Journal of Integrative Medicine-Jim最新文献

Atopic dermatitis (AD) is the most common chronic inflammatory skin condition. It has significant socioeconomic consequences and complex pathophysiology, necessitating updated management guidelines that consider the age, sex and geographic location of patients. Despite the widespread use of Western medicine (WM), including topical corticosteroids, as the primary treatment for AD, the possible negative effects of WM therapies are inescapable. Although there is still a lack of strong evidence, the integration of traditional Chinese medicine (TCM) with WM may yield a more favorable therapeutic response for AD than WM alone, due to the synergistic effects involved. Balancing the application of diagnostic and therapeutic approaches from TCM and WM is crucial for the management of AD, enhancing treatment efficacy for patients, and averting disease recurrence. In 2025, a new clinical guideline for the diagnosis and treatment of AD was released; it emphasized the integration of TCM with WM. This guideline is crucial as it consolidates global expertise and data to provide a standardized framework for the practical integration of techniques to bridge divides among clinical disciplines. As more substantial data emerge, the development and enhancement of integrative medicine for AD management should be prioritized globally, particularly in Asian regions. Please cite this article as: Chen M, Liao WQ. Atopic dermatitis management in the era of integrative medicine. J Integr Med. 2026; Epub ahead of print.

Invasive laser acupuncture (ILA) is an innovative integration of traditional acupuncture with precise laser stimulation delivered directly into acupoints, yet it is not widely used in clinical practice and lacks extensive clinical studies. In the era of digital healthcare and patient-specific treatment, computational predictive models have become essential tools for optimizing medical procedures and ensuring treatment safety. However, existing computational models for laser-based therapies primarily focused on skin surface treatments or ablation procedures, creating a significant gap in understanding unique characteristics of ILA. This study addressed this challenge by developing and validating a novel computational predictive model that incorporates the geometric characteristics of needle-integrated optical fiber delivery. The model was validated through ex vivo experiments using a 650 nm laser device, demonstrating good agreement in temporal temperature changes at the irradiation point with an average difference of 11.6%. Using this validated model, systematic investigation of ILA responses to varying laser parameters was conducted to analyze the photothermal effects in tissue. These quantitative insights into the relationships between laser parameters and photothermal responses provided a foundation for evidence-based selection of treatment parameters. This computational framework contributes to the advancement of ILA therapy by enabling more precise control of therapeutic outcomes and supporting the development of safety protocols. Please cite this article as: Kim HJ, Kim J, Kim JG, Lee S, Chae Y, Lee IS. Photothermal effect of invasive laser acupuncture: A computational study with experimental validation J Integr Med. 2026; Epub ahead of print.

Objective: We developed a novel silk fibroin@polydopamine (SF@PDA) material and investigated the mechanism of SF@PDA acupoint implantation for the treatment of Alzheimer's disease (AD) in a mouse model.

Methods: In the materials research phase, we characterized the surface morphology and properties of the novel SF@PDA composites and evaluated their safety using the cell counting kit-8 assay. Following the intervention, C57BL/6 mice underwent open-field experiments and the Morris water maze test. We analyzed the collected tissues with hematoxylin-eosin staining, immunofluorescent staining, Western blotting, reverse transcription-quantitative polymerase chain reaction and enzyme-linked immunosorbent assay.

Results: After acupoint implantation, SF@PDA reduced amyloid-β (Aβ) deposition and preserve neurons, thereby improving cognitive performance. In particular, SF@PDA can reduce the expression of inflammatory factors, including interleukin-1β (IL-1β), IL-6 and tumor necrosis factor-α, and inhibit the inflammatory response, thereby further reducing Aβ accumulation and neuronal damage. The SF@PDA treatment resulted in an increase in exploratory behavior and a decrease in the number of errors in mice. Meanwhile, the number of Aβ plaques in the brain was significantly reduced (P < 0.05), and inflammatory cell infiltration was lessened.

Conclusion: SF@PDA acupoint implantation has significant therapeutic effects on AD model mice. The mechanism can be related to the inhibition of inflammatory response, reduction of Aβ deposition, and promotion of nerve regeneration. Please cite this article as: Wang C, Liu X, Fan Y, Liu GY, Wu P, Li SC, Du YJ. Silk fibroin@polydopamine for acupoint catgut-embedding therapy in Alzheimer's disease. J Integr Med. 2026; Epub ahead of print.

Acupoint therapy is widely applied in clinical practice, yet its precise mechanism of action has not been completely elucidated. In recent years, the neuro-immune regulatory mechanism has emerged as a prominent focus in acupoint research. This review provides a comprehensive summary of the mechanisms of acupoint stimulation at the central, peripheral and local neural levels. It further explores the neurogenic inflammatory responses induced by acupoint stimulation and its regulatory effects on local immune cells. Studies have demonstrated that acupuncture can exert anti-inflammatory, analgesic and immunomodulatory effects through local neuro-immune interactions. However, a direct biological connection between acupoints and visceral organs has yet to be identified. Future research should prioritize elucidating the nuanced changes within the local neuro-immune microenvironment of acupoints and delineating their indirect mechanistic pathways. This deeper understanding is expected to provide a more robust theoretical foundation for the precision and scientific application of acupuncture therapy. Please cite this article as: Yao YL, Gu XXY, Xie XB, Wang Y, Wang QL. Research advances in neural and immune regulatory mechanisms underlying the distant therapeutic effects of acupoints. J Integr Med. 2026; Epub ahead of print.

