Modulating inflammatory cytokines through acupuncture: Evidence from a systematic review.

Abstract

Evidence shows the positive effects of acupuncture on the modulation of cytokines. However, findings are conflicting. The present systematic review aimed to clarify the effects of acupuncture on pro- and anti-inflammatory cytokines in adults. Five databases, including Scopus, PubMed, Web of Science, Embase, and Cochrane Library, were searched without language restrictions until July 1, 2024. Clinical trials that examine the effects of manual acupuncture on at least one of the inflammatory factors (IL-6, TNF-&#x3b1;, or hs-CRP/CRP) in adults, regardless of background disease, were included. Of 12,197 articles, finally 29 were included. All clinical trials examined the effects of acupuncture on both genders aged 21 to 72 years. Duration of the intervention varied between 2 and 12 weeks. The effects of acupuncture on inflammatory and anti-inflammatory parameters were examined on osteoarthritis/ rheumatoid arthritis (<i>n</i>&#x2009;=&#x2009;8), obesity (<i>n</i>&#x2009;=&#x2009;4), allergy (<i>n</i>&#x2009;=&#x2009;4), healthy subjects (<i>n</i>&#x2009;=&#x2009;3), and Crohn's disease (CD) (<i>n</i>&#x2009;=&#x2009;2). For several diseases, only one eligible article was found. Risk of bias assessment revealed concerns in all studies across at least three of the six main domains. Acupuncture as an adjuvant therapy is likely modulate cytokine levels in patients with diverse disease backgrounds. Although the positive effects of this type of therapy were reported in most studies, some showed no or even negative effects on cytokine levels. Overall, due to concerns about a high or unclear risk of bias, the findings must be interpreted with great caution. Further high-quality clinical trials are needed to draw definitive conclusions. The online version contains supplementary material available at https://doi.org/10.1007/s40200-026-02098-w.