Neurobiological Mechanism of Acupuncture for Pain and Itch

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Background

Both chronic pain and chronic itch are great challenges in clinical practice. Over 1.5 billion people worldwide suffer from chronic pain. Chronic itch, beyond dermatologic disorders, is associated with systemic, neurologic as well as psychological diseases, which has a high impact to quality of life. While opioids are clinically effective for certain types of pain, the overuse has led to the current opioid crisis and caused a variety of health, social, and economic problems around the world.

Acupuncture has been recognized for its clinical effectiveness in pain management, endorsed by WHO, NIH, and American Pain Society. Underlying this, extensive studies show that the endogenous opioid, adenosine, and endocannabinoid system in the peripheral and central nervous systems play a vital role in acupuncture analgesia. For example, electroacupuncture stimulates the release of β-endorphin, enkephalin, and endomorphin, which in turn activates the μ- and δ-opioid receptors, key receptor sites in the management of acute, chronic, and neuropathic pain.

Although Pain an Itch are two distinct sensations, research reveals that they are closely associated due to the potentially common neural pathways and molecular mechanisms. Itch-producing agents activate nociceptive primary afferent fibers and can generate simultaneous pruritic and nociceptive sensations. Moreover, surgical lesion of the anterolateral funiculus of the spinal cord relieves chronic pain and also abolishes itch. Therefore, acupuncture, which has been studied primarily for pain relief could be applied for itch management; indeed, evidence already shows its effectiveness as an alternative approach. The mechanisms underlying acupuncture have been researched extensively in the past few decades; however there is still a lack of understanding on its effects on molecules, neural transmitters, and neural circuits, which need to be further studied.

In this Research Topic, we welcome research to further our understanding of the role of the central nervous system and peripheral nervous system in the regulatory function of acupuncture treatment in animal or human experiments. Methods used for the research can be broad but within the spectrum of cellular neurobiology, molecular neurobiology, behavioral neurobiology, or developmental neurobiology. The experimental methods can include behavioral tests, optogenetics, chemical genetics, immunofluorescence, and western blotting, etc. We welcome contributions addressing the following sub-themes:
1. Neurobiological mechanism of acupuncture analgesia
2. Neurobiological mechanism of acupuncture for itch control
3. Novel approaches and tools in the research of acupuncture for pain and itch

Keywords: Neural Circuit, Molecular Neurobiology, Acupuncture Therapy, Pain, Itch

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