Electroacupuncture Alleviates Pulmonary and Intestinal Injury in Septic Mice via Inhibiting NLRP3 Inflammasome and Remodeling Gut Microbiota

Xiao-lei Zhang , Hai-ming Hu , Qun-feng Yao , Xiong-jie Sun , Xiao-wei Yao , Lu Cao , Jun Ma , Hong-tao Liu

Current Medical Science ›› 2026, Vol. 46 ›› Issue (1) : 143 -160.

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Current Medical Science ›› 2026, Vol. 46 ›› Issue (1) :143 -160. DOI: 10.1007/s11596-025-00147-8
Original Article
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Electroacupuncture Alleviates Pulmonary and Intestinal Injury in Septic Mice via Inhibiting NLRP3 Inflammasome and Remodeling Gut Microbiota
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Abstract

Objective

Electroacupuncture (EA) has emerged as a clinically adopted complementary modality in the management of respiratory and digestive disorders. This investigation sought to elucidate the therapeutic potential of EA against sepsis-induced pulmonary and gastrointestinal injuries, with particular emphasis on delineating its multimodal mechanistical pathways.

Methods

Sepsis was induced in C57BL/6 mice by administeringting lipopolysaccharide (LPS) one hour after EA intervention at the Zusanli (ST36) and Tianshu (ST25) acupoints for eight days. Inflammatory responses and barrier function were evaluated in the lung and colon tissues. Hematoxylin and Eosin (H&E) staining was performed on lung tissues, while colon tissues were subjected to H&E staining, Wheat Germ Agglutinin-Fluorescein Isothiocyanate (WGA-FITC) staining, and Alcian Blue staining. Additionally, Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR) and Western blotting were used to explore potential molecular mechanisms. Furthermore, 16S rRNA gene sequencing was employed to analyze changes in the gut microbiota.

Results

EA ameliorated both pulmonary injury and intestinal damage in septic mice. This protective effect was mediated through significant attenuation of pulmonary and intestinal inflammation, coupled with partial restoration of gut microbiota homeostasis. Specifically, EA inhibited the activation of Nod-like receptor thermal protein domain associated protein 3 (NLRP3) inflammasome and mitogen-activated protein kinase (MAPK) pathways, and upregulated the transcription of lung barrier-related factors (MMP2, MMP9, Occludin) in the lung. In addition, EA improved inflammation and reduced damage to the intestinal mucosal barrier in the colon. This was accomplished by decreasing the expression of pro-inflammatory cytokines (IL-1β, TNF-α) and increasing the levels of mucin and glycoproteins. Furthermore, EA intervention altered the structure of the gut microbiota, resulting in a significant increase in the abundance of beneficial bacteria, such as Ruminococcaceae and Roseburia.

Conclusion

EA is a potential adjunct therapy for sepsis-related pulmonary and intestinal injury. The mechanism involves the inhibition of the NLRP3 inflammasome and remodeling of the gut microbiota.

Keywords

Electroacupuncture / Sepsis / Acute lung injury / Intestinal barrier dysfuntion / Gut microbiota / NLRP3 inflammation / MAPK signaling

Cite this article

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Xiao-lei Zhang, Hai-ming Hu, Qun-feng Yao, Xiong-jie Sun, Xiao-wei Yao, Lu Cao, Jun Ma, Hong-tao Liu. Electroacupuncture Alleviates Pulmonary and Intestinal Injury in Septic Mice via Inhibiting NLRP3 Inflammasome and Remodeling Gut Microbiota. Current Medical Science, 2026, 46(1): 143-160 DOI:10.1007/s11596-025-00147-8

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References

[1]

Besnier E, Coquerel D, Kouadri Get al. . Hypertonic sodium lactate improves microcirculation, cardiac function, and inflammation in a rat model of sepsis. Crit Care (London, England).. 2020, 24(1): 354.

[2]

Pan S, Wu Z, Liu Xet al. . Simvastatin Ameliorates PAK4 Inhibitor-Induced Gut and Lung Injury. BioMed Research International.. 2017, 2017: 8314276.

[3]

Haak BW, Wiersinga WJ. The role of the gut microbiota in sepsis. Lancet Gastroenterol Hepatol.. 2017, 22135-143.

[4]

Cruz CS, Ricci MF, Vieira AT. Gut microbiota modulation as a potential target for the treatment of lung infections. Front Pharmacol.. 2021, 12: 724033.

[5]

Steinhagen F, Schmidt SV, Schewe JCet al. . Immunotherapy in sepsis—brake or accelerate?. Pharmacol Ther.. 2020, 208107476.

