Li Yicheng, Xiong Jun, Lin Meng, Hu Han, Yao Lijun
Graduate School of Jiangxi University of CM, Nanchang 330004, China.
Department of TCM, Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province.
Zhongguo Zhen Jiu. 2025 Jul 12;45(7):957-966. doi: 10.13703/j.0255-2930.20240517-k0004.
To observe the effect of heat-sensitive moxibustion at "Feishu" (BL13) on immunoinflammatory response in rats with allergic rhinitis (AR) based on phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway, so as to explore its underlying mechanism.
Thirty-two male SD rats were randomly divided into a blank group (6 rats) and a modeling group (26 rats). In the modeling group, AR model was prepared using systemic and local attack sensitization method with ovalbumin. The successfully-modeled rats were randomized into a model group (6 rats), a medication group (6 rats) and a moxibustion group (14 rats). In the moxibustion group, the suspending moxibustion was operated at bilateral "Feishu" (BL13), 40 min each time, once daily, for 21 consecutive days; during which, the temperature of the body and tail was recorded. During intervention, if the temperature of the body and tail increased by >1 ℃, the heat-sensitive reaction at the point was determined in the rats of the moxibustion group, and these rats were collected in a heat-sensitive moxibustion group (8 rats involved and 6 rats of them were randomly collected to ensure the sample-size consistency); and those without heat-sensitive moxibustion reaction were assigned to a traditional moxibustion group (6 rats). In the medication group, fluticasone propionate nasal spray was applied, 8 μL on each side, once daily and for 21 days. The behavioral score for AR symptoms after modeling and intervention, and the content of serum immunoglobulin E (IgE) after modeling were observed. After intervention, the histological morphology of the nasal mucosa was observed using HE staining, the positive expression of thymic stromal lymphopoietin (TSLP) in the nasal mucosa was detected using immunohistochemistry, the levels of IgE, interleukin (IL)-4, IL-5, IL-13 and interferon-γ (IFN-γ) were detected by ELISA, and the protein expression of the member 4 of tumor necrosis factor receptor superfamily (OX40), phosphorylated protein kinase B (p-AKT), phosphorylated phosphatidylinositol 3-kinase (p-PI3K) in nasal mucosa was detected by Western blotting.
After modeling, the behavioral score of AR symptoms and serum IgE level in the modeling group were higher than those of the blank group (<0.01), suggesting the success of AR modeling. After intervention, compared with the blank group, the behavioral score of AR symptoms was increased (<0.01)；the nasal mucosa structure was disordered, the inflammatory infiltration was severe; the positive expression of TSLP in the nasal mucosa increased (<0.01), the levels of serum IgE, IL-4, IL-5, and IL-13 elevated (<0.01), and the level of IFN-γ decreased (<0.01); and the protein expression of OX40, p-AKT, and p-PI3K in the nasal mucosa increased (<0.05) in the model group. Compared with the model group, the behavioral score of AR symptoms was reduced (<0.01); the nasal mucosa structure, inflammatory infiltration, and vascular dilation were ameliorated to varying degrees; the positive expression of TSLP in the nasal mucosa decreased (<0.01); the content of serum IgE, IL-4, IL-5, and IL-13 decreased (<0.05), and that of IFN-γ increased (<0.05) in the medication, traditional moxibustion, and heat-sensitive moxibustion groups. Compared with the model group, the protein expression of p-AKT was reduced in the medication and traditional moxibustion groups (<0.05), the protein expression of OX40, p-AKT, and p-PI3K in the nasal mucosa decreased in the heat-sensitive moxibustion group (<0.05). When compared with the medication group, the positive expression of TSLP in the nasal mucosa was reduced (<0.05) in the heat-sensitive moxibustion group. In comparison with the traditional moxibustion group, the content of serum IL-13 was reduced and the content of IFN-γ elevated in the heat-sensitive moxibustion and the medication groups (<0.05), the protein expression of p-PI3K reduced in the medication group (<0.05), and the positive expression of TSLP and the protein expression of OX40 and p-PI3K in the nasal mucosa were reduced in the heat-sensitive moxibustion group (<0.05).
