A recent collaborative study by Professor Shufeng Zhou, MD, PhD, USF Health College of Pharmacy together with Professor Xinsheng Lai, MD, College of Acupuncture, Guangzhou University of Chinese Medicine, Guangzhou, China, has demonstrated that acupuncture can significantly reduce blood pressure in a spontaneous hypertensive rats, possibly through the modulation of redox-oxidation balance. The findings from this interesting study have been recently published in PLOS One (http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0044216), a top biomedical journal with open access to all readers worldwide. In about three weeks, this article has been read by 327 people. This study was funded by China National 973 Programs (top funding programs for key basic and translational research) and startup fund from the USF Heath College of Pharmacy.

In this study, 5-min of acupuncture treatment was incorporated daily for 7 days. The acupoint stimulated was ‘Taichong,’ also known as LR-3, located in “in the hollow distal to the junction of the first and second metatarsal bones” and was compared to stimulation of a non-acupoint (sham control). A comparison of the Taichong treated subgroup to the non-acupoint treated subgroup revealed seven proteins were downregulated in the Taichong group. These include heat shock protein-90, myelin basic protein, NAD-dependent deacetylase sirtuin-2, protein kinase C inhibitor protein 1, pyruvate kinase isozyme, synapsin-1, and ubiquitin hydrolase isozyme L1, while six proteins were upregulated in the Taichong group including aldehyde dehydrogenase 2, DJ-1 protein, glutamate dehydrogenase 1, glutathione S-transferase M5, Rho GDP dissociation inhibitor 1, and superoxide dismutase. These results were further confirmed by ELISA, Western blot and RT-PCR assays. The data clearly show that acupuncture can modulate the expression of enzymes in neurons that are involved in redox-oxidation processes. Further studies at Professor Shufeng Zhou’s lab are ongoing to investigate how epigenetic factors such as microRNAs play a role in acupuncture’s biological and clinical effects.

Hypertension is a major factor in human morbidity and mortality world-wide. The overall death rate from hypertension in the US in 2008 was reported as 18.3%. Hypertension is called the ‘silent killer’ due to frequent lack of symptoms it often escapes diagnosis and as many as 80% of US adults who have hypertension are unaware of their condition. Primary barriers to conventional treatment include unwanted effects, patient noncompliance, costs for medication, and improper dose and administration. Acupuncture has been applied by many doctors to manage various diseases including cancer, diabetes, and hypertension.

Currently greater than 2 million Americans report recently using acupuncture. Extensive studies in China have shown significant outcome-based efficacy of acupuncture for the treatment of hypertension; however, until now the mechanisms have remained unknown. Oriental medicine theory, also known as Traditional Chinese Medicine or as it is coined in the US, ‘East Asian Medicine’ (EAM), views the patient comprehensively from a functionally integrated systems perspective, which incorporates union of the body/mind and focuses on manipulation of systems to maintain or rescue physiological equilibrium (i.e. homeostasis) known as ‘yin-yang’ balance. There are eight aspects of patient care in EAM theory from which this balance can be achieved. The “Two Pillars” are acupuncture and traditional Chinese herbal medicine; other aspects are movement (fitness), nutrition, massage, meditation, an environmental spatial aspect, and a temporal aspect (often viewed as consciousness). Oriental medicine physicians diagnose from patient symptoms, evaluation of pulses and tongue, physical exam, and 10 traditional questions. Collectively this assessment provides an individualized diagnostic pattern, from which the physician can determine appropriate treatment.

East Asian medicine presents a comprehensive 2500 y.o. personalized, functional, holistic model of health care, which views the body/mind as traversed by energetically connecting channels, called meridians, that are linked to interior/exterior paired organ systems. The acupuncture points (acupoints) are specific therapeutic contact centers on the meridians (similar to an electrical outlet connection to a power source) that also have defined integrating connections with other meridians, and over more than two millennia came to be recognized as reliable for promoting positive therapeutic results (EAM outcome-based traditional medicine).

Acupuncture ‘meridians’ are thought to modulate the flow of ‘Qi,’ which is considered to correlate in part with an ‘energetic’ or electromagnetic flow that is not scientifically well defined within the physical confines of the body/mind; however, has been indicated in the human aura; the meridians also may have effects based on what bioscience and Western medicine have identified as neuroendocrine-immune integration (i.e. ‘biocrosstalk’). Notably the mechanisms underlying some electroporation functions may be grounded in EAM theory; in fact, acupuncturists often incorporate electro-stimulation to hasten or enhance acupuncture treatment.

The demonstration of decrease in symptomatic blood presssure levels in hypertension and potentially related biomarkers gives scientific validation to EAM outcome-based practices, furthers the understanding between biomedicine and traditional medicines, and may lead to broadened incorporation of acupuncture in mainstream standards of care. Further study is necessary regarding potential anti-oxidative effects of acupuncture on hypertension, as well as acupuncture efficacy, additional potentially related biomarkers, and cost-effectiveness as it relates to hypertension and particularly other barrier diseases.

Authors:
Rhonda R. Wilbur, MS in Oriental Medicine, PhD student, Integrative Biomedical Sciences Program, USF Health Colleges of Medicine and Pharmacy; and Professor Shufeng Zhou, MD, PhD, Associate Vice President of Global Medical Development and Associate Dean of International Affairs, College of Pharmacy, USF Health, Tampa, FL33612 (emails: rwilbur@health.usf.edu and szhou@health.usf.edu).