Appearance of Human Meridian-Like Structure and Acupoints and Its Time Correlation by Infrared Thermal Imaging

Electroacupuncture stimulation improves cognitive ability and regulates metabolic disorders in Alzheimer's disease model mice: new insights from brown adipose tissue thermogenesis

Background

Metabolic defects play a crucial role in Alzheimer's disease (AD) development. Brown adipose tissue (BAT) has been identified as a novel potential therapeutic target for AD due to its unique role in energy metabolism. Electroacupuncture (EA) shows promise in improving cognitive ability and brain glucose metabolism in AD, but its effects on peripheral and central metabolism are unclear.

Methods

In this study, SAMP8 mice (AD model) received EA stimulation at specific acupoints. Cognitive abilities were evaluated using the Morris water maze test, while neuronal morphology and tau pathology were assessed through Nissl staining and immunofluorescence staining, respectively. Metabolic variations and BAT thermogenesis were measured using ELISA, HE staining, Western blotting, and infrared thermal imaging.

Results

Compared to SAMR1 mice, SAMP8 mice showed impaired cognitive ability, neuronal damage, disrupted thermoregulation, and metabolic disorders with low BAT activity. Both the EA and DD groups improved cognitive ability and decreased tau phosphorylation (p<0.01 or p<0.05). However, only the EA group had a significant effect on metabolic disorders and BAT thermogenesis (p<0.01 or p<0.05), while the DD group did not.

Conclusion

These findings indicate that EA not only improves the cognitive ability of SAMP8 mice, but also effectively regulates peripheral and central metabolic disorders, with this effect being significantly related to the activation of BAT thermogenesis.

The Moxibustion-Induced Thermal Transport Effect Between the Heart and Lung Meridians With Infrared Thermography

Objectives

By comparing the differences in the thermal transport effect between the heart and lung meridians induced by moxibustion, this study aimed to investigate the specificity of site-to-site associations on the body surface between different meridians.

Methods

Eighty healthy participants were divided into the heart meridian intervention group and the lung meridian intervention group; moxibustion was performed at these two meridians, respectively. Baseline temperature and its change magnitude from baseline induced by moxibustion in 6 measuring sites of the heart and lung meridians were assessed by infrared thermography (IRT). Measuring sites included: Site 1 (Chize, LU5), Site 2 (midpoint of LU9 and LU5), Site 3 (Taiyuan, LU9), Site 4 (Shaohai, HT3), Site 5 (midpoint of HT7 and HT3), and Site 6 (Shenmen, HT7).

Results

Forty participants (20 male and 20 female, 27.90 ± 0.52 years) were assigned to the heart meridian intervention group, and 40 participants (20 male and 20 female, 28.08 ± 0.54 years) were assigned to the lung meridian intervention group. In the lung meridian intervention group (moxibustion over LU5), the temperature of the distal sites in the lung meridian increased significantly at 5, 10, and 15 min compared with pre-moxibustion (P &lt; 0.001). The temperature of Site 4 in the heart meridian, which was nearest to the moxibustion site, increased significantly compared with pre-moxibustion (P &lt; 0.05), while the temperature in the distal sites of the heart meridian did not differ significantly during moxibustion. Regarding the comparison of temperature change magnitude from baseline (ΔT) between the two meridians, the ΔT of Site 2 in the lung meridian was significantly higher than Site 4 in the heart meridian at 5 and 10 min after moxibustion (P &lt; 0.05), despite that Site 2 was more distal from the moxibustion site than Site 4. Similarly, the ΔT of Site 3 in the lung meridian was significantly higher than Site 5 and Site 6 in the heart meridian at 5, 10, and 15 min after moxibustion (P &lt; 0.05). In the heart meridian invervention group, similar thermal transport effect between the two meridians was observed. The thermal transport effect of the distal sites along the heart meridian was more significant than that of the site closer to the moxibustion site but located in the lung meridian. Taken together, aforementioned results indicated that the moxibustion-induced thermal transport effect between the heart and lung meridians is generally more significant in the distal sites along the corresponding meridian than that in the closer sites of the other meridian.

Conclusions

In the heart and lung meridians, the moxibustion-induced thermal transport effect is closely related to meridian routes, not just related to the absolute distance from the moxibustion site, thereby confirming the relative specificity of “site-to-site” associations on the body surface in these two meridians.

Systematic Review Registration

https://clinicaltrials.gov/ct2/show/NCT05330403, identifier NCT05330403.

