Acupuncturists making their point on allergies
Drugs are effective and convenient, but needles have a lasting effect on sufferers
Acupuncture is becoming an appealing option for a growing number of allergy sufferers. The treatment has been practised in China since before the advent of metal technology - when a small, pointed stone tool was used to press on the points rather than puncturing the skin - and it is now gaining acceptance from conventional medicine in West.
Today, new acupuncture studies comparing the effects of the therapy against the standard available treatment, are showing that in the treatment of some allergies, acupuncture performs just as well as conventional medical interventions.
Recent research conducted by Dresden University, for example, has shown acupuncture to perform as well as standard antihistamines in the relief of allergic rhinitis - with one major difference: 80pc of patients in the acupuncture group still experienced improvement of symptoms 10 weeks after the end of the treatment period, compared to none of the drug group.
The report attributed this finding to the 'immunomodulatory effect' of the treatment. In other words, the key to the longevity of the symptom relief was the physical workings of acupuncture itself.
Both treatments acted directly on histamine release, but in very different ways. It was found that acupuncture worked through immune modulation, while the drug worked through immune suppression.
To understand how antihistamines work, imagine a game of musical chairs where all the histamines want to take a seat. When the drug molecules come into the room they take all the seats so that the histamines are left hanging around, unable to act. It's a good strategy, until the drug wears off and the body produces more histamine.
What happened in the acupuncture group was an increase in a signalling molecule called interleukin-10 (IL-10).
This immune chemical tells the histamine not to come out to play at all so that, instead, all the chairs in the room are empty. The amount of this native chemical being produced in the patients' bodies gradually increased during the acupuncture treatment period so that the offending histamine naturally reduced over the course of the treatments.
That explains the reduction in symptoms, but what's even more interesting is that 10 weeks later, when the participants were tested again for immune-system markers, the level of IL-10 in the blood had increased even more.
It was as if the participants' immune systems had learned something and had changed conduct. The needle stimulation set some behaviour in motion that then perpetuated itself. That's what modulation of the system means rather than suppression.
Scientific investigation using microscopy and gene-expression profiling has rightly identified allergy as an alternate immune response compared to the body's normal reaction to pathogens like bacteria.
There are specific immune soldiers, IgE antibodies and mast cells, that are responsible for those telltale signs of itching eyes, swelling, sneezing and running nose that are not the same as the soldiers for infections.
Traditional Chinese Medicine (TCM) doesn't really make this distinction but it does acknowledge, in the chronic case, a separate cause for ongoing symptoms. TCM judges the immunity of the chronic allergy sufferer to be somehow lacking. In this case, the defensive mechanisms are seen to be compromised due to either inherited weakness or previous incidence of infections that weren't treated properly and left the body with residual inflammation and unresolved damage.
The TCM theory of what causes the symptoms of allergy and inflammation are down to an invasion of 'wind' that gives rise to 'fire' in the body. Use of such elemental terms in medicine seems outrageously esoteric and quite out of touch with the physical realities of molecular biology.
As someone with a scientific mind, it was something I found very difficult to grapple with when I first studied TCM. I was stunned then when I discovered that although the word for 'wind' in the environmental sense and 'wind' in the sense of pathogenic invasion is pronounced the same in Chinese, an important distinction is made in the written form.
The medical term is made up of two characters. One is the normal character for wind and inside this is drawn the character for a kind of maggot. Within this single pictogram is the concept that sickness enters the body via invisible organisms carried on the air.
This is precisely germ theory and it was recorded in Chinese medical texts written over 1,000 years before Louis Pasteur (of 'pasteurisation') proposed his theory of micro-organisms as the causative agents of disease in the 1850s.
While in Europe, we looked at people becoming sick on contact with rotting food and presumed there was foul air around this food that caused sickness upon inhalation, the Chinese saw minuscule worms appearing and growing on decaying biowaste and presumed that they must, at first, have been so small that they were invisible to the naked eye, but nonetheless, were present and light enough to float on the air.
In Austria, the health authorities there asked doctors what kind of natural therapies would be worth investigating. The majority of medics there considered TCM to be the most likely therapy to garner reproducible results and the most feasible for integration into mainstream healthcare regimes.
A biomedical engineer, Dr Gerhard Litscher, was assigned to lead the acupuncture arm of the investigations to ascertain whether this really is an effective and reliable technology.
Studies like the one at Dresden University mentioned earlier are quite convincing, but how can we know definitively the effect is not due to placebo?
Rather than conducting studies on ill patients and monitoring their disease progression, Dr Litscher is attempting to objectify the generalised effects of acupuncture on the brains of healthy volunteers. His team is finding that acupuncture can, in fact, supply quantifiable and reproducible results. In one study, using lasers for stimulation instead of stainless steel needles, an acupoint at the side of the nose was targeted for investigation. This point was also used in Dresden University's allergic rhinitis study because it treats blocked nose associated with rhinitis and common cold.
I was curious as to the outcome of the study because I've seen how this point can temporarily open blocked nasal passages within seconds of stimulating it. Transcranial Doppler ultrasonography is a technique used in hospitals to check the health of the arteries in the brain. It was adopted in this study to monitor the speed of blood flow in the main cerebral arteries before, during and after laser-needle acupuncture stimulation. They determined that the blood flow velocity increased in the artery towards the front of the brain that supplies the nasal area, whereas there were no changes in the other arteries. The big significance in this data lies in realising that the body's resources can be redirected according to stimulation coming from specific points along the peripheral nerves.
Inflammation, which is the main source of undesirable symptoms in any allergy-associated illness, from pollen exposure to food intolerance, is particularly susceptible to alteration by acupuncture stimulation.
Conventional glucocorticoid drugs act at multiple sites to suppress inflammation. Taking them for relief of bothersome allergy symptoms is convenient and effective. If symptoms persist and the condition becomes chronic, acupuncture could be a chance to reeducate the immune system to work more efficiently.
A wealth of studies on the online database PubMed have identified a number of anti-inflammatory pathways that can be activated by acupuncture. One of them, the Hypothalamus Hypophysis Adrenal axis leads naturally to the secretion of cortisol, the body's very own supply of glucocorticoid, which is the best known anti-inflammatory hormone and drug.
Although acupuncture so far seems to have a limited effect for patients on long-term immunosuppressive drugs, or people with innate allergies, it appears to be very helpful for those who have developed various food sensitivities or recurrent allergic symptoms over time.
* Clare Foley is a practising acupuncturist with extensive training in hospitals in Beijing. She has a BSc in experimental physics and biology and is pursuing further research in biophysics. See facebook. com/ClareFoleyAcupuncture/.
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