Acupuncture may hold promise for treating inflammatory diseases such as sepsis, a condition that often develops in hospital intensive care units, springs from infection and inflammation, and kills an estimated 250,000 people in the United States every year.
“Sepsis is the major cause of death in the hospital,” says Luis Ulloa, an immunologist at Rutgers New Jersey Medical School. “But in many cases patients don’t die because of the infection. They die because of the inflammatory disorder they develop after the infection. So we hoped to study how to control the inflammatory disorder.”
Researchers already knew that stimulation of one of the body’s major nerves, the vagus nerve, triggers processes in the body that reduce inflammation, so they set out to see whether a form of acupuncture that sends a small electric current through that and other nerves could reduce inflammation and organ injury in septic mice.
Increasing the current magnifies the effect of needle placement, and notes that electrification is already FDA-approved for treating pain in human patients.
When electroacupuncture was applied to mice with sepsis, molecules called cytokines that help limit inflammation were stimulated as predicted. Half of those mice survived for at least a week. None of the mice that didn’t receive acupuncture survived.
The researchers then probed further, to figure out exactly why the acupuncture treatments were successful. And they made a discovery that, on its face, was disappointing. When they removed adrenal glands, which produce hormones in the body, the electroacpuncture stopped working.
A double triumph
That discovery presented a potential roadblock to use of acupuncture for sepsis in humans, because most human cases of sepsis include sharply reduced adrenal function. In theory, electroacupuncture might still help a minority of patients whose adrenal glands work well, but not many others.
Researchers then found the specific anatomical changes that occur when electroacupuncture is performed with functioning adrenal glands. Those changes include increased levels of dopamine, a substance that has important functions within the immune system. But they found that adding dopamine by itself doesn’t curb the inflammation.
They then substituted a drug called fenoldopam that mimics some of dopamine’s most positive effects, and even without acupuncture they succeeded in reducing sepsis-related deaths by 40 percent.
Ulloa says the finding is a double triumph.
On the one hand, the research shows physical evidence of acupuncture’s value beyond any that has been demonstrated before. The results show potential benefits, not just for sepsis, but for treating other inflammatory diseases such as rheumatoid arthritis, osteoarthritis, and Crohn’s disease.
By establishing that a drug reduces sepsis deaths in mice, the research also provides an innovative road map toward developing potential drugs for people. That road map may be crucial, because no FDA-approved drug to treat sepsis currently exists.
“I don’t even know whether in the future the best solution for sepsis will be electroacupuncture or some medicine that will mimic electroacupuncture,” Ulloa sayss. The bottom line is that this research has opened the door to both.