A "4D" systemic view on meridian essence: Substantial, functional, chronological and cultural attributes

The term Jingluo, translated as meridian or channel, is a core component of traditional Chinese medicine (TCM) and has played a fundamental role in guiding the clinical practice of acupuncture for thousands of years. However, the essence of the meridian remains elusive and is a source of both confusion and debate for researchers. In this study, a "4D" systemic view on the essence of the meridian, namely substantial, functional, chronological, and cultural dimensions, was proposed based on a review of the ancient medical classics, recent research developments, and results from clinical practice. Previous studies have primarily focused on the substantial dimension of the meridian system, with scant interpretation about its functional domain. Neither systemic data nor evaluations have been adequately documented. Additionally, a limited but increasing number of studies have focused on the chronological and cultural dimensions. More investigations that embody the holistic concept of TCM and integrate the systemic modes and advanced techniques with dominant diseases of TCM need to be performed to obtain a more comprehensive understanding of the essence of meridians. The goal of this study is to yield useful information in understanding the essence of meridians and provide a reference and perspective for further research.

The difference in heat transport characteristics of the heart and lung meridians: A comparative study of COPD patients and healthy subjects

BACKGROUND

The vast majority of previous studies focused on the relationship between 1 meridian and 1 organ, and the comparison and specificity between 2 meridians is rarely explored. Thus, the aim of this study is to compare the heat transport characteristics between 2 different meridians and the specificity between them will also be investigated.

METHODS

The Lung and Heart meridians are chosen for comparison of 2 different meridians. We will enroll 120 subjects and divide them into the healthy control group, chronic obstructive pulmonary disease (COPD) group and healthy intervention group, in a 1:1:1 ratio. Infrared thermography (IRT) will be used to assess the heat transport characteristics of the Heart and Lung meridians. The specificity for the meridian-visceral association will be investigated by comparing the difference in heat transport characteristic between the Heart and Lung meridians in the healthy control group and COPD group. Meanwhile, moxibustion will be given to subjects in the Heart meridian and Lung meridian respectively in the healthy intervention group to verify the specificity for the surface-surface association.

RESULTS

The primary outcomes will be the temperature of corresponding sites along the Heart and Lung meridians.

CONCLUSION

This study will verify the specificity between different meridians by comparing the difference in heat transport characteristic. The findings will guide the selection of acupoints to optimize the therapeutic effect of acupuncture and help determine whether IRT could be used to assist in the diagnosis of COPD.

ETHICS AND DISSEMINATION

The study has been approved by the Third Affiliated Hospital of Zhejiang Chinese Medical University (Approval No. ZSLL-KY-2019-001G-01).

TRIAL REGISTRATION NUMBERS

NCT04046588.

Intrarater and Interrater Reliability of Infrared Image Analysis of Forearm Acupoints before and after Moxibustion

The objective of this study was to determine the intrarater and interrater reliabilities of infrared image analysis of forearm acupoints before and after moxibustion. In this work, infrared images of acupoints in the forearm of 20 volunteers (M/F, 10/10) were collected prior to and after moxibustion by infrared thermography (IRT). Two trained raters performed the analysis of infrared images in two different periods at a one-week interval. The intraclass correlation coefficient (ICC) was calculated to determine the intrarater and interrater reliabilities. With regard to the intrarater reliability, ICC values were between 0.758 and 0.994 (substantial to excellent). For the interrater reliability, ICC values ranged from 0.707 to 0.964 (moderate to excellent). Given that the intrarater and interrater reliability levels show excellent concordance, IRT could be a reliable tool to monitor the temperature change of forearm acupoints induced by moxibustion.

Difference in the metabolic characteristics of chronic obstructive pulmonary disease patients and healthy adults

INTRODUCTION

By detecting the metabolic difference of the Heart and Lung meridians, the present study aims to investigate the specificity of different meridians and verify whether functional near infrared spectroscopy is validated as an add-on technique to assist diagnosis of chronic obstructive pulmonary disease (COPD).

METHODS AND ANALYSIS

The Lung and Heart meridians are chosen as the target for comparison; accordingly, 120 eligible participants will be included and divided into the COPD group, healthy control group, and healthy intervention group. Functional near infrared spectroscopy will be adopted to measure the metabolic characteristics of the Heart and Lung meridians. On one hand, the specificity of the meridian-visceral association will be investigated by comparing the metabolic difference in the Heart and Lung meridians between the healthy control group and COPD group. On the other hand, the specificity of site-to-site association will be determined by comparing the metabolic change between the 2 meridians that induced by moxibustion in the Heart meridian and Lung meridian, respectively, in the healthy control group. The primary outcome will be regional oxygen saturation of corresponding regions along the Heart and Lung meridians.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04046666.

