Study On The Treatment Of CIA Rats By Regulating The Balance Of Th17/Treg Cells By Catgut Implantation At Zusanli And Guanyuan Point

Objective:(1)To observe the expression of Th17 / Treg cell related cytokines in serum of SD rats in the CIA model,confirm the balance regulation of cytokine Th17 / Treg cells in the CIA model is related with the progression of RA,in order to make clear the mechanism of intervention effect of RA Th17/Treg cells in the treatment of acupoint catgut embedding therapy.(2)To explore the mechanism of acupoint catgut embedding treatment of rheumatoid arthritis: inhibition of Th17 cells and Treg cells was increased,and achieve the purpose of treatment of RA,the possible mechanism is TGF-beta through upregulation of Foxp3 expression level,promote Th0 cell differentiation into Thl7 cells by inhibiting ROR induced endogenous TGF-beta gamma T and inflammatory mediators in IL-6 then,with the reduction of inflammatory mediators such as IL-6 content,ROR gamma t was inhibited by Foxp3,and promote the differentiation of Th0 cells into Treg cells and maintain the function of Treg Th17 simultaneously.The expression and secretion of IL-21 and IL-17 were decreased,and the secretion and expression of IL-6,TNF-?,and IL-1 were inhibited(3)Acupoint catgut embedding therapy for RA patients can effectively alleviate the symptoms of arthritis,bone destruction,protecting and maintaining joint function.Methods: 1 packet model: The rats were randomly divided into normal control group(sacrificed 42 days after the first immunization),model group(sacrificed 42 days after the first immunization),leflunomide group,catgut embedding group,leflunomide + catgut embedding group,two per cage as a group,a total of 5 groups,8 rats in each group.Each cage according to the random way to picric acid as material(yellow)from 1 to 4 number.Methods according to the literature provides slightly modified established collagen induced arthritis model in rats.2.treatment methods: Each group was treated for tenth days(1)the blank group was not treated(2)model group: intragastric administration of normal saline 1ml/d(3): according to "acupoint catgut embedding group rat acupoint atlas" selected "Guan yuan" and "Zusanli".From the tenth day after modeling to begin operation.The 0.5cm long catgut embedding catgut embedding needle into sterile No.12,rat ventral upward fixed and the operating platform,draw Double hind limbs the catgut embedding needle needle into the routine disinfection has "Guan yuan" and "Zusanli",will be completely inserted inside hole.Catgut embedding operation 3 times,once every 14 days,a total of 42 days.(4)leflunomide group: 0.6mg/100 g was injected into the stomach every day,and the treatment was carried out on the tenth day after modeling(5)leflunomide + catgut embedding group: simultaneous acupoint catgut embedding and leflunomide gavage.3.observation index: serum index: serum IL-1 beta,ELISA method was used to detect IL-6,IL-17,TNF-alpha,TGF-beta 1.The content of pathological index: according to the infiltration of inflammatory cells,macrophage A cell hyperplasia,synovial hyperplasia,fibrous tissue hyperplasia,4 aspects of the pathological changes to evaluate the scoring.4.statistical method:The data obtained(x ±s),statistical analysis will use the spss V15.0 statistical software to calculate.Analysis of variance,F test was used to test the q.5.Results:The study found that acupoint catgut embedding therapy can effectively reduce the adjuvant arthritis in rats serum IL-1,IL-6,IL-17,TNF-? content elevated levels of alpha,TGF-beta 1,from the two aspects of correct Th17/Treg imbalance,while preventing the infiltration of inflammatory cells,macrophage A cells,synovial membrane and fiber tissue hyperplasia and improve the pathological morphology of synovial tissue in rats with adjuvant arthritis,to reduce disease activity,prevent the progression of the disease,to prevent irreversible joint damage.No less than the existing acupoint catgut embedding therapy for rheumatoid arthritis in the lower level of Th17 cell line effect Use of leflunomide,and at elevated levels of Treg cells more than leflunomide,combined with acupoint catgut embedding and leflunomide better.6.Conclusion:(1)The serum SD IFA in rat model of Th17 cells was significantly higher than that in normal rats,while the level of Treg cells compared with normal rats significantly decreased,indicating Th17/Treg related cytokines balance is positively correlated with the severity of RA;(2)The acupoint catgut embedding therapy can effectively reduce the adjuvant arthritis in rats serum IL-1,IL-6,IL-17,TNF-?content elevated levels of alpha,TGF-beta 1,inhibition of Th17 cells and Treg cells was increased,imbalance corrected Th17/Treg,expression of Treg cells by increasing TGF-beta 1 level,while the inhibition of Th17 cell differentiation and Th17 cytokines such as IL-6,IL-17,IL-1 beta,TNF-alpha expression and prevent the accumulation of inflammatory cells and adhesion molecules in the lesion,the infiltration of inflammatory cells,vascular With the proliferation and destruction of the articular cartilage,so as to achieve the purpose of treatment of RA.The possible mechanism is through upregulation of Foxp3 expression level,promote the differentiation of Th0 cells into Thl7 cells by inhibiting ROR induced endogenous TGF-beta gamma T and inflammatory mediators in IL-6,and with the reduction of inflammatory mediators such as IL-6 content,ROR gamma the function of T was inhibited by Foxp3,and promote the differentiation of Th0 cells into Treg cells and maintain the function of Treg and Th17 cells and the secretion of IL-21,reduce the expression of IL-17,inhibition of IL-6 TNF-alpha,IL-1 beta secretion and expression,the specific mechanism needs further study;(3)The treatment of acupoint catgut embedding therapy can effectively alleviate the symptoms of RA patients with arthritis,bone destruction,protect and maintain the function of joint.The acupoint catgut embedding of Th17 cells decreased the level of not less than the existing first-line drugs in the treatment of rheumatoid arthritis with leflunomide,and in Treg cells increased more than the level of leflunomide,combined with acupoint application catgut embedding and leflunomide better.