BP:针刺治疗多囊卵巢综合征的机制研究

2021-10-21 Vivi MedSci原创

激素治疗多囊卵巢综合征(PCOS)仍有不足,而针刺对PCOS排卵功能和卵泡发育有改善作用,因其简便、有效、成本低、无毒副作用而被广泛应用,本文所述研究探索针刺治疗PCOS的机制,以期临床应用推广

多囊卵巢综合征(PCOS)多表现为生殖异常和代谢紊乱,其患妊娠糖尿病、妊高征、先兆子痫、2型糖尿病、冠心病、代谢综合征、宫颈癌、脑血管疾病和精神疾病的风险明显增加。PCOS的主要特征是卵泡发育异常和排卵障碍,这是由卵巢颗粒细胞过度自噬引起的。

目前PCOS的治疗方案包括雌激素和孕激素治疗、促排卵治疗等。然而,激素疗法仍有许多不足,而针刺对PCOS患者的排卵功能和卵泡发育有改善作用,因其简便、有效、成本低、无毒副作用而被广泛应用,但其机制尚不清楚。

近期在Biomed Pharmacother的一项研究,假设针刺的有益作用是LncMEG3介导PI3K/AKT/mTOR通路作用的结果。通过皮下植入18-左炔诺孕酮硅橡胶植入物诱导PCOS模型,采用针刺穴位(关元、中极、气海、三阴交、子宫)治疗多囊卵巢综合征大鼠模型【目前已知的大鼠穴位只有42个】,HE染色观察卵巢形态,酶联免疫吸附法,western blotting、免疫组化和实时荧光定量PCR检测LH、E2、FSH、T、AMH、LncMEG3、PI3K、AKT、mTOR、P62和LC3II/I的表达。

该模型的成功率为92.86%,结果表明针刺治疗组90%大鼠卵巢形态经连续11 d治疗后明显改善。针刺治疗组血清LH、FSH、T、AMH水平显著降低,E2水平显著升高。针刺后卵巢颗粒细胞LncMEG3、PI3K、AKT、mTOR、P62、LC3II/I表达较PCOS组和假手术组组降低,而促卵泡激素受体表达升高

这些结果提示,针刺对PCOS大鼠性激素水平和卵泡发育的调节作用优于假针和西药。LncMEG3介导PI3K/AKT/mTOR通路调控卵巢颗粒细胞自噬,参与PCOS排卵障碍的发病机制。针刺可通过这一途径调节卵巢颗粒细胞的自噬,这些发现表明,对于安全治疗多囊卵巢综合征排卵障碍针刺具有临床潜力

文献来源:

Chen X, Tang H, Liang Y, Wu P, Xie L, Ding Y, Yang P, Long B, Lin J. Acupuncture regulates the autophagy of ovarian granulosa cells in polycystic ovarian syndrome ovulation disorder by inhibiting the PI3K/AKT/mTOR pathway through LncMEG3. Biomed Pharmacother. 2021 Oct 13;144:112288. doi: 10.1016/j.biopha.

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