Open AccessA neuroanatomical basis for electroacupuncture to drive the vagal–adrenal axis
Author(s) -
Shenbin Liu,
Zhifu Wang,
Yang-Shuai Su,
Lu Qi,
Wei Yang,
Mingzhou Fu,
Xiang-Hong Jing,
Yan-Qing Wang,
Qiufu Ma
Publication year - 2021
Publication title -
nature
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 15.993
H-Index - 1226
eISSN - 1476-4687
pISSN - 0028-0836
DOI - 10.1038/s41586-021-04001-4
Subject(s) - reflex , medicine , efferent , stimulation , hindlimb , somatosensory system , neuroscience , electroacupuncture , nociception , anatomy , biology , anesthesia , acupuncture , pathology , receptor , alternative medicine , afferent
Somatosensory autonomic reflexes allow electroacupuncture stimulation (ES) to modulate body physiology at distant sites 1-6 (for example, suppressing severe systemic inflammation 6-9 ). Since the 1970s, an emerging organizational rule about these reflexes has been the presence of body-region specificity 1-6 . For example, ES at the hindlimb ST36 acupoint but not the abdominal ST25 acupoint can drive the vagal-adrenal anti-inflammatory axis in mice 10,11 . The neuroanatomical basis of this somatotopic organization is, however, unknown. Here we show that PROKR2 Cre -marked sensory neurons, which innervate the deep hindlimb fascia (for example, the periosteum) but not abdominal fascia (for example, the peritoneum), are crucial for driving the vagal-adrenal axis. Low-intensity ES at the ST36 site in mice with ablated PROKR2 Cre -marked sensory neurons failed to activate hindbrain vagal efferent neurons or to drive catecholamine release from adrenal glands. As a result, ES no longer suppressed systemic inflammation induced by bacterial endotoxins. By contrast, spinal sympathetic reflexes evoked by high-intensity ES at both ST25 and ST36 sites were unaffected. We also show that optogenetic stimulation of PROKR2 Cre -marked nerve terminals through the ST36 site is sufficient to drive the vagal-adrenal axis but not sympathetic reflexes. Furthermore, the distribution patterns of PROKR2 Cre nerve fibres can retrospectively predict body regions at which low-intensity ES will or will not effectively produce anti-inflammatory effects. Our studies provide a neuroanatomical basis for the selectivity and specificity of acupoints in driving specific autonomic pathways.