Acupuncture treatment May improve the bone metabolism and pathological ossification by regulating the gut microbiota...

To explore the effects of acupuncture on osteogenic signaling and gut microbiota in ankylosing spondylitis (AS).

AS mice were treated with drug (oral sulfasalazine) or acupuncture (Du Mai meridian and Jia Ji acupoints). After one month of treatment, pathological alterations in the Achilles tendon tissue were observed. Serum levels of alkaline phosphatase (ALP), bone gla protein (BGP) and tumor necrosis factor-alpha (TNF-α), expressions of microRNA-21 (miR-21), bone morphogenetic protein-2 (BMP-2) and SMAD Family Member 1 (Smad1) in the Achilles tendon tissue, as well as ALP, BGP, Dickkopf-1 (DKK1) and Wnt Family Member 5a (Wnt5a) levels, were measured. Further, 16S Ribosomal RNA (16S rRNA) gene sequencing technology was used to analyze changes in the gut microbiota.

After drug and acupuncture treatments, pathological scores were reduced. Both drug and acupuncture treatments downregulated ALP, although only the drug treatment led to a reduction in BGP. Moreover, the mRNA levels of miR-21, BMP-2, and Smad1, along with the protein levels of ALP, BGP, and Wnt5a in the drug and acupuncture groups, showed varying degrees of reduction, while DKK1 level was increased. The results of the analysis using 16S rRNA gene sequencing technology revealed that bacterial richness was significantly increased in both treatment groups compared to AS model mice (P < 0.05), with a more pronounced elevation observed in the acupuncture group than in the drug group (P < 0.05).

Acupuncture may alleviate AS by modulating osteogenic pathways and gut microbiota, thus reducing inflammation and pathological ossification.