Experimental Evidence on Acupuncture Targeting Ferroptosis for Neurological Function Improvement in Cerebral Stroke: A Systematic Review and Meta‐Analysis

ABSTRACT Background Acupuncture, a traditional Chinese medicinal practice, has been studied for its ability to regulate ferroptosis and improve neurological function. This systematic review aimed to evaluate the evidence about the effects of acupuncture on ferroptosis and the improvement of neurolog...

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Main Authors: Wenyu Zhang, Xiaoxi Liu, Xuyang Feng, Donglei Lu, Ruiyu Li, Haizhen Guo, Kun Nie, Xuezhu Zhang
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Brain and Behavior
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Online Access:https://doi.org/10.1002/brb3.70507
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author Wenyu Zhang
Xiaoxi Liu
Xuyang Feng
Donglei Lu
Ruiyu Li
Haizhen Guo
Kun Nie
Xuezhu Zhang
author_facet Wenyu Zhang
Xiaoxi Liu
Xuyang Feng
Donglei Lu
Ruiyu Li
Haizhen Guo
Kun Nie
Xuezhu Zhang
author_sort Wenyu Zhang
collection DOAJ
description ABSTRACT Background Acupuncture, a traditional Chinese medicinal practice, has been studied for its ability to regulate ferroptosis and improve neurological function. This systematic review aimed to evaluate the evidence about the effects of acupuncture on ferroptosis and the improvement of neurological function in animal models of cerebral stroke. Methods The research was conducted in accordance with the preferred reporting items for systematic reviews and meta‐analyses (PRISMA 2020) guidelines. We conducted a literature search in web of science, Embase, Ebsco, PubMed, Cochrane library, China biomedical literature database (CBM), China national knowledge infrastructure (CNKI), Wanfang database (WF), and VIP database for Chinese technical periodicals, covering pertinent studies up to May 30, 2024. The inclusion criteria covered experimental animal models of cerebral stroke that underwent acupuncture interventions (electroacupuncture [EA], manual acupuncture [MA], or moxibustion [Moxi]). The primary outcomes consisted of neurological function scores (Longa, modified neurological severity score [mNSS], Zausinger, Garcia, Ludmila Belayev scores, and levels of brain‐derived neurotrophic factor [BDNF]). Secondary outcomes encompassed iron metabolism (iron ion content, ferritin heavy chain 1 [FTH1], transferrin receptor 1 [TFR1]), lipid peroxidation (malondialdehyde [MDA], reactive oxygen species [ROS]), antioxidative parameters (glutathione peroxidase 4 [GPX4], glutathione [GSH], superoxide dismutase [SOD]), and ferroptosis markers (long‐chain acyl‐CoA synthetase 4 [ACSL4]). Two authors independently evaluated the methodological quality of the included studies utilizing the collaborative approach to meta‐analysis and review of animal data from experimental studies (CAMARADES) 10‐item checklist. Results The meta‐analysis indicated that acupuncture markedly enhanced neurological function scores (Longa, Longa [mNSS], Zausinger, Garcia, Ludmila Belayev) and elevated levels of BDNF, GSH, GPX4, and SOD in animal models of cerebral stroke. Furthermore, it significantly reduced the levels of cerebral iron, FTH1, TFR1, MDA, ROS, and ACSL4. Conclusions Acupuncture effectively inhibits ferroptosis and enhances neurological function in animal models of cerebral stroke by modulating brain iron metabolism, decreasing lipid peroxidation, and improving brain antioxidant capacity.
