Mesenchymal Stem Cells Combined With Electroacupuncture Treatment Regulate the Subpopulation of Macrophages and Astrocytes to Facilitate Axonal Regeneration in Transected Spinal Cord

Abstract

Objective: Herein, we investigated whether mesenchymal stem cells (MSCs) transplantation combined with electroacupuncture (EA) treatment could decrease the proportion of proinflammatory microglia/macrophages and neurotoxic A1 reactive astrocytes and inhibit glial scar formation to enhance axonal regeneration after spinal cord injury (SCI). Methods: Adult rats were divided into 5 groups after complete transection of the spinal cord at the T10 level: a control group, a nonacupoint EA (NA-EA) group, an EA group, an MSC group, and an MSCs+EA group. Immunofluorescence labeling, quantitative real-time poly-merase chain reaction, enzyme-linked immunosorbent assay, and Western blots were per-formed. Results: The results showed that MSCs+EA treatment reduced the proportion of proinflam-matory M1 subtype microglia/macrophages, but increased the differentiation of anti-inflam-matory M2 phenotype cells, thereby suppressing the mRNA and protein expression of pro-inflammatory cytokines (tumor necrosis factor-α and IL-1β) and increasing the expression of an anti-inflammatory cytokine (interleukin [IL]-10) on days 7 and 14 after SCI. The changes in expression correlated with the attenuated neurotoxic A1 reactive astrocytes and glial scar, which in turn facilitated the axonal regeneration of the injured spinal cord. In vitro, the proinflammatory cytokines increased the level of proliferation of astrocytes and increased the expression levels of C3, glial fibrillary acidic protein, and chondroitin sulfate proteogly-can. These effects were blocked by administering inhibitors of ErbB1 and signal transducer and activator of transcription 3 (STAT3) (AG1478 and AG490) and IL-10. Conclusion: These findings showed that MSCs+EA treatment synergistically regulated the mi-croglia/macrophage subpopulation to reduce inflammation, the formation of neurotoxic A1 as-trocytes, and glial scars. This was achieved by downregulating the ErbB1-STAT3 signal path-way, thereby providing a favorable microenvironment conducive to axonal regeneration after SCI.