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When what an acupuncture study shows is much more interesting than what acupuncture believers think it showshttp://scienceblogs.com/insolence/2010/06/when_what_an_acupuncture_study_shows_is.php"...
So what does this all mean? First of all, this study is actually quite interesting for its implications for adenosine as a mediator of both inflammatory and neuropathic pain. It was cleverly done and is pretty clear in supporting the conclusion that mimicking the action of adenosine or somehow increasing its local concentration around a nerve might be a good strategy for relieving pain in humans. But does it actually support the efficacy of acupuncture, as Nedergaard claims. Not so fast.
All this study shows isthat sticking needles in mice causes adenosine production and that that adenosine can blunt the pain response in nerves by binding to the A1 receptor. That's all well and good, but it doesn't validate acupuncture. The only thing in common with acupuncture is the needle sticking part, and the investigators might as well conclude that this study validates ear piercing for pain relief. (Egads! Battlefield acupuncture strikes back!) So, it's quite possible that needles twisted in the area near a nerve might release a flood of adenosine that might bind to A1 receptors in nearby neurons and blunt the pain sensation. No "meridians" or qi needed to explain that. Moreover, this study notwithstanding, Nedergaard seems at a loss to explain how her results might be reconciled with numerous studies in humans that show clearly that (1) it does not matter where you stick the needles and (2) it doesn't even matter if the needles are stuck through the skin. As I've pointed out before, just twisting the end of a toothpick against the skin produces the same effect as acupuncture.
...
Finally, there are two huge problems with this paper. Here's the second biggest. Mice are much, much smaller than humans. This Zusanli point in a mouse is going to be within a couple of millimeters of the sciatic nerve. In the human, it's going to be centimeters away. In the mouse, the size of the needle relative to the size of the leg and distance from the sciatic nerve, as well as the nerve's branches, the tibial and peroneal nerves, is going to be very close. The tissue damage, virtually no matter where the needle is stuck, is going to be close to these nerves. In humans, this is unlikely to be the case, particularly since the nerves are much further beneath the skin than they are in mice. Thus, there is no good reason to think that these results will necessarily translate easily to humans. Moreover, contrary to the claim that "merdians" map to ascending nerve tracts is stretching it a bit, if you look at these maps. For instance, the kidney, stomach, and spleen acupuncture points line up somewhat with nerves at certain points in the body but are nowhere near ascending nerves in other parts. However, this works in mice, size differences alone will make it hard to replicate in humans.
What really bugs me about this article, though, is that it's cool science. These guys have found something interesting that may even have a potential clinical application. For instance, local injection of A1 receptor agonists works the same as the "acupuncture." Adding compounds that slow the removal of adenosine fromt the tissues improves the efficacy of the adenosine released into the tissues by minor trauma. Scientists can work with that. Scientists could take this observation and use it as a justification to work on better, more specific, and longer acting A1 agonists. Perhaps they could even develop oral drugs that are broken down into adenosine or A1 receptor agonists in the peripheral tissues. If this paper's conclusions regarding the importance of adenosine in pain signaling are correct, these would represent stragies that could very well work and very well improve pain control. One could even envision implantable pellets that could be placed in wounds or near relevant nerves to release A1 receptor agonists right where they're needed over a long period of time. Unfortunately, Nedergaard and her team are too enamored of the woo that is acupuncture to emphasize the true significance and potential usefulness of their findings.
..."------------------------- In pain, get some piercings! :hi:
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