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Journal of Cellular and Molecular Medicine logoLink to Journal of Cellular and Molecular Medicine
. 2023 Jul 30;27(20):3127–3146. doi: 10.1111/jcmm.17891

Serum lipidomics‐based study of electroacupuncture for skin wound repair in rats

Weibin Du 1,2,, Lihong He 1,2, Zhenwei Wang 1,2, Yi Dong 3, Xiaofen He 4, Jintao Hu 5, Min Zhang 1,2,
PMCID: PMC10568671  PMID: 37517065

Abstract

Lipid metabolism plays an important role in the repair of skin wounds. Studies have shown that acupuncture is very effective in skin wound repair. However, there is little knowledge about the mechanism of electroacupuncture. Thirty‐six SD rats were divided into three groups: sham‐operated group, model group and electroacupuncture group, with six rats in each group. After the intervention, orbital venous blood was collected for lipid metabolomics analysis, wound perfusion was detected and finally the effect of electroacupuncture on skin wound repair was comprehensively evaluated by combining wound healing rate and histology. Lipid metabolomics analysis revealed 11 differential metabolites in the model versus sham‐operated group. There were 115 differential metabolites in the model versus electro‐acupuncture group. 117 differential metabolites in the electro‐acupuncture versus sham‐operated group. There were two differential metabolites common to all three groups. Mainly cholesteryl esters and sphingolipids were elevated after electroacupuncture and triglycerides were largely decreased after electroacupuncture. The electroacupuncture group recovered faster than the model group in terms of blood perfusion and wound healing (p < 0.05). Electroacupuncture may promote rat skin wound repair by improving lipid metabolism and improving local perfusion.

Keywords: blood perfusion, electroacupuncture, lipid metabolomics, serum, wound repair

1. INTRODUCTION

The skin is the largest organ of the body and is the first line of defence against external invasion and has properties that protect against microbial, mechanical, chemical, osmotic and thermal damage. 1 , 2 Skin trauma is very common in surgery and is characterized by high morbidity and complications which adversely affect the quality of life of patients and cause high global health system costs. 3 , 4 As patients' expectations of the speed and quality of wound healing increase, there is a need to seek additional treatment strategies that can promote rapid and high‐quality healing of skin wounds.

Acupuncture is an important part of Chinese traditional medicine, and plays an important role in clinical treatment. Acupuncture can promote wound healing through anti‐inflammatory effects improving microcirculation, and increasing re‐epithelialization and angiogenesis. 5 , 6 Electrical stimulation is widely used as a physical stimulus in the medical field and is gaining more and more attention in the area of skin wound repair. 7 , 8 Electrical stimulation accelerates wound healing by promoting cell proliferation and migration and regulating the expression of growth factors and is a green therapy that mobilizes endogenous currents in the skin and corrects the internal environment of the wounds. 9 Electroacupuncture, on the other hand, embodies the combination of traditional Chinese medicine and modern medicine, combining acupuncture with electrical stimulation to bring out its greater benefits. Electroacupuncture for wound repair is safe, non‐invasive, effective and easy to use. However, the role and mechanism of electroacupuncture for cutaneous wound healing are less reported and need further study.

Skin wound healing involves several processes, including extracellular matrix remodelling, synthesis of pro‐inflammatory mediators and angiogenesis. The new blood vessels formed by repair can promote tissue blood perfusion and is a key factor in determining the quality of skin wound healing. Therefore, blood perfusion is essential in skin wound healing. 10 , 11 Human skin homeostasis requires the regulation of lipid metabolic balance and lipids secreted by sebocytes together with lipids derived from keratin‐forming cells form an important component of the skin barrier. 12 Chromatography‐mass spectrometry (LC–MS) combines the capabilities of both HPLC and MS, significantly improving the analytical platform and providing a sensitive and specific tool for the identification and quantification of lipids. 13 , 14 However, there are fewer reports on the mechanism of whether electroac upuncture can promote skin wound healing by regulating serum lipid metabolism. In order to better understand the mechanism of skin wound healing by electroacupuncture, we established a rat sk in model of total skin defect. This study focused on the changes in serum lipid metabolites, related lipid pathways and wound blood perfusion during electroacupuncture intervention in rats with total skin defects to promote skin wound repair.

2. METHOD

2.1. Experimental animals

Eighteen male SD rats (weight 160 ± 20 g) were grouped in the Animal Experimentation Centre of Zhejiang University of Traditional Chinese Medicine for 1 week after acclimatization. SD rats were purchased and fed, and other animal procedures followed the animal research guidelines of the National Institutes of Health and the Animal Research Committee. And approved by the Experimental Animal Ethics Committee of Zhejiang University of Traditional Chinese Medicine (NO. IACUC‐20220221‐19).

2.2. Model preparation

Combined with the group's previous modelling basis, a full‐layer skin defect model was prepared. After anaesthesia, the modelling area (2 cm on the left and right side of the spine) was fixed at five points, trimmed and dehaired, rinsed with saline, disinfected with iodophor and deiodinated with ethanol. A 1*1 cm square model of the full skin defect was created using surgical scissors. Post‐operatively, the wound was naturally haemostatic and the wound was kept dry to prevent wound infection.

2.3. Grouping and processing

Eighteen SD rats were randomly divided into three groups of six rats each according to the table of random number methods, as follows: sham‐operated group, model group and electroacupuncture group. (1) Sham‐operated group: only hair clipping was done in the modelling area, and no wound model was made. (2) Model group: full skin defect model was prepared, and only iodophor was given daily for routine disinfection to prevent wound infection. (3) Electroacupuncture group: Based on the operation of the model group, electroacupuncture treatment was started on the same day. The central point of the wound and the normal skin at the edge of the wound (the edge of the midpoint of the four sides of the square wound) were selected and given electroacupuncture stimulation. The negative electrode was located at the centre and the positive electrode was located at the edge of the midpoint of the four sides of the square wound. Continuous pulses with a frequency of 2 Hz and an output current of 0.3 mA was used to stimulate each point successively for 5 min at each point, once a day for a total time of 20 min to prevent wound infection.

2.4. LC–MS model preparation

Orbital venous blood was taken from each group after 7 days. Take 200 μL of serum into a 1.5 mL centrifuge tube, add 800 μL of isopropanol and vortex for 1 min. After 30 min of ultrasonication in an ice bath, the samples were vortexed for 1 min and placed in a refrigerator at −20°C overnight. The next day, the centrifuge was pre‐cooled to 4°C and centrifuged at 13000 rpm for 15 min. 600 μL of Serum supernatant was taken, blown to dryness with nitrogen and 150 μL of isopropanol was re‐dissolved and centrifuged at 13000 rpm for 15 min. 100 μL of supernatant was taken into the injection vial for sample injection. The supernatant of the homogenate was centrifuged in equal amounts, blown dry with nitrogen and re‐dissolved to prepare QC samples. The liquid conditions were set and the samples were analysed by UHPLC‐QTOF/MS.

2.5. UHPLC‐QTOF/MS analysis

2.5.1. Chromatography

Chromatographic separation was performed on an ExionLC system (AB Sciex). A Waters Acquity HSS T3 column (2.1 × 100 mm, 1.7 μm) was applied at the temperature of 55°C. Mobile phase A: water‐acetonitrile (40:60, containing 0.1% formic acid with 5 mM ammonium formate); mobile phase B: isopropanol‐acetonitrile (90:10, containing 0.1% formic acid with 5 mM ammonium formate) The gradient was optimized as follows: 0–13 min from 30% to 80% B, 13–20 min from 80% to 90% B, 20–21 min from 90% to 100% B, 21–26 min at 100% B, then back to the initial ratio of 30% B and maintained with additional 8 min for re‐equilibration. The injection volume of all samples was 2 μL.

2.5.2. Mass spectrometry

To provide high‐resolution detection, an X500B Q‐TOF mass spectrometer (AB Sciex) equipped with an electrospray ionization source (Turbo Ionspray) was applied. MS detection was implemented both in negative and positive ion mode with the mass rang at m/z 150–1050. The parameters of the mass spectrometer were summarized as follows: gas1 and gas2, 45 psi; curtain gas, 35 psi. Heat block temperature, 550°C; ion spray voltage, − 4.5 kV in negative mode and 5.5 kV in positive; declustering potential, 50 V; collision energy, ±35 V; and the collision energy spread (CES) was ±15 V. To monitor the reproducibility and stability of the acquisition system, QC samples were prepared by pooling small aliquots of each sample. The QC specimens were analysed every six samples throughout the whole analysis procedure.

