Acupuncture therapy in autoimmune diseases: A narrative review

We provide a narrative review of experimental and clinical evidence for the effect of acupuncture in autoimmune diseases, based on randomized controlled studies, systematic review and meta-analyses, published between the years 2000-2023. Acupuncture in experimental models of rheumatoid arthritis (RA), multiple sclerosis, psoriasis, ulcerative colitis (UC) downregulated inflammatory cytokine expression, increased IL-10 expression, improved Treg cell differentiation, and also modulated macrophage polarization in RA and UC models. The anti-inflammatory effect of acupuncture in autoimmune disorders has been demonstrated to involve vagal-adrenal and cholinergic antiinflammatory pathways. The analgesic effect of acupuncture involves both peripheral and central antinociceptive mechanisms. Randomized controlled studies support the use of acupuncture in rheumatoid arthritis, fibromyalgia, Crohn's disease and in Sjogren's syndrome. Some evidence indicates that acupuncture may be beneficial as a symptomatic treatment for multiple sclerosis, myasthenia gravis, psoriasis and ankylosing spondylitis.