Acupuncture’s Regulatory Role in Glial Cells and Their Interactions for Antidepressant Effects: A Review of Research Progress

Jing Cao,1,2,* Lian Yang,3,4,* Deguang Ding,2 Xiaolei Zhang,2 Nana Ding,3 Fengmin Ding,1 Qinglai Bian,1 Jiaxu Chen1,3,5 1School of Basic Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei, 430070, People’s Republic of China; 2Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, Hubei, 430065, People’s Republic of China; 3Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong, 510000, People’s Republic of China; 4Affiliated Hospital of Xiangnan University, Chenzhou, Hunan, 423000, People’s Republic of China; 5School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qinglai Bian, Email [email protected] Jiaxu Chen, Email [email protected]: The clinical management of depression presents significant challenges. While acupuncture has shown efficacy in alleviating depressive symptoms, the underlying mechanisms through which it exerts its antidepressant effects remain incompletely understood. Recent research has underscored the crucial role of glial cells in the pathophysiology of depression. This discovery opens a novel and promising avenue for investigating the mechanisms underlying acupuncture’s antidepressant actions. Based on clinical evidence supporting the use of acupuncture in treating depression, this article reviews recent studies on how acupuncture influences the glial cell network. This is the first review of studies examining the effects of acupuncture on glial cells in depression. The review encompasses several key aspects, including microglial polarization and associated inflammatory signaling pathways, the role of astrocytes in maintaining metabolic homeostasis, the processes of oligodendrocyte differentiation and myelin repair, as well as the intricate interactions among these three types of glial cells. However, this paper also has certain limitations, such as the majority of mechanistic evidence deriving from animal models, and due to the heterogeneity of acupuncture protocols and the lack of human causal data.Keywords: acupuncture, depression, microglia, astrocytes, oligodendrocytes