Heat-sensitive moxibustion at "Feishu" (BL13) can alleviate the symptoms of AR rats, ameliorate the inflammatory infiltration and telangiectasia of nasal mucosa, and inhibit immunoinflammatory response, which may be obtained by regulating PI3K/AKT signal pathway.
基于磷脂酰肌醇3激酶（PI3K）/蛋白激酶B（AKT）信号通路，观察“肺俞”（BL13）热敏灸对变应性鼻炎（AR）大鼠免疫炎症反应的影响，以探讨其作用机制。
将32只雄性SD大鼠随机分为空白组（6只）和造模组（26只）。造模组采用卵清蛋白全身和局部攻击致敏法制备AR模型。将造模成功的大鼠随机分为模型组（6只）、药物组（6只）和艾灸组（14只）。艾灸组于双侧“肺俞”（BL13）行悬灸，每次40分钟，每日1次，连续21天；期间记录大鼠体尾温度。干预过程中，若艾灸组大鼠体尾温度升高>1℃，则判定该点有热敏反应，并将这些大鼠纳入热敏灸组（共8只，随机选取6只以保证样本量一致）；无热敏反应者纳入传统艾灸组（6只）。药物组给予丙酸氟替卡松鼻喷雾剂，每侧8 μL，每日1次，共21天。观察造模及干预后AR症状行为学评分、造模后血清免疫球蛋白E（IgE）含量。干预后，采用HE染色观察鼻黏膜组织形态学变化，免疫组化法检测鼻黏膜中胸腺基质淋巴细胞生成素（TSLP）的阳性表达，ELISA法检测IgE、白细胞介素（IL）-4、IL-5、IL-13及干扰素-γ（IFN-γ）水平，Western blotting法检测鼻黏膜中肿瘤坏死因子受体超家族成员4（OX40）、磷酸化蛋白激酶B（p-AKT）、磷酸化磷脂酰肌醇3激酶（p-PI3K）的蛋白表达。
造模后，造模组AR症状行为学评分及血清IgE水平高于空白组（<0.01），提示AR造模成功。干预后，与空白组比较，模型组AR症状行为学评分升高（<0.01）；鼻黏膜结构紊乱，炎症浸润严重；鼻黏膜中TSLP阳性表达增加（<0.01），血清IgE、IL-4、IL-5、IL-13水平升高（<0.01），IFN-γ水平降低（<0.01）；鼻黏膜中OX40、p-AKT、p-PI3K蛋白表达增加（<0.05）。与模型组比较，药物组、传统艾灸组及热敏灸组AR症状行为学评分降低（<0.01）；鼻黏膜结构、炎症浸润及血管扩张均有不同程度改善；鼻黏膜中TSLP阳性表达降低（<0.01）；血清IgE、IL-4、IL-5、IL-13含量降低（<0.05），IFN-γ含量升高（<0.05）。与模型组比较，药物组和传统艾灸组p-AKT蛋白表达降低（<0.05），热敏灸组鼻黏膜中OX40、p-AKT、p-PI3K蛋白表达降低（<0.05）。与药物组比较，热敏灸组鼻黏膜中TSLP阳性表达降低（<0.05）。与传统艾灸组比较，热敏灸组和药物组血清IL-13含量降低，IFN-γ含量升高（<0.05），药物组p-PI3K蛋白表达降低（<0.05），热敏灸组鼻黏膜中TSLP阳性表达及OX40、p-PI3K蛋白表达降低（<0.05）。
“肺俞”（BL-13）热敏灸可减轻AR大鼠症状，改善鼻黏膜炎症浸润及毛细血管扩张，抑制免疫炎症反应，其机制可能与调节PI3K/AKT信号通路有关。
