Release and Actions of Inflammatory Exosomes in Pulmonary Emphysema: Potential Therapeutic Target of Acupuncture

References

• Robbins PD, Morelli AE. Regulation of immune responses by extracellular vesicles. Nat Rev Immunol. 2014;14(3):195–208. doi:10.1038/nri3622
   PubMed Web of Science ®Google Scholar
• Dong R, Liu Y, Yang Y, Wang H, Xu Y, Zhang Z. MSC-derived exosomes-based therapy for peripheral nerve injury: a novel therapeutic strategy. Biomed Res Int. 2019;2019:6458237. doi:10.1155/2019/6458237
   PubMed Web of Science ®Google Scholar
• Cheng X, Zhang G, Zhang L, et al. Mesenchymal stem cells deliver exogenous miR-21 via exosomes to inhibit nucleus pulposus cell apoptosis and reduce intervertebral disc degeneration. J Cell Mol Med. 2018;22(1):261–276. doi:10.1111/jcmm.13316
   PubMed Web of Science ®Google Scholar
• Xu J, Camfield R, Gorski SM. The interplay between exosomes and autophagy - partners in crime. J Cell Sci. 2018;131(15). doi:10.1242/jcs.215210
   Web of Science ®Google Scholar
• Sun JF, Zhang D, Gao CJ, Zhang YW, Dai QS. Exosome-mediated MiR-155 transfer contributes to hepatocellular carcinoma cell proliferation by targeting PTEN. Med Sci Monit Basic Res. 2019;25:218–228. doi:10.12659/MSMBR.918134
   PubMed Web of Science ®Google Scholar
• Boulestreau J, Maumus M, Rozier P, Jorgensen C, Noel D. Mesenchymal stem cell derived extracellular vesicles in aging. Front Cell Dev Biol. 2020;8:107. doi:10.3389/fcell.2020.00107
   PubMed Web of Science ®Google Scholar
• Chan BD, Wong WY, Lee MM, et al. Exosomes in inflammation and inflammatory disease. Proteomics. 2019;19(8):e1800149. doi:10.1002/pmic.201800149
   PubMed Web of Science ®Google Scholar
• Franzen CA, Blackwell RH, Foreman KE, Kuo PC, Flanigan RC, Gupta GN. Urinary exosomes: the potential for biomarker utility, intercellular signaling and therapeutics in urological malignancy. J Urol. 2016;195(5):1331–1339. doi:10.1016/j.juro.2015.08.115
   PubMed Web of Science ®Google Scholar
• Guiot J, Struman I, Louis E, Louis R, Malaise M, Njock MS. Exosomal miRNAs in lung diseases: from biologic function to therapeutic targets. J Clin Med. 2019;8(9):1345. doi:10.3390/jcm8091345
   PubMed Web of Science ®Google Scholar
• Roh JA, Kim KI, Park J, Lee BJ, Jung HJ. The efficacy of manual therapy (Chuna) for chronic obstructive pulmonary disease protocol for a systematic review. Medicine. 2020;99(9):e18832. doi:10.1097/MD.0000000000018832
   PubMed Web of Science ®Google Scholar
• Stockley RA, Mannino D, Barnes PJ. Burden and pathogenesis of chronic obstructive pulmonary disease. Proc Am Thorac Soc. 2009;6(6):524–526. doi:10.1513/pats.200904-016DS
   PubMedGoogle Scholar
• Patel AR, Patel AR, Singh S, Singh S, Khawaja I. Global Initiative for chronic obstructive lung disease: the changes made. Cureus. 2019;11(6).
