eCAM Advance Access originally published online on November 21, 2007
eCAM 2009 6(1):31-39; doi:10.1093/ecam/nem122
© 2007 The Author(s).
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Prospective Tests on Biological Models of Acupuncture
Charles Shang
Department of Medicine, Cambridge Health Alliance, Harvard Medical School, 103 Garland Street, Everett, MA 02149, USA
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Abstract
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The biological effects of acupuncture include the regulation
of a variety of neurohumoral factors and growth control factors.
In science, models or hypotheses with confirmed predictions
are considered more convincing than models solely based on retrospective
explanations. Literature review showed that two biological models
of acupuncture have been prospectively tested with independently
confirmed predictions: The neurophysiology model on the long-term
effects of acupuncture emphasizes the trophic and anti-inflammatory
effects of acupuncture. Its prediction on the peripheral effect
of endorphin in acupuncture has been confirmed. The growth control
model encompasses the neurophysiology model and suggests that
a macroscopic growth control system originates from a network
of organizers in embryogenesis. The activity of the growth control
system is important in the formation, maintenance and regulation
of all the physiological systems. Several phenomena of acupuncture
such as the distribution of auricular acupuncture points, the
long-term effects of acupuncture and the effect of multimodal
non-specific stimulation at acupuncture points are consistent
with the growth control model. The following predictions of
the growth control model have been independently confirmed by
research results in both acupuncture and conventional biomedical
sciences: (i) Acupuncture has extensive growth control effects.
(ii) Singular point and separatrix exist in morphogenesis. (iii)
Organizers have high electric conductance, high current density
and high density of gap junctions. (iv) A high density of gap
junctions is distributed as separatrices or boundaries at body
surface after early embryogenesis. (v) Many acupuncture points
are located at transition points or boundaries between different
body domains or muscles, coinciding with the connective tissue
planes. (vi) Some morphogens and organizers continue to function
after embryogenesis. Current acupuncture research suggests a
convergence of the neurophysiology model, the connective tissue
model and the growth control model. The growth control model
of acupuncture set the first example of a biological model in
integrative medicine with significant prediction power.
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Introduction
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According to the World Health Organization (WHO), a broad definition
of acupuncture is the stimulation of certain points on the body
(acupuncture points) using needling, moxibustion, electricity,
laser or acupressure for therapeutic purposes (
1). The standard
acupuncture nomenclature published by the WHO listed about 400
acupuncture points and 20 meridians connecting most of the points
(
2). Results from randomized controlled trials (RCTs) have shown
that acupuncture is effective in treating dozens of disorders
(
1) such as osteoarthritis (
3–5), pelvic and back pain
(
6), neck pain (
7), migraine and tension headache (
8,
9), nausea/vomiting
(
10) and inflammatory bowel disease (
11). Mixed results widely
exist in acupuncture research (
12) for various reasons such
as poor trial design, irregularity of this highly operator-dependent
technique and the unique biological basis of acupuncture which
will be explained later in this article. Many neurohumoral (
13–15)
mechanical (
16) and growth control effects of acupuncture (
17)
have been observed. Several models of acupuncture mechanism
have been proposed. The focus of this article is on the biological
models of acupuncture which have been prospectively tested and
independently confirmed.
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The Observations from Acupuncture Research
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In the mid-70s, the discovery of endorphin induction in acupuncture
analgesia and its blockade by naloxone was instrumental in establishing
the validity of acupuncture in modern science (
18,
19). In acupuncture
analgesia, the peripheral nervous system has been shown to be
crucial in mediating the effect. The analgesia can be abolished
if the acupuncture site is affected by postherpetic neuralgia
(
20) or injection of local anesthetics (
21). Different frequencies
of electric stimulation in electroacupuncture lead to release
of different neuropeptides (
13). Electroacupuncture has been
shown to release nociceptin and inhibit the reflex-induced increases
in blood pressure (
15), and increased the synthesis of nitric
oxide in mediating the protective effect on gastric mucosa (
22).
Since the 1950s, it has been discovered and confirmed with refined techniques (23) that many acupuncture points and meridians have high electrical conductance (24–26) though the results are sometimes mixed (27). High electric conductance of acupuncture points have been successfully used for locating acupuncture points in acupuncture therapy (28). The high electric conductance at acupuncture points is further supported by preliminary finding of high density of gap junctions at the epithelia of the acupuncture points (29–32). Gap junctions are hexagonal protein complexes that form channels between adjacent cells. It is well established in cell biology that gap junctions facilitate intercellular communication and increase electric conductance. High concentrations of nitric oxide and nitric oxide synthase have also been observed at acupuncture points and meridians (33).
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Modern Biological Models of Acupuncture
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In the 1970s, the relation between the nervous system and acupuncture
alteration of visceral function was explored by examining the
cortical evoked potentials, single unit discharges and neurochemistry
associated with acupuncture. These studies brought forth the
Meridian-Cortex-Viscera correlation hypothesis which states
that: (i) the meridian system is an independent system connected
via the nervous system to the cerebral cortex, (ii) it acts
through neurohumoral mechanisms (
34). A contending model claimed
that the meridian system as described in the classic acupuncture
literature does not exist and that all the effects of acupuncture
are mediated through nervous system (
35,
36).
Another hypothesis suggested that the network of acupuncture points and meridians is a signal transduction network formed by interstitial connective tissue. Mapping of acupuncture points on human arm showed an 80% correspondence between the sites of acupuncture points and the location of intermuscular or intramuscular connective tissue planes in postmortem tissue sections (37).
Modern biological models of acupuncture are confronted with the following puzzling facts:
- The distribution of acupuncture points: The distribution of acupuncture points is different from the distribution of nerves, blood vessels, lymphatics or connective tissue. For example, an auricle has no important nerves or blood vessels or lymphatics or complex connective tissue planes and no significant physiological function other than sound collection. While the vagus nerve has an auricular branch, this branch has no known important function in modern neuroscience. A search of Medline did not yield any article on the function of the auricular branch of vagus nerve in the past 50 years. The auricle nevertheless has the highest density of acupuncture points. According to the WHO, 43 auricular points have proven therapeutic value (2) which consist of more than 10% of the acupuncture points of the entire human body. Numerous RCTs have demonstrated the efficacy of auricular acupuncture (38–43) while some results are mixed (12).
