Acupuncture alleviates nasal and eye itching, sneezing, and runny nose for patients with allergic rhinitis. Researchers confirm that acupuncture successfully downregulates IgE (immunoglobulin E), an antibody active in hypersensitivity reactions, while simultaneously reducing symptoms of allergic rhinitis. In a highly controlled investigation published in the Annals of Allergy, Asthma & Immunology, university researchers present the first study to prove that acupuncture downregulates allergen specific IgE for dust mites.

Researchers from Stanford, RMIT, Griffith, and Western Sydney Universities conclude that acupuncture alleviates persistent allergic rhinitis. Important subjective and objective measures support the conclusion. Allergy symptoms and overall quality of life scores significantly improved as a result of acupuncture therapy. Moreover, symptoms and quality of life scores continued to improve, measured four weeks after completion of acupuncture treatments.

In objective measures, acupuncture significantly decreased IgE levels for patients with allergic rhinitis. Total IgE and allergen specific IgE for dust mites were significantly downregulated, including measurements taken four weeks after completion of acupuncture therapy. Sham acupuncture did not downregulate either of the IgE levels.

The researchers add that real acupuncture exerts an immunomodulatory effect on patients with allergic rhinitis. They note that this effect may also benefit patients with other allergic conditions, including allergy related asthma. In addition, real acupuncture downregulated proinflammatory neuropeptide SP.

A total of 110 subjects were divided into real acupuncture, sham acupuncture, and no acupuncture groups. Participants receiving real acupuncture experienced significant improvement in allergic rhinitis symptoms. This included reductions of nasal and eye itching, sneezing, and runny nose. Patients in both the real and sham acupuncture groups had sleep improvements, however, sham acupuncture group participants did not have any improvements in other symptoms. Only real acupuncture alleviated nasal and eye related symptoms of allergic rhinitis.

The Mini-Rhinoconjunctivitis Quality of Life Questionnaire revealed that patients receiving real acupuncture demonstrated continued improvements at weeks 9 – 12. Patients receiving only sham acupuncture deteriorated at weeks 9 – 12. Regarding IgE, the researchers note, "This was the first study to report a significant decrease in allergen specific IgE for house dust mite in adults with persistent allergic rhinitis. These findings suggest that acupuncture modulates the allergic immune response through down-regulation of allergen specific IgE for house dust mite possibly through the reduction of TH2 dominance."

The rigor of this clinical trial is significant. It is a 3-arm, double blinded, randomized, sham-controlled trial. Ethics clearance was given by the Griffith University Human Research Ethics Committee and the study was registered with the Australian New Zealand Clinical Trials Registry.

Positive patient outcomes were taken, in part, by measurements of upper respiratory regulation of mucosal immunes responses by the application of acupuncture. Samples were taken from saliva and blood for laboratory analysis. Objective measurements used in outcome determinations included those of total IgE, allergen specific IgE, proinflammatory neuropeptides, eosinophilic cationic proteins, cytokines, and neurotrophins. Subjective measures tracked nasal airway clearance and quality of life scores.

The researchers did not simulate acupuncture needles to obtain deqi, as is standard clinical practice. Instead, needles were inserted without any manipulation. This may have been necessary to preserve the double-blinded aspect of the study and sham controls.

The researchers included a brief discussion concerning sham acupuncture protocols and noted, "Non-channel points used in sham acupuncture protocols have been shown not to be inert; however, because there is no sham acupuncture protocol that has been validated as inert, needling non-channel points was the most appropriate invasive sham protocol available." They add, "The use of sham acupuncture protocols that are not inert can lead to underestimation of the effect size of real acupuncture."

Chinese sterile disposable needles (0.25 x 40 mm) were used for the real acupuncture group. Acupuncture was performed between 6 am – 12 pm, two times per week, for a total of 16 acupuncture sessions over a period of 8 weeks. All needles were retained for twenty minutes prior to removal. All acupuncture treatments were applied by a licensed acupuncturist with greater than 35 years of clinical experience. Acupoints needled obliquely to a depth of 3 – 5 mm were:
Yintang
LI20
GV23

Additional needles were inserted perpendicularly to a depth of 10 – 15 mm into the following acupoints:
LI4
ST36

Based on the data, the researchers conclude that acupuncture is a safe and effective treatment modality for patients with allergic rhinitis. Acupuncture reduces nasal and eye symptoms including itching, sneezing, and runny nose. In addition, acupuncture regulates IgE for patients with allergic rhinitis.

References:
McDonald, John Leslie, Peter K. Smith, Caroline A. Smith, Charlie Changli Xue, Brenda Golianu, Allan W. Cripps, and Mucosal Immunology Research Group. "Effect of acupuncture on house dust mite specific IgE, substance P, and symptoms in persistent allergic rhinitis." Annals of Allergy, Asthma & Immunology 116, no. 6 (2016): 497-505.

Wu MT, Sheen JM, Chuang KH, et al. Neuronal specificity of acupuncture response: a fMRI study with electroacupuncture. Neuroimage. 2002;16: 1028e1037.

Liu B, Liu X, Chen J, et al. Study on the effects of acupuncture at acupoint and non-acupoint on functional connectivity of different brain regions with functional magnetic resonance imaging [in Chinese]. Zhongguo Zhen Jiu. 2009; 29:981e985.

Dincer F, Linde K. Sham interventions in randomized clinical trials of acupuncture: a review. Complement Ther Med. 2003;11:235e242.