Acupuncture, metabolomics and mitochondrial function

[Jenny TipsforME]

Zhen Ci Yan Jiu. 2018 Jun 25;43(6):335-40. doi: 10.13702/j.1000-0607.171010.
[Electroacupuncture of "Zusanli" (ST 36) Raises Muscular Force by Adjusting AMPK/PGC-1 α Signaling in Rats with Chronic Fatigue Syndrome].
[Article in Chinese]
Dong JZ1, Wei YT2, Xu HY3, Zhang Y1, Yong RL1, Xue YN1, Zhang LD1.
Author information:
1. Liaoning University of Traditional Chinese Medicine, Shenyang 110847, China.
2. Liaoning Cancer Hospital, Shenyang 110042.
3. Shunde Hospital for Memorizing Wu Zhong-pei, Foshan 528333, Guangdong Province.

Abstract
OBJECTIVE:
To observe the effect of electroacupuncture (EA) of "Zusanli" (ST 36) on mitochondrial oxidative stress of skeletal muscle in rats with chronic fatigue syndrome (CFS) based on adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK)/ peroxlsome proliferator-activated receptor-γ coactivator-1 α (PGC-1 α) signaling, in order to reveal its mechanism underlying improvement of CFS.

METHODS:
Forty SD rats were randomly divided into normal control, CFS model, EA-Zusanli (ST 36) and EA-non-acupoint groups (n=10 rats in each group). The CFS model was established by forced exhausted load-bearing swimming (twice daily), chronic constraint (1 h) and sleep deprivation (20 h/day) for 14 days. Following modeling, EA (2 Hz/100 Hz, 2 V) was applied to bilateral Zusanli (ST 36) or non-acupoint (about 10-15 mm superior to the bilateral Iliac creast and about 20 mm lateral to the posterior median line) for 20 min, once a day for 10 days. The expression levels of ATP synthase, AMPK, phosphorylated (p)-AMPK, silent mating type information regulation 2 homolog-1 (SIRT 1) and PGC-1 α proteins, and ATP synthase, SIRT 1 and PGC-1 α mRNAs of the quadriceps femoris muscle were detected by Western blot and fluorescence quantitative PCR, respectively. The rats' grabbing force was detected by using a grabbing-force detector.

RESULTS:
Compared with the normal group, the grabbing force, and the expression levels of ATP synthase and PGC-1 α proteins and mRNAs were significantly decreased (P<0.05, P<0.01), while the expression of SIRT 1 protein was significantly up-regulated (P<0.05) in the CFS model group. Following EA intervention, the grabbing force and the expression levels of ATP synthase mRNA, SIRT 1 and PGC-1 α proteins and mRNAs, and p-AMPK/AMPK were significantly up-regulated in the EA-Zusanli (ST 36) group (P<0.05, P<0.01).

CONCLUSION:
EA of ST 36 can raise the grabbing force of CFS rats, which may be related to its effects in up-regulating the expression of ATP synthase mRNA, SIRT 1 and PGC-1 α proteins and mRNAs, and p-AMPK/AMPK to reduce mitochondrial oxidative stress reaction and in increasing ATP synthesis.

PMID: 30091537

I got this in my inbox today and it piqued my cognitively foggy interest for a couple of reasons. NB these posts move onto considering a study on metabolomics and the credibility of acupuncture (the thread isn’t specific to this study).

First of all I want to comment that I’m very sceptical of a rat model of CFS. I don’t think we should read this assuming it has any particular relevance to us as a group.

But it is interesting that acupuncture seems to increase muscle force as a consequence of improved mitochondrial function (ATP synthase, AMPK etc). The rat aspect, despite being suspect in terms of CFS modelling, does probably get around placebo issues. If anything those exhausted rats would have nocebo effects from electro acupuncture they weren’t able to understand. They also used objective measures.