[6]

Li D, Sun T, Chi Let al. . Acupoint catgut embedding improves the lipopolysaccharide-induced acute respiratory distress syndrome in rats. BioMed Research International.. 2020, 20202394734.

[7]

Feng D, Zhou H, Jin Xet al. . Electroacupuncture pretreatment alleviates LPS-induced acute respiratory distress syndrome via regulating the PPAR Gamma/NF-Kappa B Signaling Pathway. Evid Based Complement Alternat Med.. 2020, 20204594631.

[8]

Zhang Y, Zheng L, Deng Het al. . Electroacupuncture alleviates LPS-induced ARDS through α7 nicotinic acetylcholine receptor-mediated inhibition of ferroptosis. Front Immunol.. 2022, 13832432.

[9]

Wei B, Chen Y, Zhou Wet al. . Interleukin IL-5 alleviates sepsis-induced acute lung injury by regulating the immune response in rats. Bioengineered.. 2021, 1212132-2139.

[10]

Dong R, Xue Z, Fan Get al. . Pin1 promotes NLRP3 inflammasome activation by phosphorylation of p38 MAPK pathway in septic shock. Front Immunol.. 2021, 12: 620238.

[11]

Sun J, Ding X, Liu Set al. . Adipose-derived mesenchymal stem cells attenuate acute lung injury and improve the gut microbiota in septic rats. Stem Cell Res Ther.. 2020, 111384.

[12]

Xu M, Luo LL, Du MYet al. . Simvastatin improves outcomes of endotoxin-induced coagulopathy by regulating intestinal microenvironment. Curr Medical Sci.. 2022, 42126-38.

[13]

Xu Y, Zhu J, Feng Bet al. . Immunosuppressive effect of mesenchymal stem cells on lung and gut CD8 T cells in lipopolysaccharide-induced acute lung injury in mice. Cell Prol.. 2021, 545e13028.

[14]

Liu GH, Liu HM, Chen YSet al. . Effect of electroacupuncture in mice with dextran sulfate sodium-induced colitis and the influence of gut microbiota. Evid Based Complement Alternat Med.. 2020, 2020: 2087903.

[15]

Anderson ST, Commins S, Moynagh PN, et al. Lipopolysaccharide-induced sepsis induces long-lasting affective changes in the mouse. Brain Behav Immun. 2015:43.

[16]

Sun H, Li X, Gao S, et al. RIPK1 Drives JAK1-STAT3 Signaling to Promote CXCL1-Mediated Neutrophil Recruitment in Sepsis-Induced Lung Injury. Adva Sci. 2025:e07123.

[17]

Hu B, Ye C, Leung EL-H, et al. Bletilla striata oligosaccharides improve metabolic syndrome through modulation of gut microbiota and intestinal metabolites in high fat diet-fed mice. Pharmacol Res. 2020;159:104942.

[18]

Zhang C, Wang X, Wang Cet al. . Qingwenzhike prescription alleviates acute lung injury induced by LPS inhibiting TLR4/NF-kB pathway and NLRP3 inflammasome activation. Front Pharmacol.. 2021, 12790072.

[19]

Azambuja JH, Mancuso RI, Via FIDet al. . Protective effect of green tea and epigallocatechin-3-gallate in a LPS-induced systemic inflammation model. J Nutr Biochem.. 2022, 101108920.

[20]

Guo Y, Liu Y, Zhao Set al. . Oxidative stress-induced FABP5 S-glutathionylation protects against acute lung injury by suppressing inflammation in macrophages. Nat Commun.. 2021, 1217094.

[21]

Zhang Y, Li Y, Ye Zet al. . Expression of matrix metalloproteinase-2, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1, and changes in alveolar septa in patients with chronic obstructive pulmonary disease. Med Sci Monit.. 2020, 26e925278

[22]

Luo D, Dai W, Feng Xet al. . Suppression of lncRNA NLRP3 inhibits NLRP3-triggered inflammatory responses in early acute lung injury. Cell Death Dis.. 2021, 1210898.

[23]

Han S, Yuan R, Cui Yet al. . Hederasaponin C alleviates lipopolysaccharide-induced acute lung injury and through the PIP2/NF-κB/NLRP3 signaling pathway. Front Immunol.. 2022, 13846384.

[24]

Alam MB, Chowdhury NS, Sohrab MHet al. . Cerevisterol alleviates inflammation via suppression of MAPK/NF-κB/AP-1 and activation of the Nrf2/HO-1 signaling cascade. Biomolecules.. 2020, 102199.

[25]

Saitoh A, Nagayama Y, Yamada Det al. . Disulfiram produces potent anxiolytic-like effects without benzodiazepine anxiolytics-related adverse effects in mice. Front Pharmacol.. 2022, 13826783.

