Name: Du-Moxibustion in the Treatment of Ankylosing Spondylitis (AS) in an AS Mouse Model
Uploaded: 2023-10-27T12:20:00
Description: Watch this Scientific Journal Video about Du-Moxibustion in the Treatment of Ankylosing Spondylitis AS in an AS Mouse Model at JoVE.com

du-moxibustion in the treatment of ankylosing spondylitis (as) in an as mouse model

強直性脊椎炎におけるデュモキシションの治療可能性の探求

Ankylosing spondylitis (AS) is a progressively worsening and disabling form of arthritis that primarily affects the axial skeleton. According to the latest epidemiological survey, ~0.01%-1.8% of people in the world suffer from this condition1, most of whom are young males (male to female ratio is ~2-3:1)2. The incidence of AS in the Chinese population is 0.2%-0.4%. This disease mainly involves the spine and the sacroiliac joint. Fusion of the spine and the sacroiliac joint may occur in the later stages of the disease, resulting in spinal stiffness and kyphosis, as well as difficulty in walking, which seriously affects the quality of work and daily living activities and imposes a heavy burden on the patient, family, and society1. Currently, there is no definitive solution for AS, and the provided treatments, both pharmacological and non-pharmacological, primarily focus on alleviating pain, slowing disease progression, and enhancing the quality of life. In recent years, because pharmacotherapeutic options have been very limited3, increasing attention has been paid to non-pharmacotherapy, which has become an alternative therapy for AS. In China, patients often prefer external treatment consisting of Traditional Chinese Medicine (TCM), which has minor side effects and great convenience during the treatment.
Moxibustion is an ancient therapeutic technique used in TCM. Du-moxibustion is an external treatment technique consisting of &#34;medicated moxibustion with foam&#34; on the spine segment of the Du meridian. It is mainly used in the treatment of AS and has shown safety and effectiveness. Compared with ordinary moxibustion, Du-moxibustion has the characteristics of a wide moxibustion area, a large moxa cone, strong firepower, and high temperature4. A systematic review and meta-analysis suggest that moxibustion is an effective complementary treatment for AS5. A recent study confirmed that the clinical symptoms and some inflammatory factors of AS patients were improved by moxibustion6. Studies have revealed that Du-moxibustion can increase the brain content of &#946;-endorphin and exert a central analgesic effect7, downregulate the expression of the HLA-B27 gene8, and delay the recurrence rate of AS. Du-moxibustion also has an ameliorating effect on the progression of AS by decreasing the inflammatory index ESR (ESR) and levels of C-reactive protein (CRP), C-terminal peptide of type I collagen (CTX-I), and Dickkopf1 protein (DKK1)9,10.
Another clinical study showed that Du-moxibustion can further adjust the disordered T cell subsets, Ig, and complement C3 to balance the immune mechanism11. In terms of bone metabolism, moxibustion can inhibit the rise of serum alkaline phosphatase (ALP) and serum phosphorus (S-P), increase serum calcium (S-Ca), bone mineral density (BMD), and bone strength12. Moreover, Du-moxibustion can repair spinal function at multiple points to relieve fatigue symptoms in AS patients13. Some animal studies have revealed the potential mechanism of moxibustion in treating AS. A study indicated that moxibustion significantly improved the overall health status, reduced the levels of paw thickness, and decreased the levels of IL-1&#946;, PGE2, IL-6, and TNF-&#945; in the ligament tissue samples of the spine. Metabolic pathway analysis linked the identified metabolites to the TCA cycle, as well as lipid, amino acid, intestinal flora, and purine metabolism14. Another study showed that moxibustion suppressed the expression of pro-inflammatory cytokines, IL-1&#946;, TNF-&#945;, IL-17, and IL-6; reduced the mRNA levels of RANKL, RANK, ALP, and OCN; and improved the histopathological features in AS mice15.
While these studies suggest that moxibustion may be effective in the treatment of AS, more research is needed to confirm these findings and determine the optimal treatment protocol for moxibustion in patients with AS. Our team created and modified the moxibustion therapy based on the basic theory and practical operation of traditional Chinese moxibustion, which has been widely carried out and applied in Chinese clinical practice for over 35 years. Although there are few high-quality studies on the treatment of AS by Du-moxibustion, its indication in treating AS has been supported by evidence. However, the mechanism of treating AS with Du-moxibustion is worthy of further study. Animal study is an important method to explore the mechanism of Du-moxibustion in the treatment of AS. The clinical operation of Du-moxibustion is relatively mature but rarely used in the study of the mechanism in animal experiments. This paper describes in detail the operation and precautions to be taken during Du-moxibustion in the treatment of AS experimental mice.

