Aberrant parasympathetic responses in acupuncture therapy for restoring immune homeostasis

Acupuncture is an effective therapy used worldwide to treat various diseases, including infections, allergic disorders, autoimmune diseases, and immunodeficiency syndromes. Except for the hypothalamic-pituitary-adrenal axis, acupuncture exerts its regulatory effect mainly by producing autonomic reflexes, including somatic-sympathetic and somatic-parasympathetic reflexes. In this review, we discuss the updated progress of the cholinergic vagal efferent pathway, vagal-adrenal axis, local spinal sacral-parasympathetic pathway, and the somatotopic evocation of parasympathetic responses related to restoring immune homeostasis within acupuncture therapy. Targeting the parasympathetic reflex offers scientific instruction for the design of acupuncture protocols for immunological diseases, providing more specialized comprehensive treatment recommendations. Graphical abstract: http://links.lww.com/AHM/A49