Can Cupping Improve COVID Vaccine Delivery?

Tara Haelle

November 22, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Until mRNA vaccines against COVID-19 emerged, RNA or DNA vaccines had not been used at a large scale even though the technology had existed for years. Now researchers are seeking ways to deliver these vaccines more efficiently, and they've found one: cupping, which is rooted in a practice used for centuries in China and the Middle East.

The tradition typically involves placing heated cups on a person's skin. As the air inside the cup cools, the air pressure under the cup drops. Practitioners believe that the resulting suction of the skin promotes healing, although evidence for its effectiveness is limited. But scientists suspected that the process might stimulate skin cells to soak up injected DNA as a vaccine or gene therapy.

In the body, injected RNA usually degrades quickly if it's unprotected. In the mRNA COVID vaccines, an oily droplet surrounds the mRNA, protecting it long enough to reach cells. DNA is less vulnerable to breakdown but faces a different problem: getting enough cells to take it up. Current methods to get DNA into cells include using an electric pulse to open an entry point for the DNA. But the side effects include muscle contractions, pain, and tissue damage, and the method isn't usable in people with pacemakers or other electrical device implants.

In a new study published in Science Advances, researchers tried out vaccination plus cupping on rats. They injected one or two doses of a DNA-only COVID vaccine, immediately followed by cupping suction where the shot was given. Even if only one dose of vaccine was used, the immune response with cupping was about 100 times greater than without cupping.

Scientists aren't certain why the suction helps, but they suspect that it strains the skin layers, stretching the cells so that they take up more of the DNA. This method of enhancing DNA uptake is less painful than other methods and has fewer side effects, including no tissue damage.

DNA vaccines don't require cold storage, making them an encouraging option in areas where maintaining low temperatures during vaccine transport can be difficult. A successful delivery system for DNA vaccines that doesn't involve the side effects of other methods could add another advantage. The company that developed this method, GeneOne Life Science, has already begun clinical trials with a DNA vaccine against COVID-19.


Science Advances: "Novel suction-based in vivo cutaneous DNA transfection platform."


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