Copyright © 2014 David I. Shrieber - Rutgers, The State University of New Jersey - All Rights Reserved.
Acupuncture is an ancient Eastern therapy that has become increasingly popular in the West during the last three decades. Although
it has been in use for more than 2,000 years, scientific studies of the technique are only recent. Despite growing evidence of acupuncture's
effectiveness and its growing appeal with the public, skepticism and reluctance to incorporate it into mainstream medical treatment
protocols remain. This stems primarily from a relative paucity of high-quality, well-controlled scientific research and a resulting
lack of understanding of acupuncture's mechanism of effect.
An intriguing hypothesis regarding mechanotransdcution as a potential mechanism for initiating the biological response has emerged
recently (Buettner et al., Sci-ence & Medicine, 10: 81-83, 2005). Research from Dr. Helene Langevin has shown that subcutaneous
connective tissue selectively winds around an acupuncture needle during therapeutic manipulation, which exerts force on and elicits
morphological responses from resident fibroblasts. Anatomical studies revealed a strong correlation between the location of acupuncture
points and inter- and intramuscular connective tissue planes. The interstitial connective tissue plane forms a continuous extension
of the subcutaneous connective tissue, which may permit increased needle interaction with the connective tissue at that point, and
thus, a means of potentiating the mechanical stimulus delivered by the needle. The deformation of mechanically sensitive nociceptors
in under- and overlying tissues would allow the signals to propagate centrally. Though it is clear that connective tissue is involved
in the biomechanical response to acupuncture, why it is involved - what about its composition and structure causes the biomechanical
coupling during needling - remains unknown, as does whether the mechanical response is linked to the physiological manifestations.
Buettner, Shreiber, and Langevin
Science & Medicine, 2005
With Dr. Helen Buettner, we have initiated a novel approach to examine acupuncture in the laboratory using three-dimensional, collagen-based
in vitro models that allows us to systematically change composition, structure, geometry, loading conditions, and boundary conditions
and observe and quantify elements of the biological and biophysical responses. For example, we used image analysis following polarized
light microscopy to quantify the evolution of alignment during in vitro acupuncture of collagen gels (Julias et al., Biomed Eng Online,
7: 19, 2008). Increasing collagen concentration increased the degree of alignment, whereas crosslinking the collagen to produce a
stiffer construct decreased alignment and caused the gel to fail after significantly fewer needle rotations. This last observation
is intriguing, since it has been demonstrated that the loose connective tissue, which selectively couples to the needle during rotation
in vivo, is significantly more compliant than dermal tissue, which does not couple to the needle. Our subsequent work has shown that
the narrowing geometry associated with connective tissue planes may also accentuate the biomechanical response and may also allow
greater propagation of the response to nearby tissues (Julias et al., Anat Record, 2011). Fibroblasts trapped within the collagen
network follow the orientation of the collagen fibers. Current work is aimedd at measuring and controlling the applied torque to standardize
the delivered mechanical signal and assay the biological response of resident cells.