CGRP) prevented the effects of 3-mm neurogenic spot stimulation on blood pressure in IMH rats. Conversely, artificial injection of SP or CGRP generated anti-hypertensive effects in IMH rats.

Conclusion

Our data suggest that neurogenic spot stimulation at a 3-mm depth generated anti-hypertensive effects through the local release of SP and CGRP and activation of rVLM and vlPAG.

Efficacy and safety of community-based moxibustion for primary hypertension: A randomized controlled trial with patient preference arms

Moxibustion has been shown to have a potential antihypertensive effect, but its applicability for the primary care of hypertension is unclear. The authors conducted a multicenter randomized controlled trial (RCT) with patient preference arms to investigate the effect, safety, cost-effectiveness, and compliance of moxibustion in community patients with hypertension. Patients with primary hypertension were enrolled from seven communities randomly or nonrandomly assigned to receive self-administered moxibustion + the original hypertensive regimen or the original hypertensive regimen alone for 6 months. The authors mainly evaluated the effects of moxibustion on hypertensive outcomes and adverse events. As a result, a total of 160 and 240 patients were recruited into the randomized and nonrandomized arms, respectively, with 87.5% completing the follow-up. At month 6, there was a significantly greater reduction in systolic blood pressure (SBP) (difference: -10.57 mmHg), a higher proportion of responders (82.2% vs. 53.7%; odds ratio 4.00), and better improvements in hypertensive symptoms and quality of life (QoL) in the moxibustion group than in the control group in the randomized population, but there was no significant between-group difference in diastolic blood pressure (DBP). The nonrandomized findings showed the same effect direction for all outcomes, except for DBP. All moxibustion-related adverse events were mild. In conclusion, moxibustion can reduce SBP and improve hypertensive symptoms and QoL in community patients with hypertension, with good safety and low cost, although its effect on DBP remains uncertain. The findings suggest that moxibustion may be an appropriate technique for community primary care of hypertension.

Adrenal sympathetic nerve mediated the anti-inflammatory effect of electroacupuncture at ST25 acupoint in a rat model of sepsis

Acupuncture plays a vital anti-inflammatory action in sepsis by activating autonomic nerve anti-inflammatory pathways, such as sympathoadrenal medullary pathway, but the mechanism remains unclear. This study aims to explore the optimum parameter of electroacupuncture (EA) stimulation in regulating the sympathoadrenal medullary pathway and evaluate EA's anti-inflammatory effect on sepsis. To determine the optimum parameter of EA at homotopic acupoint on adrenal sympathetic activity, the left adrenal sympathetic nerve firing rate evoked by different intensities of single shock electrical stimulation (ES) at ST25 in healthy male Sprague-Dawley rats were evaluated by in vivo electrophysiological recording, and the levels of norepinephrine (NE) and its metabolites normetanephrine (NMN) were also examined using mass spectrometry. To verify the role of EA at ST25 in sepsis, the rats were given an intraperitoneal injection of lipopolysaccharide (LPS) to induce sepsis model, and survival rate, clinical score, and the level of interleukin (IL)-6, IL-1β, and IL-10 were evaluated after EA application. We observed that 3 mA is the optimal intensity for activating adrenal sympathetic nerve, which significantly elevated the level of NE in the peripheral blood. For LPS-treated rats, EA at the ST25 apparently increased the survival rate and improved the clinical score compared to the control group. Furthermore, 3 mA EA at ST25 significantly decreased pro-inflammatory cytokines IL-6 and IL-1β and upregulated anti-inflammatory cytokine IL-10 compared to the LPS-treated group. Overall, our data suggested that 3 mA is the optimal EA intensity at ST25 to activate the sympathoadrenal medullary pathway and exert an anti-inflammatory effect in sepsis.