In my convoluted journey to improve symptoms I gave acupuncture a really decent go with weekly treatments for over a year. Obviously it didn’t cure me. Possibly it enabled me to work for that amount of time, possibly purely through placebo effect. Though I think mistranslation likely makes it sound more woohoo than it actually is. It could also be in the category of treatment which can be effective but not for the reasons given. I’m not sure what I think of it now.

Particular points I perceived to be of benefit did include Stomach 36 which is what was used in this study

I’ll see if I can find a diagram. It is possible to do acupressure on yourself.

 

[Jenny TipsforME]

Before thinking about other relevant studies, you probably need a sense of what they’re talking about. This video shows you how to do acupressure on Zusanli (Stomach 36)



It’s considered a point for low metabolism, immune issues, fatigue and digestive issues. It seems like western science might evidence this too.

If you wanted to give acupressure a go it’s an acupoint worth trying. On me it’s sensitive on that spot so easy to find, I don’t know if that’s universal.

As an aside, Acupuncturists would tend to do this with Spleen 6 for me (ignore the English translations, it’s not really to do with the spleen)


Another one which seemed to work for me for whatever reason was
Anmian or Peaceful Sleep (EXHN22)

 

[Jenny TipsforME]

A similar study is

Chin J Integr Med. 2015 Aug;21(8):618-23. doi: 10.1007/s11655-013-1512-9. Epub 2013 Sep 3.
Effects of electroacupuncture of different intensities on energy metabolism of mitochondria of brain cells in rats with cerebral ischemia-reperfusion injury.
Tian WQ1, Peng YG, Cui SY, Yao FZ, Li BG.
Author information

Abstract
OBJECTIVE:
To observe the effects of electroacupuncture (EA) of different intensities on lactate dehydrogernase (LDH), succinate dehydrogenase (SDH) and ATPase in brain tissue of rats with cerebral ischemia-reperfusion injury (CI/R).

METHODS:
Forty male SD rats were uniformly randomized into sham operation group (group A), CI/R group (group B), CI/R+5 mA EA (group C), CI/R+3 mA EA (group D) and CI/R+1 mA EA (group E) groups with eight rats in each group. Transient general brain ischemia was induced by four-vessel occlusion and reperfusion. The rats in group C, group D and group E were punctured and stimulated at Baihui (GV20), Mingmen (GV4) and Zusanli (ST36) with the same intermittent and rarefaction-dense wave (30 to 50 Hz) and different electric current intensities: 5 mA, 3 mA and 1 mA for 20 min after CI/R. Then the activities of Na(+)-K(+)-ATPase, SDH and LDH in mitochondria of brain tissue were measured by spectrophotometry. The ischemic cerebral cortex tissue was taken for observing the ultrastructure changes of impaired nerve cells.

RESULTS:
Compared with group A, the activities of LDH, SDH and Na(+)-K(+)-ATPase were lowerer in the group B (P<0.05 or P<0.01). However, the activities of LDH, SDH and Na(+)-K(+)-ATPase were higher in the group D than those in the group B (P<0.05 orP<0.01). In group A, the anatomical structure of the cerebral cortex cells was basically normal; in group B, the neuronal cellular structures were severely damaged, the neuronal mitochondria got swelling, the mitochondrial cristae were broken, the medullated nerve fifibers were not integrated. In group C, group D and group E, the ultrastructure of impaired neuron were improved. Group D was the best among three groups above.

CONCLUSION:
EA of 3 mA intensity could strengthen aerobic metabolism by elevating the activities of SDH and LDH, meanwhile maintaining the ionic equilibrium in the exterior and interior brain cell and relieving the cellular edema by reinforcing the activities of Na(+)-K(+)-ATPase.

PMID:

24002710

DOI:

10.1007/s11655-013-1512-9

And this one brings in immunoregulatory benefits from the same acupoint

Evid Based Complement Alternat Med. 2007 Mar; 4(1): 51–57.
Published online 2006 Aug 18. doi: 10.1093/ecam/nel054
PMCID: PMC1810363
PMID: 17342241
Electro-acupuncture at acupoint ST36 reduces inflammation and regulates immune activity in Collagen-Induced Arthritic Mice
Yun-Kyoung Yim,1 Hyun Lee,2 Kwon-Eui Hong,2 Young-Il Kim,2 Byung-Ryul Lee,2Chang-Gue Son,3 and Jung-Eun Kim1
Author information ► Article notes ► Copyright and License information ► Disclaimer
This article has been cited by other articles in PMC.

