Summary

Operation Procedure and Precautions of Thread-Embedding Acupuncture Therapy in Alzheimer

Published: May 10, 2024
doi:

Summary

This study presents a protocol for thread-embedding acupuncture therapy in Alzheimer’s disease-like rats.

Abstract

Thread-embedding therapy (TEAT) is a treatment that prevents and manages diseases by inserting a biodegradable suture into an acupoint, providing long-lasting stimulation. TEAT is a simple approach that avoids the discomfort of regular acupuncture and provides sustained therapeutic effects. This article discusses the potential impact of TEAT on the learning and memory abilities of rats with Alzheimer's disease-like symptoms. Since chemically induced neuronal degeneration and cognitive impairments in rats does not entirely reflect the true pathological changes observed in Alzheimer's disease. Consequently, our research group has designated these manifestations as Alzheimer's disease-like symptoms. A protocol has been established to outline the selection of acupoints, the operation process, and necessary precautions for the head and lower back. The experiment was conducted on three groups: a control group, a model group, and a TEAT group, each containing 6 rats. To induce Alzheimer's disease-like symptoms, rats were intraperitoneally injected with D-galactose for 7 weeks (49 days). The rats in the TEAT group received acupoint catgut embedding treatment. Following the intervention period, a Morris Water Maze (MWM) was conducted to evaluate the rats' learning and memory. Subsequently, the rats were sacrificed, and their brain tissue was examined. A histological examination was performed to understand the effects of TEAT on the pathology of rats exhibiting symptoms of Alzheimer's disease. This study suggests that TEAT may improve learning and memory in rats with Alzheimer's disease-like symptoms, indicating a potentially promising new treatment approach for this neurodegenerative condition.

Introduction

Thread-embedding acupuncture (TEA) involves embedding catgut or absorbable sutures into acupoints using a special needle. This technique has a prolonged effect until the sutures are absorbed and degraded. It provides continuous and sustained stimulation to the acupoints for a week or longer1, achieving a comparable outcome without the necessity for daily repetitive procedures2. This reduces the number of patients seeking medical treatment, thus conserving medical resources to some extent. In recent years, TEAT has been increasingly used in various medical fields in China, including internal medicine, external medicine, dermatology, facial features, gynecology, and pediatrics3. Studies have shown that it is effective in producing long-term and reliable effects for certain chronic and complex diseases, such as epilepsy4 and facial nerve paralysis5. It has the advantages of minimal trauma and simple operation6. Additionally, the treatment costs of TEAT have been reported to be lower than those of electroacupuncture (EA)7. Therefore, TEAT is increasingly valued in clinical and scientific research.

Alzheimer’s disease (AD) is a neurodegenerative condition that progresses over time. Its pathophysiological process begins to accumulate approximately 20 years before clinical symptoms appear, but its mechanism is still not fully understood8. Given the limited availability of effective drugs for AD, research is increasingly focusing on the prodromal and preclinical stages of the disease9. Prevention is a crucial strategy for addressing the development and progression of AD9,10. In recent years, traditional Chinese medicine (TCM) has made significant progress, and it is expected to offer new possibilities for preventing and treating AD11,12. As a subtype of acupuncture, TEAT is preferred over other therapies due to its wide treatment range, minimal trauma, simple operation, low treatment frequency, and long-lasting efficacy6. Emerging literature suggests that TEAT may benefit individuals with obesity13,14, diabetes15, insomnia16, postmenopausal osteoporosis17, and depression18, all of which are risk factors for AD. It also improves senescence in aging rats by regulating mitophagy2, improves spatial learning and memory impairment, alleviates pathological damage of the hippocampus, and inhibits inflammation response in vascular dementia (VD) rats19. It appeared attractive to figure out whether TEAT could also act on pathological processes during AD.

The current research lacks uniformity and standardization in several critical elements of TEAT operation, including the embedding method, embedding tool, thread, and embedding interval period. This lack of standardization affects the evaluation of the therapy’s effect and the exploration of related mechanisms and restricts external promotion and communication. Prior research20,21 has demonstrated that intraperitoneal administration of D-galactose (D-gal) can induce Alzheimer’s disease-like pathological changes in rats, including neuronal degeneration and cognitive impairments. Furthermore, electroacupuncture at the Baihui(GV20) and Shenshu(BL23) has been shown to effectively ameliorate cognitive decline, mitigate neuroinflammation, and reduce neuronal damage. This study takes Alzheimer’s disease-like model rats as an example to introduce the selection of acupoints and the operation process and precautions of TEAT under this model. It discusses the critical operational elements of TEAT in experimental research to provide a reference for future studies.

