Jinshui Huanxian Formula Combined with Acupuncture inhibits Epithelial Mesenchymal Transition in Pulmonary Fibrosis Rats via TGF-β1/Smad Pathway

<bold>Background:</bold> Jinshui Huanxian Formula (JHF) combined with acupuncture has beneficial effect in pulmonary fibrosis (PF), but the mechanism remains unclear. Epithelial Mesenchymal Transition (EMT) is one of the main mechanism of PF. This study aimed to explore the potential mechanisms of JHF combined with acupuncture in inhibiting EMT on PF. <bold>Methods:</bold> A Pulmonary Fibrosis (PF) rat model was created using bleomycin (BLM). Treatments included JinHuang Formula (JHF), acupuncture, and combined therapies. Lung function, histopathology, and collagen were assessed. Quantitative real-time PCR was used to detect the mRNA levels of E-cad, N-cad and Vim, and Western blotting was used to detect the protein expression of P-Smad2, P-Smad3 and TGF-β1 in lung tissues. <bold>Results:</bold> In model group, the rats had the decreased lung function and damaged alveolar structure. Meanwhile, collagen deposition and fibroblast foci were found in the lung, as well as decreased the expression of E-cad and increased N-cad, Vim mRNA. All the therapies improved lung function and lung histopathology. Among them, the combined therapy had a better effect in elevating the E-cad gene level than the acupuncture or JHF therapy alone. PF rats had elevated p-Smad2, p-Smad3 and TGF-β1 protein expression. After the intervention, pathway-related indexes decreased in all treatment groups. The combined group was better than the JHF group in affecting TGF-β1 protein expression. <bold>Conclusion:</bold> JHF combined with acupuncture can effectively improve BLM-induced pulmonary fibrosis, the mechanisms maybe associated with the suppression of EMT by inhibiting the activation of the TGF-β1/Smad pathway.