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How does acupuncture regulate our immune response?

Updated: Jun 20, 2020

Before we look at the scientific research on how acupuncture modulates immune system, let's briefly review immune response basics.

First, it is important to realize that coming to contact with numerous bacteria and viruses is part of our everyday life. Although mostly we associate viruses with causing diseases, such as hepatitis or HIV, and bacteria with bacterial infections, such as sinusitis, E. Coli, Strep or Staph, there are many more viruses and bacteria that are not interested in human cells at all. In fact, these types of viruses and bacteria make up our microbiome and alone or together with our army of white blood cells, they constantly ward off pathogens and help us maintain good health.

Second, our ability to fight pathogens lies within the white blood cells (WBCs) that live in the blood and in the lymph. WBCs provide us with innate immunity (non-specific) through various cell types such as phagocytes, neutrophils, macrophages and natural killer cells that have special characteristics and way to destroy the pathogens. In addition, WBCs also provide us with adaptive immunity (specific) through communication of dendritic cells with T- and B-lymphocytes. Dendritic cells link our innate and adaptive immune response by eating pathogens and sharing information about them with T- and B-lymphocytes so that they can identify and destroy specific pathogens. Keeping these basic concepts in mind, now one can imagine how important it is to keep strengthening one's innate immunity by living a healthy lifestyle and simultaneously, training one's adaptive immune response by exposing oneself to various environments.

Unlike drugs that either have a stimulating or inhibiting effect, acupuncture can do both. It can enhance innate immunity and also modulate adaptive immunity. Let's examine these specific mechanisms.

1. Acupuncture is effective in treating certain aspects of infectious diseases and in preventing infections via its effect on phagocytosis and increased production of antibodies.

For example, research by the Beijing Medical School has demonstrated that when LI-4 and ST-36 acupoints are needled on a healthy individual phagocytosis of Staphylococcus Auerus bacteria by white blood cell (WBC) count increased 1 to 2 times with the highest increase 24 hours after needling. Another research conducted by the Shenxi Province Traditional Medicine Research Institute found that the bactericidal capability of WBCs increased to its highest 3 to 6 hours after acupuncture and remained above normal values even 48 hours later. However, this type of immune response can be further enhanced by combining acupuncture with preventative injections such as vaccines. The Jilin Medical College found that when they injected cholera/typhoid/paratyphoid AB vaccine at acupoint ST-36, the rate at which the bacteria lysed in the acupuncture-vaccinated group was significantly higher and the duration of the effect was longer than that of the control group. (1)

2. Acupuncture enhances natural killer (NK) cells activity.

NK cells provide body's primary defense against pathogens and are important for our innate immune response. Dr. Hisamitsu's group showed that electro-acupuncture (EA) at ST-36 acupoint once a day for 3 days increased splenic NK cell activity by increasing levels of IFN-γ and that β-endorphin secretion caused by EA plays an important role in this process. (2)

3. Acupuncture regulates T-helper 1 and T-helper 2 cell (Th1/Th2) balance.

Naïve CD4+ T cells can be divided into Th1 and Th2 cells. Th1 cells are primarily responsible for cell-mediated immunity while Th2 cells are mainly involved in humoral immunity. The imbalance of Th1/Th2 cell responses could be a main cause of infectious, allergic and autoimmune diseases. Acupuncture can regulate T-cell activity by suppressing overwhelmed stimulation of T-helper cells to prevent progression of allergic and autoimmune disease. Several studies indicated that EA is effective for asthma chronic urticaria and allergic rhinitis. (3) Additionally, there have been clinical reports that showed positive effect of acupuncture on rheumatoid arthritis, a Th1 dominant disorder, by downregulating the levels of IFN-γ and TNF-α and thus preventing destruction of joint. (4).

4. Acupuncture activates neural-immune interactions.

A number of brain imaging studies have shown that EA treatment activates the hypothalamus, which is primary center for neuroendocrine-immune modulation and regulates activities of autonomic nervous system. (5) Kasahara et al. (1993) already suggested that both the central opioid and non-opioid systems might be involved in the suppressive effect of EA stimulation at DU-4 acupoint on delayed-type hypersensitivity.


(1) O'Connor, J. & Bensky, D. (1981). Chapter 10, A summary of research concerning the effects of acupuncture. Acupuncture. Seattle, USA. Eastland Press.

(2) Hisamitsu, T., Kasahara, T., Umezawa, T., Ishino, T. & Hisamitsu, T. (2002). The effect of acupuncture on natural killer cell activity. Int. Cong. Ser. 1238, 125–131.

(3) Woodfolk, J.A. (2006). Cytokines as a therapeutic target for allergic diseases: a complex picture. Current Pharmaceutical Design 12, 2349–2363.

(4) Yim, Y.K., Lee, H., Hong, K.E., Kim, Y.I., Lee, B.R. et al. (2007). Electroacupuncture at acupoint ST36 reduces inflammation and regulates immune activity in collagen-induced arthritic mice. Evidence-Based Complementary and Alternative Medicine 4, 51–57.

(5) Napadow, V., Kettner, N., Liu, J., Li, M., Kwong, K.K. et al. (2007). Hypothalamus and amygdala response to acupuncture stimuli in Carpal Tunnel Syndrome. Pain 130, 254–266.

(6) Kasahara, T.,Amemiya, M.,Wu, Y. & Oguchi, K. (1993). Involvement of central opioidergic and nonopioidergic neuroendocrine systems in the suppressive effect of acupuncture on delayed type hypersensitivity in mice. International Journal of Immunopharmacology 15, 501–508.

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