| Rheumatoid arthritis(RA)is a chronic autoimmune disease that mainly accumulates small joints of the extremities.The lesions are mainly located in the synovial membrane,and can affect articular cartilage,ligaments,tendons,and heart,lung and other body tissues and organs.The initial symptoms are related to joint swelling and pain,adverse activities,followed by the destruction of joint cartilage,joint space narrowing,and joint stiffness may occur late symptoms,deformity,skeletal muscle atrophy,and ultimately there may be different degrees of dysfunction resulting in disability.At present,the specific etiology is not yet clear,but it is believed to be related to factors such as heredity,infection,and smoking.Anti-cyclic citrullinated peptide antibody(ACPA)has become one of the most important biomarkers.In the pathogenesis of this disease,it has promoted the pathogenesis of rheumatoid arthritis with Tumor necrosis factor(TNF-a).As part of the traditional Chinese medicine external treatment method,the fire needle has the effect of warming the meridians,removing cold and relieving pain,and has achieved good clinical results,but the related mechanism is less.ObjectiveIn this experiment,the effect of fire on the mechanism of RA was investigated by intervening the fire needle in rats with collagen-induced arthritis(CIA)and observing the contents of TNF-a and ACPA.MethodsA total 40 of male Wistar rats were used in the present study,and 8 rats were randomly selected as a normal control group.The other 32 rats were modeled.The primary immunity emulsion was made with mixed type II chicken collagen and Complete Freund’s Adjuvant,the emulsion containing 1 mg/ml collagen.On the bottom of the right foot tail root and back were injected with 0.1ml emulsion on each part.After 7 days,the same way to injected emulsion which were made with type II chicken collagen and Incomplete Freund’s adjuvant.The modeled last 21 days.Twenty-four rats were randomly divided into model group,methotrexate group and fire needle group,with 8 rats in each group.Rats in the control group and modeling group were put in the set in each day,then infused with 2 ml normal saline.Fire needle group was applied at the rats "Zusanli(ST36)" and "Kunlun(BL60)",once daily,alternating left and right legs in each time,a total of 10 times.Methotrexate group gavage with O.lmg/100g Methotrexate Normal saline,1 time/5 days,2 times in total.The body weight and diameter of the right ankle joint of each group were measured before modeling,before and after intervention.At the end of the intervention,the X-ray films of the rats’ the right ankle were taken and the serum TNF-a and ACPA contents were measured.Results1.Body weight:There was no significant difference in body weight between groups before modeling(P>0.05).After modeling,the body weight of each group was lower than that of the blank group(P<0.05);After intervention,the body weight of the model group,methotrexate group and fire needle group increased slowly,and there was a significant difference compared with the blank group(P<0.05).Compared with the model group,the body weight of rats in the methotrexate group and the fire needle group increased significantly(P<0.05),intervention description methotrexate group and fire needle group can improve the general condition of rats,growth trend of an increase in body weight in rats.There was no significant difference between the two groups in the methotrexate group and the fire needle group(P<0.05).2.Ankle diameter:There was no significant difference in ankle diameter between groups before modeling(P>0.05).Before intervention,the ankle diameter of model group,methotrexate group and fire needle group increased,and the difference was statistically significant compared with blank group(P<0.05).After intervention,compared with the blank group,the ankle diameter of each model group was still high,and the difference was statistically significant(P<0.05).Compared with the model group,the ankle diameter of methotrexate group and fire needle group decreased.the difference was statistically significant(P<0.05).Comparison between the methotrexate group and fire needle group,there was no statistically significant difference.3.Ankle X-ray image:After the intervention,the rats in the blank group had normal joint growth,no swelling,and clear joint space.In the model group,the joints of the foot and ankle were deformed,the bone was destroyed,the joint space was narrow,and the swelling around the joint was obvious.In methotrexate group and fire needle group,joint swelling was mild,mild bone deformity,and less bone destruction.4.Histomorphology of ankle joint:It can be seen from the HE stained slides that in the blank group,the synovial surface is smooth,the synovial cells are only 1-2 layers,and there is no inflammatory cell infiltration around the synovium.In the model group,the synovial cells proliferate,the synovium thickens,the surface is not smooth,and a large number of inflammatory cells infiltrate around the synovium.In the methotrexate group,synovial cell hyperplasia,synovial thick,but compared with the model group synovial thickening is less,inflammatory cell infiltration is also reduced.The histomorphology of the ankle joint in the fire needle group was similar to that in methotrexate group,Synovial cell proliferation is less and inflammatory cell infiltration is reduced.5.Serum TNF-a and ACPA:After intervention,compared with the blank group,the serum levels of TNF-alpha and ACPA increased.Compared with the model group,the levels of TNF-and ACPA in methotrexate group and fire needle group decreased(P>0.05),while the decrease of ACPA was more obvious,which was close to the blank group.There was no significant difference between methotrexate group and fire needle group(P>0.05).Conclusions1.The fire needle can improve the general condition of CIA rats.It can help the rats to reduce the movement disorders,lameness,squall diameter,increase food intake,body weight,restore hair growth and other indicators that affect quality of life.2.Fire needle can reduce the infiltration of inflammatory cells in the joints of CIA rats,improve joint deformities and slow down the destruction of bone,which is similar to methotrexate.3.Fire needles can reduce the serum levels of TNF-a and ACPA in RA rats,which may block the TLR-4 pathway,reduce the inflammatory response,and improve the immune mechanism of RA,thereby inhibiting the destruction of synovial tissue and bone damage.This may be one of the potential mechanisms for fire needle treatment of RA. |
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