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Regulatory Effect of Moxibustion on Macrophage Polarization and Migration in RA Model Rats and the Role of TIM-3.

Journal of visualized experiments : JoVE·March 2026·Jingwei Nie, Siyu Wang, Yimei Xu et al.
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Key Finding

Moxibustion treatment reduced arthritis inflammation by increasing TIM-3 expression, which restored macrophage balance and decreased excessive macrophage migration in rat models.

What This Means For You

Researchers investigated how moxibustion, a traditional Chinese medicine therapy that uses burning mugwort to warm specific points on the body, might help reduce inflammation in rheumatoid arthritis. Using rats with induced arthritis, scientists examined what happens to immune cells called macrophages, which play a key role in inflammation. The study found that arthritis caused significant paw swelling and redness in rats, along with an imbalance in macrophage types—some macrophages promote inflammation (M1 type) while others help resolve it (M2 type). Arthritic rats had too many inflammatory macrophages that were also moving more actively to inflamed areas. However, when rats received moxibustion treatment over three cycles (each cycle consisting of six days of treatment followed by one day of rest), the therapy reduced swelling and helped restore a healthier balance of macrophage types. The researchers discovered that moxibustion works partly by increasing levels of a protein called TIM-3, which appears to regulate how macrophages behave. When they blocked TIM-3 production, the beneficial effects of moxibustion were diminished, confirming its importance in the treatment mechanism. This research suggests moxibustion may help manage rheumatoid arthritis by modulating immune cell activity and reducing inflammation through specific molecular pathways. While this study was conducted in animals, it provides scientific insight into how moxibustion might benefit patients with inflammatory joint conditions. If considering moxibustion therapy, patients should seek treatment from a licensed acupuncturist or qualified traditional Chinese medicine practitioner.

Clinical Notes for Practitioners

This rat model study investigated moxibustion's regulatory effects on macrophage polarization in rheumatoid arthritis, specifically examining the role of T cell immunoglobulin and mucin domain-containing protein 3 (TIM-3). Sprague-Dawley rats received Complete Freund's adjuvant to induce arthritis, followed by three cycles of moxibustion (six days treatment, one day rest). Outcomes were assessed via histological analysis, paw thickness measurement, ELISA, immunofluorescence, qRT-PCR, and Western blot for M1/M2 macrophage markers and TIM-3 expression. Transwell assays measured macrophage migration using peritoneal exudate macrophages. Results demonstrated that moxibustion significantly attenuated paw swelling, reduced excessive macrophage migration, and restored M1/M2 balance. Lentivirus-mediated Havcr2 RNA interference decreased TIM-3 expression and abolished moxibustion's therapeutic effects, confirming TIM-3 as a key mediator. Clinical relevance: This study provides mechanistic evidence that moxibustion modulates inflammatory responses in RA through TIM-3-dependent regulation of macrophage polarization and migration, supporting its clinical application for inflammatory arthropathies.

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