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Acupuncture Inhibits Ferroptosis to Attenuate Cerebral Ischemia-Reperfusion Injury Through FTO-Mediated m6A Modification of ACSL4.

Applied biochemistry and biotechnology·March 2026·Xinyu Liu, Zheng Huang, Qianqian Liu et al.
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Key Finding

Xingnao Kaiqiao acupuncture significantly reduced cerebral ischemia-reperfusion injury by upregulating FTO expression, which decreased m6A methylation of ACSL4 and subsequently inhibited ferroptosis-mediated brain cell death.

What This Means For You

Researchers have discovered new insights into how acupuncture may help stroke patients recover from brain damage. This study focused on a specific acupuncture protocol called Xingnao Kaiqiao (XNKQ), which is commonly used in traditional Chinese medicine for stroke treatment.

The research team created a laboratory model of stroke in rats by temporarily blocking blood flow to the brain, then restoring it—a situation called ischemia-reperfusion injury that mimics what happens during human stroke. They compared rats receiving XNKQ acupuncture to those receiving needle insertion at non-acupuncture points.

The results showed that proper acupuncture treatment significantly improved neurological function and reduced the size of brain damage. The researchers discovered that acupuncture works by preventing a specific type of cell death called ferroptosis, which involves iron buildup and oxidative damage in brain cells. Specifically, acupuncture increased levels of a protein called FTO, which then reduced harmful modifications to another protein (ACSL4) that triggers this damaging process.

This study is important because it provides biological evidence for how acupuncture may protect the brain after stroke. The findings suggest that acupuncture doesn't just provide symptom relief—it may actually influence the molecular processes that determine how much brain damage occurs after stroke. While this research was conducted in animals and needs confirmation in human studies, it supports the traditional use of acupuncture as part of comprehensive stroke rehabilitation programs.

If you're considering acupuncture for stroke recovery, consult with a licensed acupuncturist experienced in neurological conditions.

Clinical Notes for Practitioners

This study investigated Xingnao Kaiqiao (XNKQ) acupuncture's mechanisms in cerebral ischemia-reperfusion injury using a rat middle cerebral artery occlusion model. Researchers compared XNKQ acupuncture versus non-acupoint needling, evaluating outcomes through neurobehavioral scoring, TTC staining, Western blot, RT-qPCR, and MeRIP techniques. Results demonstrated that XNKQ acupuncture significantly improved neurological function and reduced infarct volume. Mechanistically, acupuncture inhibited ferroptosis by upregulating FTO expression, which decreased m6A methylation of ACSL4 mRNA, subsequently reducing ACSL4 protein levels and ferroptosis markers (MDA and Fe2+). FTO overexpression and knockdown experiments confirmed this pathway. The study provides molecular evidence that acupuncture's neuroprotective effects operate through epigenetic regulation—specifically FTO-mediated m6A modification—leading to ferroptosis inhibition. Clinical implications suggest XNKQ acupuncture may offer neuroprotection in acute and subacute stroke phases through mechanisms beyond traditional neurovascular explanations, warranting further investigation in human trials.

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