- The non-specific activation of acupuncture points: Therapeutic effect of acupuncture has been achieved by a variety of stimuli (1,10) including needling, injection of non-specific chemicals, electricity, temperature variation, laser and pressure. No conventional nerve stimulation technique has such diverse modalities of stimulation. Non-noxious stimuli such as non-thermal low intensity laser irradiation, which does not cause local nerve excitation (44) or collagen fiber reorganization at acupuncture points, can cause extensive systemic effects (45) and stimulate local cellular calcium oscillation (45) cell proliferation, release of basic fibroblast growth factor, interleukins as well as other growth control effects (46). This suggests that another system other than nervous system mediates the initial signal transduction in acupuncture.
- Transient acupuncture stimulation often causes long lasting effect over weeks or months. For example, two RCTs (8,9) have shown that the relief of migraine headache lasted 1 year after acupuncture treatment—thousands of times longer than the physiological half life of endorphin (47) and other common neurotransmitters. Similar long-term benefits of acupuncture have been shown by RCTs on the treatment of shoulder pain (48), chronic low back pain (49,50), primary dysmenorrhea (51), spinal cord injuries (42), urinary urgency (41) and osteoarthritis (5,52,53). This long lasting effect is almost non-existent in conventional therapy using transient mild peripheral nerve stimulation. In conventional nerve stimulation, long lasting effects require long-term stimulation as observed in the effects of opioids, serotonin reuptake inhibitors, sacral nerve stimulation (54) and vagal nerve stimulation (55).
- The existence of acupuncture points. That is, why do stimuli at many acupuncture points cause diverse systemic effects without obvious benefit of survival for normal animals? For example, stimulation at acupuncture points PC6 and ST36 which are at the extremities increases the gastric motility in dogs (56). This is contrary to the fight or flight response and seems to offer no survival benefit to animals. What is the intrinsic function of acupuncture points? How did these acupuncture points come into existence over the course of evolution?
In science, models or hypotheses capable of successful prospective predictions are considered more convincing than models solely based on retrospective explanations or accommodations (57,58). It is therefore important to assess which biological models of acupuncture have been prospectively tested and independently confirmed (i.e. with correct predictions). A literature research in PubMed with full text (Medline) using keywords acupuncture AND (predict* OR corollary) identified 101 articles. Similar search strategy in Chinese medical literature databases including http://www.wanfangdata.com.cn/, http://engine.cqvip.com/ and http://www.chinainfobank.com/identified over 300 articles. Further analysis of the literature and discussion with the experts in this field narrowed down to two biological models (17,59) which have independently confirmed predictions: The neurophysiology model on the long-term effects of acupuncture (59) suggests: (i) The trophic and anti-inflammatory effects of acupuncture are important in mediating its long-term effects. (ii) Long-term potentiation and long-term depression are likely involved in acupuncture signal transduction. Its prediction on the peripheral anti-inflammatory effect of endorphin in acupuncture has been confirmed (60). The growth control model first published in the 1980s (61) correctly predicted multiple research results not only in acupuncture, but also in conventional biomedical sciences. It also has shed light on the puzzling observations mentioned above (17,62). This model encompasses the neurophysiology of acupuncture (17) and is supported by the research results on connective tissue at acupuncture points (16,37).
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The Origin and Function of Acupuncture Points
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It is well known that all the physiological systems, including
nervous system, are derived from a system of embryogenesis—a
growth control system (
63) (
Fig. 1). In growth control, the
fate of a larger region is frequently controlled by a small
group of cells, which is termed an organizing center or organizer
(
64). A gradient of messenger molecules called morphogens forms
around organizers. Organizers have highest (sources) or lowest
(sinks) local concentration of morphogens (
64,
65) and therefore
are macroscopic singular points of morphogen gradient field.
A singular point is a point of discontinuity. It indicates abrupt
transition from one state to another. Small, non-specific perturbations
around singular points—organizers can have important systemic
effect (
66,
67). Several lines of evidence suggests that the
bioelectric field interacts with morphogens and growth factors,
and guides morphogenesis (
68,
69). The growth and migration of
a variety of cells are sensitive to electric fields of physiological
strength (
70,
71). Organizers and acupuncture points share several
common features: Both commonly distribute at the extreme points
of surface curvature (
17,
61,
62) and are activated by non-specific
stimuli (
61,
67). Both are associated with bioelectric field
(
17). The growth control model therefore suggested that acupuncture
points originate from organizers (
17,
61).
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Figure 1. The role of the growth control system. In embryogenesis, the development of organizers precedes the development of other physiological systems. The formation, maintenance and regulation of all the physiological systems are dependent on the activity of the growth control system both during and after embryogenesis. The growth control model of acupuncture suggests that acupuncture points and meridians originate from organizers and growth boundaries, respectively, and play important roles in the maintenance and regulation of all the physiological systems after embryogenesis.
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Confirmed Predictions on Organizers and Morphogens
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Based on the connection between acupuncture points and organizers,
the growth control model predicted that organizers have high
electric conductance, high electric current density and high
density of gap junctions (
17,
61). These predictions on organizers
have been independently confirmed: Organizers such as blastopore
(
Fig. 2) and zone of polarizing activity have high electric
conductance, high current density (
72) and high density of gap
junctions (
73–76). Multi-cellular organisms maintain regular
form and function despite constant replacement of cells, intra-cellular
components and extracellular matrix. Without growth control,
this constant regeneration is prone to structural disintegration
and degeneration into various tumors. The growth control model
predicted that organizers and morphogens partially retain their
regulatory function after embryogenesis (
17,
61). This prediction
has also been independently confirmed: Morphogens such as retinoic
acid, Wnt, bone morphogenetic protein and Hedgehog as well as
some organizers continue to exist and function in adults after
embryogenesis (
77–81).
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Figure 2. Electric currents traversing an embryo (Source: Shi and Borgens, Dev Dynamics 1996;202:102. Courtesy of John Wiley & Sons). The blastopore, a classic organizer, has high electric conductance and current density. A steady blastopore current persists after early embryogenesis. The electric fields polarize the embryo and serve as cues for morphogenesis. These results confirmed earlier predictions. (Shang, Am J Chin Med 1989;17:119–27).
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Confirmed Predictions on Acupuncture
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One corollary from the growth control model is that acupuncture
has extensive growth control effects which have been confirmed:
Acupuncture has been shown to regulate various growth factors
and growth control genes. It can induce vascular endothelial
growth factor (
82) and basic fibroblast growth factor (
83) during
brain ischemia. It also induces glial cell line-derived neurotrophic
factor (
84) and expression of the c-fos proto-oncogene (
85,
86).
Acupuncture regulates the expression of Bcl-2 (
87), Bax, fas
and FasL proteins which are involved in apoptosis signaling.