This study aimed to investigate the anti-inflammatory, anti-arthritic and immuno-regulatory effects of electro-acupuncture (EA) at ST36 on Collagen-induced arthritis (CIA) in mice. Male DBA/1J mice were divided into five groups: Normal, Control, NR (needle retention), EAI and EAII. All mice except those in the normal group were immunized with Collagen II for arthritis induction. Acupuncture needles were inserted into mice ST36 and electrical currents at a frequency of 2 Hz in a continuous rectangular wave form were conducted through the needles for 15 min, 3 times a week. EA treatments were administered for 5 weeks in the EAI group and for 9 weeks in the EAII group. The mice in the NR group were acupunctured in the same manner as the EA groups and the needles were retained for 15 min without electrical stimulation. CIA incidence analysis, ELISA, histological analysis and FACS analysis were performed to evaluate the effect of EA on CIA. EA at ST36 significantly reduced CIA incidence, IL-6, TNF-a, INF-γ, collagen II antibody, IgG and IgM levels in CIA mice serum and prevented knee joint destruction. EA at ST36 also reduced CD69+/CD3e+ cells and CD11a+/CD19+ cells in CIA mice lymph nodes, and CD11b+/Gr1+ cells in CIA mice knee joints. The ratios of CD3e+ cells to CD19+ cells, and CD8+ cells to CD4+ cells were maintained closer to the normal range in the EA groups as compared with the control group or the NR group. EAII was more effective than EAI throughout all the measurements. The NR was effective as well, though less effective than EA. EA at ST36 may have an anti-inflammatory, anti-arthritic and immuno-regulatory effects on CIA in mice. The effectiveness is stronger when EA starts earlier and is applied longer. Needle retention without electrical stimulation may be effective on CIA as well, however less effective than EA. Electrical stimulation and acupoint ST36 may have synergistic effects on CIA.

Keywords

From the results of the present study, we speculate that EA at ST36 may have an anti-inflammatory and anti-arthritic effect on CIA via suppressing autoimmunity and modulating immune abnormality. The mechanism of these effects is not clear yet

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1810363/

 

[Jenny TipsforME]

This is probably more useful again that same acupoint below the knee but using a metabolomics approach in humans (haven’t read yet)

Deciphering the biological effects of acupuncture treatment modulating multiple metabolism pathways
Zhang et al

Scientific Reports volume6, Article number: 19942 (2016) | Download Citation

Abstract
Acupuncture is an alternative therapy that is widely used to treat various diseases. However, detailed biological interpretation of the acupuncture stimulations is limited. We here used metabolomics and proteomics technology, thereby identifying the serum small molecular metabolites into the effect and mechanism pathways of standardized acupuncture treatments at ‘Zusanli’ acupoint which was the most often used acupoint in previous reports. Comprehensive overview of serum metabolic profiles during acupuncture stimulation was investigated. Thirty-four differential metabolites were identified in serum metabolome and associated with ten metabolism pathways. Importantly, we have found that high impact glycerophospholipid metabolism, fatty acid metabolism, ether lipid metabolism were acutely perturbed by acupuncture stimulation. As such, these alterations may be useful to clarify the biological mechanism of acupuncture stimulation. A series of differentially expressed proteins were identified and such effects of acupuncture stimulation were found to play a role in transport, enzymatic activity, signaling pathway or receptor interaction. Pathway analysis further revealed that most of these proteins were found to play a pivotal role in the regulation of multiple metabolism pathways. It demonstrated that the metabolomics coupled with proteomics as a powerful approach for potential applications in understanding the biological effects of acupuncture stimulation.

https://www.nature.com/articles/srep19942
(My bold)

The metabolomic approach is interesting anyway

 

[Jenny TipsforME]

I woke up thinking about the mysterious impact of prodding just below the knee. It is very puzzling.

