Objective To observe the effect of moxibustion of "Shenshu" (BL 23) and "Zusanli" (ST 36) on synovial nuclear factor (NF)-kB p 65 expression

and plasma adrenocorticotropic hormone (ACTH) and serum cortisol (CS) contents in rheumatic arthritis (RA) rats with adrenalectomy (ADX) so as to study the underlying mechanism in ameliorating RA. Methods Fifty male SD rats were randomly divided into control (n=10)

model (n=10)

moxibustion (n=10)

ADX (n=10) and false ADX (n=10) groups according to SPSS-aided random digits table. RA model was established by injecting 0.1 mL Freund's complete adjuvant into the right paw. ADX operation was performed on the sixth day after successful establishment of RA model. Moxibustion was given to "Shenshu" (BL 23) and "Zusanli" (ST 36) from the 7th day on

five moxa cones each session

and once daily for 18 days. Then plasma ACTH and serum CS contents

for which the blood was collected during night

were detected by ELISA

and NF-kB p 65 immunoactivity in synovial tissue was detected by immunohistochemistry. Results In comparison with control group

the foot volumes (swelling degree) of model

moxibustion

ADX

and false ADX groups increased significantly (P<0.01)

while compared with model group

the swelling degrees of moxibustion and false ADX groups were decreased remarkably after the treatment (P<0.01). No significant difference was found between ADX and model groups in the foot volume (P>0.05). Compared with control group

plasma ACTH content in RA model group decreased obviously (P<0.05)

while serum CS level and NF-kB p 65 immunoactivity increased apparently in model group (P<0.01). Compared with model group

serum CS contents in moxibustion

ADX and false ADX groups and synovial NF-kB p 65 immunoactivity in moxibustion and false ADX groups reduced considerably (P<0.01

P<0.05). No significant difference was found between ADX and model groups in synovial NF-kB p 65 immunoactivity (P>0.05). Conclusion Moxibustion treatment can reduce inflammation reactions in RA rats

which is closely associated with its effects in upregulating plasma ACTH

downregulaing serum CS level and synovial NF-kB p 65 immunoactivity

and the intact hypothalamus-pituitary-adrenal axis (HPAA).