Acupuncture inhibits the apoptosis of intestinal epithelial
cells in inflammatory bowel disease of rats (
88) and enhances
proliferation of CD8+ lymphocytes (
89), reduces nerve growth
factor in polycystic ovaries (
90,
91) and reduces IL-6 expression
and proliferation of osteoclasts (
92). The neuro-humoral factors
induced by acupuncture such as endorphins, nitric oxide and
serotonin also have growth-control effects (
93,
94,
95). In RCTs,
acupuncture has shown efficacy in treating growth-control-related
disorders including spinal cord injuries (
38) and low sperm
quality (
96,
97).
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Growth Control System as Foundation of Pathophysiology
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A growth control system originates from a network of organizers
(
98). In embryogenesis, the development of organizers precedes
the development of other physiological systems (
17,
64). The
formation, maintenance and regulation of all the physiological
systems are dependent on the activity of the growth control
system. Growth control is a primary function of all multi-cellular
organisms. The evolutionary origin of the growth control system
likely preceded all the other physiological systems. Its genetic
blueprint served as a template from which the newer systems
evolved. Consequently, it overlaps and interacts with other
systems but is not merely part of the nervous system, immune
system or circulatory system. The growth control signal transduction
is embedded in the activity of the function-based physiological
systems: The regulation of many neural, circulatory, immune
processes and related disorders are mediated through growth
control mechanisms such as hypertrophy, hyperplasia, atrophy,
apoptosis with shared messenger molecules including morphogens
(
77,
81,
95,
99) and common signal transduction pathways involving
growth control genes such as proto-oncogenes (
100–102).
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The Non-specific Stimulation and the Long-term Effects of Acupuncture
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Based on the growth control model, acupuncture points and organizers
are singular points and therefore prone to non-specific perturbation.
The long lasting systemic effects of acupuncture can be achieved
by non-specific stimuli as mentioned earlier. Similarly, long
lasting growth control activities of organizers have been induced
by various stimuli such as mechanical injury and injection of
non-specific chemicals (
67). Based on the growth control model,
acupuncture effect is a byproduct of the growth control network.
Stimulating organizers—acupuncture points can not only
cause transient modulation of neurotransmission, but also alter
the growth control signal transduction in various systems—leading
to long-term effects (
17).
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The Distribution of Acupuncture Points and Organizers
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Organizers are at the extreme points of curvature on the body
surface such as the locally most convex points (e.g. apical
ectodermal ridge and other growth tips) or concave or saddle
points (e.g. zone of polarizing activity) (
17,
103). Similarly,
almost all the extreme points of the body surface curvature
are acupuncture points. For example, the convex points include
EX-UE11 Shixuan (finger tips), EX-LE12 Qiduan (toe tips), ST17
Ruzhong (tip of nipple), ST42 Chongyang, (the convex, palpable
point of arteria dorsalis pedis) and GV25 Suliao (nose tip).
The concave points include TE3 Zhongzhu (the concave point between
the fourth and fifth metacarpal), KI1 Yongquan (at the concave
point of the sole), GB20 Fengchi (the concave point below occipital
bone, between upper ends of sternocleidomastoid and trapezius),
BL40 Weizhong (midpoint of the transverse crease of the popliteal
fossa), HT1 Jiquan (the most concave point of axilla), BL1 Jingming
(at the concave point above medial canthus) and CV8 Shenque
(navel). Based on growth control model, the extreme points of
surface curvature are associated with organizers—acupuncture
points. The auricle obviously has the most convoluted surface
morphology of the human body. Therefore, it has the highest
density of extreme points of surface curvature and is expected
to have the highest density of organizers—acupuncture
points. Auricle exemplifies the interconnection of growth control:
Auricular morphology is a sentinel of malformation in other
organs. Auricular malformation has been observed in numerous
malformation syndromes. It is recommended in a standard textbook
of pediatrics that any auricular anomaly should initiate a search
for malformations in other parts of the body (
104).
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The Origin of Meridians
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The growth control model suggests that the discontinuity or
abrupt transition in growth control not only exists at organizers
but also along boundaries (
17,
61). The growth control boundaries
or folds between different structures are also called separatrices
in mathematics and often connect singular points—organizers.
The model predicted that growth control boundaries have high
electric conductance and high density of gap junctions—just
as the meridians in acupuncture which likely originate from
growth control boundaries. These predictions have been confirmed:
As embryogenesis progresses, high density gap junctions become
restricted at discrete boundaries, leading to the subdivision
of the embryo into communication compartment domains (
105,
106).
Increasing or decreasing the gap junctions can cause various
developmental defects (
107) such as spina bifida (
108). These
high electric conductance boundaries are likely major pathways
of bioelectric currents. Organizers are known to locate at boundaries
between different structures (
109). The growth control model
suggests that meridians originate from separatrices—boundaries
in growth control and form an underdifferentiated (
17,
61), interconnected
cellular network that regulates growth and physiology. In consistence
with the prediction of underdifferentiation of the meridian
system and growth control system, it has been observed that
the most apical part of folds of embryo remain undifferentiated
in morphogenesis (
110), including organizers such as apical
ectodermal ridge (
111). As predicted by the growth control model,
singular point and separatrix have important roles in morphogenesis
(
112,
113). Growth control boundaries/separatrices are similar
to organizers in controlling growth and pattern formation with
morphogen gradient (
114). Many acupuncture points are located
at boundaries between different body domains or muscles, coinciding
with the connective tissue planes which connect adjacent body
domains or muscles (
16,
37,
115).
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Conclusion
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Current acupuncture research suggests a convergence of the neurophysiology
model, the connective tissue model and the growth control model.
The growth control model of acupuncture set the first example
of a biological model in integrative medicine with significant
prediction power across multiple disciplines. The following
predictions of the growth control model have been independently
confirmed by research results in both acupuncture and conventional
biomedical sciences: (i) Acupuncture has extensive growth control
effects. (ii) Singular point and separatrix have important roles
in morphogenesis. (iii) Organizers have high electric conductance,
high current density and high density of gap junctions. (iv)
A high density of gap junctions is distributed as separatrices
or boundaries at body surface after early embryogenesis. (v)
Many acupuncture points are located at transition points or
boundaries between different body domains or muscles, coinciding
with the connective tissue planes. (vi) Some morphogens and
organizers continue to function after embryogenesis. The growth
control model has also shed light on several puzzling phenomena
of acupuncture such as the distribution of auricular acupuncture
points, the long-term effects of acupuncture and the effect
of multimodal non-specific stimulation at acupuncture points.
