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Review
. 2025 Nov 6;45(1):464.
doi: 10.1007/s10792-025-03833-7.

Mechanisms of acupuncture in the treatment of dry eye disease: narrative review of experimental studies

Yuanchao Fu  1 , Chengzhi Liu  2 , Guzhi Xu  1   3
Affiliations
Review

Mechanisms of acupuncture in the treatment of dry eye disease: narrative review of experimental studies

Yuanchao Fu et al. Int Ophthalmol. .

Abstract

Purpose: Dry Eye Disease (DED) is a common ocular disorder characterized by tear film instability, ocular inflammation, and discomfort, which significantly affects the quality of life. Traditional treatments primarily address the symptoms but do not always target the underlying pathophysiology of DED. Acupuncture, a complementary therapy in traditional Chinese medicine, has shown the potential to improve DED symptoms through multiple mechanisms. This review aimed to explore the therapeutic effects of acupuncture on DED, focusing on its role in enhancing lacrimal gland function, modulating inflammatory pathways, and alleviating ocular pain.

Methods: A comprehensive literature search was conducted across PubMed, Web of Science, and Scopus databases for studies published up to May 2025, using combinations of keywords including "acupuncture," "dry eye," and "experimental studies." Inclusion criteria were limited to laboratory-based studies investigating the mechanistic effects of acupuncture on DED.

Results: Acupuncture has been shown to improve tear production, reduce ocular surface inflammation, and regulate pain through various molecular pathways, including the upregulation of aquaporin 5 (AQP5), activation of the Vasoactive Intestinal Peptide (VIP)/cyclic Adenosine Monophosphate (cAMP)/Protein Kinase A (PKA) signaling pathway, and modulation of inflammatory mediators, including cytokines and microRNAs. Despite the promising clinical findings, the precise mechanisms through which acupuncture exerts its effects remain poorly understood.

Conclusion: Collectively, experimental findings provide mechanistic evidence supporting acupuncture as a multifaceted approach for DED management. Future research should aim to elucidate these mechanisms, optimize treatment protocols, and explore the integration of acupuncture with conventional therapies. Personalized acupuncture treatment strategies, combined with the development of biomarkers to monitor treatment efficacy, could further enhance their clinical application. This review highlights the potential of acupuncture as a novel and holistic approach to managing DED, warranting further investigation to fully establish its therapeutic role.

Keywords: Acupuncture; Dry eye disease; Inflammation; Lacrimal gland; Pain management.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that the research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest.

References

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