Salvia miltiorrhiza-asarum ointment combined with Chinese medical massage alleviates symptoms of osteoarthritis in a rat model through the Notch1/matrix metalloproteinase-13 signaling pathway

OBJECTIVE:This study investigated the effect of salvia miltiorrhiza-asarum ointment(SMAO)plus Chinese medical massage on knee osteoarthritis in a rat model.METHODS:Hulth's method was used to establish a Sprague-Dawley rat model of knee osteoarthritis(OA).The levels of matrix metalloproteinase-13(MMP-13),collagen-Ⅱ,aggrecan,interleukin(IL)-1β,tumor necrosis factor-α(TNF-α),and IL-6 were measured by enzyme-linked immunosorbent assays.The joint space was assessed by a Perlove X-ray system.Histopathology was examined by hematoxylin-eosin and Safranin O staining.The mRNA and protein expression levels of Notch1,MMP-13,collagen-Ⅱ,and aggrecan were measured by quantitative reverse transcription-polymerase chain reaction and Western blotting,respectively.RESULTS:SMAO plus Chinese medical massage significantly decreased the levels of MMP-13,IL-1β,TNF-α,and IL-6,and increased serum collagen-Ⅱ and aggrecan levels.Pathological injury of the knee joint was improved by SMAO treatment.mRNA and protein expression of Notch1 and MMP-13 was remarkably downregulated,but collagen-Ⅱ and aggrecan levels were significantly upregulated in cartilage tissues.CONCLUSION:SMAO combined with Chinese medical massage effectively relieves OA symptoms,which may involve inhibiting inflammation through the Notch1/MMP-13 signaling pathway.