New Acupuncture article on Nature (Neuro) website

[Kuko 4000]

Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture

http://www.nature.com/neuro/journal/vaop/ncurrent/full/nn.2562.html

Here's a PDF of the stats:

http://www.nature.com/neuro/journal/vaop/ncurrent/extref/nn.2562-S1.pdf

Headline in Physorg:

Acupuncture's molecular effects pinned down

http://www.physorg.com/news194418635.html

From the Physorg article:

The new findings add to the scientific heft underlying acupuncture, said neuroscientist Maiken Nedergaard, M.D., D.M.Sc., who led the research. Her team is presenting the work this week at a scientific meeting, Purines 2010, in Barcelona, Spain.

"Acupuncture has been a mainstay of medical treatment in certain parts of the world for 4,000 years, but because it has not been understood completely, many people have remained skeptical," said Nedergaard, co-director of the University's Center for Translational Neuromedicine, where the research was conducted.

...

"It's clear that acupuncture may activate a number of different mechanisms," said Josephine P. Briggs, M.D., director of the National Center for Complementary and Alternative Medicine at the National Institutes of Health. "This carefully performed study identifies adenosine as a new player in the process. It's an interesting contribution to our growing understanding of the complex intervention which is acupuncture," added Briggs, who is the spouse of co-author Jurgen Schnermann.

Ok, most of that paper is way over my head as usual, but my amateur reading of all this is that needling releases* adenosines in the body, this in turn eases the pain of the patient. The question is, what has this got to do with real acupuncture? If anything, this study seems to have found another "allopathic" (yes, the paper uses this term) explanation for why needling can lessen pain locally, pretty much explaining the real acupuncture away bit by bit. Correct me if I'm wrong...


* I don't really know what happens and how.

 

[Uncayimmy]

Kuko - You've hit on the big problem I have every time we discuss acupuncture, which is, "What do you mean by acupuncture?"

If you mean sticking needles in people while following the quaint patchwork of folklore surrounding chi and meridians, it seems that most of the studies say there's nothing to the theory. However, if you mean "just sticking people with needles" then there seems to be ample evidence that it can be effective for a few conditions such as nausea.

Obviously, sticking somebody with needles is going to cause a biological reaction. We feel it, right? The body is going to release chemicals and fire up the nervous system. Otherwise, we wouldn't know about it. Well, if you step back and think about it, this is fundamentally no different than how drugs affect our bodies. A drug is only "medicine" if it does something beneficial in regards to a specific ailment.

Where it gets screwy is that "Real Acupuncture" advocates tend to ignore the studies that fail to demonstrate their folklore has any meaning and latch on to other studies that simply look for a mechanism for how "Needle Sticking" affects the body. They then use this as evidence to support "Real Acupuncture."

Quite frankly, I don't know how you deal with this. It's not much different than all the herbal remedies out there. We know that herbs affect the body and some of them are actually effective at treating certain conditions. Then you get some little study that says that flowers from the "Kuko* plant" contain a chemical linked to arthritis. Next thing you know, everybody is buying Kuko extract when there are no actual studies show the Kuko flowers have any real benefit.

* Just used your screen name to avoid getting sidetracked discussing a real herb. No offense intended.

 

[Kuko 4000]

Yeah, and acupuncture advocates (among others) usually stress that acupuncture treats the person as a whole and treats the underlying problem instead of just the superficial symptoms as "western medicine" does. All this is of course served with a load of convincing (well, to many people at least) mysticism and woo.

Quite frankly, I don't know how you deal with this.

I can't think of any short cuts either. For making my own decisions, I would first have to know the real benefits of a certain "acupuncture" treatment versus other already available treatments. Next I would need to know how much they cost. When talking to believers (which is what you probably had in mind), using that knowledge + carefully "explaining away" the real acupuncture might be a good combo to inspire different ways of thinking about the issue. That's what I'd like to believe anyways.

 

[Deetee]

The paper comes from acupuncturists.
Some replication would be nice.
Perhaps some human studies could be tried using the adenosine blocker in a randomised placebocontrolled trial? Would be pretty easy to do this.
That would help establish whether this mechanism even passes the start line.

 

[Kuko 4000]

Deetee, if the study was successfully replicated with humans wouldn't that just point more and more to explaining the real acupuncture away? That's pretty much how I see this, or maybe I'm missing some important details in the study because these guys seem to think that these results make the case for real acupuncture stronger?

