Multidimensional regulation and precision therapeutic prospects of acupuncture against depression from the perspective of immunity-metabolism-nerve coupling

Depression is a complex systemic disease dominated by emotional disorders, whose occurrence and progression involve multiple pathological processes including imbalance of immune inflammatory response, disrupted metabolic homeostasis and abnormal neural plasticity. Recent studies indicate that a single mechanism cannot fully interpret the pathological characteristics of depression, and multi-system coupling dysfunction serves as a crucial biological basis. As a characteristic traditional Chinese medical therapy, acupuncture presents favorable efficacy in the prevention and treatment of depression, yet its action mechanism lacks a systematically integrated theoretical framework. Based on a systematic review of relevant studies on the antidepressant effect of acupuncture, this paper summarizes regulatory evidence of acupuncture on immune inflammation, oxidative stress, energy metabolism, neural plasticity and brain network from the immunity-metabolism-nerve coupling perspective. It mainly discusses the cross-system cascade regulation mediated by key molecular nodes and signaling pathways. Furthermore, it proposes that acupuncture may exert antidepressant effects by remodeling the dynamic balance of the immunity-metabolism-nerve network and restoring systemic homeostasis. This study aims to provide theoretical references for clarifying the systematic regulatory mechanism of acupuncture against depression and promoting its individualized clinical application.