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Electroacupuncture enhances anti-tumor immunity in TNBC by reducing NE release and blocking α2-AR-mediated NGF/Hippo signaling.

Overview

Authors: Fei-Fei Li1,2, Yan Huang1,3, Chun-Fang Gao1, Chun-Yu Wu2, Chen-Ping Sun2, Yue-Nong Qin2, Ying Xie4, Sheng Liu2,4, Huan-Gan Wu1,3
  1. Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine,Shanghai, 200437 People’s Republic of China
  2. Integrated Traditional Chinese and Western Medicine Breast Department, Longhua Hospital Shanghai University of Traditional Chinese Medicine,Shanghai, 200030 People’s Republic of China
  3. Shanghai Institute of Acupuncture and Meridian Research, Shanghai, 200030 People’s Republic of China
  4. Institute of Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine,Shanghai, 200030 People’s Republic of China
Journal: Chinese medicine, volume 21, issue 1, article 186
Dates: received 14 April 2026; accepted 9 June 2026; published online 13 July 2026
Type: Research article · Language: English
License: CC BY
Identifiers: DOI 10.1186/s13020-026-01445-6 · PMID 42443928 · PMCID PMC13361121 · OpenAlex W7168190479
Open access: gold, a free copy (OpenAlex)
Status: data only
Categories: genetics / omics (modality), mouse (organism), other condition (population), cellular / molecular (subfield)
Methods: Statistics
Keywords: Electroacupuncture, Triple-negative breast cancer, Norepinephrine, Tumor immune microenvironment, CD8+ T cell
Topic: Hippo pathway signaling and YAP/TAZ (Cell Biology, Biochemistry, Genetics and Molecular Biology), according to OpenAlex
Funding: National Natural Science Foundation of China funded project (82405389); Clinical Research Project of the National Medical Center, Longhua Hospital Shanghai University of Traditional Chinese Medicine (GFB2401-1-3); High-level Chinese Medicine Key Discipline Construction Project of National Administration of Traditional Chines Medicine (zyyzdxk-2023068)
Citations: not cited yet (Europe PMC); 73 references in the paper

Abstract

Background: Targeting the neuro-immune microenvironment to suppress triple-negative breast cancer (TNBC) represents a critical strategy in tumor immunotherapy.

Methods: A syngeneic 4T1 orthotopic TNBC model in Balb/c mice was employed. EA was applied at ST36 (Zusanli) using systematically optimized parameters (2/15 Hz, 3 mA, 30 min, every other day). Multi-dimensional immunophenotyping by flow cytometry, immunofluorescence, and Western blot was performed across tumor, blood, and splenic compartments. Transcriptome sequencing coupled with KEGG/GSEA pathway analysis was used to identify downstream signaling networks. The NGF/Hippo/YAP axis and adrenergic receptor subtype specificity were validated through pharmacological intervention in vitro, while EA synergy with αPD-L1 was assessed in a CD8+ T cell-depletion model.

Results: ST36 stimulation at 3 mA preferentially suppressed TNBC tumor growth and augmented intratumoral immune infiltration, characterized by elevated CD8+ T cells, NK cells, and M1-polarized macrophages. EA significantly enhanced CD8+ T cell effector capacity, upregulating perforin, granzyme B, CD69, and ZAP70 phosphorylation, and synergized with αPD-L1 in a CD8+ T cell-dependent manner. Mechanistically, EA activated c-Fos+/ChAT+ cholinergic neurons in the dorsal motor nucleus of the vagus (DMV) and reduced norepinephrine (NE) output in both circulation and tumors. Transcriptomic profiling identified NGF downregulation and Hippo pathway activation as central events. EA upregulated AMOT, driving YAP phosphorylation at Ser127, cytoplasmic sequestration of YAP, and suppression of downstream IL-6 secretion. In vitro, exogenous NGF suppressed YAP phosphorylation and promoted TNBC malignant behavior, effects fully reversed by the YAP inhibitor verteporfin. α2-adrenergic receptor (α2-AR) antagonism with yohimbine abrogated NE-induced NGF upregulation, pinpointing α2-AR as the receptor subtype linking sympathetic signaling to the NGF/Hippo axis.

Conclusion: EA at ST36 recalibrates neuro-sympathetic tone in TNBC by activating vagal cholinergic outflow, reducing NE-driven α2-AR/NGF/Hippo signaling, and thereby relieving immunosuppression while amplifying CD8+ T cell-mediated cytotoxicity. These findings establish a neuro-immune mechanistic framework for EA-based adjuvant immunotherapy in TNBC.

Supplementary Information: The online version contains supplementary material available at 10.1186/s13020-026-01445-6.

Reproduced under the paper's license (CC BY), from the paper cited above.

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Data

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Reproduced under the paper's license (CC BY), from the paper cited above.

Versions

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Version 1, 27 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 9 authors, 5 keywords, 3 funders, 65 references.

Cite

This paper

Li, F.-F., Huang, Y., Gao, C.-F., Wu, C.-Y., Sun, C.-P., Qin, Y.-N., Xie, Y., Liu, S., & Wu, H.-G. (2026). Electroacupuncture enhances anti-tumor immunity in TNBC by reducing NE release and blocking α2-AR-mediated NGF/Hippo signaling. Chinese medicine, 21(1), 186. https://doi.org/10.1186/s13020-026-01445-6

BibTeX

@article{li2026electroacupuncture,
author = {Li, Fei-Fei and Huang, Yan and Gao, Chun-Fang and Wu, Chun-Yu and Sun, Chen-Ping and Qin, Yue-Nong and Xie, Ying and Liu, Sheng and Wu, Huan-Gan},
title = {{Electroacupuncture enhances anti-tumor immunity in TNBC by reducing NE release and blocking α2-AR-mediated NGF/Hippo signaling}},
journal = {Chinese medicine},
year = {2026},
month = jul,
volume = {21},
number = {1},
pages = {186},
publisher = {BMC},
issn = {1749-8546},
doi = {10.1186/s13020-026-01445-6},
url = {https://doi.org/10.1186/s13020-026-01445-6},
pmid = {42443928},
pmcid = {PMC13361121}
}

RIS

TY - JOUR
AU - Li, Fei-Fei
AU - Huang, Yan
AU - Gao, Chun-Fang
AU - Wu, Chun-Yu
AU - Sun, Chen-Ping
AU - Qin, Yue-Nong
AU - Xie, Ying
AU - Liu, Sheng
AU - Wu, Huan-Gan
TI - Electroacupuncture enhances anti-tumor immunity in TNBC by reducing NE release and blocking α2-AR-mediated NGF/Hippo signaling
T2 - Chinese medicine
J2 - Chin Med
PY - 2026
DA - 2026/07/13
VL - 21
IS - 1
SP - 186
SN - 1749-8546
PB - BMC
DO - 10.1186/s13020-026-01445-6
UR - https://doi.org/10.1186/s13020-026-01445-6
LA - en
ER -

CSL-JSON

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