[26]

Candelli M, Franza L, Pignataro Get al. . Interaction between lipopolysaccharide and gut microbiota in inflammatory bowel diseases. Int J Mol Sci.. 2021, 22126242.

[27]

Dickson RP, Singer BH, Newstead MWet al. . Enrichment of the lung microbiome with gut bacteria in sepsis and the acute respiratory distress syndrome. Nat Microbiol.. 2016, 11016113.

[28]

Jiao Y, Zhang T, Zhang Cet al. . Exosomal miR-30d-5p of neutrophils induces M1 macrophage polarization and primes macrophage pyroptosis in sepsis-related acute lung injury. Crit Care.. 2021, 251356.

[29]

Zhang J, Chen L, Su Tet al. . Electroacupuncture increases CB2 receptor expression on keratinocytes and infiltrating inflammatory cells in inflamed skin tissues of rats. J Pain.. 2010, 11121250-1258.

[30]

Gao F, Xiang HC, Li HPet al. . Electroacupuncture inhibits NLRP3 inflammasome activation through CB2 receptors in inflammatory pain. Brain Behav Immun.. 2018, 67: 91-100.

[31]

Liu AP, Yuan QH, Zhang Bet al. . Cannabinoid receptor 2 activation alleviates septic lung injury by promoting autophagy via inhibition of inflammatory mediator release. Cell Sig.. 2020, 69: 109556.

[32]

Grailer JJ, Canning BA, Kalbitz Met al. . Critical role for the NLRP3 inflammasome during acute lung injury. J Immunol.. 2014, 192125974-5983.

[33]

Du W, Hu H, Zhang Jet al. . The mechanism of MAPK signal transduction pathway involved with electroacupuncture treatment for different diseases. Evid Based Complement Alternat Med.. 2019, 2019: 8138017.

[34]

Liu YL, Zhang LD, Ma TMet al. . Feishu acupuncture inhibits acetylcholine synthesis and restores muscarinic acetylcholine receptor M2 expression in the lung when treating allergic asthma. Inflammation.. 2018, 413741-750.

[35]

Li Y, Zhi W, Haoxu Det al. . Effects of electroacupuncture on the expression of hypothalamic neuropeptide Y and ghrelin in pubertal rats with polycystic ovary syndrome. PloS One.. 2022, 176e0259609.

[36]

Ots T, Kandirian A, Szilagyi Iet al. . The selection of dermatomes for sham (placebo) acupuncture points is relevant for the outcome of acupuncture studies: a systematic review of sham (placebo)-controlled randomized acupuncture trials. Acupunct Med.. 2020, 384211-226.

[37]

Zhang LL, Chu Q, Wang Set al. . Is sham acupuncture as effective as traditional Chinese acupuncture? It's too early to say. Chin J Integrat Med (Chinese).. 2016, 22(7): 483-489.

[38]

Costigan D, Fenn J, Yen Set al. . A pro-inflammatory gut mucosal cytokine response is associated with mild COVID-19 disease and superior induction of serum antibodies. Mucosal immunology.. 2024, 17(1): 111-123.

[39]

Drewe J, Beglinger C, Fricker G. Effect of ischemia on intestinal permeability of lipopolysaccharides. Eur J Clin Invest. 2001;31(2):138–144.

[40]

Zhang X, Liu H, Hashimoto Ket al. . The gut–liver axis in sepsis: interaction mechanisms and therapeutic potential. Critical Care.. 2022, 26(1): 213.

[41]

Jin C, Chen J, Gu Jet al. . Gut-lymph-lung pathway mediates sepsis-induced acute lung injury. Chin Med J.. 2020, 133182212-2218.

[42]

Cicchinelli S, Pignataro G, Gemma Set al. . PAMPs and DAMPs in sepsis: a review of their molecular features and potential clinical implications. Int J Mol Sci.. 2024, 25(2): 962.

[43]

Xie B, Wang M, Zhang Xet al. . Gut-derived memory γδ T17 cells exacerbate sepsis-induced acute lung injury in mice. Nat Commun.. 2024, 1516737.

[44]

Ziaka M, Exadaktylos A. Gut-derived immune cells and the gut-lung axis in ARDS. Crit Care.. 2024, 281220.

[45]

Klingensmith NJ, Coopersmith CM. Gut Microbiome in Sepsis. Surg Infect.. 2023, 243250-257.

[46]

Chancharoenthana W, Kamolratanakul S, Schultz Marcus Jet al. . The leaky gut and the gut microbiome in sepsis – targets in research and treatment. Clin Sci.. 2023, 137(8): 645-662.