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Future Directions
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Acupuncture is becoming increasingly a multidisciplinary research
field requiring the collaboration among developmental biologists,
biophysicists, engineers, cell biologists, neurobiologists,
mathematicians and clinicians to achieve further advances.
- The structure and cell differentiation at acupuncture points as well as the neurophysiology and growth control signal transduction involved in different modalities of acupuncture should be further delineated.
- Application of singularity theory is important in integrative medicine, developmental biology as well as systems biology—requiring the collaboration between mathematicians and other biomedical researchers. Manipulating the singular points—organizers of the growth control system may be a convenient way of activating intrinsic stem cells as evident from the improvement of sperm quality after acupuncture (96,97).
- As the growth control model predicts the growth control activity at acupuncture points/extreme points of surface curvature at body surface after embryogenesis, residual morphogen gradient may still exist at these points and may be detectable by probing morphogen candidates such as Hedgehog, Wnt and TGF-beta families. Certain morphogen gradient distributes along boundaries (116). This pattern may persist after embryogenesis into adulthood and coincides with meridians.
- Mapping of the growth control system and the dynamics of its electromagnetic field with high resolution techniques such as the superconducting quantum interference device (SQUID) and atomic magnetometer (117) ‘by biophysicists and biomedical engineers’. The growth control model predicts that the singular points and separatrices of the bioelectric field in growth control correlate with the acupuncture points and meridians, respectively.
- The growth control model suggests that techniques involving the stimulation of the growth control system such as acupuncture can activate the growth control activity of an organism and improve its structure and function at a more fundamental level than symptomatic relief (17). In growth control, the change in electric field precedes morphologic change and manipulation of the electric field can affect the change (70,118). Development of the techniques of detecting and manipulating the electric field may enable the diagnosis and treatment of a pathologic process at the early signal transduction stage prior to the anatomical or morphological change.
- The growth control model suggests that apparently unrelated acupuncture points are not exactly ‘placebo’ points. The more acupuncture points are used as placebo points in a RCT, the more likely that some systemic effects will be resulted from the ‘placebo’ treatment. The self-regulatory effect of acupuncture will be difficult to predict when the patients have multiple comorbidities and many acupuncture points are used. Subtle, ‘sham’ stimulation at acupuncture points can be effective due to the response of the acupuncture points to non-specific stimuli. These reasons may contribute to the mixed results in RCTs on acupuncture.
- The growth control model suggests that the distribution of growth control system is related to both internal and external structures. Acupuncture points which are not at obvious extreme points of surface curvature or meridians which are not at obvious surface boundaries may be vestigial or related to internal structures. Intrinsic stem cells are likely part of the underdifferentiated growth control network. The germ cell is one of the least differentiated cells and also a type of stem cell—similar to the embryonic stem cell in its ability to differentiate into all three germ layers. The distribution pattern of intrinsic germ cells can be deduced based on the fact that the distribution pattern of primary tumors reflects the distribution of their normal counterpart. The primary germ cell tumors (119) have a midline and para-axial distribution pattern which spans from the sacrococcygeal region to pineal gland. It appears to concentrate at 7 locations: sacrococcygeal region, gonads, retroperitoneum, thymus, thyroid, (120) suprasellar region and pineal gland, similar to the distribution of major charkas (Fig. 3). This pattern reflects the distribution pattern of intrinsic germ cells which are likely to be highly inter-connected in a normal state, e.g. via gap junctions (121), and provide important regulatory functions (56,122). This also suggests a hierarchy in the degree of cell differentiation and function in the growth control system which is likely to be the unified biological basis of meridian system and chakra system.
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Figure 3. Just as the distribution of pheochromocytoma correlates with the distribution of sympathetic ganglions, the distribution of germ cell tumors correlates with undifferentiated cells in human body which are likely to be involved in the regulation of growth control and physiology as part of the ‘inner meridian system’. This distribution also correlates well with the chakra system used in yoga and acupuncture, suggesting a unified structural basis for chakra system and meridian system. Figure modified from: Govan ADT, MacFarlane PS, Callander R et al (1995) Pathology illustrated, 4the edn, Churchill Livingstone, London, p150 and form: Stux (1997) Bascis of acupuncture, 4th edn. Springer Berlin p287 Courtesy of Churchill Livingstone and Dr. Gabriel Stux.
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Footnotes |
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For reprints and all correspondence: Charles Shang, MD, Department of Medicine, Cambridge Health Alliance, Harvard Medical School, 103 Garland Street, Everett, MA 02149, USA. E-mail:
cshang{at}caregroup.harvard.edu
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Acknowledgement
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I thank Steven K. H. Aung, Zang-Hee Cho, Yuenan Cui, Richard
Hammerschlag, Maria do Desterro Leiros, Michael Levin, Colin
McCaig, Marc S. Micozzi, Margaret Naeser, Vitaly Napadow, Stig
Ollmar, Rosa N. Schnyer, Neil D. Theise, San Wan, Peter Wayne,
Raimond Wong, Seung-Schik Yoo and many others for their input.
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References
|
|---|
- World Health Organization. Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials ( 2002;) Geneva: WHO.
- World Health Organization. A Proposed Standard International Acupuncture Nomenclature: Report of a WHO Scientific Group ( 1991;) Geneva: World Health Organization.
- Osiri M, Welch V, Brosseau L, Shea B, McGowan J, Tugwell P, et al. Transcutaneous electrical nerve stimulation for knee osteoarthritis. Cochrane Database Syst Rev ( 2000;) CD002823.
- Kwon YD, Pittler MH, Ernst E. Acupuncture for peripheral joint osteoarthritis: a systematic review and meta-analysis. Rheumatology ( 2006;) 45:: 1331–7.[Abstract/Free Full Text]
- Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AM, Hochberg MC. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Ann Intern Med. ( 2004;) 141:: 901–10.[Abstract/Free Full Text]
- Young G, Pennick VE. Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database Syst Rev ( 2007;) CD001139.