 

[23_Tauri]

I'm just stunned at how the researchers managed to carry out acupuncture on the knees of mice?!

http://esciencenews.com/articles/2010/05/30/acupunctures.molecular.effects.pinned.down

To do the experiment, the team performed acupuncture treatments on mice that had discomfort in one paw. The mice each received a 30-minute acupuncture treatment at a well known acupuncture point near the knee, with very fine needles rotated gently every five minutes, much as is done in standard acupuncture treatments with people.

Hats off to them for patience, accuracy and a steady hand.

 

[23_Tauri]

Deetee, if the study was successfully replicated with humans wouldn't that just point more and more to explaining the real acupuncture away? That's pretty much how I see this, or maybe I'm missing some important details in the study because these guys seem to think that these results make the case for real acupuncture stronger?

This is how I see it too. By discovering one scientific basis for pain-relief through acupuncture needles, aka stimulating the production of adenosine, then the traditional explanation touted by acupuncturists (meridians, chi, blah-di-blah) is shown to be a folly.

To my mind, the research supports the use of acupuncture as a treatment for certain problems (e.g. site specific pain relief), whilst simultaneously cutting through the woo that might cause people to seek out an acupuncturist for an ailment that acupuncture cannot alleviate. Correct me if I'm wrong, but my perception of acupuncture is that it is sometimes promoted by alternative therapists as a 'holistic' treatment that can treat a wide range of symptoms.

 

[bugbear]

Kuko - You've hit on the big problem I have every time we discuss acupuncture, which is, "What do you mean by acupuncture?"

If you mean sticking needles in people while following the quaint patchwork of folklore surrounding chi and meridians, it seems that most of the studies say there's nothing to the theory. However, if you mean "just sticking people with needles" then there seems to be ample evidence that it can be effective for a few conditions such as nausea.

You should enjoy this paragraph from the Guardian's report:

Traditional practitioners claim acupuncture works by improving the flow of "qi energy" along "meridians", but the latest research, published in Nature Neuroscience, points to a less mystical explanation.

BugBear

 

[Kuko 4000]

Thanks bugbear, and welcome to the forums.

Too bad the main bulk of the article misses the point completely:

http://www.guardian.co.uk/science/2010/may/30/acupuncture-pain-natural-painkiller

 

[Tiktaalik]

Orac rips it apart pretty handily at:

http://scienceblogs.com/insolence/2..._is.php?utm_source=mostactive&utm_medium=link

Similar issue as UncaYimmy brought up: what is "acupuncture"? If it's twiddling a toothpick, this study may show pain relief effects, but it doesn't show any evidence of meridians or unblocked chi...

 

[lomiller]

The question is, what has this got to do with real acupuncture?[/B] If anything, this study seems to have found another "allopathic" (yes, the paper uses this term) explanation for why needling can lessen pain locally, pretty much explaining the real acupuncture away bit by bit.

This smacks of a goalpost shift on your part. We don’t normally demand people currently identify the underlying cause of a phenomenon to recognize the phenomenon itself. Kepler failed to identify the cause of planetary motion, yet we don’t say he was wrong or mistaken. Nor do we say the Theory of Gravity was falsified because Newton didn’t currently identify the underlying mechanism.

The relevant question around acupuncture is whether it works at all, this remains true even after this paper. Having a viable mechanism for why it works would be a step in that direction, though I’d like to see a lot more support then one paper. Arguing that “well they didn’t get the cause right so we will just change the name of the phenomenon so we can still say theirs doesn’t exist is IMO about as intellectually dishonest as it gets”. If they identified a real phenomenon that has different causes then their hypotheses is more then enough. (Should these results be repeatable/supportable)

 

[Kuko 4000]

lomller, this is not the case at all, as can be seen from my reply to Unca, here's the relevant part:

For making my own decisions, I would first have to know the real benefits of a certain "acupuncture" treatment versus other already available treatments. Next I would need to know how much they cost. When talking to believers (which is what you probably had in mind), using that knowledge + carefully "explaining away" the real acupuncture might be a good combo to inspire different ways of thinking about the issue.

So, all that matters is that something works, I don't need to know why it works. I need to know how it compares to other available treatments, both in benefit and cost. Then I can make a reasonable decision of using / endorsing it or not.

