COVID-19: Can Acupuncture Help to Prevent the “Cytokine Storm”?
By: Joe Recsnik L.Ac, DCCM
Over the last few months, I’ve read countless articles and spent many hours researching in order to gain a better understanding of how the COVID-19 virus takes hold in the body and the potential harm it can do to those who are infected. After weeks of reading reports from doctors and epidemiologists it has become apparent that this virus is very different from anything the medical community has dealt with in the past. As such our understanding of exactly how the COVID-19 virus can affect the human body has evolved greatly since the outset of the pandemic, and continues to evolve.
One aspect of COVID-19 that is very different from a typical flu virus is its tendency to trigger a phenomenon called a cytokine storm. While (like a typical flu) it’s true that the COVID-19 virus initially takes hold in the nose and throat and can do damage to lung tissue, a big difference is how the virus can progress from there. If the body’s immune response doesn’t defeat the virus during the early stages it can progress to cause severe damage of many other internal organ systems such as the heart, blood vessels, brain, liver, kidneys, and intestines. One explanation for why COVID-19 moves beyond the lungs and causes other vital organs to fail is the cytokine storm.
From the April 17, 2020 edition of “Science” magazine: “Some clinicians suspect the driving force in many gravely ill patients’ downhill trajectories is a disastrous overreaction of the immune system known as a “cytokine storm,” which other viral infections are known to trigger. Cytokines are chemical signaling molecules that guide a healthy immune response; but in a cytokine storm, levels of certain cytokines soar far beyond what’s needed, and immune cells start to attack healthy tissues. Blood vessels leak, blood pressure drops, clots form, and catastrophic organ failure can ensue.”
Given this information it is critical to note that when it comes to COVID-19, those with pre-existing inflammatory or vascular conditions (such as diabetes, hypertension and obesity) are as susceptible or more susceptible to severe complications of the virus as those with asthma or pre-existing respiratory conditions.
So what role can acupuncture play in in supporting patient health during the current pandemic? Admittedly there is not much acupuncture can do in terms of emergency care once the “cytokine storm” has taken hold of the body. But can acupuncture help to alter the internal terrain of the body so that it is less susceptible to developing a “cytokine storm” should one become infected with COVID-19?
Understanding the connection between chronic stress leading to an increase of the body’s inflammatory response system, and the proven action of acupuncture to decrease the effects of stress on the body by modulating the autonomic nervous system (ANS) may provide insight to answering these questions.
According to Won, et al: “Acute and chronic stressors have also been reported to affect the immune system, and an increase in various inflammatory markers has been reported in states of acute stress and chronic stress. A potential interaction between chronic stress and inflammatory cytokine responses to acute stress has also been reported.”
In other words, based on evidence presented in this research, there is clear relationship that exists between systemic inflammation and states of chronic stress (for example major depressive disorder). The paper points out that stress increases activity of the sympathetic nervous system (SNS) and decreases activity of the parasympathetic nervous system (PNS). (Note: The SNS is commonly attributed to governing the “fight or flight” aspect of the nervous system while the PNS governs the “rest & digest” aspect.) Chronic over activity of the SNS can increase levels of pro-inflammatory cytokines and decrease levels of anti-inflammatory cytokines resulting in a state of inflammation. Thus treatments that increase activity of the PNS not only address a wide rage of other physical effects of stress on the body (see below) but particularly also strengthen the body’s anti-inflammatory pathway. One way of increasing activity of the PNS is through stimulation of the vagus nerve.
Regarding acupuncture treatment, numerous studies show it is very effective to activate the vagus nerve(and by extension activate the PNS). Particularly when it is applied to the ear, acupuncture and acupressure directly stimulate the vagus nerveto increase PNS stimulation and thus regulate the body’s susceptibility to inflammatory conditions.
There can be no doubt that when it comes to day-to-day prevention of contracting COVID-19, the most effective methods for protecting ourselves and other continue to be:
wear a face coving when in public
maintain physical distancing
wash hands often
avoid touching eyes, nose and mouth with unwashed hands
clean & disinfect frequently touched surfaces often
However, particularly due to the fact that chronic stress can increase the body’s susceptibility to inflammation, having a regular acupuncture session at least once or twice a month can also be of great help during this time. Through activation of the PNS, acupuncture can help to moderate inflammatory conditions that might make one more susceptible to complications should COVID-19 infection arise.
In addition, here are some other noteworthy benefits of PNS/vagus nerve stimulation through acupuncture:
Regulating heart rate and lowering blood pressure
Improved sleep to treat insomnia
Relax smooth muscle to treat stiffness and pain
Dilate blood vessels to increase blood circulation
Increase motility of gastrointestinal (GI) tract to relieve abdominal distention and other discomforts due to GI dysfunction
Treats neuropsychiatric diseases such as epilepsy and depression
I am honored to be serving and supporting our community during this unprecedented historical time. My colleagues and I are continuing to implement stringent protocols to keep our clinic as safe as possible. I wish you and your loved ones good health and look forward to seeing you in the clinic soon.
Sincerely,
Joe Recsnik L.Ac, DCCM
Sources:
1)“How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes” by: Meredith Wadman, Jennifer Couzin-Frankel, Jocelyn Kaiser, Catherine Matacic
2) “Stress, the Autonomic Nervous System, and the Immune-kynurenine Pathway in the Etiology of Depression” by Eunsoo Won, Yong-Ku Kim
3) “Acupuncture Effect and Central Autonomic Regulation” by: Qian-Qian Li , Guang-Xia Shi, Qian Xu, Jing Wang, Cun-Zhi Liu, Lin-Peng Wang
4) “Auricular Acupuncture and Vagal Regulation”by: Wei He, Xiaoyu Wang, Hong Shi, Hongyan Shang, Liang Li, Xianghong Jing, and Bing Zhu