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Home > Newsletters > October 2008 > Research on Biology of Acupuncture has Met the Gold Standard of Science

Research on Biology of Acupuncture has Met the Gold Standard of Science

The Biology of AcupunctureBy Charles Shang, MD

Page 2

Confirmed Predictions on Acupuncture

One corollary from the growth control model is that acupuncture has extensive growth control effects which have been confirmed: Acupuncture has been shown to regulate various growth factors and growth control genes. It can induce vascular endothelial growth factor82 and basic fibroblast growth factor83 during brain ischemia. It also induces glial cell line-derived neurotrophic factor84 and expression of the c-fos proto-oncogene.85, 86 Acupuncture regulates the expression of Bcl-2,87 Bax, fas and FasL proteins which are involved in apoptosis signaling. Acupuncture inhibits the apoptosis of intestinal epithelial cells in inflammatory bowel disease of rats88 and enhances proliferation of CD8+ lymphocytes,89 reduces nerve growth factor in polycystic ovaries,90, 91reduces IL-6 expression and proliferation of osteoclasts.92 The neuro-humoral factors induced by acupuncture such as endorphins, nitric oxide and serotonin also have growth-control effects.92, 98, 94 In RCTs, acupuncture has shown efficacy in treating growth control related disorders including spinal cord injuries38 and low sperm quality.95, 96

Growth Control System as Foundation of Pathophysiology

A growth control system originates from a network of organizers.97 In embryogenesis, the development of organizers precedes the development of other physiological systems.18,64 The formation, maintenance and regulation of all the physiological systems are dependent on the activity of the growth control system. Growth control is a primary function of all multi-cellular organisms. The evolutionary origin of the growth control system likely preceded all the other physiological systems. Its genetic blueprint served as a template from which the newer systems evolved. Consequently, it overlaps and interacts with other systems but is not merely part of the nervous system, immune system or circulatory system. The growth control signal transduction is embedded in the activity of the function-based physiological systems: The regulation of many neural, circulatory, immune processes and related disorders are mediated through growth control mechanisms such as hypertrophy, hyperplasia, atrophy, apoptosis with shared messenger molecules including morphogens98, 99, 77,81 and common signal transduction pathways involving growth control genes such as proto-oncogenes.100, 101, 102

The Nonspecific Stimulation and the Long Term Effects of Acupuncture

Based on the growth control model, acupuncture points and organizers are singular points and therefore prone to nonspecific perturbation. The long lasting systemic effects of acupuncture can be achieved by nonspecific stimuli as mentioned above. Similarly, long lasting growth control activities of organizers have been induced by various stimuli such as mechanical injury and injection of nonspecific chemicals.67 Based on the growth control model, acupuncture effect is a byproduct of the growth control network. Stimulating organizers – acupuncture points can not only cause transient modulation of neurotransmission, but also alter the growth control signal transduction in various systems - leading to long term effects.18

The Distribution of Acupuncture Points and Organizers

Organizers are at the extreme points of curvature on the body surface such as the locally most convex points (e.g., apical ectodermal ridge and other growth tips) or concave or saddle points (e.g., zone of polarizing activity).103, 18 Similarly, almost all the extreme points of the body surface curvature are acupuncture points. For example, the convex points include EX-UE11 Shixuan (finger tips), EX-LE12 Qiduan (toe tips), ST17 Ruzhong (tip of nipple), ST42 Chongyang, (the convex, palpable point of arteria dorsalis pedis), GV25 Suliao (nose tip) ... The concave points include TE3 Zhongzhu (the concave point between the 4th and 5th metacarpal), KI1 Yongquan (at the concave point of the sole), GB20 Fengchi (the concave point below occipital bone, between upper ends of sternocleidomastoid and trapezius), BL40 Weizhong (midpoint of the transverse crease of the popliteal fossa), HT1 Jiquan (the most concave point of axilla), BL1 Jingming (at the concave point above medial canthus), CV8 Shenque (navel)... Based on growth control model, the extreme points of surface curvature are associated with organizers – acupuncture points. The auricle obviously has the most convoluted surface morphology of the human body. Therefore it has the highest density of extreme points of surface curvature and is expected to have the highest density of organizers - acupuncture points. Auricle exemplifies the interconnection of growth control: Auricular morphology is a sentinel of malformation in other organs. Auricular malformation has been observed in numerous malformation syndromes. It is recommended in a standard textbook of pediatrics that any auricular anomaly should initiate a search for malformations in other parts of the body.104

The Origin of Meridians

The growth control model suggests that the discontinuity or abrupt transition in growth control not only exists at organizers but also along boundaries.18,61 The growth control boundaries or folds between different structures are also called separatrices in mathematics and often connect singular points - organizers. The model predicted that growth control boundaries have high electric conductance and high density of gap junctions – just as the meridians in acupuncture which likely originate from growth control boundaries. These predictions have been confirmed: As embryogenesis progresses, high density gap junctions become restricted at discrete boundaries, leading to the subdivision of the embryo into communication compartment domains.105, 106 Increasing or decreasing the gap junctions can cause various developmental defects107 such as spina bifida.108 These high electric conductance boundaries are likely major pathways of bioelectric currents. Organizers are known to locate at boundaries between different structures.109 The growth control model suggests that meridians originate from separatrices – boundaries in growth control and form an undifferentiated,18,61 interconnected cellular network that regulates growth and physiology. In consistence with the prediction of under-differentiation of the meridian system and growth control system, it has been observed that the most apical part of folds of embryo remain undifferentiated in morphogenesis,110 including organizers such as apical ectodermal ridge.111 As predicted by the growth control model, singular point and separatrix have important roles in morphogenesis.112, 113 Growth control boundaries/separatrices are similar to organizers in controlling growth and pattern formation with morphogen gradient.114 Many acupuncture points are located at boundaries between different body domains or muscles, coinciding with the connective tissue planes which connect adjacent body domains or muscles.17, 37, 115