Sympathetic-Sensory Coupling as a Potential Mechanism for Acupoints Sensitization

A series of studies have demonstrated acupoint sensitization, in which acupoints can be activated in combination with sensory hypersensitivity and functional plasticity during visceral disorders. However, the mechanisms of acupoint sensitization remain unclear. Neuroanatomy evidence showed nociceptors innervated in acupoints contribute to the mechanism of acupoint sensitization. Increasing studies suggested sympathetic nerve plays a key role in modulating sensory transmission by sprouting or coupling with sensory neuron/nociceptor in the peripheral, forming the functional structure of the sympathetic-sensory coupling. Notably, the sensory inputs of the disease-induced sensitized acupoint contribute to the homeostatic regulation and also involve in delivering therapeutic information under acupuncture, hence, the role of sprouted sympathetic in acupoint function should be given attention. We herein reviewed the current knowledge of sympathetic and its sprouting in pain modulation, then discussed and highlighted the potential value of sympathetic-sensory coupling in acupoint functional plasticity.

Grain-sized moxibustion at Zusanli (ST36) promotes hepatic autophagy in rats with hyperlipidemia by regulating the ULK1 and TFEB expression through the AMPK/mTOR signaling pathway

Objective

Grain-sized moxibustion is an effective treatment for hyperlipidemia, but how it regulates dyslipidemia and liver lipid deposits still needs to be fully understood. This study explored the molecular biological mechanism of grain-sized moxibustion to regulate hepatic autophagy in hyperlipidemic rats by affecting ULK1 and TFEB through the AMPK/mTOR signaling pathway.

Methods

Thirty male Sprague-Dawley (SD) rats were fed a high-fat diet for eight weeks to induce hyperlipidemia. Hyperlipidemic rats were divided into the HFD group, HFD + Statin group, HFD + CC + Moxi group, and grain-sized moxibustion intervention group (HFD + Moxi group). The control (Blank) group consisted of normal rats without any intervention. Grain-sized moxibustion and drug interventions were initiated eight weeks after high-fat diet induction and continued for ten weeks. Serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), as well as hepatic triglyceride (TG), were measured after treatment. Hepatic steatosis and the expression of LC3I, LC3II, p62, p-AMPK, AMPK, p-mTOR, mTOR, ULK1, p-ULK1, and TFEB in the liver were analyzed.

Results

Compared with the HFD group, grain-sized moxibustion improved hyperlipidemia and hepatocyte steatosis, increased the LC3, p-AMPK, p-ULK1, and nuclear TFEB expression in the liver, but decreased the p62 and p-mTOR expression.

Conclusion

Grain-sized moxibustion at ST36 acupoints could regulate the blood lipid level of SD rats with hyperlipidemia, increase the expression level of ULK1 and TFEB by activating the AMPK/mTOR signaling pathway in liver tissues, and initiate the transcription of autophagy genes such as LC3.

Spinal VGLUT3 lineage neurons drive visceral mechanical allodynia but not sensitized visceromotor reflexes

Visceral pain is among the most prevalent and bothersome forms of chronic pain, but their transmission in the spinal cord is still poorly understood. Here, we conducted focal colorectal distention (fCRD) to drive both visceromotor responses (VMRs) and aversion. We first found that spinal CCK neurons were necessary for noxious fCRD to drive both VMRs and aversion under naive conditions. We next showed that spinal VGLUT3 neurons mediate visceral allodynia, whose ablation caused loss of aversion evoked by low-intensity fCRD in mice with gastrointestinal (GI) inflammation or spinal circuit disinhibition. Importantly, these neurons were dispensable for driving sensitized VMRs under both inflammatory and central disinhibition conditions. Anatomically, a subset of VGLUT3 neurons projected to parabrachial nuclei, whose photoactivation sufficiently generated aversion in mice with GI inflammation, without influencing VMRs. Our studies suggest the presence of different spinal substrates that transmit nociceptive versus affective dimensions of visceral sensory information.

Somatotopic organization of autonomic reflexes by acupuncture

Acupuncture has been practiced for more than 2000 years in China and now all over the world. One core idea behind this medical practice is that stimulation at specific body regions (acupoints) can distantly modulate organ physiology, but the underlying scientific basis has been long debated. Here, I summarize evidence supporting that long-distant acupuncture effects operate partly through somato-autonomic reflexes, leading to activation of sympathetic and/or parasympathetic pathways. I then discuss how the patterning of the somatosensory system along the rostro-caudal axis and the cutaneous-deep tissue axis might explain acupoint specificity and selectivity in driving specific autonomic pathways, particularly those modulating gastrointestinal motility and systemic inflammation.