[Mechanism of acupotomy on cartilage degeneration in rabbits with knee osteoarthritis based on Piezo1/p38MAPK/ERK5 mechanosensitive pathway].

Researchers studied a specialized acupuncture technique called acupotomy for knee osteoarthritis, a common condition causing joint pain and cartilage breakdown. The study used rabbits with knee osteoarthritis to understand how acupotomy might protect cartilage from further damage. Scientists divided 24 rabbits into four groups: healthy rabbits, untreated rabbits with arthritis, rabbits treated with acupotomy, and rabbits treated with acupotomy plus a chemical that blocks its effects. Acupotomy involves using a special needle-knife tool to treat tight tissue around the knee joint. Treatments were given once weekly for three weeks. Results showed that acupotomy significantly improved knee function scores and protected cartilage structure compared to no treatment. The cartilage in treated rabbits showed better staining patterns, more organized cells, and clearer structural layers. Blood tests revealed lower levels of cartilage breakdown products in acupotomy-treated rabbits. The researchers found that acupotomy works by affecting special pressure-sensing proteins in cartilage cells called Piezo1, along with related signaling pathways (p38MAPK and ERK5). When acupotomy was combined with a chemical activating Piezo1, the benefits were blocked, confirming this mechanism. The treatment appeared to reduce inflammation and maintain the balance of cartilage metabolism, preventing further degeneration. While this animal study shows promising biological mechanisms, human clinical trials are needed to confirm these benefits for knee osteoarthritis patients. If considering acupotomy for knee arthritis, seek treatment from a licensed acupuncturist with specialized training in this technique.

This animal study investigated acupotomy's mechanism for treating knee osteoarthritis through the Piezo1/p38MAPK/ERK5 mechanosensitive pathway. Twenty-four New Zealand rabbits were randomized into four groups (n=6): blank control, KOA model, acupotomy, and acupotomy plus Piezo1 agonist (Yoda1). The modified Videman method induced KOA. Weekly acupotomy targeting periarticular nodules and cord-like tissues was administered for three weeks. Results demonstrated significant improvements: acupotomy reduced Lequesne MG scores (P<0.05), decreased serum and synovial fluid COMP and CTX-II levels (P<0.01), improved cartilage histomorphology with safranin O staining, and increased Col-II and Aggrecan expression while decreasing Piezo1, p38MAPK, and ERK5 protein expression (P<0.01). Administration of Piezo1 agonist before acupotomy negated therapeutic benefits, confirming pathway involvement. Clinical implications suggest acupotomy exerts mechano-biological effects that inhibit extracellular matrix degradation and maintain cartilage homeostasis, potentially offering a mechanism-based intervention for osteoarthritis management.