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Chinese researchers have used metabolomic analysis to differentiate between the effects of active and inactive acupoints in treating hypertension. Metabolomics, which identifies multiple small molecular metabolites in tissue samples using high-throughput analytical tools, is frequently employed to explore disease mechanisms in humans. It can also elucidate biological changes that occur due to environmental exposures, such as nutrition or lifestyle. Metabolomics can also be used to systematically characterise changes in metabolic profile due to acupuncture, and thus to help understand the possible mechanisms behind acupuncture’s ability to regulate blood pressure. Thirteen eligible patients randomly received either active acupoint treatment (AT) or inactive acupoint treatment (IT). For AT, four acupoints, Taichong LIV-3, Renying ST-9, Taixi KID-3 and Neiguan P-6 were selected. For IT, Fengchi GB-20, Waiguan SJ-5, Yinlingquan SP-9 and Xuehai SP-10 were used. In both groups needles were gently inserted and deqi was obtained before connecting the needles to electro-stimulation for 30 minutes, three times a week for a total of six weeks. The results showed that AT significantly lowered 24-hour systolic blood pressure, but not diastolic blood pressure, as compared with IT. Distinctive changes were observed between the metabolomic data of the two groups. Only in the active acupoint treatment group was the follow-up plasma clearly different from the baseline plasma. In addition, the follow-up plasma of the two groups could be clearly differentiated, indicating two different post-treatment metabolic phenotypes. Three metabolites, hypoxanthine, sucrose and cellobiose, were shown to be the most important ‘signature metabolites’ of active acupoint treatment. Hypoxanthine is the precursor of uric acid, the end product of purine degradation in humans. Uric acid is a sensitive biomarker for blood pressure elevation and a predictor of hypertension onset, long-term cardiovascular and all-cause mortality. AT treatment increases hypoxanthine levels, indicating a suppression of purine degradation and uric acid production. Plasma sucrose levels were also significantly reduced following AT, suggesting that acupuncture may inhibit duodenal absorption of sucrose, or accelerate its anabolism, thus improving metabolic abnormality. The study also found that AT reduced levels of cellobiose, a prebiotic which is fermented in the large intestine of humans by bifidobacteria. This suggests that restoration of gut-microbiota interactions induced by acupuncture may participate in the blood pressure regulation mechanisms of acupuncture.

Active Acupoints Differ from Inactive Acupoints in Modulating Key Plasmatic Metabolites of Hypertension: A Targeted Metabolomics Study. Sci Rep. 2018 Dec 13;8(1):17824.

 

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