A Neurovascular Blood-Flow Modulation Model via Acupuncture Induced Nitric Oxide - 수련의 몫

[문형철]

침자극으로 유도된 NO를 통해 blood supply를 촉진시킨다는 논문

A Neurovascular Blood-Flow Modulation Model via acupunctur.pdf

1. Introduction

Acupuncture is a practice of inserting needles into the body to reduce pain or induce

anesthesia. More broadly, acupuncture is a family of procedures involving the stimulation

of anatomical locations on or beneath the skin by a variety of techniques. Employing

acupuncture to treat human illness or to maintain body health has been practiced for

thousands of years. Recently, models able to describe the mode of action of acupuncture

have aroused scientists’ curiosity. Scientific interest in acupuncture has led numerous

investigators to conduct clinical trials that have tested the efficacy of acupuncture at various

acupuncture points. However, the mechanism(s) of action of acupuncture at the various

meridians are still poorly understood.

The traditional Chinese medical theory says: ‘Qi acts as the commander of blood and blood

acts as the mother of Qi’. This is a general description of the effects of Qi on blood and this

theory can be extended to include the ideas that Qi promotes blood circulation and controls

the blood functioning. Furthermore blood conveying Qi and blood nourishing Qi.

Previous studies have provided a variety of information regarding the physiological effects

of acupuncture on animal and human bodies. Most of them have indicated that acupuncture

is able to increase blood flow [1], and at the acupuncture points and meridians have a high

electrical conductance [2, 3]. A relationship has also been suggested that among those

acupuncture points and meridians with connective tissue planes [4] and the perivascular space

[5]. A number of possible mechanisms by which acupuncture acts have been reviewed [6].

The results obtained from human and animal studies have shown that acupuncture

enhances the generation of nitric oxide (NO) and increases local circulation [7]. Kim, et al.

(2006) pointed out that employing acupuncture on stomach 36 point (ST-36) is able to reduce

blood pressure by activating NO signaling mechanisms [8]. Ma (2003) showed that NO

content and Nitric Oxide Synthase (NOS) expression‎ were consistently higher at skin

acupuncture points/meridians [9]. Chen et al. (2005) showed that L-arginine-derived NO

synthesis appears to mediate the noradrenergic function of skin sympathetic nerve

activation and that this contributes to skin electrical resistance of the acupuncture points

and meridians [10].

NO is known to exert an effect on a number of functions including the regulation of blood

pressure, contributing to the immune response, the control of neurotransmission and

participation in cell differentiation and other physiological functions [11]. NO, a diffusible signaling gas is synthesized by three NOS isoforms, namely neuronal NOS (nNOS),

inducible NOS (iNOS) [12] and endothelial NOS (eNOS) [13, 14]. In the cardiovascular

system, NO is tonically released by the endothelial cells in response to shear stress to

maintain vascular tone [15]. This effect is due to the relaxation of the vascular smooth

muscle cells in the medium layer (tunica media) of the arterial wall. However, NO is also

involved in the regulation of synaptic neurotransmission, platelet aggregation,

inflammation, appetite, peristalsis, renal metabolism, respiratory function, lipid metabolism

and glucose metabolism.

It is supposed that the gas (NO) is part of Qi, then the proposed model can be annotated as

this part of Traditional Chinese Medical theory. This hypothesis involves a blood-flow

modulate model. Briefly, the acupuncture stimulus is able to induce a burst of NO

production through mechanotransduction at the local acupuncture point and this NO

diffuses and changes the blood flow either at the local and/or organ microcirculation level.

Erythrocytes in blood vessel detect the oxygen and modulate vascular tone via controlled

NO processing, and this is able to change the frequency of resonance and modulate the

vascular tone.

Chinese acupuncture theory has long been recognized that there are twelve main meridians

or energy channels that relate to the internal organs. These include the lungs, large intestine,

stomach, spleen, heart, the pericardium (the sac around the heart), etc.

Acupuncture induced differential production of NO in various meridian organs, which are

connected via tissue/cells coupled to the cyclically strained blood vessel; vascular blood

flow and its distribution among different vascular beds, are regulated by the changes in

micro vascular tone.