Protocol

All experiments were carried out following the National Institutes of Health Guide for the Care and Use of Laboratory Animals and were approved by the Hubei Provincial Center for Disease Control and Prevention Laboratory Animal Management and Use Committee. A total of 18 3-month-old female Sprague-Dawley (SD) rats weighing 220-250 g were used for the test. All rats were maintained on a 12 h light/dark cycle at 23 ± 1 °C and 40%-50% humidity, with free access to food and water. Following a one-week acclimatizati…

Representative Results

This article introduces the specific operation method of TEAT in Alzheimer's disease-like rats. It discusses the critical operational elements of TEAT in experimental research to provide a reference for future studies. TEAT improves learning in Alzheimer's disease-like rats As illustrated in the flowchart (Figure 5), during the adaptive training period, it was observed that rats in each group were observing the surrounding environmen…

Discussion

Intervention time
The etiology of AD is complex, and its pathogenesis remains uncertain. Currently, there is no effective treatment for the disease, and its course is irreversible. Therefore, the academic community has reached a consensus on the importance of focusing on the prevention and treatment of AD. The prevention and treatment strategies for AD emphasize early intervention, following the TCM concept of treating conditions before they occur, emphasizing treatment before its onset, transmissi…

Disclosures

The authors have nothing to disclose.

Acknowledgements

This work was supported with funds from the National Natural Science Foundation of China (NSFC) Nos. 82374564 (to YJD) and Nos. 82074566 (to YJD) and from Sun Guojie Inheritance Base for TCM Acupuncture-Moxibustion of World Federation of Acupuncture-Moxibustion Societies in Wuhan, China (World Federation of Acupuncture-Moxibustion Societies [2019] No. 26) (to YJD) and the National Famous TCM Inheritance Studio construction project of the National Administration of Traditional Chinese Medicine, China (the National Administration of Traditional Chinese Medicine [2022] No. 5) (to YJD).

Materials

0.9% saline, 4% paraformaldehyde, Hematoxylin, Eosin Y (water-soluble), absolute ethanol, 0.01M PBS powder, xylene, hydrochloric acid, embedded paraffin, neutral gum sinopharm (www.sinopharm.com)
5-0 absorbable surgical suture bodamedical (www.bodamedical.com)
70% alcohol, iodophor, cotton ball Used for disinfection.
chloral hydrate sigma C8383
coverslips, glass slides Guangzhou Wuqiang Experimental Equipment Co., Ltd
Dehydrator Wuhan Junjie JT-12J Computerized Biological Tissue Dehydrator
DELUXE THERMOSTAT HEAT MAT Zhenhua Instruments For maintaining the body temperature of rats.
D-galactose sigma G0750
electric men's beard trimmer Used for shaving rats.
Electronic scale for small animals (ZK-DST) Henan Zhike Information Technology Co., Ltd
erythromycin ointment frontpharm
glass dish Used to place cut absorbable sutures.
High-Pressure Steam Sterilization Pot (YM100Z) Shanghai Sanshen medical equipment factory For sterilization of surgical instruments.
Ice Maker (CMB40) Shanghai Sheyan Instrument Co., Ltd.
Microscope (BX-53) OLYMPUS
milk powder Used for the MWM test.
Morris Water Maze Video Tracking System & Data Analysis Software (Version: Watermaze 2.0) Chengdu Taimeng Technology Co., Ltd
No.6 thread-embedding needle bodamedical (www.bodamedical.com)
ophthalmic scissors, trays, tweezers
Pathology Microtome  (RM 2016) LEICA, Germany
pentobarbital Germany P11011
permanent marker Used to mark the acupoint.
Slicing knives (R35) Feathers, Japanese
soap Used to wash hands.
sterile gloves

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Cite This Article
You, M., Miao, J., Yang, M., Liu, Q., Liu, Y., Du, Y. Operation Procedure and Precautions of Thread-Embedding Acupuncture Therapy in Alzheimer. J. Vis. Exp. (207), e65895, doi:10.3791/65895 (2024).

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