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Dilley A, Harris M, Barbe MF, Bove GM. Aberrant Neuronal Activity in a Model of Work-Related Upper Limb Pain and Dysfunction. THE JOURNAL OF PAIN 2022; 23:852-863. [PMID: 34958943 PMCID: PMC9086086 DOI: 10.1016/j.jpain.2021.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/26/2021] [Accepted: 12/03/2021] [Indexed: 05/03/2023]
Abstract
Work-related musculoskeletal disorders associated with intense repetitive tasks are highly prevalent. Painful symptoms associated with such disorders can be attributed to neuropathy. In this study, we characterized the neuronal discharge from the median nerve in rats trained to perform an operant repetitive task. After 3-weeks of the task, rats developed pain behaviors and a decline in grip strength. Ongoing activity developed in 17.7% of slowly conducting neurons at 3-weeks, similar to neuritis. At 12-weeks, an irregular high frequency neuronal discharge was prevalent in >88.4% of slow and fast conducting neurons. At this time point, 8.3% of slow and 21.2% of fast conducting neurons developed a bursting discharge, which, combined with a reduction in fast-conducting neurons with receptive fields (38.4%), is consistent with marked neuropathology. Taken together, we have shown that an operant repetitive task leads to an active and progressive neuropathy that is characterized by marked neuropathology following 12-weeks task that mainly affects fast conducting neurons. Such aberrant neuronal activity may underlie painful symptoms in patients with work-related musculoskeletal disorders. PERSPECTIVE: Aberrant neuronal activity, similar to that reported in this study, may contribute to upper limb pain and dysfunction in patients with work-related musculoskeletal disorders. In addition, profiles of instantaneous frequencies may provide an effective way of stratifying patients with painful neuropathies.
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Affiliation(s)
- Andrew Dilley
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, England
| | - Michele Harris
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Mary F Barbe
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Geoffrey M Bove
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania; Bove Consulting, Kennebunkport, Maine.
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Sadri M, Hirosawa N, Le J, Romero H, Martellucci S, Kwon HJ, Pizzo D, Ohtori S, Gonias SL, Campana WM. Tumor necrosis factor receptor-1 is selectively sequestered into Schwann cell extracellular vesicles where it functions as a TNFα decoy. Glia 2022; 70:256-272. [PMID: 34559433 PMCID: PMC10656730 DOI: 10.1002/glia.24098] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 12/19/2022]
Abstract
Schwann cells (SCs) are known to produce extracellular vesicles (EV) that participate in cell-cell communication by transferring cargo to target cells, including mRNAs, microRNAs, and biologically active proteins. Herein, we report a novel mechanism whereby SC EVs may regulate PNS physiology, especially in injury, by controlling the activity of TNFα. SCs actively sequester tumor necrosis factor receptor-1 (TNFR1) into EVs at high density, accounting for about 2% of the total protein in SC EVs (~1000 copies TNFR1/EV). Although TNFR2 was robustly expressed by SCs in culture, TNFR2 was excluded from SC EVs. SC EV TNFR1 bound TNFα, decreasing the concentration of free TNFα available to bind to cells and thus served as a TNFα decoy. SC EV TNFR1 significantly inhibited TNFα-induced p38 MAPK phosphorylation in cultured SCs. When TNFR1 was proteolytically removed from SC EVs using tumor necrosis factor-α converting enzyme (TACE) or neutralized with antibody, the ability of TNFα to activate p38 MAPK in the presence of these EVs was restored. As further evidence of its decoy activity, SC EV TNFR1 modified TNFα activities in vitro including: (1) regulation of expression of other cytokines; (2) effects on SC morphology; and (3) effects on SC viability. SC EVs also modified the effects of TNFα on sciatic nerve morphology and neuropathic pain-related behavior in vivo. By sequestering TNFR1 in EVs, SCs may buffer against the potentially toxic effects of TNFα. SC EVs provide a novel mechanism for the spatial and temporal regulation of neuro-inflammation.
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Affiliation(s)
- Mahrou Sadri
- Department of Anesthesiology, University of California, San Diego, La Jolla, California, USA
| | - Naoya Hirosawa
- Department of Anesthesiology, University of California, San Diego, La Jolla, California, USA
- Department of Orthopaedic Surgery and Graduate School in Medicine, Chiba University, Chiba, Japan
| | - Jasmine Le
- Department of Anesthesiology, University of California, San Diego, La Jolla, California, USA
- Veterans Administration San Diego Healthcare System, San Diego, California, USA
| | - Haylie Romero
- Department of Anesthesiology, University of California, San Diego, La Jolla, California, USA
- Program in Neuroscience, University of California, San Diego, La Jolla, California, USA
| | - Stefano Martellucci
- Department of Anesthesiology, University of California, San Diego, La Jolla, California, USA
| | - Hyo Jun Kwon
- Department of Anesthesiology, University of California, San Diego, La Jolla, California, USA
| | - Donald Pizzo
- Department of Pathology, University of California, San Diego, California, USA
| | - Seiji Ohtori
- Department of Orthopaedic Surgery and Graduate School in Medicine, Chiba University, Chiba, Japan
| | - Steven L. Gonias
- Department of Pathology, University of California, San Diego, California, USA
| | - Wendy M. Campana
- Department of Anesthesiology, University of California, San Diego, La Jolla, California, USA
- Veterans Administration San Diego Healthcare System, San Diego, California, USA
- Program in Neuroscience, University of California, San Diego, La Jolla, California, USA
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Barbe MF, Panibatla ST, Harris MY, Amin M, Dorotan JT, Cruz GE, Bove GM. Manual Therapy With Rest as a Treatment for Established Inflammation and Fibrosis in a Rat Model of Repetitive Strain Injury. Front Physiol 2021; 12:755923. [PMID: 34803739 PMCID: PMC8600143 DOI: 10.3389/fphys.2021.755923] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Repetitive strain injuries caused by repetitive occupational work are difficult to prevent for multiple reasons. Therefore, we examined the effectiveness of manual therapy (MT) with rest to treat the inflammation and fibrosis that develops through the performance of a repetitive task. We hypothesized that this treatment would reduce task-induced sensorimotor declines and neuromuscular inflammation. Methods: Twenty-nine female Sprague-Dawley rats performed a reaching and lever-pulling task for 14weeks. All ceased performing the task at 14weeks. Ten were euthanized at this timepoint (TASK). Nine received manual therapy to their upper extremities while resting 7weeks (MTR); 10 were assigned to rest alone (REST). Ten additional food restricted rats were included that neither performed the task nor received manual therapy (FRC). Results: Confirming previous experiments, TASK rats showed behavioral changes (forepaw mechanical hypersensitivity, reduced grip strength, lowered forelimb/forepaw agility, and noxious cold temperature sensitivity), reduced median nerve conduction velocity (NCV), and pathological tissue changes (myelin degradation, increased median nerve and muscle inflammation, and collagen production). Manual therapy with rest (MTR) ameliorated cold sensitivity seen in REST rats, enhanced muscle interleukin 10 (IL-10) more than in REST rats, lead to improvement in most other measures, compared to TASK rats. REST rats showed improved grip strength, lowered nerve inflammation and degraded myelin, and lowered muscle tumor necrosis factor alpha (TNFα) and collagen I levels, compared to TASK rats, yet maintained lowered forelimb/forepaw agility and NCV, and increased neural fibrosis. Conclusion: In our model of repetitive motion disorder, manual therapy during rest had modest effects on behavioral, histological, and physiological measures, compared to rest alone. These findings stand in contrast to the robust preventive effects of manual therapy in this same model.
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Affiliation(s)
- Mary F Barbe
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Siva Tejaa Panibatla
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Michele Y Harris
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Mamta Amin
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Jocelynne T Dorotan
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Geneva E Cruz
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Geoffrey M Bove
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States.,Bove Consulting, Kennebunkport, ME, United States
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Williamson PM, Freedman BR, Kwok N, Beeram I, Pennings J, Johnson J, Hamparian D, Cohen E, Galloway JL, Ramappa AJ, DeAngelis JP, Nazarian A. Tendinopathy and tendon material response to load: What we can learn from small animal studies. Acta Biomater 2021; 134:43-56. [PMID: 34325074 DOI: 10.1016/j.actbio.2021.07.046] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/16/2021] [Accepted: 07/21/2021] [Indexed: 12/20/2022]
Abstract
Tendinopathy is a debilitating disease that causes as much as 30% of all musculoskeletal consultations. Existing treatments for tendinopathy have variable efficacy, possibly due to incomplete characterization of the underlying pathophysiology. Mechanical load can have both beneficial and detrimental effects on tendon, as the overall tendon response depends on the degree, frequency, timing, and magnitude of the load. The clinical continuum model of tendinopathy offers insight into the late stages of tendinopathy, but it does not capture the subclinical tendinopathic changes that begin before pain or loss of function. Small animal models that use high tendon loading to mimic human tendinopathy may be able to fill this knowledge gap. The goal of this review is to summarize the insights from in-vivo animal studies of mechanically-induced tendinopathy and higher loading regimens into the mechanical, microstructural, and biological features that help characterize the continuum between normal tendon and tendinopathy. STATEMENT OF SIGNIFICANCE: This review summarizes the insights gained from in-vivo animal studies of mechanically-induced tendinopathy by evaluating the effect high loading regimens have on the mechanical, structural, and biological features of tendinopathy. A better understanding of the interplay between these realms could lead to improved patient management, especially in the presence of painful tendon.
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Barbe MF, Harris MY, Cruz GE, Amin M, Billett NM, Dorotan JT, Day EP, Kim SY, Bove GM. Key indicators of repetitive overuse-induced neuromuscular inflammation and fibrosis are prevented by manual therapy in a rat model. BMC Musculoskelet Disord 2021; 22:417. [PMID: 33952219 PMCID: PMC8101118 DOI: 10.1186/s12891-021-04270-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 04/07/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND We examined the effectiveness of a manual therapy consisting of forearm skin rolling, muscle mobilization, and upper extremity traction as a preventive treatment for rats performing an intensive lever-pulling task. We hypothesized that this treatment would reduce task-induced neuromuscular and tendon inflammation, fibrosis, and sensorimotor declines. METHODS Sprague-Dawley rats performed a reaching and lever pulling task for a food reward, 2 h/day, 3 days/week, for 12 weeks, while simultaneously receiving the manual therapy treatment 3 times per week for 12 weeks to either the task-involved upper extremities (TASK-Tx), or the lower extremities as an active control group (TASK-Ac). Results were compared to similarly treated control rats (C-Tx and C-Ac). RESULTS Median nerves and forearm flexor muscles and tendons of TASK-Ac rats showed higher numbers of inflammatory CD68+ and fibrogenic CD206+ macrophages, particularly in epineurium, endomysium and epitendons than TASK-Tx rats. CD68+ and CD206+ macrophages numbers in TASK-Tx rats were comparable to the non-task control groups. TASK-Ac rats had more extraneural fibrosis in median nerves, pro-collagen type I levels and immunoexpression in flexor digitorum muscles, and fibrogenic changes in flexor digitorum epitendons, than TASK-Tx rats (which showed comparable responses as control groups). TASK-Ac rats showed cold temperature, lower reflexive grip strength, and task avoidance, responses not seen in TASK-Tx rats (which showed comparable responses as the control groups). CONCLUSIONS Manual therapy of forelimbs involved in performing the reaching and grasping task prevented the development of inflammatory and fibrogenic changes in forearm nerves, muscle, and tendons, and sensorimotor declines.