- Trinh KV, Graham N, Gross A, Goldsmith CH, Wang E, Cameron ID, et al. Acupuncture for neck disorders. Cochrane Database Syst Rev ( 2006;) 3:: CD004870.[Medline]
- Vincent CA. A controlled trial of the treatment of migraine by acupuncture. Clin J Pain ( 1989;) 5:: 305–12.[Web of Science][Medline]
- Vickers AJ, Rees RW, Zollman CE, McCarney R, Smith CM, Ellis N. Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial. Br Med J ( 2004;) 328:: 744–7.[Abstract/Free Full Text]
- Vickers AJ. Can acupuncture have specific effects on health? A systematic review of acupuncture antiemesis trials. J R Soc Med ( 1996;) 89:: 303–11.[Abstract]
- Joos S, Brinkhaus B, Maluche C, Maupai N, Kohnen R, Kraehmer N, et al. Acupuncture and moxibustion in the treatment of active Crohn's disease: a randomized controlled study. Digestion ( 2004;) 69:: 131–9.[CrossRef][Web of Science][Medline]
- Kim YS, Jun H, Chae Y, Park HJ, Kim BH, Chang IM, et al. The practice of Korean medicine: an overview of clinical trials in acupuncture. Evid Based Complement Alternat Med ( 2005;) 2:: 325–52.[Abstract/Free Full Text]
- Han JS. Acupuncture: neuropeptide release produced by electrical stimulation of different frequencies. Trends Neurosci ( 2003;) 26:: 17–22.[CrossRef][Web of Science][Medline]
- Han JS. Opioid and antiopioid peptides: a model of Yin-Yang balance in acupuncture mechanism of pain modulation. In: Clinical Acupuncture: Scientific Basis —Stux G, Hammerschlag R, eds. ( 2000;) Berlin: Springer-Verlag;. 51–68.
- Crisostomo MM, Li P, Tjen-A-Looi SC, Longhurst JC. Nociceptin in rVLM mediates electroacupuncture inhibition of cardiovascular reflex excitatory response in rats. J Appl Physiol ( 2005;) 98:: 2056–63.[Abstract/Free Full Text]
- Langevin HM, Churchill DL, Wu J, Badger GJ, Yandow JA, Fox JR, et al. Evidence of connective tissue involvement in acupuncture. FASEB J ( 2002;) 16:: 872–4.[Abstract/Free Full Text]
- Shang C. Electrophysiology of growth control and acupuncture. Life Sci ( 2001;) 68:: 1333–42.[CrossRef][Web of Science][Medline]
- Pomeranz B, Chiu D. Naloxone blocks acupuncture analgesia and causes hyperalgesia: endorphin is implicated. Life Sci ( 1976;) 19:: 1757–62.[CrossRef][Web of Science][Medline]
- Mayer DJ, Price DD, Raffii A. Antagonism of acupuncture analgesia in man by the narcotic antagonist naloxone. Brain Res ( 1977;) 121:: 368–72.[CrossRef][Web of Science][Medline]
- Bowsher D. Mechanisms of acupuncture. In: Medical Acupuncture —Filshie J, White A, eds. ( 1998;) Edinburgh: Churchill Livingston. 69–80.
- Chiang CY, Chang CT. Peripheral afferent pathway for acupuncture analgesia. Scientia Sinica ( 1973;) 16:: 210–7.
- Xu GS, Wang ZJ, Zhu SL, Chen QZ, Zhang DQ. Nitric oxide participates in protective effect of acupuncture on gastric mucosal damages in rats. World J Gastroenterol ( 1996;) 2:: 58–9.
- Colbert AP, Yun J, Larsen A, Edinger T, Gregory WL, Thong T. Skin impedance measurements for acupuncture research: development of a continuous recording system. Evid Based Complement Alternat Med ( 2007;) 10.1093/ecam/nem060.
- Comunetti A, Laage S, Schiessl N, Kistler A. Characterisation of human skin conductance at acupuncture points. Experientia ( 1995;) 51:: 328–31.[CrossRef][Web of Science][Medline]
- Saku K, Mukaino Y, Ying H, Arakawa K. Characteristics of reactive electropermeable points on the auricles of coronary heart disease patients. Clin Cardiol ( 1993;) 16:: 415–9.[Web of Science][Medline]
- Oleson TD, Kroenig RJ, Bresler DE. An experimental evaluation of auricular diagnosis: the somatotopic mapping of musculoskeletal pain at acupuncture points. Pain ( 1980;) 8:: 217–29.[CrossRef][Web of Science][Medline]
- Ahn AC, Wu J, Badger GJ, Hammerschlag R, Langevin HM. Electrical impedance along connective tissue planes associated with acupuncture meridians. BMC Complement Alternat Med ( 2005;) 5:: 10.[CrossRef]
- Shiraishi T, Onoe M, Kageyama T, Sameshima Y, Kojima T, Konishi S, et al. Effects of auricular acupuncture stimulation on nonobese, healthy volunteer subjects. Obes Res ( 1995;) 3:: 667S–73S.[Medline]
- Mashanskii VF, Markov IuV, Shpunt VKh, Li SE, Mirkin AS. Topography of the gap junctions in the human skin and their possible role in the non-neural signal transduction. Arkh Anat Gistol Embriol ( 1983;) 84:: 53–60.[Medline]
- Cui H-M. Meridian system - specialized embryonic epithelial conduction system. Shanghai J Acupunct ( 1988;) 3:: 44–5.
- Fan JY. The role of gap junctions in determining skin conductance and their possible relationship to acupuncture points and meridians. Am J Acupunct ( 1990;) 18:: 163–70.[Web of Science]
- Zheng CH, Huang GY, Zhang MM, Xiao YL. Experimental study on expression of connexin 43 in meridians of rats. Zhongguo Zhen Jiu ( 2005;) 25:: 629–32.[Medline]
- Ma SX. Enhanced nitric oxide concentrations and expression of nitric oxide synthase in acupuncture points/meridians. J Altern Complement Med ( 2003;) 9:: 207–15.[CrossRef][Web of Science][Medline]
- Chang HC, Xie YK, Wen YY, Zhang SY, Qu JH, Lu WJ. Further investigation on the hypothesis of meridian-cortex-viscera interrelationship. Am J Chin Med ( 1983;) 11:: 5–13.[CrossRef][Web of Science][Medline]
- Ulett GA. Beyond Yin and Yang: How Acupuncture Really Works ( 1992;) St Louis, MO: Warren H. Green, Inc.
- Mann F. A new system of acupuncture. In: Medical Acupuncture —Filshie J, White A, eds. ( 1998;) Edinburgh: Churchill Livingston. 63.
