Acupuncture preconditioning protects against myocardial ischemia/reperfusion injury mediated apoptosis through miR-214/NCX1 activation: a hypothesis

摘要

Highlights This review provides evidences for the recommendation of acupuncture preconditioning at Neiguan (PC6) point in coronary heart disease patients as a non-pharmacological therapeutic method to activate the miR-214/NCX1 pathway. Traditionality The concept of acupuncture preconditioning is described in the ancient book of Fan Wang Fang (Eastern Jin Dynasty of China). It refers to the application of acupuncture before the occurrence of disease or when the disease is relatively mild. According to the record of the ancient book of Huang Di Nei Jing (Qin Han Period of China, 475 B.C.-221 B.C.), acupuncture at Neiguan (PC6) point can prevent and treat angina pectoris in coronary heart disease (CHD). The WHO also recommends acupuncture as one of the alternative and complementary therapies for the prevention and treatment of angina pectoris in CHD. Abstract Early reperfusion of ischemic cardiac tissue is usually the best option to improve clinical outcome of angina pectoris, especially of acute myocardial infarction. However, myocardial reperfusion may cause an abnormal increase of intracellular Casup2+/sup-mediated cardiomyocyte death and consequent loss of cardiac function, which is referred to myocardial ischemia/reperfusion (I/R) injury. Recently, the microRNA-214 (miR-214)/Nasup+/sup/Casup2+/sup exchanger (NCX) 1 co-expression is a key factor in cellular protection against myocardial apoptosis for myocardial I/R injury. Once activated, miR-214/NCX1 axis can inhibit several Casup2+/sup downstream signaling effectors that mediate cell death simultaneously. Studies have shown that acupuncture preconditioning has a protective effect on myocardial I/R injury, but its mechanism deserves further research. It has been proved that acupuncture preconditioning for ischemic myocardium successfully inhibit multiple Casup2+/sup handling related microRNAs that mediate cell death pathways, and miR-214 is one of its targets. In terms of clinical practice, coronary heart disease (CHD) patients benefit a lot from this intervention. However, there is barely no study correlating acupuncture preconditioning to the miR-214/NCX1 co-expression in patients with CHD. This review aims to discuss whether there is some evidence to justify a recommendation of acupuncture preconditioning in CHD patients as a non-pharmacological therapeutic method to activate the miR-214/NCX1 co-expression network model.