Revealing the biological mechanism of acupuncture in alleviating excessive inflammatory responses and organ damage in sepsis: a systematic review

Abstract

Sepsis is a systemic inflammation caused by a maladjusted host response to infection. In severe cases, it can cause multiple organ dysfunction syndrome (MODS) and even endanger life. Acupuncture is widely accepted and applied in the treatment of sepsis, and breakthroughs have been made regarding its mechanism of action in recent years. In this review, we systematically discuss the current clinical applications of acupuncture in the treatment of sepsis and focus on the mechanisms of acupuncture in animal models of systemic inflammation. In clinical research, acupuncture can not only effectively inhibit excessive inflammatory reactions but also improve the immunosuppressive state of patients with sepsis, thus maintaining immune homeostasis. Mechanistically, a change in the acupoint microenvironment is the initial response link for acupuncture to take effect, whereas PROKR2 neurons, high-threshold thin nerve fibres, cannabinoid CB2 receptor (CB2R) activation, and Ca2+ influx are the key material bases. The cholinergic anti-inflammatory pathway of the vagus nervous system, the adrenal dopamine anti-inflammatory pathway, and the sympathetic nervous system are key to the transmission of acupuncture information and the inhibition of systemic inflammation. In MODS, acupuncture protects against septic organ damage by inhibiting excessive inflammatory reactions, resisting oxidative stress, protecting mitochondrial function, and reducing apoptosis and tissue or organ damage.

Lobetyolin protects mice against LPS-induced sepsis by downregulating the production of inflammatory cytokines in macrophage

“…Sepsis, a life-threatening condition resulting from an imbalanced host response to infection, has surpassed myocardial infarctions in terms of mortality rate and emerged as a prominent cause of death among non-cardiac patients in intensive care units (Nazer et al, 2023;Yang et al, 2023). In China, herbal medicines are frequently employed alongside conventional sepsis management strategies (Usmani et al, 2021).…”

“…Sepsis is a life-threatening condition characterized by systemic inflammation resulting from the body's immune response to an infection (Yang et al, 2023). If left untreated, it can lead to multiple organ dysfunction and ultimately death (Zampieri et al, 2023).…”

Does acupuncture treatment modulate inflammatory cytokines in rodent models of depression? A systematic review and meta-analysis

“…Acupuncture exerts its anti-inflammatory effects through various pathways, including the vagus nerve-adrenal medulla-dopamine pathway, vagus nerve-adrenal axis/spinal sympathetic pathway, vagus nerve-spleen cholinergic pathway, or percutaneous auricular vagus nerve-cholinergic anti-inflammatory pathway. Acupuncture at superficial acupoints induces various somatosensory-autonomic reflex pathways, playing a crucial role in modulating the body’s immune-inflammatory responses ( Liu et al, 2021 ; Yang et al, 2023 ).…”