Abstract
OBJECTIVE: Mast cells drive allergic diseases (asthma, rhinitis, dermatitis) via degranulation and pro-inflammatory mediator release. This review explores acupuncture's role in modulating mast cells to alleviate allergic symptoms. METHODS: We screened PubMed and Embase databases from January 2010 to January 2025 to search for published studies. The search keywords used are as follows: ["acupuncture" or "electroacupuncture"], ["allergic disease" or "asthma" or "allergic rhinitis" or "dermatitis" or "urticaria"], ["mast cell"]. 365 peer-reviewed studies on human/animal models were included, and articles that did not meet the requirements were excluded. RESULTS: Acupuncture inhibited mast cell degranulation, reducing histamine and IgE levels. It downregulated pro-inflammatory cytokines (TNF-α, IL-4, IL-5, IL-13) and upregulated anti-inflammatory IL-10, via suppressing NF-κB, MAPK (p38, ERK), and TLR4/MyD88 pathways. Clinically, it improved asthma (FEV1/PEF elevation), allergic rhinitis, and atopic dermatitis. Preclinically, it reduced eosinophil infiltration and inhibited NLRP3/caspase-1-mediated pyroptosis, further mitigating inflammation. CONCLUSION: Acupuncture alleviates allergic disorders by targeting mast cells and inflammatory cascades, supporting its potential as a safe, effective therapeutic option.