Siu Wing Sum, Shum Wai Ting, Cheng Wen, Wong Chun Wai, Shiu Hoi Ting, Ko Chun Hay, Leung Ping Chung, Lam Christopher Wai Kei, Wong Chun Kwok
1Institute of Chinese Medicine, The Chinese University of Hong Kong, Shatin, NT Hong Kong SAR, China.
2State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, The Chinese University of Hong Kong, Shatin, NT Hong Kong SAR, China.
Chin Med. 2019 Dec 9;14:55. doi: 10.1186/s13020-019-0278-1. eCollection 2019.
The potential adverse effects of conventional oral pharmacotherapy of osteoarthritis (OA) restrict their long-term use. Topical application of a Chinese herbal paste for relieving OA knee pain can be effective and safe. However, evidence-based scientific research is insufficient to support its application worldwide. The aim of this study was to investigate the in vivo efficacy of a topical Chinese herbal paste on relieving OA knee pain and its underlying mechanism.
An OA rat model was developed by anterior cruciate ligament transection (ACLT) followed by treadmill running. A herbal paste including Dipsaci Radix, Achyranthis Bidentatae Radix, Eucommiae Cortex and Psoraleae Fructus, named as DAEP, was applied topically on the knee joint of the rats (DAEP). The rats without DAEP treatment served as Control. Rats with surgery but without ACLT, treadmill running and DAEP treatment acted as Sham. The morphologic change of the knee joint was observed radiographically. Nociception from the knee of the rats was assessed using Incapacitent test and CatWalk gait system. The therapeutic mechanism was investigated by analyzing the gene and protein expression of inflammatory markers via qPCR and Western blot, respectively.
Radiographic images showed less destruction at the posterior tibial plateau of the DAEP group compared with the Control after 2 weeks of treatment. The static weight ratio and the gait parameters of the Control were reduced significantly via Incapacitance test and CatWalk gait analysis, respectively. DAEP treatment increased the Print Area and Maximum Intensity significantly compared with the Control. DAEP significantly suppressed the upregulation of gene expression of interleukin (IL)-6, tumor necrosis factor (TNF)-α, and inducible nitric oxide synthase (iNOS).
DAEP exhibited its effect via the nuclear factor (NF)-κB pathway by suppressing the phosphorylation of IκB kinase αβ (p-IKKαβ) and cyclooxygenase-2 (COX-2) protein expression. This study provides scientific evidence to support the clinical application of the Chinese herbal paste on reliving OA pain.
骨关节炎（OA）传统口服药物治疗的潜在不良反应限制了其长期使用。外用中药膏剂缓解OA膝关节疼痛具有有效性和安全性。然而，基于证据的科学研究不足以支持其在全球范围内的应用。本研究旨在探讨外用中药膏剂缓解OA膝关节疼痛的体内疗效及其潜在机制。
通过切断前交叉韧带（ACLT）并进行跑步机跑步建立OA大鼠模型。将一种包含续断、牛膝、杜仲和补骨脂的药膏，命名为DAEP，局部应用于大鼠膝关节（DAEP组）。未接受DAEP治疗的大鼠作为对照组。接受手术但未进行ACLT、跑步机跑步和DAEP治疗的大鼠作为假手术组。通过X线摄影观察膝关节的形态变化。使用 incapacitent 试验和 CatWalk 步态系统评估大鼠膝关节的痛觉。分别通过qPCR和Western blot分析炎症标志物的基因和蛋白表达，以研究治疗机制。
治疗2周后，X线图像显示DAEP组胫骨后平台的破坏程度低于对照组。通过 incapacitent 试验和 CatWalk 步态分析，对照组的静态体重比和步态参数分别显著降低。与对照组相比，DAEP治疗显著增加了印迹面积和最大强度。DAEP显著抑制白细胞介素（IL）-6、肿瘤坏死因子（TNF）-α和诱导型一氧化氮合酶（iNOS）基因表达的上调。
DAEP通过抑制IκB激酶αβ（p-IKKαβ）的磷酸化和环氧合酶-2（COX-2）蛋白表达，经由核因子（NF）-κB途径发挥作用。本研究为支持中药膏剂缓解OA疼痛的临床应用提供了科学依据。