- Langevin HM, Yandow JA. Relationship of acupuncture points and meridians to connective tissue planes. Anat Rec (New Anat) ( 2002;) 269:: 257–65.[CrossRef][Medline]
- Barker R, Kober A, Hoerauf K, Latzke D, Adel S, Kain ZN, et al. Out-of-hospital auricular acupressure in elder patients with hip fracture: a randomized double-blinded trial. Acad Emerg Med ( 2006;) 13:: 19–23.[CrossRef][Web of Science][Medline]
- Usichenko TI, Dinse M, Hermsen M, Witstruck T, Pavlovic D, Lehmann Ch. Auricular acupuncture for pain relief after total hip arthroplasty - a randomized controlled study. Pain ( 2005;) 114:: 320–7.[CrossRef][Web of Science][Medline]
- Sator-Katzenschlager SM, Scharbert G, Kozek-Langenecker SA, Szeles JC, Finster G, Schiesser AW, et al. The short- and long-term benefit in chronic low back pain through adjuvant electrical versus manual auricular acupuncture. Anesth Analg ( 2004;) 98:: 1359–64.[Abstract/Free Full Text]
- Ricci L, Minardi D, Romoli M, Galosi AB, Muzzonigro G. Acupuncture reflexotherapy in the treatment of sensory urgency that persists after transurethral resection of the prostate: a preliminary report. Neurourol Urodyn ( 2004;) 23:: 58–62.[CrossRef][Web of Science][Medline]
- Wong AM, Leong CP, Su TY, Yu SW, Tsai WC, Chen CP. Clinical trial of acupuncture for patients with spinal cord injuries. Am J Phys Med Rehabil ( 2003;) 82:: 21–7.[CrossRef][Web of Science][Medline]
- Bier ID, Wilson J, Studt P, Shakleton M. Auricular acupuncture, education, and smoking cessation: a randomized, sham-controlled trial. Am J Public Health ( 2002;) 92:: 1642–7.[Abstract/Free Full Text]
- Jarvis D, MacIver MB, Tanelian DL. Electrophysiologic recording and thermodynamic modeling demonstrate that helium-neon laser irradiation does not affect peripheral Adelta- or C-fiber nociceptors. Pain ( 1990;) 43:: 235–42.[CrossRef][Web of Science][Medline]
- Whittaker P. Laser acupuncture: past, present, and future. Lasers Med Sci ( 2004;) 19:: 69–80.[CrossRef][Web of Science][Medline]
- Yu HS, Wu CS, Yu CL, Kao YH, Chiou MH. Helium-neon laser irradiation stimulates migration and proliferation in melanocytes and induces repigmentation in segmental-type vitiligo. J Invest Dermatol ( 2003;) 120:: 56–64.[CrossRef][Web of Science][Medline]
- Foley KM, Kourides IA, Inturrisi CE, Kaiko RF, Zaroulis CG, Posner JB, et al. Endorphin: analgesic and hormonal effects in humans. Proc Natl Acad Sci USA. ( 1979;) 76:: 5377–81.[Abstract/Free Full Text]
- Guerra de Hoyos JA, Andres Martin Mdel C, Bassas y Baena de Leon E, Vigara Lopez M, Molina Lopez T, Verdugo Morilla FA, et al. Randomised trial of long term effect of acupuncture for shoulder pain. Pain ( 2004;) 112:: 289–98.[CrossRef][Web of Science][Medline]
- Sator-Katzenschlager SM, Scharbert G, Kozek-Langenecker SA, Szeles JC, Finster G, Schiesser AW, et al. The short- and long-term benefit in chronic low back pain through adjuvant electrical versus manual auricular acupuncture. Anesth Analg ( 2004;) 98:: 1359–64.[Abstract/Free Full Text]
- Carlsson CP, Sjölund BH. Acupuncture for chronic low back pain: a randomized placebo-controlled study with long-term follow-up. Clin J Pain ( 2001;) 17:: 296–305.[CrossRef][Web of Science][Medline]
- Helms JM. Acupuncture for the management of primary dysmenorrhea. Obstet Gynecol ( 1987;) 69:: 51–6.[Web of Science][Medline]
- Witt CM, Jena S, Brinkhaus B, Liecker B, Wegscheider K, Willich SN. Acupuncture in patients with osteoarthritis of the knee or hip: a randomized, controlled trial with an additional nonrandomized arm. Arthritis Rheum ( 2006;) 54:: 3485–93.[CrossRef][Web of Science][Medline]
- Stener-Victorin E, Kruse-Smidje C, Jung K. Comparison between electro-acupuncture and hydrotherapy, both in combination with patient education and patient education alone, on the symptomatic treatment of osteoarthritis of the hip. Clin J Pain ( 2004;) 20:: 179–85.[Web of Science][Medline]
- Janknegt RA, Janknegt RA, Hassouna MM, Hassouna MM, Siegel SW, Siegel SW, et al. Long-term effectiveness of sacral nerve stimulation for refractory urge incontinence. Eur Urol ( 2001;) 39:: 101–6.[CrossRef][Web of Science][Medline]
- Schachter SC. Vagus nerve stimulation therapy summary: five years after FDA approval. Neurology ( 2002;) 59:: S15–20.[Abstract/Free Full Text]
- Qian L, Peters LJ, Chen JD. Effects of electroacupuncture on gastric migrating myoelectrical complex in dogs. Dig Dis Sci ( 1999;) 44:: 56–62.[CrossRef][Web of Science][Medline]
- Lipton P. Testing hypotheses: prediction and prejudice. Science ( 2005;) 307:: 219–21.[Abstract/Free Full Text]
- Desbiens NA. More support for prediction. ( 2005;) http://www.sciencemag.org/cgi/eletters/307/5707/219.
- Carlsson C. Acupuncture mechanisms for clinically relevant long-term effects–reconsideration and a hypothesis. Acupunct Med ( 2002;) 20:: 82–99.[Medline]
- Kim HW, Roh DH, Yoon SY, Kang SY, Kwon YB, Han HJ, et al. The anti-inflammatory effects of low- and high-frequency electroacupuncture are mediated by peripheral opioids in a mouse air pouch inflammation model. J Altern Complement Med ( 2006;) 12:: 39–44.[CrossRef][Web of Science][Medline]
- Shang C. Singular point, organizing center and acupuncture point. Am J Chin Med ( 1989;) 17:: 119–27.[CrossRef][Web of Science][Medline]
- Shang C. The past, present and future of the meridian system research. In: Clinical Acupuncture: Scientific Basis —Stux G, Hammerschlag R, eds. ( 2000;) Berlin: Springer-Verlag. 69–82.
- Bryant PJ, Simpson P. Intrinsic and extrinsic control of growth in developing organs. Quart Rev Biol ( 1984;) 59:: 387–415.[CrossRef][Medline]
- Meinhardt H. Models of Biological Pattern Formation ( 1982;) London: Academic. 20.
- Niehrs C. Regionally specific induction by the Spemann-Mangold organizer. Nat Rev Genet ( 2004;) 5:: 425–34.[Web of Science][Medline]
- Winfree AT. The Geometry of Biological Time ( 1980;) New York: Springer-Verlag. 71.