The point is that this kind of publicity gives unwarranted credence to the whole worldview around real acupuncture. Imagine if the acupuncturists would market their brand of woo honestly by known medical terms and physiology. I imagine they would pretty quickly lose the majority of their customers who are after a "holistic" treatment that targets the cause of the problem rather than symptoms. This is a question of the bigger overall picture. Magical thinking leads to more magical thinking.

The bottom line: call spade a spade.

 

[lomiller]

That’s not really relevant to what I’m saying.

We, as skeptics, lose credibility is we start to redefine phenomenon when people uncover plausible physical mechanisms for that phenomenon. What we are after is for people to bring forward evidence and logical reasoning for their claims, when manage to do so we can’t go and say “I’m going to give this phenomenon a new name so the one you have been talking about the whole time is still woo”.

This is completely aside from the efficacy of acupuncture or the results of this new paper. There are plenty of legitimate avenues to challenge both without resorting to redefining terms in an attempt to make them “still wrong”.

 

[technoextreme]

We, as skeptics, lose credibility is we start to redefine phenomenon when people uncover plausible physical mechanisms for that phenomenon. What we are after is for people to bring forward evidence and logical reasoning for their claims, when manage to do so we can’t go and say “I’m going to give this phenomenon a new name so the one you have been talking about the whole time is still woo”.

As someone kindly pointed out on Gorski's blog these people managed to co-opt a phenomenon that was all ready common in the pharmaceutical industry and somehow try and associate it with acupuncture. On top of that I really wouldn't use a source that uses argumentum ad verecundiam in one of the most idiotic manners I have ever seen that should have been struck off a paper as prestigious as Nature.

 

[Uncayimmy]

That’s not really relevant to what I’m saying.

We, as skeptics, lose credibility is we start to redefine phenomenon when people uncover plausible physical mechanisms for that phenomenon. What we are after is for people to bring forward evidence and logical reasoning for their claims, when manage to do so we can’t go and say “I’m going to give this phenomenon a new name so the one you have been talking about the whole time is still woo”.

This is completely aside from the efficacy of acupuncture or the results of this new paper. There are plenty of legitimate avenues to challenge both without resorting to redefining terms in an attempt to make them “still wrong”.

Sorry, but what you describe doesn't apply here. Acupuncture is a relatively specific treatment. They have pretty little charts describing energy flow and specific points claimed to treat specific ailments. This "philosophy" was developed at a time when they had zero evidence to back their claims. People just made it up as they went along. They did not observe a phenomenon and create an explanation. They invented a mythology and along with a healthy dose of wishful thinking have kept it going for centuries.

The studies have clearly shown that it doesn't work as described. For most ailments neither real acupuncture or sham acupuncture actually does anything. For a few conditions both seem to be equally effective - better than placebo and sometimes just as good as some conventional medicines.

The "mechanisms" have been "found" before - this is not the first time anybody has looked at the body's response to needle sticking. As skeptics we need to make it very clear what the studies mean, and right now the evidence says that real acupuncture is bunk. Period. You're falling into the trap of believing that the biological responses support acupuncture when they don't.

What's really frustrating is that none of this should be surprising. If you're hungry and then painfully stub your toe, do you think you will still be hungry immediately afterwards? I wouldn't. So, if somebody tells me that they can poke me with needles and affect my digestive system (relieve nauseau), I'm not surprised in the least.

If I'm in pain and somebody tells me to relax on a table while they manipulate my body in locations other than the one that hurts (massage, for example), I'm not surprised at all if my pain subsides. I'm also not surprised if for some people getting stimulated with needles under similar conditions would result in some pain relief.

We don't need chi or meridians to understand this, and the sooner we can dispel those myths, the sooner we can explore needle sticking as a science. We do it the right way, which is through controlled studies. What we shouldn't waste anymore time on is trying to verify 2,000 year old folklore. It's a waste of resources.

 

[technoextreme]

Sorry, but what you describe doesn't apply here. Acupuncture is a relatively specific treatment. They have pretty little charts describing energy flow and specific points claimed to treat specific ailments. This "philosophy" was developed at a time when they had zero evidence to back their claims. People just made it up as they went along. They did not observe a phenomenon and create an explanation. They invented a mythology and along with a healthy dose of wishful thinking have kept it going for centuries.

The studies have clearly shown that it doesn't work as described. For most ailments neither real acupuncture or sham acupuncture actually does anything. For a few conditions both seem to be equally effective - better than placebo and sometimes just as good as some conventional medicines.

