Basic Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Aug 15, 2025; 16(8): 107779
Published online Aug 15, 2025. doi: 10.4239/wjd.v16.i8.107779
Electroacupuncture with different current intensities can improve gastrointestinal motility in diabetic gastroparesis via vagal and sympathetic pathways
Yi-Wen Tang, You Zhang, Jin Zhou, Yu-Ting Peng, Yan Zi, Yan-Rong Wei, Zeng-Hui Yue
Yi-Wen Tang, You Zhang, Jin Zhou, Yu-Ting Peng, Yan Zi, Yan-Rong Wei, Zeng-Hui Yue, College of Acupuncture, Massage and Rehabilitation, Hunan University of Chinese Medicine, Changsha 410208, Hunan Province, China
Author contributions: Tang YW and Yue ZH designed the study; Tang YW, Zhang Y, and Zhou J performed the experiments; Tang YW, Zhou J, Peng YT, Zi Y, and Wei YR conducted the survey and research; Tang YW analyzed the results and wrote the article. All authors studied and approved the final version.
Supported by National Natural Science Foundation of China, No. 82205298; Natural Science Foundation of Hunan Province, No. 2023JJ30462; Hunan Provincial Department of Science and Technology, No. 2023SK2045, No. 22JBZ007, No. Z2023XJYQ07, No. B2024007, and No. Z2023JB01; and 2024 Graduate Innovation Topics, No. 2024CX031.
Institutional animal care and use committee statement: The animal protocol was approved by the Animal Experimentation and Laboratory Animal Welfare Committee of Hunan University of Chinese Medicine, No. HNUCM21-2311-08.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Data sharing statement: The datasets generated or analyzed during the current study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zeng-Hui Yue, Postdoc, Professor, College of Acupuncture, Massage and Rehabilitation, Hunan University of Chinese Medicine, No. 300 Bachelor Road, Yuelu District, Changsha 410208, Hunan Province, China. yue5381316@126.com
Received: March 30, 2025
Revised: April 21, 2025
Accepted: June 25, 2025
Published online: August 15, 2025
Processing time: 139 Days and 1.1 Hours
Abstract
BACKGROUND

Diabetic gastroparesis (DGP) disrupts gastric motility. Electroacupuncture (EA) at Zusanli (ST36) may alleviate DGP symptoms via neural pathways.

AIM

To investigate how EA current intensities at ST36 regulate neural pathways and improve gastric motility in DGP models.

METHODS

A DGP model was established using intraperitoneal injection of streptozotocin. Gastrointestinal motility was measured in rats after 2 weeks of continuous EA at ST36. Current intensity was selected as 0.5 mA, 1 mA, and 3 mA. Gastric electrodynamics were detected by recording and analyzing the number of gastric discharges. The gastric emptying rate and propulsion rate of the small intestine were measured to assess dynamic gastrointestinal function. Hematoxylin-eosin staining was conducted to measure histopathological changes in the gastric sinus. Reverse transcription-polymerase chain reaction was conducted to determine mRNA levels of Rho guanine nucleotide-binding protein A and Rho-associated coiled-coil forming protein kinase. Western blotting was conducted to determine the expression levels of choline acetyltransferase, tyrosine hydroxylase, Rho guanine nucleotide-binding protein A, and Rho-associated coiled-coil forming protein kinase. Immunofluorescence staining in the stomach was conducted to detect the distribution of C-kit, an interstitial cell of Cajal marker. An enzyme-linked immunosorbent assay was conducted to detect serum levels of acetylcholine and norepinephrine.

RESULTS

Treatment with EA improved gastric emptying and gastric smooth muscle disorders in rats with DGP, mitigated pathological damage, and restored the function of interstitial cells of Cajal. In addition, different current intensities of EA affected gastrointestinal function of rats with DGP. The 0.5 mA, 1 mA, and 3 mA EA groups all improved gastrointestinal function. 0.5 mA EA increased acetylcholine levels by increasing protein expression of choline acetyltransferase (P < 0.05), thereby upregulating vagus nerve activity and enhancing parasympathetic nerve regulation. 3 mA EA increased norepinephrine levels (P < 0.05) by increasing protein expression of tyrosine hydroxylase, thereby activating the sympathetic nervous pathway. 1 mA coordinated the function of the vagus and sympathetic nerves to improve gastrointestinal motility.

CONCLUSION

EA with ST36 improved gastric motility in rats with DGP. 0.5 mA EA activated the vagus nerve, while 3 mA EA regulated gastrointestinal motility by activating the sympathetic nerves.

Keywords: Diabetic gastroparesis; Electroacupuncture; Current intensity; Vagus nerve; Sympathetic nerve

Core Tip: Electroacupuncture (EA) repairs the interstitial cells of Cajal network by upregulating smooth muscle-related factors Rho guanine nucleotide-binding protein A and Rho-associated coiled-coil forming protein kinase, thereby significantly enhancing gastric emptying, restoring gastric slow wave rhythms, and improving smooth muscle structure. We found that EA may activate the vagal-cholinergic pathway at 0.5 mA current intensity and modulate the sympathoadrenergic pathway at 3 mA current intensity, finally promoting gastrointestinal motility.