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      Electroacupuncture pretreatment mediates sympathetic nerves to alleviate myocardial ischemia–reperfusion injury via CRH neurons in the paraventricular nucleus of the hypothalamus

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          Abstract

          Background

          Myocardial ischemia–reperfusion can further exacerbate myocardial injury and increase the risk of death. Our previous research found that the paraventricular nucleus (PVN) of the hypothalamus plays a crucial role in the improvement of myocardial ischemia–reperfusion injury (MIRI) by electroacupuncture (EA) pretreatment, but its mechanism of action is still unclear. CRH neurons exhibit periodic concentrated expression in PVN, but further research is needed to determine whether they are involved in the improvement of MIRI by EA pretreatment. Meanwhile, numerous studies have shown that changes in sympathetic nervous system innervation and activity are associated with many heart diseases. This study aims to investigate whether EA pretreatment improves MIRI through sympathetic nervous system mediated by PVN CRH neurons.

          Methods

          Integrated use of fiber-optic recording, chemical genetics and other methods to detect relevant indicators: ECG signals were acquired through Powerlab standard II leads, and LabChart 8 calculated heart rate, ST-segment offset, and heart rate variability (HRV); Left ventricular ejection fraction (LVEF), left ventricular short-axis shortening (LVFS), left ventricular end-systolic internal diameter (LVIDs) and interventricular septal thickness (IVSs) were measured by echocardiography; Myocardial infarct area (IA) and area at risk (AAR) were calculated by Evans-TTC staining. Pathological changes in cardiomyocytes were observed by HE staining; Changes in PVN CRH neuronal activity were recorded by fiber-optic photometry; Sympathetic nerve discharges were recorded for in vivo electrophysiology; NE and TH protein expression was assayed by Western blot.

          Results

          Our data indicated that EA pretreatment can effectively alleviate MIRI. Meanwhile, we found that in the MIRI model, the number and activity of CRH neurons co labeled with c-Fos in the PVN area of the rat brain increased, and the frequency of sympathetic nerve discharge increased. EA pretreatment could reverse this change. In addition, the results of chemical genetics indicated that inhibiting PVN CRH neurons has a similar protective effect on MIRI as EA pretreatment, and the activation of PVN CRH neurons can counteract this protective effect.

          Conclusion

          EA pretreatment can inhibit PVN CRH neurons and improve MIRI by inhibiting sympathetic nerve, which offers fresh perspectives on the application of acupuncture in the management of cardiovascular disease.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s13020-024-00916-y.

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          Most cited references58

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          Brain-heart interactions: physiology and clinical implications.

          The brain controls the heart directly through the sympathetic and parasympathetic branches of the autonomic nervous system, which consists of multi-synaptic pathways from myocardial cells back to peripheral ganglionic neurons and further to central preganglionic and premotor neurons. Cardiac function can be profoundly altered by the reflex activation of cardiac autonomic nerves in response to inputs from baro-, chemo-, nasopharyngeal and other receptors as well as by central autonomic commands, including those associated with stress, physical activity, arousal and sleep. In the clinical setting, slowly progressive autonomic failure frequently results from neurodegenerative disorders, whereas autonomic hyperactivity may result from vascular, inflammatory or traumatic lesions of the autonomic nervous system, adverse effects of drugs and chronic neurological disorders. Both acute and chronic manifestations of an imbalanced brain-heart interaction have a negative impact on health. Simple, widely available and reliable cardiovascular markers of the sympathetic tone and of the sympathetic-parasympathetic balance are lacking. A deeper understanding of the connections between autonomic cardiac control and brain dynamics through advanced signal and neuroimage processing may lead to invaluable tools for the early detection and treatment of pathological changes in the brain-heart interaction.
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            Acupuncture as Adjunctive Therapy for Chronic Stable Angina

            The effects of acupuncture as adjunctive treatment to antianginal therapies for patients with chronic stable angina are uncertain.
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              Sema3a maintains normal heart rhythm through sympathetic innervation patterning.

              Sympathetic innervation is critical for effective cardiac function. However, the developmental and regulatory mechanisms determining the density and patterning of cardiac sympathetic innervation remain unclear, as does the role of this innervation in arrhythmogenesis. Here we show that a neural chemorepellent, Sema3a, establishes cardiac sympathetic innervation patterning. Sema3a is abundantly expressed in the trabecular layer in early-stage embryos but is restricted to Purkinje fibers after birth, forming an epicardial-to-endocardial transmural sympathetic innervation patterning. Sema3a(-/-) mice lacked a cardiac sympathetic innervation gradient and exhibited stellate ganglia malformation, which led to marked sinus bradycardia due to sympathetic dysfunction. Cardiac-specific overexpression of Sema3a in transgenic mice (SemaTG) was associated with reduced sympathetic innervation and attenuation of the epicardial-to-endocardial innervation gradient. SemaTG mice demonstrated sudden death and susceptibility to ventricular tachycardia, due to catecholamine supersensitivity and prolongation of the action potential duration. We conclude that appropriate cardiac Sema3a expression is needed for sympathetic innervation patterning and is critical for heart rate control.
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                Author and article information

                Contributors
                ronglincai@ahtcm.edu.cn
                yuqing@ahtcm.edu.cn
                Journal
                Chin Med
                Chin Med
                Chinese Medicine
                BioMed Central (London )
                1749-8546
                6 March 2024
                6 March 2024
                2024
                : 19
                : 43
                Affiliations
                [1 ]GRID grid.252251.3, ISNI 0000 0004 1757 8247, College of Acupuncture and Moxibustion, , Anhui University of Chinese Medicine, ; Hefei, 230012 China
                [2 ]Center for Xin’an Medicine and Modernization of Traditional Chinese Medicine, Insitute of Health and Medicine, Hefei Comprehensive National Science Center, Hefei, 230601 China
                [3 ]Institute of Acupuncture and Meridian Research, Anhui Academy of Chinese Medicine, Hefei, 230038 China
                [4 ]Anhui Province Key Laboratory of Meridian Viscera Correlationship, Hefei, 230038 China
                [5 ]Key Laboratory of Xin’an Medicine, Ministry of Education, Hefei, 230038 China
                Author information
                http://orcid.org/0000-0002-1600-2647
                Article
                916
                10.1186/s13020-024-00916-y
                10916233
                38448912
                e675ea80-8233-4e9e-a62d-5f1082da0aee
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 1 December 2023
                : 26 February 2024
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
                Award ID: 82074536
                Award ID: 82104999
                Award Recipient :
                Funded by: Natural Science Foundation of Anhui Province
                Award ID: 2108085Y30
                Award ID: 2108085QH364
                Award Recipient :
                Funded by: Anhui Province University Outstanding Top Talent Cultivation Funding Project
                Award ID: gxgwfx2019025
                Award Recipient :
                Funded by: Anhui Province Excellent Youth Backbone Talent Domestic Visit and Training Program
                Award ID: gxgnfx2022014
                Award Recipient :
                Funded by: Anhui Province University Scientific Research Project
                Award ID: 2022AH020043
                Award ID: 2022AH030062
                Award Recipient :
                Funded by: Research Funds of Center for Xin'an Medicine and Modernization of Traditional Chinese Medicine of IHM
                Award ID: 2023CXMMTCM019
                Award Recipient :
                Categories
                Research
                Custom metadata
                © International Society for Chinese Medicine and BioMed Central Ltd. 2024

                Complementary & Alternative medicine
                electroacupuncture pretreatment,paraventricular nucleus of hypothalamus,crh neurons,myocardial ischemia- reperfusion injury,neural mechanism

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