Neuropeptides SP and CGRP Underlie the Electrical Properties of Acupoints

Electrical skin measurements at acupuncture points (acupoints) have been utilized as a diagnostic and therapeutic aid for more than 50 years. Although acupoints are described as having distinct electrical properties, such as high conductance and low impedance, the underlying mechanisms are currently unknown. The present study investigated in a rat model of hypertension whether the high conductance at acupoints is a result of the release of the neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP) during neurogenic inflammation in the referred pain area. When plasma extravasation from neurogenic inflammation was examined by exploring the leakage of intravenously injected Evans blue dye (EBD) to the skin, extravasated EBD was found most frequently in acupoints on the wrist. The increased conductance and temperature at these acupoints occurred during the development of hypertension. The increase in conductance and plasma extravasation at acupoints in hypertensive rats was ablated by cutting median and ulnar nerves, blocking small diameter afferent fibers with resiniferatoxin (RTX) injection into median and ulnar nerves, or antagonizing SP or CGRP receptors in acupoints. In turn, intradermal injection of SP or CGRP resulted in increased conductance and plasma extravasation in naïve rats. Elevated levels of SP and CGRP were found in the acupoints of hypertensive rats. These findings suggest that the high conductance at acupoints is due to vascular leakage following local release of SP and CGRP during neurogenic inflammation.

Laser acupuncture causes thermal changes in small intestine meridian pathway

The acupuncture meridians represent the flow of corporal energy which contains the acupuncture points. Laser acupuncture is a form of acupuncture stimulation by the use of laser. Thermographic images represent the propagation of heat in micro-environmental systems. The objective of this study was to investigate the use of thermographic images to document the changes on the small intestine meridian (S.I.M.) when submitted to laser acupuncture. Another important issue regards to the analysis of the flow direction if it is upward when stimulated by acupuncture points. For the execution of this work, a laser acupuncture pen was used in points of the meridian in the S.I.M. Two healthy male volunteers were selected (18 and 60 years old, respectively), and doses of 576,92 J/cm² with low-power infrared laser equipment with a wavelength of 780 nm in the SI.3 and SI.19 points were applied. An infrared thermal camera was used to measure the temperature of the S.I.M. during the 6 min laser acupuncture pen stimulus. When the laser acupuncture of both volunteers was conducted in the SI.3 point, it presented hyper-radiation of the hemi face in the same side, far from the application site. When this was applied in the SI.19 point, hyper-radiation in the same point and temperature lowering at the end of the meridian were observed. The laser energy caused thermal changes along the path of the S.I.M., distal, and proximal at the same time, proving the existence of the S.I.M.

The existence of propagated sensation along the meridian proved by neuroelectrophysiology

Propagated sensation along the meridian can occur when acupoints are stimulated by acupuncture or electrical impulses. In this study, participants with notable propagated sensation along the dian were given electro-acupuncture at the Jianyu (LI15) acupoint of the large intestine meridian. When participants stated that the sensation reached the back of their hand, regular nervous system action discharge was examined using a physiological recording electrode placed on the superficial branch of the radial nerve. The topographical maps of brain-evoked potential in the primary cortical somatosensory area were also detected. When Guangming (GB37) acupoint in the lower limb and Hegu (LI4) acupoint in the upper limb were stimulated, subjects without propagated sensation along the meridian exhibited a high potential reaction in the corresponding area of the brain cortical so-matosensory area. For subjects with a notable propagated sensation along the meridian, the tion area was larger and extended into the face representative area. These electrophysiological measures directly prove the existence of propagated sensation along the meridian, and the pheral stimulated site is consistent with the corresponding primary cortical somatosensory area, which presents a high potential reaction.

