Autophagy is a well conserved metabolic system that maintains homeostasis by relying on lysosomal breakdown. Both the endometrium of patients with intrauterine adhesion (IUA) and an animal model exhibit impaired autophagy. Autophagy is negatively correlated with inflammation. Activation of autophagy can inhibit the inflammatory response, while defects in autophagy will activate the inflammatory response.
Here, we studied whether electroacupuncture inhibits inflammation and promotes endometrial injury repair by activating endometrial autophagy. The IUA animal model was established by mechanical injury plus lipopolysaccharide (LPS) infection. Electroacupuncture stimulation was applied to the acupoints Guanyuan (CV4), bilateral Sanyinjiao (SP6), and Zusanli (ST36).
The results indicated that electroacupuncture could improve endometrial morphology, attenuate endometrial fibers, and enhance endometrial receptivity in the rat. Electroacupuncture could increase the autophagosomes of endometrial epithelial cells, increase the levels of LC3 and Beclin1, and decrease the level of p62. Additionally, electroacupuncture may also suppress the nuclear factor (NF)-κB signaling pathway and reduce the release of inflammatory factors. Additionally, the effect of electroacupuncture was comparable to that of the autophagy agonist rapamycin, and the autophagy inhibitor 3-methyladenine reversed the therapeutic effect of electroacupuncture.
Therefore, we assume that electroacupuncture may facilitate endometrial healing by activating autophagy and reducing NF-κB signal pathway-mediated inflammation.