穴位針灸埋線減緩脂多醣誘導之敗血症小鼠之發炎和低血糖反應及致死率

Acupoint Catgut-embedding Therapy Attenuates Lipopolysaccharide-induced Inflammatory and Hypoglycaemic Responses and Mortality in Septic Mice

器官損傷是醫療尚未滿足之需求。在這篇研究報告中，我們評估了穴位埋線針灸對於脂多糖所誘導的敗血性休克小鼠的影響。四組C57J/B6小鼠分組方式如下：(1)無埋線+無脂多糖(2)埋線+無脂多糖(3)無埋線+脂多糖(4)埋線+脂多糖。穴位埋線每周一次共計兩次。穴位為：水分（Ren-9），氣海（Ren-6），四滿（Ki-14）。第三周起，小鼠接受腹腔注射食鹽水或是脂多糖（15mg/kg）。生化參數，蛋白及基因表現及存活率統計等實驗於注射後陸續分析。結果顯示，脂多糖誘導低血壓並不受到埋線影響。但是脂多糖注射所增加的乳酸脫氫脢，肌酸酐，介白素-17皆因埋線而改善。令人驚訝的，埋線預處理之小鼠在脂多糖注射後完全存活。在分子層次上，埋線降低了脂多糖誘導之IκB-α降解及發炎反應。埋線所減緩因脂多糖注射所導致的低血糖則與下視丘的單磷酸腺苷活化蛋白質激酶以及肝臟的磷酸烯醇丙酮酸羧激酶有關。這些協同作用避免了小鼠因脂多糖注射而死亡。因此總結來說，目前的研究結果提供了穴位埋線針灸對於降低因敗血症導致死亡的潛在醫學應用價值。

Reducing mortality from septic shock and damage to multiple organs from systemic inflammation and endotoxic hypoglycaemia is an unmet medical need. In the current investigation, we evaluated the effects of acupoint catgut-embedding therapy (ACET) on lipopolysaccharide (LPS)-induced septic shock in mice. Four groups of male C57J/B6 mice were examined: (1) sham without LPS, (2) ACET without LPS, (3) sham with LPS, and (4) ACET with LPS. ACET was performed once a week for 2 weeks at the following acupoints: Shui Fen (Ren-9), Qihai (Ren-6), and bilateral Siman (Ki-14). During week 3, mice received saline or LPS (15 mg/kg intraperitoneally). Biochemical parameters, protein and gene expression levels, and survival rates were analysed after saline or LPS administration. As a result, LPS-induced hypotension was unaffected, but the increases in lactic dehydrogenase, creatinine, and interleukin-17 levels were attenuated by ACET. Strikingly, ACET pretreatment completely prevented mortality in septic mice. At the molecular level, both LPS-induced IκB-αdegradation and inflammation were attenuated. Prevention of LPS-induced hypoglycaemia was associated with the regulation of hypothalamic 5' AMP-activated protein kinase and hepatic phosphoenolpyruvate carboxykinase. The synergistic actions of ACET prevented mortality in septic mice. In conclusion, the current investigation revealed the important medicinal value of ACET for the reduction of mortality during sepsis.