In the molecular function analysis, most of these proteins were found to play a role in transport, enzymatic activity, signaling pathway or receptor interaction, suggested that the proteins in these functional categories were highly expressed and may be active during the acupuncture treatment condition. These differentially expressed proteins may be related to several metabolic pathways, including carbohydrate digestion and absorption, protein digestion and absorption, amino sugar and nucleotide sugar metabolism, fructose and mannose metabolism, complement and coagulation cascades etc. Based on the number of unique proteins identified, the most interesting functional categories were “gastric acid secretion” and “pancreatic secretion”, representing 2.53% and 6.33% of all the protein identified, respectively. The result would facilitate the understanding that ST-36 point is commonly used in human acupuncture to treat gastrointestinal disorders.

Gastric acid is a key factor in normal upper gastrointestinal functions, including protein digestion and calcium and iron absorption, as well as providing some protection against bacterial infections21. Stimulation of acid secretion typically involves an initial elevation of intracellular calcium and cAMP, followed by activation of protein kinase cascades, which trigger the translocation of the proton pump, H+ -K+ -ATPase, from cytoplasmic tubulovesicles to the apical serum membrane and thereby H+ secretion into the stomach lumen. The pancreas performs both exocrine and endocrine functions22. The exocrine pancreas consists of two parts, the acinar and duct cells. The primary functions of pancreatic acinar cells are to synthesize and secrete digestive enzymes. The major task of pancreatic duct cells is the secretion of fluid and bicarbonate ions (HCO3−), which neutralize the acidity of gastric contents that enter the duodenum. An increase in intracellular cAMP by secretin is one of the major signals of pancreatic HCO3− secretion.

...We found 22 target proteins that were highly specific to the acupuncture. The detection of these proteins with distinct regulatory patterns provides evidence that novel biomarkers are actively involved in multifunctional pathways that are likely essential for acupuncture. The biological functions of these critical proteins can be sorted into five groups: (A) generation and degradation of the extracellular matrix, including fibronectin 1, fibrinogen gamma chain isoform CRA_o, and fibrinogen gamma chain isoform CRA_a; (B) the regulation of transcription and translation, as provided by phospholipid transfer protein; (C) acute phase reaction and immunity protection, as provided by immunoglobulin heavy chain constant region mu, immunoglobulin kappa light chain VLJ region, immunoglobulin kappa light chain variable region, Ig gamma3 heavy chain; (D) oxygenation and cell apoptosis, to which anti-pneumococcal antibody 57E2 light chain contributes; and (E) transport and metabolism, as provided by apolipoprotein A-II, apolipoprotein C-II, apolipoprotein B-100 precursor, apolipoprotein B variant, tubulin alpha-4A chain. The characteristic functions of these differentially expressed proteins were enriched within clusters that were based on biological processes such as “immunity”, “cellular apoptosis”, “transport”, “signal transduction”, and “metabolism”.

This graph is from that Nature article which was a study on 20 healthy men (not a large sample but I don’t think you’d expect that with metabolomics).

On the lower graph
B) Construction of the metabolism pathways in acupuncture-treated human. The map was generated using the reference map by KEGG (http://www.genome.jp/kegg/). The green boxes: enzymatic activities with putative cases of analogy in acupuncture-treated human.

1, glycerophospholipid metabolism;
From another non TCM paper
“Marked alterations in neural membrane glycerophospholipid composition have been reported to occur in neurological disorders. These alterations result in changes in membrane fluidity and permeability. These processes along with the accumulation of lipid peroxides and compromised energy metabolism may be responsible for the neurodegeneration observed in neurological disorders.” https://www.ncbi.nlm.nih.gov/pubmed/10878232
So could an acupoint affecting this be useful for neurological conditions?