2.5.3. Data processing

The raw profiles were extracted by SCIEX OS Analytics and transformed into a data matrix, mainly including information on the mass‐to‐charge ratio (m/z) and retention time (Rt) and peak area (intensity). All data were normalized by the total peak area and the Excel sheet was generated for subsequent metabolome analysis. To reduce signal interference from chance errors, variables with RSD ≥40% in QC were excluded in excel first.

The Excel files were imported into SIMCA 14.1 (Umetrics) software for multivariate mathematical and statistical analysis. Principal component analysis (PCA) was used to observe the overall distribution of the samples. In addition, the consistency of the samples within the group was analysed by PCA‐Class analysis. Generally, when a sample falls outside the ‘2‐std. dev.’ line under a principal component, the sample was considered abnormal data and the sample data was considered to be excluded before the subsequent analysis.

The OPLS‐DA replacement test statistically analyzes the validity of the OPLS‐DA model when Q2 intersects with the y‐axis at a negative value, indicating that the model is valid, which in turn screens for differential metabolites. Based on this model, the differential variables were screened according to the variable projection importance index (VIP value), and the variables with VIP >1 were generally considered to be meaningful variables causing the differences. The variables with a high impact on OPLS‐DA model building were further screened by the partial correlation coefficient (pcorr). Finally, the screened variables were tested for significance (Mann–Whitney Test), and a p < 0.05 was considered a significant difference variable. Potential markers were identified by HMDB (http://www.hmdb.ca/) and LIPID MAPS (https://www.lipidmaps.org/). All differential metabolites involved in the three groups were summarized by Venn diagrams. Heat maps of the differential metabolites were produced to visualize the high and low levels of the response of the compounds after the intervention, and corresponding bar charts were produced for further analysis. Based on the results of the significantly different metabolites screened and identified, the compound name results for each group were imported into Metabo Analyst 5.0 (http://www.MetaboAnalyst.ca/) for metabolic pathway analysis.

2.6. Laser doppler perfusion imaging test

The groups were examined at 1d, 4d and 7d using laser Doppler perfusion imaging with a distance of 10 cm between the probe and the test object and an imaging range of 1.0 cm × 1.0 cm. and the PIMSoft software was applied to the record, analyse, process and store the body surface flow maps. The changes in perfusion in each group were compared.

2.7. Post‐operative wound observation

The model and electroacupuncture groups were photographed in 1d, 4d and 7d using a digital camera, and trauma healing was analysed using image‐pro Plus 6.0 image analysis software. Percentage of trauma healing = [(original trauma area ‐ trauma area at the time of observation) ÷ original trauma area] × 100%.

2.8. Histological testing

Skin tissues of each group were taken from the moulded area after 7 days, fixed with 4% PFA solution for more than 24 h, dehydrated, and paraffin‐embedded to make 4 um sections. H&E and Masson staining were performed, and after completing the steps, the sections were dehydrated and sealed, observed under the microscope and photographed for comparison.

2.9. Statistical analysis

All of the experimental results were expressed as the mean ± SD (standard deviation). All statistical analyses were performed using SPSS 21.0 software. The significance of differences between groups was determined by 2‐tailed unpaired Student's t‐test or one‐way anova with Dunnett's post hoc test when samples were not distributed normally. A value of p < 0.05 was considered to be statistically significant.

3. RESULTS

3.1. Repeatability and stability of the UHPLC‐QTOF/MS method

Figure 1(A),1(B) show the QC Base Peak Chromatograms (BPC) in positive and negative ion modes. The Base Peak Chromatogram is a continuous depiction of the most intense ion intensity obtained at each time point, and the BPC contains the ion intensity as well as the retention time of the ion in the chromatogram. Figure 1(C), Figure 1(G) show the PCA plots of all samples in positive and negative ion mode, respectively. It can be seen that the QC samples are more tightly clustered, indicating that this experiment has good stability and reproducibility. The consistency of the samples within the group was analysed by PCA‐Class analysis, and all data could be retained as seen from the results in Figure 1 (C–F) and Figure 1 (G–J).

FIGURE 1.

FIGURE 1

(A, B) The TIC diagram of QC samples in positive and negative ion mode. (A) Negative ion mode, (B) Positive ion mode. Figure 1 (C–F) PCA analysis of negative ions. (C) PCA analysis of all samples (R2X 0.770, Q2 0.450). (D) PCA‐class analysis of sham‐operated group. (E) PCA‐class analysis of model group. (F) PCA‐class analysis of electro‐acupuncture group. Figure 1 (G–J) PCA analysis of positive ions. (G) PCA analysis of all samples (R2X 0.763, Q2 0.547), (H) PCA‐class analysis of sham‐operated group. (I) PCA‐class analysis of model group. (J) PCA‐class analysis of electro‐acupuncture group.

3.2. Results of differential metabolite analysis

3.2.1. Post‐modelling affects 11 lipid metabolites in serum

Figure 2 (A–F) shows the OPLS‐DA plots for model versus sham‐operated, which shows that the two groups are clearly differentiated and the model is valid. Figure 2 (G–H) shows the volcano plot for model versus sham‐operated, with red colour indicating variables up‐regulated after modelling, blue colour indicating variables down‐regulated after modelling, and grey colour indicating variables with no differences. Eleven differential metabolites of model versus sham‐operated were screened and identified, and the results are shown in Table 1. Detailed response changes are shown in Figure 2I.

FIGURE 2.

FIGURE 2

(A–F) OPLS‐DA: Model versus sham‐operated; (A) Negative ions (R2X 0.472, R2Y 0.984, Q2 0.366). (B) Positive ions (R2X 0.776, R2Y 0.998, Q2 0.658). (C) Negative ion replacement test. (D) Positive ion replacement tests. (E) Negative ion S‐plot. (F) Positive ion S‐plot. Figure 2 (G, H) Volcano diagram. (G) Negative ions. (H) Positive ions. ①Fold change (M/S) > 1.2 or <0.83, and ②p < 0.05 was the effective variable. Blue means down, red means up. Figure 2I model versus sham‐operated bar chart of differential metabolites. Red indicates an increase in the model group and green indicates a decrease in the model group. (J–O) OPLS‐DA: electro‐acupuncture versus sham‐operated; (J) Negative ions (R2X 0.702, R2Y 0.986, Q2 0.897). (K) Positive ions (R2X 0.878, R2Y 0.997, Q2 0.894). (l) Negative ion replacement test. (M) Positive ion replacement tests. (N) Negative ion S‐plot. (O) Positive ion S‐plot. Figure 2 (P, Q). Volcano diagram. (P) Negative ions. (Q) Positive ions. ①Fold change (E/S) > 1.2 or <0.83, and ②p < 0.05 was the effective variable. Blue means down, red means up.

TABLE 1.

Basic information of differential metabolites of model versus sham‐operated.

Name Formula Rt min Ion m/z VIP p (corr) p Value Fold change
CAR 2:0 C9H17NO4 0.75 M + H 204.1219 1.89 −0.70 0.0260 1.45
DG 34:0 C37H72O5 13.06 M + NH4 614.5725 1.48 0.59 0.0411 0.83
DG 36:2 C39H72O5 12.40 M + NH4 638.5734 1.14 0.65 0.0260 0.78
LPE O‐18:1;O C23H48NO7P 2.62 M‐H 480.3071 2.53 0.62 0.0152 0.96
PC 34:4 C42H76NO8P 8.89 M + FA‐H 798.5227 2.31 −0.68 0.0152 1.18
PC 40:4 C48H88NO8P 11.74 M + FA‐H 882.6202 1.50 −0.69 0.0411 1.25
PE 38:3 C43H80NO8P 10.22 M‐H 768.5568 1.08 −0.62 0.0411 1.19
PE O‐42:4 C47H88NO7P 11.00 M + FA‐H 854.6225 1.26 −0.68 0.0411 1.28
SM 41:1;O2 C46H93N2O6P 12.92 M + FA‐H 845.6714 3.69 −0.54 0.0411 1.11
TG 54:6 C57H98O6 15.46 M + NH4 896.7688 1.61 −0.69 0.0043 1.33
TG 56:7 C59H100O6 15.59 M + NH4 922.7829 4.02 −0.63 0.0411 1.19

3.2.2. Electroacupuncture affects 117 lipid metabolites in serum

Figure 2 (J–O) shows the OPLS‐DA plot for electro‐acupuncture versus sham‐operated, with a clear distinction between the two. Figure 2 (P,Q) shows the volcano plot for electro‐acupuncture versus sham‐operated, with red colour indicating variables upregulated after electro‐acupuncture, blue colour indicating variables downregulated after electro‐acupuncture, and grey colour indicating variables with no difference. The 117 differential metabolites of electro‐acupuncture versus sham‐operated were screened and identified, and it was seen that cholesteryl esters and sphingolipids were elevated after electro‐acupuncture, triglycerides were largely decreased after electro‐acupuncture with some triglycerides up‐regulated, and phospholipids showed no significant change pattern, the results are shown in Table 2. Detailed response changes are shown in Figure 3.