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Affiliation(s)
- Mary F Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA.
| | - Michele Y Harris
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Geneva E Cruz
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Mamta Amin
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Nathan M Billett
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Jocelynne T Dorotan
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Emily P Day
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Seung Y Kim
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Geoffrey M Bove
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA.,Bove Consulting, Kennebunkport, ME, 04046, USA
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Keir PJ, Farias Zuniga A, Mulla DM, Somasundram KG. Relationships and Mechanisms Between Occupational Risk Factors and Distal Upper Extremity Disorders. HUMAN FACTORS 2021; 63:5-31. [PMID: 31314601 DOI: 10.1177/0018720819860683] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE The relationships between workplace risk factors and upper extremity injuries from epidemiological and laboratory studies were examined. BACKGROUND Epidemiological studies are associated with several limitations, affecting the strength of association between risk factors and the development of injuries. METHOD In this narrative review, we identified epidemiological and laboratory studies (published primarily since 1997) investigating exposure to workplace risk factors (force, repetition, posture, vibration) and risk of hand/wrist tendon-related disorders, epicondylitis, and carpal tunnel syndrome (CTS). RESULTS Forceful exertions are strongly associated with hand/wrist tendon-related disorders, epicondylitis, and CTS. Dose-response relationships were found for epicondylitis (repetition) and CTS (posture). Interactions demonstrate multiplicative effects of risk factors for injury risk. Laboratory studies display clear associations between task demands and biomechanical measures linked to mechanisms for upper extremity injuries with animal models providing further evidence of a dose-response between risk factors and injury. CONCLUSION Forceful, repetitive work requiring non-neutral postures are associated with increasing risk of hand/wrist tendon-related disorders, epicondylitis, and CTS as evidenced by epidemiology studies and laboratory-based investigations of humans and animals. APPLICATION Understanding the relationship between exposure levels of workplace risk factors and upper extremity disorders can improve injury prevention and rehabilitation strategies.
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Mourad BH. Prevalence of work-related musculoskeletal disorders among Egyptian printing workers evidenced by using serum biomarkers of inflammation, oxidative stress, muscle injury, and collagen type I turnover. Toxicol Ind Health 2020; 37:9-22. [PMID: 33295250 DOI: 10.1177/0748233720977399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Printing workers experience a high rate of musculoskeletal disorders (MSDs). This study aims to determine the prevalence of MSDs, estimate serum biomarkers denoting musculoskeletal tissue changes, and determine some individual risk factors for MSDs among Egyptian printing workers. METHODS Eighty-five male printing workers and 90 male administrative employees (control group) were recruited from a printing press in Giza. A validated version of the standardized Nordic questionnaire was used. Serum biomarkers of inflammation (interleukin (IL)-1α, IL-1β, IL-6, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP)), cell stress or injury (malondialdehyde (MDA) and creatine kinase skeletal muscle (CK-MM)), and collagen metabolism (collagen-I carboxy-terminal propeptide (PICP) and type-I collagen cross-linked C-telopeptide (CTx)) were measured for all participants. RESULTS This study showed a significant (p < 0.001) prevalence of the musculoskeletal symptoms (76.5%) and significant (p < 0.001) elevation in the levels of all measured biomarkers among the printing workers (means ± SD: IL-1α = 1.55 ± 0.9, IL-1β = 1.53 ± 0.87, IL-6 = 1.55 ± 0.85, TNF-α = 4.9 ± 2.25, CRP = 6.78 ± 3.07, MDA = 3.41 ± 1.29, CK-MM = 132.47 ± 69.01, PICP = 103.48 ± 36.44, and CTx = 0.47 ± 0.16) when compared with their controls (prevalence: 34.4%; means ± SD: IL-1α = 0.88 ± 0.61, IL-1β = 0.96 ± 0.72, IL-6 = 1.03 ± 0.75, TNF-α = 2.56 ± 1.99, CRP = 2.36 ± 1.1, MDA = 0.85 ± 0.21, CK-MM = 53.48 ± 33.05, PICP = 56.49 ± 9.05, and CTx = 0.31 ± 0.06). Also, significant (p < 0.001) positive strong associations were observed between age, body mass index (BMI), and the duration of employment with all measured biomarkers, where all correlation coefficients were >0.7. CONCLUSION Printing workers suffer a high prevalence of work-related MSDs that might be related to some individual factors (age, BMI, and duration of employment). Consequently, preventive ergonomic interventions should be applied. Further studies should be done to elucidate the link between tissue changes and detected biomarkers to follow the initiation and progression of MSDs and study the effectiveness of curative interventions.
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Affiliation(s)
- Basma Hussein Mourad
- Department of Occupational and Environmental Medicine, 63527Faculty of Medicine, Cairo University, Cairo, Egypt
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Barbe MF, Hilliard BA, Amin M, Harris MY, Hobson LJ, Cruz GE, Dorotan JT, Paul RW, Klyne DM, Popoff SN. Blocking CTGF/CCN2 reverses neural fibrosis and sensorimotor declines in a rat model of overuse-induced median mononeuropathy. J Orthop Res 2020; 38:2396-2408. [PMID: 32379362 PMCID: PMC7647961 DOI: 10.1002/jor.24709] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/24/2020] [Accepted: 04/29/2020] [Indexed: 02/04/2023]
Abstract
Encapsulation of median nerves is a hallmark of overuse-induced median mononeuropathy and contributes to functional declines. We tested if an antibody against CTGF/CCN2 (termed FG-3019 or Pamrevlumab) reduces established neural fibrosis and sensorimotor declines in a clinically relevant rodent model of overuse in which median mononeuropathy develops. Young adult female rats performed a high repetition high force (HRHF) lever-pulling task for 18 weeks. Rats were then euthanised at 18 weeks (HRHF untreated), or rested and systemically treated for 6 weeks with either an anti-CCN2 monoclonal antibody (HRHF-Rest/FG-3019) or IgG (HRHF-Rest/IgG), with results compared with nontask control rats. Neuropathology was evident in HRHF-untreated and HRHF-Rest/IgG rats as increased perineural collagen deposition and degraded myelin basic protein (dMBP) in median nerves, and increased substance P in lower cervical dorsal root ganglia (DRG), compared with controls. Both groups showed functional declines, specifically, decreased sensory conduction velocity in median nerves, noxious cold temperature hypersensitivity, and grip strength declines, compared with controls. There were also increases of ATF3-immunopositive nuclei in ventral horn neurons in HRHF-untreated rats, compared with controls (which showed none). FG-3019-treated rats showed no increase above control levels of perineural collagen or dMBP in median nerves, Substance P in lower cervical DRGs, or ATF3-immunopositive nuclei in ventral horns, and similar median nerve conduction velocities and thermal sensitivity, compared with controls. We hypothesize that neural fibrotic processes underpin the sensorimotor declines by compressing or impeding median nerves during movement, and that inhibiting fibrosis using an anti-CCN2 treatment reverses these effects.
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Affiliation(s)
- Mary F. Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
| | - Brendan A. Hilliard
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
| | - Mamta Amin
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
| | - Michele Y. Harris
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
| | - Lucas J. Hobson
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
| | - Geneva E. Cruz
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
| | - Jocelynne T. Dorotan
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
| | - Ryan W. Paul
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
| | - David M. Klyne
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania,NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
| | - Steven N. Popoff
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
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Eckenrode BJ, Kietrys DM, Stackhouse SK. PAIN SENSITIVITY IN CHRONIC ACHILLES TENDINOPATHY. Int J Sports Phys Ther 2019; 14:945-956. [PMID: 31803527 PMCID: PMC6878865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Achilles tendinopathy is a common overuse injury sustained by athletes (including runners) that often becomes chronic. There is evidence that chronic musculoskeletal pain conditions exhibit signs of nervous system sensitization. HYPOTHESIS/PURPOSE The objective of this study was to compare pain sensitivity (pressure pain threshold [PPT], heat pain threshold [HPT], and heat temporal summation [HTS]) between active healthy adults with and without chronic Achilles tendinopathy in order to determine if signs of peripheral and/or central sensitization exist in chronic Achilles tendinopathy. STUDY DESIGN Cohort study. METHODS Seventeen participants with chronic ( ≥ 3 months) Achilles tendinopathy (39.0 years ± 10.81) and 24 healthy controls (31.83 years ± 8.92) were included. All participants completed the Pain Catastrophizing Scale (PCS). Participants in the Achilles group also completed the Lower Extremity Functional Scale (LEFS) and the Victorian Institute of Sport Assessment-Achilles (VISA-A). Pain processing was quantified using PPT, HPT and HTS tests. RESULTS There were no significant differences in PCS scores between groups. In the Achilles tendinopathy group, the mean VISA-A score was 58.5 ± 18.4; the mean LEFS was 63.7 ± 8.0. Primary hyperalgesia (decreased pain threshold at injury site) was detected in the Achilles tendinopathy group, as evidenced by lower PPT (p<0.0001) and lower HPT (p = 0.028). Mechanical secondary hyperalgesia, a sign of central sensitization, was found in the Achilles tendinopathy group at the tibialis anterior (p = 0.042) and non-involved Achilles (p = 0.025), but not at the thenar eminence (p = 0.276). The degree of HTS was not different between groups (p = 0.981). CONCLUSION Active participants with chronic Achilles tendinopathy showed signs of both peripheral and central sensitization; however, widespread hyperalgesia into the upper extremities and elevated temporal summation were not observed. Evidence of differences in pain sensitivity lend support to the theory for a multifactorial model of tendinopathy, which consists of an impaired motor system, local tendon pathology, and changes in the pain/nociceptive system. Physical therapy management of chronic Achilles tendinopathy may need to address potential changes in the nervous system. Interventions used to treat chronic tendinopathies should be investigated for their potential to resolve peripheral and central sensitization. LEVEL OF EVIDENCE Therapy, level 2b.
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Manual therapy prevents onset of nociceptor activity, sensorimotor dysfunction, and neural fibrosis induced by a volitional repetitive task. Pain 2019; 160:632-644. [PMID: 30461558 DOI: 10.1097/j.pain.0000000000001443] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Painful and disabling musculoskeletal disorders remain prevalent. In rats trained to perform repetitive tasks leading to signs and dysfunction similar to those in humans, we tested whether manual therapy would prevent the development of the pathologies and symptoms. We collected behavioral, electrophysiological, and histological data from control rats, rats that trained for 5 weeks before performing a high-repetition high-force (HRHF) task for 3 weeks untreated, and trained rats that performed the task for 3 weeks while being treated 3x/week using modeled manual therapy (MMT) to the forearm (HRHF + MMT). The MMT included bilateral mobilization, skin rolling, and long axis stretching of the entire upper limb. High-repetition high-force rats showed decreased performance of the operant HRHF task and increased discomfort-related behaviors, starting after training. HRHF + MMT rats showed improved task performance and decreased discomfort-related behaviors compared with untreated HRHF rats. Subsets of rats were assayed for presence or absence of ongoing activity in C neurons and slow Aδ neurons in their median nerves. Neurons from HRHF rats had a heightened proportion of ongoing activity and altered conduction velocities compared with control and MMT-treated rats. Median nerve branches in HRHF rats contained increased numbers of CD68 macrophages and degraded myelin basic protein, and showed increased extraneural collagen deposition, compared with the other groups. We conclude that the performance of the task for 3 weeks leads to increased ongoing activity in nociceptors, in parallel with behavioral and histological signs of neuritis and nerve injury, and that these pathophysiologies are largely prevented by MMT.
