Spinal Cord Stimulation Attenuates Neural Remodeling, Inflammation, and Fibrosis After Myocardial Infarction

Yuxian He; Zewei Sun; Jiajia Jiang; Xiang Yin; Jie Han; Yuanyuan Zhang; Liangrong Zheng

doi:10.1016/j.neurom.2021.09.005

Spinal Cord Stimulation Attenuates Neural Remodeling, Inflammation, and Fibrosis After Myocardial Infarction

Neuromodulation. 2023 Jan;26(1):57-67. doi: 10.1016/j.neurom.2021.09.005. Epub 2021 Dec 18.

Authors

Yuxian He¹, Zewei Sun¹, Jiajia Jiang¹, Xiang Yin¹, Jie Han¹, Yuanyuan Zhang², Liangrong Zheng³

Affiliations

¹ Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
² Department of Cardiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China.
³ Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. Electronic address: 1191066@zju.edu.cn.

PMID: 35088742
DOI: 10.1016/j.neurom.2021.09.005

Abstract

Objectives: Spinal cord stimulation (SCS) is an established neuromodulation method that regulates the cardiac autonomic system. However, the biological mechanisms of the therapeutic effects of SCS after myocardial infarction (MI) remain unclear.

Materials and methods: Twenty-five rabbits were divided into five groups: SCS-MI (voltage: 0.5 v; pulse width: 0.2 ms; 50 Hz; ten minutes on and 30 minutes off; two weeks; n = 5), MI (n = 5), sham SCS-MI (voltage: 0 v; two weeks; n = 5), sham MI (n = 5), and blank control (n = 5) groups. MI was induced by permanent left anterior descending artery ligation. SCS-MI and sham SCS-MI rabbits received the corresponding interventions 24 hours after MI. Autonomic remodeling was evaluated using enzyme-linked immunosorbent assay and immunohistochemistry. Inflammation and myocardial fibrosis were assessed using immunohistochemistry, quantitative polymerase chain reaction, hematoxylin and eosin staining, Masson staining, and Western blot.

Results: SCS improved the abnormal systemic autonomic activity. Cardiac norepinephrine decreased after MI (p < 0.01) and did not improve with SCS. Cardiac acetylcholine increased with SCS compared with the MI group (p < 0.05). However, no difference was observed between the MI and blank control groups. Growth-associated protein 43 (p < 0.001) and tyrosine hydroxylase (p < 0.001) increased whereas choline acetyltransferase (p < 0.05) decreased in the MI group compared with the blank control group. These changes were attenuated with SCS. SCS inhibited inflammation, decreased the ratio of phosphorylated-Erk to Erk (p < 0.001), and increased the ratio of phosphorylated-STAT3 to STAT3 (p < 0.001) compared with the MI group. Myocardial fibrosis was also attenuated by SCS.

Conclusions: SCS improved abnormal autonomic activity after MI, leading to reduced inflammation, reactivation of STAT3, and inhibition of Erk. Additionally, SCS attenuated myocardial fibrosis. Our results warrant future studies of biological mechanisms of the therapeutic effects of SCS after MI.

Keywords: Autonomic remodeling; inflammation; myocardial fibrosis; myocardial infarction; spinal cord stimulation.

MeSH terms

Animals
Disease Models, Animal
Fibrosis
Inflammation / therapy
Myocardial Infarction* / drug therapy
Rabbits
Spinal Cord Stimulation* / methods