Notes from NGF, Nerve Growth Factor, and Electroacupuncture Article by Manni

Having read the article in full from yesterday's blog post, (link to article here) I wanted to draw attention to a few points. One: they flesh out the concept of acupuncture causing stimulation similar to exercise. I remember reading Anderson's paper a long time ago and was happy to have the citation. Two: It turns out that NGF, nerve growth factor, may be involved en Electroacupuncture's effect on the sympathetic tone of Polycystic Ovarian Syndrome patients(as discussed here.) I discussed PCOS and electroacupuncture here and here. Three: They discuss electroacupuncture's effect on mast cells (MC) and NGF, postulating that acupuncture's effectiveness is due to their modulation of the immune system. I had come to think that the effectiveness of acupuncture for allergy was due to a general decrease in sympathetic tone leading to improved immunity, but they argue pretty convincingly that it may be due to release of these factors. I virtually never use electroacupuncture for allergy, rather manual acupuncture, but I certainly going to try in conjunction with HRV monitoring. Four: They discuss other aspects of NGF on peripheral neuropathy and Central Nervous System insults also, but I didn't include that discussion here.
I have excerpted and highlighted a bit of the article below. (Info on my practice here.)

It has been reported that manual acupuncture and EA
effects can be correlated to activation of all kinds of
type A (alpha, beta, gamma and delta) and C sensory
nerve fibers. However, particular significance has
been given to a group of receptors in the skeletal
muscles, which have both low- and high-threshold
for mechanical stimulation, and are innervated by
A-delta fibers and possibly C-fibers. Physiologically
they are activated by strong muscle contractions and
have been denoted ergoreceptors. Based on this, it
has been suggested that EA with repetitive muscle
contraction results in the activation of physiological
processes similar to those resulting from physical
exercise (Andersson et al., 1995).
Both acupuncture and physical exercise release
endogenous opioids, which seems to be essential
in the induction of acupuncture-mediated functional
changes of different organ systems. However,
other systems may be involved in the acupuncture
modulation of stress, pain, autonomic activity and
immune systems. Indeed, research carried out in
the last 20 years shown that through acupuncture
it is possible to affect synthesis, release and action
of several neurotransmitters (catecholamines, glutamate,
acetylcholine, GABA, serotonin) and neuropeptides
(among others: oxytocin, NPY, CCK,
VIP, SP, CGRP, PACAP) in both CNS and PNS.
It has recently been proposed that at least some of
the effects attributed to acupuncture are mediated
by neurotrophins, particularly NGF (Manni et al.,
2010a).
...The results suggested that EA inhibits
hyperactivity in the sympathetic nervous system (Cao
et al., 1983; Chao et al., 1999), a major pathogenetic
cause of PCO (Barria et al., 1993; Lara et al., 1993;
Lara et al., 2000; Lara et al., 2002). Supporting this
hypothesis, in a following study (Stener-Victorin
et al., 2003) we demonstrated the effect of EA
in reducing ovarian NGF along with ovarian and
hypothalamic sympathetic activation markers...

Neutralization of endogenous NGF reversed most
of these abnormalities (Manni et al., 2006). Almost
identical results were obtained by EA treatment
(Manni et al., 2005c), demonstrating that the results
were probably achieved through the actions of EA
on the NGF system.
Overall, the data on EA/NGF interaction in PCOS models indicated that the
therapeutic potential of EA is exerted via its ability
to modulate the activity of the autonomic nervous
system by inducing a long-lasting depression of the
sympathetic nervous system, with a concomitant
down-regulation of NGF in peripheral organs...

Since MC (mast cells) are critically involved
in allergic responses (Song et al., 2009), these observations
suggest that EA, through the modulation
of MC activity, can influence the release of their
preformed mediators, including NGF, in allergic
reactions.

Moxibustion Activates Host Defense Against Herpes Simplex Virus in Mice

As time consuming as it is to use moxibustion in modern practice, it does seem to be the mainstay of enhancing immune function. I use it most often in patients with allergy and HIV. During my training the treatment rooms were full of moxa smoke. Here, at least in my practice, even using smokeless moxa, many notice and comment on the smell. This study reinforces my own biases, so of course I love it! ;)
Of note is that they used the moxa preventatively, before the virus was introduced. (Anecdotally this makes sense vis a vis my attempts to get patients in for treatment before the allergy season, and ongoing treatment to prevent illness in HIV positive patients.)
Also, of interest is that not only cytokine production but also natural killer cells.
The abstract follows, emphases are mine.

(To read more about acupuncture and my practice, please click here.)

Microbiol Immunol. 2010 Sep;54(9):551-7.
Moxibustion activates host defense against herpes simplex virus type I through augmentation of cytokine production.

Takayama Y, Itoi M, Hamahashi T, Tsukamoto N, Mori K, Morishita D, Wada K, Amagai T.

Department of Immunology and Microbiology, Meiji University of Integrative Medicine, Hiyoshi-cho, Nantan, Kyoto 629-0392, Japan.
Abstract

Moxibustion is a technique used in traditional oriental medicine, the aim of which is to cure and/or prevent illness by activating a person's ability for self-healing. In this study, we assessed how moxibustion would affect the immune system and whether it would augment protective immunity. Mice were treated with moxibustion at Zusanli (ST36) acupoints; we analyzed mortality and cytokine activity in sera after infection with herpes simplex virus type 1 (HSV-1), and cytokine gene expression in the skin and the spleen without a virus challenge. Our study demonstrates that pretreatment of BALB/c mice with moxibustion resulted in a marked increase in the survival rate after infection with lethal doses of HSV-1, and elevated serum levels of IL-1β and IFN-γ on days 1 and 6 post-infection with HSV-1. Semi-quantitative RT-PCR assay showed that moxibustion treatment augmented the expression of IL-1α, IL-1β, IL-6, universal-IFN-α, MIP-1α, and TNF-α mRNA in the skin, and IL-1α, IL-1β, IL-12p40, IL-15, u-IFN-α, MIP-1α, and TNF-α mRNA in the spleen. Moreover, moxibustion induces augmentation of natural killer cell activity. Collectively, our study demonstrates that moxibustion activates protective responses against HSV-1 infection through the activation of cytokine production including IFN, and of NK cells.