Anti-apoptotic signal transduction mechanism of electroacupuncture in acute spinal cord injury.

Spinal cord injury (SCI) can be caused by a variety of pathogenic factors. In China, acupuncture is widely used to treat SCI. We previously found that acupuncture can reduce apoptosis and promote repair after SCI. However, the antiapoptotic mechanisms by which acupuncture exerts its effects on SCI remain unclear. Our aim was to investigate the role of the PI3K/Akt and extracellular signal-regulated kinases (ERK)1/2 signalling pathways in acupuncture treatment of acute SCI. Eighty pure-bred New Zealand rabbits were randomly divided into the following five groups (n=16 per group): control; model; elongated needle electroacupuncture (EA); EA+LY294002; and EA+PD98059. We established a spinal cord contusion model of SCI in all experimental groups except controls, in which only a laminectomy was performed. After SCI, three of the groups received EA once daily for 3 days. One hour before SCI, the two drug groups received LY294002 (Akt inhibitor; 10 μg, 20 μL) or PD98059 (ERK inhibitor; 3 μg, 20 μL) via intrathecal injection. At 48 h after SCI, animals were killed and spinal cord tissue samples were collected for transferase dUTP nick end labelling (TUNEL) assays, immunohistochemistry and western blot assays. EA significantly increased p-Akt and p-ERK1/2 expression, reduced cytochrome c and caspase-3 expression and inhibited neuronal apoptosis in the injured spinal cord segment. The opposite effects were seen after using Akt and ERK inhibitors. Acupuncture promotes the repair of SCI, possibly by activation of the PI3K/Akt and ERK1/2 signalling pathways and by inhibition of the mitochondrial apoptotic pathway. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.