Cupping alleviates lung injury through the adenosine/A2BAR pathway

Yifan Ren; Lei Qi; Lin Zhang; Jinkai Xu; Jiancan Ma; Yi Lv; Yuanyuan Zhang; Rongqian Wu

doi:10.1016/j.heliyon.2022.e12141

Cupping alleviates lung injury through the adenosine/A_2BAR pathway

Heliyon. 2022 Dec 5;8(12):e12141. doi: 10.1016/j.heliyon.2022.e12141. eCollection 2022 Dec.

Authors

Yifan Ren^{1

2}, Lei Qi³, Lin Zhang^{1

4}, Jinkai Xu², Jiancan Ma², Yi Lv^{1

4}, Yuanyuan Zhang⁵, Rongqian Wu¹

Affiliations

¹ National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
² Department of General Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
³ Department of Neurosurgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
⁴ Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
⁵ Department of Pediatrics, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.

Abstract

Background: Acute lung injury (ALI) is a serious condition. Inflammation plays a crucial role in the pathogenesis of ALI. Cupping, as a part of traditional Chinese medicine, is still a popular complementary and alternative therapy for a variety of ailments including respiratory diseases. However, reliable scientific data about cupping therapy are scarce. Adenosine, a purine nucleoside produced under metabolic stress by the action of extracellular ectonucleotidases (i.e. CD39 and CD73), can attenuate ALI through the A_2BAR receptor. The aim of this study was to investigate the protective effect of cupping in a rat model of ALI and the role of adenosine in it.

Methods: Male adult rats were subjected to ALI by intratracheal LPS instillation (0.3 mg/kg). Immediately after intratracheal LPS instillation, vacuum pressure was applied to a sanitized plastic bell cup on the back of the rat by suction for 10 min. Pulmonary injury and inflammation were assessed at 4 h after LPS challenge. The role of adenosine and A_2BAR in cupping's protection after LPS instillation were evaluated.

Results: Cupping alleviated LPS-induced lung injury, reduced inflammation and inhibited NF-kB activation in rats. Cupping upregulated CD39 and CD73 mRNA expression of the skin tissue at the cupping site and increased circulating levels of adenosine. Administration of PSB1115, a specific adenosine A_2BAR receptor antagonist, abolished cupping's beneficial effects in LPS-induced ALI.

Conclusions: Cupping attenuates lung inflammation and injury through the adenosine/A_2BAR pathway. The current study provides evidence-based information about cupping therapy in ALI.

Keywords: A2BAR; Acute lung injury; Adenosine; Cupping; Inflammation; NF-κB.