TABLE 2.

Basic information of differential metabolites of electro‐acupuncture versus Sham‐operated.

Name Formula Rt min Ion m/z VIP p (corr) p Value Fold change
CAR 2:0 C9H17NO4 0.75 M + H 204.1219 1.21 −0.78 0.0152 1.66
CE 18:2 C45H76O2 15.98 M + NH4 666.6158 3.09 −0.87 0.0022 1.80
CE 20:4 C47H76O2 15.68 M + NH4 690.6132 5.84 −0.93 0.0022 1.39
CE 22:4 C49H80O2 16.14 M + NH4 718.6475 1.74 −0.80 0.0022 1.57
CE 22:6 C49H76O2 15.35 M + NH4 714.6165 2.56 −0.92 0.0022 1.72
Cer 40:1;O2 C40H79NO3 13.33 M + FA‐H 666.6015 1.53 −0.74 0.0260 1.42
Cer 41:1;O2 C41H81NO3 13.66 M + FA‐H 680.6162 1.74 −0.76 0.0087 1.35
CerPE 38:1;O2 C40H81N2O6P 10.40 M + FA‐H 761.5775 1.19 −0.86 0.0022 2.00
DG 34:2 C37H68O5 11.71 M + NH4 610.5434 1.09 0.67 0.0260 0.56
DG 36:3 C39H70O5 11.73 M + NH4 636.5554 1.46 0.74 0.0152 0.52
DG 36:4 C39H68O5 11.01 M + NH4 634.5416 1.17 0.64 0.0411 0.55
HexCer 42:1;O2 C48H93NO8 13.42 M + FA‐H 856.6847 1.66 −0.78 0.0087 1.55
LPC 14:0 C22H46NO7P 1.78 M + FA‐H 512.2970 2.07 0.77 0.0022 0.86
LPC 16:0 C24H50NO7P 2.62 M + FA‐H 540.3283 8.08 0.85 0.0022 0.95
LPC 16:1 C24H48NO7P 1.92 M + FA‐H 538.3134 6.20 0.84 0.0022 0.51
LPC 17:0 C25H52NO7P 3.2 M + H 510.3542 1.72 −0.57 0.0152 1.27
LPC 17:1 C25H50NO7P 2.33 M + FA‐H 552.3290 1.44 0.83 0.0087 0.68
LPC 18:0 C26H54NO7P 3.56 M + FA‐H 568.3595 4.25 −0.84 0.0087 1.14
LPC 18:1 C26H52NO7P 2.71 M + FA‐H 566.3492 2.98 0.81 0.0043 0.78
LPC 18:2 C26H50NO7P 2.13 M + FA‐H 564.3283 12.87 0.91 0.0022 0.82
LPC 19:1 C27H54NO7P 3.34 M + FA‐H 580.3628 1.06 0.81 0.0043 0.70
LPC 20:2 C28H54NO7P 3.03 M + FA‐H 592.3576 2.21 0.85 0.0022 0.76
LPC 20:3 C28H52NO7P 2.43 M + FA‐H 590.3457 5.50 0.86 0.0022 0.55
LPC 20:4 C28H50NO7P 2.05 M + FA‐H 588.3278 4.68 0.61 0.0411 0.95
LPC 20:5 C28H48NO7P 1.62 M + FA‐H 586.3144 2.98 0.90 0.0022 0.52
LPC 22:6 C30H50NO7P 1.9 M + FA‐H 612.3289 3.44 0.79 0.0260 0.86
LPE O‐18:1;O C23H48NO7P 2.62 M‐H 480.3071 2.00 0.81 0.0043 0.93
PC 32:0 C40H80NO8P 10.86 M + FA‐H 778.5571 2.45 −0.77 0.0087 1.17
PC 32:1 C40H78NO8P 9.95 M + H 732.5520 2.66 0.74 0.0087 0.61
PC 34:0 C42H84NO8P 11.73 M + FA‐H 806.5884 2.15 −0.76 0.0152 1.20
PC 34:1 C42H82NO8P 10.89 M + FA‐H 804.5726 5.73 0.76 0.0087 0.81
PC 34:2 C42H80NO8P 10.13 M + FA‐H 802.5553 6.30 0.70 0.0411 0.91
PC 34:3 C42H78NO8P 9.17 M + FA‐H 800.5409 2.47 0.83 0.0022 0.79
PC 35:2 C43H82NO8P 10.63 M + H 772.5835 2.16 −0.54 0.0411 1.18
PC 35:4 C43H78NO8P 9.43 M + H 768.5561 1.79 −0.58 0.0260 1.49
PC 36:0 C44H88NO8P 12.50 M + FA‐H 834.6222 1.52 −0.93 0.0022 1.42
PC 36:2 C44H84NO8P 11.09 M + H 786.5969 2.78 −0.78 0.0087 1.04
PC 36:3 C44H82NO8P 10.36 M + FA‐H 828.5711 6.54 0.81 0.0087 0.78
PC 36:4 C44H80NO8P 9.94 M + H 782.5660 4.17 −0.84 0.0022 1.09
PC 36:5 C44H78NO8P 9.23 M + FA‐H 824.5439 1.78 0.69 0.0260 0.73
PC 37:4 C45H82NO8P 10.46 M + FA‐H 840.5739 3.04 −0.63 0.0260 1.45
PC 38:2 C46H88NO8P 11.84 M + FA‐H 858.6198 1.85 0.68 0.0260 0.87
PC 38:4 C46H84NO8P 10.92 M + FA‐H 854.5866 7.74 −0.70 0.0260 1.17
PC 38:4 C46H84NO8P 10.33 M + FA‐H 854.5860 3.07 0.91 0.0022 0.72
PC 38:5 C46H82NO8P 10.00 M + FA‐H 852.5739 2.73 0.69 0.0152 0.86
PC 38:6 C46H80NO8P 9.63 M + H 806.5649 3.49 −0.89 0.0022 1.09
PC 38:6 C46H80NO8P 9.19 M + H 806.5679 3.16 −0.71 0.0260 1.16
PC 40:6 C48H84NO8P 10.64 M + FA‐H 878.5869 3.48 −0.67 0.0260 1.12
PC 40:7 C48H82NO8P 9.7 M + FA‐H 876.5757 1.94 0.85 0.0043 0.75
PC 40:8 C48H80NO8P 8.94 M + FA‐H 874.5584 1.84 −0.75 0.0087 1.15
PC O‐34:1 C42H84NO7P 11.43 M + FA‐H 790.5953 1.08 −0.75 0.0152 1.19
PC O‐36:5 C44H80NO7P 10.38 M + FA‐H 810.5664 1.48 −0.85 0.0043 1.53
PE 34:2 C39H74NO8P 10.42 M‐H 714.5078 1.36 0.85 0.0022 0.63
PE 36:2 C41H78NO8P 11.34 M‐H 742.5356 2.07 0.86 0.0022 0.60
PE 36:4 C41H74NO8P 10.22 M‐H 738.5123 1.01 0.73 0.0087 0.69
PE 38:4 C43H78NO8P 11.16 M‐H 766.5366 1.42 0.61 0.0411 0.79
PE O‐36:5 C41H74NO7P 10.67 M‐H 722.5137 1.57 −0.86 0.0022 1.60
PE O‐38:5 C43H78NO7P 11.58 M‐H 750.5406 2.17 −0.90 0.0022 1.68
PE O‐38:5 C43H78NO7P 11.33 M‐H 750.5447 1.24 −0.89 0.0022 1.76
PE O‐38:6 C43H76NO7P 10.72 M‐H 748.5301 1.56 −0.87 0.0022 1.45
PE O‐38:7 C43H74NO7P 10.37 M‐H 746.5078 1.08 −0.83 0.0022 1.43
PE O‐40:4 C45H84NO7P 12.26 M‐H 780.5909 1.32 −0.91 0.0022 2.02
PE O‐40:4 C45H84NO7P 12.47 M‐H 780.5890 1.22 −0.88 0.0022 2.05
PE O‐40:5 C45H82NO7P 12.15 M‐H 778.5738 1.49 −0.94 0.0022 1.81
PE O‐40:5 C45H82NO7P 12.37 M‐H 778.5716 1.17 −0.94 0.0022 1.66
PE O‐40:6 C45H80NO7P 11.57 M‐H 776.5602 1.35 −0.92 0.0022 1.59
PE O‐40:7 C45H78NO7P 11.28 M‐H 774.5435 1.13 −0.94 0.0022 1.67
PE O‐42:4 C47H88NO7P 12.95 M‐H 808.6168 1.01 −0.85 0.0043 2.02
PE O‐42:6 C47H84NO7P 12.34 M‐H 804.5895 1.06 −0.90 0.0022 1.71
SM 33:1;O2 C38H77N2O6P 9.26 M + H 689.5599 1.33 −0.83 0.0043 1.38
SM 36:1;O2 C41H83N2O6P 10.88 M + FA‐H 775.5962 1.55 −0.85 0.0022 1.63
SM 40:1;O2 C45H91N2O6P 12.59 M + FA‐H 831.6596 3.96 −0.89 0.0043 1.39
SM 40:2;O2 C45H89N2O6P 11.73 M + H 785.6541 1.49 −0.78 0.0043 1.40
SM 41:1;O2 C46H93N2O6P 12.92 M + FA‐H 845.6714 4.35 −0.75 0.0022 1.44
SM 42:1;O2 C47H95N2O6P 13.26 M + FA‐H 859.6842 5.99 −0.82 0.0043 1.26
SM 43:1;O2 C48H97N2O6P 13.46 M + FA‐H 873.7043 2.53 −0.76 0.0043 1.33
SM 43:2;O2 C48H95N2O6P 12.84 M + FA‐H 871.6880 1.32 −0.66 0.0152 1.27
TG 48:0 C51H98O6 16.62 M + NH4 824.7692 1.48 0.88 0.0022 0.47
TG 48:1 C51H96O6 16.00 M + NH4 822.7537 2.08 0.75 0.0087 0.34
TG 48:2 C51H94O6 15.42 M + NH4 820.7375 2.63 0.77 0.0043 0.28
TG 48:3 C51H92O6 14.94 M + NH4 818.7248 1.39 0.86 0.0022 0.27
TG 49:1 C52H98O6 16.26 M + NH4 836.7679 1.39 0.85 0.0022 0.34
TG 49:2 C52H96O6 15.72 M + NH4 834.7527 2.00 0.90 0.0022 0.35
TG 49:3 C52H94O6 15.22 M + NH4 832.7388 1.17 0.92 0.0022 0.32
TG 50:1 C53H100O6 16.57 M + NH4 850.7825 3.92 0.79 0.0087 0.45
TG 50:2 C53H98O6 15.97 M + NH4 848.7664 6.43 0.81 0.0022 0.42
TG 50:3 C53H96O6 15.47 M + NH4 846.7517 5.12 0.83 0.0043 0.39
TG 50:4 C53H94O6 14.96 M + NH4 844.7417 2.83 0.92 0.0022 0.36
TG 51:2 C54H100O6 16.24 M + NH4 862.7850 2.53 0.82 0.0022 0.38
TG 51:3 C54H98O6 15.71 M + NH4 860.7677 2.70 0.91 0.0022 0.42
TG 51:4 C54H96O6 15.26 M + NH4 858.7551 1.97 0.94 0.0022 0.43
TG 52:1 C55H104O6 17.18 M + NH4 878.8185 1.64 0.71 0.0152 0.52
TG 52:2 C55H102O6 16.56 M + NH4 876.7966 7.35 0.79 0.0087 0.53
TG 52:3 C55H100O6 15.99 M + NH4 874.7787 6.55 0.86 0.0043 0.74
TG 52:4 C55H98O6 15.51 M + NH4 872.7644 5.93 0.87 0.0043 0.75
TG 52:5 C55H96O6 15.09 M + NH4 870.7541 4.54 0.89 0.0022 0.52
TG 52:5 C55H96O6 15.95 M + H 853.7278 1.25 0.78 0.0087 0.55
TG 53:2 C56H104O6 16.85 M + NH4 890.8129 1.10 0.77 0.0087 0.50
TG 53:3 C56H102O6 16.32 M + NH4 888.7928 1.82 0.84 0.0022 0.52
TG 53:4 C56H100O6 15.79 M + NH4 886.7815 1.72 0.90 0.0022 0.56
TG 53:5 C56H98O6 15.24 M + NH4 884.7687 1.08 0.89 0.0022 0.60
TG 54:2 C57H106O6 17.12 M + NH4 904.8272 2.05 0.76 0.0087 0.47
TG 54:3 C57H104O6 16.57 M + NH4 902.8122 4.09 0.83 0.0022 0.57
TG 54:4 C57H102O6 15.99 M + NH4 900.7970 5.25 0.84 0.0022 0.61
TG 54:5 C57H100O6 15.52 M + NH4 898.7803 5.89 0.88 0.0022 0.57
TG 54:6 C57H98O6 15.04 M + NH4 896.7657 6.28 0.87 0.0022 0.39
TG 54:7 C57H96O6 14.62 M + NH4 894.7518 2.94 0.85 0.0043 0.34
TG 54:8 C57H94O6 14.59 M + NH4 892.7418 1.32 0.91 0.0022 0.48
TG 56:3 C59H108O6 17.15 M + NH4 930.8400 1.22 0.71 0.0087 0.51
TG 56:4 C59H106O6 16.52 M + NH4 928.8289 1.69 0.76 0.0087 0.67
TG 56:5 C59H104O6 16.26 M + NH4 926.8127 2.42 0.76 0.0087 0.78
TG 56:6 C59H102O6 15.02 M + NH4 924.7995 1.53 0.88 0.0022 0.55
TG 56:7 C59H100O6 15.59 M + NH4 922.7829 2.11 0.84 0.0022 0.82
TG 58:11 C61H96O6 14.31 M + NH4 942.7602 1.07 −0.70 0.0152 2.09
TG 60:10 C63H102O6 15.09 M + NH4 972.8038 1.49 −0.77 0.0087 1.91
TG 60:11 C63H100O6 14.85 M + NH4 970.7877 1.32 −0.72 0.0411 2.34
TG 60:12 C63H98O6 14.47 M + NH4 968.7703 1.70 −0.75 0.0043 4.05
FIGURE 3.

