Perspectives on Integrative Medicine

Review Articles

Role of Acupuncture on the Brain-Gut-Joint Axis in Osteoarthritis: Jae-Hwan Jang, Seok Hee Han, Yurim Song, Ju-Young Oh, Hi-Joon Park; Perspect Integr Med. 2025;4(3):153-163. Published online October 22, 2025; DOI: https://doi.org/10.56986/pim.2025.10.004

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Graphical Abstract Abstract PDF Supplementary Material: Osteoarthritis (OA) is a predominantly degenerative disease with heterogeneous phenotypes, including subsets with low-grade inflammation. Emerging data suggest that the gut microbiota may contribute to OA biology. While noting that definitive, longitudinal links between acupuncture-induced microbiome modulation and joint outcomes are yet to be established clinically, acupuncture has been associated with symptomatic improvement of OA alongside immune and microbiome changes. Within a brain-gut-joint framework, preclinical, and mechanistic studies (N = 13) were assessed in this scoping review. The neuro-immune pathways, such as the vagal–adrenal/splenic, and sympatho–adrenal/splenic axes, when activated by acupuncture, can modulate gut microbial composition. These activated pathways likely involve the vagus nerve (a component of the parasympathetic nervous system) and the sympathetic nerves (which are connected to gastrointestinal-related organs, including the adrenal gland, spleen, and gut). Acupuncture may also activate the neuroendocrine system via the hypothalamic–pituitary–adrenal axis, which regulates stress, thereby releasing hormones that contribute to anti-inflammatory effects. Acupuncture may support the treatment and management of OA via the brain-gut-joint axis. Given that acupuncture is associated with fewer side effects than conventional medications, it represents a promising therapeutic strategy for OA.

Effects of Acupuncture on Cartilage Degradation and Joint Pain in Osteoarthritis: Jae-Hwan Jang, Jaejin Han, Changsu Na, Hi-Joon Park; Perspect Integr Med. 2024;3(3):134-141. Published online October 23, 2024; DOI: https://doi.org/10.56986/pim.2024.10.002

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Osteoarthritis, resulting from joint decline, leads to various symptoms including joint pain, stiffness, tenderness, and local inflammation. These symptoms may be caused by the remodeling of the five structural phenotypes: inflammatory, subchondral bone, meniscal cartilage, atrophic, and hypertrophic phenotypes. Studies have shown that acupuncture can inhibit cartilage degradation by regulating extracellular matrix-degradation and enzyme synthesis. Notably, the efficacy of acupuncture treatment in osteoarthritis may be attributed to regulated inflammation and apoptosis of chondrocytes, as well as endogenous opioid production, and activation of the endocannabinoid systems (in the central and peripheral nervous systems), to contribute towards cartilage protection and joint pain relief. This review provides a current summary of the mechanisms of action of acupuncture in osteoarthritis, indicating that acupuncture, a therapy with fewer side effects than conventional medications, may be an effective treatment strategy for the management of osteoarthritis.

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Effects of 650 nm laser acupuncture on cartilage, bone, and skeletal muscle in osteoarthritis
Seung-Ho Seo, Sang-Mi Kang, Yang-Hee You, Chang-Su Na
Bone Reports.2025; 26: 101864. CrossRef

Effects of Acupuncture on Neuropathic Pain: Mechanisms in Animal Models: Jae-Hwan Jang, Hi-Joon Park; Perspect Integr Med. 2022;1(1):17-20. Published online September 22, 2022; DOI: https://doi.org/10.56986/pim.2022.09.004

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Neuropathic pain is a chronic condition/disease characterized by mechanical and thermal pain. Neuropathic pain can have various comorbidities such as depression, anxiety disorders and cognitive impairment, and as a result, can have a detrimental effect on quality of life. Pain and comorbid symptoms are often complicated, intertwined, affect each other, and present difficulties in treatment. Therefore, it is necessary to improve both pain and comorbid symptoms to treat neuropathic pain. Acupuncture is effective in treating not only pain but other conditions/diseases such as depression, anxiety, and cognitive impairment. Recently, acupuncture was reported to be effective in improving comorbid symptoms in patients with chronic pain. This review aimed to describe the mechanisms of action of acupuncture on the brain with respect to the improvement of comorbid symptoms that appeared in animal models of chronic neuropathic pain. Comorbidity-pain studies were comprehensively reviewed. Both manual acupuncture and electroacupuncture improved not only mechanical and thermal pain but also comorbid symptoms such as depression, anxiety, and cognitive impairment in patients with chronic neuropathic pain. The results of this review suggest that comorbid symptoms can be improved through various mechanisms, including the dopamine system in the brain, glutamate system, inflammation, epigenetic modulation, and mitochondrial function.

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Long-term follow-up of inpatients with meniscus tears who received integrative Korean medicine treatment: A retrospective analysis and follow-up survey
June Haeng Lee, Jin Young Song, Kyoung Sun Park, Jinho Lee, In-Hyuk Ha, Yoon Jae Lee
Medicine.2024; 103(6): e36917. CrossRef
The analgesic effect of acupuncture in neuropathic pain: regulatory mechanisms of DNA methylation in the brain
Jae-Hwan Jang, Yoon Jae Lee, In-Hyuk Ha, Hi-Joon Park
PAIN Reports.2024; 9(6): e1200. CrossRef

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