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Diverse Role of Biological Plasticity in Low Back Pain and Its Impact on Sensorimotor Control of the Spine. J Orthop Sports Phys Ther 2019; 49:389-401. [PMID: 31151376 DOI: 10.2519/jospt.2019.8716] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Pain is complex. It is no longer acceptable to consider pain solely as a peripheral phenomenon involving activation of nociceptive neurons. The contemporary understanding of pain involves consideration of different underlying pain mechanisms and an increasing awareness of plasticity in all of the biological systems. Of note, recent advances in technology and understanding have highlighted the critical importance of neuroimmune interactions, both in the peripheral and central nervous systems, and the interaction between the nervous system and body tissues in the development and maintenance of pain, including low back pain (LBP). Further, the biology of many tissues changes when challenged by pain and injury, as reported in a growing body of literature on the biology of muscle, fat, and connective tissue. These advances in understanding of the complexity of LBP have implications for our understanding of pain and its interaction with the motor system, and may change how we consider motor control in the rehabilitation of LBP. This commentary provides a state-of-the-art overview of plasticity of biology in LBP. The paper is divided into 4 parts that address (1) biology of pain mechanisms, (2) neuroimmune interaction in the central nervous system, (3) neuroimmune interaction in the periphery, and (4) brain and peripheral tissue interaction. Each section considers the implications for clinical management of LBP. J Orthop Sports Phys Ther 2019;49(6):389-401. doi:10.2519/jospt.2019.8716.
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Barbe MF, White AR, Hilliard BA, Salvadeo DM, Amin M, Harris MY, Cruz GE, Hobson L, Popoff SN. Comparing effects of rest with or without a NK1RA on fibrosis and sensorimotor declines induced by a voluntary moderate demand task. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2019; 19:396-411. [PMID: 31789291 PMCID: PMC6944794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Fibrosis is one contributing factor in motor dysfunction and discomfort in patients with overuse musculoskeletal disorders. We pharmacologically targeted the primary receptor for Substance P, neurokinin-1, using a specific antagonist (NK1RA) in a rat model of overuse with the goal of improving tissue fibrosis and discomfort. METHODS Female rats performed a low repetition, high force (LRHF) grasping task for 12 weeks, or performed the task for 12 weeks before being placed on a four week rest break, with or without simultaneous NK1RA treatment. Results were compared to control rats (untreated, or treated 4 weeks with NK1RA or vehicle). RESULTS Rest improved LRHF-induced declines in grip strength, although rest plus NK1RA treatment (Rest/NK1RA) rescued it. Both treatments improved LRHF-induced increases in muscle TGFβ1 and collagen type 1 levels, forepaw mechanical hypersensitivity (Rest/NK1RA more effectively), macrophage influx into median nerves, and enhanced collagen deposition in forepaw dermis. Only Rest/NK1RA reduced muscle hypercellularity. However, LRHF+4wk Rest /NK1RA rats showed hyposensitivity to noxious hot temperatures. CONCLUSIONS While the NK1RA induced hot temperature hyposensitivity should be taken into consideration if this or related drug were used long-term, the NK1RA more effectively reduced muscle hypercellularity and improved grip strength and forepaw mechanical hypersensitivity.
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Affiliation(s)
- Mary F. Barbe
- Anatomy and Cell Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, USA,Corresponding author: Mary F. Barbe, Ph.D., Professor of Anatomy and Cell Biology, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, Philadelphia, PA 19140, USA E-mail:
| | - Amanda R. White
- Anatomy and Cell Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, USA
| | - Brendan A. Hilliard
- Anatomy and Cell Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, USA
| | - Danielle M. Salvadeo
- Anatomy and Cell Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, USA
| | - Mamta Amin
- Anatomy and Cell Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, USA
| | - Michele Y. Harris
- Anatomy and Cell Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, USA
| | - Geneva E. Cruz
- Anatomy and Cell Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, USA
| | - Lucas Hobson
- Anatomy and Cell Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, USA
| | - Steven N. Popoff
- Anatomy and Cell Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, USA
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13
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Frara N, Fisher PW, Zhao Y, Tarr JT, Amin M, Popoff SN, Barbe MF. Substance P increases CCN2 dependent on TGF-beta yet Collagen Type I via TGF-beta1 dependent and independent pathways in tenocytes. Connect Tissue Res 2018; 59:30-44. [PMID: 28399671 PMCID: PMC5581284 DOI: 10.1080/03008207.2017.1297809] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Transforming growth factor beta 1 (TGFbeta-1) and connective tissue growth factor (CCN2) are important mediators of tissue repair and fibrosis, with CCN2 functioning as a downstream mediator of TGFβ-1. Substance P (SP) is also linked to collagen production in tenocytes. A link between SP, TGFbeta-1 and CCN2 has yet to be established in tenocytes or fibrogenic processes. We sought to determine whether SP induces tenocyte proliferation, CCN2, or collagen production via TGFbeta-1 signaling or independently in rat primary tenocytes. Tenocytes were isolated from rat tendons, cultured and stimulated by SP and/or TGFbeta-1. Cultured cells expressed proteins characteristic of tenocytes (vimentin and tenomodulin) and underwent increased proliferation dose dependently after SP and TGFbeta-1 treatments, alone or combined (more than SP alone when combined). SP induced TGFbeta-1 expression in tenocytes in both dose- and time-dependent manners. SP and TGFbeta-1, alone or combined, stimulated CCN2 expression in tenocytes and their supernatants after both 24 and 48 h of stimulation; a response blocked with addition of a TGFbeta-1 receptor inhibitor. In contrast, SP potentiated collagen type I secretion by tenocytes, a response abrogated by the TGFbeta-1 receptor inhibitor after 48 h of stimulation, but not after the shorter 24 h of stimulation. Our findings suggest that both SP and TGFbeta-1 can stimulate tenocyte fibrogenic processes, albeit differently. TGFbeta-1 pathway signaling was involved in CCN2 production at all time points examined, while SP induced collagen type I production independently prior to the onset of signaling through the TGFbeta-1 pathway.
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Affiliation(s)
| | | | | | | | | | | | - Mary F. Barbe
- Corresponding Author: Mary F. Barbe, PhD, Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad St., Philadelphia, PA 19140, 215/707-6422 phone, 215/707-2966 fax,
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Morita W, Dakin SG, Snelling SJB, Carr AJ. Cytokines in tendon disease: A Systematic Review. Bone Joint Res 2017; 6:656-664. [PMID: 29203638 PMCID: PMC5935810 DOI: 10.1302/2046-3758.612.bjr-2017-0112.r1] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 08/21/2017] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Emerging evidence indicates that tendon disease is an active process with inflammation that is critical to disease onset and progression. However, the key cytokines responsible for driving and sustaining inflammation have not been identified. METHODS We performed a systematic review of the literature using MEDLINE (U.S. National Library of Medicine, Bethesda, Maryland) in March 2017. Studies reporting the expression of interleukins (ILs), tumour necrosis factor alpha (TNF-α) and interferon gamma in diseased human tendon tissues, and animal models of tendon injury or exercise in comparison with healthy control tissues were included. RESULTS IL-1β, IL-6, IL-10, and TNF-α are the cytokines that have been most frequently investigated. In clinical samples of tendinopathy and tendon tears, the expression of TNF-α tended not to change but IL-6 increased in tears. Healthy human tendons showed increased IL-6 expression after exercise; however, IL-10 remained unchanged. Animal tendon injury models showed that IL-1β, IL-6, and TNF-α tend to increase from the early phase of tendon healing. In animal exercise studies, IL-1β expression showed a tendency to increase at the early stage after exercise, but IL-10 expression remained unchanged with exercise. CONCLUSIONS This review highlights the roles of IL-1β, IL-6, IL-10, and TNF-α in the development of tendon disease, during tendon healing, and in response to exercise. However, there is evidence accumulating that suggests that other cytokines are also contributing to tendon inflammatory processes. Further work with hypothesis-free methods is warranted in order to identify the key cytokines, with subsequent mechanistic and interaction studies to elucidate their roles in tendon disease development.Cite this article: W. Morita, S. G. Dakin, S. J. B. Snelling, A. J. Carr. Cytokines in tendon disease: A Systematic Review. Bone Joint Res 2017;6:656-664. DOI: 10.1302/2046-3758.612.BJR-2017-0112.R1.
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Affiliation(s)
- W Morita
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Windmill Road, Headington OX3 7LD, UK and NIHR Oxford Biomedical Research Centre, Botnar Research Centre, University of Oxford, Windmill Road, Headington OX3 7LD, UK
| | - S G Dakin
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Windmill Road, Headington OX3 7LD, UK and NIHR Oxford Biomedical Research Centre, Botnar Research Centre, University of Oxford, Windmill Road, Headington OX3 7LD, UK
| | - S J B Snelling
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Windmill Road, Headington OX3 7LD, UK and NIHR Oxford Biomedical Research Centre, Botnar Research Centre, University of Oxford, Windmill Road, Headington OX3 7LD, UK
| | - A J Carr
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Windmill Road, Headington OX3 7LD, UK and NIHR Oxford Biomedical Research Centre, Botnar Research Centre, University of Oxford, Windmill Road, Headington OX3 7LD, UK
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15
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Fujiwara M, Iwata M, Inoue T, Aizawa Y, Yoshito N, Hayashi K, Suzuki S. Decreased grip strength, muscle pain, and atrophy occur in rats following long-term exposure to excessive repetitive motion. FEBS Open Bio 2017; 7:1737-1749. [PMID: 29123982 PMCID: PMC5666401 DOI: 10.1002/2211-5463.12315] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 07/31/2017] [Accepted: 09/05/2017] [Indexed: 12/22/2022] Open
Abstract
Work‐related musculoskeletal disorders (WMSD) are caused by the overuse of muscles in the workplace. Performing repetitive tasks is a primary risk factor for the development of WMSD. Many workers in highly repetitive jobs exhibit muscle pain and decline in handgrip strength, yet the mechanisms underlying these dysfunctions are poorly understood. In our study, rats performed voluntary repetitive reaching and grasping tasks (Task group), while Control group rats did not perform these activities. In the Task group, grip strength and forearm flexor withdrawal threshold declined significantly from week 2 to week 6, compared with these values at week 0 (P < 0.05). Relative muscle weight and muscle fiber cross‐sectional area of flexor digitorum superficialis (FDS) muscles decreased significantly in the Task group, compared with the Control group, at 6 weeks (P < 0.05 and P < 0.01, respectively). Nerve growth factor, glial cell line‐derived neurotrophic factor, and tumor necrosis factor α‐expression in FDS muscles were not significantly different in Control and Task groups at 3 and 6 weeks. At 6 weeks, the Task group had elevated MuRF1 protein levels (P = 0.065) and significant overexpression of the autophagy‐related (Atg) proteins, Beclin1 and Atg5–Atg12, compared with in the Control group (both P < 0.05). These data suggested that long‐term exposure to excessive repetitive motion causes loss of grip strength, muscle pain, and skeletal muscle atrophy. Furthermore, this exposure may enhance protein degradation through both the ubiquitin‐proteasome and autophagy‐lysosome systems, thereby decreasing skeletal muscle mass.