FIGURE 3

Bar chart of electro‐acupuncture versus sham‐operated differential metabolites. Red indicates an increase in the electroacupuncture group and green indicates a decrease in the electroacupuncture group. (A) Sphingolipids. (B) Cholesteryl esters. (C) Glycerides. (D) Glycerophospholipids.

3.2.3. Electro‐acupuncture and modelling can trigger different lipid metabolites in serum

Figure 4 (A–F) shows the OPLS‐DA plots for electro‐acupuncture versus model, which shows that the two groups are clearly differentiated and the model is valid. Figure 4 (G–H) shows the volcano plot for electro‐acupuncture versus model, with red colour indicating variables that were upregulated after electroacupuncture, blue colour indicating variables that were downregulated after electroacupuncture, and grey colour indicating variables with no difference. The 115 differential metabolites of the electro‐acupuncture versus model were screened and identified, and the pattern of differential metabolite changes was consistent with the results of 3.2.2, and the results are shown in Table 3. Detailed response changes are shown in Figure 5.

FIGURE 4.

FIGURE 4

(A–F) OPLS‐DA: Electro‐acupuncture versus Model; (A) Negative ions (R2X 0.736, R2Y 0.999, Q2 0.949). (B) Positive ions (R2X 0.892, R2Y 1.000, Q2 0.933). (C) Negative ion replacement test. (D) Positive ion replacement tests. (E) Negative ion S‐plot. (F) Positive ion S‐plot. Figure 5 (G, H). Volcano diagram. (G) Negative ions. (H) Positive ions. ①Fold change (E/M) > 1.2 or <0.83, and ②p < 0.05 was the effective variable. Blue means down, red means up.

TABLE 3.

Basic information of differential metabolites of electro‐acupuncture versus model.

