[Effect of acupuncture on expression of matrix metalloproteinase and tissue inhibitor in cartilage of rats with knee osteoarthritis].
ABSTRACT To explore the curative mechanism of acupuncture treatment on osteoarthritis (OA).
Forty cases of female SD rats were randomly divided into a normal group, a model group, an acupuncture group and a medication group, 10 cases in each group. OA animal model was established by using the method of heel tendon resection for unilateral hind limb. The acupuncture group was treated with electroacupuncture at "Xiqian"(ST 35) and "Housanli"(ST 36), and the medication group with inunction of Diclofenac cream, and the normal group and the model group without any treatment. The expression of matrix metalloproteinase-1, 3 (MMP-1, MMP-3) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the cartilage were observed by immunohistochemistry.
There were significant differences among four groups. The expressions of MMP-1, MMP-3 and TIMP-1 in the model, acupuncture and medication groups were all significantly stronger than those in the normal group (all P < 0.01). The expressions of MMP-1 and MMP-3 in the acupuncture and medication groups were down regulated and TIMP-1 expression up-regulated with significant differences as compared with the model group (all P < 0.01), and the expressions of MMP-1 and MMP-3 in acupuncture group were significantly lower, while TIMP-1 expression significantly higher than that in the medication group (all P < 0.01).
Acupuncture can down-regulate the expression of MMP-1 and MMP-3 and up-regulate the expression of TIMP1, which is superior to that of Diclofenac cream, showing that acupuncture has a certain protective effect on cartilage from OA.
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ABSTRACT: Background There is lack of well-designed trials evaluating structural benefits of non-pharmacologic therapies for management of knee osteoarthritis (OA). In this parallel-group randomised controlled trial, we aim to compare the possible structural and functional advantages of two non-pharmacologic interventions; lateral wedge insole and acupuncture; in patients with medial knee OA. Method Patients with medial knee OA and radiological findings consistent with grade two or three of Kellgren-Lawrence classification system were randomly allocated to group one who received an in shoe lateral wedge and two who underwent acupuncture. We assessed patients’ pain and function in addition to knee joint cartilage thickness before and after each intervention. Paired t-test and independent samples t-test were used for in group and between group analyses. (Level of evidence: 2). Results Twenty patients in each group recruited in the study. Pain significantly decreased after therapy in both group one and two (paired t test, P < 0.001, 95%CI: 1.62-3.25 and 1.58-3.20 respectively). Also, function significantly increased in each group (paired t test, P = 0.001, 95%CI of 0.94-2.38 in group one and 0.97-2.43 in group two). A non-clinically statistically significant difference regarding the femoral and tibial cartilage thickness was obtained in both group one (P = 0.005, CI: -0.43-0.82 and P = 0.037, CI: -0.44-0.80 respectively) and two (P = 0.025, CI: -0.45-0.79 and P = 0.035, CI: -0.29-0.96 respectively). Between groups analysis showed no significant difference regarding all above mentioned measures. Conclusion Both lateral wedge insole and acupuncture can be effective in the treatment of medial knee osteoarthritis without any superiority of one over the other. Iranian Registry of Clinical Trials: IRCT201201108235N1 URL: http://irct.ir/searchen.php?keyword=wedge+and+acupuncture&field=g&lang=enThe Knee 01/2013; 21(2). DOI:10.1016/j.knee.2013.12.002 · 2.01 Impact Factor