Acupuncture as adjunctive treatment for linezolid-induced peripheral neuropathy: a case series report.

Background: The treatment of multidrug-resistant tuberculosis (MDR-TB) and pre-extensively drug-resistant tuberculosis (pre-XDR-TB) remains challenging due to the limited availability of effective drugs. Linezolid has emerged as a promising therapeutic option for these cases. However, its long-term use can lead to complications such as peripheral and optic neuropathies. Acupuncture, a cornerstone of traditional Chinese medicine, has been shown to be effective in the treatment of peripheral neuropathy (PN). This study examines the potential benefits of acupuncture in the treatment of linezolid-induced peripheral neuropathy (LIPN). Methods: Four patients, aged 27 to 60 years, diagnosed with LIPN, underwent daily acupuncture treatments. The main endpoint was to assess the efficacy of acupuncture in reducing neuropathic pain associated with LIPN in patients. This was primarily measured using changes in the Short Form McGill Pain Questionnaire (SF-MPQ) scores before and after acupuncture treatment. Results: Three of the patients experienced significant symptom remission, while one experienced marginal improvement. Treatments ranged from 7 to 18 sessions. Specifically, the first patient reported substantial relief with a score reduction from 33 to 13; the second patient observed minimal change; the third patient's score decreased dramatically from 10 to 2 after eight sessions; the last patient had a score reduction from 21 to 12 after five sessions, but did not continue treatment for a second assessment. Conclusion: Acupuncture is a promising therapeutic approach for LIPN. However, larger and more thorough studies are needed to determine its full potential.

Case report: Significant relief of linezolid-induced peripheral neuropathy in a pre-XDR-TB case after acupuncture treatment.

The revised WHO guidelines on multidrug- or rifampicin-resistant tuberculosis (MDR/RR-TB) include linezolid in the core drug group. Common adverse events of prolonged linezolid use are bone marrow suppression and peripheral neuropathy (PN). Available measures against linezolid-induced PN (LIPN) often have insignificant effects, leading to linezolid discontinuation and a decline in the success rate of MDR/RR-TB treatment. Acupuncture treatment is a symptomatic treatment measure from traditional Chinese medicine (TCM) to relieve pain with overall very low evidence and has never been reported in LIPN. The pilot use of acupuncture in a pre-extensively drug-resistant (XDR)-TB (a more severe form of MDR/RR-TB) patient exhibited significant improvements in LIPN and thus maintained linezolid in the regimen for a longer period.

[Effect of Electroacupuncture Stimulation at "Dazhui" (GV 14) and "Mingmen"(GV 4) on Cell Apoptosis of Spinal Cord and Expression of JNK Signaling Related Protein in Spinal Cord Injury Rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) stimulation at "Dazhui" (GV 14) and "Mingmen" (GV 4) of the Governor Vessel at different time-points on spinal cord neuronal apoptosis and the expression of c-Jun N-terminal kinases (JNK) protein in spinal cord injury (SCI) rats, so as to reveal its mechanism underlying improving SCI. METHODS: A total of 108 male SD rats were randomly divided into normal control, SCI model and EA groups which were further divided into 1, 3 and 7 d subgroups (12 rats/subgroup, 6 rats in each subgroup for TUNEL or Western blot, separately). SCI model was established by using the modified Allen's method. EA was applied to GV 14 and GV 4 for 20 min, once daily, for 1, 3 and 7 days, respectively. Basso-Beattie-Bresnahan (BBB) scale was adopted to assess the locomotor function of rats, the TUNEL method was used to examine neuronal apoptosis of injuried spinal cord, and the expression of phosphorylated (p)-c-Jun protein of T9-T11 spinal cord was detected by using Western blot. RESULTS: After modeling, the BBB scores of SCI rats on day 1, 3 and 7 were signi-ficantly decreased (P<0.01), while the numbers of apoptotic neuronal cells and the expression levels of p-c-Jun protein in the spinal cord were considerably increased at the 3 time-points in the model group (P<0.01, P<0.05). Following EA intervention, the decreased BBB scores on day 3 and 7, and the increased numbers of apoptotic neuronal cells on day 1, 3 and 7 and the up-regulated expression levels of p-c-Jun protein on day 3 and 7 were obviously suppressed (P<0.05, P<0.01). CONCLUSIONS: EA intervention can improve the locomotor function of SCI rats, which Feb be related to its effects in reducing neuronal apoptosis and down-regulating p-c-Jun protein in the injuried spinal cord.

Improvement of Electroacupuncture on APP/PS1 Transgenic Mice in Spatial Learning and Memory Probably due to Expression of Aß and LRP1 in Hippocampus.

