The effects of acupuncture and electroacupuncture on Parkinson's disease: Current status and future perspectives for molecular mechanisms.

Among the progressive neurodegenerative disorders, Parkinson's disease (PD) is the second most common. Different factors have critical role in pathophysiology of PD such as apoptosis pathways, inflammatory cytokines, oxidative stress, and neurotransmitters and its receptors abnormalities. Acupuncture and electroacupuncture were considered as nondrug therapies for PD. Although numerous studies has been conducted for assessing the mechanism underlying electroacupuncture and acupuncture, various principal aspects of these treatment procedures remain not well-known. There have also been few investigations on the molecular mechanism of acupuncture and electroacupuncture therapy effects in PD. This review evaluates the effects of electroacupuncture and acupuncture on the molecular mechanism in PD.

¿Es útil la acupuntura para tratar el dolor de la artrosis de rodilla? Los árboles que no dejan ver el bosque / Is acupuncture useful to treat the pain of knee osteoarthritis? Can't see the forestfor the trees

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MiRNAs are involved in chronic electroacupuncture tolerance in the rat hypothalamus.

Acupuncture tolerance is the gradual decrease in analgesic effect due to its prolonged application. However, its mechanism in terms of miRNA is still unknown. To explore the role of miRNAs in electroacupuncture (EA) tolerance of rats using deep sequencing, rats with more than a 50 % increase in tail flick latency (TFL) in response to EA were selected for this experiment. EA tolerance was induced by EA once daily for eight consecutive days. The hypothalami were harvested for deep sequencing. As a result, 49 differentially expressed miRNAs were identified and validated by real-time PCR. Of them, let-7b-5p, miR-148a-3p, miR-124-3p, miR-107-3p, and miR-370-3p were further confirmed to be related to EA tolerance by an intracerebroventricular injection of agomirs or antagomirs of these miRNAs. Potential targets of the 49 miRNAs were enriched in 9 pathways and 282 gene ontology (GO) terms. Five miRNAs were confirmed to participate in EA tolerance probably through the functional categories related to nerve impulse transmission, receptor signal pathways, and gene expression regulation, as well as pathways related to MAPK, neurotrophin, fatty acid metabolism, lysosome, and the degradation of valine, leucine, and isoleucine. Our findings reveal a characterized panel of the differentially expressed miRNAs in the hypothalamus in response to EA and thus provide a solid experimental framework for future analysis of the mechanisms underlying EA-induced tolerance.

[Research progress on quantification of electroacupuncture parameters].

By reviewing literature, summarization and generalization are respectively pertormed according to different electroacupunture (EA) parameters. Based on the understanding of clinical and experimental usage of EA parameters, effects of different parameters are summarized, and a preliminary evaluation is done to point out the advantages and disadvantages. It is found out that different EA parameters would produce different effects on the body, and researches are more in the field of experimental area and less in the clinical area. What's more, the majority of scholars focuses their attention on single-factor study, leading to fewer researches on the effects of parameters combination.

[Chronic pelvic pain syndrome: neurostimulation, neuromodulation and acupuncture]. / Chronisches Schmerzsyndrom des Beckens : Neurostimulation, Neuromodulation und Akupunktur.

Chronic pelvic pain syndrome (CPPS) is defined by the European Association of Urology guidelines as a non-malignant pain perceived in structures related to the pelvis of either women or men for at least 6 months without proven infection or other obvious pathology. It affects the quality of life of millions of people worldwide and has an impact similar to that reported for other chronic diseases, such as diabetes mellitus, Crohn's disease and congestive heart failure. The treatment of CPPS remains a challenge despite several established first line therapies because many patients are therapy refractory. Unconventional treatments, such as neurostimulation, neuromodulation and acupuncture may be highly successful for treating CPPS and have a favorable adverse event profile. Thus, these promising therapeutic alternatives should be considered more often in daily clinical practice.

Fundamentos actuales de la terapia acupuntural / No disponible

La acupuntura es una de las modalidades terapéuticas últimamente más estudiadas y documentadas en el campo de la medicina y la veterinaria. El mecanismo de acción de la acupuntura ha resultado controvertido durante bastante tiempo por el intento de identificación de un proceso único. La estimulación con acupuntura de las fibras nerviosas periféricas envía impulsos a la médula espinal y activa varios centros en el cerebro, para liberar neurotransmisores que ejercen un efecto homeostático en todo el cuerpo. Modula la actividad neural en el diencéfalo, que ejerce influencia en las funciones autonómica, endocrina e inmune a través del eje hipotálamo-hipófisis-adrenal, regulando la liberación circadiana de ACTH, vasopresina y cortisol, conduciendo igualmente a la homeostasis. Los estudios por imagen han mostrado que la estimulación por acupuntura activa estructuras de inhibición descendente del dolor, demostrando que la acupuntura asume una vía central en el control del dolor. Igualmente, la acupuntura actúa sobre el sistema límbico y la integración talámica. Los potenciales evocados corticales somatosensoriales han mostrado que los canales de acupuntura son pasajes bioeléctricos que permiten la transmisión de impulsos. Diversos mecanismos locales de acción explican algunos de los efectos de la acupuntura. Es preciso estudiar si el genotipo y la influencia de factores ambientales ejercen una influencia importante en predecir qué pacientes serán beneficiados por la terapia acupuntural (AU)