2, ether lipid metabolism;
From another paper “Emerging studies suggest that altered ether lipid production is also associated with several other disorders including neurodegenerative diseases, cancer, and metabolic disorders.“ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818364/

3, fatty acid metabolism; 4, glycerolipid metabolism; 5, porphyrin metabolism; 6, sphingolipid metabolism; 7, primary bile acid biosynthesis; 8, fatty acid elongation in mitochondria; 9, fatty acid biosynthesis; 10, tryptophan metabolism.

In the discussion

Integrated network analysis of the differentially expressed proteins in acupuncture-perturbed yields highly related signaling networks, suggests strongly that the involvement of these signaling networks could be essential for the biological basis of ST-36.

 

[Jenny TipsforME]

Ha no one seems to want to comment on empirical studies into complementary treatments, too much of a hot potato?

My mind is currently stuck in the warren of whether acupoints have an anatomical basis though so I’ll add a couple more thoughts in case anyone else is interested.

Deciphering conflicting conclusions from Google is tricky. It is more tricky than normal because language and cultural issues come into play.

One paper concludes

Research on the nature of acupuncture points and meridians is often difficult to evaluate because of the diverse nature of the claims made, incomplete data provided in published studies and the variety of parameters involved in the assessment of these claims. Many of the studies purporting to have identified acupuncture points or meridians come from China; the role of publication bias in Chinese literature needs to be considered in light of the fact that no trial published in China from 1966 through 1995 found a test treatment to be ineffective.35 Ob- vious contradictions exist between current acupunc- ture practice and the historical record, as well as on the “correct” number of points and meridians reported by current practitioners of acupuncture. From an empirical standpoint— discrete structures such as acupuncture points and/or meridians would revolu- tionize the study of anatomy and physiology—no such revolution has occurred. Whatever the clinical effi- cacy of needling, there is, as yet, no convincing evi- dence to show that acupuncture points or meridians exist as discrete entities.36

https://pdfs.semanticscholar.org/04bc/91e4598cb1f65fc684925430faf0a368234f.pdf

I think it is worth separating the concept of meridians from specific acupoints. My hunch is it is very unlikely that meridians and every point on them is as described, especially as meridians haven’t stayed the same over time.

There are claims that a primo vascular system has been found which would correspond with the meridian concept

The Primo Vascular System as a New Anatomical System
Author links open overlay panelMiroslavStefanov12MichaelPotroz2JungdaeKim23JakeLim2RichardCha24Min-HoNam2
https://doi.org/10.1016/j.jams.2013.10.001Get rights and content
Open Access funded by International Pharmacopuncture Institute
Under a Creative Commons license

Abstract
Traditional Eastern medicine has had a successful existence for a long time and has provided functional paths for curing disease. However, some scientists do not accept acupuncture, primarily because the meridian system lacks a physical anatomical basis. To date, scientific theories have not been able to explain the functional paths used by traditional Eastern medicine to cure disease. According to Western medicine, no known anatomical foundation exists for the meridians and unknown nervous, circulatory, endocrine, and immune mechanisms mediate the effects of acupuncture. In the early 1960s, only one hypothesis was proposed to explain the anatomical basis of the meridians. By using different experimental approaches during the past 10 years, the number of scientific papers that report the discovery of different anatomical and physiological evidence confirming the existence of an anatomical basis for the meridian system has increased. Morphological science is greatly challenged to offer a new biomedical theory that explains the possible existence of new bodily systems such as the primo vascular system (PVS). The PVS is a previously unknown system that integrates the features of the cardiovascular, nervous, immune, and hormonal systems. It also provides a physical substrate for the acupuncture points and meridians. Announcements of the morphological architectonics and the function of the PVS fundamentally changed the basic understanding of biology and medicine because the PVS is involved in the development and the functions of living organisms. We propose a new vision of the anatomical basis for the PVS and the vital energy—called “Qi”—as an electromagnetic wave that is involved very closely with the DNA in the PVS. DNA provides genetic information and it functions as a store of information that can be obtained from the electromagnetic fields of the environment. The PVS is the communication system between living organisms and the environment, and it lies at the lowest level of life. The theory of the PVS could be a good basis for forming a new point of view of Darwin's evolutionary theory. Discoveries in morphological theory—such as discoveries with respect to the PVS—have not been made since the 18th century. For that reason, the PVS needs more attention.

