In the present paper

we summarize the literature about mechanisms of acupuncture and moxibustion [including ordinary acupuncture

electroacupuncture

fire needling

warm acupuncture(acupuncture with the needle warmed by burning moxa)

cheek acupuncture

wheat-sized moxibustion

suspension moxibustion

etc.] treatments of rheumatoid arthritis(RA) both domestically and abroad in recent years. Results indicate that the role of acupuncture and moxibustion therapies in improving RA involves multi-targets and multi-levels. These targets and levels include 1) improving joint and synovial inflammatory response by regulating inflammatory cytokines

inhibiting cell adhesion factor and interferon expression

2) directly or indirectly regulating immune cell balance

3) regulating peripheral and central neurotransmitters(plasma CCK-8 and β-endorphin

hypothalamic prodynorphin

etc.)

4) regulating related signaling pathways(suppressing nuclear factor-kB/vascular endothelial growth factor

Janus tyrosine kinase-signal transducer and activator of transcription

transient receptor potential vanilloid and canonical Wnt/β-catenin pathways)

and activating cholinergic anti-inflammatory pathway

5) regulating histocyte energy metabolism(improving amino acid supply and reducing negative nitrogen balance to improve immune regulation function)

6) maintaining the balance of bone cells and articular cartilage(by regulating the balance between synthesis and degradation of articular cartilage matrix

and the balance of bone cells and osteoclasts)

7) up-regulating energy metabolism gene(Atp50

Atp6V1B2) expression and regulating biological rhythm gene(clock

Per2

Rev-erb) expression

8) regulating miRNAs-mediated chondrocyte apoptosis. All these provide experimental basis for acupuncture and moxibustion treatments of RA.