The "mechanisms" have been "found" before - this is not the first time anybody has looked at the body's response to needle sticking. As skeptics we need to make it very clear what the studies mean, and right now the evidence says that real acupuncture is bunk. Period. You're falling into the trap of believing that the biological responses support acupuncture when they don't.

What's really frustrating is that none of this should be surprising. If you're hungry and then painfully stub your toe, do you think you will still be hungry immediately afterwards? I wouldn't. So, if somebody tells me that they can poke me with needles and affect my digestive system (relieve nauseau), I'm not surprised in the least.

If I'm in pain and somebody tells me to relax on a table while they manipulate my body in locations other than the one that hurts (massage, for example), I'm not surprised at all if my pain subsides. I'm also not surprised if for some people getting stimulated with needles under similar conditions would result in some pain relief.

We don't need chi or meridians to understand this, and the sooner we can dispel those myths, the sooner we can explore needle sticking as a science. We do it the right way, which is through controlled studies. What we shouldn't waste anymore time on is trying to verify 2,000 year old folklore. It's a waste of resources.

Why do we need to risk infection and stick needles in ourselves?
http://www.ncbi.nlm.nih.gov/pubmed/16032451
http://www.ncbi.nlm.nih.gov/pubmed/9248564

 

[casebro]

How could they tell the mice felt better? After five minutes in a clamp. and being jabbed with needles, the mice were released and the improvement in motion was obvious as they ran away shrieking...

 

[Prometheus]

That’s not really relevant to what I’m saying.

We, as skeptics, lose credibility is we start to redefine phenomenon when people uncover plausible physical mechanisms for that phenomenon. What we are after is for people to bring forward evidence and logical reasoning for their claims, when manage to do so we can’t go and say “I’m going to give this phenomenon a new name so the one you have been talking about the whole time is still woo”.

This is completely aside from the efficacy of acupuncture or the results of this new paper. There are plenty of legitimate avenues to challenge both without resorting to redefining terms in an attempt to make them “still wrong”.

It seems to me that you've got it backwards here. It's not skeptics that are shifting goalposts, but acupuncture proponents. They claim that they already have a correct explanation (chi, meridians, energy blockage) for an actual phenomenon (wide ranging holistic effects), then when skeptics point out that their 'explanation' is bunk and their phenomenon doesn't seem to exist, they go and find another similar phenomenon (local pain relief) and offer a completely different explanation (adenosine release, or whatever) of that instead.

 

[Mojo]

How could they tell the mice felt better?

http://www.nature.com/news/2010/100509/full/news.2010.228.html

 

[Kuko 4000]

lomiller, I do see where you're coming from, but I think you're barking up the wrong tree. I try to explain what I mean more carefully.

That’s not really relevant to what I’m saying.

We, as skeptics, lose credibility is we start to redefine phenomenon when people uncover plausible physical mechanisms for that phenomenon. What we are after is for people to bring forward evidence and logical reasoning for their claims, when manage to do so we can’t go and say “I’m going to give this phenomenon a new name so the one you have been talking about the whole time is still woo”.

This is completely aside from the efficacy of acupuncture or the results of this new paper. There are plenty of legitimate avenues to challenge both without resorting to redefining terms in an attempt to make them “still wrong”.

There are a few different things going on here.

I am not criticizing acupuncturists for "bringing forward evidence and logical reasoning for their claims". I applaud that.

So, what did the researchers find?

(For the sake of the argument, let's accept their results as reliable.)

1) The researchers found out that sticking a needle (etc.) into a well known acu-point lessens the pain on that area. Acupuncture works!

2) They found out that this is because the needling releases adenosines. Wait, this is not acupuncture!

The more we seem to understand the phenomena, the more it explains the real acupuncture away. This is not me redefining anything, I am just pointing out that the effect of this particular treatment is due to known physical reactions and not the ancient concepts of chi or meridians, which promise a lot more than what the treatment can actually deliver. It is these baseless promises of meridians, chi and treating the root cause instead of the symptoms that many people are thinking about when going to an acupuncturist. Articles like the ones linked on this thread are giving the impression that real acupuncture (or maybe I should say "the philosophy" of acupunture) is vindicated by this research. This is what I'm criticizing.

Ok, so the study was about the mechanisms behind acupuncture. Good. Let's see the literature for how big the effect actually is: Ummm..not too impressive, right? This study tells nothing new about the efficacy of acupuncture and actually goes a long way to debunking the basic hypothesis of chi and meridians. Now, if you compare all this to the media reports you will probably relate to my pow a bit more.