The induction of a coma by traumatic brain injury (TBI) is a crucial factor for poor clinical prognoses. We report that acupuncture at the hand 12 Jing-Well points (HTWP) improved consciousness and neurologic function in TBI rats. Gene chip analyses showed that HTWP acupuncture mostly activated genes modulating neuronal projections (P2rx7, P2rx3, Trpv1, Tacr1, and Cacna1d), protein secretion (Exoc1, Exoc3l1, Fgb, and Fgr), and dopamine (DA) receptor D3 (Drd3) in the ventral periaqueductal gray (vPAG), among which the expression rate of P2rx7 was the most obviously increased. Acupuncture also increased the expression and excitability of DA and P2RX7 neurons, and the DA neurons expressed P2RX7, P2RX3, and TRPV1 in the vPAG. Intracerebroventricular administration of P2RX7, P2RX3, or TRPV1 antagonists blocked acupuncture-induced consciousness, and the subsequent injection of a P2RX7 antagonist into the vPAG nucleus also inhibited this effect. Our findings provide evidence that acupuncture alleviates TBI-induced comas via DA neurons expressing P2RX7 in the vPAG, so as to reveal the cellular and molecular mechanisms of the improvement of TBI clinical outcomes by HTWP acupuncture.

外伤性脑损伤（TBI）引起的昏迷是临床预后不良的关键因素。我们报告针灸在手12景-Well Points（HTWP）改善了TBI大鼠的意识和神经功能。基因芯片分析显示，HTWP针灸大多激活调节神经元投射的基因（P2rx7，P2rx3，Trpv1，Tacr1和 卡那1d），蛋白质分泌（Exoc1，Exoc3l1，Fgb和 Fgr）和多巴胺（DA）受体D3（博士3）在腹腔导水管灰色（vPAG）中，其中 P2rx7是最明显的增加。针灸还增加了DA和P2RX7神经元的表达和兴奋性，并且DA神经元在vPAG中表达了P2RX7，P2RX3和TRPV1。脑室内施用P2RX7，P2RX3或TRPV1拮抗剂可阻断针刺诱导的意识，随后将P2RX7拮抗剂注入vPAG核也可抑制这种作用。我们的发现提供了证据，针灸通过在vPAG中表达P2RX7的DA神经元减轻了TBI诱发的昏迷，从而揭示了HTWP针刺改善TBI临床结果的细胞和分子机制。