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. 2023 Apr;25(2):326-335.
doi: 10.1177/10998004221136567. Epub 2022 Oct 28.

Feasibility of Acupuncture and Exploration of Metabolomic Alterations for Psychoneurological Symptoms Among Breast Cancer Survivors

Hongjin Li  1   2 , Judith M Schlaeger  1 , Crystal L Patil  1 , Oana C Danciu  2   3 , Yinglin Xia  3 , Jun Sun  2   3 , Ardith Z Doorenbos  2   4
Affiliations

Feasibility of Acupuncture and Exploration of Metabolomic Alterations for Psychoneurological Symptoms Among Breast Cancer Survivors

Hongjin Li et al. Biol Res Nurs. 2023 Apr.

Abstract

Objective: Approximately 24-68% of breast cancer survivors report co-occurring psychoneurological symptoms of pain, fatigue, sleep disturbance, depression, and anxiety during and after cancer treatment. This study aimed to assess the feasibility and acceptability of acupuncture for the treatment of multiple psychoneurological symptoms among breast cancer survivors and explore metabolomic changes before and after acupuncture.

Methods: We conducted a single-arm, prospective pilot study of breast cancer survivors with at least two moderate to severe psychoneurological symptoms (>3 on a 0-10 scale). Acupuncture was administered twice weekly for 5 weeks, for 30 minutes per session. Along with Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires, a fasting serum comprehensive hydrophilic metabolites panel was analyzed at baseline and after acupuncture.

Results: Eight participants (mean age 52.5 ± 10.9 years; 62.5% Black) were enrolled. Feasibility was supported, with 67% recruitment, 87.5% retention, and 98% acceptability. Post intervention, PROMIS T-scores were reduced for all psychoneurological symptoms. Significant differences in serum metabolites before and after acupuncture were F-1,6/2,6-DP, glutathione disulfide, phosphorylcholine, 6-methylnicotinamide, glutathione, and putrescine (variable importance of projection values larger than 1.5 and p values <0.05). Pathway analysis indicated that glutathione metabolism (p = 0.002, q = 0.071), and arginine and proline metabolisms (p = 0.009, q = 0.166) were potentially involved in mechanisms of acupuncture.

Conclusions: Acupuncture to reduce multiple psychoneurological symptoms among breast cancer survivors was feasible and acceptable. Study findings also shed light on the metabolic pathways involved in the acupuncture response and will be tested in future studies.

Keywords: acupuncture; breast cancer; metabolites; psychoneurological symptoms.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
(a) Volcano plot showing metabolites that were upregulated (red dots) or downregulated (blue dots) before versus after the acupuncture intervention. (b) Principal component analysis for same samples; red dots represent before-acupuncture cases and green dots represent after-acupuncture cases. (c) Heat map showing the top 25 metabolite changes before (red) and after (green) the acupuncture intervention.
Figure 2.
Figure 2.
Pathway analysis of differential serum metabolites false discovery rate.
See this image and copyright information in PMC

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