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Affiliation(s)
- Mitsuhiro Fujiwara
- Program in Physical and Occupational Therapy Nagoya University Graduate School of Medicine Japan.,Department of Rehabilitation Kamiiida Rehabilitation Hospital Nagoya Japan
| | - Masahiro Iwata
- Program in Physical and Occupational Therapy Nagoya University Graduate School of Medicine Japan.,Department of Rehabilitation Faculty of Health Sciences Nihon Fukushi University Handa Aichi Japan
| | - Takayuki Inoue
- Department of Rehabilitation Nagoya University Hospital Japan
| | - Yosuke Aizawa
- Department of Rehabilitation Japanese Red Cross Nagoya Daiichi Hospital Nagoya Japan
| | - Natsumi Yoshito
- Department of Rehabilitation Nagoya City University Hospital Japan
| | - Kazuhiro Hayashi
- Multidisciplinary Pain Center Aichi Medical University Nagakute Aichi Japan
| | - Shigeyuki Suzuki
- Program in Physical and Occupational Therapy Nagoya University Graduate School of Medicine Japan
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16
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Bove GM, Harris MY, Zhao H, Barbe MF. Manual therapy as an effective treatment for fibrosis in a rat model of upper extremity overuse injury. J Neurol Sci 2016; 361:168-80. [PMID: 26810536 PMCID: PMC4729290 DOI: 10.1016/j.jns.2015.12.029] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 12/16/2015] [Accepted: 12/17/2015] [Indexed: 01/08/2023]
Abstract
Key clinical features of carpal tunnel syndrome and other types of cumulative trauma disorders of the hand and wrist include pain and functional disabilities. Mechanistic details remain under investigation but may involve tissue inflammation and/or fibrosis. We examined the effectiveness of modeled manual therapy (MMT) as a treatment for sensorimotor behavior declines and increased fibrogenic processes occurring in forearm tissues of rats performing a high repetition high force (HRHF) reaching and grasping task for 12 weeks. Young adult, female rats were examined: food restricted control rats (FRC, n=12); rats that were trained for 6 weeks before performing the HRHF task for 12 weeks with no treatment (HRHF-CON, n=11); and HRHF task rats received modeled manual therapy (HRHF-MMT, n=5) for 5 days/week for the duration of the 12-week of task. Rats receiving the MMT expressed fewer discomfort-related behaviors, and performed progressively better in the HRHF task. Grip strength, while decreased after training, improved following MMT. Fibrotic nerve and connective tissue changes (increased collagen and TGF-β1 deposition) present in 12-week HRHF-CON rats were significantly decreased in 12-week HRHF-MMT rats. These observations support the investigation of manual therapy as a preventative for repetitive motion disorders.
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Affiliation(s)
- Geoffrey M Bove
- Department of Biomedical Sciences, University of New England College of Osteopathic Medicine, 11 Hills Beach Rd, Biddeford, ME 04005, USA
| | - Michele Y Harris
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, PA, USA
| | - Huaqing Zhao
- Department of Clinical Sciences and Biostatistical Consulting Center, Temple University School of Medicine, Philadelphia, PA, USA
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, PA, USA.
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17
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Massicotte VS, Frara N, Harris MY, Amin M, Wade CK, Popoff SN, Barbe MF. Prolonged performance of a high repetition low force task induces bone adaptation in young adult rats, but loss in mature rats. Exp Gerontol 2015; 72:204-17. [PMID: 26517953 PMCID: PMC4655973 DOI: 10.1016/j.exger.2015.10.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 10/06/2015] [Accepted: 10/26/2015] [Indexed: 10/22/2022]
Abstract
We have shown that prolonged repetitive reaching and grasping tasks lead to exposure-dependent changes in bone microarchitecture and inflammatory cytokines in young adult rats. Since aging mammals show increased tissue inflammatory cytokines, we sought here to determine if aging, combined with prolonged performance of a repetitive upper extremity task, enhances bone loss. We examined the radius, forearm flexor muscles, and serum from 16 mature (14-18 months of age) and 14 young adult (2.5-6.5 months of age) female rats after performance of a high repetition low force (HRLF) reaching and grasping task for 12 weeks. Young adult HRLF rats showed enhanced radial bone growth (e.g., increased trabecular bone volume, osteoblast numbers, bone formation rate, and mid-diaphyseal periosteal perimeter), compared to age-matched controls. Mature HRLF rats showed several indices of radial bone loss (e.g., decreased trabecular bone volume, and increased cortical bone thinning, porosity, resorptive spaces and woven bone formation), increased osteoclast numbers and inflammatory cytokines, compared to age-matched controls and young adult HRLF rats. Mature rats weighed more yet had lower maximum reflexive grip strength, than young adult rats, although each age group was able to pull at the required reach rate (4 reaches/min) and required submaximal pulling force (30 force-grams) for a food reward. Serum estrogen levels and flexor digitorum muscle size were similar in each age group. Thus, mature rats had increased bone degradative changes than in young adult rats performing the same repetitive task for 12 weeks, with increased inflammatory cytokine responses and osteoclast activity as possible causes.
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Affiliation(s)
- Vicky S Massicotte
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad St., Philadelphia, PA 19140, USA
| | - Nagat Frara
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad St., Philadelphia, PA 19140, USA
| | - Michele Y Harris
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad St., Philadelphia, PA 19140, USA
| | - Mamta Amin
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad St., Philadelphia, PA 19140, USA
| | - Christine K Wade
- Department of Physical Therapy, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Steven N Popoff
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad St., Philadelphia, PA 19140, USA
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad St., Philadelphia, PA 19140, USA; Department of Physical Therapy, Temple University, Philadelphia, PA 19140, USA.
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18
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McDonald AC, Tse CTF, Keir PJ. Adaptations to isolated shoulder fatigue during simulated repetitive work. Part II: Recovery. J Electromyogr Kinesiol 2015; 29:42-9. [PMID: 26076931 DOI: 10.1016/j.jelekin.2015.05.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 04/18/2015] [Accepted: 05/25/2015] [Indexed: 01/22/2023] Open
Abstract
The shoulder allows kinematic and muscular changes to facilitate continued task performance during prolonged repetitive work. The purpose of this work was to examine changes during simulated repetitive work in response to a fatigue protocol. Participants performed 20 one-minute work cycles comprised of 4 shoulder centric tasks, a fatigue protocol, followed by 60 additional cycles. The fatigue protocol targeted the anterior deltoid and cycled between static and dynamic actions. EMG was collected from 14 upper extremity and back muscles and three-dimensional motion was captured during each work cycle. Participants completed post-fatigue work despite EMG manifestations of muscle fatigue, reduced flexion strength (by 28%), and increased perceived exertion (∼3 times). Throughout the post-fatigue work cycles, participants maintained performance via kinematic and muscular adaptations, such as reduced glenohumeral flexion and scapular rotation which were task specific and varied throughout the hour of simulated work. By the end of 60 post-fatigue work cycles, signs of fatigue persisted in the anterior deltoid and developed in the middle deltoid, yet perceived exertion and strength returned to pre-fatigue levels. Recovery from fatigue elicits changes in muscle activity and movement patterns that may not be perceived by the worker which has important implications for injury risk.
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Affiliation(s)
- Alison C McDonald
- Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Calvin T F Tse
- Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Peter J Keir
- Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, ON L8S 4K1, Canada.
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BARBE MF, JAIN NX, MASSICOTTE VS, POPOFF SN, BARR-GILLESPIE AE. Ergonomic task reduction prevents bone osteopenia in a rat model of upper extremity overuse. INDUSTRIAL HEALTH 2015; 53:206-221. [PMID: 25739896 PMCID: PMC4466874 DOI: 10.2486/indhealth.2014-0159] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 01/05/2015] [Indexed: 06/04/2023]
Abstract
We evaluated the effectiveness of ergonomic workload reduction of switching rats from a high repetition high force (HRHF) lever pulling task to a reduced force and reach rate task for preventing task-induced osteopenic changes in distal forelimb bones. Distal radius and ulna trabecular structure was examined in young adult rats performing one of three handle-pulling tasks for 12 wk: (1) HRHF, (2) low repetition low force (LRLF); or (3) HRHF for 4 wk and than LRLF thereafter (HRHF-to-LRLF). Results were compared to age-matched controls rats. Distal forelimb bones of 12-wk HRHF rats showed increased trabecular resorption and decreased volume, as control rats. HRHF-to-LRLF rats had similar trabecular bone quality as control rats; and decreased bone resorption (decreased trabecular bone volume and serum CTX1), increased bone formation (increased mineral apposition, bone formation rate, and serum osteocalcin), and decreased osteoclasts and inflammatory cytokines, than HRHF rats. Thus, an ergonomic intervention of HRHF-to-LRLF prevented loss of trabecular bone volume occurring with prolonged performance of a repetitive upper extremity task. These findings support the idea of reduced workload as an effective approach to management of work-related musculoskeletal disorders, and begin to define reach rate and load level boundaries for such interventions.
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Affiliation(s)
- Mary F. BARBE
- Department of Anatomy and Cell Biology, Temple University
School of Medicine, USA
| | - Nisha X. JAIN
- Washington University School of Medicine in St. Louis,
USA
| | - Vicky S. MASSICOTTE
- Department of Anatomy and Cell Biology, Temple University
School of Medicine, USA
| | - Steven N. POPOFF
- Department of Anatomy and Cell Biology, Temple University
School of Medicine, USA
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Increased CCN2, substance P and tissue fibrosis are associated with sensorimotor declines in a rat model of repetitive overuse injury. J Cell Commun Signal 2015; 9:37-54. [PMID: 25617052 DOI: 10.1007/s12079-015-0263-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 01/14/2015] [Indexed: 01/24/2023] Open
Abstract
Key clinical features of cumulative trauma disorders include pain, muscle weakness, and tissue fibrosis, although the etiology is still under investigation. Here, we characterized the temporal pattern of altered sensorimotor behaviors and inflammatory and fibrogenic processes occurring in forearm muscles and serum of young adult, female rats performing an operant, high repetition high force (HRHF) reaching and grasping task for 6, 12, or 18 weeks. Palmar mechanical sensitivity, cold temperature avoidance and spontaneous behavioral changes increased, while grip strength declined, in 18-week HRHF rats, compared to controls. Flexor digitorum muscles had increased MCP-1 levels after training and increased TNFalpha in 6-week HRHF rats. Serum had increased IL-1beta, IL-10 and IP-10 after training. Yet both muscle and serum inflammation resolved by week 18. In contrast, IFNγ increased at week 18 in both muscle and serum. Given the anti-fibrotic role of IFNγ, and to identify a mechanism for the continued grip strength losses and behavioral sensitivities, we evaluated the fibrogenic proteins CCN2, collagen type I and TGFB1, as well as the nociceptive/fibrogenic peptide substance P. Each increased in and around flexor digitorum muscles and extracellular matrix in the mid-forearm, and in nerves of the forepaw at 18 weeks. CCN2 was also increased in serum at week 18. At a time when inflammation had subsided, increases in fibrogenic proteins correlated with sensorimotor declines. Thus, muscle and nerve fibrosis may be critical components of chronic work-related musculoskeletal disorders. CCN2 and substance P may serve as potential targets for therapeutic intervention, and CCN2 as a serum biomarker of fibrosis progression.
