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Inflammation and Acupuncture

Inflammation is part of our natural healing process. When we are faced with injury, illness, or a foreign substance that’s toxic to our body, our immune system releases inflammatory cells to protect us.




Introduction

These inflammatory cells secrete cytokines, which in turn, stimulate more inflammatory cells. Most of us are familiar with acute inflammation - the type of inflammation that is produced by a bacterial infection or injured tissue. Once the bacteria has been trapped or the tissue has been repaired, the inflammatory cells and cytokines leave the site of inflammation and the affected tissue returns to its normal state. Chronic inflammation on the other hand, occurs when the immune system continues sending inflammatory cells and cytokines - even though there is no infection or injury.


Chronic inflammatory diseases are the most significant cause of death in the world. The World Health Organization (WHO) ranks chronic inflammatory diseases as the greatest threat to human health. A study published by the European Journal of Preventive Cardiology concluded that:

Worldwide, 60% of death are due to chronic inflammatory diseases”.

Inflammation and fertility:

As reported by many studies, chronic inflammation is at the core of several diseases including cardiovascular disease, stroke, cancer, diabetes, and many others. In addition, there is increasing evidence revealing that chronic inflammation could also be the culprit of infertility. A study by the Oxford Journals – Human Reproductive Update, published in 2016 reported that:

“Systemic inflammation may impair infertility by affecting the uterus, cervix and placenta".

Inflammation has been documented to cause anatomic disorders, affect ovulation and hormone production as well as be associated with endometriosis – all of which can dramatically affect fertility. According to the Oxford Journals – Human Reproductive Update, most anatomic abnormalities that cause infertility are acquired. These acquired anatomic abnormalities include infection, inflammation, ischemia, and surgical injury. The report further explains that the most significant cause of inflammatory infertility is Chlamydia trachomatis infection. However, it is interesting to note that in a study published by the European Journal of Obstetrics and Gynecology and Reproductive Biology, where 277 couples were screened for chlamydia, it concluded that the presence of chlamydia was not associated with the success of in vitro fertilization (IVF). Infertility was associated with inflammation rather than the presence of chlamydia.


The Human Reproductive Update of 2016 summarized its annual report by saying that reproductive disorders (endometriosis, adenomyosis, polycystic ovary syndrome and uterine fibroids) and unexplained infertility share inflammatory pathways, hormonal aberrations, and vascular abnormalities that may impair pregnancy success through common mechanisms.




Causes of inflammation:

While infections can create inflammation, the biggest culprit of inflammation is diet. Stress plays a big part as well, but the quality of the food found in the standard American diet (SAD), has initiated a number of studies suggesting that the way most people eat contributes to chronic inflammation. The Journal of Nutrition published a study in 2022 where they concluded by saying that:

Higher meat consumption, particularly of processed meat, was positively associated with inflammatory markers”.

The Nurses' Health Study (NHS) was launched in 1976 with over 121,700 nurse participants to examine the risk factors for major chronic diseases in women. The study, now with over 280,000 participants, looked at several health issues including the effect of advanced glycation end products (AGEs) and infertility. AGEs are harmful compounds that are formed when protein or fat combine with sugar in the bloodstream. Foods highest in AGEs include meat (especially red meat), certain cheeses, fried eggs, butter, cream cheese, margarine, mayonnaise, oils, and nuts. Fried foods and highly processed products also contain high levels. The Nurses’ Health Study concluded that:

AGEs have a negative impact on fertility.”.

Nutrients, a peer-reviewed, open access journal of human nutrition, published an article in 2022 where it mentions that women with PCOS have elevated circulating AGEs, which is exacerbated by exogenous absorption of AGEs from western heat processed diets. It continues to say that AGEs contribute to the pathogenesis of PCOS as well as the consequential metabolic and reproductive system effects.


Current Pharmaceutical Design, a peer-reviewed journal, published in 2016 a paper where it explains that the biochemical composition of meals, cooking methods, time and temperature of food preparation may contribute to AGEs formation. The standard American diet (SAD), rich in animal-derived products as well as a predominance of fast foods (cooked at a high temperature), could be considered one of the main sources of AGEs.



Inflammation biomarkers:

C-reactive protein (CRP) serves as an early marker of inflammation. This is a very inexpensive bloodwork, $29 through Ulta Lab, that can tell us a lot about our levels of inflammation. A randomized controlled trial published in 2018 by Fertility and Sterility found that:

High preconception CRP levels (≥1.95 mg/L) were associated with a significant decrease in the number of clinical pregnancies and live birth rates among women attempting to conceive naturally".

The same journal in 2016 published a study on CRP levels and IVF cycles. Their conclusion was that

“High serum CRP level on OPU (Ovum Pick-Up or Egg Retrieval) day has a negative effect on embryo quality. CRP level can be considered as a predictive marker for IVF outcome”.


Inflammation and Acupuncture

Evidence-Based Complementary and Alternative Medicine, a peer-reviewed open-access medical journal covering complementary and alternative medicine, published a paper in 2013 showing that acupuncture can reduce inflammation via several physiological pathways. One is the hypothalamus-pituitary-adrenal (HPA) axis, which regulates the body’s response to stress via the release of cortisol and other hormones like glucocorticoids that play a role in inflammation. Another is via the sympathetic and parasympathetic nervous system which activates neurotransmitters that affect the inflammatory process. A third pathway is the antihistamine and cytokine process that occurs in allergic or autoimmune conditions.


The Journal of Inflammation Research, a peer-reviewed medical journal covering research on inflammation, published in 2021 a study titled “The Anti-Inflammatory Actions and Mechanisms of Acupuncture from Acupoint to Target Organs via Neuro-Immune Regulation”. The study presents literature from the last five years, showing that acupuncture indeed exerts strong anti-inflammatory effects in multiple biological systems. The study details the many and very complicated pathways that are activated with acupuncture to reduce inflammation. The study summarizes all these mechanisms by saying that:

Acupuncture drastically reduces inflammation by inhibiting oxidative stress”.

Conclusion

Prior studies have clarified the anti-inflammatory and anti-infection effects of acupuncture on multiple tissues and organs by targeting certain classical inflammatory cells, cytokines, and cellular signaling pathways. In addition, the World Health Organization (WHO) recommends acupuncture for the treatment of 16 types of inflammatory diseases, and several clinical practice guidelines suggest acupuncture for the treatment of several inflammatory diseases.

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