Allergies – Condition Resources

Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.

About the research: It is worth noting that in research, randomised controlled studies (RCT) are the most reliable in terms of quality of evidence, with a systematic review or meta analysis of numerous studies being the best way of seeing the overall picture of the state of the evidence. Below we have a selection of the available research, which does include some larger RCTs, and reviews of the literature alongside smaller studies. The n= figure tells you how many people were participants in the study.

Allergic Asthma:

A large, randomised controlled research study in Germany (Brinkhaus et al 2017; n=1445) showed that up to 15 sessions of acupuncture given in addition to routine care increased both disease specific, and health related quality of life, when compared to the group who received routine care alone.

Allergic Dermatitis:

In an animal model study, acupuncture treatment was shown to inhibit swelling of the ears and ear weight in mice with oxazolone-induced skin allergic dermatitis, compared to non-acupuncture treatment (Pkumura et al, 2002), and lower levels of inflammatory markers (serum and ear tissue cytokines) were also lowered in the acupuncture group.

Atopic Eczema:

The results of a small (n=10), randomised controlled trial (Pfab et al, 2011), suggested acupuncture reduced itch intensity and the expression of certain immune factors (basophils) in patients with atopic eczema. The acupuncture group showed less CD63 positive basophils (allergy markers in the body) and rated mean itch intensity significantly lower than did the control group after exposure to allergens (house dust mite and timothy grass pollen).  Pfab et al 2010 (n=30) had also found that after an allergen stimulus (house mite or grass pollen skin prick), the size of the wheal and flare at the skin site were smaller in the group receiving preventative acupuncture than in the control (no acupuncture) and placebo (non-specific acupuncture points used) groups, suggesting that the actual points used are also relevant and not just the overall action of needling.  Mean itch ratings were also lower once again in the true acupuncture group.

Allergic Rhinitis (Hayfever):

The British Acupuncture Council has a Research digest where they examined some recent studies on Allergic Rhinitis, with an overall trend that acupuncture was found beneficial, comparing favourably with antihistamine use.  A review of the literature (Taw et al, 2015) found that high-quality RCTs demonstrated efficacy and effectiveness of acupuncture in this condition, and also was beneficial in terms of quality of life measures, the researchers also stated that further high quality studies are desirable in this area due to some methodological limits on study designs.  

Feng et al, (2015) carried out a systematic review and meta-analysis of acupuncture in allergic rhinitis, entailing 13 papers (N=2365 in total); the researchers stated this was a safe intervention which gave improvement in the Rhinitis Quality of Life Questionnaire (RQLQ) scores of the participants in the acupuncture groups.

Two studies have also established cost effectiveness of acupuncture in allergic rhinitis; Kim et al, (2012) carried out a systematic review of 17 RCTs using the quality-adjusted life years (QALYs) measure the NHS uses, demonstrating that as well as offering benefits, these were value for money where acupuncture was used.  Witt and Brinkhaus (2010) reached a similar conclusion but more tentatively, calling for further studies to establish this.

Possible mechanisms of action in allergy:

A review article (Kavoussi & Ross, 2007) suggests that the anti-inflammatory actions that have been demonstrated to be brought about by acupuncture may be mediated via activation of the vagus nerve, alongside deactivation of inflammatory macrophages and other proinflammatory cytokines.  The researchers concluded that “The use of acupuncture as an adjunct therapy to conventional medical treatment for a number of chronic inflammatory and autoimmune diseases seems plausible and should be validated by confirming its cholinergicity”.  Other studies (Zijlstra et al, 2003) have revealed that acupuncture some of the pain modulating and anti-inflammatory effects exhibited in acupuncture may be due to the fact that it has been shown to stimulate certain substances in the body which act as vasodilators, neurotransmitters and painkillers (beta-endorphins, CGRP and substance P) and further stimulate cytokines and nitric oxide, all of which play roles in inflammatory states. 

Resources:

British Acupuncture Council Research Digest – Allergic Rhinitis (approx halfway down the document)

British Acupuncture Council (BAcC) evidence based factsheet about Allergic Rhinitis including specific research, trials and mechanisms of action for acupuncture in this condition

Our pages on Asthma, Eczema and Psoriasis and Allergic Rhinitis (Hayfever) may also be of interest.

References:

Brinkhaus, B., Roll, S., Jena, S., Icke, K., Adam, D., Binting, S., Lotz, F., Willich, S.N. and Witt, C.M., 2017. Acupuncture in patients with allergic asthma: a randomized pragmatic trial. The Journal of Alternative and Complementary Medicine, 23(4), pp.268-277.

Feng, S., Han, M., Fan, Y., Yang, G., Liao, Z., Liao, W. and Li, H., 2015. Acupuncture for the treatment of allergic rhinitis: a systematic review and meta-analysis. American journal of rhinology & allergy29(1), pp.57-62.

Kavoussi B, Ross BE. The neuroimmune basis of anti-inflammatory acupuncture. Integr Cancer Ther 2007;  6:  251-7.

Kim, S.Y., Lee, H., Chae, Y., Park, H.J. and Lee, H., 2012. A systematic review of cost-effectiveness analyses alongside randomised controlled trials of acupuncture. Acupuncture in Medicine30(4), pp.273-285.

Okumura M et al. Effects of acupuncture on an oxazolone induced skin allergic dermatitis animal model using male ICR mice. Journal of the Showa Medical Association 2002; 62: 229-36.

Pfab, F., Huss‐Marp, J., Gatti, A., Fuqin, J., Athanasiadis, G.I., Irnich, D., Raap, U., Schober, W., Behrendt, H., Ring, J. and Darsow, U., 2010. Influence of acupuncture on type I hypersensitivity itch and the wheal and flare response in adults with atopic eczema–a blinded, randomized, placebo‐controlled, crossover trial. Allergy, 65(7), pp.903-910.

Pfab, F., Athanasiadis, G.I., Huss-Marp, J., Fuqin, J., Heuser, B., Cifuentes, L., Brockow, K., Schober, W., Konstantinow, A., Irnich, D. and Behrendt, H., 2011. Effect of acupuncture on allergen-induced basophil activation in patients with atopic eczema: a pilot trial. The Journal of Alternative and Complementary Medicine, 17(4), pp.309-314.

Taw, M.B., Reddy, W.D., Omole, F.S. and Seidman, M.D., 2015. Acupuncture and allergic rhinitis. Current opinion in otolaryngology & head and neck surgery23(3), pp.216-220.

Witt, C.M. and Brinkhaus, B., 2010. Efficacy, effectiveness and cost-effectiveness of acupuncture for allergic rhinitis—an overview about previous and ongoing studies. Autonomic Neuroscience157(1-2), pp.42-45.

Zijlstra, F.J., van den Berg-de Lange, I., Huygen, F.J. and Klein, J., 2003. Anti-inflammatory actions of acupuncture. Mediators of inflammation, 12(2), pp.59-69.

Helen
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