Electroacupuncture alleviates acute gouty arthritis by inhibiting NLRP3 inflammasome activation via modulation of the circadian-inflammation axis

Electroacupuncture (EA) has shown anti-inflammatory potential in gouty arthritis (GA). This study aimed to investigate its therapeutic effects and underlying mechanisms. Core acupoints (ST36 and SP6) were identified through data-mining. In MSU-induced GA rats, EA significantly alleviated joint swelling, improved gait, reduced serum TNF-α, IL-6 and IL-1β, and suppressed synovial inflammatory infiltration. Mechanistically, EA downregulated NLRP3, caspase-1 and IL-1β in joint tissue. Further analyses revealed that EA modulates sciatic nerve signaling, influences the central circadian clock in the suprachiasmatic nucleus, and restores rhythmic expression of peripheral circadian genes (e.g., Bmal1, Rev-erbα), thereby inhibiting NLRP3 inflammasome activation. In conclusion, EA at ST36 and SP6 ameliorates acute GA by regulating the circadian-inflammation axis and suppressing NLRP3 inflammasome activation, providing experimental evidence for EA as a promising therapy for gout, although further translational studies are warranted to confirm its clinical applicability.