Advances in molecular mechanisms of acupuncture in chronic pain with depression

Chronic pain is often accompanied by depressive emotions, and they are interacted with each other, which is one of the crucial factors to affect the clinical efficacy on pain. Acupuncture therapy has the advantages of multi-dimensional and multi-target regulation, and it is remarkably effective on chronic pain and pain-related depressive emotions. This paper reviews the mechanism researches of acupuncture in treatment of chronic pain with depression.Research indicates that the primary molecular mechanism by which acupuncture exerts analgesic and anti-depressive effects involves the regulation of central nervous system neurotransmitters, including 5-hydroxytryptamine, glutamic acid, gamma-aminobutyric acid, and dopamine. Additionally, acupuncture inhibits inflammatory responses within the central nervous system, modulates the expression of neurotrophic factors, enhances neuronal synaptic plasticity, and regulates the BDNF/TrkB/CREB and ERK signaling pathways. These findings underscore the multifaceted and multi-targeted regulatory advantages of acupuncture. 慢性疼痛多伴发抑郁情绪, 二者相互影响, 是临床影响疼痛疗效的重要原因之一.针刺疗法具有多维度,多靶点的调节优势, 临床治疗慢性疼痛疗效显著, 亦可明显改善疼痛伴发的抑郁情绪.本文梳理了针刺干预慢性疼痛伴抑郁的机制研究资料, 总结发现针刺镇痛-抗抑郁的中枢分子机制与调节5-羟色胺,谷氨酸,γ-氨基丁酸,多巴胺等中枢神经递质水平, 抑制中枢神经炎症反应, 调控神经营养因子表达,改善神经元突触可塑性, 调节BDNF/TrkB/CREB信号通路,ERK信号通路等密切相关, 具有显著的多靶点,多途径调节的优势.