Acupuncture alleviates the progression of lumbar disc herniation by regulating the autophagy level of nucleus pulposus cells through the SIRT1/Sestrin2 pathway.

Researchers investigated how acupuncture helps treat lumbar disc herniation (LDH), a common cause of lower back pain that increasingly affects younger people. Using rat models and human cell samples, scientists explored the biological mechanisms behind acupuncture's therapeutic effects on damaged spinal discs.

The study created LDH conditions in laboratory rats through nucleus pulposus transplantation and treated human disc cells with a substance that mimics degenerative damage. Researchers then applied acupuncture treatment and measured various biological markers to understand how it works at the cellular level.

Results showed that acupuncture treatment improved the health of spinal disc tissue through multiple pathways. Specifically, it activated a process called autophagy—the body's natural cellular cleaning system—which helps remove damaged components and maintain healthy cells. Acupuncture increased beneficial proteins like Collagen II (important for disc structure) and Bcl-2 (which protects cells), while decreasing harmful proteins associated with cell death.

The mechanism involves two key proteins: SIRT1 and Sestrin2. The research found these proteins are low in people with disc herniation. Acupuncture works by increasing SIRT1, which then protects and increases Sestrin2 levels, ultimately activating the autophagy pathway that keeps disc cells healthy and prevents further degeneration.

For patients with lumbar disc herniation, this research provides scientific evidence supporting acupuncture as a conservative treatment option. The study demonstrates that acupuncture doesn't just relieve symptoms—it may actually influence the biological processes that cause disc degeneration, potentially slowing disease progression. If considering acupuncture for back pain, seek treatment from a licensed acupuncturist with experience treating spinal conditions.

This preclinical study elucidates the molecular mechanism by which acupuncture alleviates lumbar disc herniation (LDH) progression. Researchers established an LDH rat model via autologous nucleus pulposus transplantation and an in vitro model using human NP cells treated with 50 μM TBHP for 24 hours. Outcomes were assessed through CCK-8 assay, flow cytometry, histological staining (H&E, Safranin O-Fast Green), and western blotting.

Acupuncture treatment upregulated Collagen II, Bcl-2, LC3II/I ratio, and Beclin1, while downregulating Bax, Cleaved Caspase-3, and p62, indicating enhanced autophagy and reduced apoptosis in NP tissue. The study identified SIRT1 and Sestrin2 as critical mediators, both expressed at low levels in LDH. Mechanistically, acupuncture upregulates SIRT1, which inhibits MDM2-mediated ubiquitination of Sestrin2, thereby stabilizing Sestrin2 expression and activating autophagy.

Clinical relevance: This research provides molecular evidence supporting acupuncture's disease-modifying potential in LDH through autophagy activation via the SIRT1/Sestrin2 pathway, suggesting therapeutic benefit beyond symptomatic relief for disc degeneration patients.