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1.成都市中西医结合医院疼痛科,成都 610041
2.成都中医药大学针灸推拿学院,成都 610075
3.成都中医药大学养生康复学院,成都 610075
周海燕,E-mail:zhouhaiyan@cdutcm.edu.cn
收稿:2025-04-06,
修回:2025-05-05,
网络首发:2026-05-06,
纸质出版:2026-05-25
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钟玉梅,郭彦玎,罗堃,等.基于Tim-3/Gal-9信号通路探讨艾灸调控巨噬细胞极化抑制类风湿关节炎滑膜炎性反应的作用机制[J].针刺研究,2026,51(5):603-611.
ZHONG Yu-mei,GUO Yan-ding,LUO Kun,et al.Mechanism of moxibustion in inhibiting synovial inflammation of rheumatoid arthritis by regulating macrophage polarization based on the Tim-3/Gal-9 signaling pathway[J].Acupuncture Research,
钟玉梅,郭彦玎,罗堃,等.基于Tim-3/Gal-9信号通路探讨艾灸调控巨噬细胞极化抑制类风湿关节炎滑膜炎性反应的作用机制[J].针刺研究,2026,51(5):603-611. DOI: 10.13702/j.1000-0607.20250351.
ZHONG Yu-mei,GUO Yan-ding,LUO Kun,et al.Mechanism of moxibustion in inhibiting synovial inflammation of rheumatoid arthritis by regulating macrophage polarization based on the Tim-3/Gal-9 signaling pathway[J].Acupuncture Research, DOI:10.13702/j.1000⁃0607.20250351.
目的
2
观察艾灸“肾俞”“足三里”对类风湿关节炎(RA)大鼠T细胞免疫球蛋白黏蛋白分子-3/半乳糖凝集素-9(Tim-3/Gal-9)信号通路及巨噬细胞极化的影响,分析艾灸改善RA滑膜炎性反应的机制。
方法
2
雄性SD大鼠随机分为空白组、模型组、艾灸组、干扰组,每组8只。采用足跖皮下注射弗氏完全佐剂制备RA模型。干扰组一次性足跖皮下多点注射Tim-3慢病毒,艾灸组、干扰组予“肾俞”“足三里”麦粒灸,每穴5壮,1次/d,6次为1个疗程,每疗程结束后休息1 d,共治疗3个疗程。分别于实验第1、7、14、21、28、35天测量双侧足跖厚度,HE染色观察关节病理改变并进行评分,ELISA法检测血清白细胞介素(IL)-4、血管内皮生长因子(VEGF)含量,免疫荧光染色法检测滑膜组织Tim-3、Gal-9及巨噬细胞极化相关分子CD86、CD206的表达。
结果
2
与空白组比较,模型组大鼠双侧足跖厚度增加(
P
<
0.01),关节间隙变窄,滑膜组织、纤维组织增生,滑膜组织增生、纤维组织增生、炎细胞浸润评分升高(
P
<
0.01),大鼠血清IL-4含量降低(
P
<
0.05),血清VEGF含量升高(
P
<
0.01),大鼠滑膜组织Tim-3、Gal-9、CD86表达升高(
P
<
0.01,
P
<
0.05),CD206表达降低(
P
<
0.01)。与模型组比较,艾灸组大鼠第35天双侧足跖厚度减少(
P
<
0.01),关节间隙变窄程度减轻,滑膜组织、纤维组织增生减轻,滑膜组织增生、纤维组织增生、炎细胞浸润评分降低(
P
<
0.01),血清IL-4含量升高(
P
<
0.05),血清VEGF含量降低(
P
<
0.01),滑膜组织Tim-3、Gal-9、CD206表达升高(
P
<
0.05,
P
<
0.01),CD86表达降低(
P
<
0.05)。与艾灸组比较,干扰组大鼠关节间隙变窄,滑膜组织增生、炎性细胞浸润评分升高(
P
<
0.05),血清IL-4含量、关节滑膜组织Tim-3、Gal-9、CD206表达降低(
P
<
0.05,
P
<
0.01),CD86表达升高(
P
<
0.05)。
结论
2
艾灸可以改善RA大鼠滑膜炎性反应,其作用机制可能与调节Tim-3/Gal-9信号通路的表达,抑制巨噬细胞M1型极化,促进巨噬细胞M2型极化有关。
Objective
2
To observe the effects of moxibustion at “Shenshu” (BL23) and “Zusanli” (ST36) on the T-cell immunoglobulin and mucin domain-containing molecule 3/galectin-9 (Tim-3/Gal-9) signaling pathway and macrophage polarization in rats with rheumatoid arthritis (RA), so as to explore the mechanism by which moxibustion ameliorates synovial inflammation in RA.
Methods
2
Male Sprague-Dawley (SD) rats were randomly divided into the blank control, model, moxibustion, and Tim-3 knockdown (Tim-3 KD) group, with 8 rats in each group. The RA model was established by subcutaneous injection of Freund’s complete adjuvant (FCA) into the plantar region. The Tim-3 KD group received a single multi-point subcutaneous injection of Tim-3 lentivirus into the plantar region. Both the moxibustion group and Tim-3 KD group were treated with grain-sized moxibustion at BL23 and ST36, 5 cones per acupoint, once daily, with 6 treatments as one course and 1 day of rest after each course, totaling 3 courses. The thickness of bilateral plantar regions was measured on days 1, 7, 14, 21, 28, and 35 of the experiment. HE staining was used to observe joint pathological changes and pathological scores were evaluated. ELISA was employed to detect the serum contents of interleukin (IL)-4 and vascular endothelial growth factor (VEGF). Immunofluorescence staining was used to determine the expression of Tim-3, Gal-9, and macrophage polarization-related molecules (CD86, CD206) in synovial tissue.
Results
2
Compared with the blank control group, the model group showed increased thickness of bilateral plantar regions (
P
<
0.01), narrowed joint space, proliferation of synovial and fibrous tissues, elevated scores of synovial hyperplasia, fibrous tissue proliferation, and inflammatory cell infiltration (
P<
0.01), decreased serum IL-4 content (
P<
0.05), increased serum VEGF content (
P<
0.01), up-regulated expression of Tim-3, Gal-9, and CD86 (
P<
0.01,
P<
0.05) and down-regulated expression of CD206 (
P<
0.01) in synovial tissue. Compared with the model group, the moxibustion group exhibited reduced thickness of bilateral plantar regions (
P<
0.01), alleviated joint space narrowing, decreased proliferation of synovial and fibrous tissues, lowered scores of synovial hyperplasia, fibrous tissue proliferation, and inflammatory cell infiltration (
P<
0.01), increased serum IL-4 content (
P<
0.05), decreased serum VEGF content (
P<
0.01), up-regulated expression of Tim-3, Gal-9, and CD206 (
P<
0.05,
P<
0.01) and down-regulated expression of CD86 (
P<
0.05) in synovial tissue. Compared with the moxibustion group, the Tim-3 KD group showed narrowed joint space, increased score of synovial hyperplasia and inflammatory cell infiltration (
P<
0.05), decreased serum IL-4 content, and down-regulated expression of Tim-3, Gal-9, and CD206 (
P<
0.05,
P<
0.01), along with up-regulated CD86 expression (
P<
0.05) in synovial tissue.
Conclusion
2
Moxibustion can ameliorate synovial inflammation in RA rats, and its mechanism may be related to regulating the expression of the Tim-3/Gal-9 signaling pathway, inhibiting M1 macrophage polarization, and promoting M2 macrophage polarization.
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