Different Surface Electromyography of Propagated Sensation along Meridians Produced by Acupuncturing Quchi Acupoint (LI11) or Control Points

This study investigated the propagated sensation along meridians (PSM) produced respectively by acupuncture at a specific acupoint of right-side Quchi (LI11), a nonacupoint on meridian (control meridian point), and neither meridian nor acupoint (control point). All the stimulated points were on the right brachioradialis along the large intestine meridian of hand Yangming. Surface electromyography (sEMG) was used to reflect the activity of the brachioradialis along the large intestine meridian of hand Yangming. The PSM rate of LI11 (59.21%) and the control meridian point (53.95%) were significantly higher than the control point (38.16%) (P < 0.05). After acupuncture, the brachioradialis sEMG amplitude was 5.08 ± 2.93 uV at LI11, 3.08 ± 1.18 uV at the control point, and 2.77 ± 1.36 uV at the control meridian point. The amplitude of LI11 was significantly higher than both the control meridian point and the control point (P < 0.05). When the sEMG activity of brachioradialis returned to the stable base line, brachioradialis sEMG duration at LI11 (265 ± 87.87 s) was significantly longer than that at the control meridian point (91.69 ± 42.98 s) and the control point (83.31 ± 32.76 s) (P < 0.05). In conclusion, acupuncture activated PSM at all points but showed an acupoint specificity at LI11 and a meridian specificity at the control meridian point.

A review of Omics research in acupuncture: the relevance and future prospects for understanding the nature of meridians and acupoints

RELEVANCE

Acupuncture is an intrinsic part of traditional Chinese medicine. The current understanding of the acupuncture meridian system, acupoints and the potential utilizing Omics technologies are summarized in this review.

MATERIAL AND METHODS

A systematic search for acupuncture involving Omics technologies was carried out using multiple online literature databases. The records retrieved were from the full collections of each database dated to September 2011. Data produced from functional genomic technologies were extracted from the collected acupuncture/moxibustion studies and subjected to evaluation. Analyses and comments were summarized on the advances in experimental research in acupuncture/moxibustion-related studies, and the future for strategies and approaches in the era of functional genomics highlighted.

RESULTS

An overview of articles indicated that several diseases or symptoms with evidence of effectiveness had been piloted for using functional genomic technologies, such as Parkinson's disease, allergic disorders, pain, and spinal cord injury, most of which are chronic "difficult diseases". High-throughput genomic and proteomic profiling of gene expression in tissues has been able to identify potential candidates for the effects of acupuncture and provide valuable information toward understanding the possible mechanisms of the therapy. However, without further holistic and sophisticated analyses in the context of metabolomics and systems biology, the current attempts and the foreseeable developments appear to be insufficient to produce firm conclusions. Noticeably, the recent rapid advances in functional molecular imaging targeting specific metabolites have shown great promise and if combined with other post-genomic technologies, could be extremely helpful for the acupuncture studies in human subjects.

CONCLUSION

This review suggest that disease-oriented studies using the approach of multi-indexed high-throughput technologies and systems biology analyses will be a preferred strategy for future acupuncture/moxibustion research.

Violet laser acupuncture--part 3: pilot study of potential effects on temperature distribution

Infrared thermography for temperature distribution monitoring was performed in ten healthy volunteers (M/F, 5/5; mean age ± SD, 24.9 ± 3.3 years) before, during, and after stimulation by noninvasive violet (405 nm) laser needle at the Dazhui (GV14) acupoint. Significant (p<0.001) increases of temperature at a region of interest around the acupoint were observed. Furthermore, temperature also increased significantly (p<0.05) at a so-called "far field" area Zhiyang (GV9). In two persons, however, needle acupuncture and placebo (deactivated laser) did not have the same temperature effects. Violet laser induces changes in skin surface temperature distributions.

Congenital syndromes involving the lungs: pathogenetic models based on chinese medicine theories

BACKGROUND

Striking similarity seems to exist between the Jing-Luo and Zang-Fu theories of Chinese Medicine (CM) and clinical features of many so-called multiple congenital anomaly/mental retardation syndromes (MCA/MRs), as both may involve multiple organs and/or body systems.

MATERIALS, METHODS, AND RESULTS

Comparison of MCA/MRs involving the lungs and paths of 5 Jing-Mai traversing the organ has suggested that development of lung and radial ray (embryonic structure that gives rise to radial-side structures of the upper limb, in particular thumb and radius) are closely connected. The Lung Jing-Mai and those traversing the Kidneys may well explain combined malformations involving the lungs, radial ray, and the body's developmental midline. Furthermore, Zang-Fu theories such as "The Lungs rule the skin and body hair," and "The Lungs as a Zang pair with the Large Intestine" also seem to be in keeping with syndromes simultaneously affecting the lungs, colon, and skin. It may be deducible that the Jing-Mai, as described by CM, probably exists, and that the Jing-Mai and Zang-Fu theories have correctly summarized the connections between particular parts of the human body during embryonic development.

CONCLUSIONS

The CM theories therefore may provide important insights into the pathogenesis of relevant diseases as well as clues for development of new treatment for lung-related diseases.