[47]

Liu J, Wang M, Chen Wet al. . Altered Gut Microbiota Taxonomic Compositions of Patients With Sepsis in a Pediatric Intensive Care Unit. Front Pediatr.. 2021, 9: 645060.

[48]

Shang W, Zhang S, Yang Let al. . Gut microbiota: a novel target for sepsis treatment. Chin Med J.. 2025, 138(13): 1513-1515.

[49]

Hu Y, Chen Z, Xu Cet al. . Disturbances of the gut microbiota and microbiota-derived metabolites in inflammatory bowel disease. Nutrients.. 2022, 14235140.

[50]

Siddiqui MT, Cresci GAM. The immunomodulatory functions of butyrate. J Inflam Res.. 2021, 14: 6025-6041.

[51]

Shen Z, Luo W, Tan Bet al. . Roseburia intestinalis stimulates TLR5-dependent intestinal immunity against Crohn's disease. EBioMedicine.. 2022, 85: 104285.

[52]

Zhang Y, Guo C, Li Yet al. . Alginate oligosaccharides ameliorate DSS-induced colitis through modulation of AMPK/NF-κB pathway and intestinal microbiota. Nutrients.. 2022, 14142864.

[53]

Zhang Y, Wu Z, Liu Jet al. . Identification of the core active structure of a Dendrobium officinale polysaccharide and its protective effect against dextran sulfate sodium-induced colitis via alleviating gut microbiota dysbiosis. Food Res Int (Ottawa, Ont).. 2020, 137109641.

[54]

Nabizadeh E, Sadeghi J, Rezaee MAet al. . The profile of key gut microbiota members and short-chain fatty acids in patients with sepsis. Heliyon.. 2023, 97e17880.

[55]

Zafar H, Saier MHJr. Gut Bacteroides species in health and disease. Gut Microbes.. 2021, 1311848158.

[56]

Rohr MW, Narasimhulu CA, Rudeski-Rohr TAet al. . Negative effects of a high-fat diet on intestinal permeability: a review. Adv Nutr.. 2020, 11177-91.

[57]

Wang ZX, Qin RJ, Yu LLet al. . Acupuncture treats sepsis through immune modulation and organ protection. Curr Med Sci.. 2024, 4461185-1192.

[58]

Liu YL, Li SS, Yang YRet al. . Research progress on the molecular mechanism of electroacupuncture at "Zusanli" (ST36) for regulating gastrointestinal dysfunction. Zhen Ci Yan Jiu (Chinese).. 2023, 48(10): 1048-1054

[59]

Oh J-E, Kim S-N. Anti-Inflammatory Effects of Acupuncture at ST36 Point: A Literature Review in Animal Studies. Front Immunol.. 2021, 12: 813748.

[60]

Liu S, Wang Z, Su Yet al. . A neuroanatomical basis for electroacupuncture to drive the vagal-adrenal axis. Nature.. 2021, 5987882641-645.

[61]

Li P, Luo Y, Wang Qet al. . Efficacy and safety of acupuncture at Tianshu (ST25) for functional constipation: evidence from 10 randomized controlled trials. Evid Based Complement Alternat Med.. 2020, 202012171587.

[62]

Bao C, Zhang J, Liu Jet al. . Moxibustion treatment for diarrhea-predominant irritable bowel syndrome: study protocol for a randomized controlled trial. BMC Complement Altern Med.. 2016, 161408.

[63]

Guo H, Zhu SF, Zhang RRet al. . Electroacupuncture ameliorates acute lung injury through promoting gastrointestinal motility in rats with acute pancreatitis. Evid Based Complement Alternat Med.. 2014, 2014943596.

[64]

Lai F, Ren Y, Lai Cet al. . Acupuncture at Zusanli (ST36) for experimental sepsis: a systematic review. Evid Based Complement Alternat Med.. 2020, 20203620741.

[65]

Yang L, Zhou D, Cao Jet al. . Revealing the biological mechanism of acupuncture in alleviating excessive inflammatory responses and organ damage in sepsis: a systematic review. Front Immunol.. 2023, 141242640.

Funding

National Natural Science Foundation of China(81473788)

National Key Research and Development Program(2020YFC0845800)

Hubei Provincial Natural Science Foundation and Traditional Chinese Medicine Innovation and Development-of China(2023AFD156)

Educational Commission of Hubei Province of China(D20212003)

Wuhan Knowledge Innovation Project(NO. 2022020801010420)

Hubei Provincial Natural Science Joint Fund(no.2024AFD298)

Wuhan Knowledge Innovation Project(NO. 2023020201020794)

RIGHTS & PERMISSIONS

The Author(s), under exclusive licence to the Huazhong University of Science and Technology

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