title: Minimal immunoreactive plasma beta-endorphin and decrease of cortisol at standard analgesia or different acupuncture techniques.
abstract: OBJECTIVE
  Acupuncture has been claimed to be associated with activation of the endogenous antinociceptive system. The analgesic effects of acupuncture have been ascribed to beta-endorphin interacting with opioid receptors. However, firstly, the release of beta-endorphin into the blood has been proven to be induced by stress, i.e. under dysphoric conditions, and, secondly, if released under stress, beta-endorphin has been shown not to be analgesic. Our aim was to test whether beta-endorphin immunoreactive material is released into the cardiovascular compartment during acupuncture comparing the most frequently used types of acupuncture with standard pain treatment under apparently low stress conditions.
  
  
  METHODS
  This prospective study included 15 male patients suffering from chronic low back pain. beta-Endorphin immunoreactive material and cortisol were measured in the plasma of patients who underwent, in random order, therapy according to a standard pain treatment, traditional Chinese acupuncture, sham acupuncture, electro acupuncture and electro acupuncture at non-acupuncture points before, at and after the treatment. Statistical analysis was performed using two-way ANOVA with repeated measures.
  
  
  RESULTS
  A decrease in plasma cortisol concentration measured over the five treatment protocols was highly significant (P < 0.001). The beta-endorphin immunoreactive material concentrations in plasma were minimal at all times and in all treatment conditions. The influence of treatments by various acupuncture procedures on cortisol and beta-endorphin immunoreactive material plasma concentrations over the three time points was not significantly different.
  
  
  CONCLUSIONS
  beta-endorphin immunoreactive material in blood is not released by any type of acupuncture as tested under low stress conditions.
authors.affiliation: University of Giessen, Department of Anaesthesiology, Intensive Care, Pain Therapy, Palliative Medicine, Germany. heinz.harbach@chiru.med.uni-giessen.de
authors.forename: H
authors.initials: H
authors.lastname: Harbach
authors.forename: B
authors.initials: B
authors.lastname: Moll
authors.forename: R-H
authors.initials: RH
authors.lastname: Boedeker
authors.forename: U
authors.initials: U
authors.lastname: Vigelius-Rauch
authors.forename: H
authors.initials: H
authors.lastname: Otto
authors.forename: J
authors.initials: J
authors.lastname: Muehling
authors.forename: G
authors.initials: G
authors.lastname: Hempelmann
authors.forename: P
authors.initials: P
authors.lastname: Markart
mesh_terms: D015667:Acupuncture Analgesia; D000328:Adult; D000698:Analgesia; D015671:Electroacupuncture; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D001615:beta-Endorphin / Q000097:blood* / Q000276:immunology
chemical_list: D001615:beta-Endorphin; D006854:Hydrocortisone