What is the Biological Basis of Acupuncture for Systemic Inflammation Modulation?

PainRelief.com Interview with:
QIUFU MA, PhD
Professor, Neurobiology, Cancer Biology
Harvard Medical School
Dana-Farber Cancer Institute

PainRelief.com:  What is the background for this study?  What are the main findings?

Response: This study aimed to understand the biological basis behind acupuncture practice. Modern randomized clinical trials have demonstrated the efficacy of acupuncture practice in treating certain human diseases, such as gastrointestinal disorders and chronic pain, but the underlying biological basis still poorly understood.

Our hypothesis is that acupuncture can drive the somatosensory autonomic pathways to modulate body physiology. A key innovation of this study is the development of new genetic tools to manipulate different autonomic nervous pathways, and we then used the severe systemic inflammation (cytokine storms) induced by bacterial endotoxins as the experimental model.

We found that electroacupuncture stimulation (ES) can drive distinct autonomic pathways in acupoint- and stimulation-intensity-dependent manners. Low intensity ES at hindlimb regions drives the vagal-adrenal axis, producing anti-inflammatory effects that depend on adrenal chromaffin cells. High intensity ES at the abdomen activates splenic noradrenergic neurons via the spinal-sympathetic axis, and this activation produces either anti- or pro-inflammatory effects, dependent on adrenergic receptor profiles under different diseases states

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Acupuncture for Migraine Pain Relief

PainRelief.com Interview with:

Prof. Wei Wang
Department of Neurology,
Tongji Hospital, Tongji Medical College,
Huazhong University of Science and Technology,
Wuhan, Hubei, P.R. China

acupuncture

PainRelief.com:  What is the background for this study?

Response: The burden of migraine is substantial, resulting in considerable economic and social losses. The latest Global Burden of Disease Study showed that 1.25 billion people had migraine in 2017. A significant number of patients are still not responding well to drug therapy, or cannot tolerate the adverse effects of drugs, or have contraindications, which can lead to low medication compliance, headache chronification and acute medication overuse. Prophylactic drugs should be recommended for migraineurs who have at least four headache days per month, but only 13% of patients reported current use of preventive drugs. Besides, ineffectiveness of and/or contraindications to migraine medication affect 10-15% of people with migraine. Hence, a need exists to investigate non-drug interventions.

Previous studies suggest that acupuncture works particularly well on a range of pain disorders. However, clinical evidence for the benefit of manual acupuncture for migraine prophylaxis remains scarce. Appropriate placebo control settings and successful blinding are two critical elements in addressing this challenge. Sham acupuncture involving penetrating needles should be avoided in clinical trials. Previous acupuncture research has often used penetrating sham acupuncture, involving needling non-acupuncture points, needling irrelevant acupuncture points, or superficial needling. However, whether the needle is inserted into an acupuncture point or a non-acupuncture point, it could produce a physiological effect. Comparisons between true acupuncture and sham acupuncture might also be biased by unsuccessful blinding. To ensure an inert placebo control and successful blinding, we recruited acupuncture-naive patients, using non-penetrating sham acupuncture at heterosegmental non-acupuncture points as the control, and designed the same procedures to perform the same rituals as much as possible in the manual and sham acupuncture groups.

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Acupuncture for Chronic Musculoskeletal Pain Relief: A Review of Randomized Trial

PainRelief.com Interview with:
Chenchen Wang MD, MSc
Professor of Medicine
Tufts University School of Medicine
 Director, Center For Complementary And Integrative Medicine                                             
Division of Rheumatology
Tufts Medical Center, Boston, MA

Dr. Chenchen Wang
Dr. Chenchen Wang

PainRelief.com:  What is the background for this study?  What are the main findings?

Response: Chronic Musculoskeletal Pain is a complex disorder without effective treatment Acupuncture, originating in China more than 3,000 years ago, is one of the most popular sensory stimulation therapies. However, despite the fact that acupuncture is widely used for pain relief in a number of conditions including severe knee osteoarthritis, acute postoperative pain, musculoskeletal disorders, evidence of the effect of Chronic Musculoskeletal Pain relief is scarce.


Our study was to determine the efficacy of acupuncture for pain relief in this field.

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Acupunture Studies for Pain Relief of Chronic Angina

PainRelief.com Interview with:
Fanrong Liang MD
and Ling Zhao PhD

acupuncture

Acupuncture and Tuina School
Chengdu University of Traditional Chinese Medicine
Chengdu, Sichuan, China

PainRelief.com:  What is the background for this study?

Response: Chronic stable angina (CSA) is the cardinal symptom of myocardial ischemia and is associated with an increased risk of major cardiovascular events and sudden cardiac death. CSA affects with an average of 3.4 million people over 40 years of age each year. The most recent survey reported a CSA prevalence of 9.6% in China, making it a considerable burden on healthcare and medical costs, considering China’s large population base. Because of limited medical resources and lack of obvious improvement with percutaneous coronary intervention, Chinese clinicians choose traditional Chinese medicine (TCM) and acupuncture in addition to antianginal treatment for CSA. In China, acupuncture has been used as nonpharmacological treatment for several decades, especially to relieve myocardial ischemia symptoms, improve cardiac function, and prevent recurrence.  

Acupuncture Provided Pain Relief From Cancer and Related Symptoms

PainRelief.com Interview with:
Jai N. Patel, PharmD, BCOP
Chief, Pharmacology Research
Associate Professor, Division of Hematology/Oncology
Department of Cancer Pharmacology
Levine Cancer Institute
Charlotte, NC 28204 

PainRelief.com: What is the background for this study? What are the main findings?

Response: Pain is one of the most prevalent and burdensome symptoms affecting patients with cancer. Cancer-related pain is most commonly treated with opioid analgesics; however, nearly two-thirds of patients have inadequate pain relief and/or experience opioid-related side effects.

Furthermore, the fear of opioid abuse/addiction and toxicity deters some from prescribing opioids and reduces patient compliance. Thus, nonpharmacologic interventions such as acupuncture may be safer approaches to cancer-related pain.  Randomized controlled trials suggest acupuncture reduces chronic neuropathic and postoperative pain in patients with cancer. It is unknown whether any patient characteristics predict post-acupuncture pain response.

We assessed acupuncture’s effectiveness for cancer-related pain, identified patient characteristics associated with pain response, and determined its effect on other concurrent cancer-related symptoms in palliative medicine outpatients. We identified significant benefits in pain scores immediately after the first treatment and across multiple treatments. Significant pain reduction was associated with higher baseline pain and more advanced disease stage.

We also identified significant changes in anxiety, depression, drowsiness, dyspnea, fatigue, nausea and well-being. Improvements in fatigue and depression also correlated with significant pain reduction after acupuncture.  Continue reading