Name Formula Rt min Ion m/z VIP p (corr) p Value Fold change
CE 18:2 C45H76O2 15.98 M + NH4 666.6158 2.96 −0.88 0.0022 1.86
CE 20:4 C47H76O2 15.68 M + NH4 690.6132 5.87 −0.94 0.0022 1.47
CE 22:4 C49H80O2 16.14 M + NH4 718.6475 1.64 −0.77 0.0087 1.53
CE 22:6 C49H76O2 15.35 M + NH4 714.6165 2.56 −0.93 0.0022 1.92
Cer 40:1;O2 C40H79NO3 13.33 M + FA‐H 666.6015 1.40 −0.74 0.0152 1.35
Cer 41:1;O2 C41H81NO3 13.66 M + FA‐H 680.6162 1.22 −0.61 0.0411 1.20
CerPE 38:1;O2 C40H81N2O6P 10.40 M + FA‐H 761.5775 1.19 −0.88 0.0022 2.00
DG 36:3 C39H70O5 11.73 M + NH4 636.5554 1.20 0.65 0.0411 0.59
DG 36:4 C39H68O5 11.01 M + NH4 634.5416 1.05 0.58 0.0260 0.59
HexCer 42:1;O2 C48H93NO8 13.42 M + FA‐H 856.6847 1.65 −0.81 0.0087 1.56
LPC 14:0 C22H46NO7P 1.78 M + FA‐H 512.297 1.71 0.78 0.0087 0.90
LPC 16:1 C24H48NO7P 1.92 M + FA‐H 538.3134 6.35 0.77 0.0022 0.49
LPC 17:0 C25H52NO7P 3.2 M + H 510.3542 1.68 −0.56 0.0260 1.29
LPC 17:1 C25H50NO7P 2.33 M + FA‐H 552.329 1.50 0.85 0.0022 0.65
LPC 18:0 C26H54NO7P 3.56 M + FA‐H 568.3595 4.78 −0.82 0.0043 1.20
LPC 18:2 C26H50NO7P 2.13 M + FA‐H 564.3283 12.79 0.88 0.0022 0.81
LPC 19:1 C27H54NO7P 3.34 M + FA‐H 580.3628 1.14 0.84 0.0022 0.67
LPC 20:1 C28H56NO7P 3.98 M + FA‐H 594.3771 1.08 −0.59 0.0260 1.11
LPC 20:2 C28H54NO7P 3.03 M + FA‐H 592.3576 2.13 0.80 0.0043 0.75
LPC 20:3 C28H52NO7P 2.43 M + FA‐H 590.3457 5.68 0.88 0.0022 0.52
LPC 20:5 C28H48NO7P 1.62 M + FA‐H 586.3144 2.74 0.78 0.0022 0.55
LPC 22:5 C30H52NO7P 2.42 M + FA‐H 614.3463 1.07 0.53 0.0411 0.73
PC 32:1 C40H78NO8P 9.95 M + H 732.552 2.74 0.65 0.0152 0.57
PC 32:2 C40H76NO8P 9.07 M + FA‐H 774.5251 1.48 0.71 0.0152 0.89
PC 34:0 C42H84NO8P 11.73 M + FA‐H 806.5884 2.23 −0.80 0.0043 1.22
PC 34:1 C42H82NO8P 10.89 M + FA‐H 804.5726 5.21 0.65 0.0152 0.83
PC 34:2 C42H80NO8P 10.13 M + FA‐H 802.5553 5.48 0.59 0.0411 0.93
PC 34:3 C42H78NO8P 9.17 M + FA‐H 800.5409 2.79 0.75 0.0022 0.74
PC 36:0 C44H88NO8P 12.50 M + FA‐H 834.6222 1.35 −0.83 0.0022 1.35
PC 36:2 C44H84NO8P 11.09 M + H 786.5969 2.49 −0.69 0.0260 1.04
PC 36:3 C44H82NO8P 10.36 M + FA‐H 828.5711 7.33 0.85 0.0022 0.73
PC 36:3 C44H82NO8P 10.57 M + FA‐H 828.5763 1.77 0.66 0.0411 0.58
PC 36:4 C44H80NO8P 9.94 M + H 782.566 3.73 −0.87 0.0022 1.08
PC 36:5 C44H78NO8P 9.23 M + FA‐H 824.5439 2.04 0.73 0.0043 0.67
PC 36:5 C44H78NO8P 8.99 M + FA‐H 824.5422 1.92 0.57 0.0411 0.76
PC 37:2 C45H86NO8P 11.49 M + FA‐H 844.6031 2.05 0.75 0.0043 0.81
PC 38:2 C46H88NO8P 11.84 M + FA‐H 858.6198 2.32 0.73 0.0087 0.81
PC 38:3 C46H86NO8P 11.30 M + FA‐H 856.6046 4.66 0.63 0.0260 0.76
PC 38:4 C46H84NO8P 10.92 M + FA‐H 854.5866 5.85 −0.58 0.0411 1.11
PC 38:4 C46H84NO8P 10.33 M + FA‐H 854.586 3.55 0.90 0.0022 0.65
PC 38:5 C46H82NO8P 10.00 M + FA‐H 852.5739 3.78 0.77 0.0087 0.80
PC 38:6 C46H80NO8P 9.63 M + H 806.5649 3.65 −0.93 0.0022 1.11
PC 40:6 C48H84NO8P 10.64 M + FA‐H 878.5869 3.58 −0.62 0.0260 1.16
PC 40:6 C48H84NO8P 10.13 M + FA‐H 878.5936 1.38 0.80 0.0043 0.74
PC 40:7 C48H82NO8P 9.7 M + FA‐H 876.5757 2.31 0.80 0.0043 0.68
PC O‐36:5 C44H80NO7P 10.38 M + FA‐H 810.5664 1.26 −0.83 0.0043 1.37
PE 34:2 C39H74NO8P 10.42 M‐H 714.5078 1.54 0.87 0.0022 0.57
PE 36:2 C41H78NO8P 11.34 M‐H 742.5356 2.36 0.87 0.0022 0.53
PE 36:4 C41H74NO8P 10.22 M‐H 738.5123 1.29 0.81 0.0022 0.60
PE 38:4 C43H78NO8P 11.16 M‐H 766.5366 1.94 0.74 0.0087 0.70
PE O‐36:5 C41H74NO7P 10.67 M‐H 722.5137 1.19 −0.66 0.0411 1.39
PE O‐38:5 C43H78NO7P 11.58 M‐H 750.5406 1.82 −0.79 0.0043 1.47
PE O‐38:5 C43H78NO7P 11.33 M‐H 750.5447 1.09 −0.82 0.0043 1.62
PE O‐38:6 C43H76NO7P 10.72 M‐H 748.5301 1.21 −0.72 0.0087 1.30
PE O‐40:4 C45H84NO7P 12.26 M‐H 780.5909 1.18 −0.90 0.0022 1.73
PE O‐40:4 C45H84NO7P 12.47 M‐H 780.589 1.08 −0.82 0.0043 1.79
PE O‐40:5 C45H82NO7P 12.15 M‐H 778.5738 1.31 −0.92 0.0022 1.58
PE O‐40:5 C45H82NO7P 12.37 M‐H 778.5716 1.03 −0.84 0.0022 1.53
PE O‐40:6 C45H80NO7P 11.57 M‐H 776.5602 1.24 −0.91 0.0022 1.50
PE O‐40:7 C45H78NO7P 11.28 M‐H 774.5435 1.01 −0.89 0.0022 1.55
SM 33:1;O2 C38H77N2O6P 9.26 M + H 689.5599 1.32 −0.84 0.0022 1.45
SM 34:1;O2 C39H79N2O6P 9.85 M + FA‐H 747.5638 5.35 −0.81 0.0022 1.26
SM 34:2;O2 C39H77N2O6P 8.79 M + H 701.5589 1.09 −0.64 0.0411 1.33
SM 36:1;O2 C41H83N2O6P 10.88 M + FA‐H 775.5962 1.62 −0.86 0.0022 1.69
SM 40:1;O2 C45H91N2O6P 12.59 M + FA‐H 831.6596 3.44 −0.86 0.0043 1.28
SM 40:2;O2 C45H89N2O6P 11.73 M + H 785.6541 1.46 −0.77 0.0087 1.48
SM 41:1;O2 C46H93N2O6P 12.92 M + FA‐H 845.6714 3.65 −0.69 0.0087 1.30
SM 41:2;O2 C46H91N2O6P 12.25 M + FA‐H 843.6561 1.93 −0.57 0.0260 1.30
SM 42:1;O2 C47H95N2O6P 13.26 M + FA‐H 859.6842 5.23 −0.80 0.0260 1.21
SM 42:2;O2 C47H93N2O6P 12.50 M + FA‐H 857.6718 4.99 −0.69 0.0260 1.18
SM 42:3;O2 C47H91N2O6P 11.79 M + FA‐H 855.6544 3.13 −0.65 0.0260 1.23
SM 43:1;O2 C48H97N2O6P 13.46 M + FA‐H 873.7043 2.27 −0.78 0.0087 1.28
SM 43:2;O2 C48H95N2O6P 12.84 M + FA‐H 871.688 1.43 −0.76 0.0043 1.34
SPB 16:0;O2 C16H35NO2 1.13 M + H 274.2719 2.10 −0.52 0.0411 1.16
SPB 18:0;O2 C18H39NO2 1.52 M + H 302.3032 1.04 −0.67 0.0152 1.19
TG 48:0 C51H98O6 16.62 M + NH4 824.7692 1.33 0.86 0.0022 0.48
TG 48:1 C51H96O6 16.00 M + NH4 822.7537 1.79 0.70 0.0152 0.38
TG 48:2 C51H94O6 15.42 M + NH4 820.7375 2.31 0.69 0.0043 0.31
TG 48:3 C51H92O6 14.94 M + NH4 818.7248 1.25 0.75 0.0043 0.29
TG 49:1 C52H98O6 16.26 M + NH4 836.7679 1.19 0.85 0.0022 0.38
TG 49:2 C52H96O6 15.72 M + NH4 834.7527 1.77 0.90 0.0022 0.37
TG 49:3 C52H94O6 15.22 M + NH4 832.7388 1.04 0.87 0.0022 0.34
TG 50:1 C53H100O6 16.57 M + NH4 850.7825 3.42 0.80 0.0087 0.49
TG 50:2 C53H98O6 15.97 M + NH4 848.7664 5.70 0.81 0.0022 0.45
TG 50:3 C53H96O6 15.47 M + NH4 846.7517 4.66 0.78 0.0043 0.41
TG 50:4 C53H94O6 14.96 M + NH4 844.7417 2.61 0.88 0.0022 0.37
TG 51:2 C54H100O6 16.24 M + NH4 862.785 2.17 0.82 0.0043 0.42
TG 51:3 C54H98O6 15.71 M + NH4 860.7677 2.30 0.89 0.0022 0.46
TG 51:4 C54H96O6 15.26 M + NH4 858.7551 1.78 0.93 0.0022 0.44
TG 52:1 C55H104O6 17.18 M + NH4 878.8185 1.49 0.71 0.0152 0.53
TG 52:2 C55H102O6 16.56 M + NH4 876.7966 6.36 0.77 0.0087 0.57
TG 52:3 C55H100O6 15.99 M + NH4 874.7787 5.87 0.86 0.0022 0.76
TG 52:4 C55H98O6 15.51 M + NH4 872.7644 5.92 0.88 0.0043 0.73
TG 52:4 C55H98O6 15.86 M + NH4 872.7717 1.24 0.79 0.0087 0.65
TG 52:5 C55H96O6 15.09 M + NH4 870.7541 4.46 0.90 0.0022 0.51
TG 52:5 C55H96O6 15.95 M + H 853.7278 1.04 0.75 0.0087 0.61
TG 53:3 C56H102O6 16.32 M + NH4 888.7928 1.55 0.83 0.0043 0.56
TG 53:4 C56H100O6 15.79 M + NH4 886.7815 1.57 0.90 0.0022 0.58
TG 54:2 C57H106O6 17.12 M + NH4 904.8272 1.82 0.79 0.0087 0.49
TG 54:3 C57H104O6 16.57 M + NH4 902.8122 3.84 0.89 0.0022 0.57
TG 54:4 C57H102O6 15.99 M + NH4 900.797 5.26 0.90 0.0022 0.58
TG 54:5 C57H100O6 15.52 M + NH4 898.7803 5.69 0.89 0.0022 0.56
TG 54:5 C57H100O6 15.85 M + NH4 898.7812 2.10 0.67 0.0152 0.81
TG 54:6 C57H98O6 15.04 M + NH4 896.7657 6.07 0.90 0.0022 0.38
TG 54:6 C57H98O6 15.46 M + NH4 896.7688 1.08 0.88 0.0022 0.57
TG 54:7 C57H96O6 14.62 M + NH4 894.7518 2.85 0.85 0.0022 0.33
TG 54:8 C57H94O6 14.59 M + NH4 892.7418 1.35 0.92 0.0022 0.44
TG 56:3 C59H108O6 17.15 M + NH4 930.84 1.11 0.76 0.0087 0.53
TG 56:4 C59H106O6 16.52 M + NH4 928.8289 1.60 0.79 0.0043 0.66
TG 56:5 C59H104O6 16.26 M + NH4 926.8127 2.34 0.74 0.0087 0.78
TG 56:6 C59H102O6 15.80 M + NH4 924.7982 3.09 0.77 0.0022 0.77
TG 56:6 C59H102O6 15.02 M + NH4 924.7995 1.25 0.79 0.0043 0.62
TG 56:7 C59H100O6 15.31 M + NH4 922.7825 3.86 0.72 0.0043 0.69
TG 56:7 C59H100O6 15.59 M + NH4 922.7829 2.93 0.87 0.0022 0.69
TG 56:8 C59H98O6 15.12 M + NH4 920.7671 4.47 0.68 0.0152 0.66
FIGURE 5.

