刺血加艾灸疗法对急性痛风性关节炎大鼠外周血单个核细胞TLR2与TLR4 mRNA表达的影响

Effects of Moxibustion Combined with Blood-pricking Therapy on mRNA Expression of Toll-like Receptor 2 and Toll-like Receptor 4 in Peripheral Blood Mononuclear Cells among Rats with Acute Gouty Arthritis

目的探究刺血加艾灸疗法治疗急性痛风性关节炎的作用机制。方法将40只Wistar雄性大鼠随机分为正常对照组、模型组、秋水仙碱组、刺血艾灸组,每组10只,采用尿酸钠混悬液右后踝关节注射法复制痛风性关节炎大鼠模型。分别在模型复制时、模型复制后24h及灌胃治疗后3d测量右后足肿胀度;灌胃3d后,从腹主动脉取血,检测血清尿酸(uric acid,UA)含量及外周血单个核细胞中Toll样受体2(toll-like receptor 2,TLR2)和Toll样受体4(toll-like receptor 4,TLR4)mRNA的表达水平。结果与正常对照组比较,模型组大鼠足肿胀度,血清UA含量及TLR2、TLR4mRNA表达水平均显著上调(P<0.01)。刺血艾灸组足肿胀度,血清UA含量,TLR2、TLR4mRNA表达水平较模型组均显著下调(P<0.05,或P<0.01),且显著低于秋水仙碱组(P<0.05,或P<0.01)。结论刺血加艾灸疗法能够降低痛风性关节炎大鼠的关节肿胀度及血清UA水平,其机制可能与外周血单个核细胞中TLR2与TLR4mRNA的表达水平下调有关。

Objective To investigate the action mechanism of moxibustion combined with blood-pricking therapy in the treatment of acute gouty arthritis. Methods Forty male Wistar rats were randomly and equally divided into normal control group, model group, colchicine group, and moxibustion/blood-pricking therapy group. A rat model of gouty arthritis was induced by injecting sodium urate suspension （0.2 ml） into the right hind ankle joint. The degree of swelling of right hind foot was determined based on the toe volumes measured when the model was induced, at 24 h after the model was induced, and after 3 d of treatment. Three days after treatment, blood samples were taken from the abdominal aorta, and the serum uric acid （UA） level and mRNA expression of Toll-like receptor 2 （TLR2） and Toll-like receptor 4 （TLR4） in peripheral blood mononuclear cells （PBMCs） were measured. Results Compared with the normal control group, the model group had significantly increased foot swelling, serum UA level, and mRNA expression of TLR2 and TLR4 （P〈0.01）. Compared with the model group and colchicine group, the moxibustion/blood-pricking therapy group had significantly reduced foot swelling, serum UA level, and mRNA expression of TLR2 and TLR4 （P〈0.05 or P〈0.01）. Conclusion Moxibustion combined with blood-pricking therapy can reduce joint swelling and serum UA level in rats with gouty arthritis, which may be related to down-regulated expression of TLR2 and TLR4 in PBMCs.