著者スポットライト:マウスの強直性脊椎炎に対する伝統的な中国療法の評価 

強直性脊椎炎のマウスモデルにおけるDu-Hoxibustion

The scope of our research focuses on the treatment of ankylosing spondylitis using du-moxibustion, the traditional Chinese external therapy. This paper describes in detail the operating procedures and precautions to be taken during du-moxibustion in treating ankylosing spondylitis in experimental mice. Our study found that du-moxibustion could improve motor coordination and autonomic movement, reduce ankle swelling, and alleviate inflammation in mice with AS.The traditional Chinese medicine external treatment of du-moxibustion was introduced for the first time in detail and more experiments, laying the foundation for future treatment of AS mechanism research.As a external therapeutic technique used in traditional Chinese medicine, du-moxibustion skillfully combines the compatible technicals of TCM to integrate meridians, acupoints, Chinese herbal medicine, and moxibustion, which directly acts on the spine area and makes overall adjustment to related site. In future studies, we will pay attention to the evaluation of different parameters, such as placebo moxibustion dose range and treatment time to obtain the most effective combination schemes. In later studies, imaging methods can be used to evaluate the treatment results in a more intuitive way.

Watch this Scientific Journal Video about Du-Moxibustion in the Treatment of Ankylosing Spondylitis AS in an AS Mouse Model at JoVE.com

Du-Moxibustion in the Treatment of Ankylosing Spondylitis (AS) in an AS Mouse Model  

ASマウスモデルにおける強直性脊椎炎(AS)の治療におけるDu-Hoxibustion

まず、ベルベットの切れ端を取り、それを紡錘形にねじってお灸コーンを作ります。次に、生姜を細かく切り、ジューサーでピューレにします。生姜のピューレを綿ガーゼでろ過して、生姜ジュースと泥をピューレから分離します。後で使用するために、紙コップに10グラムの生姜泥と20ミリリットルの生姜ジュースを入れます。次に、0.1グラムの漢方薬粉末を取り、乳鉢で挽きます。マウスに麻酔を投与し、適切な手術深度を確認した後、麻酔導入ボックスから取り出します。マウスを手術台に伏せた姿勢で固定します。マウスの口と鼻を麻酔薬の出口に合わせます。麻酔を維持し、操作手順中はマウスを摂氏37度の加熱パッドの上に置きます。乾燥を防ぐために、マウスの目に潤滑剤を塗布します。次に、マウスのツボを見つけて、刺激領域を特定します。マウスの背中の肌色の皮膚が見えるまで、マウスの背中の毛を剃ります。脱毛幅は1.5センチで、C7から尾椎まで伸びていることを確認してください。綿ガーゼを使用して、準備した生姜ジュースをマウスの背中の剃った部分に塗ります。次に、筆で、ネズミの背中の正中線に漢方薬の粉末を均等に振りかけ、その部分を桑紙で覆います。次に、生姜泥を使って台形の生姜柱を作り、それを桑紙に塗ります。生姜柱の正中線の上に溝を作り、準備したお灸を溝に入れます。次に、お灸コーンに火をつけ、燃え尽きたら新しいものと交換します。ネズミの背中から生姜と漢方薬の粉末を拭き取ります。マウスの背面を清掃し、麻酔を中止して、マウスが回復するのを待ちます。

Research

JoVE Journal

Immunology and Infection

Du-Moxibustion in the Treatment of Ankylosing Spondylitis (AS) in an AS Mouse Model

Du-Moxibustion in a Mouse Model of Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a progressively worsening and disabling form of arthritis that primarily affects the axial skeleton. This disease mainly ...