Journal
JOURNAL OF INFLAMMATION RESEARCH
Volume 14, Issue -, Pages 7191-7224Publisher
DOVE MEDICAL PRESS LTD
DOI: 10.2147/JIR.S341581
Keywords
inflammation; acupuncture; immune; vagus; sympathetic nerve
Categories
Funding
- National Natural Science Foundation of China (NSFC) [82030125, 81873369, 82074534, 82105023, 82004467, 82105024]
- Key scientific program of integrated traditional Chinese and Chinese and Western medicine of Tianjin Health Commission [2021019]
- National Key R&D Program of China [2019YFC1712200-2019YFC1712204]
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Acupuncture exhibits strong anti-inflammatory effects in multiple biological systems by regulating various immune cell populations and functions.
Inflammation plays a significant role in the occurrence and development of multiple diseases. This study comprehensively reviews and presents literature from the last five years, showing that acupuncture indeed exerts strong anti-inflammatory effects in multiple biological systems, namely, the immune, digestive, respiratory, nervous, locomotory, circulatory, endocrine, and genitourinary systems. It is well known that localized acupuncture-mediated anti-inflammatory effects involve the regulation of multiple populations and functions of immune cells, including macrophages, granulocytes, mast cells, and T cells. In acupuncture stimulation, macrophages transform from the M1 to the M2 phenotype and the negative TLR4 regulator PPAR gamma is activated to inhibit the intracellular TLR/MyD88 and NOD signaling pathways. The downstream I kappa B alpha/NF-kappa B and P38 MAPK pathways are subsequently inhibited by acupuncture, followed by suppressed production of inflammasome and proinflammatory mediators. Acupuncture also modulates the balance of helper T cell populations. Furthermore, it inhibits oxidative stress by enhancing SOD activity via the Nrf2/ HO-1 pathway and eliminates the generation of oxygen free radicals, thereby preventing inflammatory cell infiltration. The anti-inflammatory effects of acupuncture on different biological systems are also specific to individual organ microenvironments. As part of its anti-inflammatory action, acupuncture deforms connective tissue and upregulates the secretion of various molecules in acupoints, further activating the NF-kappa B, MAPK, and ERK pathways in mast cells, fibroblasts, keratinocytes, and monocytes/macrophages. The somatic afferents present in acupuncture-activated acupoints also convey sensory signals to the spinal cord, brainstem, and hypothalamic neurons. Upon information integration in the brain, acupuncture further stimulates multiple neuro-immune pathways, including the cholinergic anti-inflammatory, vagus-adrenal medulla-dopamine, and sympathetic pathways, as well as the hypothalamus-pituitary-adrenal axis, ultimately acting immune cells via the release of crucial neurotransmitters and hormones. This review provides a scientific and reliable basis and viewpoints for the clinical application of acupuncture in various inflammatory conditions.
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