The 4th International Conference on Nursing

Author :

(1) Laily Yuliatun; (2) Pudji Rahayu, (2) Sri Puranto, (1) Ahsan

Affiliation :

(1) School of Nursing, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia; (2) School of Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia

Abstract :

Introduction Insulin resistance is one of symptom of cachexia in breast cancer. Proinflammatory cytokines IL-6 and TNF-α have important role in insulin resistance. Acupuncture is a popular complementary therapy in breast cancer patients in Indonesia. This study reviewed the available research regarding the mechanism of acupuncture for balancing blood sugar in insulin resistance in breast cancer patients with cachexia. Methods The study was carried out by retrieving related articles published in PubMed and MEDLINE databases over the period of 2001 to 2018. Inclusion criterion included relevant articles related to patients with acupuncture, cachexia and insulin resistance. In this study, there were 25 articles reviewed and synthesized. Results Acupuncture causes HPA axis activation, through the release of corticotropin-releasing hormone (CRH) in the hypothalamus, and adrenocorticotropic hormone (ACTH) in the anterior lobe of the pituitary gland. ACTH in the peripheral circulation, stimulates the adrenal cortex to release glucocorticoids, especially cortisol into the blood. Glucocorticoids inhibit HPA axis activity through negative feedback on CRH and ACTH secretions. Glucocorticoid suppresses the production of proinflammatory cytokines such as TNF-α and IL-6. Acupuncture also acts as an anti-inflammatory through cholinergic anti-inflammatory pathways, by releasing of acetylcholine from the vagus nerve which binds to α7-nicotinic receptors (a7-nAChRs) in macrophages and inhibits proinflammatory cytokines. Previous study revealed that low-frequency electroacupuncture increase Sirtuin1 (SIRT1) that in pancreatic β-cells positively regulates insulin secretion. Increasing insulin sensitivity resulting in blood sugar balance in breast cancer patients with cahexia. Conclusion Acupuncture could balance blood sugar in insulin resistance in breast cancer patients with cachexia through HPA axis activation, cholinergic anti-inflammatory pathways, and increasing SIRT1.

Keywords :

Breast Cancer; Cachexia; Insulin Resistance; Acupuncture