Yin Yang Podcast: March 2014

Episode: #19 The Science Behind Acupuncture

Special guest Dr. Helene Langevin joins the show today. She is Director of the Osher Center for Integrative Medicine at Harvard and a neuroendocrinologist at the University of Vermont College of Medicine. Her area of focus is analyzing and viewing what occurs to the connective tissue when an acupuncture needle is inserted and stimulated.

Helene Langevin is a neuroendocrinologist at the University of Vermont College of Medicine and Director of the Osher Center for Integrative Medicine Harvard. She is a leading researcher of on how connective tissue responds to acupuncture. Her first published research project in 1999 demonstrated structural changes in the tissue when manipulating the needle. See Picture blow

A) no needle twirling B) Needle twirling

She has found that during needle stimulation there is a binding of connective tissue to the needle. Fibroblast (the cells that build connective tissue like collagen) respond to the needle several cm away from the site. This binding of connective tissue to the needle last for about 30 minutes. Amazingly enough that is about the same time we are taught as acupuncturists to retain the needles. As you can see below, these cells actually increase their body size in response to acupuncture.

The direction of needle twirling also makes a difference in how tissue respond to needling. For example using uni-directional needling techniques, like tonifying or sedating. Compared to bi-directional needling techniques where an acupuncturist would twirl the needles clock and counter clock wise.

Bi-Directional

Uni-Directional

Dr. Helene Langevin is doing research on other modalities that cause tissue to expand. Techniques like massage and yoga. Her findings are suggestive of a possible anti-inflammatory response to these forms of tissue manipulation. Her ultimate goal is to ascertain the best treatment for a patient with pain with the least amount of opioids and NSAIDs as possible.

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Peer Reviewed Publications:

1. Langevin HM, Fujita T, Bouffard NA, Takano T, Koptiuch C, Badger GJ, Nedergaard M. Fibroblast cytoskeletal remodeling induced by tissue stretch involves ATP signaling. J Cell Physiol. 2013 Sep; 228(9):1922-6.

2. Langevin HM, Nedergaard M, Howe AK. Cellular control of connective tissue matrix tension. J Cell Biochem. 2013 Aug; 114(8):1714-9.

3. Snapp RR, Goveia E, Peet L, Bouffard NA, Badger GJ, Langevin HM. Spatial organization of fibroblast nuclear chromocenters: component tree analysis. J Anat. 2013 Sep; 223(3):255-61.

4. Goldman N, Chandler-Militello D, Langevin HM, Nedergaard M, Takano T. Purine receptor mediated actin cytoskeleton remodeling of human fibroblasts. Cell Calcium. 2013 Apr; 53(4):297-301.

5. Abbott RD, Koptiuch C, Iatridis JC, Howe AK, Badger GJ, Langevin HM. Stress and matrix-responsive cytoskeletal remodeling in fibroblasts. J Cell Physiol. 2013 Jan; 228(1):50-7.

6. Abbott RD, Howe AK, Langevin HM, Iatridis JC. Live free or die: stretch-induced apoptosis occurs when adaptive reorientation of annulus fibrosus cells is restricted. Biochem Biophys Res Commun. 2012 May 4; 421(2):361-6.

7. Davis RT, Churchill DL, Badger GJ, Dunn J, Langevin HM. A new method for quantifying the needling component of acupuncture treatments. Acupunct Med. 2012 Jun; 30(2):113-9.

8. Corey SM, Vizzard MA, Bouffard NA, Badger GJ, Langevin HM. Stretching of the back improves gait, mechanical sensitivity and connective tissue inflammation in a rodent model. PLoS One. 2012; 7(1):e29831.

9. Wu J, Chen D, Langevin HM, Nyborg WL. Interaction between parallel polymer fibers insonificated by ultrasound of low/mild intensity: an analytical theory and experiments. Ultrasonics. 2012 Mar; 52(3):417-21.

10. Langevin HM, Fox JR, Koptiuch C, Badger GJ, Greenan-Naumann AC, Bouffard NA, Konofagou EE, Lee WN, Triano JJ, Henry SM. Reduced thoracolumbar fascia shear strain in human chronic low back pain. BMC Musculoskelet Disord. 2011; 12:203.

11. Park JJ, Akazawa M, Ahn J, Beckman-Harned S, Lin FC, Lee K, Fine J, Davis RT, Langevin H. Acupuncture sensation during ultrasound guided acupuncture needling. Acupunct Med. 2011 Dec; 29(4):257-65.

12. Langevin HM, Bouffard NA, Fox JR, Palmer BM, Wu J, Iatridis JC, Barnes WD, Badger GJ, Howe AK. Fibroblast cytoskeletal remodeling contributes to connective tissue tension. J Cell Physiol. 2011 May; 226(5):1166-75.

