Jade Health Acupuncture · Research Insight
Acupuncture, Neuro–Immune Modulation, and Psoriasis
Translating findings from an imiquimod-induced psoriasis-like murine model into an accessible overview of how acupuncture may help regulate inflammation in psoriasis.
Psoriasis is a chronic inflammatory skin disease that can be considered an autoimmune condition. Immune cells – particularly activated T cells – drive excessive keratinocyte proliferation, forming the characteristic erythematous, scaly plaques. Modern research has highlighted the IL-23 / IL-17 cytokine axis as a central pathway in the pathogenesis of psoriasis and an important target for biologic therapies.
In traditional East Asian medicine, acupuncture is understood to have a bidirectional regulatory effect on the body, helping to harmonize immune, endocrine, and metabolic function. A preclinical study using an imiquimod (IMQ)-induced psoriasis-like mouse model explored how three acupuncture-related techniques – acupuncture needling, electroacupuncture, and fire needling – might improve psoriatic skin lesions by influencing local inflammatory responses.
Study Overview: What Did the Researchers Do?
In this animal model, mice were treated with IMQ to induce psoriasis-like lesions on the skin. The researchers then compared:
- Acupuncture needling (manual acupuncture)
- Electroacupuncture
- Fire needling
- Methotrexate (MTX), a conventional systemic drug
- Model group without active treatment
The team examined skin lesions, local inflammatory markers, serum cytokines, and neuropeptide expression to understand how these interventions might influence immune and neurogenic inflammation in psoriasis-like skin.
Key Finding 1 – Modulating the IL-23 / IL-17 Inflammatory Axis
The IL-23 / IL-17 axis is now recognized as a core inflammatory pathway in psoriasis. In the IMQ model, inflammatory cytokines such as IL-17A, IL-1β, and IL-23p40 were elevated in the affected skin. After treatment, the study found that:
- All three acupuncture techniques (acupuncture, electroacupuncture, and fire needling) significantly reduced IL-17A, IL-1β, and IL-23p40 in the local skin.
- Electroacupuncture and fire needling showed a relatively stronger ability to suppress IL-1β compared with manual acupuncture and MTX.
- Methotrexate (MTX) showed the most pronounced inhibition of IL-17 in the local skin.
When the researchers looked at serum (blood) samples, they observed that:
- IL-23p40 decreased in the fire needling group.
- IL-22 levels decreased in the acupuncture, electroacupuncture, and fire needling groups.
These changes support the idea that acupuncture-related techniques can down-regulate proinflammatory cytokines associated with psoriasis, potentially contributing to the visible improvement of skin lesions.
Key Finding 2 – Neurogenic Inflammation and Neuropeptides (SP, NKA)
Beyond immune cells, a growing body of evidence suggests that neurogenic inflammation plays an important role in psoriasis. Neuropeptides such as Substance P (SP) and Neurokinin A (NKA), mainly released by dermal sensory nerves, can interact with inflammatory cytokines and amplify skin inflammation.
In this study:
- IMQ-induced psoriasis-like lesions showed elevated levels of SP and NKA in the skin.
- Acupuncture needling and electroacupuncture reduced the expression of NKA, which was associated with improved skin inflammation.
- Correlation analysis revealed that NKA levels were positively correlated with IL-1β and IL-23p40 in the model group.
These findings suggest a link between neuropeptide activity and immune inflammation in psoriatic skin, and they hint that acupuncture may exert part of its effect by modulating neurogenic inflammation – not only the immune system itself.
Key Finding 3 – A Possible Effect on Angiogenesis (VEGFA)
The researchers also examined vascular endothelial growth factor A (VEGFA), a molecule involved in blood vessel formation, which can be upregulated in inflamed skin. Electroacupuncture showed a tendency toward decreasing VEGFA expression in the skin, although the difference did not reach statistical significance. This suggests a possible, but as yet unconfirmed, influence of acupuncture on angiogenesis in psoriasis.
What Does This Mean for Clinical Practice?
While this study was performed in a murine (mouse) model and not in human patients, it offers several valuable insights:
- Acupuncture needling, electroacupuncture, and fire needling all improved psoriasis-like skin lesions induced by IMQ.
- Electroacupuncture, in particular, appeared relatively more effective in reducing local inflammatory responses.
- The mechanisms likely involve both immune modulation (lowering IL-17A, IL-1β, IL-23p40, IL-22) and neuropeptide regulation (reducing NKA and its association with inflammatory cytokines).
For patients and clinicians, these findings support a view of acupuncture as a potential complementary approach in psoriasis management, aimed at calming overactive neuro–immune signaling. Future clinical studies in humans will be essential to confirm how these mechanisms translate into real-world symptom relief, quality of life, and long-term outcomes.
Wang Y, Fu Y, Zhang L, et al. Acupuncture Needling, Electroacupuncture, and Fire Needling Improve Imiquimod-Induced Psoriasis-Like Skin Lesions through Reducing Local Inflammatory Responses. Evidence-Based Complementary and Alternative Medicine. 2019.
Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6699296/
Jade Health Acupuncture · 研究整理
銀屑病的神經免疫調節：針灸可能如何參與？
以 IMQ 誘發銀屑病樣小鼠模型為例，整理針灸、電針與火針在調控發炎反應上的可能機轉。
銀屑病（psoriasis）是一種慢性發炎性皮膚疾病，也常被視為 自體免疫疾病。在免疫學觀點中，銀屑病的關鍵機制包含 T 細胞的活化與角質細胞過度增生，並與 IL-23／IL-17 發炎軸密切相關。這條發炎路徑同時也是許多 生物製劑的主要治療靶點。
傳統醫學中，針灸被認為具有雙向調節作用，可以協調免疫、內分泌與代謝。 這篇以IMQ（imiquimod）誘發的銀屑病樣小鼠模型為基礎的研究， 便試圖從現代免疫與神經科學角度，觀察三種針刺相關技術： 傳統針刺、電針與火針，如何透過調控局部發炎反應，改善皮膚病灶。
研究設計：在小鼠身上模擬銀屑病
研究團隊以 IMQ 在小鼠背部誘發銀屑病樣皮膚病灶，之後分別給予：
- 傳統針刺（manual acupuncture）
- 電針（electroacupuncture）
- 火針（fire needling）
- 甲氨蝶呤（MTX，常見系統性用藥）
- 單純 IMQ 模型組（未接受有效治療）
研究者觀察皮膚外觀、組織病理變化，並測量皮膚與血清中的多種 發炎細胞激素與神經肽，以了解不同治療方式 對免疫發炎與神經性發炎的影響。
重點一：調控 IL-23／IL-17 發炎軸
在 IMQ 誘發的銀屑病樣皮膚中， IL-17A、IL-1β、IL-23p40 等發炎細胞激素明顯升高。 介入治療後，研究結果顯示：
- 三種針刺技術（傳統針刺、電針、火針）皆可顯著 降低皮膚中 IL-17A、IL-1β、IL-23p40 的表達。
- 電針與火針在抑制IL-1β方面的效果較為突出。
- 甲氨蝶呤（MTX）則在抑制IL-17上最為明顯。
在血清（全身循環）方面：
- 火針可降低血清中IL-23p40。
- 傳統針刺、電針與火針皆可降低IL-22。
這些變化說明，針灸相關技術確實能在動物模型中 下調與銀屑病相關的發炎細胞激素，與皮膚外觀的改善相互呼應。
重點二：神經性發炎與神經肽（Substance P、NKA）
近年愈來愈多研究指出，銀屑病不僅是免疫系統的問題， 神經性發炎（neurogenic inflammation）也深度參與其中。 其中，Substance P（SP） 與 Neurokinin A（NKA） 是由皮膚感覺神經末梢釋放的重要神經肽， 能與多種發炎細胞激素互相影響。
在這篇研究中可以看到：
- IMQ 模型組的皮膚中，SP 與 NKA 表達量明顯升高。
- 傳統針刺與電針可降低NKA的表達， 並與皮膚發炎狀況的改善相對應。
- 統計相關分析顯示，NKA 的表達量與 IL-1β、IL-23p40 呈正相關。
這意味著局部皮膚的神經肽變化與免疫發炎程度彼此連動， 也提示針灸的部分作用，可能是透過 調節神經性發炎來間接降低免疫發炎。
重點三：對血管新生標誌物 VEGFA 的可能影響
研究同時觀察了與血管新生有關的 血管內皮生長因子 A（VEGFA）。結果顯示， 電針在降低 VEGFA 表達上有趨勢，但尚未達到統計顯著。 這代表針灸可能對血管新生亦有一定影響，但仍需要更多研究來釐清。
對臨床與患者的啟示
雖然這是一項動物實驗，尚不能直接等同於人類臨床結果， 但它提供了幾個重要訊息：
- 傳統針刺、電針與火針皆能在 IMQ 小鼠模型中 改善銀屑病樣皮膚病灶。
- 電針在降低局部發炎反應與神經肽 NKA方面表現相對更佳。
- 作用機制可能同時涉及免疫發炎調控 （降低 IL-17A、IL-1β、IL-23p40、IL-22） 以及神經肽調節（降低 NKA 並減弱其與發炎因子的聯動）。
對臨床而言，這些結果並非要取代現有皮膚科治療， 而是提供一個科學基礎，支持「針灸可作為銀屑病照護中的 輔助療法」，從神經與免疫兩個層面協助穩定發炎反應。 未來仍需要更多高品質的人體臨床試驗來確認：對於搔癢程度、皮損範圍、 生活品質與復發率等面向，針灸能帶來多大、多久期的實際幫助。
Wang Y, Fu Y, Zhang L, et al. Acupuncture Needling, Electroacupuncture, and Fire Needling Improve Imiquimod-Induced Psoriasis-Like Skin Lesions through Reducing Local Inflammatory Responses. Evidence-Based Complementary and Alternative Medicine. 2019。
線上全文： https://pmc.ncbi.nlm.nih.gov/articles/PMC6699296/
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