- Toivonen S. Regionalization of the embryo. In: Organizer – A Milestone of a Half- Century from Spemann —Nakamura O, Toivonen S, eds. ( 1978;) Amsterdam: Elsevier. 132.
- McCaig CD, Zhao M. Physiological electrical fields modify cell behaviour. Bioessays ( 1997;) 19:: 819–26.[CrossRef][Web of Science][Medline]
- Marx JL. Electric currents may guide development. Science ( 1981;) 211:: 1147–9.[Free Full Text]
- Huttenlocher A, Horwitz AR. Wound healing with electric potential. N Engl J Med ( 2007;) 356:: 303–4.[Free Full Text]
- Erickson CA. Morphogenesis of the neural crest. In: Developmental Biology —Browder LW, ed. ( 1985;) 2:. New York: Plenum. 528.
- Hotary KB, Robinson KR. Endogenous electrical currents and voltage gradients in Xenopus embryos and the consequences of their disruption. Dev Biol ( 1994;) 166:: 789–800.[CrossRef][Web of Science][Medline]
- Laird DW, Yancey SB, Bugga L, Revel JP. Connexin expression and gap junction communication compartments in the developing mouse limb. Dev Dyn ( 1992;) 195:: 153–61.[Web of Science][Medline]
- Yancey SB, Biswal S, Revel JP. Spatial and temporal patterns of distribution of the gap junction protein connexin43 during mouse gastrulation and organogenesis. Development ( 1992;) 114:: 203–12.[Abstract]
- Coelho CN, Kosher RA. A gradient of gap junctional communication along the anterior-posterior axis of the developing chick limb bud. Dev Biol ( 1991;) 148:: 529–35.[CrossRef][Web of Science][Medline]
- Meyer RA, Cohen MF, Recalde S, Zakany J, Bell SM, Scott WJ, et al. Developmental regulation and asymmetric expression of the gene encoding Cx43 gap junctions in the mouse limb bud. Dev Genet ( 1997;) 21:: 290–300.[CrossRef][Web of Science][Medline]
- Rosendahl A, Pardali E, Speletas M, Ten Dijke P, Heldin CH, Sideras P. Activation of bone morphogenetic protein/Smad signaling in bronchial epithelial cells during airway inflammation. Am J Respir Cell Mol Biol ( 2002;) 27:: 160–9.[Abstract/Free Full Text]
- Maden M. The role of retinoic acid in embryonic and post-embryonic development. Proc Nutr Soc ( 2000;) 59:: 65–73.[Web of Science][Medline]
- Farquharson C, Jefferies D, Seawright E, Houston B. Regulation of chondrocyte terminal differentiation in the postembryonic growth plate: the role of the PTHrP-Indian hedgehog axis. Endocrinology ( 2001;) 142:: 4131–40.[Abstract/Free Full Text]
- Kishimoto J, Burgeson RE, Morgan BA. Wnt signaling maintains the hair-inducing activity of the dermal papilla. Genes Dev ( 2000;) 14:: 1181–5.[Abstract/Free Full Text]
- Miano JM, Topouzis S, Majesky M, Olson EN. Retinoid receptor expression and all-trans retinoic acid-mediated growth inhibition in vascular smooth muscle cells. Circulation ( 1996;) 93:: 1886–95.[Abstract/Free Full Text]
- Wang SJ, Omori N, Li F, Jin G, Hamakawa Y, Sato K, et al. Functional improvement by electro-acupuncture after transient middle cerebral artery occlusion in rats. Neurol Res ( 2003;) 25:: 516–21.[CrossRef][Web of Science][Medline]
- Ou YW, Han L, Da CD, Huang YL, Cheng JS. Influence of acupuncture upon expressing levels of basic fibroblast growth factor in rat brain following focal cerebral ischemia–evaluated by time-resolved fluorescence immunoassay. Neurol Res ( 2001;) 23:: 47–50.[CrossRef][Web of Science][Medline]
- Liang XB, Luo Y, Liu XY, Lu J, Li FQ, Wang Q, et al. Electro-acupuncture improves behavior and upregulates GDNF mRNA in MFB transected rats. Neuroreport ( 2003;) 14:: 1177–81.[CrossRef][Web of Science][Medline]
- Pan B, Castro-Lopes JM, Coimbra A. Activation of anterior lobe corticotrophs by electroacupuncture or noxious stimulation in the anaesthetized rat, as shown by colocalization of Fos protein with ACTH and beta-endorphin and increased hormone release. Brain Res Bull ( 1996;) 40:: 175–82.[CrossRef][Web of Science][Medline]
- Lee JH, Beitz AJ. The distribution of brain-stem and spinal cord nuclei associated with different frequencies of electroacupuncture analgesia. Pain ( 1993;) 52:: 11–28.[CrossRef][Web of Science][Medline]
- Zhang Y, Wu GC, He QZ, Cao XD. Effect of morphine and electro-acupuncture (EA) on apoptosis of thymocytes. Acupunct Electrother Res ( 2000;) 25:: 17–26.[Medline]
- Wu HG, Gong X, Yao LQ, Zhang W, Shi Y, Liu HR, et al. Mechanisms of acupuncture and moxibustion in regulation of epithelial cell apoptosis in rat ulcerative colitis. World J Gastroenterol ( 2004;) 10:: 682–8.[Medline]
- Chen Y, Zhao C, Chen H, Qin H, Fang F. Effects of "moxibustion serum" on proliferation and phenotypes of tumor infiltrating lymphocytes. J Tradit Chin Med ( 2003;) 23:: 225–9.[Medline]
- Stener-Victorin E, Lundeberg T, Waldenstrom U, Manni L, Aloe L, Gunnarsson S, et al. Effects of electro-acupuncture on nerve growth factor and ovarian morphology in rats with experimentally induced polycystic ovaries. Biol Reprod ( 2000;) 63:: 1497–503.[Abstract/Free Full Text]
- Bai YH, Lim SC, Song CH, Bae CS, Jin CS, Choi BC, et al. Electro-acupuncture reverses nerve growth factor abundance in experimental polycystic ovaries in the rat. Gynecol Obstet Invest ( 2004;) 57:: 80–5.[Web of Science][Medline]
- Liu X, Shen L, Wu M, Wu B, Gao L, Hu W, et al. Effects of acupuncture on myelogenic osteoclastogenesis and IL-6 mRNA expression. J Tradit Chin Med ( 2004;) 24:: 144–8.[Medline]
