Complementary Therapies in Medicine
Volume 36, February 2018, Pages 25-29
Is cupping blister harmful?—A proteomical analysis of blister fluid induced by cupping therapy and scald
Zhidan Liu (a) Chunlan Chen( a), Xiaoyan Li (a), Chuang Zhao (a), Zunyuan Li (a), Wei Liang (a), Yufang Lin (b)
a. Department of Acupuncture, Shanghai Baoshan Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 201999, China
b. Department of Acupuncture, Zhejiang Hospital, Hangzhou, 310013, China
Abstract
Objective:
Cupping therapy has a long history in traditional medicine especially in Asian countries. It was controversial whether cupping induced blisters are beneficial to healing effects, and the formation and content in the blisters remain unexplored. We aimed to identify and compare the molecular components of the blister fluid from the cupping therapy and the scalds to explore the necessary of inducing cupping induced blisters.
Methods:
Fluid sample of blisters from fifteen patients receiving cupping therapy (Cupping group) and scald burns (Scald group) were collected in this study. Proteins from the blisters were separated by two-dimensional electrophoresis (2D-gel) and further analyzed by mass spectrometry. In addition, the changes in particular proteins were confirmed by Western blotting.
Results: The protein components are significantly different between blister from cupping therapy and scalds. The immune responses, oxidative stress and metabolic related proteins (Ig lambda-2 chain C regions, Ig gamma-1 chain C region, hemopexin, prdx2, calmodulin, succinyl-CoA ligase and tetranectin) were increased, whereas the hemoglobin subunit beta was decreased in the Cupping group compared with the Scald group.
Conclusions:
Cupping induced blisters contain several proteins which relate to the activation of certain immune pathways including anti-oxidation, anti-apoptosis, tissue repairing and metabolic regulation. This proteomic analysis may indicate a significant clue to the mechanism study of cupping.
Free full text:
https://www.sciencedirect.com/science/article/pii/S0965229917304880Excerpts:
“Cupping therapy which utilize a glass or bamboo cup to create suction on the skin has a long history in the traditional medicine in Asia, especially in China.1, 2, 3 The efficacy has been shown in treating dysmenorrheal, pain, osteoarthritis, et al. 4, 5, 6.”
“Some opinion holds that cupping-induced blisters are embodiment of ‘damp evil’ suction to excrete the ‘toxin’ in vivo,7 so it’s beneficial to recovery, and symptoms including edema, crepitation and stiffness were significantly relieved after blister formation. But some others argue that cupping-induced blisters might be similar to blisters caused by scalds which manifest the production of severe skin damage, and the blisters could leave skin scars and will affect the patient’s appearance, or induce erythematous based vesiculobullous plaque.8 So practitioners should try to avoid blisters when applying cupping therapy.
“Thus it’s unclear whether the composition of the cupping-induced blisters will promote therapy efficiency; and if it is, what is the molecular mechanisms underline. Therefore, it should be answered that is there something different be produced in cupping-induced blisters? So it is necessary to firstly compare the protein components between blister fluid samples caused by cupping therapy and scalds. We characterized the molecular elements of the blister fluid by proteomic analysis.”
“4.1. Positive immune responses might be stimulated by blistering cupping therapy”
“We found that Ig gamma C region was increased in cupping-induced blisters, indicating that the expression of IgG was up-regulated after cupping therapy. Ig lambda-2 chain C region has stable antigenicity and is positively correlated with the immune function of the body. Its high expression in patients accepting cupping therapy suggested that humoral immunity mediated by B lymphocyte was enhanced.
“4.2. Anti oxidative stress and anti apoptotic functions might be activated by blistering cupping therapy
“Peroxiredoxin-2/Prdx2 is involved in redox regulation of the cell metabolism...The enhanced expression of prdx2 and hemopexin in cupping-induced blisters indicated that they had enlarged antioxidant capacity and stable internal environment. This finding was consistent with Chinese Traditional Medicine theory of ‘dispelling dampness’.
“4.3. Tissue repair process might start after blistering cupping therapy
“Tetranectin is a plasmiraogen binding protein, causing local thrombus dissolution and matrix repair...Our study found that the tetranectin was highly expressed in cupping patients, suggesting that cupping therapy may promote tissue repairing and enhance blood circulation.
“4.4. Local substances in pain sensation might be eliminated by blistering cupping therapy
“Calmodulin is involved in drug-induced anti-nociception, which could mediate emotional responses to pain and tolerance to morphine analgesia.20...We discovered that calmodulin was up-regulated in blisters from cupping patients for neck pain, suggesting that calcium/CaMK II may mediate the pain sensation and cupping changes the pain signaling transduction. The decreased hemoglobin subunit beta suggested that the oxygen transporting is altered after blistering cupping therapy.
“But nonetheless, limitations are obvious since the fluid is already excreted from the skin, which means the fluid is not reintroduced into the body to lead to any therapeutic or harmful effect. Thus changes in superficial blister fluid are indirect evidences for its' therapeutic effect. Protein transformations in peripheral blood which directly presents in vivo reactions still need further study.
“5. Conclusion and prospect
“This work identified several proteins in superficial blisters induced by cupping therapy which relate to the activation of certain immune pathways including anti-oxidation, anti-apoptosis, tissue repairing and metabolic regulation. This proteomic analysis may indicate a significant clue to the mechanism study of cupping. In future, proteomic study on serum proteins should be carried out to provide direct evidence proving the therapeutic benefit of blistering cupping therapy.”