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21
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Matute Wilander A, Kåredal M, Axmon A, Nordander C. Inflammatory biomarkers in serum in subjects with and without work related neck/shoulder complaints. BMC Musculoskelet Disord 2014; 15:103. [PMID: 24669872 PMCID: PMC3973377 DOI: 10.1186/1471-2474-15-103] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 03/20/2014] [Indexed: 12/26/2022] Open
Abstract
Background Although it has recently been recognised that inflammation is important in the development of work-related musculoskeletal disorders (MSDs), the exact pathophysiological pathways are unknown. Methods We investigated serum concentrations of inflammatory cytokines in 35 female supermarket cashiers with repetitive work tasks and work related neck/shoulder complaints, compared with those from 25 women without MSDs (6 supermarket cashiers and 19 middle-school teachers or faculty staff). None of the subjects were pregnant or lactating, and showed no signs of rheumatoid arthritis, systemic lupus erythematosus, cancer, diabetes, coronary artery disease or inadequately controlled hypertension. Serum levels of IL-1α, IL-1β, IL-6, IL-8, IL-10, IL-12, MCP-1, MIP-1α, MIP-1β, TNF-α, GM-CSF, CTGF and CRP were analysed. Results The women with pain related to MSD had higher serum concentrations of MIP-1β (median, 25th-75th percentile: 90.0 pg/mL, 62.5-110 vs. 73.1 pg/mL, 54.6-88.3; p = 0.018), IL-12 (0.26 pg/mL, 0.26-0.26 vs. 0.26 pg/mL, 0.26-0.26; p = 0.047) and CRP (0.5 mg/L, 0.5-1.6 vs. 0.5 mg/L, 0.5-0.5; p = 0.003), than control subjects. Levels of MIP-1α, MIP-1β and CRP were correlated with the reported intensity of neck/shoulder pain (r = 0.29, p = 0.03 for MIP-1α; r = 0.29, p = 0.02 for MIP-1β and r = 0.43, p = 0.001 for CRP). No statistically significant differences in serum levels were found for the remaining cytokines. Conclusions Otherwise healthy females with ongoing work-related neck/shoulder pain showed higher serum concentrations of MIP-1β, IL-12 and CRP than controls, and the levels of MIP-1α, MIP-1β and CRP were correlated to pain intensity. These results support previous findings that inflammatory processes play a part in work related MSDs.
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Affiliation(s)
| | | | | | - Catarina Nordander
- Division of Occupational and Environmental Medicine, Skåne University Hospital, Lund SE-221 85, Sweden.
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22
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Jain NX, Barr-Gillespie AE, Clark BD, Kietrys DM, Wade CK, Litvin J, Popoff SN, Barbe MF. Bone loss from high repetitive high force loading is prevented by ibuprofen treatment. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2014; 14:78-94. [PMID: 24583543 PMCID: PMC4067254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We examined roles of loading and inflammation on forearm bones in a rat model of upper extremity overuse. Trabecular structure in distal radius and ulna was examined in three groups of young adult rats: 1) 5% food-restricted that underwent an initial training period of 10 min/day for 5 weeks to learn the repetitive task (TRHF); 2) rats that underwent the same training before performing a high repetition high force task, 2 hours/day for 12 weeks (HRHF); and 3) food-restricted only (FRC). Subsets were treated with oral ibuprofen (IBU). TRHF rats had increased trabecular bone volume and numbers, osteoblasts, and serum osteocalcin, indicative of bone adaptation. HRHF rats had constant muscle pulling forces, showed limited signs of bone adaptation, but many signs of bone resorption, including decreased trabecular bone volume and bone mineral density, increased osteoclasts and bone inflammatory cytokines, and reduced median nerve conduction velocity (15%). HRHF+IBU rats showed no trabecular resorptive changes, no increased osteoclasts or bone inflammatory cytokines, no nerve inflammation, preserved nerve conduction, and increased muscle voluntary pulling forces. Ibuprofen treatment preserved trabecular bone quality by reducing osteoclasts and bone inflammatory cytokines, and improving muscle pulling forces on bones as a result of reduced nerve inflammation.
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Affiliation(s)
- Nisha X. Jain
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad St., Philadelphia, PA 19140
| | - Ann E. Barr-Gillespie
- College of Health Professions, Pacific University, 190 SE 8th Avenue, Hillsboro, OR 97123
| | - Brian D. Clark
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, 2900 Queen Lane, Philadelphia, PA 19129
| | - David M. Kietrys
- Department of Rehabilitation and Movement Sciences, Rutgers School of Health Related Professions, 40 E. Laurel Rd, Stratford, NJ, 08084
| | - Christine K. Wade
- Department of Physical Therapy, Thomas Jefferson University, Philadelphia, PA, 19107,USA
| | - Judith Litvin
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad St., Philadelphia, PA 19140
| | - Steven N. Popoff
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad St., Philadelphia, PA 19140
| | - Mary F. Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad St., Philadelphia, PA 19140
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Barbe MF, Gallagher S, Massicotte VS, Tytell M, Popoff SN, Barr-Gillespie AE. The interaction of force and repetition on musculoskeletal and neural tissue responses and sensorimotor behavior in a rat model of work-related musculoskeletal disorders. BMC Musculoskelet Disord 2013; 14:303. [PMID: 24156755 PMCID: PMC3924406 DOI: 10.1186/1471-2474-14-303] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 10/22/2013] [Indexed: 12/01/2022] Open
Abstract
Background We examined the relationship of musculoskeletal risk factors underlying force and repetition on tissue responses in an operant rat model of repetitive reaching and pulling, and if force x repetition interactions were present, indicative of a fatigue failure process. We examined exposure-dependent changes in biochemical, morphological and sensorimotor responses occurring with repeated performance of a handle-pulling task for 12 weeks at one of four repetition and force levels: 1) low repetition with low force, 2) high repetition with low force, 3) low repetition with high force, and 4) high repetition with high force (HRHF). Methods Rats underwent initial training for 4–6 weeks, and then performed one of the tasks for 12 weeks, 2 hours/day, 3 days/week. Reflexive grip strength and sensitivity to touch were assayed as functional outcomes. Flexor digitorum muscles and tendons, forelimb bones, and serum were assayed using ELISA for indicators of inflammation, tissue stress and repair, and bone turnover. Histomorphometry was used to assay macrophage infiltration of tissues, spinal cord substance P changes, and tissue adaptative or degradative changes. MicroCT was used to assay bones for changes in bone quality. Results Several force x repetition interactions were observed for: muscle IL-1alpha and bone IL-1beta; serum TNFalpha, IL-1alpha, and IL-1beta; muscle HSP72, a tissue stress and repair protein; histomorphological evidence of tendon and cartilage degradation; serum biomarkers of bone degradation (CTXI) and bone formation (osteocalcin); and morphological evidence of bone adaptation versus resorption. In most cases, performance of the HRHF task induced the greatest tissue degenerative changes, while performance of moderate level tasks induced bone adaptation and a suggestion of muscle adaptation. Both high force tasks induced median nerve macrophage infiltration, spinal cord sensitization (increased substance P), grip strength declines and forepaw mechanical allodynia by task week 12. Conclusions Although not consistent in all tissues, we found several significant interactions between the critical musculoskeletal risk factors of force and repetition, consistent with a fatigue failure process in musculoskeletal tissues. Prolonged performance of HRHF tasks exhibited significantly increased risk for musculoskeletal disorders, while performance of moderate level tasks exhibited adaptation to task demands.
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Affiliation(s)
- Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad St, Philadelphia 19140, PA, USA.
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Kietrys DM, Barr-Gillespie AE, Amin M, Wade CK, Popoff SN, Barbe MF. Aging contributes to inflammation in upper extremity tendons and declines in forelimb agility in a rat model of upper extremity overuse. PLoS One 2012; 7:e46954. [PMID: 23056540 PMCID: PMC3463562 DOI: 10.1371/journal.pone.0046954] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 09/10/2012] [Indexed: 01/08/2023] Open
Abstract
We sought to determine if tendon inflammatory and histopathological responses increase in aged rats compared to young rats performing a voluntary upper extremity repetitive task, and if these changes are associated with motor declines. Ninety-six female Sprague-Dawley rats were used in the rat model of upper extremity overuse: 67 aged and 29 young adult rats. After a training period of 4 weeks, task rats performed a voluntary high repetition low force (HRLF) handle-pulling task for 2 hrs/day, 3 days/wk for up to 12 weeks. Upper extremity motor function was assessed, as were inflammatory and histomorphological changes in flexor digitorum and supraspinatus tendons. The percentage of successful reaches improved in young adult HRLF rats, but not in aged HRLF rats. Forelimb agility decreased transiently in young adult HRLF rats, but persistently in aged HRLF rats. HRLF task performance for 12 weeks lead to increased IL-1beta and IL-6 in flexor digitorum tendons of aged HRLF rats, compared to aged normal control (NC) as well as young adult HRLF rats. In contrast, TNF-alpha increased more in flexor digitorum tendons of young adult 12-week HRLF rats than in aged HRLF rats. Vascularity and collagen fibril organization were not affected by task performance in flexor digitorum tendons of either age group, although cellularity increased in both. By week 12 of HRLF task performance, vascularity and cellularity increased in the supraspinatus tendons of only aged rats. The increased cellularity was due to increased macrophages and connective tissue growth factor (CTGF)-immunoreactive fibroblasts in the peritendon. In conclusion, aged rat tendons were overall more affected by the HRLF task than young adult tendons, particularly supraspinatus tendons. Greater inflammatory changes in aged HRLF rat tendons were observed, increases associated temporally with decreased forelimb agility and lack of improvement in task success.
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Affiliation(s)
- David M. Kietrys
- Department of Rehabilitation and Movement Sciences, University of Medicine and Dentistry of New Jersey, School of Health Related Professions, Stratford, New Jersey, United States of America
| | - Ann E. Barr-Gillespie
- College of Health Professions, Pacific University, Hillsboro, Oregon, United States of America
| | - Mamta Amin
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Christine K. Wade
- Department of Physical Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Steve N. Popoff
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Mary F. Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America
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Cheng BC, Tao PL, Cheng YY, Huang EYK. LVV-hemorphin 7 and angiotensin IV in correlation with antinociception and anti-thermal hyperalgesia in rats. Peptides 2012; 36:9-16. [PMID: 22484286 DOI: 10.1016/j.peptides.2012.03.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 03/20/2012] [Accepted: 03/20/2012] [Indexed: 12/01/2022]
Abstract
Hemorphins, a family of atypical endogenous opioid peptides, are produced by the cleavage of hemoglobin β-chain. Hemorphins were proved to bind to the μ-opioid receptors (agonist) and angiotensin IV receptors (insulin-regulated aminopeptidase; IRAP) (inhibitor). Among the hemorphins, LVV-hemorphin-7 (LVV-H7) was found to be abundant and with a longer half life in the CNS. Using intrathecal and intracerebroventricular injections, LVV-H7 and angiotensin IV were given to the rats, which were then subjected to the plantar test and the tail-flick test. Our results showed that LVV-H7 attenuated carrageenan-induced hyperalgesia at the spinal level, which could not be reversed by the co-administration of naloxone. At the supraspinal level, LVV-H7 also produced a significant anti-hyperalgesia effect but with a lower extent. Angiotensin IV showed a similar anti-hyperalgesia effect at the spinal level, but had no effect at the supraspinal level. In the tail-flick test and paw edema test, both peptides showed no effect. These results suggest that LVV-H7 mainly exert the anti-hyperalgesia effect at the spinal level, possibly through IRAP but not μ-opioid receptors. In addition, we observed the expression of IRAP in the CNS of animals with/without carrageenan-induced hyperalgesia. Our results showed a significant expression of IRAP in the spinal cord of rats. However, there was no significant quantitative change of IRAP after the development of hyperalgesia. The serum level of LVV-H7 was also found to be with no change caused by hyperalgesia. These results indicated that the endogenous LVV-H7 and IRAP may not regulate the severity of hyperalgesia through a quantitative change.
