Acupuncture for allergic diseases: Clinical evidence and neuroimmune mechanisms

Objective To define the disease-specific clinical profile of acupuncture in allergic disorders and examine whether reported benefits align with convergent neuroimmune mechanisms. Methods PubMed/MEDLINE, Web of Science, Embase, and the Cochrane Library were searched from inception to 16 July 2026. Systematic reviews, meta-analyses, randomized controlled trials, and mechanistic studies were synthesized across allergic rhinitis, allergic asthma, atopic dermatitis, chronic spontaneous urticaria, and other allergic conditions. Results A disease-specific pattern emerged. Evidence was strongest for allergic rhinitis, with improvements in nasal symptoms, medication use, and disease-specific quality of life. In allergic asthma, reported benefits included better symptom control, selected pulmonary-function measures, and quality of life, particularly when acupuncture was added to conventional treatment. In atopic dermatitis and chronic spontaneous urticaria, the clearest signals involved pruritus and disease-activity outcomes. Mechanistic findings converged on regulation of type 2 inflammation through Th1/Th2-associated responses, IgE, eosinophils, and mast-cell activity, together with sensory afferent signaling, autonomic and hypothalamic–pituitary–adrenal regulation, central itch and affective processing, epithelial-barrier integrity, and gut microbiota. Conclusions Acupuncture shows greatest promise as a disease-specific adjunctive strategy rather than a uniform intervention across allergic disorders. Its most compelling applications involve symptom and medication-burden reduction in allergic rhinitis, selected asthma outcomes, and itch control in allergic skin diseases. Future trials should integrate standardized stimulation protocols, clinically meaningful outcomes, and embedded mechanistic measures to identify responsive patient phenotypes and clarify how neuroimmune regulation translates into clinical benefit.