Interest in the scientific basis of acupuncture has been increasing, as reflected by a dramatic rise in the number of scientific publications on medical and veterinary acupuncture. The mechanism of action remains unclear because it is not only one. Activation of the descending pain inhibitory system with spinal and supraspinal endorphin release as well as the involvement of other neurotransmitters like serotonin and norepinephrine have been analyzed. Acupuncture triggers a sequence of events involving the release of central endogenous opioid-like substances, as well as ACTH, vasopressin and cortisol, which modulate signals processed along the pathway and have effects on the immunoinflammatory response, the hypothalamic-pituitary axis and homeostasis. Central nervous system imaging techniques allow evaluate the events that occur after acupuncture-induced stimulation, including spinal gating and descending inhibitory pathways. The limbic system and thalamus play an important role in acupuncture-induced analgesia. Cortical somatosensoryevoked potentials have provided compelling evidence for the hypothesis that peripheral driver stimulation is the key element in producing propagated sensations along the meridians. Acupuncture has both local and distant analgesic effects that may be mediated by different mechanisms. The acupuncture points traditionally used for the treatment have a neuroanatomical significance from the viewpoint of western medicine; from that one can hypothesizes a plausible mechanism of action as to how acupuncture achieves its therapeutic effects in terms of contemporary western medicine (AU)

Eletroacupuntura no reparo do tendão calcanear comum em coelhos após enxertia com peritônio bovino / Eletro-acupuncture in the rabbit acchiles tendon repair using bovine peritoneum graft

Avaliou-se o efeito da eletroacupuntura (EA) sobre os aspectos macroscópicos e microscópicos em 36 coelhos que tiveram o tendão calcanear comum seccionado e que, após 30 dias, receberam enxerto de peritônio bovino conservado em solução saturada de sal. Após a cirurgia, os animais foram distribuídos em três grupos de igual número: os do grupo E10 foram estimulados pela EA do segundo ao 11º dia de pós-operatório, os do grupo E20 do 11º ao 31º dia de pós-operatório e os do grupo C não foram estimulados. Posteriormente, os animais foram redistribuídos em três subgrupos de igual número, os quais foram observados no pós-operatório por 11, 31 e 91 dias. Nos coelhos do E10 e E20, ocorreu diminuição de aderência da área enxertada aos tecidos circunvizinhos. Aos 31 dias de pós-operatório, observou-se nos do E10 tecido conjuntivo. Verificou-se intensa neovascularização no local enxertado em todos os animais que receberam estímulo pela EA. Nos coelhos do E10, aos 91 dias, verificou-se intensa quantidade de tecido conjuntivo, com fibras colágenas organizadas e paralelas ao eixo do tendão. O estímulo pela EA na fase precoce do pós-operatório estimulou a maturação cicatricial com mínima reação inflamatória.

The effects of eletro-acupuncture (EA) were evaluated on clinical and histological aspects in 36 rabbits that had the acchiles tendon sectioned and grafted after 30 days using bovine peritoneum graft preserved in saturated salt solution. The animals were randomly distributed into three groups. They were stimulated by EA from the 2nd to the 11th post-operative day (S10 group), from the 11th to the 31st post-operative day (S20 group), and were not stimulated (C group). Then, the rabbits were distributed into three sub-groups and were observed for 11, 31, and 91 days. The rabbits from S10 and S20 groups presented decreased adhesions between graft and adjacent tissues. The rabbits from S10 group showed connective tissue at 31 days of the post-operative period. Intense graft neovascularization was observed in all animals stimulated by EA. Large amounts of connective tissue with organized and parallel to the tendon axis collagen fibers were detected on the day 91st in the S10 group animals. The early EA stimulation during the post-operative period stimulated the tendon healing with minimal inflammatory reaction.

Electroacupuntura en un caso de neuralgia postherpética con afectación de la rama oftálmica del V par craneal / Electroacupuncture in a case of postherpetic neuralgia with involvement of the ophthalmic branch of the trigeminal nerve

Neuralgia postherpética: cuadro de dolor neuropático crónico que aparece como complicación de una infección por el virus de la varicela zóster. La clínica se caracteriza por un dolor intenso y episódico. El tratamiento de elección es farmacológico, pero en un porcentaje de pacientes no se consigue una adecuada respuesta terapéutica, bien por intolerancia a los fármacos bien por inadecuado control del dolor. Se presenta el caso clínico de una paciente con una neuralgia postherpética que afecta a la rama oftálmica izquierda del V par craneal, en la cual no conseguimos un adecuado manejo del cuadro doloroso tras probar diferentes pautas farmacológicas. Ante esta situación, se inició sesiones de electroacupuntura combinadas con fármacos. Se obtuvo una mejoría progresiva de las crisis dolorosas en intensidad y frecuencia, lo que permitió la supresión del tratamiento farmacológico. Alternativa terapéutica a pacientes que no toleran los tratamientos farmacológicos para su dolor neuropático o cuando éstos son ineficaces (AU)

Postherpetic neuralgia consists of chronic neuropathic pain that appears as a complication of varicella-zoster virus infection and is characterized by intense and episodic pain. The treatment of choice is pharmacological but adequate therapeutic response is not always achieved, either due to drug intolerance or to inadequate pain control. Were port the case of a woman with postherpetic neuralgia affecting the left ophthalmic branch of the trigeminal nerve, in whom distinct drug treatments failed to achieve adequate pain control. Given this situation, electro-acupuncture sessions were started, combined with pharmacological therapy. The frequency and intensity of the pain exacerbations progressively diminished, allowing drug treatment to be discontinued. Electroacupuncture can constitute a therapeutic alternative in patients with drug intolerance or inadequate control of neuropathic pain with pharmacological treatment (AU)

Can we evaluate electrodermal testing?

Electrodermal testing (ED testing) is an acupuncture-based approach and was developed to refine homeopathic prescriptions. It is currently being used to advise patients about their "allergies". The evidence for its use in "allergy testing" is limited and often misrepresented. This article addresses the research and clinical issues involved in investigating the reliability and validity of various ED testing machines.