Zhen Ci Yan Jiu. 2025 Oct 25. pii: 1000-0607(2025)10-1133-10. [Epub ahead of print]50(10):
1133-1142
OBJECTIVES: To observe whether the effect of electroacupuncture(EA) on the improvement of NOD-like receptor protein 3 (NLRP3)-mediated inflammation and gastric motility in diabetic gastroparesis (DGP) rats is exerted through the activation of AMP-activated protein kinase(AMPK) and the protection of mitochondrial homeostasis, so as to explore the mechanism of EA in the prevention and treatment of DGP.
METHODS: Forty SD rats were randomly divided into the control group and modeling group, and the ones in modeling group were injected with 2% streptozotocin and fed with high-glucose and high-fat diet irregularly. The 20 successfully modeled rats were randomized into the model group and EA group with 10 rats each. Rats in the EA group received EA at "Zusanli" (ST36), "Liangmen" (ST21) and "Sanyinjiao" (SP6) with sparse and dense waves of 20 Hz/100 Hz for 15 min, while rats in the control and model group received bundled controls. Blood glucose, general symptoms, gastric emptying rate and small intestinal propulsion rate were observed in each group. Hematoxylin-eosin(HE) staining was used to observe the pathological changes of gastric antrum tissues. Western blot was used to detect the protein expression of AMPK, phosphorylated AMPK (p-AMPK), and NLRP3 in gastric antrum tissue, and transmission electron microscopy was used to observe the mitochondrial ultrastructure in gastric antrum cells. Dihydroethidium (DHE) fluorescent probe was used to detect the level of reactive oxygen species (ROS), the JC-1 method was used to detect changes in mitochondrial membrane potential, while a biochemical assay kit was employed to measure adenosine triphosphate (ATP) levels in gastric antrum tissue.
RESULTS: After modeling, compared with the control group, the blood glucose levels and general symptom scores of rats in the modeling group were significantly increased (P<0.01) while gastric emptying rate and intestinal propulsion rate were significantly decreased(P<0.01). After intervention, compared with the control group, blood glucose and symptom scores remained elevated, gastric emptying rate and intestinal propulsion rate were significantly decreased (P<0.01) in the model group, while gastric antrum tissues showed obvious inflammatory damage. Meanwhile, the model group exhibited decreased AMPK and p-AMPK protein expression levels and increased NLRP3 protein expression level(P<0.01), mitochondrial structure was severely damaged, with an increase in the intracellular ROS content (P<0.01), and a decrease in the mitochondrial membrane potential level and ATP content (P<0.01). Compared with the model group, rats in the EA group had lower blood glucose levels and general symptom scores (P<0.05) and higher gastrointestinal propulsion (P<0.01), and EA had improved gastric histopathology. The expression of AMPK and p-AMPK proteins were increased while NLRP3 protein was decreased in gastric antrum tissue (P<0.01). The ultrastructure of mitochondria was improved, and ROS content was decreased (P<0.01), the mitochondrial membrane potential level and ATP content were elevated (P<0.01).
CONCLUSIONS: EA may improve DGP by activating AMPK to improve damaged mitochondrial structure and function and promote the restoration of mitochondrial homeostasis, thereby inhibiting NLRP3 inflammasome and its mediated inflammation in gastric antrum tissues.
Keywords: AMP-activated protein kinase; Diabetic gastroparesis; Electroacupuncture; Mitochondria; Nod-like receptor protein 3