Table 1.

Possible mechanisms of action of acupuncture

Possible mechanisms of action of acupuncture	Effects	References
Local inflammatory response Histamine Prostaglandins Chemokines	increasing permeability and dilatation of the capillaries promotion of blood flow to the site initiation of the migration of phagocytes and signaling them to increase production of various mediators	[20]
Cytokines decreased expression of IL-6, βNGF and TIMP-1 reducing proinflammatory cytokines IL-1, IL-6, TNF-α through activation of CB2 receptors	anti-inflammatory effect antinociceptive effect on inflammatory pain	[21, 22]
ANS increasing synchronization between the two branches of the ANS and improvement of HRV	mediating global physiological regulation	[23]
Stem cells increasing levels of non-differentiated progenitor of stem cells CD133+ and CD34– cell in the serum of patients after spinal cord injury promotion of proliferation and differentiation of neural stem cells, up-regulation of the growth factors and the expression of VEGF mRNA in the rats ischemic brain	spinal cord stem cell mobilization protection cerebral injuries after ischemia and promotion nerve regeneration	[24]

IL – interleukin; NGF – nerve growth factor; TIMP-1 – tissue inhibitors of metalloproteinase-1; CB2 – cannabinoid receptor 2; ANS – autonomic nervous system; HRV – heart rate variability; CD – cluster of differentiation; VEGF – vascular endothelial growth factor