Effect of Warm Acupuncture Combined with Bone Marrow Mesenchymal Stem Cells Transplantation on Cartilage Tissue in Rabbit Knee Osteoarthritis

Abstract

The current study was designed to investigate the effect and underlying mechanism of warm acupuncture combined with bone marrow mesenchymal stem cells (BMSC) transplantation on cartilage tissue injury in rabbit knee osteoarthritis (KOA). In the study, 50 rabbits were randomly divided into 5 groups: blank group, KOA group, warm acupuncture group, BMSCs group, and warm acupuncture combined with BMSCs group. After warm acupuncture combined with BMSCs, the Modified Lequesne MG knee joint assessment scale was used to evaluate the degree of knee joint behavior, the Taiping Peng method generally observed the histomorphology changes of KOA rabbit cartilage, and hematoxylin-eosin staining, safranin O green staining, and toluidine blue staining were conducted to evaluate the extent of cartilage tissue pathology. Furthermore, transmission electron microscopy and TUNEL staining were used to observe cell apoptosis, and immunohistochemistry and qPCR analysis were used to detect the expression of apoptosis-related proteins and mRNA. Results showed that administration of warm acupuncture combined with BMSCs recovered the joint function and significantly decreased Lequesne MG score. The degree of cartilage tissue pathological damage has been improved, cartilage ultrastructure degeneration has recovered, peripheral blood vessels have mild edema, blood supply has gradually recovered, and even small amounts of red blood cells have appeared. In addition, warm acupuncture combined with BMSCs treatment suppressed chondrocyte apoptosis in rabbits with knee osteoarthritis by reduced TUNEL-positive chondrocytes and simultaneously reversed the mRNA expression of Bax, Bcl-2, and Caspase-3. These results indicate that warm acupuncture combined with BMSCs transplantation has a potential protective effect on rabbit KOA, which may be mediated by inhibiting chondrocyte apoptosis.

Comparison of Warming Needle Moxibustion and Drug Therapy for Treating Knee Osteoarthritis: A Systematic Review and Meta-analysis

“…Among them, warming needle acupuncture is one of the most commonly used methods. Warming needle moxibustion (WNM) is a therapeutic method that combines acupuncture and moxibustion, with efficacy of “channel-warming and cold-dispersing” and “blood-activating and stasis-eliminating” [ 15 , 16 ]. Studies have demonstrated that WNM is one of the primary approaches for KOA treatment in China, and the potential mechanisms might be associated with the deceleration of knee cartilage degeneration [ 17 – 19 ], the regulation of inflammatory cytokines, and the reduction of algogenic substance release.…”

Effects of acupuncture on cartilage p38MAPK and mitochondrial pathways in animal model of knee osteoarthritis: A systematic evaluation and meta-analysis

“…The included studies’ quality scores ranged from 4 to 9 out of 10: one study ( Zhou et al, 2018 ) received a score of 9, eight studies ( Liao et al, 2016 ; Ma et al, 2017 ; Wu et al, 2019 , 2022 ; Wang et al, 2020 ; Jie et al, 2021 ; Liu J. W. et al, 2021 ; Zhu S. Q. et al, 2021 ) received a score of 8, 16 studies ( Xiong et al, 2012 ; Liang et al, 2015 ; Fu et al, 2016a ; Fu et al, 2016b ; Xi et al, 2016 ; Yu, 2016 ; Liu N. G. et al, 2018 ; Wan et al, 2019 ; Zhang et al, 2019a ; Zhang et al, 2019b ; Wang, 2020 ; Chen, 2021 ; Liu H. et al, 2021 ; Zeng et al, 2021 ; Zhu D. Y. et al, 2021 ; Qin et al, 2022 ) received a score of 7, four studies ( Liang, 2015 ; Lin and Xu, 2019 ; Chen et al, 2020 ; Liu D. et al, 2021 ) received a score of 6, three studies ( Wu et al, 2018 ; Liu, 2019 ; Wan et al, 2021 ) received a score of 5, and three studies ( Bao et al, 2011 ; Liu D. et al, 2017 ; Wang D. et al, 2021 ) received a score of 4. There was no research that reported on the sample size calculation.…”

“…Acupuncture can delay KOA progression by modulating p38MAPK and the mitochondrial signaling pathway ( Liao et al, 2016 ; Liu J. W. et al, 2021 ), but the mechanism by which it effects cartilage repair in KOA has not been systematically studied. Systematic review methods facilitate evidence-based clinical decision making ( Ritskes-Hoitinga et al, 2014 ), indicate gaps in research, reduce unnecessary duplication of studies, and support the “replacement, refinement, and reduction of animals” principle in animal research ( Murphy and Murphy, 2010 ).…”

Research Progress on Pain Mechanism of Knee Osteoarthritis

“…On the other hand, the epiphyseal blood supply of subchondral bone can also nourish articular cartilage. Studies have shown that when the blood supply around articular cartilage is disturbed, articular cartilage damage may occur, thus showing signs of arthritis [9].…”