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Could the use of a “cupping” approach help in vaccine development?

cupping' technique
  • Using a method similar to an ancient cupping technique, a group of researchers have established a unique approach of administering nucleic acid-based medicines.
  • According to their findings, the approach improves vaccine delivery by several orders of magnitude.
  • Clinical studies for a COVID-19 vaccination using the cupping method are now underway.

Scientists have produced a variety of nucleic acid-based drugs as therapies and vaccinations in the last 20 years.

Nucleic acids, most notably DNA and RNA, are found in all living organisms.

Nucleic acid-based treatments and vaccines function by blocking, replacing, or modifying DNA and RNA in host cells.

The effectiveness of these medicines and vaccinations is determined by their ability to reach the host’s cells. Most nucleic acids will rapidly decay if injected directly into tissue, for example, unless they are protected.

Both the Pfizer-BioNTech and Moderna COVID-19 vaccines are based on nucleic acids. Lipid nanoparticles encase and protect nucleic acids in these vaccinations as they travel through the host cell membrane.

Drugs administered in this manner, while effective, are susceptible to deterioration during storage.

Electroporation is one way of delivering nucleic acid-based medications. A pulse of electricity is used to transfer nucleic acids to cells that have been rendered more permeable.

While these electrical impulses are partially successful, they can induce muscular spasms, tissue damage, and discomfort, and they may not be appropriate for those who have implantable electrical devices like defibrillators or pacemakers.

This procedure also necessitates extensive training, and the high cost of equipment may make it unavailable to locations and populations with little resources.

Developing a mechanism for administering nucleic acid-based medications that avoids undesired side effects and costs while remaining effective should improve vaccination accessibility in low-resource countries.

Researchers from Rutgers, the State University of New Jersey in Piscataway, and GeneOne Life Science in Seoul, South Korea, recently devised a method for delivering nucleic acid-based therapeutics based on an ancient cupping technique.

Prof. Hao Lin, senior research author, said, “Development of improved delivery technologies plays a vital role in bringing nucleic acid-based biologics to broad usage and therapeutic relevance, and worldwide vaccine distribution is only one example.”

“We have demonstrated an alternative, safe, and effective transfection platform that yields high levels of transgene expression.”

“The advantages also include device cost effectiveness, […] manufacturing scalability, and minimal requirements for user training,” he added.

“Because of the inherent advantages of DNA, not least of which is avoiding cold-chain requirements of other vaccines, this technology facilitates vaccination programs into remote regions of the world where resources are limited,” he added.

The findings have been published in the journal Science Advances.


Cupping therapy is an old Middle Eastern and Chinese healing practice. It entails pressing warm cups on the skin to produce negative pressure and improve blood circulation, which aids in healing.

Doctors have been using the procedure in hospitals in China and worldwide since 1950 for problems like acne, facial paralysis, and dyspnea.

Despite the lack of proof for its health advantages, the authors of a new study chose to look at a similar methodology as a possible delivery route for nucleic acid-based therapy.

The researchers gathered two groups of rats and injected DNA into the top layers of their skin to test the approach. The “suction cup treatment” was applied to one group’s injection site, whereas the other did not.

Fluorescence microscopy was used to monitor the activity of the DNA. They discovered that 4 hours after immunization, the vaccine’s gene expression could be detected. However, gene expression was detected 1 hour after immunization in the rats that also received cupping.

The researchers discovered that gene expression was eight times deeper under the skin in the rats that underwent cupping than in those who just got DNA injections after 24 hours.

COVID-19 vaccine delivery

The researchers next injected the rats with a synthetic SARS-CoV-2 DNA candidate vaccine to see if this method might be used to deliver possible COVID-19 vaccines.

The rats were divided into three groups:

  • The first group received two injections of the vaccine candidate without suction on days 0 and 14.
  • The second group received one vaccine, followed by dermal suction on day 0.
  • The third group received two vaccinations and dermal suction on days 0 and 14.

Blood samples were taken from the rats on days 0 and 14 before immunization, as well as on day 29.

They discovered that animals given cupping after receiving the immunization had a considerably greater immunological response than rats that just got the vaccine.

Immune responses in rats given a single vaccine followed by suction were not statistically different from those given two immunizations followed by suction, according to the researchers.

They also point out that the rats that were suctioned showed no signs of tissue injury or lymphocyte infiltration in the locations where they were injected.

The underlying processes for suction-enhanced delivery, according to the researchers, are unknown. However, they believe it may function through the CG route. This has an impact on which chemicals pass through membranes and enter cells.

Due to the intricacy of the processes involved and a dearth of available medications for testing, the researchers stress that confirming the underlying mechanisms of cupping will be difficult.

Nonetheless, the researchers claim that even without a molecular explanation, the system might be improved.

Dr. Lin informed Medical News Today that the technique is now two-step: an injection followed by suction.

“We’re developing a combined device/method to enable one-step application,” he said, “that is, injection and suction in a single step via a single instrument.” “We’re also attempting to cut suction time even more in order to improve patient and staff acceptability.”

“Theoretically, this may be possible,” Dr. Lin said when asked if this method could work for COVID-19 vaccines. “However, we cannot answer without testing because, except for DNA vaccines, COVID-19 vaccines are delivered into the muscle, whereas this device delivers [the] vaccine to the upper layers of the skin.”

“A COVID-19 vaccine is now being investigated in phase 1 and phase 2 clinical trials with the [suction] device. “We’re preparing the material to file with regulatory bodies for general and extensive clinical usage,” he added.

According to the researchers, cupping is a viable way for delivering nucleic acid-based therapy. However, more study is needed to establish if COVID-19 vaccines can be delivered to humans using this method.

“In comparison to existing DNA vaccine delivery systems, the suction device provides a number of benefits. First, it’s low-cost and simple to operate, with little training required,” Dr. Lin told MNT. “Secondly, the gadget is powered by a user-rechargeable battery.”

“The third is the high level of patient acceptability,” he explained, “since the device will assist administer DNA vaccinations without pain or suffering.”

“Fourth, unlike other devices that require lengthy setup, this one merely involves removing a cap and hitting the power button; the machine will switch off in a matter of seconds.”

“This, along with the numerous advantages of DNA as a vaccine type — the largest ones being the potential to fully circumvent the need for freezers from the clinician’s viewpoint, and low side effects and pain from the patient’s perspective,” he concluded.