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 anti-inflammatory pathways. The analgesic effect of acupuncture involves both peripheral and central anti-nociceptive 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.