Effect of Electroacupuncture on Urea and Creatinine Levels in the Wistar Sepsis Model

Abstract

Objective: Sepsis is a life-threatening organ dysfunction caused by dysregulation of a host's response to infections. Sepsis-one of the most common contributing factors to acute kidney injuries in critically ill patients-is caused by bacterial endotoxins that lead to excessive production of proinflammatory cytokines. This condition can be treated with few side-effects by using electroacupuncture (EA) to regulate the neuroendocrine immune system to control the production of these cytokines. A number of studies have proven that EA stimulates the vagus nerve to manage inflammatory responses through the cholinergic pathway, slowing sepsis. This study was conducted to investigate the effect of bilateral EA at ST 36 (Zusanli) on rats' renal function by measuring their levels of plasma urea and creatinine. Materials and Methods: This study was a randomized, double-blinded, laboratory experimental post-test, with both subjects and laboratory investigators blinded. Twenty-eight male Wistar rats were divided randomly into 4 groups of 7 rats each: (1) a control group; (2) a sepsis group; (3) an EA + group; and (4) a sham EA + group. EA and sham EA was applied once for 30 minutes before intraperitoneal administration of live Eschericia coli bacteria ATCC 25922. Six hours after administration of the bacteria the rats' plasma urea and creatinine levels were measured. Results: There was a statistically significant difference in the mean levels of urea (P < 0.001, 95% confidence interval (CI): 57.1-76.6) and creatinine (P = 0.005, 95% CI: 0.14-0.62) between the sepsis and control groups. Conclusions: These findings suggest that EA pretreatment at ST 36 attenuated the induced inflammatory bacteria response and mitigated acute kidney injury.

Anti-Inflammatory Effects of Acupuncture at ST36 Point: A Literature Review in Animal Studies

“…In the Wistar sepsis model, EA reduced the levels of urea and creatinine in the blood, which are parameters of kidney function, and it showed that EA may prevent kidney injuries ( 36 ).…”

Traditional Chinese medicine for treatment of sepsis and related multi-organ injury

“…Its application improved survival rate in CLP model rats, and ameliorated cognitive impairment in rats with sepsis-related encephalopathy by inhibiting hippocampal synaptic damage, neuronal loss, oxidative stress, and release of inflammatory cytokines trough activation of the Nrf-2/HO-1 pathway and hippocampal α7 nicotinic acetylcholine receptors ( Han et al, 2018 ; Li C et al, 2020 ). In a rat model of sepsis, electroacupuncture pretreatment at ST36 attenuated inflammatory responses, decreased plasma urea, creatinine, and D-lactate levels, and increased intestinal tight junction protein occludin expression and intestinal barrier permeability, thereby reducing acute kidney and intestinal injury ( Zhu et al, 2015 ; Zhang Z et al, 2018 ; Harpin et al, 2020 ). In the rat CLP model, electroacupuncture treatment at ST 36 reduced the activity of plasma CK-MB and offered cardioprotection by reducing TNF-α, NO, MPO levels and water content in myocardial tissue by activating the cholinergic anti-inflammatory pathway ( Zhang L et al, 2018 ).…”

Revealing the biological mechanism of acupuncture in alleviating excessive inflammatory responses and organ damage in sepsis: a systematic review

“…EA has a significant inhibitory effect on oxidative stress and excessive inflammatory reactions in patients with SAKI. For example, Harpin et al found that EA pretreatment at the ST36 acupoint significantly reduced urea and creatinine levels in SAKI rat models and protected renal function (84). Endotoxic shock results in an abnormal adrenal glucose metabolism and decreased adrenal glycogen levels.…”