Acupuncture's Multisystem Neuroimmunomodulation: Central–Peripheral Interactions in Gastroenteric, Psychiatric, and Chronic Pain Disorders

BACKGROUND: Acupuncture, an ancient therapeutic modality rooted in traditional Chinese medicine, has evolved into a globally recognized intervention. Mounting evidence indicates that modulation of central-peripheral interactions constitutes a key pathophysiological mechanism underlying its efficacy. This review examines how acupuncture bridges neural, immune, and endocrine systems through these dynamic interactions to address complex modern diseases. METHODS: We integrate cutting-edge advances from neuroimaging and mechanistic studies to elucidate acupuncture's mechanisms targeting central-peripheral crosstalk. Three paradigmatic conditions-functional gastrointestinal disorders, psychiatric disorders, and chronic pain-are employed to dissect its systemic effects. RESULTS: Acupuncture consistently demonstrates therapeutic benefits across paradigms through multisystem modulation. Core mechanisms include: neural circuitry dynamics (brain-gut/sensory axis regulation), neuro-immune-endocrine integration (cytokine-HPA-glial signaling), and humoral network modulation (hormone/metabolite-mediated cross-talk). These actions remodel complex pathophysiological networks, translating into improved clinical outcomes. CONCLUSIONS: Acupuncture emerges as an integrative therapy with a robust scientific foundation in systems biology. Future research leveraging omics and neuroimaging should focus on developing precision protocols targeting individual genetic, epigenetic, and connectomic profiles. This evolution holds significant promise for advancing integrative neurology and expanding the application of acupuncture against complex diseases.