https://www.sciencedirect.com/science/article/pii/S2005290113002082
I don’t feel convinced

But there are also claims that meridians weren’t part of the Chinese concept of medicine and this is a lost in translation issue, which is also in the context of the mistranslation of qi (perhaps better translated as oxygen and blood vessels??)

Since the energy meridian model is clearly incorrect, we must look to the classic Chinese medical texts to discover the authentic fundamental concepts of Chinese medicine. In the Huangdi Neijing, the Chinese describe the lungs breathing in what they call “da qi”. If you look up da qi in a Chinese dictionary, you’ll see it defined as “great air”. The Chinese explained that the lungs breathed in air, and the lungs extracted the qi from the da qi.

What do our lungs get from the air that sustains life? Oxygen. If you look up qi in a Chinese dictionary, there are ten definitions but not a single one of them is energy. Qi is defined as vital vapor, air, or the essence of air. It can also refer to the function of something (i.e. the qi of an organ would refer to the function of that organ) and the weather. Qi does not mean energy.

Of course the Chinese hadn’t identified the molecule we know as oxygen 2,000 years ago. They didn’t have the technology for that. But they did understand that we extracted something essential to life from the air we breathed, and they knew that this vital air (qi) was circulated around the body to support physiological processes. Therefore the closest translation of qi in a modern medical context is not energy, but oxygen.

The Chinese also described how this oxygen (qi) gets around the body: through the blood. They knew this from the dissections they had performed. The blood of the ancient Chinese is exactly the same as the blood of the 21st century! They knew blood circulated through blood vessels and the vascular system, which they had painstakingly identified and measured.

The word the Chinese used for vessel in the HDNJ is “mai”. Mai is correctly translated as vessel. “Xue Mai” is correctly translated as blood vessel (xue = blood). Morant took the word mai and incorrectly translated it as the French word “meridian”. He did this in spite of the fact that there was no word for meridian in the ancient Chinese language.

...As it turns out, de Morant wasn’t too far off. Energy is an abstract concept that means “in work”. It can’t be circulated in the blood. However, the potential for energy, in the form of oxygen and glucose, is transported through the cardiovascular system.

Energy production within each cell is initiated by breaking down each molecule of glucose (from absorbed nutrients) to form two molecules of pyruvate. Pyruvate produced in the cell cytoplasm is taken up by the mitochondria and enters the Krebs cycle.

The Krebs cycle involves a cyclic seris of reactions that convert ADP to ATP, the fundamental unit of energy in the body. This requires inhaled oxygen supplied by the red blood cells via capillaries.

This energy production cycle was discovered by Albert Szent-Györgyi and Hans Adolph Krebs well before de Morant died, in 1937. Had de Morant been aware of their work, he would have recognized that energy does not flow through the blood vessels. It is transmitted in its potential form, oxygen and glucose.

https://chriskresser.com/chinese-medicine-demystified-part-iii-the-energy-meridian-model-debunked/

Although I’m happy to accept mistranslation is more likely than not, I’m equally unconvinced about this explanation. Wouldn’t more bilingual TCM practitioners speak up about this?

But it does shift focus from a mysterious, spiritual sounding system to specific acupoints. I find it easier to accept that specific points could have a biomedical impact. It would make some sense if acupuncturists noticed by trial and error that some points had a stronger impact and points such as ST36 were gradually used frequently, and other points became more obscure. You can hit on a successful treatment without knowing why (western medicine also does this).

Next I’m going to google if there’s a specific anatomical reason why ST36 has health benefits and then hopefully I can switch my mind off from it.

 

[Esther12]

"rats with chronic fatigue syndrome"?

