Chronic hypertension evoked aberrant myocardial remodeling is the main reason for progressive death from heart failure. It is of great clinical significance to find effective prevention and treatment methods to block this pathological process. It has been shown that imbalance of the autonomic nervous system (ANS) induced by chronic hypertension, i.e., hyper-excitation of sympathetic nerve system and suppression of parasympathetic (vagal) nerve system, activates immune cells-mediated inflammatory responses, and exacerbates the pathological remodeling of cardiac tissue. Except the negative inotropic outcomes, excitation of vagal nerves also has an anti-inflammatory effect which is mediated by activating the cholinergic anti-inflammatory pathway (CAIP). Previous studies showed that electroacupuncture (EA) could exert anti-hypertensive and systematic anti-inflammatory effects by increasing vagal activity. In addition, preliminary study from our lab demonstrated that EA was able to alleviate the pathological progress from hypertension to cardiac hypertrophy. However, the potential role of CAIP in restoring hypertension induced aberrant myocardial remodeling is still unknown. Herein, based on the alteration of ANS function in hypertension and EA's impact on vagal activity, we propose novel research ideas that EA could attenuate the pathological process of hypertension induced abnormal myocardial remodeling via activating CAIP.
慢性高血压状态可引起自主神经功能失衡，主要表现为交感活动增强，副交感(迷走)活动受到抑制，从而激活由免疫细胞介导的炎性反应，加剧心肌组织的病理性重构。而迷走神经激活除具有负性心力作用外，还可发挥胆碱能抗炎效应，电针可通过激活迷走神经发挥降压和系统性抗炎效应。电针可延缓高血压—心肌肥厚的病理进程，而胆碱能抗炎通路在电针缓解慢性高血压—心肌重构病理进程中的作用犹未可知。本文通过系统梳理自主神经功能与高血压—心肌重构发生发展机制之间的联系，以及针刺对胆碱能抗炎通路中关键信号分子的调节作用，提出胆碱能抗炎通路参与介导针刺延缓高血压—心肌重构病理进程相关机制研究的新思路。.
Keywords: Acupuncture; Cholinergic anti-inflammatory pathway; Hypertension; Myocardial remodeling.