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Affiliation(s)
- Bor-Chih Cheng
- Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan, ROC
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Huie JR, Baumbauer KM, Lee KH, Bresnahan JC, Beattie MS, Ferguson AR, Grau JW. Glial tumor necrosis factor alpha (TNFα) generates metaplastic inhibition of spinal learning. PLoS One 2012; 7:e39751. [PMID: 22745823 PMCID: PMC3379985 DOI: 10.1371/journal.pone.0039751] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 05/28/2012] [Indexed: 12/28/2022] Open
Abstract
Injury-induced overexpression of tumor necrosis factor alpha (TNFα) in the spinal cord can induce chronic neuroinflammation and excitotoxicity that ultimately undermines functional recovery. Here we investigate how TNFα might also act to upset spinal function by modulating spinal plasticity. Using a model of instrumental learning in the injured spinal cord, we have previously shown that peripheral intermittent stimulation can produce a plastic change in spinal plasticity (metaplasticity), resulting in the prolonged inhibition of spinal learning. We hypothesized that spinal metaplasticity may be mediated by TNFα. We found that intermittent stimulation increased protein levels in the spinal cord. Using intrathecal pharmacological manipulations, we showed TNFα to be both necessary and sufficient for the long-term inhibition of a spinal instrumental learning task. These effects were found to be dependent on glial production of TNFα and involved downstream alterations in calcium-permeable AMPA receptors. These findings suggest a crucial role for glial TNFα in undermining spinal learning, and demonstrate the therapeutic potential of inhibiting TNFα activity to rescue and restore adaptive spinal plasticity to the injured spinal cord. TNFα modulation represents a novel therapeutic target for improving rehabilitation after spinal cord injury.
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Affiliation(s)
- J. Russell Huie
- Department of Psychology, Texas A&M University, College Station, Texas, United States of America
- Brain and Spinal Injury Center, Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, United States of America
- * E-mail: (JRH); (ARF)
| | - Kyle M. Baumbauer
- Department of Psychology, Texas A&M University, College Station, Texas, United States of America
| | - Kuan H. Lee
- Department of Psychology, Texas A&M University, College Station, Texas, United States of America
| | - Jacqueline C. Bresnahan
- Brain and Spinal Injury Center, Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, United States of America
| | - Michael S. Beattie
- Brain and Spinal Injury Center, Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, United States of America
| | - Adam R. Ferguson
- Brain and Spinal Injury Center, Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, United States of America
- * E-mail: (JRH); (ARF)
| | - James W. Grau
- Department of Psychology, Texas A&M University, College Station, Texas, United States of America
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Elliott MB, Oshinsky ML, Amenta PS, Awe OO, Jallo JI. Nociceptive neuropeptide increases and periorbital allodynia in a model of traumatic brain injury. Headache 2012; 52:966-84. [PMID: 22568499 DOI: 10.1111/j.1526-4610.2012.02160.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE This study tests the hypothesis that injury to the somatosensory cortex is associated with periorbital allodynia and increases in nociceptive neuropeptides in the brainstem in a mouse model of controlled cortical impact (CCI) injury. METHODS Male C57BL/6 mice received either CCI or craniotomy-only followed by weekly periorbital von Frey (mechanical) sensory testing for up to 28 days post-injury. Mice receiving an incision only and naïve mice were included as control groups. Changes in calcitonin gene-related peptide (CGRP) and substance P (SP) within the brainstem were determined using enzyme-linked immunosorbent assay and immunohistochemistry, respectively. Activation of ionized calcium-binding adaptor molecule-1-labeled macrophages/microglia and glial fibrillary acidic protein (GFAP)-positive astrocytes were evaluated using immunohistochemistry because of their potential involvement in nociceptor sensitization. RESULTS Incision-only control mice showed no changes from baseline periorbital von Frey mechanical thresholds. CCI significantly reduced mean periorbital von Frey thresholds (periorbital allodynia) compared with baseline and craniotomy-only at each endpoint, analysis of variance P < .0001. Craniotomy significantly reduced periorbital threshold at 14 days but not 7, 21, or 28 days compared with baseline threshold, P < .01. CCI significantly increased SP immunoreactivity in the brainstem at 7 and 14 days but not 28 days compared with craniotomy-only and controls, P < .001. CGRP levels in brainstem tissues were significantly increased in CCI groups compared with controls (incision-only and naïve mice) or craniotomy-only mice at each endpoint examined, P < .0001. There was a significant correlation between CGRP and periorbital allodynia (P < .0001, r = -0.65) but not for SP (r = 0.20). CCI significantly increased the number of macrophage/microglia in the injured cortex at each endpoint up to 28 days, although cell numbers declined over weeks post-injury, P < .001. GFAP(+) immunoreactivity was significantly increased at 7 but not 14 or 28 days after CCI, P < .001. Craniotomy resulted in transient periorbital allodynia accompanied by transient increases in SP, CGRP, and GFAP immunoreactivity compared with control mice. There was no increase in the number of macrophage/microglia cells compared with controls after craniotomy. CONCLUSION Injury to the somatosensory cortex results in persistent periorbital allodynia and increases in brainstem nociceptive neuropeptides. Findings suggest that persistent allodynia and increased neuropeptides are maintained by mechanisms other than activation of macrophage/microglia or astrocyte in the injured somatosensory cortex.
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Affiliation(s)
- Melanie B Elliott
- Department of Neurological Surgery, Thomas Jefferson University, 1025 Walnut Street, Philadelphia, PA 19107, USA.
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TNF-Alpha in the Locomotor System beyond Joints: High Degree of Involvement in Myositis in a Rabbit Model. Int J Rheumatol 2012; 2012:637452. [PMID: 22505941 PMCID: PMC3312332 DOI: 10.1155/2012/637452] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Revised: 11/03/2011] [Accepted: 12/04/2011] [Indexed: 12/14/2022] Open
Abstract
The importance of TNF-alpha in arthritis is well documented. It may be that TNF-alpha is also markedly involved in muscle inflammation (myositis). An animal model where this can be investigated is needed. A newly developed rabbit myositis model involving pronounced muscle overuse and local injections of substances having proinflammatory effects was therefore used in the present study. The aim was to investigate the patterns of TNF-alpha expression in the developing myositis and to evaluate the usefulness of this myositis model for further TNF-alpha research. Human rheumatoid arthritis (RA) synovial tissue was examined as a reference. TNF-alpha immunoexpression and TNF-alpha mRNA, visualized via in situ hybridization, were detected in cells in the inflammatory infiltrates of the affected muscle (soleus muscle). Coexistence of TNF-alpha and CD68 immunoreactions was noted, suggesting that the TNF-alpha reactive cells are macrophages. Expression of TNF-alpha mRNA was also noted in muscle fibers and blood vessel walls in areas with inflammation. These findings demonstrate that TNF-alpha is highly involved in the myositis process. The model can be used in further studies evaluating the importance of TNF-alpha in developing myositis.
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Kietrys DM, Barr AE, Barbe MF. Exposure to repetitive tasks induces motor changes related to skill acquisition and inflammation in rats. J Mot Behav 2011; 43:465-76. [PMID: 22087754 DOI: 10.1080/00222895.2011.627897] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The authors elucidate exposure-response relationships between repetitive tasks, inflammation, and motor changes with work-related musculoskeletal disorders. Using a rat model of reaching and handle pulling, they examined effects of performing a high-repetition, low-force (HRLF); low-repetition, high-force (LRHF); or high-repetition, high-force (HRHF) task (2 hr/day, 3 days/week, 12 weeks) on reach rate and force, percentage of successful reaches, duration of participation, and grip strength. Reach rate and reach force improved with HRLF, and percentage success increased in all groups in Week 9, and in HRLF and HRHF in Week 12, indicative of skill acquisition. Duration and grip strength showed force-dependent declines with task performance. A subset of HRHF rats received ibuprofen in Weeks 5-12. Ibuprofen significantly improved reach rate, reach force, and duration in treated rats, indicative of an inflammatory influence on reach performance. Ibuprofen improved percentage of successful reaches in Week 9, although this increase was not sustained. However, declines in grip strength, a nocifensive behavior, were not prevented by ibuprofen. Examination of cervical spinal cords of untreated and ibuprofen treated HRHF rats showed increased IL-1beta, an inflammatory cytokine, in neurons. These findings suggest that only a preventive intervention could have addressed all motor declines.
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Affiliation(s)
- David M Kietrys
- Department of Rehabilitation and Movement Sciences, University of Medicine and Dentistry of New Jersey, School of Health Related Professions, Stratford, New Jersey, USA
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31
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Yang G, Marras WS, Best TM. The biochemical response to biomechanical tissue loading on the low back during physical work exposure. Clin Biomech (Bristol, Avon) 2011; 26:431-7. [PMID: 21349614 DOI: 10.1016/j.clinbiomech.2011.01.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Revised: 01/07/2011] [Accepted: 01/10/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND Our understanding of low back disorder causality is limited in that how biomechanical loading acting on various spinal tissues initiates the pain pathway is not clear. Previous studies suggest that cytokines may be important in mediating the inflammatory responses in patients with back pain. This study quantified the acute biochemical responses to physical work stressing the low back and assessed the relationships between these systemic responses and specific lumbar spine tissue loads. METHODS Twelve healthy males were tested under control and two weight-lifting conditions (light and heavy). Venous blood was sampled at various time points before and after the physical work and analyzed for cytokine, granulocyte, and creatine kinase levels. Biomechanical data were collected during the tasks and a biologically-assisted lumbar spine model was used to calculate spinal loads at various lumbar spine levels and trunk muscle forces. FINDINGS Levels of interleukin-6, granulocytes, and creatine kinase all increased after both weight-lifting tasks, with the greatest changes observed with the heavier lifting task. Similarly, plasma levels of interleukin-1β and tumor necrosis factor-α both increased following the heavier lifting task. These inflammatory responses were significantly correlated with specific spinal tissue loads. INTERPRETATION This study suggests that it may be possible to use inflammatory cytokines as biomarkers to monitor the physiological responses of the human body to biomechanical loading. Identifying the possible sources of cytokine up-regulation using an advanced biomechanical model may help a more effective understanding of the causal pathways that lead to low back disorders.
