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In recent years, a considerable amount of research has been focused on the underlying mechanisms of electroacupuncture and moxibustion assisted tissue repair. Intracellular protein denaturation is a significant pathological step of acute conditions such as stroke, myocardial infarction and acute pancreatitis. Protein aggregation can be observed after the protein denaturation step in chronic diseases of the central nervous system like Alzheimer's and Parkinson's disease, and also in other chronic system diseases including cataract formation. Heat shock proteins (HSPs) are fundamental for intracellular protein repair and work by preventing protein aggregation and assisting denaturated proteins to refold. Further, HSPs can also function for extracellular cell signalling. The focus of this review is to analyse the data studying electroacupuncture and moxibustion induced HSPs, and how acupuncture can survive cells from apoptosis under stress.
Downloaded from aim.bmj.com on January 5, 2010 - Published by group.bmj.com Education and practice folding and the maturation of large A review of the potential effect of proteins such as cellular receptors in the cell (see figure 2).23 Further, it is worth electroacupuncture and moxibustion on cell noting that the HSP70 and HSP100 bichaperone system is able to disentangle repair and survival: the role of heat shock polypeptides from aggregates which, in turn, results in the disaggregation pro- proteins cess.24 See figure 1. Yusuf Ozgur Cakmak Acupuncture and heat shock proteins The first study on HSP and acupuncture In recent years, a considerable amount of research has been focused on the underlying related techniques was published in 1995. It has been shown that levels of HSP70, mechanisms of electroacupuncture and moxibustion assisted tissue repair. Intracellular protein denaturation is a significant pathological step of acute conditions such as stroke, myocardial HSP85 and HSP100 are increased by infarction and acute pancreatitis. Protein aggregation can be observed after the protein moxibustion, in which heat is applied to acupuncture points directly or through denaturation step in chronic diseases of the central nervous system like Alzheimer’s and Parkinson’s disease, and also in other chronic system diseases including cataract formation. Heat needles via burning of artemisia vulgaris shock proteins (HSPs) are fundamental for intracellular protein repair and work by preventing (mugwort).25 It is not surprising that heat protein aggregation and assisting denaturated proteins to refold. Further, HSPs can also function for assisted acupuncture techniques triggers extracellular cell signalling. The focus of this review is to analyse the data studying an increase of HSP levels. However, it is electroacupuncture and moxibustion induced HSPs, and how acupuncture can survive cells from worth noting that HSPs act on moxibus- apoptosis under stress. tion rather than the smoke of mugwort.26 The first evidence of the relationship between HSPs and EA was demonstrated Heat shock proteins (HSPs), also called help of HSPs. These active folded proteins by Zamotrinsky et al in 1997.27 stress proteins, are a group of proteins can be misfolded when the cell experience Zamotrinsky et al applied 3Hz auricular present in all cells in all life forms. stressful conditions. In such a case, the EA daily for 10 days to patients with Although HSPs are named after an inves- most significant action of HSPs occurs. coronary artery disease. After the seventh tigation studying heat exposure in droso- HSPs stabilise and repair misfolded pro- and eighth EA no ECG signs of myocardial philia (fruitfly), they are produced in any teins and thereby help to protect the cell ischaemia are observed. The patients kind of stress when a cell undergoes against irreversible damage, apoptosis and could tolerate a bicycle exercise test and various types of environmental stresses death. HSPs (especially HSP70 and they also could climb 5–7 flights of stairs such as heat, heavy metal,1 UV-B,2 etha- HSP60) repair misfolded proteins by without requiring sublingual glyceryl tri- nol,3 oxygen deprivation.4 Experiments refolding them back to their original size. nitrate or developing angina. Three days with bacteria,5 yeast,6 fruitflies,7 plants,8 If these processes are ineffective, proteins after the final EA session, HSP70 fruits,9 mice10 and humans have shown are targeted for degradation in the ubiqui- amounts, whose presence is specific for that increased production of HSPs can tin-proteasome pathway. Further, these ischaemic heart pathology, were not protect an organism against stress-induced misfolded or unfolded proteins tend to detectable in samples of the EA group.27 damage. It is worth noting that even noise accumulate. If they accumulate they This was the first, indirect evidence of can be a stress factor for cochlear cells and trigger apoptosis and cell death. Even if HSP levels increasing with EA and EA triggers HSP production,11 12 which inhibits an accumulation occurs, HSPs (HSP100- assisted tissue repair via HSPs. the cochlear hair cell death.13–15 The aim of HSP70) can still help cell survival by In 2001, Lin YH et al28 applied local this review is to clarify the relationship of stimulating disaggregation. HSPs are somatothermal stimulation by using HSPs and mechanisms underlying the mandatory molecules for the cells to shift heated rods on the intersection point of electroacupuncture (EA) and moxibustion the apoptosis pathway to the survival the midclavicular line and right seventh assisted regeneration. pathway. See figure 1. intercostal space at the liver ischaemia- There are many different subgroups of reperfusion model of rats. Although the Protein folding heat shock proteins—each one of them point at which the heated rod was applied When harmful substances denature pro- performs a variety of functions that help fits with acupuncture point of GB24, teins and cause them to unfold, the the cell in both stressful and non-stressful according to World Health Organization proteins lose their original configuration conditions. HSP40 presents unfolded description,29 it has not been indicated in and are no longer able to function (nonfunctional)
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