There seem to be a lot of weak papers that try to claim traditional Chinese medicine is valuable and I'm not enthusiastic about reading more of them tbh.

edit: This sounds a bit rude by mistake.

 

[Jenny TipsforME]

@Esther12 Yes as I commented we should take it with a pinch of salt that the rats have CFS, it’s just that I saw it because I get CFS abstracts sent to my email. The CFS bit isn’t what I’m commenting on here. It’s more that that paper set me thinking about TCM again.

What’s curious is objective measurement of improvement in things like mitochondrial function using this specific acupoint. I don’t think we should dismiss all studies of acupuncture out of hand because they’re on acupuncture (but it’s also wise to take into account the issues with this body of research mentioned in my last post).

It could well be explained by methodological issues, or there could be something specific of interest.

 

[Jenny TipsforME]

So focusing on the anatomy of ST36/Zusanli

Wang, et. al., have identified a “vessel-like structure” made of “calcitonin gene related peptide (CGRP)-positive neurofibers in local tissues” at acupuncture points. The researchers discovered that “CGRP-positive nerve fibers were found to distribute in the dermis and subcutaneous layers of local tissues of acupoint ST 44, ST 36 and ST 32, mainly concentrating around the vessel-like structure.” They add, “CGRP-positive neurofibers are an important element in the local tissues of acupoint ST 44, ST 36 and ST 32 regions…
CGRP is a type of neurotransmitter. Nerve fibers that are positive for the presence of CGRP play many roles in human physiology. For example, Hara-Irie, et. al., note that “CGRP-positive nerve fibers could be a crucial element in bone metabolism during bone growth and development.” Kunst, et. al., from the Yale School of Medicine (New Haven, Connecticut) note that CGRP is “a wake-promoting neuropeptide that regulates sleep maintenance at night.” Evans, et. al., from the University of Miami School of Medicine (Miami, Florida) note that CGRP is “a potent vasodilator neuropeptide.” The density of nerve fibers containing CGRP located at acupuncture points may correlate to the ability of acupuncture to stimulate signal conduction and induce health benefits...
.”

The acupuncture points ST36 (Zusanli) and ST37 (Shangjuxu) were shown to have distinct structural differences from surrounding areas. At the acupuncture points, microvascular densities with bifurcations “can be clearly seen around thick blood vessels” but non-acupuncture point areas showed few thick blood vessels and none showed fine, high density structures. The acupuncture points contained fine structures with more large blood vessels that are several dozen micrometers in size plus beds of high density vascularization of vessels 15-50 micrometers in size. This structure was not found in non-acupuncture point areas.

Both from https://www.acupunctureclinic.ie/acupuncture-point-anatomy-found/

I’m out of spoons to evaluate this info.

 

[Hoopoe]

Ha no one seems to want to comment on empirical studies into complementary treatments, too much of a hot potato?

As far as I know, acupuncture studies that control for biased reporting tend to find no effects.

Electroacupuncture is probably just electrostimulation with a dubious explanatory model attached to it. I have no problem believing that electrostimulation has an effect on muscles. Similarly, if you stick needles into tissue, it's going to provoke some reaction. It doesn't necessarily mean there is something to acupuncture.

 

[TiredSam]

Ha no one seems to want to comment on empirical studies into complementary treatments, too much of a hot potato?

Chinese electro-acupuncture on rats? I certainly don't think we should be afraid the grasp the potato. Firstly I'd like to know which criteria was used to diagnose the rats with "CFS" - Fukuda, CCC, SEID, or Ramsey? Secondly I note that there were only a small number of rats (n=10) in each group, so obviously any findings will need replicating on a larger scale. Thirdly, on the positive side

The rats' grabbing force was detected by using a grabbing-force detector.

The authors are to be commended for exceeding the number of objective measurements used by the PACE trial authors, making their paper more reliable and less open to criticism.

Will there be a follow-up study on these rats just to make sure the effects weren't temporary, and due to e.g. having a grabbing force detector to play with?