Summary

Current acupuncture research suggests a convergence of the neurophysiology model, the connective tissue model and the growth control model. The growth control model of acupuncture set the first example of a biological model in integrative medicine with significant prediction power across multiple disciplines. It is the first theory in basic acupuncture research which has met the gold standard in testing scientific theory. The following predictions of the growth control model have been independently confirmed by research results in both acupuncture and conventional biomedical sciences: 1. Acupuncture has extensive growth control effects. 2. Singular point and separatrix have important roles in morphogenesis. 3. Organizers have high electric conductance, high current density and high density of gap junctions. 4. A high density of gap junctions is distributed as separatrices or boundaries at body surface after early embryogenesis. 5. Many acupuncture points are located at transition points or boundaries between different body domains or muscles, coinciding with the connective tissue planes. 6. Some morphogens and organizers continue to function after embryogenesis. The growth control model has also shed light on several puzzling phenomena of acupuncture such as the distribution of auricular acupuncture points, the long term effects of acupuncture and the effect of multimodal nonspecific stimulation at acupuncture points.

Future Directions

  1. The structure and cell differentiation at acupuncture points as well as the neurophysiology and growth control signal transduction involved in different modalities of acupuncture should be further delineated.
     
  2. Manipulating the singular points - organizers of the growth control system may be a convenient way of activating intrinsic stem cells as evident from the improvement of sperm quality after acupuncture.95, 96
     
  3. As the growth control model predicts the growth control activity at acupuncture points/extreme points of surface (or interface) curvature after embryogenesis, residual morphogen gradient may still exist at these points and may be detectable by probing morphogen candidates such as Hedgehog, Wnt and TGF-beta families. Certain morphogen gradient distributes along boundaries.116 This pattern may persist after embryogenesis into adulthood and coincides with meridians.
     
  4. Mapping of the growth control system and the dynamics of its electromagnetic field with high resolution techniques such as the superconducting quantum interference device (SQUID) and atomic magnetometer :117 The growth control model predicts that the singular points and separatrices of the bioelectric field in growth control correlate with the acupuncture points and meridians respectively.
     
  5. The growth control model suggests that techniques involving the stimulation of the growth control system such as acupuncture can activate the growth control activity of an organism and improve its structure and function at a more fundamental level than symptomatic relief.18 In growth control, the change in electric field precedes morphologic change and manipulation of the electric field can affect the change.70, 118 Development of the techniques of detecting and manipulating the electric field may enable the diagnosis and treatment of a pathologic process at the early signal transduction stage prior to the anatomical or morphological change.
     
  6. The growth control model suggests that apparently unrelated acupuncture points are not exactly ‘placebo’ points. The more acupuncture points are used as placebo points in a RCT, the more likely that some systemic effects will be resulted from the ‘placebo’ treatment. The self-regulatory effect of acupuncture will be difficult to predict when the patients have multiple comorbidities and many acupuncture points are used. Subtle, ‘sham’ stimulation at acupuncture points can be effective due to the response of the acupuncture points to nonspecific stimuli. These reasons may contribute to the mixed results in RCTs on acupuncture. This model also suggests that acupuncture is mostly likely to demonstrate its efficacy and advantage in a patient population with few comorbidities, relatively good general health and Vitality and a regimen with efficient use of acupoints.
     
  7. The growth control model suggests that the distribution of growth control system is related to both internal and external structures. Acupuncture points which are not at obvious extreme points of surface curvature or meridians which are not at obvious surface boundaries may be vestigial or related to interface between internal structures such as muscles and bones. Intrinsic stem cells are likely part of the undifferentiated growth control network. The germ cell is one of the least differentiated cells and also a type of stem cell – similar to the embryonic stem cell in its ability to differentiate into all three germ layers. The distribution pattern of intrinsic germ cells can be deduced based on the fact that the distribution pattern of primary tumors reflects the distribution of their normal counterpart. The primary germ cell tumors119 have a midline and para-axial distribution pattern which spans from the sacrococcygeal region to pineal gland. It appears to concentrate at 7 locations: sacrococcygeal region, gonads, retroperitoneum, thymus, thyroid,120 suprasellar region, and pineal gland. This pattern reflects the distribution pattern of intrinsic germ cells which are likely to be highly inter-connected in a normal state (e.g. via gap junctions121 ) and provide important regulatory functions.122, 56 This also suggests a hierarchy in the degree of cell differentiation and function in the growth control system.

Acknowledgments

I thank Steven K.H. Aung, Zang-Hee Cho, Yuenan Cui, Li Dingzhong, Maria do Desterro Leiros, Michael Levin, Vitaly Napadow, Richard Nuccitelli, Stig Ollmar, Rosa N. Schnyer, San Wan, Peter Wayne, Raimond Wong, Seung-Schik Yoo for their input.

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Charles Shang, MD
Department of Medicine
New England Baptist Hospital
Harvard Medical School
125 Parker Hill Ave.
Boston, MA 02120
Tel: 617-754-5248
Email: cshang@caregroup.harvard.edu

 

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This Month's Articles

October 2008
Volume 6, Number 10

Apples: The Live Longer Fruit

Chinese Medicine Mitigates the Pain, Swelling and Weakness of Multiple Sclerosis

Research on Biology of Acupuncture has Met the Gold Standard of Science

Recent Research

Ask The Doctor

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