The double effect of autophagy on stroke and the progress of acupuncture intervention

Stroke is defined as a severe malignant cerebrovascular event that poses a significant threat to human health. It is distinguished by a high incidence, high disability rate and high mortality rate. The exploration of the pathogenesis and effective treatment methods of stroke is a key and challenging focus of both traditional Chinese medicine and Western medicine research. Autophagy, a pivotal degradation and metabolic mechanism in eukaryotic cells, plays a crucial role in maintaining cellular homeostasis, responding to oxidative stress and regulating energy metabolism. Researchers have demonstrated that autophagy exhibits a bidirectional regulatory function in the context of stroke: moderate autophagy is beneficial for clearing damaged organelles and proteins, maintaining energy homeostasis, and exerting protective effects; however, excessive or insufficient autophagy may promote inflammatory responses and cell death. Furthermore, the role of autophagy exhibits dynamic variation across the various pathological stages of stroke. Acupuncture, a fundamental element of traditional Chinese medicine, has been demonstrated to play a substantial role in promoting recovery from central nervous system diseases. Among its advantages are high safety and proven therapeutic efficacy in the treatment of stroke. Mechanistic studies have demonstrated that acupuncture can regulate key autophagy proteins and affect multiple signaling pathways, thus promoting normal autophagy activation to aid cellular self-repair, while also inhibiting excessive autophagy to reduce cell death, achieving neuroprotection and functional recovery. The therapeutic effect of acupuncture on stroke is closely related to its dynamic regulation of autophagy levels. This regulatory process is not simply activation or suppression, but is tailored according to disease stages and pathological types. This review methodically summarizes the mechanisms of autophagy in stroke, and the potential role of acupuncture in regulating autophagy for stroke treatment, with the objective of providing more comprehensive theoretical support for acupuncture therapy in stroke.