Acupuncture and Moxibustion Inhibited Intestinal Epithelial-Mesenchymal Transition in Patients with Crohn’s Disease Induced by TGF- β 1/Smad3/Snail Pathway: A Clinical Trial Study

• Published in: Chinese journal of integrative medicine Vol. 28; no. 9; pp. 823 - 832
• Main Authors: Guo, Sen, Zhou, Jing, Zhang, Liang, Bao, Chun-hui, Zhao, Ji-meng, Gao, Yan-ling, Wu, Pin, Weng, Zhi-jun, Shi, Yin
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.09.2022
• Subjects: Acupuncture Research; Medicine; Medicine & Public Health; acupuncture; intestinal epithelial-mesenchymal transition; transforming growth factor β 1/Smad3/Snail pathway; moxibustion; Crohn’s disease
• ISSN: 1672-0415; 1993-0402
• DOI: 10.1007/s11655-022-2888-1

Objective To explore whether acupuncture combined with moxibustion could inhibit epithelialmesenchymal transition in Crohn’s disease by affecting the transforming growth factor β 1 (TGF- β 1)/Smad3/Snail pathway. Methods Sixty-three patients with Crohn’s disease were randomly divided into an observation group (31 cases) receiving moxibustion at 43 °C combined with acupuncture, and a control group (32 cases) receiving moxibustion at 37 °C combined with sham acupuncture using a random number table. Patients were treated for 12 weeks. Crohn’s Disease Activity Index (CDAI) was used to evaluate disease activity. Hematoxylin-eosin staining and transmission electron microscopy were utilized to observe the morphological and ultrastructural changes. Immunohistochemistry was used to detect the expression of transforming growth factor β 1 (TGF-β 1), T β R1, T β R2, Smad3, Snail, E-cadherin and fibronectin in intestinal mucosal tissues. Results The decrease of the CDAI score, morphological and ultrastructural changes were more significant in observation group. The expression levels of TGF- β 1, Tβ R2, Smad3, and Snail in the observation group were significantly lower than those before the treatment ( P <0.05 or P <0.01). After treatment, the expression levels of TGF-β 1, TβR2, and Snail in the observation group were significantly lower than those in the control group (all P <0.05); compared with the control group, the expression of fibronectin in the observation group was significantly decreased, and the expression of E-cadherin was significantly increased (all P <0.05). Conclusions Moxibustion at 43 °C combined with acupuncture may suppress TGF-β 1/Smad3/Snail pathway-mediated epithelial-mesenchymal transition of intestinal epithelial cells in Crohn’s disease patients by inhibiting the expression levels of TGF-β 1, Tβ R2, Smad3, and Snail. (Registration No. ChiCTR-IIR-16007751)