Journal of Traditional Chinese Medicine ›› 2026, Vol. 46 ›› Issue (2): 316-325.DOI: 10.19852/j.cnki.jtcm.2026.02.005

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Acupuncture inhibits astrocytic hyperactivation via the p38 mitogen-activated protein kinase/mitogen- and stress-activated protein kinase 1 signaling pathway in cerebral ischemia-reperfusion injury

ZHUANG Zifeng1, WO Choying1, CHEN Hongling1, XIE Hailiang2, ZHAO Canghuan2, ZHANG Di1(), QING Peng2()   

  1. 1 College of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, China
    2 Department of Acupuncture, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
  • Received:2025-06-11 Accepted:2025-11-10 Online:2026-04-15 Published:2026-04-04
  • Contact: ZHANG Di, College of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, China. dizhang0915@jnu.edu.cn; QING Peng, Department of Acupuncture, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China. qingpeng5602@163.com; Telephone: +86-15521245050
  • Supported by:
    Guangzhou Basic and Applied Basic Research Foundation: Mechanistic Investigation of Ziwu Liuzhu Acupuncture for Insomnia Based on the Heat Shock Protein 90/Stimulator of Interferon Genes-nuclear Factor Kappa B Immune Pathway and Its Regulation of Sleep-Wake Rhythms(2025A03J3400);Guangdong Basic and Applied Basic Research Foundation: Danggui Sini Decoction Promotes Damaged Nerve Repair and Treats Sciatica by Inhibiting Secreted Phosphoprotein 1/Cluster of Differentiation 44-Mediated Macrophage-Schwann Cell Crosstalk(2025A1515011267);Guangzhou Doctoral Start-up Program: Danggui Sini Decoction Regulates Angiopoietin-like 4/Syndecan-4-mediated Neurovascular Coupling to Promote Injured Nerve Repair for the Treatment of Sciatica(2025A04J3397);National Natural Science Foundation of China (Youth Program): Investigation of Danggui Sini Decoction in Improving Neuro-microcirculation and Promoting Nerve Repair for the Treatment of Sciatica Based on Angptl4/Sdc4-mediated Endothelial Cell-Schwann Cell Coupling(82405081);China Postdoctoral Science Foundation Special Funding (Pre-Station): Danggui Sini Decoction Inhibits Peripheral Sensitization and Alleviates Sciatica by Regulating Macrophage-neuron Crosstalk(2023TQ0135);China Postdoctoral Science Foundation General Funding: Danggui Sini Decoction Promotes Damaged Nerve Repair and Treats Sciatica by Modulating Endothelial Cell-schwann Cell Coupling(2024M751136)

Abstract:

OBJECTIVE: To observe the effect of acupuncture on astrocyte activation following cerebral ischemia-reperfusion injury (CIRI) viathe p38 mitogen-activated protein kinase (p38 MAPK)/mitogen- and stress-activated protein kinase 1 (MSK1) signaling pathway.

METHODS: Transcriptome and single-cell sequencing were used to analyse gene expression in middle cerebral artery occlusion (MCAO)-induced rats. Acupuncture was applied at Baihui (GV20) and Dazhui (GV14) for 7 d. The infarct volume was assessed via2,3,5-triphenyltetrazolium chloride staining and T2-weighted imaging. Serum interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-alpha levels were measured viaenzyme-linked immunosorbent assay. The expression of glial fibrillary acidic protein (GFAP), complement component 3 (C3), and S100 calcium-binding protein A10 (S100A10), as well as components of the p38 MAPK/MSK1 pathway, was examined by Western blotting and immunohistochemistry.

RESULTS: CIRI activated p38 MAPK signaling, increased the expression of A1 markers (GFAP and C3), and proinflammatory cytokines, and decreased the expression of the A2 marker S100A10. Acupuncture inhibited p38 phosphorylation, upregulated MSK1, reduced C3 and inflammatory cytokines, increased S100A10 expression, decreased infarct volume, and improved neurological function.

CONCLUSION: Acupuncture protects against ischemic stroke by targeting the p38 MAPK/MSK1 pathway. It inhibits p38 MAPK phosphorylation and activates MSK1, thereby promoting a shift in astrocyte polarization from the pro-inflammatory A1 to the reparative A2 type, as reflected by decreased C3 and increased S100A10 expression. This shift reduces pro-inflammatory cytokines, alleviates cerebral inflammation, and promotes neural repair, ultimately diminishing infarct volume, restoring neurons, and improving behavior. These findings elucidate the mechanism of acupuncture and support its clinical use.

Key words: stroke, cerebral ischemia-reperfusion injury, p38 mitogen-activated protein kinase, astrocytes, acupuncture, inflammatory response

Cite this article

ZHUANG Zifeng, WO Choying, CHEN Hongling, XIE Hailiang, ZHAO Canghuan, ZHANG Di, QING Peng. Acupuncture inhibits astrocytic hyperactivation via the p38 mitogen-activated protein kinase/mitogen- and stress-activated protein kinase 1 signaling pathway in cerebral ischemia-reperfusion injury[J]. Journal of Traditional Chinese Medicine, 2026, 46(2): 316-325.