FIGURE 5

Bar chart of electro‐acupuncture versus Model differential metabolites. Red indicates an increase in the electroacupuncture group and green indicates a decrease in the electroacupuncture group. (A) Sphingolipids. (B) Cholesteryl esters. (C) Glycerides. (D) Glycerophospholipids.

3.2.4. Different metabolite profiles in different groups

PLS‐DA analysis was performed for all groups to observe the trend of the overall metabolic group of the three groups. The results are shown in Figure 6 (A–D), model, electro‐acupuncture and sham‐operated were distinguishable between all three groups, the model group was relatively close to the sham‐operated group and the electroacupuncture group was more clearly distinguished from the other two groups, suggesting the overall lipidome migrated more after electroacupuncture, which is generally consistent with previous results. All differential metabolites involved in the three groups were summarized by venn diagram (Figure 6E): the red box surrounded by the number of differential lipids for model versus sham‐operated, 11 in total; the blue box surrounded by the number of differential lipids for electro‐acupuncture versus model, 115 in total; and the green box surrounded by the number of differential lipids for electro‐acupuncture versus sham‐operated was 117. There are only two differential lipids common to all three groups. And 94 metabolites that overlap between electro‐acupuncture versus model and electro‐acupuncture versus sham‐operated (Table 4), mainly included glycerol esters, phospholipids and sphingolipids, and the trend of response changes after electroacupuncture was the same, which likewise indicated that the electroacupuncture had a much more pronounced effect on the serum lipid group than the model group.

FIGURE 6.

FIGURE 6

(A–D) PLS‐DA diagram of all samples. (A) PLS‐DA plot in negative ion mode (R2X 0.721, R2Y 0.963, Q2 0.844), (B) PLS‐DA plot in positive ion mode (R2X 0.777, R2Y 0.907, Q2 0.741), (C) Negative ion replacement test, (D) Positive ion replacement test. Figure 7E Venn diagram of the number of differential metabolites. The red box Model versus sham‐operated, the blue box electro‐acupuncture versus Model and the green box electro‐acupuncture versus sham‐operated.

TABLE 4.

Common differential lipid information after electroacupuncture.