   Web of Science ®Google Scholar
• Yuksel H, Turkeli A. Airway epithelial barrier dysfunction in the pathogenesis and prognosis of respiratory tract diseases in childhood and adulthood. Tissue Barriers. 2017;5(4):e1367458. doi:10.1080/21688370.2017.1367458
   PubMed Web of Science ®Google Scholar
• Conley SM, Abais JM, Boini KM, Li PL. Inflammasome activation in chronic glomerular diseases. Curr Drug Targets. 2017;18(9):1019–1029. doi:10.2174/1389450117666160817103435
   PubMed Web of Science ®Google Scholar
• Wang RQ, Wang YQ, Mu NN, et al. Activation of NLRP3 inflammasomes contributes to hyperhomocysteinemia-aggravated inflammation and atherosclerosis in apoE-deficient mice. Lab Invest. 2017;97(8):922–934. doi:10.1038/labinvest.2017.30
   PubMed Web of Science ®Google Scholar
• Li GB, Chen ZD, Bhat OM, et al. NLRP3 inflammasome as a novel target for docosahexaenoic acid metabolites to abrogate glomerular injury. J Lipid Res. 2017;58(6):1080–1090. doi:10.1194/jlr.M072587
   PubMed Web of Science ®Google Scholar
• Sharma A, Tate M, Mathew G, Vince JE, Ritchie RH, de Haan JB. Oxidative stress and NLRP3-inflammasome activity as significant drivers of diabetic cardiovascular complications: therapeutic implications. Front Physiol. 2018;9. doi:10.3389/fphys.2018.00114
   Web of Science ®Google Scholar
• Saresella M, La Rosa F, Piancone F, et al. The NLRP3 and NLRP1 inflammasomes are activated in Alzheimer’s disease. Mol Neurodegener. 2016;11:11. doi:10.1186/s13024-016-0088-1
   PubMed Web of Science ®Google Scholar
• Yang WL, Ni HY, Wang HF, Gu HL. NLRP3 inflammasome is essential for the development of chronic obstructive pulmonary disease. Int J Clin Exp Pathol. 2015;8(10):13209–13216.
   PubMed Web of Science ®Google Scholar
• Mahalanobish S, Dutta S, Saha S, Sil PC. Melatonin induced suppression of ER stress and mitochondrial dysfunction inhibited NLRP3 inflammasome activation in COPD mice. Food Chem Toxicol. 2020;144:111588. doi:10.1016/j.fct.2020.111588
   PubMed Web of Science ®Google Scholar
• Cao Y, Zhou XY, Yin ZX, et al. The anti-inflammatory effect of BML-111 on COPD may be mediated by regulating NLRP3 inflammasome activation and ROS production. Prostaglandins Other Lipid Mediat. 2018;138:23–30.
   PubMed Web of Science ®Google Scholar
• Pauwels NS, Bracke KR, Dupont LL, et al. Role of IL-1alpha and the Nlrp3/caspase-1/IL-1beta axis in cigarette smoke-induced pulmonary inflammation and COPD. Eur Respir J. 2011;38(5):1019–1028. doi:10.1183/09031936.00158110
   PubMed Web of Science ®Google Scholar
• Zhang X, Sai B, Wang F, et al. Hypoxic BMSC-derived exosomal miRNAs promote metastasis of lung cancer cells via STAT3-induced EMT. Mol Cancer. 2019;18(1):40. doi:10.1186/s12943-019-0959-5
   PubMed Web of Science ®Google Scholar
• Mohan A, Agarwal S, Clauss M, Britt NS, Dhillon NK. Extracellular vesicles: novel communicators in lung diseases. Respir Res. 2020;21(1):175.
   PubMed Web of Science ®Google Scholar
• Bhat OM, Yuan XX, Li GB, et al. Regulatory role of ceramide/mTOR signaling in exosome secretion from smooth muscle cells during arterial stiffening and medial calcification. FASEB J. 2020;34:1.
   Web of Science ®Google Scholar
• Yuan XX, Bhat OM, Lohner H, Zhang Y, Li PL. Endothelial acid ceramidase in exosome-mediated release of NLRP3 inflammasome products during hyperglycemia: evidence from endothelium-specific deletion of Asah1 gene. BBA Mol Cell Biol L. 2019;1864(12):158532.
