College of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China.
Zhen Ci Yan Jiu. 2023 Oct 25;48(10):993-1000. doi: 10.13702/j.1000-0607.20220952.
To observe the similarities and differences of effects of moxibustion at "Zusanli" (ST36) on target tissues and macrophages polarization in knee osteoarthritis (KOA) and rheumatoid arthritis (RA) rats, and to summarize its efficacy and characteristics.
Thirty rats were equally and randomly divided into control, KOA, RA, KOA+Moxi and RA+Moxi groups. The KOA model and RA model were induced by injection of sodium monoiodoacetate or Freund's complete adjuvant into the rats' knee joints, respectively. Rats of the KOA+Moxi and RA+Moxi groups received moxibustion stimulation at bilateral ST36 for 30 min, once a day for 21 days, beginning from the 7 day on after modeling. The contents of serum interleukin(IL)-1β and IL-10 were detected by ELISA. Histopathological changes (Markin score of the knee cartilage and synovial pathology score) of the knee joints were observed after HE staining. The polarization state of M1 and M2 macrophages in the synovial tissue of the knee joints was assessed by detecting the expression of CD86 and CD206 after immunofluorescence staining.
Compared with the control group, the content of serum IL-1β, synovial pathology score, and synovial CD86 expression were significantly increased (<0.01, <0.05), while the content of serum IL-10 and synovial CD206 expression markedly decreased (<0.01) in both KOA and RA groups；the Markin score was increased (<0.01) in the KOA group. In comparison with the KOA group, the Markin score was obviously decreased (<0.01), while the content of serum IL-10 and CD206 expression were apparently increased (<0.01) in the KOA+Moxi group. No significant changes were found in the content of serum IL-1β, synovial pathology score and CD86 expression in the KOA+Moxi group relevant to the KOA group. In comparison with the RA group, the content of serum IL-1β, synovial pathology score, and CD86 expression were considerably decreased (<0.01) in the RA+Moxi group. No marked differences were found in the serum IL-10 level, Markin score, and CD206 expression between RA+Moxi and RA model groups. The increased Markin score was significantly higher in the KOA group than in the RA group (<0.01), but the increased synovial pathology score was significantly lower in the KOA group than in the RA group (<0.01). Correspondingly, the effect of moxibustion at ST36 was significantly better in RA model than in KOA model in reducing serum IL-1β (<0.05).
Moxibustion at ST36 can effectively reduce cartilage injury of knee joint in rats with KOA and reduce synovial injury in rats with RA, which may be related with its effects in lowering IL-1β level in RA model by inhibiting the polarization of M1 macrophages, and up-regulating level of IL-10 in KOA model by promoting the polarization of M2 macrophages. However, the relevant mechanism needs to be further studied.
观察艾灸“足三里”（ST36）对膝骨关节炎（KOA）和类风湿关节炎（RA）大鼠靶组织和巨噬细胞极化的影响异同，总结其疗效特点。
30 只大鼠等分为空白组、KOA 组、RA 组、KOA+艾灸组、RA+艾灸组。采用向大鼠膝关节内注射单碘乙酸钠或弗氏完全佐剂的方法诱导 KOA 及 RA 模型。KOA+艾灸组和 RA+艾灸组从造模第 7 天开始，每日对双侧 ST36 进行艾灸 30min。采用 ELISA 法检测血清白细胞介素（IL）-1β和 IL-10 含量，HE 染色观察膝关节软骨的组织病理学变化（软骨马克林评分）和滑膜组织病理学评分，免疫荧光染色检测膝关节滑膜组织中 M1 和 M2 型巨噬细胞的极化状态（CD86 和 CD206 的表达）。
与空白组比较，KOA 组和 RA 组大鼠血清 IL-1β 含量、滑膜组织病理学评分和 CD86 表达均显著升高（P<0.01、P<0.05），血清 IL-10 含量和 CD206 表达均显著降低（P<0.01），KOA 组软骨马克林评分升高（P<0.01）；与 KOA 组比较，KOA+艾灸组大鼠血清 IL-10 含量和 CD206 表达均显著升高（P<0.01），软骨马克林评分降低（P<0.01），血清 IL-1β 含量、滑膜组织病理学评分和 CD86 表达无明显变化。与 RA 组比较，RA+艾灸组大鼠血清 IL-1β 含量、滑膜组织病理学评分和 CD86 表达均显著降低（P<0.01），血清 IL-10 含量、软骨马克林评分和 CD206 表达无明显变化。KOA 组大鼠软骨马克林评分显著高于 RA 组（P<0.01），滑膜组织病理学评分显著低于 RA 组（P<0.01）；艾灸 ST36 对 RA 模型大鼠的血清 IL-1β 降低作用优于 KOA 模型（P<0.05）。
艾灸 ST36 可有效减轻 KOA 大鼠膝关节软骨损伤，减轻 RA 大鼠滑膜损伤，其机制可能与艾灸通过抑制 M1 型巨噬细胞极化降低 RA 模型大鼠 IL-1β 水平，促进 KOA 模型大鼠 M2 型巨噬细胞极化升高 IL-10 水平有关，但具体机制尚需进一步研究。
