neuroimmune basis of anti-inflammatory acupuncture, The

American Journal of Clinical Hypnosis,  Jan 2008  by Wickramasekera, Ian II

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Kavoussi, B. & Ross. B. (2007). The neuroimmune basis of anti-inflammatory acupuncture. Integrative Cancer Care, 6(3), 251-257. The authors provide an interesting review of the evidence regarding how acupuncture may positively affect a person's health. The authors propose that acupuncture may affect the immune system via mechanisms that involve psychoneuroimmunology.

Their model holds that acupuncture may inhibit inflammatory actions of the immune system through actions of the endocrine, central, and autonomic nervous systems that the field of psychoneuroimmunology has identified as being important in modulating the activity of the immune system. The authors thus ascribe a similar mechanism of action for reducing inflammation with acupuncture as their proposed mechanism of action for other methods which are primarily psychologically based. They specifically mention that they think hypnosis, biofeedback, meditation, prayer, and guided imagery all potentially share this common mechanism in their efficacy for reducing inflammation. The authors review the physiological details of their model in some detail and in particular highlight the possible actions of the vagus nerve which we also know has some action in hypnosis given the findings of Steve Porges and others who have examined the relationship between cardiac vagal tone and hypnotic ability. Their model is critical of traditional acupuncture practice which tends to hold that specific needle site placement and specific types of needle stimulation are critical factors in acupuncture's success independent of biomedical conditioning, expectancy, or mother mind/body placebo factors. They base their assertions that the traditional model of acupuncture does not hold upon the relative lack of evidence showing the efficacy of acupuncture above placebo factors in well designed and controlled studies. It is important to note, however, that the authors are not in any way critical of the concept of utilizing traditional acupuncture with patients. On the contrary, their model seems aimed at providing a scientifically based theory of acupuncture's action that could help make its acceptance in general medicine more prevalent. They do in fact call for an integration of acupuncture into the treatment of chronic diseases like autoimmune disorders where they also offer some guidelines and predictions to assess for its mind/body efficacy. Hopefully, the authors model will be well received by the acupuncture community as indeed the authors model could easily be accepted by any medical professional with a basic working knowledge of psychoneuroimmunology. The fact that they propose a psychoneuroimmunological explanation for acupuncture does not in any way detract from the ability of acupuncture to assist patients. Address for reprints: B. Kavoussi, Southern California University of Health Sciences, College of Acupuncture and Oriental Medicine, Whittier, CA. Email address: kavoussi@ucla.edu.

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