Qi Xin, Chen You-Nan, Ma Yun-Xuan, Xing Long-Fei, Cui Yong-Qi, Guo Chang-Qing
School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China.
Zhen Ci Yan Jiu. 2025 Apr 25;50(4):402-410. doi: 10.13702/j.1000-0607.20240323.
To observe the effect of acupotomy on expression of long-chain acyl-CoA synthetase 4 (ACSL4), lysophosphatidylcholine acyltransferase 3 (LPCAT3), malondialdehyde (MDA) and 4-hydroxynonenal (4-HNE) in knee cartilage of rabbits with knee osteoarthritis (KOA), so as to explore whether acupotomy can treat KOA by inhibiting lipid peroxidation of chondrocytes.
Six-month-old New Zealand male rabbits were randomly divided into control, model, acupotomy and electroacupuncture (EA) groups, with 7 rabbits in each group. The KOA model was established by left hindlimb straightening fixation according to Videman method. In the acupotomy group, the high stress points, such as tendons attachment points of the vastus medialis, vastus lateralis, rectus femoris, biceps femoris and pes anserine bursa of the left hind limb knee joint were selected for acupotomy lysis treatment, once a week for 3 weeks. In the EA group, EA (2 Hz/100 Hz, 3 mA) was applied to "Neixiyan" (EX-LE4), "Dubi" (ST35), "Xuehai" (SP10) and "Liangqiu" (ST34) of the left hind limb of rabbits for 20 min, once every other day for 3 weeks. Before and after the treatment, Lequesne MG score and passive range of motion (PROM) of knee joint were detected in each group. After the treatment, safranin O-fast green staining was used to observe the morphological changes of rabbit knee cartilage and Mankin scoring was evaluated. Immunohistochemistry method was used to detect the location and positive expression of ACSL4. Western blot was used to detect the protein expression levels of ACSL4 and LPCAT3, and TBA and ELISA methods were used to detect the expression levels of MDA and 4-HNE in the affected knee cartilage, respectively.
Compared to the control group, the Lequesne MG score was significantly increased (<0.01), while PROM was significantly decreased (<0.01) in the model group;after the intervention and compared to the control group, the model group exhibited significant increase in Mankin score, enhancement in the positive expression of ACSL4 in knee cartilage (<0.01), along with significant elevation in ACSL4 and LPCAT3 protein expression levels (<0.01), as well as elevated contents of MDA and 4-HNE (<0.01). Compared to the model group, both the acupotomy group and EA group showed significant reductions in Lequesne MG score (<0.01) and increases in PROM (<0.01). Additionally, there were marked decreases in Mankin score and the positive expression of ACSL4 in knee cartilage (<0.01), as well as significant decreases in the protein expression levels of ACSL4 and LPCAT3 (<0.01). Moreover, the contents of MDA and 4-HNE decreased significantly (<0.01, <0.05). Compared to the EA group, the acupotomy group exhibited reduced Lequesne MG score (<0.01), increased PROM (<0.01), significant reductions in ACSL4 and LPCAT3 protein expression levels (<0.01), and lowered content of MDA (<0.01). Post-intervention, both groups showed significant reductions in Lequesne MG score (<0.01) and significant increases in PROM (<0.01) compared to their respective pre-intervention data.
Acupotomy intervention can down-regulate the levels of ACSL4, LPCAT3, MDA and 4-HNE in knee cartilage, improve the behavior of affected limbs, indicating that acupotomy therapy may inhibit lipid peroxidation in chondrocytes and slow down cartilage injury to treat KOA.
观察针刀对膝骨关节炎(KOA)家兔膝关节软骨中长链脂酰辅酶A合成酶4(ACSL4)、溶血磷脂酰胆碱酰基转移酶3(LPCAT3)、丙二醛(MDA)和4-羟基壬烯醛(4-HNE)表达的影响,探讨针刀是否可通过抑制软骨细胞脂质过氧化来治疗KOA。
将6月龄新西兰雄性家兔随机分为对照组、模型组、针刀组和电针组,每组7只。参照Videman法通过左后肢伸直固定建立KOA模型。针刀组选取左后肢膝关节内侧、外侧股四头肌、股直肌、股二头肌肌腱附着点及鹅足囊等高应力点进行针刀松解治疗,每周1次,共3周。电针组将电针(2 Hz/100 Hz,3 mA)施加于家兔左后肢的“内膝眼”(EX-LE4)、“犊鼻”(ST35)、“血海”(SP10)和“梁丘”(ST34),每次20分钟,隔日1次,共3周。治疗前后,检测每组的Lequesne MG评分和膝关节被动活动度(PROM)。治疗后,采用番红O-固绿染色观察家兔膝关节软骨的形态变化并进行Mankin评分。采用免疫组织化学方法检测ACSL4的定位及阳性表达。采用蛋白质印迹法检测ACSL4和LPCAT3的蛋白表达水平,分别采用硫代巴比妥酸(TBA)法和酶联免疫吸附测定(ELISA)法检测患侧膝关节软骨中MDA和4-HNE的表达水平。
与对照组相比,模型组Lequesne MG评分显著升高(<0.01),而PROM显著降低(<0.01);干预后与对照组相比,模型组Mankin评分显著升高,膝关节软骨中ACSL4阳性表达增强(<0.01),同时ACSL4和LPCAT3蛋白表达水平显著升高(<0.01),MDA和4-HNE含量升高(<0.01)。与模型组相比,针刀组和电针组Lequesne MG评分均显著降低(<0.01),PROM均升高(<0.01)。此外,Mankin评分及膝关节软骨中ACSL4阳性表达均显著降低(<0.01),ACSL4和LPCAT3蛋白表达水平显著降低(<0.01)。而且,MDA和4-HNE含量显著降低(<0.01,<0.05)。与电针组相比,针刀组Lequesne MG评分降低(<0.01),PROM升高(<0.01),ACSL4和LPCAT3蛋白表达水平显著降低(<0.01),MDA含量降低(<0.01)。干预后,两组与各自干预前数据相比,Lequesne MG评分均显著降低(<0.01),PROM均显著升高(<0.01)。
针刀干预可下调膝关节软骨中ACSL4、LPCAT3、MDA和4-HNE水平,改善患肢行为,表明针刀疗法可能通过抑制软骨细胞脂质过氧化、减缓软骨损伤来治疗KOA。