Acupuncture Reduces Stress Protein

Posted in GUMC Stories

Ladan Eshkevari, Ph.D., C.R.N.A., L.Ac., has been told so many times by her patients that the acupuncture she gives them relieves stress that she decided to put all that good feeling to a rigorous scientific test.

While traditional Chinese acupuncture has long been thought to relieve stress—in fact, the World Health Organization states that acupuncture is useful as adjunct therapy in more than 50 disorders, including chronic stress—no one has biological proof that it does so, says Eshkevari, an assistant professor, and assistant program director of the Nurse Anesthesia Program at Georgetown’s School of Nursing & Health Studies.

But how do you design such a study? A patient survey of stress levels before and after acupuncture isn’t solid proof. And drawing blood to test certain stress-related chemicals in the blood of her patients seemed a little invasive as a first step, says Eshkevari, who is also a nurse anesthetist and a certified acupuncturist.

So she turned to rats.

These animals had already been used in Georgetown laboratories studying the biochemical pathways involved in stress. Researchers there had discovered that neuropeptide Y (NPY) can be elevated under chronic stress with this model.

NPY is a peptide that is secreted by the sympathetic nervous system, which is involved in the “flight or fight” response to acute stress, resulting in constriction of blood flow to all parts of the body except to the heart, lungs, and brain (the organs most needed to react to danger). When NPY is chronically elevated, maladaptive responses to stress can occur.

Rats are useful animals to help study stress because they mount a stress response when exposed to winter-like cold temperatures for an hour a day.

But how do you give acupuncture to a rat? You can’t give them anything to relax, because that would, by itself, reduce stress.

Use of a slightly used sock helps, Eshkevari says.

She allowed the rats to become familiar with her, and encouraged them to rest by crawling into a small sock that exposed their legs. She very gently conditioned them to become comfortable with the kind of stimulation used in electroacupuncture—an acupuncture needle that delivers a painless small electrical charge. This form of acupuncture is a little more intense than manual acupuncture and is often used for pain management, she says, adding, “I used electroacupuncture because I could make sure that every rat was getting the same treatment dose.”

Eshkevari has studied the two main stress pathways. Her work on the sympathetic nervous system and changes in NPY was published in the January issue of Experimental Biology and Medicine, and she says it counts as the first study to show molecular proof of the stress reduction benefit of acupuncture. In this study, she selected a single acupuncture spot to test, Zuslanli (ST36 on the stomach meridian, found on the leg below the knee in humans). In a controlled study, Eshkevari found that NPY levels in an experimental group that was stressed, and then given acupuncture, came almost down to the level of a non-stressed group of rats, compared to animals that were stressed and then untreated.

In a second experiment performed separately, Eshkevari stopped acupuncture in the experimental group but continued to stress the rats for an additional four days, and found NPY levels remained low. “We were surprised to find what looks to be a protective effect against stress,” she says.

She has also completed a study looking at the second, more important stress pathway, the hypothalamus-pituitary-adrenal axis (HPA), part of the neuroendocrine system that controls the body’s reaction to chronic stress.

“The SNS and HPA work in tandem to handle stress, and when stress becomes chronic, it becomes maladaptive,” Eshkevari says. “My study is really the first of its kind looking at the effect of acupuncture on this type of stress with the two classic pathways.”

While she can’t relate specific findings of the second set of experiments with regards to the HPA until the study is published, Eshkevari says the results are exciting, and just as she suspected. She has submitted this second study for publication.

Eshkevari wants to take her findings and study into a human population, looking for the same effects in patients—especially in soldiers those suffering from post traumatic stress disorder.

“If my animal findings are replicated in humans, acupuncture would offer a proven adjunct, or sole therapy for stress, which is often difficult to treat,” she says. “A belief held for thousands of years might yet be accepted by modern medicine without such data.”

By Renee Twombly, GUMC Communications
(Published January 11, 2012)