The pain relief action of acupuncture is through activation of the body’s own opioids while improving the brain’s sensitivity to opioids. Other biochemicals involved in pain reduction have been found to be regulated by acupuncture stimulation, including ATP and adenosine, GABA and substance P.
Many studies have demonstrated that extracellular ATP signaling functions as an important dynamic regulatory pathway to coordinate appropriate immune responses in various pathological processes, including intracellular infection, host-tumor interaction, pro-inflammation vascular injury, and transplant immunity (Clin Immunol. 2018 Mar;188:67-73). ATP functions as a peripheral pain mediator (J Auton Nerv Syst. 2000 Jul 3;81(1-3):187-94.), and ATP in human skin elicits a dose-related pain response (Brain, Volume 123, Issue 6, June 2000, Pages 1238–1246 ). Nedergaard Lab (URMC) study showed that when the extracellular concentration of ATP exceeds the capacity for rapid removal, stimulated by acupuncture insertion, it will be enzymatically degraded and adenosine will accumulate, resulting in suppression of conductance of painful input, by activation of adenosine A1 receptors on peripheral pain fibers. Therefore, ATP signaling pathway may be one of the signal transduction pathways related to pain reduction, anti-inflammatory and Immunoregulatury actions of acupuncture. The mechanisms of acupuncture actions are complicated. Huge amount of work needs to be done to explore the mechanisms of acupuncture personalized pain treatment modalities.