Effect of Acupuncture on Polycystic Ovary Syndrome in Animal Models: A Systematic Review

Abstract

Background. Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. As a widely used complementary and alternative therapy, acupuncture is increasingly used to treat PCOS. However, the effect of acupuncture in treating PCOS is uncertain, and the mechanisms are unclear. This systematic review aims to determine the efficacy of acupuncture on PCOS in animal preclinical models. Methods. Experimental animal studies of acupuncture in PCOS animal models were searched in PubMed, Web of Science, China National Knowledge Infrastructure, and the Chinese Science and Technology Periodical Database from inception to December 2020. The risk of bias was assessed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) risk of bias tool. Results. A total of 358 studies were screened based on the title and abstract, and 31 studies were included. A total of 722 animals were involved, and all studies used either Wistar rats or SD rats. Twenty-six studies used electroacupuncture, 9 studies used manual acupuncture, and 5 of them employed both electroacupuncture and manual acupuncture. A total of 22 acupoints were involved; 7 studies followed the modern acupuncture pattern, and the rest followed classic acupuncture theory. Conclusions. The present review summarizes the current evidence of the effects of acupuncture on PCOS in animal models. Unfortunately, we could not draw a definite conclusion due to the methodological weakness of the included studies and the high heterogeneity. Well-designed studies are needed in the future to fill this gap.

Underlying mechanisms of acupuncture therapy on polycystic ovary syndrome: Evidences from animal and clinical studies

“…In addition, our multinational study protocol on acupuncture or metformin to improve insulin resistance in women with PCOS has been published ( 124 ). In recent years, there have been an increasing number of systematic reviews and/or meta-analyses on the effect of acupuncture on PCOS in both patients and animal models ( 22 , 23 , 96 , 100 ). This study reviewed the feasibility and efficacy of acupuncture for managing PCOS and summarized the potential mechanisms of acupuncture on treating PCOS.…”

“…Evidence has shown that acupuncture elevates the level of β-endorphin not only in the central endocrine system but also in the peripheral circulation ( 94 ), which is associated with both direct and indirect tonic inhibitions of GnRH and subsequent LH release ( 132 ). Aberrant sympathetic neurogenic regulation of the ovary is involved in the pathogenesis of PCOS ( 23 ), and acupuncture can also inhibit the overexpression of NGF to decrease sympathetic activity, resulting in a restoration to the normal level of the ovarian steroid response to gonadotropins ( 25 ). Moreover, acupuncture regulates the phosphorylation of insulin substrates and receptors and inhibits the abnormal expression of signaling pathways, thereby improving metabolic dysfunction such as insulin resistance ( 32 , 56 , 133 ).…”

“…A systematic review by Zheng et al found that acupuncture was relatively effective in improving glucose metabolism and insulin sensitivity in patients with PCOS (100). Furthermore, a systematic review assessed the efficacy of acupuncture on animal models with PCOS (23). They found that a definite conclusion was difficult to draw because the methodology was weak and heterogeneity was high.…”

“…Recent reviews have demonstrated that acupuncture adjusts hormone levels by regulating hypothalamic-pituitary-ovarian (HPO) axis or regulating levels of anti-Müllerian hormone (AMH) and P450arom. A recent systematic review on effect of acupuncture on PCOS in animal models summarized that acupuncture could improve insulin resistance by upregulating the insulin receptor substrate-1 (IRS-1)/PI3K/glucose transporter 4 (GLUT4) pathway, or inhibiting the PI3K/AKT/mTOR pathway, or activating the adenosine 5’-monophosphate activated protein kinase (AMPK) pathway in PCOS animals ( 23 ).…”

Effects of electroacupuncture on the expression of hypothalamic neuropeptide Y and ghrelin in pubertal rats with polycystic ovary syndrome

“…Electroacupuncture (EA) has a benign regulating effect on neuroendocrine levels in organs. A more recent meta-analysis indicated that acupuncture might have the potential to restore hormone levels in PCOS animal models [ 22 ]. Repeated low-frequency EA inhibited the expression of GnRH and NPY in the hypothalamus of early adolescent Sprague Dawley (SD) female rats [ 23 ].…”