Name Formula Rt min Fold change
E vs. M E vs. S
TG 48:3 C51H92O6 14.94 0.29 0.27
TG 48:2 C51H94O6 15.42 0.31 0.28
TG 49:3 C52H94O6 15.22 0.34 0.32
TG 48:1 C51H96O6 16.00 0.38 0.34
TG 54:7 C57H96O6 14.62 0.33 0.34
TG 49:1 C52H98O6 16.26 0.38 0.34
TG 49:2 C52H96O6 15.72 0.37 0.35
TG 50:4 C53H94O6 14.96 0.37 0.36
TG 51:2 C54H100O6 16.24 0.42 0.38
TG 50:3 C53H96O6 15.47 0.41 0.39
TG 54:6 C57H98O6 15.04 0.38 0.39
TG 50:2 C53H98O6 15.97 0.45 0.42
TG 51:3 C54H98O6 15.71 0.46 0.42
TG 51:4 C54H96O6 15.26 0.44 0.43
TG 50:1 C53H100O6 16.57 0.49 0.45
TG 54:2 C57H106O6 17.12 0.49 0.47
TG 48:0 C51H98O6 16.62 0.48 0.47
TG 54:8 C57H94O6 14.59 0.44 0.48
TG 56:3 C59H108O6 17.15 0.53 0.51
LPC 16:1 C24H48NO7P 1.92 0.49 0.51
TG 52:1 C55H104O6 17.18 0.53 0.52
LPC 20:5 C28H48NO7P 1.62 0.55 0.52
DG 36:3 C39H70O5 11.73 0.59 0.52
TG 53:3 C56H102O6 16.32 0.56 0.52
TG 52:5 C55H96O6 15.09 0.51 0.52
TG 52:2 C55H102O6 16.56 0.57 0.53
LPC 20:3 C28H52NO7P 2.43 0.52 0.55
DG 36:4 C39H68O5 11.01 0.59 0.55
TG 52:5 C55H96O6 15.95 0.61 0.55
TG 56:6 C59H102O6 15.02 0.62 0.55
TG 53:4 C56H100O6 15.79 0.58 0.56
TG 54:3 C57H104O6 16.57 0.57 0.57
TG 54:5 C57H100O6 15.52 0.56 0.57
PE 36:2 C41H78NO8P 11.34 0.53 0.60
TG 54:4 C57H102O6 15.99 0.58 0.61
PC 32:1 C40H78NO8P 9.95 0.57 0.61
PE 34:2 C39H74NO8P 10.42 0.57 0.63
TG 56:4 C59H106O6 16.52 0.66 0.67
LPC 17:1 C25H50NO7P 2.33 0.65 0.68
PE 36:4 C41H74NO8P 10.22 0.60 0.69
LPC 19:1 C27H54NO7P 3.34 0.67 0.70
PC 38:4 C46H84NO8P 10.33 0.65 0.72
PC 36:5 C44H78NO8P 9.23 0.67 0.73
TG 52:3 C55H100O6 15.99 0.76 0.74
TG 52:4 C55H98O6 15.51 0.73 0.75
PC 40:7 C48H82NO8P 9.7 0.68 0.75
LPC 20:2 C28H54NO7P 3.03 0.75 0.76
PC 36:3 C44H82NO8P 10.36 0.73 0.78
TG 56:5 C59H104O6 16.26 0.78 0.78
PE 38:4 C43H78NO8P 11.16 0.70 0.79
PC 34:3 C42H78NO8P 9.17 0.74 0.79
PC 34:1 C42H82NO8P 10.89 0.83 0.81
TG 56:7 C59H100O6 15.59 0.69 0.82
LPC 18:2 C26H50NO7P 2.13 0.81 0.82
PC 38:5 C46H82NO8P 10.00 0.80 0.86
LPC 14:0 C22H46NO7P 1.78 0.90 0.86
PC 38:2 C46H88NO8P 11.84 0.81 0.87
PC 34:2 C42H80NO8P 10.13 0.93 0.91
PC 36:2 C44H84NO8P 11.09 1.04 1.04
PC 38:6 C46H80NO8P 9.63 1.11 1.09
PC 36:4 C44H80NO8P 9.94 1.08 1.09
PC 40:6 C48H84NO8P 10.64 1.16 1.12
LPC 18:0 C26H54NO7P 3.56 1.20 1.14
PC 38:4 C46H84NO8P 10.92 1.11 1.17
PC 34:0 C42H84NO8P 11.73 1.22 1.20
SM 42:1;O2 C47H95N2O6P 13.26 1.21 1.26
SM 43:2;O2 C48H95N2O6P 12.84 1.34 1.27
LPC 17:0 C25H52NO7P 3.2 1.29 1.27
SM 43:1;O2 C48H97N2O6P 13.46 1.28 1.33
Cer 41:1;O2 C41H81NO3 13.66 1.20 1.35
SM 33:1;O2 C38H77N2O6P 9.26 1.45 1.38
CE 20:4 C47H76O2 15.68 1.47 1.39
SM 40:1;O2 C45H91N2O6P 12.59 1.28 1.39
SM 40:2;O2 C45H89N2O6P 11.73 1.48 1.40
PC 36:0 C44H88NO8P 12.50 1.35 1.42
Cer 40:1;O2 C40H79NO3 13.33 1.35 1.42
SM 41:1;O2 C46H93N2O6P 12.92 1.30 1.44
PE O‐38:6 C43H76NO7P 10.72 1.30 1.45
PC O‐36:5 C44H80NO7P 10.38 1.37 1.53
HexCer 42:1;O2 C48H93NO8 13.42 1.56 1.55
CE 22:4 C49H80O2 16.14 1.53 1.57
PE O‐40:6 C45H80NO7P 11.57 1.50 1.59
PE O‐36:5 C41H74NO7P 10.67 1.39 1.60
SM 36:1;O2 C41H83N2O6P 10.88 1.69 1.63
PE O‐40:5 C45H82NO7P 12.37 1.53 1.66
PE O‐40:7 C45H78NO7P 11.28 1.55 1.67
PE O‐38:5 C43H78NO7P 11.58 1.47 1.68
CE 22:6 C49H76O2 15.35 1.92 1.72
PE O‐38:5 C43H78NO7P 11.33 1.62 1.76
CE 18:2 C45H76O2 15.98 1.86 1.80
PE O‐40:5 C45H82NO7P 12.15 1.58 1.81
CerPE 38:1;O2 C40H81N2O6P 10.40 2.00 2.00
PE O‐40:4 C45H84NO7P 12.26 1.73 2.02
PE O‐40:4 C45H84NO7P 12.47 1.79 2.05

3.3. Metabolomics pathway analysis of SD rat venous serum after electro‐acupuncture

The results of pathway enrichment analysis from different lipid classification levels showed that electroacupuncture mainly affected the lipids associated with four pathways: cholesteryl esters, sphingolipids, glycerides and phospholipids (the redder the colour, the more significant the expression of the pathway; the longer the bar or the larger the point, the more lipids matched in the pathway). And the metabolic pathways were further refined and analysed from the intermediate and lowermost lipid categories, see Figure 7 (A–F).

FIGURE 7.

FIGURE 7

Lipid metabolism enrichment analysis. (A) Top lipid classification, enrichment analysis bar chart. (B) Top lipid classification, enrichment analysis dot plot. (C) Intermediate lipid classification, enrichment analysis bar chart. (D) Intermediate lipid classification, enrichment analysis dot plot. (E) The lowest lipid classification, enrichment analysis bar chart. (F) The lowest lipid classification, enrichment analysis dot plot.

3.4. Post‐operative wound perfusion volume and area changes

On post‐operative day 1, the haemoperfusion volume in the model and electroacupuncture groups was comparable but significantly greater than that in the sham‐operated group, and the difference was statistically significant (p < 0.05). On post‐operative days 4 and 7, the perfusion volume of the model group and electroacupuncture group gradually decreased, but the perfusion volume of the model group was greater than that of the other two groups, and the difference was statistically significant (p < 0.05) and the results are shown in Figure 8 (A,B).On post‐operative days 4 and 7, the wound healing rate of the electroacupuncture group was faster than that of the model group, and the difference was statistically significant (p < 0.05), and the results are shown in Figure 8C.

FIGURE 8.

FIGURE 8

(A) The wounds of the three groups at different time points after surgery, the corresponding blood perfusion imaging images and the histological examination results of the three groups at 7 days after operation (X200) were compared. (B) Comparison of wound blood perfusion volume in the three groups at different time points after surgery. (C) Comparison of wound healing rate between Model group and electro‐acupunture at different time points after surgery.

3.5. Histological and immunohistochemical results

On the 7th post‐operative day, epithelial cells and fibroblasts were hyperplastic in the electro‐acupuncture group, collagen fibres were densely arranged, muscle fibres were more abundant and a thinner new epidermal layer was visible. And the skin repair status of the model group was weaker than that of the electroacupuncture group. See Figure 8A.

4. DISCUSSION

The stratum corneum (SC) of the skin plays a key role in the formation and maintenance of the skin barrier, and lipids are an important component of the SC, forming a well‐structured lipid matrix. 15 , 16 Differentiated keratin‐forming cells in the epidermis synthesize cholesterol, ceramide (CER), and free fatty acids (FFA), which form the major lipid classes present in the SC. 17 Therefore, the metabolic processes of these lipids may play a key role in the skin wound repair process.

In this study, changes in lipid metabolism of serum were found in both the electroacupuncture and model groups. There were 11 differential metabolites for model versus sham‐operated, 115 differential metabolites for electro‐acupuncture versus model, and 117 differential metabolites for electro‐acupuncture versus sham‐operated. There are two differential lipids common to all three groups. And 94 metabolites that overlap between electro‐acupuncture versus model and electro‐acupuncture versus sham‐operated (Figure 4), mainly included glycerol esters, phospholipids and sphingolipids, and the trend of response changes after electroacupuncture was the same. Further metabolic pathway analysis revealed that electroacupuncture mainly affected lipids associated with four pathways: cholesteryl esters, sphingolipids, glycerol esters and phospholipids, which was consistent with the results of differential metabolite analysis. Yeom M et al 18 have used electroacupuncture to treat hyperlipidaemia rats, and the results showed that it can significantly reduce the content of triglyceride and total cholesterol in serum and improve the level of serum lipid metabolism. In addition, the haemoperfusion volume and wound healing rate of the electroacupuncture group was faster than that of the model group. Histological and immunohistochemical also revealed that the electroacupuncture group had faster skin repair than the model group. These results suggest that electroacupuncture may promote skin wound repair in rats by mobilizing the lipid metabolism function of serum and improving local haemoperfusion volume. Therefore, our study may provide a safer and more effective complementary and alternative therapy for skin wound healing and provide an experimental basis for the study of the mechanism of electroacupuncture to promote skin wound healing.

