Figure - available from: Evidence-based Complementary and Alternative Medicine
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Schematic diagram of bile acid synthesis pathway and gut-liver circulation. The synthesis of BAs is mainly through classical and alternative pathways. The classical pathway is initiated by CYP7A1, and the alternative pathway is initiated by CYP27A1. CDCA is synthesized by cholesterol through a series of enzymatic reactions. CDCA forms conjugated CDCA by binding with glycine or taurine and are secreted into the intestine through bile duct. About 95% of BAs is transported into portal vein by intestinal epithelial cells and reabsorbed by hepatocytes and the remaining 5% will be excreted with feces. CYP7A1: cholesterol 7α-hydroxylase; HSD3B7: 3β-hydroxysteroid dehydrogenase; CYP8B1: sterol 12α-hydroxylase; CA: cholic acid; CDCA: chenodeoxycholic acid; CYP7B1: oxysterol 7α-hydroxylase; and CYP27A1: sterol 27-hydroxylase.
Source publication
Nuclear receptors (NRs) are ligand-dependent transcription factors that regulate the transcription of target genes. Bile acids (BAs) can be used as effector molecules to regulate physiological processes in the gut, and NRs are important receptors for bile acid signaling. Relevant studies have shown that NRs are closely related to the occurrence of...
Citations
Objectives
Crohn’s disease is a chronic gastrointestinal disease that belongs to inflammatory bowel disease. This systematic review aims to assess the level of evidence in randomized controlled trials (RCTs) on the effects of acupuncture for Crohn’s disease.
Methods
We searched 12 databases from the date of the establishment of each database up to May, 2023 for relevant RCTs. The risk of bias of each study was assessed independently by three reviewers. The level of evidence of meta-analysis was assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation).
Results
A total of 12 studies were included. The effective rate (odds ratio [OR] 3.23, 95% confidence interval [CI] 1.43, 7.30) for mild to moderate Crohn’s disease patients showed a significant difference between the acupuncture with moxibustion group and the sham-acupuncture with sham-moxibustion group. CDAI change (mean difference [MD] –74.15, 95% CI –93.28, –55.01) for mild to moderate Crohn’s disease showed a significant difference between the acupuncture with moxibustion group and the sham-acupuncture with sham-moxibustion group.
Conclusion
Although acupuncture with moxibustion showed significant effects compared to sham-acupuncture with sham-moxibustion, the effect of acupuncture alone is inconclusive. Moreover, only the effect of acupuncture treatment on mild to moderate Crohn’s disease patients was derived as a remarkable result. To confirm the effectiveness of acupuncture treatment for Crohn’s disease, studies using only acupuncture for intervention or more RCTs targeting various Crohn’s disease patients according to the CDAI are required.
