Objective To compare the effects of acupuncture and moxibustion alone or in combination on the number of mast cells and expression levels of cytoketatin 18(CK18) and CK19(marker of Meckel cells)

and calcitonin gene-related peptide(CGRP)

neuropeptide-Y(NPY) and bradykinin(BK) in the local acupoint area of rats with chronic atrophic gastritis(CAG). Methods Fifty male SD rats were randomly divided into normal

CAG model

moxibustion

acupuncture and acupuncture+moxi-bustion groups(10 rats in each group). The CAG model was established by gavage of 1-methyl-3-nitro-1-nitrosoguanidine(170 μg/mL

1 mL/100 g

once a week) and 40% ethanol solution(twice a week) for 12 consecutive weeks. After successful establishment of CAG model

moxibustion

manual acupuncture or acupuncture+moxibustion was applied to bilateral “Zusanli”(ST36) and “Zhongwan”(CV12) for 15 min

once daily for 14 consecutive days. At the end of the experiment

the gastric mucosal tissues were collected for observing histopathological changes of gastric mucosa after H.E. staining

and the tissues of the stimulated ST36 region collected for detecting the expression levels of CK18

CK19

CGRP

NPY and BK and the number of mast cells in the local ST36 region by immunohistochemistry. Results Compared with the normal group

the number of mast cells

the expression levels of CK19

NPY and BK in the ST36 area were significantly increased(P<0.05)

and the expression level of CGRP was apparently decreased(P<0.05) in the model group. In comparison with the model group

the number of mast cells and the expression levels of CGRP and NPY in the moxibustion group

the expression of CGRP in the acupuncture group

and the number of mast cells

as well as the expression levels of CK18

CK19 and CGRP in the acupuncture+moxibustion group were significantly up-re-gulated(P<0.05). The effect of acupuncture combined with moxibustion was obviously superior to that of moxibustion or acupuncture in up-regulating the expression of CK18 and CK19(P<0.05) and superior to that of moxibustion in down-regulating BK expressio level(P<0.05). No significant changes were found in the expression of CK18 after modeling(vs the normal group)

in the expression levels of CK18

CK19 and BK after moxibustion and acupuncture(vs the model group)

in the number of mast cells and expression of NPY after acupuncture(vs the model group)

and in the expression levels of NPY and BK after acupuncture+moxibustion(vs the model group)(P>0.05). H.E. staining showed infiltration of many lymphocytes in the gastric mucosa and submucosal layers

atrophy and necrosis of lots of main cells with vacuole-like changes

and disordered arrangement of the atrophic glands in the model group

which was milder particularly in the acupuncture + moxibustion group. Conclusion Acupuncture combined with moxibustion of ST36 can up-regulate the levels of local CK18

CK19 and CGRP proteins and number of mast cells

moxibustion may up-regulate the levels of CGRP and NPY and number of mast cells

while acupuncture may up-regulate the expression of CGRP in the local stimulated area in CAG rats.