REVIEW article
Front. Immunol.
Sec. Multiple Sclerosis and Neuroimmunology
This article is part of the Research TopicNeuro-Immune Dialogue in Pain Onset and Maintenance: classical and novel targetsView all articles
From Arthritis to Central Sensitization: Targeting the Neuro-Immune Axis via Microglial Modulation in Acupuncture Treatment for Juvenile Idiopathic Arthritis (JIA)-Associated Pain
Provisionally accepted
- School of Pediatric Medicine, Henan University of Traditional Chinese Medicine, Zhengzhou, China
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Juvenile Idiopathic Arthritis (JIA) is a common chronic rheumatic disease in children, and its associated persistent pain severely impacts the quality of life of affected patients. The severity of JIA-associated pain often does not correlate with the degree of peripheral inflammation, suggesting that Central Sensitization is a key underlying mechanism specific to JIA subtypes. At the core of this process is a dysregulation of the neuro-immune axis, particularly the aberrant activation of microglia within the central nervous system. As a non-pharmacological therapy, acupuncture demonstrates significant potential for JIA pain management, supported by a series of clinical studies. This review focuses on JIA-specific neuro-immune pathophysiology of chronic pain and systematically elucidates the complete pathway from peripheral inflammation to central microglial activation and central sensitization. By integrating evidence from both preclinical and clinical JIA studies, we provide a detailed analysis of how acupuncture remodels neuro-immune balance through mechanisms spanning peripheral autonomic regulation and central glial modulation. This modulation encompasses the inhibition of upstream pro-inflammatory signaling pathways. These include peripheral anti-inflammatory effects via the vagus nerve, regulation of systemic immunity, and direct inhibition of central microglial activity toward an anti-inflammatory phenotype. This work establishes a theoretical framework, grounded in JIA-specific neuro-immune pathophysiology, for acupuncture's application in treating JIA-associated pain, highlighting its role in reducing reliance on analgesics.
Keywords: Juvenile idiopathic arthritis (JIA), Chronic Pain, central sensitization, Microglia, Acupuncture, Neuro-immune axis, Vagus Nerve, Mitochondria
Received: 12 Aug 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 CHEN, JiXiang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xia Zhang
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