Systematic Review and Meta-analysis of Acupuncture for Modulation of Immune and Inflammatory Markers in Cancer Patients
Introduction: Inflammation is associated with tumor initiation, and existing tumors are associated with immune suppression locally and systemically. Cancer treatment is also associated with immune suppression. This review evaluates evidence related to the use of acupuncture for modulation of inflamm...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2024-12-01
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| Series: | Integrative Cancer Therapies |
| Online Access: | https://doi.org/10.1177/15347354241302072 |
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| author | Wenli Liu MD Baisong Zhong MD Richard W. Wagner PhD M. Kay Garcia DrPH, LAc Jennifer L. McQuade MD, LAc Wen Huang MD, PhD Yisheng Li PhD Graciela M. Nogueras Gonzalez PhD Michael R. Spano MS, LAc Alessandro Cohen MSc Yimin Geng MS, MSLIS Lorenzo Cohen PhD |
| author_facet | Wenli Liu MD Baisong Zhong MD Richard W. Wagner PhD M. Kay Garcia DrPH, LAc Jennifer L. McQuade MD, LAc Wen Huang MD, PhD Yisheng Li PhD Graciela M. Nogueras Gonzalez PhD Michael R. Spano MS, LAc Alessandro Cohen MSc Yimin Geng MS, MSLIS Lorenzo Cohen PhD |
| author_sort | Wenli Liu MD |
| collection | DOAJ |
| description | Introduction: Inflammation is associated with tumor initiation, and existing tumors are associated with immune suppression locally and systemically. Cancer treatment is also associated with immune suppression. This review evaluates evidence related to the use of acupuncture for modulation of inflammation and the immune system in cancer patients. Methods: Nine databases were searched for prospective, randomized, controlled trials evaluating the use of acupuncture for modulation of the immune system in cancer patients through March 2024. Only studies involving needle insertion into acupuncture points were included. No language limitations were applied. Studies were assessed for risk of bias (ROB) according to Cochrane criteria. The primary outcomes were levels of immune and inflammatory markers. Results: Of 3607 articles identified, 1526 duplicates were omitted, and 2261 articles were screened. Sixty-four (58 Chinese, 6 English) publications met all inclusion criteria and were evaluated for ROB. Forty-seven studies were rated as unclear ROB, and nine studies were rated as high ROB. However, when the blinding and allocation concealment criteria were removed, 12 studies had low ROB. Fifty-six studies were included in the meta-analysis, which found that acupuncture significantly increased interferon gamma (IFN-γ; P < .01), natural killer (NK) cells ( P < .01), immunoglobulin G (IgG; P = .04), immunoglobulin M (IgM; P = .04), CD3 cells ( P < .01), CD4 cells ( P < .01), and the CD4/CD8 cell ratio ( P < .01), and significantly lowered interleukin (IL)-1 ( P = .01), IL-4 ( P < .01), IL-6 ( P < .01), and C-reactive protein ( P < .01). Yet except for IFN-γ, there was high heterogeneity of results between studies. No significant differences were found in white blood cells, CD-8, neutrophil levels, IL-2, IL-10, or tumor necrosis factor alpha (TNF-α). Conclusion: The current evidence is insufficient to either support or refute the immunomodulatory effects of acupuncture in cancer patients due to no studies fully meeting the low ROB criterion. The preliminary data, however, are promising. Future studies that are higher powered, with low ROB designs, are warranted. |
| format | Article |
| id | doaj-art-857fef9fefdc4456945bba414831edc7 |
| institution | OA Journals |
| issn | 1552-695X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Integrative Cancer Therapies |
