Acupuncture improves the symptoms, intestinal microbiota, and inflammation of patients with mild to moderate Crohn's disease: A randomized controlled trial

Bao, Chunhui; Wu, Luyi; Wang, Di; Chen, Liming; Jin, Xiaoming; Shi, Yin; Li, Guona; Zhang, Jingzhi; Zeng, Xiaoqing; Chen, Jianhua; Liu, Huirong; Wu, Huangan

doi:10.1016/j.eclinm.2022.101300

Cited by 46 publications

(48 citation statements)

References 49 publications

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“…Some studies showed that the biological mechanisms might be related to the balance of Th1, Th17 and Treg cells. 7 22 Another study showed that acupuncture combined with moxibustion may repair intestinal epithelial barrier lesions and increase tight junction protein expression. 23 Gut microbiota may also be associated with the mechanisms of acupuncture for CD.…”

Section: Discussionmentioning

confidence: 99%

Acupuncture for Crohn’s disease: a protocol for systematic review and meta-analysis

Han¹,

Liu

Zhang

2023

BMJ Open

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IntroductionCrohn’s disease (CD) is a chronic inflammatory bowel disease that seriously affects the quality of life. While conventional medicines are of limitations, acupuncture has been shown to be a promising therapy. While no systematic review related has been published, the present study aimed to evaluate the efficacy and safety of acupuncture for CD.Methods and analysisPubMed, the Cochrane Central Register of Controlled Trials and Chinese electronic databases, including China National Knowledge Infrastructure, Wan Fang database, VIP, SinoMed and the Chinese Clinical Trial Registry, will be searched from the establishment of the database until 31 December 2022. Randomised controlled trials evaluating the efficacy and safety of acupuncture/electroacupuncture on patients with CD, controlled by conventional therapies, were included. Outcomes include induction of clinical remission and response, maintenance of remission, and the incidence of adverse events. All articles will be screened and extracted by two reviewers independently. The risk of bias will be evaluated using the revised Cochrane Risk of Bias 2 tool. A fixed effect model or a random effects model will be used based on the assessment of heterogeneity. A subgroup analysis and sensitivity analysis will be carried out if necessary. Publication bias will be analysed, and the strength of the body of evidence for primary outcomes will be graded.Ethics and disseminationThere is no necessity for this study to acquire ethical approval, and this review will be disseminated in a peer-reviewed journal or conference presentation.Trial registration numberCRD42022356967.

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Section: Discussionmentioning

confidence: 99%

Acupuncture for Crohn’s disease: a protocol for systematic review and meta-analysis

Han¹,

Liu

Zhang

2023

BMJ Open

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“…These decoctions change the diversity and community landscape of the gut microbiota and metabolic profiles and in particular significantly increased the abundance of SCFAs produced by the gut microbiota ( 81 – 83 ). Similarly, the relative abundance of Roseburia faecis and Faecalibacterium prausnitzii in gut microbiota was increased, and the expression of Th17 cell-related cytokines was decreased in CD patients treated with acupuncture ( 84 ).…”

Section: The Therapeutic Potential Of Ibd By Targeting Th17 Cellsmentioning

confidence: 99%

The role of Th17 cells in inflammatory bowel disease and the research progress

et al. 2023

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Th17 cells play an important role in the abnormal immune response in inflammatory bowel disease (IBD) and are involved in the development and progression of inflammation and fibrosis. An increasing amount of data has shown that gut microbes are important parts of intestinal immunity and regulators of Th17 cellular immunity. Th17 cell differentiation is regulated by intestinal bacteria and cytokines, and Th17 cells regulate the intestinal mucosal immune microenvironment by secreting cytokines, such as IL-17, IL-21, and IL-26. Solid evidence showed that, regarding the treatment of IBD by targeting Th17 cells, the therapeutic effect of different biological agents varies greatly. Fecal bacteria transplantation (FMT) in the treatment of IBD has been a popular research topic in recent years and is safe and effective with few side effects. To further understand the role of Th17 cells in the progression of IBD and associated therapeutic prospects, this review will discuss the progress of related research on Th17 cells in IBD by focusing on the interaction and immune regulation between Th17 cells and gut microbiota.

