The efficacy and potential mechanism of the acupuncture treatment for allergic rhinitis: A systematic review and meta-analysis of data from animal models

Abstract

Objective: This study aimed to evaluate the efficacy of acupuncture in treating allergic rhinitis (AR) in animal models of the disease, and to explore the underlying mechanism of acupuncture in AR. Methods: Related literature was retrieved from multiple databases, including China National Knowledge Infrastructure (CNKI), Wan Fang databases, SinoMed databases, VIP database, PubMed, EMBASE, the Cochrane Library, up to September 2023. The inclusion criteria were focused on animal experiments that investigated the effect of acupuncture therapy on animal models of AR. Studies combining acupuncture with other Chinese medicine therapies were excluded. Data were extracted independently by two reviewers using standardized forms. A total of 75 studies were finally included. The risk of bias in individual studies was evaluated using the Systematic Review Centre for Laboratory animal Experimentation (SYRCLE) tool, and the quality of reporting was evaluated according to Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines. Meta-analyses and plotting were conducted using STATA 17.0 and RevMan 5.4. When heterogeneity was present, a random effects model was applied. Subgroup, meta-regression and sensitivity analyses were also performed. Results: The SYRCLE scores ranged from 3 to 7, and the ARRIVE scores ranged from 6.5 to 11 points. Meta-analysis results demonstrated that acupuncture could significantly down-regulate EOS counts in both blood and nasal mucosa, and reduce the serum levels of IL-5, compared to the AR model group. The results of the qualitative analysis showed that acupuncture could reduce the behavior scores of AR, down-regulate serum levels of IL-4, IgE and sIgE, as well as up-regulate IFN-γ levels. Subgroup analysis results suggested that the different interventions might contribute to the observed heterogeneity. Conclusion: Our results demonstrate that acupuncture effectively alleviates the nasal allergic symptoms in animal models, inhibits immune and inflammatory signaling transduction, and reduces the release of inflammatory mediators. This study highlights the potential of acupuncture as a promising therapeutic option for AR, however, further studies are required to fully understand its mechanisms of action.

Keywords

• Acupuncture
• Allergic rhinitis
• Animal experiment
• Methodological quality
• Reporting quality
• Meta-analysis