Acupuncture Effects and Neuroimmune Regulation

In traditional Chinese medicine, acupuncture stresses treating the root cause. The point is not to suppress a single symptom, but to bring the body back from imbalance to a stable state. Many modern studies have treated acupuncture as a straight line — acupoint → target organ — focusing either on local stimulation or on changes in one organ’s function. The problem is that this can miss the crucial middle step: how the nervous system processes and integrates acupuncture signals, then coordinates the immune and endocrine systems to regulate the body.

Recent work in neuroscience and immunology is reshaping this picture. Acupuncture looks more like a trigger for an inbuilt regulatory programme: specific neural circuits tune the strength, timing and location of immune responses, helping repair and easing inflammation or pain. This cross-system control network is one modern way to explain the TCM holistic view.

From needle sensation to effect: a three-stage pathway. You can think of acupuncture as a classic information chain:

Sensory input → Central integration → Autonomic output

Sensory input: signals enter the nervous system from the skin and fascia

Acupuncture not only stimulates the skin surface. Needle insertion and manipulation (lifting–thrusting, twirling, etc.) create local tension and stretch, activating sensory nerve fibres with different thresholds. Lighter stimulation tends to recruit fibres carrying touch; stronger stimulation more often recruits fibres linked to aching, soreness or pain-type sensations.

This step is not simply a nerve being poked. It also engages local multi-cell cooperation: fibroblasts, muscle cells, mast cells and others release signalling molecules such as ATP and histamine, creating an information starting point that can be amplified. So even when the classic needle sensation is not obvious, effects may still occur via other routes — acupuncture is not a single mechanism but a combination of channels.

Central integration: spinal cord, brainstem and hypothalamus act as relay decision hubs

After entering the spinal cord, incoming signals are further integrated in regions such as the brainstem and hypothalamus. These areas work like control centres. Part of their role is pain modulation (which helps explain why analgesic effects can be fast or slower), but more importantly, they help decide which autonomic pathway should be used to carry out the task.

Autonomic output: vagus, sympathetic nerves and the HPA axis deliver regulatory commands

Acupuncture can influence inflammation, immunity and multi-organ function largely through the autonomic nervous system as an output arm, together with the hypothalamic–pituitary–adrenal (HPA) axis as a body-wide coordination system.

How acupuncture modulates immunity

In modern neuroimmunology, acupuncture’s anti-inflammatory and immune effects are often described as combinations of several neuro–immune pathways.

1) The vagus nerve

Think of the vagus nerve as an emergency brake line. It quietly maintains basic rhythms — heart rate, breathing, digestion — but when inflammation starts to run away, it helps bring the system back under control.

Under certain conditions (deeper stimulation, suitable intensity and frequency, and point combinations that match the current pathology), acupuncture can act like pressing a wake-up button on the body surface. What is woken first is not a single organ, but sensory nerve endings in the skin and fascia. Their signals travel upwards — to the spinal cord, then to the brainstem. The brainstem functions like a traffic controller: it does not create inflammation or directly repair tissue; it decides whether to apply the brake and how hard.

Once the system decides to contain the fire, it hands the command to the vagus nerve. The vagus is powerful because it sends instructions quickly via electrical signals, not slowly via circulating chemicals. Two common firefighting patterns are often described:

A sprinkler-like systemic response. Vagal signalling can engage adrenal-related responses. The adrenal glands act like an emergency storehouse, releasing mediators into the bloodstream that rapidly shift immune activity. Immune cells then reduce excessive pro-inflammatory output, flattening the inflammatory surge. This route is fast and suits situations where inflammation rises sharply and spreads widely.

A more targeted ‘call to immune cells’. Instead of broadcasting a whole-body signal, the command can be passed through peripheral immune hubs — the spleen is often discussed here. You can see the spleen as a major dispatch centre, packed with cells that drive inflammation. Through peripheral neural networks, vagal-related signals can increase the presence of acetylcholine around immune cells. Immune cells carry a receptor sometimes described as a mute button (often written α7nAChR). When acetylcholine activates it, immune cells downshift overly aggressive programmes: fewer pro-inflammatory cytokines, and earlier stopping of escalating cascades. This is less blanket coverage and more tight control at key posts.

These two modes are like two gears of the same braking system: when the fire is fierce, the body may first use the sprinkler to reduce overall intensity; when inflammation becomes chronic and stubborn, it may rely more on the targeted persuasion to stabilise ongoing output. In this view, acupuncture matters not because it acts locally, but because it may make these built-in anti-inflammatory circuits easier to activate and easier to set to an appropriate level.

