An econometric analysis of the national and regional characteristics of
acupuncture neuroimaging studies was performed.
The results showed that 15 countries,
led by China, the United States, South Korea and Germany,
show a significant central tendency.
China and the United States were the top two countries that aided
neuroimaging research on acupuncture effect.
The country distribution map of the neuroimaging research
on the effects of acupuncture
In 1995, the American Journal of Traditional Chinese Medicine first reported
that fMRI imaging could be used as a non-invasive method to observe
the brain response caused by acupuncture stimulation.
In 2000, a study using PET imaging technology reported
that the acupuncture of Zusanli (ST36) increased glucose metabolism
in the plant’s nerve centre, which is related to gastric function.
In 2011, for the first time, it was reported that Zusanli (ST36) acupuncture
could specifically induce neural responses in the pain-inhibiting region using MEG,
while Neiguan (PC6) acupuncture
could specifically induce the activities of the insula and amygdala.
In 2000, Hui Harvard University and Massachusetts General Hospital proposed
the ‘negative activation of the limbic system’ theory of acupuncture..
In 2008, Dhond et al. proposed the multi-network hypothesis:
the complex mechanism of acupuncture modulates
the ‘default brain network and somatosensory motor network’.
In 2009, Fang et al. further proposed the theory of
‘limbic-paralimbic-neocortical network’ regulation by acupuncture.
Tian et al: The characteristic effect of acupuncture via
‘Spatio-temporal coding brain networks’.
The Mechanism of Acupuncture Regulating Autophagy:
Progress and Prospect
(2025, China)
Apoptosis and autophagy are two important cellular processes
which control cell survival or death,
and also considered as a balanced response to pathogens and
other immune stimuli that play an important role in maintaining physiologic homeostasis.
There are few effective and safe ways to regulate cell apoptosis and autophagy
in clinical practice right now.
Modulation of acupuncture on cell apoptosis and autophagy (2017, China)
https://pmc.ncbi.nlm.nih.gov/articles/PMC11852493/pdf/biomolecules-15-00263.pdf
https://pubmed.ncbi.nlm.nih.gov/40001566/
Biomolecules. 2025 Feb 11;15(2):263.
Regulating autophagy is one of the mechanisms
through which acupuncture exerts its therapeutic effects.
The regulatory effect of acupuncture on autophagy capacity is bidirectional:
it inhibits the abnormal activation of autophagy to prevent exacerbation of injury
and reduce apoptosis, while also activating or enhancing autophagy
to promote the elimination of inflammation and reduce oxidative stress.
Autophagy is a complex molecular pathway by which eukaryotic cells
degrade longlived proteins, organelles, and pathogens,
and recycle some of the energy required for recirculation to maintain
cellular and organismal homeostasis.
Autophagy is involved in intercellular communication;
responding to cellular stress; senescence, and death;
inhibiting inflammatory responses; and improving organismal metabolism.
Acupuncture promotes self-regulation through an autostable mechanism,
with its direction of action contingent on the body’s pathological conditions.
Whether addressing abnormal autophagy resulting from various diseases
(either overactivation or under-activation) or
autophagy disorders that manifest at different stages of the same disease,
acupuncture can help restore the body’s functions from a biased state to a balanced one.
This underscores the bidirectional regulatory effect of acupuncture.
This paper systematically reviews the research progress on the use of acupuncture
for treating various diseases via the autophagy pathway.
Revealing the magic of acupuncture based on biological mechanisms:
A literature review
(2022, China)
https://www.jstage.jst.go.jp/article/bst/16/1/16_2022.01039/_pdf/-char/en
https://pubmed.ncbi.nlm.nih.gov/35153276/
The current review describes the common indications for acupuncture
recommended by the WHO and the use of acupuncture
in China, the United States, Australia,
and several other countries.
This review then summarized the mechanisms by which acupuncture treats
common conditions including lower back pain (LBP), ischemic stroke,
depression, and irritable bowel syndrome (IBS).
Understandings of acupuncture application and mechanisms
(2021, Taiwan)
https://pmc.ncbi.nlm.nih.gov/articles/PMC8991130/pdf/ajtr0014-1469.pdf
https://pubmed.ncbi.nlm.nih.gov/35422904/
Am J Transl Res 2022;14(3):1469-1481
www.ajtr.org /ISSN:1943-8141/AJTR0131272
Adenosine triphosphate (ATP) and transient receptor potential vanilloid (TRPV)
channels are involved in the stimulation of acupuncture at the acupoint area.
In the central nervous system (CNS), neurotransmissions including opioids,
serotonin, norepinephrine, orexin and endocannabinoid are modulated
by acupuncture to induce analgesia.
Moreover, acupuncture reduces cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) levels on the peripheral level by acting on the hypothalamic-pituitary-adrenal (HPA) axis, mediating peripheral opioid release.
Acupuncture helps to treat insomnia by inhibiting sympathetic activity and
down-regulating the HPA axis.
Additionally, acupuncture reduces the effects of positive and negative reinforcements
by modulating dopamine release in the nucleus accumbens.
Recently, i-needles have been developed to allow for the analysis of metagenomics,
meta-transcriptomics, and host-microbiome relationships following acupuncture,
while skin implantable microsensors or needle-shaped microsensors are feasible
for monitoring real-time microenvironmental changes in acupoints and even target organs.
These studies may further accelerate the understanding of acupuncture’s action mechanism.