Acupuncture-associated gastric mucosal repair and the EGF–EGFR-related signaling network: evidence, limitations, and prospects

Gastric mucosal injury, particularly peptic ulcer-related injury, remains clinically relevant because incomplete or unstable repair may be followed by recurrent symptoms, bleeding, or perforation. Acid suppression and Helicobacter pylori eradication are central to treatment, but they do not directly explain the cellular and molecular processes that determine the quality of mucosal healing. The epidermal growth factor (EGF)-epidermal growth factor receptor (EGFR) network is involved in epithelial restitution, proliferation, survival, glandular reconstruction, and tissue remodeling, and therefore provides a useful framework for evaluating acupuncture-associated gastric mucosal repair. Reported acupuncture, electroacupuncture, and moxibustion studies describe changes in mucosal injury, inflammation, oxidative stress, neurohumoral regulation, perfusion-related factors, epithelial survival, and downstream signaling. However, direct receptor-centered evidence is scarce. Existing acupuncture-related evidence is largely based on total EGF or EGFR and downstream markers, rather than concurrent p-EGFR assessment, linked repair outcomes, and receptor-blocking experiments. Overall, the evidence places EGF-EGFR signaling as a plausible component of acupuncture-associated gastric repair, although receptor-dependent causality has not yet been demonstrated. Future studies should use standardized intervention protocols, time-resolved receptor and downstream measurements, causal perturbation where feasible, and clinically meaningful outcomes such as endoscopic healing, histological repair, recurrence, bleeding, and safety.