 

[Jenny TipsforME]

The authors are to be commended for exceeding the number of objective measurements used by the PACE trial authors, making their paper more reliable and less open to criticism.

Will there be a follow-up study on these rats just to make sure the effects weren't temporary, and due to e.g. having a grabbing force detector to play with?

Yes I thought it was better than PACE too

Though I’m not commenting on it because I think they were actually studying CFS in rats. I can’t read the methodology but when I’ve read about rat models of CFS before it’s simply involved exhausting them which isn’t the same at all.

I’m interested in whether the mitochondrial benefits are real - sort of assuming this isn’t specific to CFS because I’m assuming they don’t know enough to model this.

The rats probably died before they’d written up the first paper so not in anticipation of a follow Up!

 

[TiredSam]

The rats probably died before they’d written up the first paper

That's hardly a glowing endorsement of their treatment.

 

[Jenny TipsforME]

As far as I know, acupuncture studies that control for biased reporting tend to find no effects.

Electroacupuncture is probably just electrostimulation with a dubious explanatory model attached to it. I have no problem believing that electrostimulation has an effect on muscles. Similarly, if you stick needles into tissue, it's going to provoke some reaction. It doesn't necessarily mean there is something to acupuncture.

These seem to be objective measures, which removes some scope for bias. I’m fairly sure the rats don’t experience placebo effects. The main area for bias seems to be publication- are the null studies simply not published?

The human metabolics study could be due to fishing expedition issues (if so something to bear in mind with the ME research too).

Also I’m not suggesting we need to buy into the theory of TCM/acupuncture to consider whether something is really happening. If sticking needles into skin improves my mitochondrial function I’m booking back into acupuncture, whether or not it has anything to do with what the therapist believes is happening.

 

[Jenny TipsforME]

That's hardly a glowing endorsement of their treatment.

I don’t know this, just because rats don’t live long and publication takes ages

 

[Esther12]

I don’t think we should dismiss all studies of acupuncture out of hand because they’re on acupuncture (but it’s also wise to take into account the issues with this body of research mentioned in my last post).

This could well be bad and prejudiced of me, but when the first author is at the University of Traditional Chinese Medicine my instinct is to not read the paper. There has been a bit of a history of dodgy findings from these sorts of places on TCM that doesn't hold up when more sceptical researchers look to replicate it. Maybe I'm missing out on some interesting work but until there's a bit more of a history of significant findings that hold up with independent investigators I think I'm going to remain instinctively sceptical.

PS: Looking back, my last post seems a bit rude. I think I was just trying to explain why people might not be going for the 'hot potato', so sorry if it seemed like I was criticising you for posting about it, or anything like that.

 

[Jenny TipsforME]

@Esther12 there’s nothing wrong in being sceptical- I’m sceptical about it too and usually I do ignore rat models and just don’t have the energy to read much TCM stuff. There’s something about this that caught my interest though.

I also think we might need to guard against a cultural prejudice with TCM. We’re not sceptical simply because a doctor in a UK hospital publishes on western medicine (though perhaps we should be automatically sceptical of that too, rather than not sceptical of TCM doctors). It seems likely to me that bits of both systems are beneficial, bits do more harm than good and some of it is nuts. Often in medicine things are discovered by accident and the given theory isn’t important or correct.

If an acupoint is evidenced to be objectively beneficial I don’t want to ignore it because it’s part of something I don’t buy into 100%, that’s treating Western Medicine as a religion I can’t be unfaithful to. The difficult thing is weighing up whether there’s anything in it. If we take an open minded approach are we convinced? It is justifiable to decide this is too difficult.

I also realise people here have emotional history with complementary medicine, we’re not discussing this in a sterile intellectual environment. Either there’s people nagging us to try things we don’t agree with, or we’re spending hope and energy on things which haven’t worked. I suppose my experience with acupuncture is a bit different in that I found it somewhat beneficial but I don’t know how to interpret that. So I’m vaguely positive in my confusion.