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Affiliation(s)
- Gang Yang
- Biodynamics Laboratory, The Ohio State University, Columbus, OH 43210, USA
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32
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Elliott MB, Tuma RF, Amenta PS, Barbe MF, Jallo JI. Acute effects of a selective cannabinoid-2 receptor agonist on neuroinflammation in a model of traumatic brain injury. J Neurotrauma 2011; 28:973-81. [PMID: 21332427 DOI: 10.1089/neu.2010.1672] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Proposed therapeutic strategies for attenuating secondary traumatic brain injury (TBI) include modulation of acute neuroimmune responses. The goal of this study was to examine the acute effects of cannabinoid-2 receptor (CB(2)R) modulation on behavioral deficits, cerebral edema, perivascular substance P, and macrophage/microglial activation in a murine model of TBI. Thirty male C57BL/6 mice underwent sham surgery, or cortical contusion impact injury (CCI). CCI mice received vehicle or the CB(2)R agonist 0-1966 at 1 and 24 h after injury. Performance on the rotarod, forelimb cylinder, and open-field tests were evaluated before and at 48 h after sham or CCI surgery. Cerebral edema was evaluated using the wet-dry weight technique. Immunohistochemical analysis was used to examine changes in substance P and macrophage/microglia-specific Iba1 protein immunoreactivity. Locomotor performance and exploratory behavior were significantly improved in mice receiving 0-1966 (CB(2)R agonist) compared to vehicle-treated mice. Significant reductions were found for cerebral edema, number of perivascular areas of substance P immunoreactivity, and number of activated macrophages/microglial cells in the injured brains of 0-1966-treated mice compared to vehicle-treated mice. The findings show that the effects of the CB(2)R agonist 0-1966 on edema, substance P immunoreactivity, and macrophage/microglial activation, were associated with recovery of acute motor and exploratory deficits. This study provides evidence of acute neuroprotective effects derived from selective CB(2)R activation that may represent an avenue for further development of novel therapeutic agents in the treatment of TBI.
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Affiliation(s)
- Melanie B Elliott
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
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33
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Chen X, Green PG, Levine JD. Abnormal muscle afferent function in a model of Taxol chemotherapy-induced painful neuropathy. J Neurophysiol 2011; 106:274-9. [PMID: 21562188 DOI: 10.1152/jn.00141.2011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Despite muscle pain being a well-described symptom in patients with diverse forms of peripheral neuropathy, the role of neuropathic mechanisms in muscle pain have received remarkably little attention. We have recently demonstrated in a well-established model of chemotherapy-induced painful neuropathy (CIPN) that the anti-tumor drug paclitaxel (Taxol) produces mechanical hyperalgesia in skeletal muscle, of similar time course to and with shared mechanism with cutaneous symptoms. In the present study, we evaluated muscle afferent neuron function in this rat model of CIPN. The mechanical threshold of muscle afferents in rats exposed to paclitaxel was not significantly different from the mechanical threshold of muscle afferents in control animals (P = 0.07). However, paclitaxel did produce a marked increase in the number of action potentials elicited by prolonged suprathreshold fixed intensity mechanical stimulation and a marked increase in the conduction velocity. In addition, the interspike interval (ISI) analysis (to evaluate the temporal characteristics of the response of afferents to sustained mechanical stimulation) showed a significant difference in rats treated with paclitaxel; there was a significantly greater ISI percentage of paclitaxel-treated muscle afferents with 0.01- and 0.02-s ISI. In contrast, an analysis of variability of neuronal firing over time (CV2 analysis) showed no effect of paclitaxel administration. These effects of paclitaxel on muscle afferent function contrast with the previously reported effects of paclitaxel on the function of cutaneous nociceptors.
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Affiliation(s)
- Xiaojie Chen
- Department of Oral and Maxillofacial Surgery, University of California, San Francisco, California 94143-0440, USA
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Andrade P, Visser-Vandewalle V, Hoffmann C, Steinbusch HWM, Daemen MA, Hoogland G. Role of TNF-alpha during central sensitization in preclinical studies. Neurol Sci 2011; 32:757-71. [PMID: 21559854 PMCID: PMC3171667 DOI: 10.1007/s10072-011-0599-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Accepted: 04/20/2011] [Indexed: 12/31/2022]
Abstract
Tumor necrosis factor-alpha (TNF-α) is a principal mediator in pro-inflammatory processes that involve necrosis, apoptosis and proliferation. Experimental and clinical evidence demonstrate that peripheral nerve injury results in activation and morphological changes of microglial cells in the spinal cord. These adjustments occur in order to initiate an inflammatory cascade in response to the damage. Between the agents involved in this reaction, TNF-α is recognized as a key player in this process as it not only modulates lesion formation, but also because it is suggested to induce nociceptive signals. Nowadays, even though the function of TNF-α in inflammation and pain production seems to be generally accepted, diverse sources of literature point to different pathways and outcomes. In this review, we systematically searched and reviewed original articles from the past 10 years on animal models of peripheral nervous injury describing TNF-α expression in neural tissue and pain behavior.
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Affiliation(s)
- Pablo Andrade
- Department of Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 50, Box 38, 6200 MD Maastricht, The Netherlands.
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Chen X, Green PG, Levine JD. Stress enhances muscle nociceptor activity in the rat. Neuroscience 2011; 185:166-73. [PMID: 21513773 DOI: 10.1016/j.neuroscience.2011.04.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2011] [Revised: 04/06/2011] [Accepted: 04/08/2011] [Indexed: 12/30/2022]
Abstract
Chronic widespread pain, such as observed in irritable bowel (IBS) and fibromyalgia (FMS) syndrome, are markedly affected by stress. While such forms of stress-induced hyperalgesia are generally considered manifestations of "central sensitization," recent studies in patients with IBS and FMS suggest an additional, peripheral contribution. To examine the effect of stress on muscle nociceptor function, we evaluated activity in nociceptors innervating the gastrocnemius muscle in an animal model of chronic widespread pain, water avoidance stress, in the rat. This stressor, which produces mechanical hyperalgesia in skeletal muscle produced a significant decrease (∼34%) in mechanical threshold of muscle nociceptors and a marked, ∼two-fold increase in the number of action potentials produced by a prolonged (60 s) fixed intensity suprathreshold 10 g stimulus. Stress also induced an increase in conduction velocity from 1.25 m/s to 2.09 m/s, and increased variability in neuronal activity. Given that these changes, each of at least moderate magnitude, would be expected to enhance nociceptor activity, it is likely that, taken together, they contribute to the enhanced nociception observed in this model of stress-induced chronic widespread pain.
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Affiliation(s)
- X Chen
- Department of Oral and Maxillofacial Surgery, University of California San Francisco, San Francisco, CA 94143, USA
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Dunk NM, Nicholson KJ, Winkelstein BA. Impaired performance on the angle board test is induced in a model of painful whiplash injury but is only transient in a model of cervical radiculopathy. J Orthop Res 2011; 29:562-6. [PMID: 21337396 DOI: 10.1002/jor.21272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Accepted: 09/02/2010] [Indexed: 02/04/2023]
Abstract
Although clinical studies report motor impairment associated with some painful injuries of the neck, assessment of motor function in animal models has been largely limited only to studies of direct trauma to the nervous system. The incline plane test was modified to evaluate motor function in two rodent pain models of facet joint distraction (FJD) and nerve root compression (NRC) injury (n = 5/group). Sham groups were also included as controls. Motor function was measured using the modified inclined plane test with rats facing downward before surgery (baseline) and following surgery on days corresponding to when mechanical sensitivity is established and remains elevated. Mean baseline values of the board angle inducing slip for FJD (45.8 ± 3.1°) was significantly greater (p = 0.014) than that for NRC (43.5 ± 2.5°), but baseline measurements did not vary for either group over time. No changes in motor function were found for shams. Motor function after FJD significantly decreased (p < 0.001) at days 1 and 7 after injury. In contrast, at day 1 after NRC injury, slip occurred at significantly lower (p = 0.0016) incline angles, but returned to baseline levels by day 7. These results show motor function impairment is induced following painful FJD and suggest the incline plane test offers utility to evaluate functional deficits in painful injuries.
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Affiliation(s)
- Nadine M Dunk
- Department of Bioengineering, University of Pennsylvania, St, Philadelphia, Pennsylvania 19104, USA
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Xin DL, Harris MY, Wade CK, Amin M, Barr AE, Barbe MF. Aging enhances serum cytokine response but not task-induced grip strength declines in a rat model of work-related musculoskeletal disorders. BMC Musculoskelet Disord 2011; 12:63. [PMID: 21447183 PMCID: PMC3072947 DOI: 10.1186/1471-2474-12-63] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Accepted: 03/29/2011] [Indexed: 05/26/2023] Open
Abstract
Background We previously reported early tissue injury, increased serum and tissue inflammatory cytokines and decreased grip in young rats performing a moderate demand repetitive task. The tissue cytokine response was transient, the serum response and decreased grip were still evident by 8 weeks. Thus, here, we examined their levels at 12 weeks in young rats. Since aging is known to enhance serum cytokine levels, we also examined aged rats. Methods Aged and young rats, 14 mo and 2.5 mo of age at onset, respectfully, were trained 15 min/day for 4 weeks, and then performed a high repetition, low force (HRLF) reaching and grasping task for 2 hours/day, for 12 weeks. Serum was assayed for 6 cytokines: IL-1alpha, IL-6, IFN-gamma, TNF-alpha, MIP2, IL-10. Grip strength was assayed, since we have previously shown an inverse correlation between grip strength and serum inflammatory cytokines. Results were compared to naïve (grip), and normal, food-restricted and trained-only controls. Results Serum cytokines were higher overall in aged than young rats, with increases in IL-1alpha, IFN-gamma and IL-6 in aged Trained and 12-week HRLF rats, compared to young Trained and HRLF rats (p < 0.05 and p < 0.001, respectively, each). IL-6 was also increased in aged 12-week HRLF versus aged normal controls (p < 0.05). Serum IFN-gamma and MIP2 levels were also increased in young 6-week HRLF rats, but no cytokines were above baseline levels in young 12-week HRLF rats. Grip strength declined in both young and aged 12-week HRLF rats, compared to naïve and normal controls (p < 0.05 each), but these declines correlated only with IL-6 levels in aged rats (r = -0.39). Conclusion Aging enhanced a serum cytokine response in general, a response that was even greater with repetitive task performance. Grip strength was adversely affected by task performance in both age groups, but was apparently influenced by factors other than serum cytokine levels in young rats.
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Affiliation(s)
- Dong L Xin
- Department of Physical Therapy, Temple University, 3307 North Broad St,, Philadelphia, PA 19140, USA
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Joint inflammation and early degeneration induced by high-force reaching are attenuated by ibuprofen in an animal model of work-related musculoskeletal disorder. J Biomed Biotechnol 2011; 2011:691412. [PMID: 21403884 PMCID: PMC3051200 DOI: 10.1155/2011/691412] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2010] [Accepted: 12/11/2010] [Indexed: 11/18/2022] Open
Abstract
We used our voluntary rat model of reaching and grasping to study the effect of performing a high-repetition and high-force (HRHF) task for 12 weeks on wrist joints. We also studied the effectiveness of ibuprofen, administered in the last 8 weeks, in attenuating HRHF-induced changes in these joints. With HRHF task performance, ED1+ and COX2+ cells were present in subchondral radius, carpal bones and synovium; IL-1alpha and TNF-alpha increased in distal radius/ulna/carpal bones; chondrocytes stained with Terminal deoxynucleotidyl Transferase- (TDT-) mediated dUTP-biotin nick end-labeling (TUNEL) increased in wrist articular cartilages; superficial structural changes (e.g., pannus) and reduced proteoglycan staining were observed in wrist articular cartilages. These changes were not present in normal controls or ibuprofen treated rats, although IL-1alpha was increased in reach limbs of trained controls. HRHF-induced increases in serum C1,2C (a biomarker of collagen I and II degradation), and the ratio of collagen degradation to synthesis (C1,2C/CPII; the latter a biomarker of collage type II synthesis) were also attenuated by ibuprofen. Thus, ibuprofen treatment was effective in attenuating HRHF-induced inflammation and early articular cartilage degeneration.
