Electroacupuncture preconditioning protects against myocardial ischemia-reperfusion injury by modulating dynamic inflammatory response

Hua Bai; Sen-Lei Xu; Jun-Jing Shi; Ya-Ping Ding; Qiong-Qiong Liu; Chun-Hong Jiang; Li-Li He; Hong-Ru Zhang; Sheng-Feng Lu; Yi-Huang Gu

doi:10.1016/j.heliyon.2023.e19396

Electroacupuncture preconditioning protects against myocardial ischemia-reperfusion injury by modulating dynamic inflammatory response

Heliyon. 2023 Aug 29;9(9):e19396. doi: 10.1016/j.heliyon.2023.e19396. eCollection 2023 Sep.

Authors

Hua Bai^{1

2}, Sen-Lei Xu^{1

2}, Jun-Jing Shi^{1

2}, Ya-Ping Ding^{1

2}, Qiong-Qiong Liu^{1

2}, Chun-Hong Jiang^{1

2}, Li-Li He^{1

2}, Hong-Ru Zhang³, Sheng-Feng Lu^{1

4}, Yi-Huang Gu^{1

2}

Affiliations

¹ Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
² Acupuncture and Tuina College, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
³ School of Medicine ＆ Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
⁴ School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, 210023, China.

Abstract

Background: The protective effects of electroacupuncture (EA) preconditioning against myocardial ischemia-reperfusion injury (MIRI) have been reported. However, the underlying mechanism remains unclear. Recent research has indicated that the dynamic inflammatory response following MIRI plays an essential role in the progression of myocardial injury. This study aimed to investigate the myocardial protective effects of EA preconditioning on MIRI in rats and to explore the relevant mechanism from the perspective of dynamic inflammatory response.

Methods: A MIRI model was employed, and the rats were subjected to EA on Neiguan for four days prior to modeling. The myocardial protective effect of EA preconditioning was evaluated by echocardiography, Evans blue and triphenyltetrazolium chloride staining. Real-time polymerase chain reaction, Western blot, hematoxylin & eosin staining, and immunohistochemistry were utilized to detect the content of mitochondrial DNA, NOD receptor family protein 3 (NLRP3) inflammasome activation, neutrophil recruitment and macrophage infiltration in blood samples and myocardium below the ligation.

Results: We found that EA preconditioning could accelerate the recovery of left ventricle function after MIRI and reduce the myocardial infarction area, thereby protecting the myocardium against MIRI. Furthermore, EA preconditioning was observed to ameliorate mitochondrial impairment, reduce the level of plasma mitochondrial DNA, modulate NLRP3 inflammasome activation, attenuate neutrophil infiltration, and promote the polarization of M1 macrophages towards M2 macrophages in the myocardium after MIRI.

Conclusion: EA preconditioning could reduce plasma mtDNA, suppress overactivation of the NLRP3 inflammasome, facilitate the transition from the acute pro-inflammatory phase to the anti-inflammatory reparative phase after MIRI, and ultimately confer cardioprotective benefits.

Keywords: Dynamic inflammatory response; Electroacupuncture preconditioning; NLRP3 inflammasome; myocardial ischemia-reperfusion injury.