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Acupuncture promotes microglial transition from pro-inflammatory glycolysis to anti-inflammatory oxidative phosphorylation metabolismAcupuncture May Tame Brain Inflammation by Changing Energy Use

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Key Takeaway
Note that acupuncture may promote an anti-inflammatory microglial phenotype by reprogramming glucose metabolism enzymes.

This systematic review examines the role of acupuncture in modulating neuroinflammation through metabolic immune pathways. The scope focuses on how acupuncture influences microglial glucose metabolism, specifically targeting the transition between pro-inflammatory and anti-inflammatory states.

The authors synthesize evidence suggesting that acupuncture promotes a shift from glycolysis-dependent pro-inflammatory states to oxidative phosphorylation-dominated anti-inflammatory states. Specifically, the review indicates that acupuncture regulates glucose transporter expression and restores the activity and nuclear translocation of hexokinase 2 and pyruvate kinase M2. These metabolic shifts are linked to several secondary pathways including AMPK signaling, mTOR signaling, and hypoxia inducible factor 1 alpha signaling.

While these findings provide a theoretical basis for acupuncture-mediated alleviation of neuroinflammation via metabolic immune pathways, the review does not quantify clinical efficacy for specific CNS disorders. The evidence is currently focused on mechanisms rather than clinical outcomes. Further research is needed to translate these metabolic observations into standardized clinical protocols.

How this fits prior evidence

This systematic review addresses a gap in understanding the mechanism of acupuncture in neuroinflammation by focusing on microglial metabolism. It complements existing knowledge regarding other potential anti-neuroinflammatory agents, such as luteolin which modulates microglial activation, and emerging pathways like lysine lactylation which links metabolism to neuroinflammation via chromatin modification.

A new review of existing research suggests acupuncture might help reduce brain inflammation by changing how immune cells use energy. The review looked at studies on microglia, the brain's main immune cells. When these cells are overactive, they can cause harmful inflammation linked to conditions like Alzheimer's and Parkinson's.

The review found that acupuncture appears to promote a shift in microglia from a pro-inflammatory state that relies on glycolysis to an anti-inflammatory state that uses oxidative phosphorylation. This change is associated with regulation of key enzymes involved in glucose metabolism, including glucose transporters, hexokinase 2, and pyruvate kinase M2.

It is important to note that this is a review of mechanisms, not a clinical trial. The review did not report on specific patient outcomes, sample sizes, or safety data. The findings provide a theoretical basis for how acupuncture might work, but they do not prove that acupuncture is an effective treatment for any specific brain disorder.

Readers should understand that this research is early and exploratory. While the mechanism is promising, more rigorous clinical studies are needed to determine if acupuncture can actually help people with neuroinflammatory conditions. Always talk to your doctor before starting any new treatment.

What this means for you:
Acupuncture may reduce brain inflammation by altering microglial energy use, but clinical proof is lacking.

Common questions

What is neuroinflammation?

Neuroinflammation is inflammation in the brain or spinal cord. It involves immune cells called microglia that can become overactive and damage neurons. It is linked to conditions like Alzheimer's, Parkinson's, and multiple sclerosis.

How might acupuncture reduce neuroinflammation?

The review suggests acupuncture promotes a shift in microglia from a pro-inflammatory state that uses glycolysis to an anti-inflammatory state that uses oxidative phosphorylation. This involves changes in glucose metabolism enzymes.

Is this proof that acupuncture works for brain disorders?

No. This is a review of mechanisms, not a clinical trial. It provides a theoretical basis but does not prove acupuncture is effective for any specific condition. More research is needed.

Are there any side effects of acupuncture for neuroinflammation?

The review did not report any safety data or adverse events. Acupuncture is generally considered safe when performed by a qualified practitioner, but individual risks should be discussed with a doctor.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedJul 2026
View Original Abstract ↓
Neuroinflammation is a common pathological feature shared by various central nervous system disorders. As the intrinsic immune cells of the brain, microglia exhibit activation states and functional phenotypes that are regulated by glucose metabolism reprogramming. Under physiological conditions, microglia primarily rely on oxidative phosphorylation to maintain energy homeostasis and immune surveillance. Upon pathological stimulation, however, microglia undergo metabolic reprogramming toward a pro-inflammatory mode dominated by glycolysis. This shift establishes a positive feedback loop between glycolysis and inflammation, which exacerbates neuronal damage. Acupuncture, as a classic non-pharmacological intervention, can suppress neuroinflammation by modulating microglial glucose metabolism reprogramming through multiple pathways. Recent studies have revealed that acupuncture can regulate glucose transporter expression and restore the activity and nuclear translocation of rate limiting enzymes such as hexokinase 2 and pyruvate kinase M2. It also modulates signaling axes including AMP activated protein kinase, mammalian target of rapamycin, and hypoxia inducible factor 1 alpha. These effects contribute to the phenotypic transition of microglia from a glycolysis dependent pro-inflammatory state to an oxidative phosphorylation dominated anti-inflammatory state. In addition, acupuncture exerts indirect anti-inflammatory effects by improving systemic glucose metabolism, optimizing cerebral blood flow, and regulating neurotransmitter balance, thereby reshaping the energy substrate composition of the brain microenvironment. This review systematically summarizes the important role of microglial glucose metabolism reprogramming in neuroinflammation and explores the potential molecular mechanisms through which acupuncture modulates this process. From a metabolic immune perspective, this work provides a new theoretical basis for acupuncture mediated alleviation of neuroinflammation.
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