Abstract
Background Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease, which will eventually lead to joints deformity and functional damage. The aim of this research is to evaluate the effect of moxibustion on the serum indicators related to bone and cartilage metabolism, matrix metalloproteinase 1 (MMP-1), matrix metalloproteinase 3 (MMP-3), and vascular endothelial growth factor (VEGF) in patients with RA and to explore the mechanism of moxibustion in the treatment of RA. Methods We recruited 70 RA patients who met the inclusion criteria, and they were randomly divided into two groups, a treatment group and a control group in equal ratio. The control group took methotrexate, folate, or leflunomide orally, while the treatment group received methotrexate, folate, or leflunomide orally and moxibustion at ST36 (Zusanli), BL23 (Shen shu), and Ashi points. We compared the clinical symptoms, RA serological disease markers and serum contents of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), MMP-1, MMP-3, and VEGF of RA patients before and after treatment. Results (1) The clinical symptoms and RA serological disease markers of the two groups improved after treatment (P < 0.05), while the clinical symptoms of the treatment group were significantly improved in comparison with the control group (P < 0.05). (2) The levels of IL-1β, TNF-α, and VEGF decreased in both groups after treatment (P < 0.05), but the treatment group was significantly decreased compared with the control group (P < 0.05). (3) There were significant differences in MMP-1 and MMP-3 contents after treatment in the treatment group (P < 0.05, P < 0.05), while there were no significant differences in the control group (P > 0.05, P > 0.05). Above all, the contents of IL-1β, TNF-α, MMP-1, MMP-3, and VEGF in the treatment group decreased more significantly than those in the control group (P < 0.05). Conclusion The improvement effect of moxibustion on the clinical symptoms of RA patients may be related to influence on the contents of IL-1β, TNF-α, MMP-1, MMP-3, and VEGF, and moxibustion may play a potential role in bone protection.
Highlights
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by chronic synovial hyperplasia, which leads to progressive and irreversible destruction of articular cartilage and bone, resulting in joints deformity and loss of function [1]
A total of 66 patients completed this study. e control group consisted of 32 subjects, 4 men, and 28 women. ere were 34 patients in the treatment group, including 3 men and 31 women. ere was no significant difference in general information between the two groups (P > 0.5)
4.2. e Effect of Moxibustion on IL-1β, tumor necrosis factor-α (TNF-α), matrix metalloproteinase 1 (MMP-1), matrix metalloproteinase 3 (MMP-3), and vascular endothelial growth factor (VEGF) in Serum of RA Patients. e results of our study showed that there was significant decrease in IL1β, TNF-α, and VEGF contents in both groups after treatment, but the decrease in the treatment group was more obvious than those in the control group. e contents of matrix metalloproteinases (MMPs)-1 and MMP-3 in the treatment group were significantly different after treatment, but there were no significant differences in the control group
Summary
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by chronic synovial hyperplasia, which leads to progressive and irreversible destruction of articular cartilage and bone, resulting in joints deformity and loss of function [1]. VEGF is a high concentration of specific endothelial cell mitogen in RA synovial fluid and tissue, which is secreted by fibroblasts, keratinocytes, lymphocytes, and macrophages in RA synovium [5]. It can induce angiogenesis and increase the local permeability of blood vessels, and promote the exudation of inflammatory factors, . We compared the clinical symptoms, RA serological disease markers and serum contents of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), MMP-1, MMP-3, and VEGF of RA patients before and after treatment. Conclusion. e improvement effect of moxibustion on the clinical symptoms of RA patients may be related to influence on the contents of IL-1β, TNF-α, MMP-1, MMP-3, and VEGF, and moxibustion may play a potential role in bone protection
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