Using reactive hyperemia to investigate the effect of cupping sizes of cupping therapy on skin blood flow responses.

BACKGROUND: Various cupping sizes of cupping therapy have been used in managing musculoskeletal conditions; however, the effect of cupping sizes on skin blood flow (SBF) responses is largely unknown. OBJECTIVE: The objective of this study was to compare the effect of three cupping sizes of cupping therapy on SBF responses. METHODS: Laser Doppler flowmetry (LDF) was used to measure SBF on the triceps in 12 healthy participants in this repeated measures study. Three cup sizes (35, 40 and 45 mm in diameter) were blinded to the participants and were tested at -300 mmHg for 5 minutes. Reactive hyperemic response to cupping therapy was expressed as a ratio of baseline SBF. RESULTS: All three sizes of cupping cups resulted in a significant increase in peak SBF (p< 0.001). Peak SBF of the 45 mm cup (9.41 ± 1.32 times) was significantly higher than the 35 mm cup (5.62 ± 1.42 times, p< 0.05). Total SBF of the 45 mm cup ((24.33 ± 8.72) × 103 times) was significantly higher than the 35 mm cup ((8.05 ± 1.63) × 103 times, p< 0.05). Recovery time of the 45 mm cup (287.46 ± 39.54 seconds) was significantly longer than the 35 mm cup (180.12 ± 1.42 seconds, p< 0.05). CONCLUSIONS: Our results show that all three cup sizes can significantly increase SBF. The 45 mm cup is more effective in increasing SBF compared to the 35 mm cup.

Using Elastographic Ultrasound to Assess the Effect of Cupping Size of Cupping Therapy on Stiffness of Triceps Muscle.

OBJECTIVE: Cupping therapy may reduce muscle stiffness for managing fatigue. However, there is no scientific evidence showing changes of muscle stiffness after cupping therapy. Furthermore, it is unclear whether the cup size of cupping therapy affects the change of muscle stiffness. The objective of this study was to compare the effect of cup size of cupping therapy on muscle stiffness. DESIGN: A repeated measures design with a counterbalanced design was used to test three cup sizes (45, 40, and 35 mm in inner diameter) in 12 healthy participants. Strain elastography was used to measure stiffness of the triceps before and after cupping therapy at 300 mm Hg for 5 mins. Strain elastogram was converted to the grayscale for the quantification of stiffness. RESULTS: The overall stiffness of triceps significantly reduced after cupping therapy with the 45-mm (106.2 ± 7.7, P < 0.05) and 40-mm (109.6 ± 7.1, P < 0.05) cups, but not the 35-mm cup (115.5 ± 10.3, nonsignificant) compared with before cupping (115.8 ± 13.5). The stiffness of superficial layer did not show significantly difference in all three sizes of cup. The stiffness of deep layer significantly reduced after the cupping therapy with the 45- and 40-mm cups. CONCLUSIONS: This is the first study demonstrating that cupping therapy significantly reduced muscle stiffness, especially at the deep layer.

Using laser Doppler flowmetry with wavelet analysis to study skin blood flow regulations after cupping therapy.

BACKGROUND: The purpose of this study was to use laser Doppler flowmetry (LDF) with wavelet analysis to investigate skin blood flow control mechanisms in response to various intensities of cupping therapy. To the best of our knowledge, this is the first study to assess skin blood flow control mechanism in response to cupping therapy using wavelet analysis of laser Doppler blood flow oscillations. MATERIALS AND METHODS: Twelve healthy participants were recruited for this repeated-measures study. Three different intensities of cupping therapy were applied using 3 cup sizes at 35, 40, and 45 mm (in diameter) with 300 mm Hg negative pressure for 5 minutes. LDF was used to measure skin blood flow (SBF) on the triceps before and after cupping therapy. Wavelet analysis was used to analyze the blood flow oscillations (BFO) to assess blood flow control mechanisms. RESULTS: The wavelet amplitudes of metabolic and cardiac controls after cupping therapy were higher than those before cupping therapy. For the metabolic control, the 45-mm cupping protocol (1.65 ± 0.09) was significantly higher than the 40-mm cupping protocol (1.40 ± 0.10, P < .05) and the 35-mm cupping protocol (1.35 ± 0.12, P < .05). No differences were showed in the cardiac control among the 35-mm (1.61 ± 0.20), 40-mm (1.64 ± 0.24), and 45-mm (1.27 ± 0.25) cupping protocols. CONCLUSION: The metabolic and cardiac controls significantly contributed to the increase in SBF after cupping therapy. Different intensities of cupping therapy caused different responses within the metabolic control and not the cardiac control.

Antitumor efficacy of viable tumor vaccine modified by heterogenetic ESAT-6 antigen and cytokine IL-21 in melanomatous mouse.

The goal of this study was to investigate whether glycosylphosphatidylinositol (GPI)-anchored 6 kDa early secreted antigenic target (ESAT-6) and IL-21-producing B16F10/ESAT-6-GPI-IL-21 viable vaccine would induce antitumor efficacy. Mice were immunized with B16F10/ESAT-6-GPI-IL-21 vaccine and challenged by B16F10 cells 2 weeks later. Antitumor efficacy and mechanisms of the vaccine were analyzed. Vaccination with the viable B16F10/ESAT-6-GPI-IL-21 vaccine resulted in an increase of IFN-γ level and the CD8(+)CTL cytotoxicity, a decrease in TGF-ß generation and increase in the expression of miR-200c that serves as melanoma suppressor by directly targeting zinc-finger E-box binding homeobox 1 to inhibit epithelial-mesenchymal transition and block tumor metastasis. The vaccine significantly inhibited the melanoma growth, reduced the lung melanoma nodules, and prolonged the mouse survival compared with the controls. These findings highlighted IL-21 as an immune adjuvant in an engineered viable tumor vaccine to reinforce heterogenetic antigen ESAT-6 immune tolerance break to induce powerful antitumor efficacy in mice.