Mechanistic Effects of Acupuncture on Stem Cells

 Tiejun Tang

Stem cell therapy is a rapidly developing field in regenerative medicine. By harnessing the self-renewal and multi-lineage differentiation capacities of stem cells, this approach aims to repair or replace damaged cells, tissues, and organs, ultimately restoring physiological function. Although stem cell–based treatments have demonstrated promising therapeutic potential across a wide range of diseases, their clinical application remains limited by high costs, technical complexity, and safety concerns.

In recent years, increasing attention has been directed toward the effects of acupuncture on stem cell activity. Rather than relying on exogenous stem cell transplantation, acupuncture appears to regulate endogenous stem cells, thereby promoting tissue repair and functional recovery. Accumulating experimental and clinical evidence suggests that acupuncture can influence stem cell mobilization, proliferation, differentiation, homing, and survival through integrated neural, immune, endocrine, and microenvironmental mechanisms ^[1]

This article reviews current research on the mechanisms by which acupuncture modulates stem cell behavior, while also exploring these findings through the lens of traditional Chinese medicine (TCM). Methodological challenges, limitations, and future directions for research and clinical translation are also discussed.

Introduction

Stem cells play a central role in tissue regeneration and physiological homeostasis due to their capacity for self-renewal and differentiation into multiple cell lineages. Modern regenerative medicine has increasingly shifted its focus from exogenous stem cell transplantation toward strategies that activate and regulate endogenous stem cells ^[2].

Acupuncture, a core therapeutic modality of traditional Chinese medicine, has been widely used to treat disorders of the nervous, cardiovascular, musculoskeletal, and reproductive systems, many of which involve tissue injury and repair ^[3]. Growing evidence indicates that acupuncture can modulate stem cell behavior at both local and systemic levels. Unlike pharmacological or genetic interventions, acupuncture acts through biophysical stimulation, activating neurovascular, immune, and endocrine networks, thereby optimizing the stem cell microenvironment and enhancing intrinsic regenerative capacity ^[1].

Types of Stem Cells Influenced by Acupuncture

1. Mesenchymal Stem Cells (MSCs)

Mesenchymal stem cells derived from bone marrow, adipose tissue, and other mesenchymal sources are the most extensively studied stem cells in acupuncture research. Experimental studies demonstrate that acupuncture can increase MSC proliferation, enhance paracrine activity, and promote differentiation toward osteogenic, chondrogenic, angiogenic, and neurotrophic lineages ^[1,4].

2. Neural Stem/Progenitor Cells (NSCs)

In models of stroke, spinal cord injury, and neurodegenerative disease, acupuncture has been shown to activate endogenous neural stem or progenitor cells, particularly in the subventricular zone and hippocampal dentate gyrus. These effects are associated with enhanced neurogenesis, synaptic plasticity, and improved neurological function ^[5,6].

3. Hematopoietic Stem Cells (HSCs) and Endothelial Progenitor Cells (EPCs)

Acupuncture may facilitate the mobilization of hematopoietic stem cells and endothelial progenitor cells from the bone marrow into peripheral circulation, contributing to immune regulation, angiogenesis, and tissue repair ^[1,7].

Mechanisms by Which Acupuncture Modulates Stem Cells

1. Increasing Stem Cell Numbers

Both animal experiments and clinical studies indicate that acupuncture can significantly increase the number of circulating stem and progenitor cells. Electroacupuncture has been shown to elevate mesenchymal stem cell counts in peripheral blood, accompanied by increased levels of stromal cell-derived factor-1α (SDF-1α), which promotes stem cell migration and mobilization ^[4].

Acupuncture can also activate endogenous neural stem cells. When combined with stem cell transplantation, electroacupuncture demonstrates a synergistic effect, outperforming cell transplantation alone. This combined therapy enhances neurotrophic factor expression, promotes angiogenesis, inhibits apoptosis, and improves neurological recovery in cerebral ischemia models ^[5].

2. Improving the Survival of Transplanted Stem Cells

Both acupuncture and stem cell transplantation independently improve functional recovery after ischemic stroke. When used together, they significantly enhance the survival rate, homing efficiency, and functional differentiation of transplanted stem cells.