13. Corey SM, Vizzard MA, Badger GJ, Langevin HM. Sensory innervation of the nonspecialized connective tissues in the low back of the rat. Cells Tissues Organs. 2011; 194(6):521-30.

14. Langevin HM, Wayne PM, Macpherson H, Schnyer R, Milley RM, Napadow V, Lao L, Park J, Harris RE, Cohen M, Sherman KJ, Haramati A, Hammerschlag R. Paradoxes in acupuncture research: strategies for moving forward. Evid Based Complement Alternat Med. 2011; 2011:180805.

15. Ahn AC, Park M, Shaw JR, McManus CA, Kaptchuk TJ, Langevin HM. Electrical impedance of acupuncture meridians: the relevance of subcutaneous collagenous bands. PLoS One. 2010; 5(7):e11907.

16. Berman BM, Langevin HM, Witt CM, Dubner R. Acupuncture for chronic low back pain. N Engl J Med. 2010 Jul 29; 363(5):454-61.

17. Langevin HM, Storch KN, Snapp RR, Bouffard NA, Badger GJ, Howe AK, Taatjes DJ. Tissue stretch induces nuclear remodeling in connective tissue fibroblasts. Histochem Cell Biol. 2010 Apr; 133(4):405-15.

18. Langevin HM, Huijing PA. Communicating about fascia: history, pitfalls, and recommendations. Int J Ther Massage Bodywork. 2009; 2(4):3-8.

19. Langevin HM, Stevens-Tuttle D, Fox JR, Badger GJ, Bouffard NA, Krag MH, Wu J, Henry SM. Ultrasound evidence of altered lumbar connective tissue structure in human subjects with chronic low back pain. BMC Musculoskelet Disord. 2009; 10:151.

20. Wayne PM, Hammerschlag R, Langevin HM, Napadow V, Park JJ, Schnyer RN. Resolving paradoxes in acupuncture research: a roundtable discussion. J Altern Complement Med. 2009 Sep; 15(9):1039-44.

21. Schnyer R, Lao L, Hammerschlag R, Wayne P, Langevin HM, Napadow V, Harris R, Park J, Milley R, Cohen M, MacPherson H. Society for Acupuncture Research: 2007 conference report: "The status and future of acupuncture research: 10 years post-NIH Consensus Conference". J Altern Complement Med. 2008 Sep; 14(7):859-60.

22. Napadow V, Ahn A, Longhurst J, Lao L, Stener-Victorin E, Harris R, Langevin HM. The status and future of acupuncture mechanism research. J Altern Complement Med. 2008 Sep; 14(7):861-9.

23. Ahn AC, Colbert AP, Anderson BJ, Martinsen OG, Hammerschlag R, Cina S, Wayne PM, Langevin HM. Electrical properties of acupuncture points and meridians: a systematic review. Bioelectromagnetics. 2008 May; 29(4):245-56.

24. Bouffard NA, Cutroneo KR, Badger GJ, White SL, Buttolph TR, Ehrlich HP, Stevens-Tuttle D, Langevin HM. Tissue stretch decreases soluble TGF-beta1 and type-1 procollagen in mouse subcutaneous connective tissue: evidence from ex vivo and in vivo models. J Cell Physiol. 2008 Feb; 214(2):389-95.

25. Whittaker JL, Teyhen DS, Elliott JM, Cook K, Langevin HM, Dahl HH, Stokes M. Rehabilitative ultrasound imaging: understanding the technology and its applications. J Orthop Sports Phys Ther. 2007 Aug; 37(8):434-49.

26. Langevin HM, Rizzo DM, Fox JR, Badger GJ, Wu J, Konofagou EE, Stevens-Tuttle D, Bouffard NA, Krag MH. Dynamic morphometric characterization of local connective tissue network structure in humans using ultrasound. BMC Syst Biol. 2007; 1:25.

27. Langevin HM, Bouffard NA, Churchill DL, Badger GJ. Connective tissue fibroblast response to acupuncture: dose-dependent effect of bidirectional needle rotation. J Altern Complement Med. 2007 Apr; 13(3):355-60.

28. Storch KN, Taatjes DJ, Bouffard NA, Locknar S, Bishop NM, Langevin HM. Alpha smooth muscle actin distribution in cytoplasm and nuclear invaginations of connective tissue fibroblasts. Histochem Cell Biol. 2007 May; 127(5):523-30.

29. Langevin HM, Sherman KJ. Pathophysiological model for chronic low back pain integrating connective tissue and nervous system mechanisms. Med Hypotheses. 2007; 68(1):74-80.

30. Langevin HM, Bouffard NA, Badger GJ, Churchill DL, Howe AK. Subcutaneous tissue fibroblast cytoskeletal remodeling induced by acupuncture: evidence for a mechanotransduction-based mechanism. J Cell Physiol. 2006 Jun; 207(3):767-74.