   PubMed Web of Science ®Google Scholar
• Li GB, Huang DD, Hong JN, Bhat OM, Yuan XX, Li PL. Control of lysosomal TRPML1 channel activity and exosome release by acid ceramidase in mouse podocytes. Am J Physiol Cell Physiol. 2019;317(3):C481–C491. doi:10.1152/ajpcell.00150.2019
   PubMed Web of Science ®Google Scholar
• Wu HG, Gong X, Yao LQ, et al. Mechanisms of acupuncture and moxibustion in regulation of epithelial cell apoptosis in rat ulcerative colitis. World J Gastroenterol. 2004;10(5):682–688. doi:10.3748/wjg.v10.i5.682
   PubMed Web of Science ®Google Scholar
• Kim S, Zhang X, O’Buckley SC, Cooter M, Park JJ, Nackley AG. Acupuncture resolves persistent pain and neuroinflammation in a mouse model of chronic overlapping pain conditions. J Pain. 2018;19(12):1384e1381–1384 e1314. doi:10.1016/j.jpain.2018.05.013
   Google Scholar
• Luo D, Liu L, Huang Q, et al. Crosstalk between acupuncture and NF-kappaB in inflammatory diseases. Evid Based Complement Alternat Med. 2020;2020:7924985. doi:10.1155/2020/7924985
   PubMed Web of Science ®Google Scholar
• Khedoe PP, Wong MC, Wagenaar GT, et al. The effect of PPE-induced emphysema and chronic LPS-induced pulmonary inflammation on atherosclerosis development in APOE*3-LEIDEN mice. PLoS One. 2013;8(11):e80196. doi:10.1371/journal.pone.0080196
   PubMed Web of Science ®Google Scholar
• Li L, Xie L, Sun S. [Progress in study on animal models of chronic obstructive pulmonary disease]. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017;42(9):1105–1110. Chinese. doi:10.11817/j.issn.1672-7347.2017.09.018
   PubMedGoogle Scholar
• Kohler JB, Cervilha DAB, Riani Moreira A, et al. Microenvironmental stimuli induce different macrophage polarizations in experimental models of emphysema. Biol Open. 2019;8(4). doi:10.1242/bio.040808
   PubMed Web of Science ®Google Scholar
• Bhat OM, Yuan X, Cain C, Salloum FN, Li PL. Medial calcification in the arterial wall of smooth muscle cell-specific Smpd1 transgenic mice: a ceramide-mediated vasculopathy. J Cell Mol Med. 2020;24(1):539–553. doi:10.1111/jcmm.14761
   PubMed Web of Science ®Google Scholar
• Hong J, Bhat OM, Li G, et al. Lysosomal regulation of extracellular vesicle excretion during d-ribose-induced NLRP3 inflammasome activation in podocytes. Biochim Biophys Acta Mol Cell Res. 2019;1866(5):849–860. doi:10.1016/j.bbamcr.2019.02.007
   PubMed Web of Science ®Google Scholar
• Koka S, Xia M, Chen Y, et al. Endothelial NLRP3 inflammasome activation and arterial neointima formation associated with acid sphingomyelinase during hypercholesterolemia. Redox Biol. 2017;13:336–344. doi:10.1016/j.redox.2017.06.004
   PubMed Web of Science ®Google Scholar
• Busch RH, Lauhala KE, Loscutoff SM, McDonald KE. Experimental pulmonary emphysema induced in the rat by intratracheally administered elastase: morphogenesis. Environ Res. 1984;33(2):497–513. doi:10.1016/0013-9351(84)90044-6
   PubMed Web of Science ®Google Scholar
• Sasaki M, Chubachi S, Kameyama N, et al. Evaluation of cigarette smoke-induced emphysema in mice using quantitative micro-computed tomography. Am J Physiol Lung Cell. 2015;308(10):L1039–L1045. doi:10.1152/ajplung.00366.2014
   PubMed Web of Science ®Google Scholar
• Yuan X, Wang L, Bhat OM, Lohner H, Li PL. Differential effects of short chain fatty acids on endothelial Nlrp3 inflammasome activation and neointima formation: antioxidant action of butyrate. Redox Biol. 2018;16:21–31. doi:10.1016/j.redox.2018.02.007
   PubMed Web of Science ®Google Scholar
• Yuan X, Bhat OM, Lohner H, Li N, Zhang Y, Li PL. Inhibitory effects of growth differentiation factor 11 on autophagy deficiency-induced dedifferentiation of arterial smooth muscle cells. Am J Physiol Heart Circ Physiol. 2019;316(2):H345–H356. doi:10.1152/ajpheart.00342.2018
   PubMed Web of Science ®Google Scholar
• Yuan X, Bhat OM, Samidurai A, Das A, Zhang Y, Li PL. Reversal of endothelial extracellular vesicle-induced smooth muscle phenotype transition by hypercholesterolemia stimulation: role of NLRP3 inflammasome activation. Front Cell Dev Biol. 2020;8:597423. doi:10.3389/fcell.2020.597423
   PubMed Web of Science ®Google Scholar
• Zhang XF, Xiang SY, Geng WY, et al. Electro-acupuncture regulates the cholinergic anti-inflammatory pathway in a rat model of chronic obstructive pulmonary disease. J Integr Med. 2018;16(6):418–426. doi:10.1016/j.joim.2018.10.003
   PubMed Web of Science ®Google Scholar
• Li J, Wu S, Tang H, et al. Long-term effects of acupuncture treatment on airway smooth muscle in a rat model of smoke-induced chronic obstructive pulmonary disease. Acupunct Med. 2016;34(2):107–113. doi:10.1136/acupmed-2014-010674
   PubMed Web of Science ®Google Scholar
• Paterno JC, Bergamaschi CT, Campos RR, et al. Electroacupuncture and moxibustion decrease renal sympathetic nerve activity and retard progression of renal disease in rats. Kidney Blood Press Res. 2012;35(5):355–364. doi:10.1159/000336095
   PubMed Web of Science ®Google Scholar
• Wang P, Yang HY, Hu YE. [Compilation experience of national standard standardized manipulation of acupuncture and moxibustion, part 11, electroacupuncture]. Zhongguo Zhen Jiu. 2010;30(5):413–416. Chinese.
