Network Mechanisms and Prospective Targets of Acupuncture in Regulating Systemic Inflammatory Responses Based on the Somatic–Autonomic Nervous–Immune Axis

Systemic inflammation involves coordinated disruption of neural reflexes, neuroendocrine responses, immune-cell activation, and epithelial or vascular barriers. In this review, the somatic–autonomic nervous–immune axis is defined as a layered neuroimmune pathway in which somatic afferent signals generated at acupoints are centrally integrated and converted into vagal, sympathetic, and neuroendocrine outputs that regulate immune-cell activity, mediator release, and tissue-barrier homeostasis. Experimental and translational studies indicate that acupuncture, particularly electroacupuncture, can activate somatic afferent pathways, engage central autonomic circuits, and regulate vagal, sympathetic, and neuroendocrine outputs. Through these routes, acupuncture may influence immune niches in the spleen, adrenal gland, intestine, cardiopulmonary system, and brain, thereby limiting excessive inflammatory amplification and supporting resolution and organ protection. This review summarizes current evidence on the somatic–autonomic nervous–immune axis, including acupoint specificity, stimulation parameters, autonomic routing, immune-effector remodeling, and molecular targets. Studies in sepsis, acute lung injury, cardiovascular inflammatory injury, intestinal inflammation, neuroinflammation, and related disorders indicate that acupuncture is best understood as a multilevel neuroimmune regulatory intervention rather than a single-pathway therapy. Future work should define acupoint–neuron–organ maps, establish measurable autonomic and immune biomarkers, and integrate multi-omics with clinical stratification to support more precise acupuncture-based control of systemic inflammation.