Acupuncture modulates immunity in sepsis: Toward a science-based protocol

Pan, Wei-Xing; Fan, Arthur Yin; Chen, Shao-Zong; Alemi, Sarah Faggert

doi:10.1016/j.autneu.2021.102793

Cited by 27 publications

(36 citation statements)

References 98 publications

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“… 4 Antibiotics and glucocorticoids have major side effects that limit their clinical implications in sepsis. 34 By contrast, acupuncture has minimal side effects and significant therapeutic potential that can provide beneficial effects on sepsis patients. Studies have shown that EA at ST36 acupoint stimulates neurons expressing Prokr2 protein on the sciatic nerve, uploads nerve signals to the central nervous system, thereby stimulating the adrenal glands to release glucocorticoids and dopamine, inhibiting the secretion of cytokines, and controlling systemic inflammation.…”

Section: Discussionmentioning

confidence: 99%

Electroacupuncture at ST36 (Zusanli) Prevents T-Cell Lymphopenia and Improves Survival in Septic Mice

Lv¹,

Shi²,

Bassi³

et al. 2022

JIR

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Purpose Sepsis is the main cause of death in intensive care unit. Maladaptive cytokine storm and T-cell lymphopenia are critical prognosis predictors of sepsis. Electroacupuncture (EA) is expected to be an effective intervention to prevent sepsis. This study aims to determine the potential of EA at ST36 ( Zusanli ) to prevent experimental septic mice. Methods Mice were randomly assigned into PBS, LPS, or EA+LPS group. EA (0.1 mA, continuous wave, 10 Hz) was performed stimulating the ST36 for 30 min, once a day for 3 days. After the third day, all mice were challenged with PBS or LPS (4 mg/kg) simultaneously. Mice were evaluated for survival, ear temperature, and other clinical symptoms. Lung and small intestine tissue injuries were analyzed by hematoxylin and eosin staining. Bio-Plex cytokine assay was used to analyze the concentration of cytokines. T lymphocytes were analyzed by flow cytometry and Western blot assays. The role of T cells in preventing sepsis by EA was analyzed by using nude mice lacking T lymphocytes. Results EA at ST36 improved survival, symptom scores, and ear temperature of endotoxemic mice. EA also improved dramatically pulmonary and intestinal injury by over 50% as compared to untreated mice. EA blunted the inflammatory cytokine storm by inducing a lasting inhibition of the production of major inflammatory factors (TNF-α, IL-1β, IL-5, IL-6, IL-10, IL-17A, eotaxin, IFN-γ, MIP-1β and KC). Flow cytometry and Western blot analyses showed EA significantly reduced T-lymphocyte apoptosis and pyroptosis. Furthermore, T lymphocytes were critical for the effects of EA at ST36 stimulation blunted serum TNF-α levels in wild-type but not in nude mice. Conclusion EA halted systemic inflammation and improved survival in endotoxemic mice. These effects are associated with the protective effect of EA on T lymphocytes, and T cells are required in the anti-inflammatory effects of EA in sepsis.

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Section: Discussionmentioning

confidence: 99%

Electroacupuncture at ST36 (Zusanli) Prevents T-Cell Lymphopenia and Improves Survival in Septic Mice

Lv¹,

Shi²,

Bassi³

et al. 2022

JIR

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“…In recent years, acupuncture has shown remarkable results in counteracting inflammation through the vagal and sympathetic nervous systems. For example, EA can reduce sepsis-induced damage to multiple internal organs such as the lung, heart, kidney, liver, and gastrointestinal tract ( 97 ). The mechanism is that EA stimulates peripheral nerves to induce somatic-autonomic reflexes that, in turn, regulate the functions of the corresponding organs.…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy and Potential Mechanisms of Acupoint Stimulation Combined With Chemotherapy in Combating Cancer: A Review and Prospects

Zhao

Guo

et al. 2022

Front. Oncol.

