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

강직성 척추염에서 듀뜸의 치료 가능성 탐색

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.

저자 스포트라이트: 생쥐의 강직성 척추염에 대한 중국 전통 요법 평가 

강직성 척추염의 마우스 모델에서의 Du-moxibustion

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 마우스 모델에서 강직성 척추염(AS) 치료에서의 Du-moxibustion

시작하려면 벨벳 조각을 가져다가 스핀들 모양으로 비틀어 뜸쑥 원뿔을 만듭니다. 이제 생강을 작은 조각으로 자르고 과즙 짜는기구에 퓌레로 만듭니다. 생강 퓌레를 면 거즈로 걸러내어 퓌레에서 생강 주스와 진흙을 분리합니다.나중에 사용할 수 있도록 종이컵에 생강 진흙 10g과 생강 주스 20mL를 담습니다. 그런 다음 한약 가루 0.1g을 절구에 갈아 넣는다. 마우스에 마취제를 투여하고 적절한 수술 깊이를 확인한 후 마취 유도 상자에서 제거합니다.마우스를 엎드린 자세로 수술대에 고정합니다. 마우스의 입과 코를 마취제의 배출구에 맞춥니다. 마취를 유지하고 수술 절차 중에 마우스를 섭씨 37도의 가열 패드에 올려 놓습니다.건조를 방지하기 위해 쥐의 눈에 윤활제를 바르십시오. 이제 마우스에서 경혈을 찾아 자극 영역을 식별합니다. 쥐 뒷면의 살색 피부가 보일 때까지 쥐 뒷면의 털을 면도합니다.제모 너비가 1.5cm이고 C7에서 꼬리 척추까지 확장되는지 확인하십시오. 면봉을 사용하여 준비한 생강즙을 쥐의 등 면도 부위에 바릅니다. 그런 다음 붓으로 한약가루를 쥐 등의 중앙선에 골고루 뿌리고 뽕나무 종이로 그 부위를 덮습니다.다음으로 생강 진흙을 사용하여 사다리꼴 생강 기둥을 만들고 뽕나무 종이에 채웁니다. 생강 기둥의 정중선 위에 홈을 만들고 준비된 뜸쑥을 홈에 놓습니다. 그런 다음 뜸 콘에 불을 붙이고 타면 새 것으로 교체하십시오.쥐의 등에 묻은 생강과 한약 가루를 닦아냅니다. 마우스 뒷면을 청소하고 마취를 중단한 다음 마우스가 회복될 때까지 기다립니다.

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 ...