31. Langevin HM. Connective tissue: a body-wide signaling network? Med Hypotheses. 2006; 66(6):1074-7.

32. Langevin HM, Storch KN, Cipolla MJ, White SL, Buttolph TR, Taatjes DJ. Fibroblast spreading induced by connective tissue stretch involves intracellular redistribution of alpha- and beta-actin. Histochem Cell Biol. 2006 May; 125(5):487-95.

33. Ahn AC, Wu J, Badger GJ, Hammerschlag R, Langevin HM. Electrical impedance along connective tissue planes associated with acupuncture meridians. BMC Complement Altern Med. 2005; 5:10.

34. Konofagou EE, Langevin HM. Using ultrasound to understand acupuncture. Acupuncture needle manipulation and its effect on connective tissue. IEEE Eng Med Biol Mag. 2005 Mar-Apr; 24(2):41-6.

35. Langevin HM, Bouffard NA, Badger GJ, Iatridis JC, Howe AK. Dynamic fibroblast cytoskeletal response to subcutaneous tissue stretch ex vivo and in vivo. Am J Physiol Cell Physiol. 2005 Mar; 288(3):C747-56.

36. Langevin HM, Konofagou EE, Badger GJ, Churchill DL, Fox JR, Ophir J, Garra BS. Tissue displacements during acupuncture using ultrasound elastography techniques. Ultrasound Med Biol. 2004 Sep; 30(9):1173-83.

37. Langevin HM, Cornbrooks CJ, Taatjes DJ. Fibroblasts form a body-wide cellular network. Histochem Cell Biol. 2004 Jul; 122(1):7-15.

38. Langevin HM, Badger GJ, Povolny BK, Davis RT, Johnston AC, Sherman KJ, Kahn JR, Kaptchuk TJ. Yin scores and yang scores: A new method for quantitative diagnostic evaluation in traditional Chinese medicine research. J Altern Complement Med. 2004 Apr; 10(2):389-95; discussion 387.

39. Hammerschlag R, Culliton PD, Langevin HM, Lao L. A new partnership: the Society for Acupuncture Research and the Journal of Alternative and Complementary Medicine. J Altern Complement Med. 2003 Dec; 9(6):807-8.

40. Iatridis JC, Wu J, Yandow JA, Langevin HM. Subcutaneous tissue mechanical behavior is linear and viscoelastic under uniaxial tension. Connect Tissue Res. 2003; 44(5):208-17.

41. Langevin HM, Yandow JA. Relationship of acupuncture points and meridians to connective tissue planes. Anat Rec. 2002 Dec 15; 269(6):257-65.

42. Langevin HM, Churchill DL, Wu J, Badger GJ, Yandow JA, Fox JR, Krag MH. Evidence of connective tissue involvement in acupuncture. FASEB J. 2002 Jun; 16(8):872-4.

43. Langevin HM, Churchill DL, Fox JR, Badger GJ, Garra BS, Krag MH. Biomechanical response to acupuncture needling in humans. J Appl Physiol. 2001 Dec; 91(6):2471-8.

44. Langevin HM, Churchill DL, Cipolla MJ. Mechanical signaling through connective tissue: a mechanism for the therapeutic effect of acupuncture. FASEB J. 2001 Oct; 15(12):2275-82.

45. Langevin HM, Vaillancourt PD. Acupuncture: does it work and, if so, how? Semin Clin Neuropsychiatry. 1999 Jul; 4(3):167-75.

Episode: #18 A Dimond Messenger

Description: 1971 provided the year acupuncture gained a foundation in the American medical system. Cardiologist, Dr. E. Grey Dimond, carried this message despite formidable obstacles. We are honored to present his story today.

How did acupuncture become main stream in America?

We as acupuncturists are usually taught and told the story of how James Reston, journalist from the New York Times, while in China with Henry Kissinger on a diplomatic endeavor, fell ill with acute appendicitis. James had the usual appendectomy but then was treated post-op with acupuncture. He published his story on July 26th, 1971.

New York Times July 26, 1971 Page2

Here is the story we are not told about:

Dr. E. Grey Dimond was one of the first American physicians to visit Red China since the communist revolution in 1949. He found himself with this unique opportunity with the aid of Edgar Snow (author of Red Star Over China). They had met previously in 1965 at a world peace conference.

Edgar Snow was eager to get an American physician over to China to view and witness their advances in acupuncture anesthesia, birth control measures, and limb reimplantation.

In 1971 that time came to fruition. The attendees of this trip would be Dr. E Grey Dimond, Dr. Paul Dudley White (Father of Cardiology), and their wives.

When Dr. Dimond returned he began immediately to write papers about his eye witness account of acupuncture anesthesia. He first published an article for The Journal of the American Medical Association (JAMA) on Dec 6th 1971. Titled: Acupuncture Anesthesia - Western Medicine and ChineseTraditional Medicine