艾灸调控巨噬细胞不同表型极化治疗RA滑膜炎症的疗效

doi:10.11958/20240418

天津医药 ›› 2025, Vol. 53 ›› Issue (3): 236-241.doi: 10.11958/20240418

艾灸调控巨噬细胞不同表型极化治疗RA滑膜炎症的疗效

钟玉梅¹(), 何流¹, 张敏¹, 周海燕²^,^△()

1 成都市第一人民医院/成都中医药大学附属中西医结合医院（邮编610041）
2 成都中医药大学针灸推拿学院

收稿日期:2024-04-07 修回日期:2024-05-21 出版日期:2025-03-15 发布日期:2025-03-31
通讯作者: △E-mail：zhouhaiyan@cdtcm.edu.cn
作者简介:钟玉梅（1991），女，主治医师，主要从事针灸治疗类风湿性关节炎的机制方面研究。E-mail：704755938@qq.com
基金资助:
四川省自然科学基金青年项目(2023NSFSC1823);国家自然科学基金面上项目(81973959);四川中医药文化协同发展研究中心一般项目(2022XT73)

Clinical effects of moxibustion regulating the different phenotypic polarization of macrophages on the treatment of RA synovitis

ZHONG Yumei¹(), HE Liu¹, ZHANG Min¹, ZHOU Haiyan²^,^△()

1 Department of Pain, Chengdu First People’s Hospital / Chengdu Integrated TCM & Western Medicine Hospital Affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu 610041, China
2 College of Acupuncture and Massage, Chengdu University of Traditional Chinese Medicine

Received:2024-04-07 Revised:2024-05-21 Published:2025-03-15 Online:2025-03-31
Contact: △E-mail：zhouhaiyan@cdtcm.edu.cn

钟玉梅, 何流, 张敏, 周海燕. 艾灸调控巨噬细胞不同表型极化治疗RA滑膜炎症的疗效[J]. 天津医药, 2025, 53(3): 236-241.

ZHONG Yumei, HE Liu, ZHANG Min, ZHOU Haiyan. Clinical effects of moxibustion regulating the different phenotypic polarization of macrophages on the treatment of RA synovitis[J]. Tianjin Medical Journal, 2025, 53(3): 236-241.

摘要/Abstract

摘要：

目的探讨艾灸对类风湿关节炎（RA）巨噬细胞不同表型表达的影响。方法 30只大鼠随机分为空白组、模型组、艾灸组，每组10只。模型组、艾灸组采用完全弗氏佐剂右足垫注射制备RA模型，艾灸组予以艾灸治疗；空白组注射等量生理盐水。测量足跖厚度并进行关节炎指数评分；苏木精伊红（HE）染色观察关节病理改变并评分；免疫荧光染色检测滑膜组织巨噬细胞不同表型CD80、CD163、SPP1的表达。结果与空白组比较，模型组、艾灸组大鼠关节炎指数评分及足跖厚度增加（P<0.05）；经艾灸治疗后，与模型组比较，艾灸组大鼠关节炎指数评分及足跖厚度降低（P<0.05）。HE染色结果显示，模型组关节间隙变窄、软骨下骨破坏、大量炎性细胞浸润；艾灸组关节间隙变窄、软骨下骨破坏、炎性细胞浸润程度较模型组减轻；关节病理评分显示，与空白组比较，模型组滑膜组织增生、纤维组织增生、炎性细胞浸润评分增加；与模型组比较，艾灸组滑膜组织增生、纤维组织增生、炎性细胞浸润评分降低（P<0.05）。免疫荧光检测结果显示，与空白组比较，上调模型组大鼠滑膜组织CD80、SPP1表达增加，CD163表达减少；与模型组比较，艾灸组CD80、SPP1表达减少，CD163表达增加（P<0.05）。结论艾灸可调节巨噬细胞不同表型的表达，减轻RA滑膜炎症，其机制可能与调节巨噬细胞不同表型的表达相关。

关键词: 关节炎, 类风湿, 巨噬细胞, 免疫表型分型, 滑膜炎, 艾灸

Abstract:

