Fig. 3

Role of neuroendocrine-immune network regulating macrophage polarization in mediating the anti-inflammatory effects of acupuncture. Acupuncture-induced electrical and biochemical signals within acupoints are transmitted to the central nervous system including spinal cord and brain. Both the hypothalamus–pituitary–adrenal axis and the autonomic nervous system (parasympathetic nerve and sympathetic nerve) are activated, and then glucocorticoids are secreted from adrenal gland and T cell polarization are regulated. Finally, the pro-inflammatory M1 phenotype macrophages in inflammatory organs or tissues are shifted into anti-inflammatory M2 phenotypes, and acupuncture pose anti-inflammation effect