Phospholipids not only constitute an important component of cell membranes, but also participate in the regulation of various cellular functions and play an important role in skin wound repair. Transcriptomic and lipidomic data revealed that Narciclasine extensively regulated lipid metabolism‐related genes, especially the Phospholipase A2 (PLA2) family, and increased anti‐inflammatory lipid molecules. 19 Lysophospholipids and FFA (especially arachidonic acid) are the main products of phospholipids catalysed by PLA2. 20 Among them, lysophosphatidylcholine (lysoPC) stimulates leukocyte activation, T‐lymphocyte chemotaxis and inflammatory cell accumulation. 21 , 22 Prostaglandins (PG) and leukotrienes (LT) produced by the PLA2‐mediated arachidonic acid cascade reaction can activate nuclear factor‐kB through the tumour necrosis factor signalling pathway, thus effectively promoting the division and activation of keratin‐forming cells. 23 It has also been shown that exogenous phosphatidylcholine accelerates the wound healing process, allowing keratinocytes to complete proliferation and migration to form a new layer of keratin in a relatively short period of time. 24 Oral administration of lactophospholipids to hairless mice exposed to UV‐B radiation‐induced photoaging resulted in downregulation of protein expression of nuclear factor kappa‐B (NF‐κB) and phosphorylated IκB‐α (κB‐α inhibitor), a significant decrease in the expression of pro‐inflammatory cytokines, especially tumour necrosis factor‐α, and improved skin hydration and barrier function. 25 The skin barrier‐improving effect of lactoferrin appears to be associated with the activation of Nrf2‐keap1, which is associated with ROS scavenging. Lactoferrin activates Nrf2 and increases the expression of the antioxidant enzyme HO‐1, thereby reducing ROS produced by UV exposure. 26 In addition, phosphatidylinositol also plays an important role in wound repair. Phosphatidylinositol is involved in the regulation of multiple signalling pathways in skin cells, including cell proliferation, apoptosis, and differentiation. 27 , 28 Li J et al 29 have reported that electroacupuncture treatment can effectively decrease the over‐expression of related factors of phosphatidylinositol system in rats with acute cerebral infarction, improve cerebral autonomy movement, and alleviate cerebral vascular spasm. Our study revealed that phospholipid serum metabolites and metabolic pathways were mobilized by electroacupuncture intervention. It suggests that electroacupuncture may promote the balance of phospholipid metabolism by inhibiting excessive oxidative stress, accelerating SC recovery, regulating cell proliferation and migration, and suppressing inflammatory responses. This may be a metabolic mechanism of action of electroacupuncture to promote wound repair.

Sphingolipids are biologically active lipid molecules that are widely present in cell membranes and are involved in the regulation of a variety of life activities, being key components of skin barrier homeostasis and cellular processes such as apoptosis and stress response. 30 , 31 Impaired sphingolipid metabolism underlies several common skin pathologies, including atopic dermatitis, psoriasis and aging. 32 , 33 There are few studies on the effects of electroacupuncture on sphingolipid metabolism in skin repair. However, other studies have shown that electroacupuncture can regulate the changes of lipid metabolism in mice with post‐traumatic stress disorder, especially the content changes of sphingolipids, glycerides and fatty acyl groups. 34 In the sphingomyelinase pathway, CER is formed by hydrolysis of sphingomyelins in the granular layer of the skin by sphingomyelinase. CERs are considered to be one of the most important epidermal sphingolipids, accounting for approximately 50% of the intercellular lipids of the SC 35 , 36 The CERs are transported from the endoplasmic reticulum to the Golgi apparatus, where the conversion to glucosyl CERs or sphingomyelin occurs. 37 Signalling pathways such as protein kinase B (Akt), protein kinase C (PKC), mitogen‐activated protein kinase (MAPK), Jun amino‐terminal kinase (JNK), or phospholipase D (PLD) are regulated during CER stimulation. 38 Although the importance of CER in skin cell proliferation and differentiation has long been known, in recent years sphingosine 1‐phosphate sphingosine (S1P) has also been found to be involved in processes such as the proliferation and differentiation of keratin‐forming cells. The ability of FTY720 to inhibit lymphocyte efflux was significantly diminished as shown by using a rat model with internalization‐resistant S1PR1. 39 In S1PR1 knockout mice, enhanced macrophage migration is eliminated during inflammation regression. 40 Incubation of macrophages with S1P appears to have an anti‐inflammatory effect, as the production of the pro‐inflammatory cytokines TNF‐α, IL‐6, IL‐12 and CCL2 is significantly reduced after activation by lipopolysaccharide (LPS). 41 In addition, by increasing sphingolipid content and altering sphingolipid metabolic pathways, cell proliferation and differentiation can be promoted, which in turn promotes wound healing. 42 , 43 Dietary Sphingomyelin may improve skin barrier function by altering skin inflammation and covalently‐bound ω‐hydroxy CERs and may promote epidermal keratinized envelope formation by altering inflammation‐associated gene expression. 44 Our study found that sphingolipids and their metabolic pathways migrated more after electroacupuncture intervention relative to the sham‐operated and model groups, suggesting that electroacupuncture may have promoted skin wound healing by promoting intra‐traumatic cell migration and regeneration, regulation of inflammatory response and immune response, enhancement of phagocytosis of immune cells, and improvement of the consequent skin barrier function. This may be another metabolic mechanism of action of electroacupuncture to promote skin wound healing.

In conclusion, as shown in Figure 9, our results suggest(that metabolites and metabolic pathways such as serum cholesteryl esters, sphingolipids, glycerides and phospholipids migrate more after electroacupuncture intervention relative to the sham and model groups and may play a key role in the mechanism of action of electroacupuncture to promote skin wound repair. In the process of skin wound healing in rats, electroacupuncture treatment helped restore the amount of wound perfusion, could promote the proliferation of epithelial cells and fibroblasts, attenuated the inflammatory response and lipid peroxidation in rat wounds, and improved serum lipid metabolism in rats. Although there are some limitations of our study, such as the urgent need for more experimental studies to verify the mechanism of action of electroacupuncture intervention on the regulation of serum lipid metabolism during skin wound repair, our results provide a new direction for the treatment of skin wound repair.

FIGURE 9.

FIGURE 9

Schematic diagram of electroacupuncture promoting skin wound repair by regulating serum lipid metabolism and local blood perfusion.

AUTHOR CONTRIBUTIONS

weibin du: Funding acquisition (lead); project administration (equal); writing – original draft (lead); writing – review and editing (lead). Lihong He: Conceptualization (equal); writing – original draft (equal); writing – review and editing (equal). Zhenwei Wang: Conceptualization (equal); data curation (equal); writing – original draft (equal). Yi Dong: Conceptualization (equal); data curation (equal); formal analysis (equal). Xiaofen He: Formal analysis (equal); resources (equal); supervision (equal). Jintao Hu: Funding acquisition (equal); methodology (equal); supervision (equal). Min Zhang: Methodology (lead); project administration (lead); supervision (lead); writing – review and editing (lead).

FUNDING INFORMATION

This work is supported by National Natural Science Foundation of China (NO. 81904053). Special Research Project of the Affiliated Hospital of Zhejiang Chinese Medical University (NO. 2021FSYYZY43). Hangzhou Medical and Health Technology Planning Project (NO. B20220021, B20200032, A20220507), Hangzhou Science and Technology Planning Project (NO. 2020ZDSJ0042, 20220919Y084). Zhejiang Province Traditional Chinese Medicine Science and Technology Project (NO. 2023ZR046, 2022ZB232), Research Project of Zhejiang Chinese Medical University (NO. 2021JKZKTS057B).

CONFLICT OF INTEREST STATEMENT

All the authors declare that they have no conflicts of interest.

CONSENT

Not applicable.

ACKNOWLEDGEMENTS

Not applicable.

Du W, He L, Wang Z, et al. Serum lipidomics‐based study of electroacupuncture for skin wound repair in rats. J Cell Mol Med. 2023;27:3127‐3146. doi: 10.1111/jcmm.17891

Weibin Du, Lihong He and Zhenwei Wang are authors contributed equally to this paper.

Contributor Information

Weibin Du, Email: dwbbdm@163.com.

Min Zhang, Email: 670627216@qq.com.

DATA AVAILABILITY STATEMENT

All data generated and/or analyzed during this study are included in this published article.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

All data generated and/or analyzed during this study are included in this published article.


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