Shiying Li1,2, Yong Lei1, Jiande D Z Chen2. 1. Veterans Research and Education Foundation, VA Medical Center, Oklahoma City, OK, USA. 2. Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA.
Abstract
OBJECTIVES: Acupuncture or electroacupuncture (EA) has been applied for treating chemotherapy-induced emesis with limited success. The aims of this study were to investigate the anti-emetic effect of EA and to explore underlying anti-emetic mechanisms. MATERIALS AND METHODS: Rats were chronically implanted with a pair of stainless steel leads at acupoint pericardium 6 (PC6). Effects of EA with different parameters on cisplatin-induced nausea were assessed by pica (intake of kaolin, a surrogate of nausea in species without vomiting reflex). C-fos expressions in the area postrema (AP) and nucleus tractus solitarii (NTS) were analyzed. Subdiaphragmatic vagotomy was used to study involvement of the vagal pathway. RESULTS: 1) EA at 20 Hz/0.6 msec reduced kaolin intake in the first and second days after cisplatin injection compared with the sham-EA group (first day: 1.0 ± 0.2 vs. 1.9 ± 0.3 g, p = 0.017; second day: 0.4 ± 0.2 vs.1.1 ± 0.3 g, p = 0.010). However, EA at 10 Hz/1.2 msec was ineffective on both days. 2) Subdiaphragmatic vagotomy significantly reduced cisplatin-induced kaolin intake (1.1 ± 0.3 vs. 2.2 ± 0.3 g, p = 0.014) and also blocked the inhibitory effect of EA on kaolin intake in the first day. 3) Cisplatin significantly increased the expression of c-fos in the NTS and AP. Vagotomy greatly reduced c-fos expression in both NTS and AP. EA reduced the cisplatin-induced c-fos expression in the AP but not the NTS. CONCLUSIONS: EA at PC6 with appropriate parameters has an inhibitory effect on cisplatin-induced nausea. The anti-emetic effect of the EA is centrally medicated involving the AP via the vagal pathway as well as the potential effect on AP by reducing the release of hormones.
OBJECTIVES: Acupuncture or electroacupuncture (EA) has been applied for treating chemotherapy-induced emesis with limited success. The aims of this study were to investigate the anti-emetic effect of EA and to explore underlying anti-emetic mechanisms. MATERIALS AND METHODS: Rats were chronically implanted with a pair of stainless steel leads at acupoint pericardium 6 (PC6). Effects of EA with different parameters on cisplatin-induced nausea were assessed by pica (intake of kaolin, a surrogate of nausea in species without vomiting reflex). C-fos expressions in the area postrema (AP) and nucleus tractus solitarii (NTS) were analyzed. Subdiaphragmatic vagotomy was used to study involvement of the vagal pathway. RESULTS: 1) EA at 20 Hz/0.6 msec reduced kaolin intake in the first and second days after cisplatin injection compared with the sham-EA group (first day: 1.0 ± 0.2 vs. 1.9 ± 0.3 g, p = 0.017; second day: 0.4 ± 0.2 vs.1.1 ± 0.3 g, p = 0.010). However, EA at 10 Hz/1.2 msec was ineffective on both days. 2) Subdiaphragmatic vagotomy significantly reduced cisplatin-induced kaolin intake (1.1 ± 0.3 vs. 2.2 ± 0.3 g, p = 0.014) and also blocked the inhibitory effect of EA on kaolin intake in the first day. 3) Cisplatin significantly increased the expression of c-fos in the NTS and AP. Vagotomy greatly reduced c-fos expression in both NTS and AP. EA reduced the cisplatin-induced c-fos expression in the AP but not the NTS. CONCLUSIONS: EA at PC6 with appropriate parameters has an inhibitory effect on cisplatin-induced nausea. The anti-emetic effect of the EA is centrally medicated involving the AP via the vagal pathway as well as the potential effect on AP by reducing the release of hormones.
Authors: R M Navari; R R Reinhardt; R J Gralla; M G Kris; P J Hesketh; A Khojasteh; H Kindler; T H Grote; K Pendergrass; S M Grunberg; A D Carides; B J Gertz Journal: N Engl J Med Date: 1999-01-21 Impact factor: 91.245