Acupuncture for depression: Decoding neuroimmune crosstalk and targeting anti-inflammatory mechanisms

Depression, a leading global health burden, involves neuroimmune dysregulation and neuroinflammation. As a promising non-pharmacological approach, acupuncture has been supported by numerous studies as an effective intervention for alleviating depression. The antidepressant mechanisms of acupuncture involve a multitarget modulation of neuroimmune crosstalk, such as restoring hypothalamic-pituitary-adrenal (HPA) axis homeostasis, inhibiting microglial and astrocytic activation, regulating autophagy, inhibiting key inflammatory signaling pathways, activating anti-inflammatory pathways via the vagus nerve, and rebalancing gut-brain axis communication by modifying microbiota. Integrating acupuncture with advanced neuromodulation techniques may enhance its effectiveness in treating depression. It needs further study to validate acupuncture as an effective therapeutic strategy in the field of neuroimmunology for depression. This review summarizes evidence elucidating how acupuncture regulates neuroimmune crosstalk in depression. It not only provides a scientific basis for its application but also advances the understanding of the pathophysiology of depression by highlighting the interplay between neuroimmune interaction and inflammatory pathways.