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Gold JE, Piligian G, Glutting JJ, Hanlon A, Frings-Dresen MHW, Sluiter JK. Cluster analysis of symptoms among patients with upper extremity musculoskeletal disorders. JOURNAL OF OCCUPATIONAL REHABILITATION 2010; 20:526-36. [PMID: 20414797 PMCID: PMC2980628 DOI: 10.1007/s10926-010-9240-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION Some musculoskeletal disorders of the upper extremity are not readily classified. The study objective was to determine if there were symptom patterns in self-identified repetitive strain injury (RSI) patients. METHODS Members (n = 700) of the Dutch RSI Patients Association filled out a detailed symptom questionnaire. Factor analysis followed by cluster analysis grouped correlated symptoms. RESULTS Eight clusters, based largely on symptom severity and quality were formulated. All but one cluster showed diffuse symptoms; the exception was characterized by bilateral symptoms of stiffness and aching pain in the shoulder/neck. CONCLUSIONS Case definitions which localize upper extremity musculoskeletal disorders to a specific anatomical area may be incomplete. Future clustering studies should rely on both signs and symptoms. Data could be collected from health care providers prospectively to determine the possible prognostic value of the identified clusters with respect to natural history, chronicity, and return to work.
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Affiliation(s)
- Judith E. Gold
- Department of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Philadelphia, PA 19122 USA
| | - George Piligian
- Program to Prevent and Treat Work-Related Musculoskeletal Disorders, Irving J. Selikoff Center for Occupational and Environmental Medicine, Mt. Sinai Medical Center, One Gustave Levy Place, New York, NY 10029-6574 USA
| | | | - Alexandra Hanlon
- Department of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Philadelphia, PA 19122 USA
- School of Nursing, University of Pennsylvania, 418 Curie Boulevard/Room 479, Philadelphia, PA 19104 USA
| | - Monique H. W. Frings-Dresen
- Academic Medical Center, Coronel Institute of Occupational Health, University of Amsterdam, 1100 DE Amsterdam, The Netherlands
| | - Judith K. Sluiter
- Academic Medical Center, Coronel Institute of Occupational Health, University of Amsterdam, 1100 DE Amsterdam, The Netherlands
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Elliott M, Barr A, Clark B, Wade C, Barbe M. Performance of a repetitive task by aged rats leads to median neuropathy and spinal cord inflammation with associated sensorimotor declines. Neuroscience 2010; 170:929-41. [DOI: 10.1016/j.neuroscience.2010.07.041] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Revised: 07/21/2010] [Accepted: 07/21/2010] [Indexed: 12/30/2022]
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Rani S, Barbe MF, Barr AE, Litivn J. Role of TNF alpha and PLF in bone remodeling in a rat model of repetitive reaching and grasping. J Cell Physiol 2010; 225:152-67. [PMID: 20458732 DOI: 10.1002/jcp.22208] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We have previously developed a voluntary rat model of highly repetitive reaching that provides an opportunity to study effects of non-weight bearing muscular loads on bone and mechanisms of naturally occurring inflammation on upper limb tissues in vivo. In this study, we investigated the relationship between inflammatory cytokines and matricellular proteins (Periostin-like-factor, PLF, and connective tissue growth factor, CTGF) using our model. We also examined the relationship between inflammatory cytokines, PLF and bone formation processes. Rats underwent initial training for 5 weeks, and then performed a high repetition high force (HRHF) task (12 reaches/min, 60% maximum grip force, 2 h/day, 3 days/week) for 6 weeks. We then examined the effect of training or task performance with or without treatment with a rat specific TNFalpha antibody on inflammatory cytokines, osteocalcin (a bone formation marker), PLF, CTGF, and behavioral indicators of pain or discomfort. The HRHF task decreased grip strength and induced forepaw mechanical hypersensitivity in both trained control and 6-week HRHF animals. Two weeks of anti-TNFalpha treatment improved grip strength in both groups, but did not ameliorate forepaw hypersensitivity. Moreover, anti-TNFalpha treatment attenuated task-induced increases in inflammatory cytokines (TNFalpha, IL-1alpha, and MIP2 in serum; TNFalpha in forelimb bone and muscles) and serum osteocalcin in 6-week HRHF animals. PLF levels in forelimb bones and flexor digitorum muscles increased significantly in 6-week HRHF animals, increases attenuated by anti-TNFalpha treatment. CTGF levels were unaffected by task performance or anti-TNFalpha treatment in 6-week HRHF muscles. In primary osteoblast cultures, TNFalpha, MIP2 and MIP3a treatment increased PLF levels in a dose dependent manner. Also in primary osteoblast cultures, increased PLF promoted proliferation and differentiation, the latter assessed by measuring Runx2, alkaline phosphatase (ALP) and osteocalcin mRNA levels; ALP activity; as well as calcium deposition and mineralization. Increased PLF also promoted cell adhesion in MC3T3-E1 osteoblast-like cell cultures. Thus, tissue loading in vivo resulted in increased TNFalpha, which increased PLF, which then induced anabolic bone formation, the latter results confirmed in vitro.
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Affiliation(s)
- Shobha Rani
- Department of Anatomy and Cell Biology, Temple Medical School, Philadelphia, Pennsylvania 19140, USA
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Mechanisms mediating vibration-induced chronic musculoskeletal pain analyzed in the rat. THE JOURNAL OF PAIN 2009; 11:369-77. [PMID: 19962353 DOI: 10.1016/j.jpain.2009.08.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2009] [Revised: 07/20/2009] [Accepted: 08/15/2009] [Indexed: 11/20/2022]
Abstract
UNLABELLED While occupational exposure to vibration is a common cause of acute and chronic musculoskeletal pain, eliminating exposure produces limited symptomatic improvement, and reexposure precipitates rapid recurrence or exacerbation. To evaluate mechanisms underlying these pain syndromes, we have developed a model in the rat, in which exposure to vibration (60-80Hz) induces, in skeletal muscle, both acute mechanical hyperalgesia as well as long-term changes characterized by enhanced hyperalgesia to a proinflammatory cytokine or reexposure to vibration. Exposure of a hind limb to vibration-produced mechanical hyperalgesia measured in the gastrocnemius muscle of the exposed hind limb, which persisted for approximately 2 weeks. When nociceptive thresholds had returned to baseline, exposure to a proinflammatory cytokine or reexposure to vibration produced markedly prolonged hyperalgesia. The chronic prolongation of vibration- and cytokine-hyperalgesia was prevented by spinal intrathecal injection of oligodeoxynucleotide (ODN) antisense to protein kinase Cepsilon, a second messenger in nociceptors implicated in the induction and maintenance of chronic pain. Vibration-induced hyperalgesia was inhibited by spinal intrathecal administration of ODN antisense to receptors for the type-1 tumor necrosis factor-alpha (TNFalpha) receptor. Finally, in TNFalpha-pretreated muscle, subsequent vibration-induced hyperalgesia was markedly prolonged. PERSPECTIVE These studies establish a model of vibration-induced acute and chronic musculoskeletal pain, and identify the proinflammatory cytokine TNFalpha and the second messenger protein kinase Cepsilon as targets against which therapies might be directed to prevent and/or treat this common and very debilitating chronic pain syndrome.
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Focal nerve inflammation induces neuronal signs consistent with symptoms of early complex regional pain syndromes. Exp Neurol 2009; 219:223-7. [DOI: 10.1016/j.expneurol.2009.05.024] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2009] [Revised: 05/15/2009] [Accepted: 05/18/2009] [Indexed: 12/25/2022]
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Coq JO, Barr AE, Strata F, Russier M, Kietrys DM, Merzenich MM, Byl NN, Barbe MF. Peripheral and central changes combine to induce motor behavioral deficits in a moderate repetition task. Exp Neurol 2009; 220:234-45. [PMID: 19686738 DOI: 10.1016/j.expneurol.2009.08.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2009] [Revised: 07/12/2009] [Accepted: 08/05/2009] [Indexed: 11/17/2022]
Abstract
Repetitive motion disorders, such as carpal tunnel syndrome and focal hand dystonia, can be associated with tasks that require prolonged, repetitive behaviors. Previous studies using animal models of repetitive motion have correlated cortical neuroplastic changes or peripheral tissue inflammation with fine motor performance. However, the possibility that both peripheral and central mechanisms coexist with altered motor performance has not been studied. In this study, we investigated the relationship between motor behavior changes associated with repetitive behaviors and both peripheral tissue inflammation and cortical neuroplasticity. A rat model of reaching and grasping involving moderate repetitive reaching with negligible force (MRNF) was used. Rats performed the MRNF task for 2 h/day, 3 days/week for 8 weeks. Reach performance was monitored by measuring reach rate/success, daily exposure, reach movement reversals/patterns, reach/grasp phase times, grip strength and grooming function. With cumulative task exposure, reach performance, grip strength and agility declined while an inefficient food retrieval pattern increased. In S1 of MRNF rats, a dramatic disorganization of the topographic forepaw representation was observed, including the emergence of large receptive fields located on both the wrist/forearm and forepaw with alterations of neuronal properties. In M1, there was a drastic enlargement of the overall forepaw map area, and of the cortex devoted to digit, arm-digits and elbow-wrist responses. In addition, unusually low current amplitude evoked digit movements. IL-1 beta and TNF-alpha increased in forearm flexor muscles and tendons of MRNF animals. The increases in IL-1 beta and TNF-alpha negatively correlated with grip strength and amount of current needed to evoke forelimb movements. This study provides strong evidence that both peripheral inflammation and cortical neuroplasticity jointly contribute to the development of chronic repetitive motion disorders.
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Affiliation(s)
- Jacques-Olivier Coq
- UMR 6149 Neurobiologie Intégrative et Adaptative, CNRS-Aix-Marseille Université, Pôle 3C, Case B, 3 Place Victor Hugo, 13331, Marseille Cedex 03, France
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Rani S, Barbe MF, Barr AE, Litvin J. Induction of periostin-like factor and periostin in forearm muscle, tendon, and nerve in an animal model of work-related musculoskeletal disorder. J Histochem Cytochem 2009; 57:1061-73. [PMID: 19620321 DOI: 10.1369/jhc.2009.954081] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Work-related musculoskeletal disorders (WMSDs), also known as repetitive strain injuries of the upper extremity, frequently cause disability and impairment of the upper extremities. Histopathological changes including excess collagen deposition around myofibers, cell necrosis, inflammatory cell infiltration, and increased cytokine expression result from eccentric exercise, forced lengthening, exertion-induced injury, and repetitive strain-induced injury of muscles. Repetitive tasks have also been shown to result in tendon and neural injuries, with subsequent chronic inflammatory responses, followed by residual fibrosis. To identify mechanisms that regulate tissue repair in WMSDs, we investigated the induction of periostin-like factor (PLF) and periostin, proteins induced in other pathologies but not expressed in normal adult tissue. In this study, we examined the level of PLF and periostin in muscle, tendon, and nerve using immunohistochemistry and Western blot analysis. PLF increased with continued task performance, whereas periostin was constitutively expressed. PLF was located in satellite cells and/or myoblasts, which increased in number with continued task performance, supporting our hypothesis that PLF plays a role in muscle repair or regeneration. Periostin, on the other hand, was not present in satellite cells and/or myoblasts.
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Affiliation(s)
- Shobha Rani
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, PA 19140, USA
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