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Although chemotherapy is the first-line treatment strategy for a variety of tumors, its side effects have limited its efficacy. This review summarizes the progress on the use of acupoint stimulation to combat chemotherapy-associated side effects, including chemotherapy-induced peripheral neuropathy (CIPN), cognitive impairment (CICI), and gastrointestinal toxicity (GI), as well as myelosuppression and immunosuppression. It was found that acupoint stimulation attenuated CIPN and GI by modulating the 5-hydroxytryptamine system in dorsal root ganglia, the dorsal horn of the spinal cord, and the duodenum by reducing oxidative stress and neuroinflammation. Acupoint stimulation also alleviated GI by activating vagal activity in the nucleus tractus solitarius and promoting the secretion of gastrointestinal neuropeptide hormones. Acupoint stimulation restored both bone marrow hematopoiesis and immune function to combat cancer. In addition, the combination of acupoint stimulation and chemotherapy could inhibit tumor growth by promoting tumor cell apoptosis and the enrichment of chemotherapeutic agents in tumor tissue and by modulating the tumor immune microenvironment and normalizing the vasculature. Multiple evidence also indicates that neuroimmune regulation may be involved in the effects of acupoint stimulation. In conclusion, the evidence suggests that acupoint stimulation can alleviate the side effects of chemotherapy and can also assist chemotherapeutic agents in inhibiting tumor growth, which expands the clinical application of acupoint stimulation in cancer treatment. However, more high-quality clinical studies are needed to confirm the clinical value of acupoint stimulation.

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“…He et al [ 21 ], pointed out that for COVID-19, acupuncture may be used, and it can play an anti-inflammatory effect by activating the vagus nerve through the cholinergic anti-inflammatory pathway [ 22 ],. In severe inflammation such as in the sepsis stage, evidence in both preclinical studies and clinical trials shows that activating the autonomic nervous system by acupuncture can significantly modulate the immunity, protect the function of internal organs and decrease the fatality rate [ 23 ],. From the perspective of Chinese medicine, current acupuncture treatments were focused on strengthening the kidney and spleen, and adjusting the lung, heart and liver.…”

Section: Discussionmentioning

confidence: 99%

Recovery of a patient with severe COVID-19 by acupuncture and Chinese herbal medicine adjuvant to standard care

Yin

Cai

Tao

et al. 2021

Journal of Integrative Medicine

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There is currently no drug or therapy that can cure the coronavirus disease 2019 (COVID-19), which is highly contagious and can be life-threatening in severe cases. Therefore, seeking potential effective therapies is an urgent task. An older female at the Leishenshan Hospital in Wuhan, China, with a severe case of COVID-19 with significant shortness of breath and decrease in peripheral oxygen saturation (SpO 2 ), was treated using manual acupuncture and Chinese herbal medicine granule formula Fuzheng Rescue Lung with Xuebijing Injection in addition to standard care. The patient’s breath rate, SpO 2 , heart rate, ratio of neutrophil/lymphocyte (NLR), ratio of monocyte/lymphocyte (MLR), C-reactive protein (CRP), and chest computed tomography were monitored. Acupuncture significantly improved the patient’s breathing function, increased SpO 2 , and decreased her heart rate. Chinese herbal medicine might make the effect of acupuncture more stable; the use of herbal medicine also seemed to accelerate the absorption of lung infection lesions when its dosage was increased. The combination of acupuncture and herbs decreased NLR from 14.14 to 5.83, MLR from 1.15 to 0.33 and CRP from 15.25 to 6.01 mg/L. These results indicate that acupuncture and Chinese herbal medicine, as adjuvants to standard care, might achieve better results in treating severe cases of COVID-19.

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Acupuncture modulates immunity in sepsis: Toward a science-based protocol

Cited by 27 publications

References 98 publications

Electroacupuncture at ST36 (Zusanli) Prevents T-Cell Lymphopenia and Improves Survival in Septic Mice

Electroacupuncture at ST36 (Zusanli) Prevents T-Cell Lymphopenia and Improves Survival in Septic Mice

Clinical Efficacy and Potential Mechanisms of Acupoint Stimulation Combined With Chemotherapy in Combating Cancer: A Review and Prospects

Recovery of a patient with severe COVID-19 by acupuncture and Chinese herbal medicine adjuvant to standard care

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