Neural mechanism of gastric motility regulation by electroacupuncture at RN12 and BL21: A paraventricular hypothalamic nucleus-dorsal vagal complex-vagus nerve-gastric channel pathway

AIM: To study the neural mechanism by which electroacupuncture (EA) at RN12 (Zhongwan) and BL21 (Weishu) regulates gastric motility. METHODS: One hundred and forty-four adult Sprague Dawley rats were studied in four separate experiments. Intragastric pressure was measured using custommade rubber balloons, and extracellular neuron firing activity, which is sensitive to gastric distention in the dorsal vagal complex (DVC), was recorded by an electrophysiological technique. The expression levels of c-fos, motilin (MTL) and gastrin (GAS) in the paraventricular hypothalamic nucleus (PVN) were assayed by immunohistochemistry, and the expression levels of motilin receptor (MTL-R) and gastrin receptor (GAS-R) in both the PVN and the gastric antrum were assayed by western blotting. RESULTS: EA at RN12 + BL21 (gastric Shu and Mu points), BL21 (gastric Back-Shu point), RN12 (gastric Front-Mu point), resulted in increased neuron-activating frequency in the DVC (2.08 +/- 0.050, 1.17 +/- 0.023, 1.55 +/- 0.079 vs 0.75 +/- 0.046, P < 0.001) compared with a model group. The expression of c-fos (36.24 +/- 1.67, 29.41 +/- 2.55, 31.79 +/- 3.00 vs 5.73 +/- 2.18, P < 0.001), MTL (22.48 +/- 2.66, 20.76 +/- 2.41, 19.17 +/- 1.71 vs 11.68 +/- 2.52, P < 0.001), GAS (24.99 +/- 2.95, 21.69 +/- 3.24, 23.03 +/- 3.09 vs 12.53 +/- 2.15, P < 0.001), MTL-R (1.39 +/- 0.05, 1.22 +/- 0.05, 1.17 +/- 0.12 vs 0.84 +/- 0.06, P < 0.001), and GAS-R (1.07 +/- 0.07, 0.91 +/- 0.06, 0.78 +/- 0.05 vs 0.45 +/- 0.04, P < 0.001) increased in the PVN after EA compared with the model group. The expression of MTL-R (1.46 +/- 0.14, 1.26 +/- 0.11, 0.99 +/- 0.07 vs 0.65 +/- 0.03, P < 0.001), and GAS-R (1.63 +/- 0.11, 1.26 +/- 0.16, 1.13 +/- 0.02 vs 0.80 +/- 0.11, P < 0.001) increased in the gastric antrum after EA compared with the model group. Damaging the PVN resulted in reduced intragastric pressure (13.67 +/- 3.72 vs 4.27 +/- 1.48, P < 0.001). These data demonstrate that the signals induced by EA stimulation of acupoints RN12 and BL21 are detectable in the DVC and the PVN, and increase the levels of gastrointestinal hormones and their receptors in the PVN and gastric antrum to regulate gastric motility. CONCLUSION: EA at RN12 and BL21 regulates gastric motility, which may be achieved through the PVN-DVCvagus- gastric neural pathway.