Table 2.
Studies supporting the role of acupuncture in the pathologies of PH.
| References | Model | Technique | Findings Potentially Relevant to Pulmonary Hypertension (PH) |
|---|---|---|---|
| [251] | Pre-clinical Hypoxic-induced PH |
Electroacupuncture (EA) | Mean pulmonary arterial pressure (mPAP) ↓, right ventricular (RV) size ↓ Pathological pulmonary remodeling ↓ Serum/lung endothelial nitric oxide synthase (eNOS) ↑, serum/lung endothelin-1 (ET-1) ↓ |
| [253,297] | Pre-clinical Hypertension |
EA Non-EA |
Sympathetic activity (e.g., via nitric oxide synthase (NOS) pathways) ↓ Serum norepinephrine ↓ Serum interleukins/C-reactive protein ↓ Serum ET-1 ↓, myocardial eNOS ↑ |
| [256,257] | Clinical Hypertension |
Non-EA + enhanced external counterpulsation (EECP) | Serum nitric oxide (NO) ↑, serum ET-1 ↓ |
| [260,261,262,263,264,265,266] | Clinical Chronic obstructive pulmonary disease (COPD) |
EA Non-EA |
Oxygen utilization/efficiency ↑, dyspnea ↓, exercise capacity ↑ |
| [298,299,300,301,302,303,304] | Pre-clinical Systemic inflammation |
EA Non-EA |
Serum/lung tumor necrosis factor alpha (TNF-α), interleukins ↓ Parasympathetic (vagus) outflow ↑ Ejection fraction ↑ |
| [267,268,269,272] | Pre-clinical Heart failure/cardiac insult |
EA | Sympathetic outflow ↓ Heart function ↑ (i.e., left ventricle ejection fraction ↑, left ventricle size ↓ |
| [271,273,274,275,276,277,278,279,280,281,291,292,294] | Pre-clinical Sympathetically stressed |
EA | Sympathetic outflow ↓ (i.e., via central opioid, corticotropin-releasing hormone (CRH) pathways) Serum CRH, cortisol, norepinephrine, adrenaline ↓ |
| [305] | Clinical Post-surgery secondary to lung cancer |
EA | Arterial oxygen partial pressure (PaO2)/fraction of inspired oxygen (FiO2) ↑ Superoxide dismutase (SOD) activity ↑ Length of hospital stay ↓ |
| [258] | Clinical Systemic sclerosis |
EA | Plasma ET-1 ↓ |
| [306,307,308] | Pre-clinical Lung injury |
EA | Lung SOD activity ↑ Serum/lung cytokines ↓ PaO2 ↑ Lung injury score ↓ |
| [252,309] | Pre-clinical COPD |
EA | Pathological pulmonary remodeling ↓ Lung cytokines ↓ Lung function (i.e., expiratory volume) ↑ |
PH = pulmonary hypertension; EA = electroacupuncture; ET-1 = endothelin-1, NO = nitric oxide, eNOS = endothelial nitric oxide synthase; EECP = enhanced external counterpulsation; COPD = chronic obstructive pulmonary disease; CRH = corticotropin-releasing hormone; PaO2/FiO2 = arterial oxygen pressure/fraction of inspired oxygen; SOD = superoxide dismutase. ↓ indicates a decrease in the stated parameter, while ↑ indicates an increase.