- Kishi H, Mishima HK, Sakamoto I, Yamashita U. Stimulation of retinal pigment epithelial cell growth by neuropeptides in vitro. Curr Eye Res ( 1996;) 15:: 708–13.[Web of Science][Medline]
- Pakala R, Benedict CR. Effect of serotonin and thromboxane A2 on endothelial cell proliferation: effect of specific receptor antagonists. J Lab Clin Med ( 1998;) 131:: 527–37.[CrossRef][Web of Science][Medline]
- Voelker CA, Miller MJ, Zhang XJ, Eloby-Childress S, Clark DA, Pierce MR. Perinatal nitric oxide synthase inhibition retards neonatal growth by inducing hypertrophic pyloric stenosis in rats. Pediatr Res ( 1995;) 38:: 768–74.[Web of Science][Medline]
- Siterman S, Eltes F, Wolfson V, Zabludovsky N, Bartoov B. Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality. Arch Androl ( 1997;) 39:: 155–61.[Web of Science][Medline]
- Pei J, Strehler E, Noss U, Abt M, Piomboni P, Baccetti B, et al. Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility. Fertil Steril ( 2005;) 84:: 141–7.[CrossRef][Web of Science][Medline]
- Rives AW, Galitski T. Modular organization of cellular networks. Proc Natl Acad Sci USA ( 2003;) 100:: 1128–33.[Abstract/Free Full Text]
- Lee CH, Whiteman AL, Murphy CJ, Barney NP, Taylor PB, Reid TW. Substance P, insulin like growth factor 1, and surface healing. Arch Ophthalmol ( 2002;) 120:: 215–7.[Free Full Text]
- Baldwin AS Jr. The NF-kappa B and I kappa B proteins: new discoveries and insights. Annu Rev Immunol ( 1996;) 14:: 649–83.[CrossRef][Web of Science][Medline]
- Bailey CH, Bartsch D, Kandel ER. Toward a molecular definition of long-term memory storage. Proc Natl Acad Sci USA ( 1996;) 93:: 13445–52.[Abstract/Free Full Text]
- Tanaka H, Samuel CE. Mechanism of interferon action: structure of the mouse PKR gene encoding the interferon-inducible RNA-dependent protein kinase. Proc Natl Acad Sci USA ( 1994;) 91:: 7995–9.[Abstract/Free Full Text]
- Winfree AT. A continuity principle for regeneration. In: Pattern Formation —Malacinski GM, ed. ( 1984;) New York: Macmillan. 106–7.
- Cotton RT. The ear, nose, oropharynx and larynx. In: Rudolph's Pediatrics —Rudolph AM, Hoffman JIE, Rudolph CD, eds. ( 1996;) Stamford: Appleton & Lange. 945.
- Lo CW. The role of gap junction membrane channels in development. J Bioenerg Biomembr ( 1996;) 28:: 379–85.[CrossRef][Web of Science][Medline]
- Levin M. Isolation and community: a review of the role of gap-junctional communication in embryonic patterning. J Membr Biol ( 2002;) 185:: 177–92.[CrossRef][Web of Science][Medline]
- Ewart JL, Cohen MF, Meyer RA, Huang GY, Wessels A, Gourdie RG, et al. Heart and neural tube defects in transgenic mice overexpressing the Cx43 gap junction gene. Development ( 1997;) 124:: 1281–92.[Abstract]
- Becker DL, McGonnell I, Makarenkova HP, Patel K, Tickle C, Lorimer J, et al. Roles for
1 connexin in morphogenesis of chick embryos revealed using a novel antisense approach. Dev Genet ( 1999;) 24:: 33–42.[CrossRef][Web of Science][Medline] - Chi CL, Martinez S, Wurst W, Martin GR. The isthmic organizer signal FGF8 is required for cell survival in the prospective midbrain and cerebellum. Development ( 2003;) 130:: 2633–44.[Abstract/Free Full Text]
- Toivonen S. Regionalization of the embryo. In: Organizer – A Milestone of a Half- Century from Spemann —Nakamura O, Toivonen S, eds. ( 1978;) Amsterdam: Elsevier. 124.
- Carlson MR, Bryant SV, Gardiner DM. Expression of Msx-2 during development, regeneration, and wound healing in axolotl limbs. J Experimental Zool ( 1998;) 282:: 715–23.[CrossRef]
- Lee D, Malpeli JG. Global form and singularity: Modeling the blind spot's role in lateral geniculate morphogenesis. Science ( 1994;) 263:: 1292–4.[Abstract/Free Full Text]
- Sawai S, Thomason PA, Cox EC. An autoregulatory circuit for long-range self-organization in Dictyostelium cell populations. Nature ( 2005;) 433:: 323–6.[CrossRef][Medline]
- Diaz-Benjumea FJ, Cohen SM. Interaction between dorsal and ventral cells in the imaginal disc directs wing development in Drosophila. Cell ( 1993;) 75:: 741–52.[CrossRef][Web of Science][Medline]
- Baldry P. Trigger point acupuncture. In: Medical Acupuncture —Filshie J, White A, eds. ( 1998;) Edinburgh: Churchill Livingston. 35.
- Neumann CJ, Cohen SM. Long-range action of wingless organizes the dorsal-ventral axis of the Drosophila wing. Development ( 1997;) 124:: 871–80.[Abstract]
- Xia H, Ben-Amar Baranga A, Hoffman D, Romalis MV. Magnetoencephalography with an atomic magnetometer. Appl Phys Lett ( 2006;) 89:: 211104–6.[CrossRef]
- McCaig CD, Rajnicek AM, Song B, Zhao M. Controlling cell behavior electrically: current views and future potential. Physiol Rev ( 2005;) 85:: 943–78.[Abstract/Free Full Text]
- Azizkhan RG, Caty MG. Teratomas in childhood. Curr Opin Pediatr ( 1996;) 8:: 287–92.[Medline]
- Gonzalez-Crussi F. Extragonadal Teratomas ( 1982;) Washington, DC: Armed Forces Institute of Pathology. 118.
- Francis RJ, Lo CW. Primordial germ cell deficiency in the connexin 43 knockout mouse arises from apoptosis associated with abnormal p53 activation. Development ( 2006;) 133:: 3451–60.[Abstract/Free Full Text]
- Nichols CR, Timmerman R, Foster RS, Roth BJ, Einhorn LH. Neoplasms of the testis. In: Cancer Medicine —Holland JF, Basst RC Jr, Morton DL, Frei E III, Kufe DW, Weichselbaum RR, eds. ( 1997;) 4th. Baltimore: Williams & Wilkins. 2206.
Received April 19, 2007; accepted July 10, 2007
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Abstract
Introduction