The hypothesis that cutaneous mast cells (MCs) are responsible for skin phenomena in acupuncture was proposed 40 years ago, but very little is known about the correlation of MC distribution with acupuncture systems in human. The aim of this study is to quantify cutaneous mast cells at different body sites and compare them with the distributions of classical acupuncture points and micro-acupuncture systems. Skin biopsies from dermatological practice were evaluated under microscope with H&E or CD117 stains. Dermal MCs were counted and expressed as MCs per high power field. Densities of classical acupuncture points at different body sites were also calculated and expressed as points per dm2. MC densities at special sites of the body were compared with micro-acupuncture systems. After examining 285 skin biopsies, MC enriched special sites (MESS) were found at peripheral parts of the body and around orifices of body surfaces. Comparative mapping showed that patterns of MC distribution are highly correlated with the distributions of classic acupuncture points in 14 classic acupuncture meridians, with the exception of the trunk areas. Mapping also revealed that all micro-acupuncture systems were established at MESS, including ear, scalp, hand, foot, eye, face, and umbilicus. The conclusion is that the densities of cutaneous MCs are highly correlated with classical acupuncture points and micro-acupuncture systems. These findings provide tissue evidence of neuroimmune basis of acupuncture and suggest that MC is a tissue target for acupuncture stimulation and may serve as a tissue marker for acupuncture points.
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