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[Exploration on the mechanism of warm needle-moxibustion in protecting cartilage in rabbits with knee osteoarthritis based on the Hippo-YAP signaling pathway].

Zhen ci yan jiu = Acupuncture research·March 2026·Wen Li, Di Liu, Ming-Lei Wang et al.
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Key Finding

Warm needle moxibustion significantly protected knee cartilage in osteoarthritis by activating the Hippo-YAP signaling pathway, promoting cartilage synthesis while inhibiting degradation with efficacy comparable to celecoxib.

What This Means For You

Researchers in China studied how warm needle acupuncture—a technique combining traditional acupuncture with moxibustion heat therapy—might help protect knee cartilage in osteoarthritis. They worked with rabbits that had knee osteoarthritis, treating them at three acupuncture points around the knee (Heding, Neixiyan, and Waixiyan) for 15 minutes daily over two weeks. The researchers compared warm needle acupuncture to medication (celecoxib) and untreated groups. They found that warm needle acupuncture significantly reduced pain, swelling, and movement limitations in the arthritic knees. More importantly, microscopic examination showed that the treatment helped protect and rebuild knee cartilage. The study revealed that warm needle acupuncture works by activating a cellular signaling pathway called Hippo-YAP, which promotes the production of important cartilage-building proteins like collagen and aggrecan while blocking enzymes that break down cartilage. The treatment group showed cartilage that was thicker, smoother, and more evenly structured compared to untreated animals. Results were comparable to those achieved with standard anti-inflammatory medication. This suggests warm needle acupuncture may offer a dual benefit: stimulating cartilage repair while preventing further breakdown. While this animal study shows promising mechanisms, human clinical trials are needed to confirm these effects in people with knee osteoarthritis. If you're considering acupuncture for knee osteoarthritis, consult with a licensed acupuncturist who has experience treating musculoskeletal conditions.

Clinical Notes for Practitioners

This rabbit model study (n=7 per group) investigated warm needle moxibustion's cartilage-protective mechanisms in knee osteoarthritis via the Hippo-YAP signaling pathway. Treatment consisted of 15-minute sessions at EX-LE2, EX-LE4, and ST35 daily for 14 days. Compared to untreated KOA models, warm needle moxibustion significantly decreased Lequesne MG scores (P<0.01) and upregulated YAP, SOX9, and TGF-β1 expression while downregulating catabolic enzymes MMP-3 and ADAMTS5 (P<0.01-0.05). Histological analysis showed improved cartilage integrity, increased extracellular matrix uniformity, and enhanced Type II collagen and aggrecan immunoreactivity. Treatment outcomes were statistically equivalent to celecoxib (20mg/kg). Results indicate warm needle moxibustion activates Hippo-YAP signaling to promote chondrocyte anabolism and inhibit catabolism, offering bidirectional ECM regulation. This provides mechanistic evidence for warm needle moxibustion's chondroprotective effects in KOA management.

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