Because this brake line is neural, it naturally has two features: speed (neural signalling is rapid) and directionality (it runs through specific routes and nodes rather than spreading uniformly). Framed this way, the potential relevance of acupuncture to excessive inflammation becomes easier to grasp: not mysterious tonification, but a chance to recruit existing neuro–immune control networks and bring runaway responses back into a controllable range.

2) The sympathetic nervous system

The sympathetic system is best pictured as the body’s accelerator. It raises energy availability, alertness and reaction speed when needed. During infection, injury or pain, it often steps on the gas: blood flow is redistributed, heart rate rises, immune cells are mobilised — as if dispatching firefighters and repair crews. This can sound pro-inflammatory, so people often equate sympathetic activity with inflammation. In reality it is more like driving: the accelerator is not bad; what matters is when you press it, how hard, and for how long.

If inflammation is a fire, early acute stages may require some acceleration: immune cells arrive faster, threats are contained, damaged tissue is cleared. In that phase, increased sympathetic activity can be useful. But once control is achieved and repair should begin, staying on the gas causes trouble — crews do not withdraw, and the site keeps being disturbed, turning inflammation into a lingering chronic state. So the same sympathetic signalling can look very different across the course of illness: sometimes rapid mobilisation, sometimes system overload.

Sympathetic instructions are often delivered via mediators such as noradrenaline. But that language is not one message with one meaning. It is more like a volume dial with different headsets: the same mediator can have opposite effects depending on concentration and on which receptors immune cells express. At low levels, high-sensitivity receptors may dominate and promote readiness; at higher levels, other receptors may dominate and signal do not overshoot, reduce intensity. So sympathetic activity can both push immune responses up and bring them down — it is a dynamic balancing lever, not a fixed-direction switch.

Here, acupuncture can be seen as a hand on the accelerator. In some acute problems, it may help necessary mobilisation become more efficient; in chronic inflammation or long-standing tension, it may reduce excessive sympathetic drive so immunity is not stuck in high firepower with poor repair. This aligns with a TCM-style clinical pattern: some people need a push, others a pull back. Acupuncture is not simple suppression; it aims to restore rhythm — fast when it should be fast, slow when it should be slow. In modern terms, that is rebalancing the accelerator and brake to the right gear.

3) The gut–brain axis

The enteric nervous system can be thought of as another self-governing city inside the body — big enough to be called a second brain. It has its own neural networks, local reflexes and rhythms, controlling gut motility, secretion, blood flow and barrier function. Crucially, it also houses dense immune populations and a vast microbial ecosystem. The gut is not just a digestion tube; it is a hub handling nutrient input, immune surveillance and microbial co-existence. When this city is orderly, the barrier acts like a strong wall: nutrients pass through, while toxins and bacterial components are kept out, and the immune system does not constantly raise alarms. But if motility becomes disordered, the barrier becomes leaky, or the microbiota shifts, the city enters a tense state. Immune cells respond repeatedly, inflammatory signals rise, and this tension can spread system-wide through blood and neural routes. That is why problems that do not seem gut-related — chronic inflammation, fatigue, mood and sleep swings, even some neurological symptoms — may be fuelled by gut disturbance.

In the gut–brain story, acupuncture often plays the role of restoring order first. It may regulate motility rhythms via autonomic pathways, stabilise the mucosal barrier, and shift local immune tone so unnecessary inflammatory mobilisation decreases. When gut alarms quieten, the central nervous system receives fewer danger signals, and both brain function and overall inflammatory burden may fall together. Put simply: sometimes acupuncture is not directly press down symptoms, but first stabilises the gut as a key hub — and once the hub steadies, many downstream reactions can ease.

Why point choice, depth, intensity and frequency affect outcomes?

Acupuncture is not merely hit the point, and it works, because different stimulation patterns can preferentially recruit different nerve fibres, central integration routes and autonomic output channels.

Deeper needling more readily engages deep fascia and related neural networks, and may favour more systemic regulation. Shallower needling may favour local reflexes and shifts in the local immune micro-environment.

Electroacupuncture settings (intensity, frequency, duration) can change neural coding patterns, which can alter which pathway is engaged and what immune effect follows.

This also helps explain clinical observations such as: the same diagnosis may require different needling strategies in different people; and the same point may produce different effects with different techniques.

Tian, J., Wan, H., & Liu, S. (2025). Zhen ci xiao ying yu shen jing mian yi tiao kong—“Zhi bing qiu ben” de tu po [Acupuncture effects and neuroimmune regulation—A breakthrough in “treating the root cause of disease”]. Zhen Ci Yan Jiu [Acupuncture Research], 50(5), 538–552.