Key Finding
TCM bioactive compounds regulate metabolic enzymes and pathways to promote microglial M2 polarization, reducing neuroinflammation and improving outcomes in neurological diseases through metabolism-immunity dual-target mechanisms.
Researchers have discovered promising new evidence about how traditional Chinese medicine (TCM) and acupuncture may help treat brain diseases by affecting special immune cells in the brain called microglia. When the brain is injured or diseased, microglia can become overactive and cause harmful inflammation. This study reviewed scientific research from 2010 to 2025 to understand how TCM herbs and acupuncture might help calm this inflammation.
The researchers found that TCM herbal compounds work by changing how microglia process energy. These cells can exist in different states - an inflammatory "M1" state that damages brain tissue, or a healing "M2" state that protects the brain. TCM medicines appear to shift microglia toward the protective M2 state by regulating metabolic enzymes and energy pathways inside these cells. This reduces harmful brain inflammation and may improve outcomes in conditions like Alzheimer's disease and depression.
While the evidence for acupuncture's direct effects on microglial metabolism is still indirect, the review suggests acupuncture may also influence these metabolic pathways, supporting brain health through similar mechanisms. This research is important because it explains how TCM works at the cellular level, targeting both metabolism and immune function simultaneously - something single-target pharmaceutical drugs cannot easily achieve.
For patients considering acupuncture for neurological conditions, these findings suggest it may offer complementary benefits alongside conventional treatments, though more research is needed to fully understand acupuncture's specific mechanisms. If you're interested in trying acupuncture for a neurological condition, seek a licensed acupuncturist with appropriate training and credentials.
This systematic review analyzed literature from PubMed, Web of Science, Sinomed, and CNKI (January 2010-December 2025) examining TCM and acupuncture's effects on microglial metabolic reprogramming in neurological diseases. The review focused on direct mechanistic studies of TCM bioactive compounds on microglial energy metabolism and indirect evidence from acupuncture's effects on brain and astrocyte metabolism. Key findings demonstrate that TCM compounds regulate metabolic enzymes and pathways (glucose, lipid, and amino acid metabolism), correcting microglial metabolic disturbances and promoting M2 anti-inflammatory polarization. This metabolic reprogramming reduces neuroinflammation and improves clinical outcomes in conditions including Alzheimer's disease and depression. Evidence for acupuncture's direct effects on microglial metabolism remains indirect. Clinical takeaway: TCM offers a multi-targeted metabolism-immunity intervention strategy for neurological diseases through microglial metabolic homeostasis restoration. This mechanistic understanding supports TCM's integration as complementary therapy, though specific sample sizes and effect sizes were not provided in this review article. Further research is warranted to elucidate acupuncture's specific microglial mechanisms.
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