Effect of Horn Therapy on Serum Levels of Glucocorticoids in Patients With Rheumatoid Arthritis

Abstract

Background: Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by multiple systemic injuries. RA may be a clinical syndrome encompassing multiple disease subsets, each characterized by immune dysregulation that, if left untreated, may lead to chronic inflammation and irreversible joint or organ damage. High-dose glucocorticoid (Gc) therapy is the first-line treatment of choice for adult patients with RA, but long-term use of Gc can cause side effects such as hypertension, hyperglycemia, hypercholesterolemia, obesity, and long-term toxicity. The ox horn cupping therapy is an external treatment method of Mongolian traditional medicine, that has been used for the treatment of joint conditions. Aim: To explore the change in Gc levels in rheumatoid arthritis patients after horn cupping therapy. Materials and Methods: Healthy participants and RA patients underwent ox horn cupping therapy for 21 days. Before, under, and after the horn cupping therapy, serum samples were collected and subjected to tandem mass tag quantitative proteomics to examine the glucocorticoid levels. In addition, glucocorticoid levels in the samples were detected by using ELISA. Results: Quantitative and differential analysis revealed that the serum Gc levels were significantly higher before the horn cupping therapy but decreased during and after (p=0.0013) the treatment in RA patients. Furthermore, ELISA showed a significant decrease in serum Gc levels in RA patients received horn cupping therapy (p<0.0001). Gene ontology enrichment analyses showed that Gc was mainly enriched in biological processes including establishment of localization, localization, transport, and vitamin transmembrane transport. Gc is also rich in cellular components including vesicle, extracellular exosome, extracellular vesicle, extracellular organelle, etc., and its molecular functions include cytoskeletal protein binding, actin binding, small molecule binding, and organic cyclic compound binding. Conclusions: Horn cupping therapy has a significant Gc-lowering effect in patients with RA. We speculate that extracting body fluids through cupping can help reduce the long-term toxicity of exogenous (therapeutic) Gc in the body, thereby reducing side effects and minimizing damage to the body.