   PubMedGoogle Scholar
• Lin XG, Li W, Xiang SY, et al. [Electroacupuncture improves lung function by suppressing mucin-5AC mediated EGFR-p38MAPK signaling and inflammation reaction in chronic obstructive pulmonary disease rats]. Zhen Ci Yan Jiu. 2021;46(3):180–186. Chinese. doi:10.13702/j.1000-0607.200420
   PubMedGoogle Scholar
• Li Y, Zhang XF, Liu ZB, et al. [Effect of electroacupuncture on pulmonary function and M1 polarization of alveolar macrophages in rats with chronic obstructive pulmonary disease]. Zhen Ci Yan Jiu. 2020;45(3):173–179. Chinese. doi:10.13702/j.1000-0607.190621
   PubMedGoogle Scholar
• Chen Y, He XX, Yuan XX, et al. NLRP3 inflammasome formation and activation in nonalcoholic steatohepatitis: therapeutic target for antimetabolic syndrome remedy FTZ. Oxid Med Cell Longev. 2018;2018:1–13. doi:10.1155/2018/2901871
   Web of Science ®Google Scholar
• Xia M, Abais JM, Koka S, et al. Characterization and activation of NLRP3 inflammasomes in the renal medulla in mice. Kidney Blood Press Res. 2016;41(2):208–221. doi:10.1159/000443424
   PubMed Web of Science ®Google Scholar
• Wortzel I, Dror S, Kenific CM, Lyden D. Exosome-mediated metastasis: communication from a distance. Dev Cell. 2019;49(3):347–360. doi:10.1016/j.devcel.2019.04.011
   PubMed Web of Science ®Google Scholar
• Mardpour S, Hamidieh AA, Taleahmad S, Sharifzad F, Taghikhani A, Baharvand H. Interaction between mesenchymal stromal cell-derived extracellular vesicles and immune cells by distinct protein content. J Cell Physiol. 2019;234(6):8249–8258. doi:10.1002/jcp.27669
   PubMed Web of Science ®Google Scholar
• Mentkowski KI, Snitzer JD, Rusnak S, Lang JK. Therapeutic potential of engineered extracellular vesicles. AAPS J. 2018;20(3):50. doi:10.1208/s12248-018-0211-z
   PubMed Web of Science ®Google Scholar
• Keerthikumar S, Chisanga D, Ariyaratne D, et al. ExoCarta: a web-based compendium of exosomal cargo. J Mol Biol. 2016;428(4):688–692. doi:10.1016/j.jmb.2015.09.019
   PubMed Web of Science ®Google Scholar
• Gutierrez-Vazquez C, Villarroya-Beltri C, Mittelbrunn M, Sanchez-Madrid F. Transfer of extracellular vesicles during immune cell-cell interactions. Immunol Rev. 2013;251(1):125–142. doi:10.1111/imr.12013
   PubMed Web of Science ®Google Scholar
• Hinger SA, Cha DJ, Franklin JL, et al. Diverse long RNAs are differentially sorted into extracellular vesicles secreted by colorectal cancer cells. Cell Rep. 2018;25(3):715–725e714. doi:10.1016/j.celrep.2018.09.054
   PubMed Web of Science ®Google Scholar
• Wang TT, Nasser MI, Shen J, Qu SJ, He QN, Zhao MY. Functions of exosomes in the triangular relationship between the tumor, inflammation, and immunity in the tumor microenvironment. J Immunol Res. 2019;2019:1–10. doi:10.1155/2019/4197829
   Web of Science ®Google Scholar
• Kim MR, Hong SW, Choi EB, et al. Staphylococcus aureus-derived extracellular vesicles induce neutrophilic pulmonary inflammation via both Th1 and Th17 cell responses. Allergy. 2012;67(10):1271–1281. doi:10.1111/all.12001
   PubMed Web of Science ®Google Scholar
• Hong SW, Kim MR, Lee EY, et al. Extracellular vesicles derived from Staphylococcus aureus induce atopic dermatitis-like skin inflammation. Allergy. 2011;66(3):351–359. doi:10.1111/j.1398-9995.2010.02483.x
   PubMed Web of Science ®Google Scholar
