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Review
. 2021 Apr 2:12:632324.
doi: 10.3389/fendo.2021.632324. eCollection 2021.

Mechanism of Action of Acupuncture in Obesity: A Perspective From the Hypothalamus

Li Wang  1 , Chao-Chao Yu  2   3 , Jia Li  1 , Qing Tian  4 , Yan-Jun Du  1
Affiliations
Review

Mechanism of Action of Acupuncture in Obesity: A Perspective From the Hypothalamus

Li Wang et al. Front Endocrinol (Lausanne). .

Abstract

Obesity is a prevalent metabolic disease caused by an imbalance in food intake and energy expenditure. Although acupuncture is widely used in the treatment of obesity in a clinical setting, its mechanism has not been adequately elucidated. As the key pivot of appetite signals, the hypothalamus receives afferent and efferent signals from the brainstem and peripheral tissue, leading to the formation of a complex appetite regulation circuit, thereby effectively regulating food intake and energy homeostasis. This review mainly discusses the relationship between the hypothalamic nuclei, related neuropeptides, brainstem, peripheral signals, and obesity, as well as mechanisms of acupuncture on obesity from the perspective of the hypothalamus, exploring the current evidence and therapeutic targets for mechanism of action of acupuncture in obesity.

Keywords: action; acupuncture; hypothalamus; mechanism; obesity.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The illustration focuses on the regulation of energy homeostasis by the hypothalamus. NPY/AgRP and POMC/CART neurons located in the ARC of hypothalamus project to secondary neurons such as PVN, DMH, VMH, LHA, and secrete orexigenic AgRP or anorectic POMC. The MC3/4R in PVN are activated after binding with the active component a-MSH cleaved by POMC, and the integrated signals are transmitted to the NTS to regulate feeding behavior. Meanwhile, PVN also secretes anorexic neurohormones CRH to suppress food intake. BDNF located in the VMH is the downstream effector of a-MSH, which plays a role in inhibiting food intake. LHA is mainly stimulated by NPY/AgRP neurons in the ARC and secretes orexigenic peptides, orexin and MCH. Peripheral signals from adipose tissue, pancreas or the gastrointestinal tract either enter the hypothalamus through the median eminence, or connect to the NTS in the brainstem via acting on the vagus nerve afferents, and these signals effectively induce activities of the related nuclei, such as ARC and NTS, then influence the second order neurons of PVN, VMH. DMH and LHA.
Figure 2
Figure 2
Mechanisms of action of acupuncture in obesity.
Figure 3
Figure 3
Locations of frequently chosen acupoints in obese rats.
Figure 4
Figure 4
The location of frequently chosen acupoints on humans for the treatment of obesity.
See this image and copyright information in PMC

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