# Novel insights of acupuncture in ischemic stroke: orchestrating neuro-endocrine-immune network

## TL;DR

This paper explores how acupuncture helps in ischemic stroke recovery by regulating the neuro-endocrine-immune network through specific pathways.

## Contribution

The paper provides new insights into acupuncture's mechanisms in ischemic stroke by highlighting its modulation of the cholinergic anti-inflammatory pathway and brain-gut axis.

## Key findings

- Acupuncture regulates neural signaling, hormonal homeostasis, and inflammatory responses after ischemic stroke.
- The cholinergic anti-inflammatory pathway and brain-gut axis are key mechanisms through which acupuncture modulates the neuro-endocrine-immune network.
- Acupuncture's multi-system synergistic effects contribute to improved neurological outcomes in ischemic stroke.

## Abstract

Ischemic stroke (IS) is a major public health challenge with high rates of mortality and disability. Its pathophysiology is complex and multifactorial. Although the pathogenesis of IS originates from local cerebral ischemia, it progresses to a systemic disorder involving dysfunction of the neuro-endocrine-immune (NEI) network. Acupuncture, a non-pharmaceutical therapy characterized by holistic regulation, holds considerable potential for correcting multi-system imbalances after IS. Nevertheless, how acupuncture coordinates this multi-system network remains poorly understood. This review synthesizes current evidence on the cellular and molecular mechanisms underlying acupuncture’s regulation of neural signaling, hormonal homeostasis, and inflammatory responses following IS. Notably, we clarify how acupuncture modulates the NEI network via the cholinergic anti-inflammatory pathway and the brain-gut axis, emphasizing its multi-system synergistic effects. In addition, we analyze the main challenges in this field and look forward to the prospects. This comprehensive perspective provides new insights into the mechanism of acupuncture for IS, signifying a transition from empirical treatment to precision medicine.

Created in BioRender. Zhou, X. (2026) https://BioRender.com/rndrzne.Illustration showing how acupuncture promotes recovery after ischemic stroke by modulating the neuro-endocrine-immune network. The key mechanisms involve the regulation of neural signaling, hormonal homeostasis, and inflammatory responses. Specifically, it highlights the modulation of the cholinergic anti-inflammatory pathway and the brain-gut axis, emphasizing the multi-system synergistic effects that contribute to improved neurological outcomes.

Created in BioRender. Zhou, X. (2026) https://BioRender.com/rndrzne.