Over the past decade, the prevalence of hepatic disorders has shown a steady upsurge, raising serious public health concerns. Alcohol consumption, indiscriminate use of medications, a high-calorie diet and exposure to viral infections are all thought to be the primary risk factors for developing hepatic diseases. Due to the lack of effective treatments for hepatic disorders, such as metabolic dysfunction-associated fatty liver disease, alcoholic liver disease, liver fibrosis, cirrhosis and liver cancers, and the numerous side effects of existing therapies, medicinal plants are receiving increased attention as an alternative treatment for hepatic disorders. Iridoids are bitter-tasting secondary metabolites found in many medicinal plants. Numerous in vitro and in vivo studies have demonstrated that iridoids or extracts containing iridoids produce hepatoprotective effects by targeting inflammation, oxidative stress, apoptosis, and mitochondrial dysfunction. This comprehensive review discusses scientific research on the hepatoprotective effects of various iridoids and the targeted pathways involved in liver disorders. Research data on iridoids as hepatoprotective molecules were obtained through multiple databases such as ScienceDirect, Web of Science, PubMed, Wiley Online Library and Scopus using relevant keywords such as iridoids and hepatoprotective. Based on the available information, further research is required for the optimization of the targeted delivery of iridoids in therapeutic and toxicity studies and randomized clinical trials in humans. Please cite this article as: Dogra S, Patial V. Iridoids in liver diseases: Mechanistic insights and molecular mechanism. J Integr Med. 2026; Epub ahead of print.

Objective: This study aimed to identify the optimal frequency of acupuncture for alleviating inflammatory pain and to explore the specific mechanisms through which it regulated microglial polarization.

Methods: We first measured the frequency and angle of acupuncture manipulation using an acupuncture manipulation parameter sensor. An inflammatory pain model was induced in Sprague-Dawley rats via injection of complete Freund's adjuvant (CFA) to the hind paw. Using the previously developed acupuncture manipulation simulator, we delivered precisely controlled stimulation with three frequencies (1, 2 and 4 Hz) to the Zusanli (ST36) acupoint. The optimal frequency for relieving inflammatory pain was determined by assessing paw withdrawal threshold, withdrawal latency and oedema. The autophagy inhibitor 3-methyladenine (3-MA) and α7 nicotinic acetylcholine receptor (α7nAChR) antagonist methyllycaconitine (MLA) were intrathecally injected to inhibit microglial autophagy and α7nAChR activation, respectively. Western blotting was used to measure autophagy-related protein levels. Spinal microglial polarization was evaluated using immunofluorescence analysis. The levels of pro- and anti-inflammatory cytokines were measured using enzyme-linked immunosorbent assay. The changes of mitochondrial morphology of spinal microglia were observed with transmission electron microscopy.

Results: The acupuncture manipulation simulator was used to precisely deliver treatments to CFA rats at three different frequencies with a rotation of 180°. Acupuncture manipulation at all three frequencies can effectively alleviate inflammatory pain and promote M2 polarization of the microglia, with 4 Hz acupuncture producing the best analgesic effect. The administration of 3-MA inhibited autophagy in spinal microglia, thereby reversing both the analgesic effect of acupuncture and its modulatory effect on microglial polarization. MLA markedly downregulated α7nAChR expression, inhibited autophagy, promoted M1 microglial polarization, and attenuated the analgesic effects of acupuncture. Moreover, acupuncture significantly decreased the expression of acetylcholinesterase.

Conclusion: Frequency of needle stimulation may be a critical factor influencing the analgesic efficacy of acupuncture. Acupuncture may mitigate inflammatory pain by promoting microglial polarization through α7nAChR-mediated autophagy. Please cite this article as: Dong GQ, Gao H, Sun YJ, Yang QH, Yao Y, Yang HY. Acupuncture alleviates inflammatory pain by regulating microglial polarization through α7nAchR-mediated autophagy. J Integr Med. 2026; Epub ahead of print.

Objective: Acute pancreatitis (AP) is a potentially life-threatening inflammatory disease with limited therapeutic options. Although honokiol has shown beneficial effects in animal models of AP, the mitochondrial mechanisms underlying these effects remain poorly understood. This study investigated whether honokiol protects against AP by activating the mitochondrial deacetylase sirtuin 3 (SIRT3) and regulating oxidative phosphorylation (OXPHOS) function.

