Basic Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2025; 16(2): 93130
Published online Feb 15, 2025. doi: 10.4239/wjd.v16.i2.93130
Electroacupuncture alleviates diabetic peripheral neuropathy through modulating mitochondrial biogenesis and suppressing oxidative stress
Chong-Xi Yuan, Xuan Wang, Yun Liu, Tian-Cheng Xu, Zhi Yu, Bin Xu
Chong-Xi Yuan, Department of Traditional Chinese Medicine, Suzhou Xiangcheng People's Hospital, Suzhou 215100, Jiangsu Province, China
Chong-Xi Yuan, Xuan Wang, Yun Liu, Tian-Cheng Xu, Zhi Yu, Bin Xu, Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
Xuan Wang, College of Traditional Chinese Medicine, Jiangsu Vocational College of Medicine, Yancheng 224000, Jiangsu Province, China
Co-first authors: Chong-Xi Yuan and Xuan Wang.
Co-corresponding authors: Zhi Yu and Bin Xu.
Author contributions: Yuan CX and Wang X contributed equally to this study as co-first authors; Yu Z and Xu B contributed equally to this study as co-corresponding authors; Yuan CX conceived and designed the experiments; Yuan CX and Wang X performed the experiments, wrote the manuscript, and analyzed the data; Liu Y and Xu TC performed the experiments; Xu B and Yu Z provided guidance and funding support.
Supported by National Natural Science Foundation of China, No. 82074532, No. 82374577, No. 82305375, No. 82305376, and No. 82405567; and The Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD).
Institutional animal care and use committee statement: All animal experiments conformed to the internationally accepted principles for the care and use of laboratory animals.
Conflict-of-interest statement: I certify that there is no actual or potential conflict of interest in relation to this article.
Data sharing statement: No additional data are available.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bin Xu, PhD, Professor, Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, No. 138 Xianlin Road, Nanjing 210023, Jiangsu Province, China. xubin@njucm.edu.cn
Received: February 20, 2024
Revised: September 15, 2024
Accepted: October 31, 2024
Published online: February 15, 2025
Processing time: 313 Days and 23.1 Hours
Abstract
BACKGROUND

Peripheral neuropathy caused by diabetes is closely related to the vicious cycle of oxidative stress and mitochondrial dysfunction resulting from metabolic abnormalities. The effects mediated by the silent information regulator type 2 homolog-1 (SIRT1)/peroxisome proliferator-activated receptor-gamma coactivator-1α (PGC-1α) axis present new opportunities for the treatment of type 2 diabetic peripheral neuropathy (T2DPN), potentially breaking this harmful cycle.

AIM

To validate the effectiveness of electroacupuncture (EA) in the treatment of T2DPN and investigate its potential mechanism based on the SIRT1/PGC-1α axis.

METHODS

The effects of EA were evaluated through assessments of metabolic changes, morphological observations, and functional examinations of the sciatic nerve, along with measurements of inflammation and oxidative stress. Proteins related to the SIRT1/PGC-1α axis, involved in the regulation of mitochondrial biogenesis and antioxidative stress, were detected in the sciatic nerve using Western blotting to explain the underlying mechanism. A counterevidence group was created by injecting a SIRT1 inhibitor during EA intervention to support the hypothesis.

RESULTS

In addition to diabetes-related metabolic changes, T2DPN rats showed significant reductions in pain threshold after 9 weeks, suggesting abnormal peripheral nerve function. EA treatment partially restored metabolic control and reduced nerve damage in T2DPN rats. The SIRT1/PGC-1α axis, which was downregulated in the model group, was upregulated by EA intervention. The endogenous antioxidant system related to the SIRT1/PGC-1α axis, previously inhibited in diabetic rats, was reactivated. A similar trend was observed in inflammatory markers. When SIRT1 was inhibited in diabetic rats, these beneficial effects were abolished.

CONCLUSION

EA can alleviate the symptoms of T2DNP in experimental rats, and its effects may be related to the mitochondrial biogenesis and endogenous antioxidant system mediated by the SIRT1/PGC-1α axis.

Keywords: Electroacupuncture; Type 2 diabetic peripheral neuropathy; Silent matching type information regulation 2 homolog-1/peroxisome proliferator-activated receptor-gamma coactivator-1α axis; Mitochondria biogenesis; Oxidative stress

Core Tip: Diabetic peripheral neuropathy (DPN) is thought to be linked to the vicious cycle of oxidative stress and mitochondrial dysfunction triggered by metabolic abnormalities. Electroacupuncture is commonly used as an adjuvant therapy for DPN in clinical practice, though its precise mechanism remains unclear. A rat model of DPN was established by combining a high-fat diet with streptozotocin injection. The final results suggest that the beneficial effects of electroacupuncture on DPN rats may be related to the regulation of the silent information regulator type 2 homolog-1/peroxisome proliferator-activated receptor-gamma coactivator-1α axis, which activates mitochondrial biogenesis and reduces oxidative stress and protects intact mitochondria.