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  • Title: Mechanisms of acupuncture for primary dysmenorrhea based on PI3K/Akt/mTOR signaling pathway in rats.
    Author: Pan SA, Liu Y, Wang SH, Xue X, Yuan HY, Li J, Yue ZH.
    Journal: Zhen Ci Yan Jiu; 2023 Dec 25; 48(12):1258-1265. PubMed ID: 38146249.
    Abstract:
    OBJECTIVES: To observe the effect of electroacupuncture(EA) on phosphatidylinositol-3-kinases(PI3K)/protein kinase B(Akt)/mammalian target of rapamycin(mTOR) signaling pathway of uterus tissue in rats with primary dysmenorrhea(PDM), so as to investigate its mechanisms underlying improvement of PDM. METHODS: Thirty healthy non-pregnant female SD rats were randomly divided into blank, model and EA groups, with 10 rats in each group. The PDM model was established by subcutaneous injection of estradiol diphenhydrate combined with intraperitoneal injection of oxytocin. For rats of the EA group, EA(50 Hz, a tolerable current intensity) was applied to "Guanyuan"(CV4) and bilateral "Sanyinjiao"(SP6) for 20 min, once a day for 10 consecutive days. The number of writhing, wri-thing score, and writhing latency were observed. The uterine histopathological changes were observed by H.E. staining, and the ultrastructural changes of uterine tissue cells in each group were observed by transmission electron microscopy. The contents of prostaglandin E2(PGE2), prostaglandin F2α(PGF2α) and ratios of PGF2α/PGE2 in the serum and uterine tissue were detected by ELISA. The relative expression levels of PI3K, Akt and mTOR and their phosphorylation proteins in the uterine tissue were detected by Western blot and the ratios were calculated. RESULTS: Compared with the blank group, the number and score of writhing, latency of writhing, pathological injury score, contents of PGF2α and ratios of PGF2α/PGE2 in the serum and uterine tissue, and the levels of p-PI3K/PI3K, p-Akt/Akt and p-mTOR/mTOR in the uterine tissue were significantly increased in the model group(P<0.01, P<0.05), while contents of PGE2 in the serum and uterine tissue were reduced(P<0.05). In comparison with the model group, the number of writhing and writhing score, pathological injury score, contents of PGF2α and ratios of PGF2α/PGE2 in both the serum and uterine tissue, the levels of p-PI3K/PI3K, p-Akt/Akt and p-mTOR/mTOR were obviously decreased(P<0.05, P<0.01), whereas the writhing latency was considerably prolonged in the EA group(P<0.01), with elevated contents of PGE2 in the serum and uterine tissue(P<0.05). H.E. staining showed slight dilation of uterine glandular cavity, and severe endometrial edema with extensive cell shedding and a large number of vacuole-like degeneration, apoptosis, pyknosis or fragmentation or disappearance of the nucleus, and neutrophil infiltration in the model group, which were relatively milder in the EA group. Ultrastructural results showed irregular fibroblasts of uterine tissue cells, obvious cytoplasmic edema, reduction in cytoplasmic electron density, seriously irregular nuclei, severe edema of mitochondria with dissolved matrix, fracture and disappearance of mitochondrial crests and vacuolation, and moderate dilation of rough endoplasmic reticulum in the model group, which were milder in the EA group. CONCLUSIONS: EA can improve pain and uterine inflammatory response in PDM rats, which may be associated with its functions in reducing uterine PGF2α and down-regulating PI3K/Akt/mTOR signaling. 目的: 观察电针对原发性痛经（PDM）大鼠子宫组织磷脂酰肌醇3-激酶（PI3K）/蛋白激酶B（Akt）/哺乳动物雷帕霉素靶蛋白（mTOR）信号通路的影响，探讨电针治疗PDM的作用机制。方法: 雌性SD大鼠随机分为空白组、模型组和电针组，每组10只。采用苯甲酸雌二醇皮下注射联合缩宫素腹腔注射法复制PDM大鼠模型。电针组予“关元”和双侧“三阴交”电针20 min，1次/d，连续10 d。观察并比较各组大鼠扭体次数、扭体评分和扭体潜伏期；HE染色法观察大鼠子宫病理形态，透射电镜观察各组大鼠子宫组织细胞超微结构的改变；ELISA法检测大鼠血清及子宫组织前列腺素E2（PGE2）、前列腺素F2α（PGF2α）的含量并计算PGF2α/PGE2；Western blot法检测各组大鼠子宫组织PI3K、Akt、mTOR及其磷酸化蛋白相对表达量并计算各自的比值。结果: HE染色显示，模型组大鼠子宫内膜严重水肿、细胞变性、凋亡，细胞核碎裂或消失，伴中性粒细胞浸润；电针组大鼠子宫内膜轻度水肿，伴少量中性粒细胞浸润。透射电镜示，模型组大鼠子宫组织成纤维细胞呈不规则形，细胞核严重不规则，线粒体肿胀，粗面内质网中度扩张；电针组上述超微结构损伤有所减轻。与空白组比较，模型组大鼠扭体次数、扭体评分升高（P<0.01），出现扭体潜伏期（P<0.01），子宫病理损伤评分，血清及子宫组织中PGF2α含量和PGF2α/PGE2比值，子宫组织中p-PI3K/PI3K、p-Akt/Akt、p-mTOR/mTOR比值升高（P<0.01，P<0.05），血清及子宫组织中PGE2含量降低（P<0.05）；与模型组比较，电针组大鼠扭体次数、扭体评分降低（P<0.05，P<0.01），扭体潜伏期延长（P<0.01），子宫病理损伤评分，血清及子宫组织中PGF2α含量和PGF2α/PGE2比值，p-PI3K/PI3K、p-Akt/Akt、p-mTOR/mTOR比值降低（P<0.05），血清及子宫组织中PGE2含量升高（P<0.05）。结论: 电针能够明显改善PDM大鼠子宫炎性反应并缓解疼痛，其机制可能与降低PGF2α含量、抑制PI3K/Akt/mTOR信号通路有关。.
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