Acupuncture for the reduction of neuroinflammation in fibromyalgia: A big data-bench- bedside study

Hung-Rong Yen, M.D., Ph.D.

Research Center for Traditional Chinese Medicine, China Medical University, Taichung, Taiwan.

Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.

School of Chinese Medicine, China Medical University, Taichung, Taiwan.

 

 

    Fibromyalgia, characterized by chronic wide-spread pain, commonly presents with associated symptoms such as fatigue, sleep disturbance, depression and cognitive dysfunction. To understand the utilization and benefits of acupuncture for fibromyalgia, we conducted a translational study in Taiwan. First of all, we conducted a study by analyzing the utilization of acupuncture among patients with fibromyalgia. We investigated a randomly selected sample of one million people enrolled in the National Health Insurance Research Database from 2000-2010. We performed a 1:1 propensity-score matched-cohort study to analyze fibromyalgia patients. 64,939 patients in both cohorts were identified. Baseline characteristics were similar in both cohorts. Cumulative incidence of stroke was significantly lower in the acupuncture cohort. The beneficial effect of acupuncture was independent of age, sex, comorbidities and drugs used. Next we investigated the mechanism of acupuncture in a murine model of fibromyalgia. We found that acupuncture significantly reduced pro-inflammatory cytokines in murine fibromyalgia model. Finally, we conducted a randomized, sham-controlled, clinical trial in China Medical University Hospital. 40 patients were randomized into acupuncture and sham-acupuncture groups. Both acupuncture and sham acupuncture decreased the widespread pain index among patients with fibromyalgia. Interestingly, acupuncture reduced proinflammatory cytokines. Furthermore, we found that acupuncture and sham-acupuncture groups had different glucose metabolism in brain by the 18F-FDG PET/CT scan. In conclusion, acupuncture may not only ameliorate pain but also reduce neuroinflammation. Our study also provided an example of big data-bench-bedside translational research in acupuncture.