Objectives. To explore the alterations of ß-amyloid (Aß) and low density lipoprotein receptor-related protein-1 (LRP1) in APP/PS1 mice after electroacupuncture (EA) treatment and further to explore the mechanism. Methods. Forty 6-month-old APP/PS1 mice were randomly divided into a model group and an EA group, with twenty wild-type mice used as a normal control group. Mice in the EA group were treated with EA at GV 20 (bai huì) and bilateral KI 1 (yong quán) acupoints for 6 weeks. The Morris water maze was applied to assess the spatial memory in behavior. Immunohistochemistry (IHC), ELISA, Western blotting, and so forth were used to observe the expression of LRP1 and Aß. Results. The Morris water maze test showed that, compared with the normal control group, the model group's learning and memory capabilities were significantly decreased (P < 0.05; P < 0.01). The EA group was reversed (P < 0.05; P < 0.01). The hippocampal expression of Aß in the EA group was significantly decreased compared to the model group (P < 0.01). The expression of LRP1 in the model group was significantly lower than that in the normal control group (P < 0.01); the expression in the EA group was significantly higher than that in the model group (P < 0.01). Conclusions. EA therapy can improve the learning and memory capabilities of APP/PS1 mice. The underlying mechanism may lie in the upregulation of an Aß transport receptor and LRP1.

Effects of Electroacupuncture at Governor Vessel Acupoints on Neurotrophin-3 in Rats with Experimental Spinal Cord Injury.

In an effort to explore new, noninvasive treatment options for spinal cord injuries (SCI), this study investigated the effects of electroacupuncture (EA) for SCI rat models. SCI was induced by a modified Allen's weight-drop method. We investigated the response of EA at Dazhui (GV 14) and Mingmen (GV 4) acupoints to understand the effects and mechanisms of EA in neuroprotection and neuronal function recovery after SCI. BBB testing was used to detect motor function of rats' hind limbs among groups, and EA was shown to promote the recovery of SCI rats' motor function. Nissl staining showed a restored neural morphology and an increase in the quantity of neurons after EA. Also, the antiapoptosis role was exposed by TUNEL staining. Western blotting analysis was used to determine the protein expression of neurotrophin-3 (NT-3) in spinal cord tissue. Compared to the sham group, the expression levels of NT-3 were significantly decreased and EA was shown to upregulate the expression of NT-3. The present study suggests that the role of EA in neuroprotection and dorsal neuronal function recovery after SCI in rats, especially EA stimulation at GV 14 and GV 4, can greatly promote neuronal function recovery, which may result from upregulating the expression of NT-3.

Electroacupuncture at Dazhui (GV14) and Mingmen (GV4) protects against spinal cord injury: the role of the Wnt/ß-catenin signaling pathway.

Electroacupuncture at Dazhui (GV14) and Mingmen (GV4) on the Governor Vessel has been shown to exhibit curative effects on spinal cord injury; however, the underlying mechanism remains poorly understood. In this study, we established rat models of spinal cord injury using a modified Allen's weight-drop method. Ninety-nine male Sprague-Dawley rats were randomly divided into three equal groups: sham (only laminectomy), SCI (induction of spinal cord injury at T10), and EA (induction of spinal cord injury at T10 and electroacupuncture intervention at GV14 and GV4 for 20 minutes once a day). Rats in the SCI and EA groups were further randomly divided into the following subgroups: 1-day (n = 11), 7-day (n = 11), and 14-day (n = 11). At 1, 7, and 14 days after electroacupuncture treatment, the Basso, Beattie and Bresnahan locomotor rating scale showed obvious improvement in rat hind limb locomotor function, hematoxylin-eosin staining showed that the histological change of injured spinal cord tissue was obviously alleviated, and immunohistochemistry and western blot analysis showed that Wnt1, Wnt3a, ß-catenin immunoreactivity and protein expression in the injured spinal cord tissue were greatly increased compared with the sham and SCI groups. These findings suggest that electroacupuncture at GV14 and GV4 upregulates Wnt1, Wnt3a, and ß-catenin expression in the Wnt/ß-catenin signaling pathway, exhibiting neuroprotective effects against spinal cord injury.

Alteration of behavioral changes and hippocampus galanin expression in chronic unpredictable mild stress-induced depression rats and effect of electroacupuncture treatment.

To explore new noninvasive treatment options for depression, this study investigated the effects of electric acupuncture (EA) for depression rat models. Depression in rats was induced by unpredictable chronic mild stress (UCMS) combined with isolation for 21 days. Eighteen male Sprague-Dawley rats were randomly assigned into three groups: control, model, and EA groups. Rats were treated by EA once daily for 21 days. The results showed that body weight and sucrose consumption were significantly increased in EA group than in the model group. The crossing numbers and rearing numbers in the open field test significantly decreased in the model group but not in the EA group. And EA treatments upregulated levels of hippocampus galanin (Gal) in UCMS rats back to relative normal levels. The present study suggested that EA had antidepressant effects on UCMS model rats. The potential antidepressant effect may be related to upregulating Gal expression in hippocampus.

