ArticleJournal of inflammation research2026
Acupuncture Activates PI3K/Akt Pathway to Promote Spinal Microglial M2 Polarization and Alleviate Spastic Hemiplegia Following Ischemic Stroke.
Article in Journal of inflammation research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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6 authors.
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Abstract
Purpose: Studies showed that post-ischemic spastic hemiplegia can be linked to neuroinflammation mediated by microglial polarization. Microglial M1/M2 polarization is regulated by the PI3K/Akt pathway. We previously reported that acupuncture alleviated spasticity after permanent middle cerebral artery occlusion (p-MCAO). This study investigated whether its antispastic effects were associated with activation of the spinal PI3K/Akt pathway and promotion of microglial M2 polarization. Methods: p-MCAO was induced in Sprague-Dawley rats to establish a model of spastic hemiplegia. Yanglingquan (GB34) was needled using waggle needling, a motion‑style acupuncture technique. Its association with spasticity alleviation and motor recovery was evaluated by behavioral assessments, TTC staining, and the H-reflex test. Molecular analyses were performed to investigate the underlying mechanisms. Minocycline was used to examine the role of microglial polarization, while LY294002 and 740Y-P were used to determine whether the effects of acupuncture were mediated through the PI3K/Akt pathway. Results: Rats with p-MCAO-induced spastic hemiplegia exhibited neurological deficits, increased muscle tone, motor dysfunction, and spinal hyperexcitability, together with microglial M1 polarization, inflammatory responses, spinal excitatory/inhibitory imbalance, and suppressed PI3K/Akt activity. Acupuncture at GB34 alleviated spasticity and promoted motor recovery. It also activated the spinal PI3K/Akt pathway, promoted microglial M2 polarization, reduced IL-6 and TNF-α, and increased IL-10 and TGF-β. In addition, acupuncture attenuated spinal hyperexcitability, as indicated by improvement in the H-reflex, and restored spinal excitatory/inhibitory balance, as reflected by regulation of vGluT1/vGAT-associated synaptic markers and Glu/GABA levels. Minocycline produced partially similar improvements, whereas LY294002 partially blocked the effects of acupuncture and 740Y-P only partially mimicked them. Conclusion: Acupuncture alleviates spastic hemiplegia by activating the PI3K/Akt pathway and promoting spinal microglial M2 polarization. These findings support its potential clinical application for post-stroke spasticity and identify the PI3K/Akt pathway as a potential therapeutic target.
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