Transplanted stem cells primarily exert neuroprotective effects through paracrine signaling and immune regulation. Acupuncture, by contrast, improves the internal environment by stimulating endogenous neurogenesis, increasing cerebral blood flow, and upregulating anti-inflammatory cytokines such as interleukin-10 (IL-10) and transforming growth factor-β (TGF-β) ^[5].

3. Promoting Stem Cell Differentiation

In rat models of traumatic brain injury, acupuncture significantly increased the expression of nestin, neurofilament protein (NF-200), and glial fibrillary acidic protein (GFAP). These markers indicate enhanced proliferation and differentiation of neural stem cells into neurons and astrocytes, supporting functional neural repair ^[6].

4. Enhancing Stem Cell Homing and Tissue Repair

Stem cell factor (SCF) plays a critical role in guiding stem cells to injured tissues. Studies of myocardial infarction demonstrate that electroacupuncture significantly increases SCF levels in both peripheral blood and myocardial tissue, promoting stem cell migration to ischemic regions and supporting myocardial regeneration. Early post-infarction acupuncture appears particularly effective in mobilizing endogenous stem cells and improving prognosis ^[7].

5. Regulating the Stem Cell Microenvironment

A key mechanism underlying the synergy between acupuncture and mesenchymal stem cell therapy is the regulation of the stem cell microenvironment. Acupuncture enhances growth factor secretion, upregulates SDF-1 expression in damaged tissues, and suppresses inflammatory signaling pathways. Both electroacupuncture and MSC therapy independently reduce NF-κB activation and decrease levels of inflammatory mediators such as IL-6 and TNF-α, creating conditions favorable for stem cell survival and tissue repair ^[8].

Discussion:

From a traditional Chinese medicine perspective, stem cell activity may correspond to the concept of kidney essence (肾精), which governs growth, development, and regeneration ^[9]. Acupuncture’s regulation of qi and blood aligns with modern concepts of energy metabolism, circulation, and cellular signaling, providing a conceptual bridge between traditional theory and contemporary stem cell biology.

Although current research employs in vivo injury models, in vitro stem cell culture with acupuncture-treated serum, and multi-omics approaches, challenges remain in acupoint specificity, dose–response relationships, and long-term stem cell tracking. Future studies should focus on standardized protocols, rigorous clinical trials, and integrative treatment strategies. As a low-risk and cost-effective intervention, acupuncture holds considerable promise for enhancing endogenous regeneration and supporting stem cell–based therapies.

References

1. Hongyan Gao, Weijun Ding. Effect and mechanism of acupuncture on endogenous and exogenous stem cells in disease treatment: A therapeutic review.Life Sciences.Volume 331, 15 October 2023, 122031.
2. Ziwei Jiang et al. Bioactive Materials That Promote the Homing of Endogenous Mesenchymal Stem Cells to Improve Wound Healing. Int J Nanomedicine. 2024 Jul 30;19:7751–7773.
3. Xiaoer Liu et al. Acupuncture accelerates wound healing via CGRP-RAMP1-TSP1-mediated macrophage M2 polarization. Chin Med. 2025 Nov 18;20:192.
4. Lizhen Liu et al. Electro-Acupuncture Promotes Endogenous Multipotential Mesenchymal Stem Cell Mobilization into the Peripheral Blood. Cellular Physiology and Biochemistry (2016) 38 (4): 1605–1617.
5. Huidong Jia et al.Combination of stem cell therapy and acupuncture to treat ischemic stroke: a prospective review. Stem Cell Res Ther. 2022 Mar 3;13:87
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7. Yuan C. Y. et al. Comparative Study on Effects of Electroacupuncture at Different Time Points on Myocardial Protection and Stem Cell Factor Expression in Rats With Myocardial Infarction, Chinese Journal of Information on Traditional Chinese Medicine. 2021; 28 (10) 70–74.
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9. Yan-Bo Ren et al. Shen-Jing as a Chinese Medicine Concept Might Be a Counterpart of Stem Cells in Regenerative Medicine. Chin J Integr Med. 2019 Jan;25(1):64-70.