| spelling | doaj-art-857fef9fefdc4456945bba414831edc72025-08-20T01:58:45ZengSAGE PublishingIntegrative Cancer Therapies1552-695X2024-12-012310.1177/15347354241302072Systematic Review and Meta-analysis of Acupuncture for Modulation of Immune and Inflammatory Markers in Cancer PatientsWenli Liu MD0Baisong Zhong MD1Richard W. Wagner PhD2M. Kay Garcia DrPH, LAc3Jennifer L. McQuade MD, LAc4Wen Huang MD, PhD5Yisheng Li PhD6Graciela M. Nogueras Gonzalez PhD7Michael R. Spano MS, LAc8Alessandro Cohen MSc9Yimin Geng MS, MSLIS10Lorenzo Cohen PhD11Integrative Medicine Clinic, Bellaire, TX, USAAmerican College of Acupuncture and Oriental Medicine, Houston, TX, USAThe University of Texas MD Anderson Cancer Center, Houston, TX, USAThe University of Texas MD Anderson Cancer Center, Houston, TX, USAThe University of Texas MD Anderson Cancer Center, Houston, TX, USAAmerican College of Acupuncture and Oriental Medicine, Houston, TX, USAThe University of Texas MD Anderson Cancer Center, Houston, TX, USATexas A&M University, College Station, TX, USAThe University of Texas MD Anderson Cancer Center, Houston, TX, USAThe University of Texas MD Anderson Cancer Center, Houston, TX, USAThe University of Texas MD Anderson Cancer Center, Houston, TX, USAThe University of Texas MD Anderson Cancer Center, Houston, TX, USAIntroduction: Inflammation is associated with tumor initiation, and existing tumors are associated with immune suppression locally and systemically. Cancer treatment is also associated with immune suppression. This review evaluates evidence related to the use of acupuncture for modulation of inflammation and the immune system in cancer patients. Methods: Nine databases were searched for prospective, randomized, controlled trials evaluating the use of acupuncture for modulation of the immune system in cancer patients through March 2024. Only studies involving needle insertion into acupuncture points were included. No language limitations were applied. Studies were assessed for risk of bias (ROB) according to Cochrane criteria. The primary outcomes were levels of immune and inflammatory markers. Results: Of 3607 articles identified, 1526 duplicates were omitted, and 2261 articles were screened. Sixty-four (58 Chinese, 6 English) publications met all inclusion criteria and were evaluated for ROB. Forty-seven studies were rated as unclear ROB, and nine studies were rated as high ROB. However, when the blinding and allocation concealment criteria were removed, 12 studies had low ROB. Fifty-six studies were included in the meta-analysis, which found that acupuncture significantly increased interferon gamma (IFN-γ; P < .01), natural killer (NK) cells ( P < .01), immunoglobulin G (IgG; P = .04), immunoglobulin M (IgM; P = .04), CD3 cells ( P < .01), CD4 cells ( P < .01), and the CD4/CD8 cell ratio ( P < .01), and significantly lowered interleukin (IL)-1 ( P = .01), IL-4 ( P < .01), IL-6 ( P < .01), and C-reactive protein ( P < .01). Yet except for IFN-γ, there was high heterogeneity of results between studies. No significant differences were found in white blood cells, CD-8, neutrophil levels, IL-2, IL-10, or tumor necrosis factor alpha (TNF-α). Conclusion: The current evidence is insufficient to either support or refute the immunomodulatory effects of acupuncture in cancer patients due to no studies fully meeting the low ROB criterion. The preliminary data, however, are promising. Future studies that are higher powered, with low ROB designs, are warranted.https://doi.org/10.1177/15347354241302072 |
| spellingShingle | Wenli Liu MD Baisong Zhong MD Richard W. Wagner PhD M. Kay Garcia DrPH, LAc Jennifer L. McQuade MD, LAc Wen Huang MD, PhD Yisheng Li PhD Graciela M. Nogueras Gonzalez PhD Michael R. Spano MS, LAc Alessandro Cohen MSc Yimin Geng MS, MSLIS Lorenzo Cohen PhD Systematic Review and Meta-analysis of Acupuncture for Modulation of Immune and Inflammatory Markers in Cancer Patients Integrative Cancer Therapies |
| title | Systematic Review and Meta-analysis of Acupuncture for Modulation of Immune and Inflammatory Markers in Cancer Patients |
| title_full | Systematic Review and Meta-analysis of Acupuncture for Modulation of Immune and Inflammatory Markers in Cancer Patients |
| title_fullStr | Systematic Review and Meta-analysis of Acupuncture for Modulation of Immune and Inflammatory Markers in Cancer Patients |
| title_full_unstemmed | Systematic Review and Meta-analysis of Acupuncture for Modulation of Immune and Inflammatory Markers in Cancer Patients |
| title_short | Systematic Review and Meta-analysis of Acupuncture for Modulation of Immune and Inflammatory Markers in Cancer Patients |
| title_sort | systematic review and meta analysis of acupuncture for modulation of immune and inflammatory markers in cancer patients |
| url | https://doi.org/10.1177/15347354241302072 |
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