Methods: A mouse model of caerulein-induced AP was established to assess the temporal expression of SIRT3 and the effects of its pharmacological inhibition. The efficacy of honokiol was evaluated in vivo using an AP mouse model and in vitro using 266-6 cells and primary pancreatic acinar cells. Proteomic analysis was performed to identify SIRT3-regulated mitochondrial proteins and pathways. Protein-protein docking and immunoprecipitation were used to validate the interaction and acetylation of the respiratory complex subunits.

Results: SIRT3 expression was markedly reduced in AP, while its inhibition exacerbated disease severity, confirming a protective role. Honokiol treatment restored SIRT3 expression, alleviated inflammation and mitochondrial damage, and partially rescued OXPHOS protein expression. The proteomic profiling identified three candidate OXPHOS subunits-adenosine triphosphate synthase membrane subunit K, cytochrome c1 (CYC1) and ubiquinol-cytochrome c reductase hinge protein-that were restored by honokiol treatment. The protein-protein docking analysis revealed strong binding affinity between SIRT3 and CYC1. The immunoprecipitation assay further confirmed that honokiol reduced the acetylation of CYC1, indicating that this effect is mediated by SIRT3 activity.

Conclusion: Honokiol activates SIRT3 and promotes deacetylation of the respiratory complex Ⅲ subunit CYC1, contributing to OXPHOS restoration and mitochondrial protection in AP. These findings suggest a previously unrecognized SIRT3-CYC1 signaling axis underlying honokiol's mitochondrial protective effects in AP. Please cite this article as: Miao YF, Yao JQ, Peng Y, Bai D, Fan SH, Li HY, Jin W, Lu Y. Honokiol protects against acute pancreatitis by activating SIRT3 to restore mitochondrial oxidative phosphorylation and alleviate hyperacetylation. J Integr Med. 2026; Epub ahead of print.

Objective: This study develops a core outcome set (COS) for clinical research concerning Chinese medicine (CM) dampness syndrome (COS-CMDS) that might improve heterogeneity of outcomes, reporting, and inadequate attention to the CM characteristic outcomes in clinical research on CM dampness syndrome.

Methods: An initial outcome pool was constructed based on a systematic review of clinical studies related to CM dampness, registered trials, and semi-structured interviews with patients and healthcare professionals. Various stakeholders were invited to participate in a 2-round Delphi survey to scrutinize the important outcomes. A consensus meeting was held to determine the final COS-CMDS.

Results: We identified 1904 studies and 73 registered trials in the systematic review. Six patients and seven healthcare professionals were invited to participate in a semi-structured interview. Then, 541 outcomes were extracted, of which 397 were physicochemical. After combining certain outcomes (especially the physicochemical outcomes) and excluding those with weak relevance by discussion, 26 outcomes were included in round 1 of the Delphi survey. Round 1 was completed by 82.89% of participants, and 22 outcomes were carried on to round 2. Round 2 was completed by 92.06% of participants, and 14 outcomes achieved consensus for inclusion in the COS. Nineteen stakeholders attended the consensus meeting, voted, and discussed the final COS. It included evaluation of dampness syndrome, CM syndrome assessment, effective response, validated laboratory outcomes of CM dampness syndrome, and adverse events.

Conclusion: The COS-CMDS provides a reference for the selection and reporting of outcomes in clinical research concerning CM dampness syndrome, embodying the characteristics of CM. Please cite this article as: Qiu XY, Tang Q, Cheng T, Cao WC, Liu BQ, Wen ZH, Li G. Developing a core outcome set for clinical research on Chinese medicine dampness syndrome. J Integr Med. 2026; Epub ahead of print.

Objective: This study used machine learning methods to develop a model that can offer personalized acupoint prescriptions for patients based on their symptoms, enhancing both the efficiency and effectiveness of acupuncture and moxibustion therapy (AMT).

Methods: We first preprocessed textual AMT data to build an acupoint prescription database designed for machine learning applications. Then, based on data analysis, we selected the hierarchical classification model hierarchical attention-based recurrent neural network (HARNN) to determine acupoint prescriptions based on symptoms. Computational experiments were conducted using 5-fold cross-validation to evaluate the model's performance, with intersection over union (IoU) as the primary evaluation metric. Finally, to enhance model interpretability, the local interpretable model-agnostic explanation (LIME) method was applied to visualize prediction results and improve its clinical applicability.

Results: On the original dataset of 5000 samples, HARNN achieved an IoU of 0.883 in predicting acupoint prescriptions. After data augmentation, the IoU reached 0.954 in 5-fold cross-validation, and 0.932 on a test set of 1000 original samples. The use of LIME enabled intuitive visualization of the model's prediction rationale, thereby enhancing the model's reliability.

Conclusion: This study developed a hierarchical and interpretable machine learning model that predicts acupoint prescriptions based on symptoms, integrating HARNN for hierarchical classification and LIME for interpretability, which provides an effective technical approach and methodology for the intellectualization of AMT. Please cite this article as: Yang H, Wu R, Nakata M, Ge QW. A hierarchical and interpretable machine learning model for acupoint determination. J Integr Med. 2026; Epub ahead of print.