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spelling doaj-art-fd5a9a2e588a4ee09af6783e57c882a42025-08-22T04:50:53ZengWileyBrain and Behavior2162-32792025-08-01158n/an/a10.1002/brb3.70507Experimental Evidence on Acupuncture Targeting Ferroptosis for Neurological Function Improvement in Cerebral Stroke: A Systematic Review and Meta‐AnalysisWenyu Zhang0Xiaoxi Liu1Xuyang Feng2Donglei Lu3Ruiyu Li4Haizhen Guo5Kun Nie6Xuezhu Zhang7First Teaching Hospital of Tianjin University of Traditional Chinese MedicineTianjinChinaFirst Teaching Hospital of Tianjin University of Traditional Chinese MedicineTianjinChinaGraduate School, Beijing University of Chinese MedicineBeijingChinaCollege of Sports Training, Wuhan Sports UniversityWuhanChinaBeijing University of Chinese Medicine Shenzhen Hospital (Longgang)ShenzhenChinaTianjin University of Traditional Chinese Medicine, Second Affiliated HospitalTianjinChinaFirst Teaching Hospital of Tianjin University of Traditional Chinese MedicineTianjinChinaFirst Teaching Hospital of Tianjin University of Traditional Chinese MedicineTianjinChinaABSTRACT Background Acupuncture, a traditional Chinese medicinal practice, has been studied for its ability to regulate ferroptosis and improve neurological function. This systematic review aimed to evaluate the evidence about the effects of acupuncture on ferroptosis and the improvement of neurological function in animal models of cerebral stroke. Methods The research was conducted in accordance with the preferred reporting items for systematic reviews and meta‐analyses (PRISMA 2020) guidelines. We conducted a literature search in web of science, Embase, Ebsco, PubMed, Cochrane library, China biomedical literature database (CBM), China national knowledge infrastructure (CNKI), Wanfang database (WF), and VIP database for Chinese technical periodicals, covering pertinent studies up to May 30, 2024. The inclusion criteria covered experimental animal models of cerebral stroke that underwent acupuncture interventions (electroacupuncture [EA], manual acupuncture [MA], or moxibustion [Moxi]). The primary outcomes consisted of neurological function scores (Longa, modified neurological severity score [mNSS], Zausinger, Garcia, Ludmila Belayev scores, and levels of brain‐derived neurotrophic factor [BDNF]). Secondary outcomes encompassed iron metabolism (iron ion content, ferritin heavy chain 1 [FTH1], transferrin receptor 1 [TFR1]), lipid peroxidation (malondialdehyde [MDA], reactive oxygen species [ROS]), antioxidative parameters (glutathione peroxidase 4 [GPX4], glutathione [GSH], superoxide dismutase [SOD]), and ferroptosis markers (long‐chain acyl‐CoA synthetase 4 [ACSL4]). Two authors independently evaluated the methodological quality of the included studies utilizing the collaborative approach to meta‐analysis and review of animal data from experimental studies (CAMARADES) 10‐item checklist. Results The meta‐analysis indicated that acupuncture markedly enhanced neurological function scores (Longa, Longa [mNSS], Zausinger, Garcia, Ludmila Belayev) and elevated levels of BDNF, GSH, GPX4, and SOD in animal models of cerebral stroke. Furthermore, it significantly reduced the levels of cerebral iron, FTH1, TFR1, MDA, ROS, and ACSL4. Conclusions Acupuncture effectively inhibits ferroptosis and enhances neurological function in animal models of cerebral stroke by modulating brain iron metabolism, decreasing lipid peroxidation, and improving brain antioxidant capacity.https://doi.org/10.1002/brb3.70507ACSL4acupunctureBDNFcerebral strokeferroptosisGPX4
spellingShingle Wenyu Zhang
Xiaoxi Liu
Xuyang Feng
Donglei Lu
Ruiyu Li
Haizhen Guo
Kun Nie
Xuezhu Zhang
Experimental Evidence on Acupuncture Targeting Ferroptosis for Neurological Function Improvement in Cerebral Stroke: A Systematic Review and Meta‐Analysis
Brain and Behavior
ACSL4
acupuncture
BDNF
cerebral stroke
ferroptosis
GPX4
title Experimental Evidence on Acupuncture Targeting Ferroptosis for Neurological Function Improvement in Cerebral Stroke: A Systematic Review and Meta‐Analysis
title_full Experimental Evidence on Acupuncture Targeting Ferroptosis for Neurological Function Improvement in Cerebral Stroke: A Systematic Review and Meta‐Analysis
title_fullStr Experimental Evidence on Acupuncture Targeting Ferroptosis for Neurological Function Improvement in Cerebral Stroke: A Systematic Review and Meta‐Analysis
title_full_unstemmed Experimental Evidence on Acupuncture Targeting Ferroptosis for Neurological Function Improvement in Cerebral Stroke: A Systematic Review and Meta‐Analysis
title_short Experimental Evidence on Acupuncture Targeting Ferroptosis for Neurological Function Improvement in Cerebral Stroke: A Systematic Review and Meta‐Analysis
title_sort experimental evidence on acupuncture targeting ferroptosis for neurological function improvement in cerebral stroke a systematic review and meta analysis
topic ACSL4
acupuncture
BDNF
cerebral stroke
ferroptosis
GPX4
url https://doi.org/10.1002/brb3.70507
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