• Nakao R, Hasegawa H, Ochiai K, et al. Outer membrane vesicles of porphyromonas gingivalis elicit a mucosal immune response. PLoS One. 2011;6(10). doi:10.1371/journal.pone.0026163
   Web of Science ®Google Scholar
• Prados-Rosales R, Baena A, Martinez LR, et al. Mycobacteria release active membrane vesicles that modulate immune responses in a TLR2-dependent manner in mice. J Clin Invest. 2011;121(4):1471–1483. doi:10.1172/JCI44261
   PubMed Web of Science ®Google Scholar
• Bhatnagar S, Shinagawa K, Castellino FJ, Schorey JRS. Exosomes released from macrophages infected with intracellular pathogens stimulate a proinflammatory response in vitro and in vivo. Blood. 2007;110(9):3234–3244. doi:10.1182/blood-2007-03-079152
   PubMed Web of Science ®Google Scholar
• Ayna G, Krysko DV, Kaczmarek A, Petrovski G, Vandenabeele P, Fesus L. ATP release from dying autophagic cells and their phagocytosis are crucial for inflammasome activation in macrophages. PLoS One. 2012;7(6):e40069. doi:10.1371/journal.pone.0040069
   PubMed Web of Science ®Google Scholar
• Goh FG, Midwood KS. Intrinsic danger: activation of toll-like receptors in rheumatoid arthritis. Rheumatology (Oxford). 2012;51(1):7–23. doi:10.1093/rheumatology/ker257
   PubMed Web of Science ®Google Scholar
• Suki B, Bartolak-Suki E, Rocco PRM. Elastase-induced lung emphysema models in mice. Methods Mol Biol. 2017;1639:67–75.
   PubMedGoogle Scholar
• Antunes MA, Rocco PR. Elastase-induced pulmonary emphysema: insights from experimental models. An Acad Bras Cienc. 2011;83(4):1385–1396. doi:10.1590/S0001-37652011005000039
   PubMed Web of Science ®Google Scholar
• Li GB, Kidd J, Li PL. Podocyte lysosome dysfunction in chronic glomerular diseases. Int J Mol Sci. 2020;21(5):1559.
   PubMed Web of Science ®Google Scholar
• Huang DD, Li GB, Camus S, Li NJ, Ritter JK, Li PL. Contribution of NLRP3 inflammasome activation to glomerular injury during hyperhomocysteinemia with and without enhanced exosome secretion. FASEB J. 2020;34:1.
   Web of Science ®Google Scholar
• Yan XM, Zhang Z, Liu JB, et al. Genome-wide identification and analysis of long noncoding RNAs in longissimus muscle tissue from Kazakh cattle and Xinjiang brown cattle. Asian-Australas J Anim Sci. 2020. doi:10.5713/ajas.20.0317
   Google Scholar
• Cypryk W, Nyman TA, Matikainen S. From inflammasome to exosome-does extracellular vesicle secretion constitute an inflammasome-dependent immune response? Front Immunol. 2018;9:2188. doi:10.3389/fimmu.2018.02188
   PubMed Web of Science ®Google Scholar
• Zhang H, Wang L, Li C, et al. Exosome-induced regulation in inflammatory bowel disease. Front Immunol. 2019;10:1464. doi:10.3389/fimmu.2019.01464
   PubMed Web of Science ®Google Scholar
• Ha H, Debnath B, Neamati N. Role of the CXCL8-CXCR1/2 axis in cancer and inflammatory diseases. Theranostics. 2017;7(6):1543–1588. doi:10.7150/thno.15625
   PubMed Web of Science ®Google Scholar
• Gao F, Xiang HC, Li HP, et al. Electroacupuncture inhibits NLRP3 inflammasome activation through CB2 receptors in inflammatory pain. Brain Behav Immun. 2018;67:91–100. doi:10.1016/j.bbi.2017.08.004
   PubMed Web of Science ®Google Scholar
• Dhar R, Zhang LJ, Li YJ, et al. Electroacupuncture ameliorates cardiopulmonary bypass induced apoptosis in lung via ROS/Nrf2/NLRP3 inflammasome pathway. Life Sci. 2019;238:238. doi:10.1016/j.lfs.2019.116962