Objective To investigate the effect of moxibustion on different phenotypic expression of macrophages in rheumatoid arthritis (RA). Methods Thirty rats were randomly divided into the blank group, the model group and the moxibustion group, with 10 rats in each group. Rats in the model group and the moxibustion group were injected with complete Freund's adjuvant (CFA) into right foot pad to prepare RA model. The moxibustion group received moxibustion treatment. The blank group was injected with the same amount of normal saline. The thickness of foot pad was measure and arthritis index score was performed. Pathological changes of joints were observed by hematoxylin eosin staining (HE), and the expressions of CD80, CD163 and SPP1 in macrophages of synovial tissue were detected by immunofluorescence. Results Compared with the blank group, arthritis index score and thickness of foot pad were increased in the model group and the moxibustion group (P<0.05). After moxibustion treatment, compared with the model group, the score of arthritis index and thickness of foot pad were decreased in the moxibustion group (P<0.05). HE staining showed joint space narrowing, subchondral bone destruction and inflammatory cell infiltration in the model group. The degree of joint space narrowing, subchondral bone destruction and inflammatory cell infiltration were less in the moxibustion group than those in the model group. Compared with the blank group, the scores of synovial tissue hyperplasia, synovial fibrous tissue hyperplasia and inflammatory cell infiltration increased in the model group. Compared with the model group, scores of synovial tissue hyperplasia, fibrous tissue hyperplasia and inflammatory cell infiltration decreased in the moxibustion group (P<0.05). Results of immunofluorescence detection showed that compared with the blank group, the expressions of CD80 and SPP1 in synovial tissue were up-regulated in the model group, while the expression of CD163 was down-regulated. Compared with the model group, the expressions of CD80 and SPP1 were down-regulated, and the expression of CD163 was up-regulated in the moxibustion group (P<0.05). Conclusion Moxibustion can regulate the expression of different phenotypes of macrophages and reduce synovial inflammation of RA. The mechanism may be related to regulating the expression of different phenotypes of macrophages.

Key words: arthritis, rheumatoid, macrophages, immunophenotyping, synovitis, moxibustion

中图分类号:

R245.81，R593.22

图/表 8

图1 实验流程及艾灸干预示意图 A：实验流程图；B：艾灸部位示意图。

Fig.1 Experimental procedure and moxibustion intervention schematic diagram

表1 各组大鼠不同时间点关节炎指数评分比较（n=10，分，$\bar{x} \pm s$）

Tab.1 Comparison of arthritis index scores at different time points between three groups of rats

组别	14 d	21 d	28 d	35 d
空白组	0.00±0.00	0.00±0.00	0.00±0.00	0.00±0.00
模型组	3.62±0.52^a	3.50±0.53^a	3.38±0.52^a	3.25±0.46^a
艾灸组	3.75±0.46^a	3.25±0.46^a	2.62±0.52^ab	1.50±0.53^ab
F	225.815^＊＊	183.000^＊＊	140.700^＊＊	127.000^＊＊

表2 各组大鼠不同时间点右足跖厚度比较（n=10，mm，$\bar{x} \pm s$）

Tab.2 Comparison of the thickness of right foot pad at different time points between three groups of rats

组别	1 d	7 d	14 d
空白组	1.70±0.09	2.51±0.15	2.83±0.12
模型组	1.73±0.09	2.49±0.15	7.14±0.18^a
艾灸组	1.71±0.10	2.45±0.16	7.09±0.12^a
F	0.143	0.348	2 436.766^＊＊
组别	21 d	28 d	35 d
空白组	3.48±0.24	3.63±0.12	3.65±0.12
模型组	7.00±0.15^a	6.64±0.17^a	6.29±0.29^a
艾灸组	6.53±0.21^ab	5.62±0.27^ab	4.56±0.34^ab
F	706.557^＊＊	500.550^＊＊	199.941^＊＊

图2 各组大鼠关节病理形态（HE染色） a：关节间隙；b：关节软骨；c：软骨下骨；d：炎性细胞。

Fig.2 Pathological morphology of joints in each group (HE staining)

表3 各组大鼠关节病理评分比较（n=10，分，$\bar{x} \pm s$）

Tab.3 Comparison of joint pathological scores between three groups of rats

组别	滑膜组织增生	纤维组织增生	炎性细胞浸润
空白组	0.00±0.00	0.00±0.00	0.00±0.00
模型组	3.50±0.53^a	3.00±0.76^a	3.75±0.46^a
艾灸组	1.63±0.74^ab	1.50±0.76^ab	1.25±0.46^ab
F	87.723^＊＊	47.250^＊＊	204.167^＊＊

图3 各组大鼠滑膜CD80型巨噬细胞的表达（免疫荧光，×400）箭头所示绿色荧光为CD80的阳性表达。

Fig.3 Expression of CD80 macrophages in synovium of rats in each group (immunofluorescence, ×400)

图4 各组大鼠滑膜CD163型巨噬细胞的表达（免疫荧光，×400）箭头所示绿色荧光为CD163的阳性表达。

Fig.4 Expression of CD163 macrophages in synovium of rats in each group (immunofluorescence, ×400)

图5 各组大鼠滑膜SPP1型巨噬细胞的表达（免疫荧光，×400）箭头所示红色荧光为SPP1的阳性表达。

Fig.5 Expression of SPP1 macrophages in synovium of rats in each group (immunofluorescence, ×400)

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艾灸调控巨噬细胞不同表型极化治疗RA滑膜炎症的疗效

Clinical effects of moxibustion regulating the different phenotypic polarization of macrophages on the treatment of RA synovitis

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