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“…Treatment of CD with acupuncture and moxibustion has been a popular research area in recent years. Previous work by our team has shown that moxibustion or moxibustion combination with acupuncture can alleviate disease activity ( Bao et al, 2014 , 2022 ), and improve serological markers of inflammation ( Bao et al, 2014 , 2022 ), immunity ( Zhao et al, 2015 ), and tight junction protein expression in the intestinal wall ( Bao et al, 2011 ; Shang et al, 2015 ) in CD. In addition, we have also demonstrated that acupuncture can improve depression ( Bao et al, 2021 ) and peripheral KP metabolism ( Bao et al, 2016 , 2021 ) in CD, and that the effects of electroacupuncture and moxibustion on brain function in CD patients are related to the brain steady-state afferent processing network and the default mode network, respectively ( Bao et al, 2017 ).…”

Section: Introductionmentioning

confidence: 96%

Moxibustion alleviates depression-like behavior in rats with Crohn’s disease by inhibiting the kynurenine pathway metabolism in the gut-brain axis

Bao

Huang

et al. 2022

Front. Neurosci.

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BackgroundMoxibustion is a potential therapy for inflammatory bowel disease-related depression, but its specific mechanism of action is unclear. This study aimed to investigate the molecular mechanism by which moxibustion alleviates depressive behavior in rats with Crohn’s disease (CD).MethodsThe CD rat model was established with 2,4,6-trinitrobenzenesulfonic acid. Treatment with moxibustion was applied to Tianshu (ST25, bilateral), Qihai (CV6), and Baihui (GV20) acupoints, and the effect of moxibustion was compared with that of the combination of moxibustion plus indoleamine-2,3-dioxygenase 1 (IDO1) inhibitor, 1-methyltryptophan (1-MT). The effects of moxibustion and moxibustion plus 1-MT combination on colonic inflammation and depressive behavior (assessed by forced swimming test, sucrose preference test, and open field test) were investigated. The changes in IDO1, TNF-α, and IL-1β in rat colon and hippocampus were assessed by Western blot (WB). Gas chromatography-mass spectrometry, immunofluorescence staining, and WB were applied to detect kynurenine pathway (KP) metabolites, hippocampal neuronal activity, and microglia activation, respectively.ResultsBoth moxibustion and moxibustion plus 1-MT combination significantly alleviated intestinal inflammation and depressive behavior, downregulated the levels of IDO1 in the colon and hippocampus, and inhibited inflammation-inducing factors IL-1β and TNF-α, as well as the kynurenine/tryptophan (KYN/TRP) ratio of KP metabolites, and upregulated the kynurenic acid (KYNA)/KYN ratio and the KYNA/quinolinic acid (QUIN) ratio in the hippocampus in rats with CD; Hippocampal ionized calcium-binding adaptor molecule-1 (Iba-1), c-fos protein expression, activated microglia, and neuronal activation was also significantly reduced by moxibustion and moxibustion plus 1-MT. The addition of 1-MT did not significantly increase the therapeutic effect of moxibustion.ConclusionMoxibustion can improve depressive behavior in rats with CD, which may be related to its regulation of KP metabolism in the gut-brain axis and inhibition of hippocampal microglia activation and neuronal activation.

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Acupuncture improves the symptoms, intestinal microbiota, and inflammation of patients with mild to moderate Crohn's disease: A randomized controlled trial

Cited by 46 publications

References 49 publications

Acupuncture for Crohn’s disease: a protocol for systematic review and meta-analysis

Acupuncture for Crohn’s disease: a protocol for systematic review and meta-analysis

The role of Th17 cells in inflammatory bowel disease and the research progress

Moxibustion alleviates depression-like behavior in rats with Crohn’s disease by inhibiting the kynurenine pathway metabolism in the gut-brain axis

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