Objective To compare the effects of filiform needling

electroacupuncture(EA) and moxibustion on articular cartilage morphology and nuclear transcription factor-κB(NF-κB) p65/Nod-like receptor protein 3(NLRP3) pathway in rats with knee osteoarthritis(KOA). Methods Wistar rats were randomly divided into blank control

model

filiform needling

EA and moxibustion groups

with 8 rats in each group. The KOA model was established by injecting sodium iodoacetate into the right knee cavity. Filiform needling

EA and moxibustion groups were treated with the right side of “Dubi”(ST35) and “Neixiyan”(EX-LE5)

and were given filiform needling

EA and mild moxibustion therapies for 15 min respectively

once every other day

for a total of 4 weeks. The diameter of the right knee joint was observed. The ultrastructure of knee chondrocytes was observed by transmission electron microscope. The contents of serum tumor necrosis factor-α(TNF-α)

interleukin(IL)-1β and IL-18 were determined by ELISA. The expression levels of NF-κB p65

NLRP3

apoptosis-related speckle like protein(ASC) and TNF-α in knee cartilage were dectected by Western blot. Results Compared with the blank control group

the right knee joint cavity was narrowed

chondrocytes were constricted significantly

mitochondria were moderately swollen

the diameter of the right knee was increased

and the contents of serum TNF-α

IL-1β and IL-18 were increased(P<0.01)

the expressions of NF-κB p65

NLRP3 and TNF-α in knee cartilage were increased(P<0.01) while the expression of ASC was decreased(P<0.01) in the model group.Compared with model group

the narrowed knee joint cavity and chondrocyte injury were improved

knee diameter decreased(P<0.01

P<0.05)

and the content of serum TNF-α and the expression of NLRP3 in knee cartilage were decreased(P<0.05

P<0.01) in 3 treatment groups; the contents of serum IL-1β and IL-18

and the expression of TNF-α in knee cartilage were decreased(P<0.01

P<0.05)

while the expression of ASC in knee cartilage was increased(P<0.01) in EA and moxibustion groups; the expression of NF-κB p65 in knee cartilage was decreased(P<0.01) in moxibustion group. Compared with EA group

the content of serum IL-18 was decreased(P<0.05) in moxibustion group. Conclusion Filiform needling

EA and moxibustion can all reduce the formation of knee osteophytosis in KOA rats

alleviate joint cavity narrowing

improve the ultrastructure of articular cartilage

reduce the level of inflammatory factors

regulate the NF-κB p65/NLRP3 pathway. Moxibustion has the most obvious regulatory effect among the 3 treatment methods.