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

Explorando o potencial terapêutico da du-moxabustão na espondilite anquilosante

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.

Autor em destaque: Avaliando a terapia tradicional chinesa para espondilite anquilosante em camundongos 

Du-Moxabustão em Modelo de Espondilite Anquilosante em Camundongos

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  

Du-Moxabustão no Tratamento da Espondilite Anquilosante (EA) em Modelo de EA em Camundongos

Para começar, pegue um pedaço de veludo e torça-o em forma de fuso para fazer cones de moxa. Agora, corte o gengibre em pedaços pequenos e purê-lo em um espremedor de frutas. Filtre o purê de gengibre através de gaze de algodão para separar o suco de gengibre e a lama do purê.Tome 10 gramas de lama de gengibre e 20 mililitros de suco de gengibre em copos de papel para uso posterior. Em seguida, tome 0,1 gramas de pó de medicina tradicional chinesa e triture em uma argamassa. Depois de administrar a anestesia no camundongo e confirmar a profundidade cirúrgica apropriada, retire-a da caixa de indução da anestesia.Fixe o mouse na mesa cirúrgica em decúbito ventral. Alinhe a boca e o nariz do rato com a saída do anestésico. Mantenha a anestesia e coloque o mouse em uma almofada de aquecimento de 37 graus Celsius durante o procedimento operacional.Aplique lubrificante nos olhos do rato para evitar a dessecação. Agora, localize os acupontos no mouse e identifique a área de estimulação. Faça a barba no cabelo na parte de trás do rato até que a pele cor de carne na parte de trás do rato seja vista.Certifique-se de que a depilação tenha 1,5 centímetro de largura e se estenda de C7 até a vértebra da cauda. Usando gaze de algodão, aplique o suco de gengibre preparado na área raspada das costas do rato. Em seguida, com um pincel de escrita, polvilhe o pó da medicina tradicional chinesa uniformemente na linha média das costas do rato e cubra a área com papel de amora.Em seguida, use lama de gengibre para fazer uma coluna de gengibre trapezoidal e preencha-a com o papel amoreira. Crie um sulco acima da linha média da coluna de gengibre e coloque o cone de moxa preparado no sulco. Em seguida, acenda o cone de moxa e substitua-o por um novo assim que ele queimar.Limpe o gengibre e o pó da medicina tradicional chinesa das costas do rato. Limpe a parte de trás do rato, interrompa a anestesia e permita que o rato recupere.

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 ...