The peripheral-central mechanism of acupuncture effects： neuroimmunology and regulation of organ function

Acupuncture， as a typical representative of non-drug therapy， regulates central functions by activating the peripheral nervous system， and has become a leading hotspot in the field of neuromodulation. Focusing on the peripheral-cerebral mechanism of acupuncture effects， this article systematically reviews the cutting-edge interdisciplinary advancements in acupuncture research and modern life sciences from 3 dimensions： neuro-immune anti-inflammatory actions， target organ function regulation， and “one acupoint affecting multiple organs” intervention for comorbidities. To analyze the key issues， clarify academic viewpoints， and trigger thoughts and discussions， the following are the main points： 1） Based on the established understanding that acupuncture stimulation activates autonomic nerve pathways such as the brainstem vagus-adrenal and spinal cord sympathetic-splenic axes， to exert anti-inflammatory effects， it has also been revealed that some vagus nerves can directly traverse and form synaptic connections with catecholaminergic neurons in the celiac ganglion via collateral branches， rather than relaying through relay neurons. It further seeks to clarify the hierarchical relationship among the catecholamine anti-inflammatory， cholinergic anti-inflammatory， sympathetic/parasympathetic nerve pathways， particularly paying attention to the relationship between the concentration-dependent receptor affinity of norepinephrine in the inflammatory microenvironment and its association with acupuncture effects. 2） Current researches have demonstrated that acupuncture regulates the homeostasis of the body and internal organs by rebalancing the sympathetic-parasympathetic system at multiple levels， identifying the “off-target” phenomenon caused by the loss of response of tissue cells and receptors under pathological conditions is a key factor affecting the “last mile” of the acupuncture effect. 3） Taking the convergence of different visceral input information mediated by the intrinsic structures of the spinal cord， as well as the occurrence of comorbidity in the interactive sensitization of the pelvic and sacral organs as an example， results of modern research have provided possible explanations for the cross-segment’s and same-segment’s “one acupoint affecting multiple organs” and “multiple acupoints affecting one organ” effects of acupuncture. In summary， this article aims to clarify how acupuncture regulates the body’s homeostasis through different peripheral-cerebral autonomic nervous pathways and levels， and offers a review of existing research through 4 dimensions of thinking and inspiration to stimulate new insights and foster intellectual exchange.