Moxibustion Treatment Restoring the Intestinal Epithelium Barrier in Rats with Crohn's Disease by Down-Regulating Tumor Necrosis Factor Alpha,Tumor Necrosis Factor Receptor 1,and Tumor Necrosis Factor Receptor 2

Objective： To investigate whether moxibustion regulates tumor necrosis factor alpha （TNF-α）, tumor necrosis factor receptor 1 （TNFR1）, and TNFR2 in the intestinal mucosa and to explore whether moxibustion could be used by means of this mechanism, to repair the intestinal epithelium barrier disruption in Crohn＇s disease （CD）. Methods： The CD rat models were established by tdnitrobenzene sulfonic acid （TNBs）, randomly divided into a model control （MC） group, an herb-partition moxibustion （HPM） group, a mild-warm moxibustion （MWM） group, and a salicylazosulfapyridine （SASP） group, and all were compared with a normal control （NC） group. The HPM and MWM groups were treated by moxibustion at Tianshu （ST25） and Qihai （RN6） for 14 days, and the SASP group obtained the SASP solution orally for the same pedod of time. The intestinal epithelium morphology and TNF-α, TNFR1, and TNFR2 contents were observed by the transmission electron microscopy and enzyme linked immunosorbent assay. Results： The sevedty of morphological changes in CD intestinal epithelium was obviously improved, and the levels of TNF-α, TNFR1, and TNFR2 in the intestinal mucosa all significantly decreased in the HPM and MWM groups. However, there were no significant differences between the HPM and MWM groups. Conclusion： The moxibustion therapies （HPM and MWM） could reduce intestinal inflammation and restore intestinal epithelium barrier disruption in CD, which might be due to down- regulating TNF- α, TNFR1, and TNFR2 in intestinal mucosa and improving intestinal epithelium morphology.

Study of tumor necrosis factor receptor in the inflammatory bowel disease

Ulcerative colitis(UC)and Crohn’s disease(CD)are part of Inflammatory Bowel Diseases(IBD)and have pathophysiological processes such as bowel necrosis and enteric neurons and enteric glial cells.In addition,the main inflammatory mediator is related to the tumor necrosis factor-alpha(TNF-α).TNF-αis a mediator of the intestinal inflammatory processes,thus being one of the main cytokines involved in the pathogenesis of IBD,however,its levels,when measured,are present in the serum of patients with IBD.In addition,TNF-αplays an important role in promoting inflammation,such as the production of interleukins(IL),for instance IL-1βand IL-6.There are two receptors for TNF as following:The tumor necrosis factor 1 receptor(TNFR1);and the tumor necrosis factor 2 receptor(TNFR2).They are involved in the pathogenesis of IBD and their receptors have been detected in IBD and their expression is correlated with disease activity.The soluble TNF form binds to the TNFR1 receptor with,and its activation results in a signaling cascade effects such as apoptosis,cell proliferation and cytokine secretion.In contrast,the transmembrane TNF form can bind both to TNFR1 and TNFR2.Recent studies have suggested that TNF-αis one of the main pro-inflammatory cytokines involved in the pathogenesis of IBD,since TNF levels are present in the serum of both patients with UC and CD.Intravenous and subcutaneous biologics targeting TNF-αhave revolutionized the treatment of IBD,thus becoming the best available agents to induce and maintain IBD remission.The application of antibodies aimed at neutralizing TNF-αin patients with IBD that induce a satisfactory clinical response in up to 60%of patients,and also induced long-term maintenance of disease remission in most patients.It has been suggested that anti-TNF-αagents inactivate the pro-inflammatory cytokine TNF-αby direct neutralization,i.e.,resulting in suppression of inflammation.However,anti-TNF-αantibodies perform more complex functions than a simple blockade.