Objective To observe the effect of penetrative needling of “Zhibian”(BL54) through “Shuidao”(ST28) on the expressions of death receptor pathway-related protein tumor necrosis factor-related apoptosis-inducing ligand(TRAIL) and its receptors

as death receptor 4(DR4)

death receptor 5(DR5)

decoy receptor 1(DcR1) and decoy receptor 2(DcR2) in premature ovarian insufficiency(POI) rats

so as to explore its mechanisms underlying improvement of POI. Methods Forty female SD rats were randomly divided into blank control

model

penetrative needling and medication(estradiol valerate) groups

with 10 rats in each group. The POI model was established by intraperitoneal injection of cyclophosphamide(D1: 50 mg·kg

(-1)

·d(-1)·d

(-1)

D 2 to D15: 8 mg·kg(-1)

D 2 to D15: 8 mg·kg

(-1)

·d(-1)·d

(-1)

for a total of 15 d). After successful modeling

the rats in the penetrative needling group received penetrative needling of BL54 through ST28

with the needle retained for 30 min

once a day for a total of 4 weeks. Rats of the medication group received gavage of estradiol valerate(0.09 mg·kg(-1)

for a total of 15 d). After successful modeling

the rats in the penetrative needling group received penetrative needling of BL54 through ST28

with the needle retained for 30 min

once a day for a total of 4 weeks. Rats of the medication group received gavage of estradiol valerate(0.09 mg·kg

(-1)

·d(-1)·d

(-1)

) once daily for 4 weeks. After the intervention

the content of serum follicles of stimulation hormone(FSH)

lateinizing hormone(LH)

estradiol(E2) and vascular endothelial growth factor(VEGF) were assayed using enzyme-linked immunosorbent assay

and histopathological changes of ovarian tissue and the number of follicles were observed under light microscope after H.E. staining. The expression levels of TRAIL

DR4

DR5

DcR1

DcR2

and Fas-associated death domain(FADD) in ovarian tissues were detected using quantitative real-time PCR

and the immunoactivity of ovarian TRAIL

DR4 and DR5 detected using immunohistochemistry. The body weight and the damp weight of ovary were measured for calculating the ovarian coefficient. Results Compared with the blank control group

the E2 and VEGF contents

ovarian coefficient

and the number of the primary

secondary and sinus follicles were significantly decreased(P

<

0.01) in the model group

whereas FSH and LH contents

the atretic follicle number

TRAIL

DR4 and DR5 immunoactivity

and the expression levels of TRAIL

DR4

DR5 and FADD mRNAs considerably increased in the model group(P

<

0.01). In comparison with the model group

the decrease of the VEGF content

ovarian coefficient

and the number of the primary

secondary and sinus follicles

and the increase of the atretic follicle number

TRAIL

DR4 and DR5 immunoactivity

and expression levels of TRAIL

DR4

DR5 and FADD mRNAs were reversed in both penetrative needling and medication groups(P

<

0.01

P

<

0.05). The number of primary follicles was significantly more in the medication group than in the penetrative needling group(P

<

0.01). Conclusion Penetrative needling of BL54 and ST28 can improve ovarian weight and promote follicular development in POI rats

which may be associated with its function in down-regulating the expression of pro-apoptotic proteins TRAIL

DR4

DR5 and FADD of the death receptor pathway to inhibit apoptosis of ovarian granulosa cells.