   Web of Science ®Google Scholar
• Huang DX, Chen M, Wang ZK, Hou L, Yu WF. Electroacupuncture pretreatment attenuates inflammatory lung injury after cardiopulmonary bypass by suppressing NLRP3 inflammasome activation in rats. Inflammation. 2019;42(3):895–903. doi:10.1007/s10753-018-0944-y
   PubMed Web of Science ®Google Scholar
• Liu H, Zhang B, Du J, et al. [Effect of acupuncture on NLRP3 inflammatory corpuscle in rats with intracerebral hemorrhage]. Zhongguo Zhen Jiu. 2020;40(7):757–763. Chinese. doi:10.13703/j.0255-2930.20190513-k0003
   PubMedGoogle Scholar
• Abais JM, Xia M, Li G, Gehr TW, Boini KM, Li PL. Contribution of endogenously produced reactive oxygen species to the activation of podocyte NLRP3 inflammasomes in hyperhomocysteinemia. Free Radic Biol Med. 2014;67:211–220. doi:10.1016/j.freeradbiomed.2013.10.009
   PubMed Web of Science ®Google Scholar
• Jin BX, Jin LL, Jin GY. The anti-inflammatory effect of acupuncture and its significance in analgesia. World J Acupunct. 2019;29(1):1–6. doi:10.1016/j.wjam.2019.03.003
   Web of Science ®Google Scholar
• Wang M, Abais JM, Meng N, et al. Upregulation of cannabinoid receptor-1 and fibrotic activation of mouse hepatic stellate cells during Schistosoma J. infection: role of NADPH oxidase. Free Radical Bio Med. 2014;71:109–120. doi:10.1016/j.freeradbiomed.2014.03.015
   PubMed Web of Science ®Google Scholar
• Li GB, Xia M, Abais JM, Boini K, Li PL, Ritter JK. Protective action of anandamide and its COX-2 metabolite against L-homocysteine-induced NLRP3 inflammasome activation and injury in podocytes. J Pharmacol Exp Ther. 2016;358(1):61–70. doi:10.1124/jpet.116.233239
   PubMed Web of Science ®Google Scholar
• Abais JM, Xia M, Li GB, et al. Nod-like receptor protein 3 (NLRP3) inflammasome activation and podocyte injury via thioredoxin-interacting protein (TXNIP) during hyperhomocysteinemia. J Biol Chem. 2014;289(39):27159–27168. doi:10.1074/jbc.M114.567537
   PubMed Web of Science ®Google Scholar
• Abais JM, Xia M, Zhang Y, Boini KM, Li PL. Redox regulation of NLRP3 inflammasomes: ROS as trigger or effector? Antioxid Redox Signal. 2015;22(13):1111–1129. doi:10.1089/ars.2014.5994
   PubMed Web of Science ®Google Scholar
• Boini KM, Xia M, Koka S, Gehr TW, Li PL. Instigation of NLRP3 inflammasome activation and glomerular injury in mice on the high fat diet: role of acid sphingomyelinase gene. Oncotarget. 2016;7(14):19031–19044. doi:10.18632/oncotarget.8023
   PubMedGoogle Scholar
• Firouzjaei A, Li GC, Wang N, Liu WX, Zhu BM. Comparative evaluation of the therapeutic effect of metformin monotherapy with metformin and acupuncture combined therapy on weight loss and insulin sensitivity in diabetic patients. Nutr Diabetes. 2016;6:e209–e209.
   PubMed Web of Science ®Google Scholar
• Zhao ZL, Lee BH, Lin F, et al. Effects of acupuncture at Zu-San- Li (ST36) on the activity of the hypothalamic-pituitary-adrenal axis during ethanol withdrawal in rats. J Acupunct Meridian Stud. 2014;7(5):225–230. doi:10.1016/j.jams.2014.03.002
   PubMedGoogle Scholar
• Fung PCW, Kong RKC. New insights on stimulating the lung meridian based on modern neurophysiology. Chin Med. 2018;09(03):75–117. doi:10.4236/cm.2018.93006
   Google Scholar