Acupoint sensitization in inflammatory bowel disease - PROJECT SUMMARY This K23 award will support career development for the candidate to become an independent acupuncturist- scientist, focused on mechanisms of acupuncture and point specificity. BACKGROUND. Acupoints represent one of the core tenets of acupuncture, yet their underlying scientific basis remains poorly understood. This gap poses challenges in advancing the fundamental science of acupuncture and determining whether point specificity is an essential, therapeutic component of acupuncture. Recent basic animal studies have provided compelling evidence that cutaneous neurogenic inflammation may be a potential physiological correlate of acupoints in the context of visceral diseases. They demonstrated that (1) experimental induction of visceral diseases (e.g., rodent models of colitis) causes cutaneous neurogenic inflammation, the distribution of which overlaps with the locations of specific acupoints, and (2) acupuncture at these sensitized locations is more effective in improving the corresponding diseases. To date, no studies have been done to validate these findings in human subjects. Thus, the goal of this K23 is to bridge this gap by conducting clinical and translational (C/T) research in human subjects, using inflammatory bowel disease (IBD) as the disease model. Key features of neurogenic inflammation include increased blood flow and hypersensitivity, so cutaneous blood perfusion and pressure pain threshold (PPT) will be collected as proxy measures, using laser speckle contrast imaging and pressure algometry. SPECIFIC AIMS. The proposal will consist of two independent, yet interrelated studies: a translational study comparing cutaneous blood perfusion and PPT between IBD patients and healthy control participants across multiple prespecified acupoints and sham points (Aim 1), and a pilot RCT in IBD patients to collect feasibility measures that will inform the design of a larger scale RCT, evaluating whether cutaneous sensitization of acupoints and/or sham points used in acupuncture treatment affects clinical outcomes (Aim 2). LONG-TERM GOAL. The candidate’s long-term career goal as an acupuncturist-scientist is to advance the science of acupuncture and translate scientific evidence to inform clinical practice to ultimately improve patient care. With the mentored research and training activities proposed in this K23, she will develop expertise in C/T research methodologies, learn more about IBD pathophysiology, deepen her understanding of biomedical imaging and biomarker science, and gain competence in longitudinal analysis. MENTORSHIP. The candidate will be supported an interdisciplinary mentoring team with expertise in acupuncture research, IBD, biomedical imaging and physiological signal analyses, and biostatistics: Drs. Peter Wayne and Vitaly Napadow (co-primary mentors) and Drs. Joshua Korzenik, Ted Kaptchuk, Weidong Lu, Andrew Ahn, and Pamela Rist (collaborators and secondary mentors). IMPACT. This K23 proposal addresses a critical gap in the field of acupuncture research surrounding the scientific basis of acupoints and aligns with NCCIH’s objective to advance the fundamental science and methods development relevant to acupuncture research.