[Effects of electroacupuncture on circadian rhythm of temperature and melatonin in depression rats model induced by chronic stress].

OBJECTIVE: To observe the effects of electroacupuncture (EA) on circadian rhythm of temperature and melatonin (MT) in depression rats model induced by chronic stress, so as to explore the biological mechanism of EA for depression. METHODS: Twenty-four SD rats were randomly divided into a control group, a model group and an EA group, 8 cases in each one. Rats in the control group were treated with normal diet for 21 days without any treatment. In the model and EA group, rat model was established by chronic unpredictable stress combined with solitarily feeding method, and rats in the EA group was treated with EA at "Baihui" (GV 20), "Yintang" (GV 29) 1 h before stress stimulation everyday, 2 Hz in frequency and intensity was favorable with the head of rat slightly shivering. The needles were retained for 20 min, once a day for totally 21 days. After EA treatment, open-field experiment was adopted to observe the behavioral improvement; the rats temperatures were monitored at six time points (2:00, 6:00, 10:00, 14:00, 18:00, 22:00) and orbital blood sampling was collected. The level of serum MT was tested by enzyme linked immunosorbent assay. The circadian rhythm changes of temperature and serum MT in each group were compared. RESULTS: The numbers of horizontal movement and vertical movement in the model group were obviously lower than those in the control group (both P < 0.05), while those in the EA group were significantly improved compared with those in the model group (both P < 0.01). The circadian rhythm of temperature and MT disappeared in the model group, which was improved into normal level after EA treatment. CONCLUSION: The electroacupuncture has regulation effects on circadian rhythm of temperature and melatonin in depression rat model induced by chronic stress.

Progress of animal research on electro-acupuncture treatment for depression(△).

This paper summarized the Chinese literatures in the previous 5 years about the pre-clinical animal researches on the application of electro-acupuncture (EA) treatment for depression, searched in China National Knowledge Infrastructure (CNKI). The efficiency of EA treatment for depression and the mechanism of it were discussed, to shed light on new ideas and new fronts for the further research on depression in clinical or pre-clinical fields.

[Effect of electroacupuncture intervention on behavioral changes and hippocampal excitatory amino acid transporter mRNA expression in depression rats].

OBJECTIVE: To observe the influence of music-electroacupuncture (EA) and pulse EA on locomotor activity and hippocampal neuron numbers and excitatory amino acid transporters (EAATs) mRNA expression in depression rats, so as to explore their mechanisms underlying improvement of depression in acupuncture clinic. METHOD: Sixty SD rats were randomly divided into blank control, depression model, medication, pulse EA and music-EA groups, with 12 rats in each group. Depression model was established by using chronic unpredictable mild stress protocols combined with solitary feeding. Rats of the medication group were treated by oral administration of fluoxetine (a standard antidepressant, 2 mg/kg). EA was applied to "Baihui" (GV 20) and "Yintang" (EX-HN 3) for 20 min, once a day for 21 days. The animals' ethological changes were detected by using field tests for recording the number of crossing squares and the number of rearing. The number of hippocampal neurons were calculated under microscope after Nissl's staining of the hippocampal tissue section. Hippocampal EAAT 1 and EAAT 2 mRNA expression levels were assayed by fluorescent quantitative real-time POR. RESULTS: In comparison with the blank control group, the numbers of crossing and rearing movements, as well as the expression levels of hippocampal EAAT 1 and EAAT 2 mRNA were significantly lower in the model group (P < 0.01), while compared with the model group, the numbers of both crossing and rearing movements of the medication, pulse EA and music-EA groups were obviously increased (P < 0.01). Correspondingly, the expression levels of hippocampal EAAT 1 and EAAT 2 mRNA were considerably upregulated in the pulse EA and music-EA groups in comparison with the model group (P < 0.01). No significant differences were found among the medication, pulse EA and music-EA groups (P > 0.05). Results of Nissl's staining displayed that in the model group, the hippocampal neurons were loose in arrangement and some of them were absent, but in the medication, pulse EA and music-EA groups, the neurons were clear in shape and lined in order. CONCLUSION: Both pulse EA and music-EA can effectively improve the locomotor activity and hippocampal neuronal structure in depression rats which may be closely associated with their effects in upregulating hippocampal EAAT 1 and EAAT 2 mRNA expression.