Effects of laser acupuncture on longitudinal bone growth in adolescent rats

Evidence-informed and consensus-based statements about SAFEty of Physical Agent Modalities Practice in physiotherapy and rehabilitation medicine (SAFE PAMP): a national Delphi of healthcare scientific societies

OBJECTIVE

A shared consensus on the safety about physical agent modalities (PAMs) practice in physiotherapy and rehabilitation is lacking. We aimed to develop evidence-informed and consensus-based statements about the safety of PAMs.

STUDY DESIGN AND SETTING

A RAND-modified Delphi Rounds' survey was used to reach a consensus. We established a steering committee of the Italian Association of Physiotherapy (Associazione Italiana di Fisioterapia) to identify areas and questions for developing statements about the safety of the most commonly used PAMs in physiotherapy and rehabilitation. We invited 28 National Scientific and Technical Societies, including forensics and lay members, as a multidisciplinary and multiprofessional panel of experts to evaluate the nine proposed statements and formulate additional inputs. The level of agreement was measured using a 9-point Likert scale, with consensus in the Delphi Rounds assessed using the rating proportion with a threshold of 75%.

RESULTS

Overall, 17 (61%) out of 28 scientific and technical societies participated, involving their most representative members. The panel of experts mainly consisted of clinicians (88%) with expertise in musculoskeletal (47%), pelvic floor (24%), neurological (18%) and lymphatic (6%) disorders with a median experience of 30 years (IQR=17-36). Two Delphi rounds were necessary to reach a consensus. The final approved criteria list comprised nine statements about the safety of nine PAMs (ie, electrical stimulation neuromodulation, extracorporeal shock wave therapy, laser therapy, electromagnetic therapy, diathermy, hot thermal agents, cryotherapy and therapeutic ultrasound) in adult patients with a general note about populations subgroups.

CONCLUSIONS

The resulting consensus-based statements inform patients, healthcare professionals and policy-makers regarding the safe application of PAMs in physiotherapy and rehabilitation practice. Future research is needed to extend this consensus on paediatric and frail populations, such as immunocompromised patients.

The Application of Laser Acupuncture in Animal Experiments: A Narrative Review of Biological Aspects

Experimental studies on animals are conducted in almost all areas of medical research. The experiments offer insights into diseases and expand biomedical knowledge. Animal experiments are also imperative for studying acupuncture treatment mechanisms and the exploration of innovative acupuncture techniques. Laser acupuncture (LA), as a promising alternative to traditional manual acupuncture (MA), has the characteristics of painless and controllable stimulation. Today, society is more aware of animal welfare than previous generations. The use of noninvasive LA as a substitute for invasive MA in basic experimental research of acupuncture should be encouraged. Thus, we conducted an overview of animal experiments in the research field of LA from January 1978 to April 2020. After careful research, 52 studies were included in the work. Among these studies, both single-point and multipoint LA studies have been reported. To make noninvasive LA better in replacing invasive MA in experimental animal research of acupuncture, further experiments should focus on exploring uniform criteria for selecting laser parameters and revealing the extent to which the curative effect of LA depends on the property of acupuncture points rather than the characteristics of photobiomodulation.

Effects of Eleutherococcus Extract Mixture on Endochondral Bone Formation in Rats

Eleutherococcus extract mixture (EEM) is an herbal mixture of dried stem of Eleutherococcus sessiliflorus and germinated barley, which has been highly effective, in previous screening and among the traditional medicines to tonify innate qi and acquired qi, respectively. In this study, we investigate the effects of EEM on endochondral bone formation. Female adolescent rats were given EEM, growth hormone or vehicle for 10 days. Tetracycline was intraperitoneally injected to light the fluorescent band 72 h before sacrifice to determine endochondral bone formation. In order to evaluate endocrine or paracrine/autocrine mechanisms, expressions of insulin-like growth factor 1 (IGF1), insulin-like growth factor binding protein 3 (IGFBP3), or bone morphogenetic protein 2 (BMP2) were evaluated after EEM administration in liver or growth plate (GP). EEM oral administration significantly increased endochondral bone formation and proliferative and hypertrophic zonal heights of tibial GP. EEM also upregulated hepatic IGF1 and IGFBP3 mRNA expressions, and IGF1 and BMP2 expressions in GP. Taken together, EEM increases endochondral bone formation through stimulating proliferation and hypertrophy with upregulation of hepatic IGF1 and IGFBP3 expressions. Considering immunohistochemical studies, the effect of EEM may be due to increased local IGF1 and BMP2 expression in GP, which may be considered growth hormone (GH)-dependent endocrine and autocrine/paracrine pathways.

Laserpuncture Increases Serum Concentration of Insulin-Like Growth Factor-1 in Adolescent Rats

Objective: Previous studies have demonstrated that laserpuncture has a positive effect on longitudinal bone growth within varying parameters. The current authors hypothesized that laserpuncture affects serum concentration of insulinlike growth factor 1 (IGF-1), a growth factor that influences growth plates, and ghrelin, a growth hormone (GH) secretagogue. The goal of this research was to investigate if laserpuncture could increase serum concentrations of IGF-1 and ghrelin in adolescent rats. Materials and Methods: This was an experimental study with a post-test only and a controlled group design. The study was performed in a laboratory on 40 male Wistar rats, age ±3 weeks and weighing >40 g. The rats were divided randomly into 2 groups, A and B, each receiving laserpuncture for 10 days and 15 days, respectively. There were 4 subgroups in each group: control (C); GV 20; ST 36; and GV 20 + ST 36. The rats were stimulated by laserpuncture with a KX Laser GX-2000B (Kangxing), a semiconductor-based low-level laser therapy (LLLT) device emitting a cold red laser (635-680 nm/5 mW) for 60 seconds (0.3 J/cm²) The length of each rat's lower limb was measured using a caliper; IGF-1 and ghrelin concentrations were assessed using enzyme-linked immunosorbent assays. Results: A marked increase in IGF-1 concentration was observed in the ST 36 and GV 20 + ST 36 subgroups after 15 days, compared to the C subgroup (P = 0.001 and P = 0.002, respectively). The GV 20 subgroup had a lower IGF-1 concentration than the C subgroup (P = 0.06) at both 10 and 15 days. Laserpuncture did not influence ghrelin concentrations significantly, compared to the C subgroups. Conclusions: Laserpuncture administered to both the ST 36 and GV 20 + ST 36 subgroups with a power density of 0.3 J/cm² increased serum concentrations of IGF-1 in adolescent rats.

Effects of Huang Bai (Phellodendri Cortex) on bone growth and pubertal development in adolescent female rats

Background

To evaluate the effects of Huang Bai (Phellodendron amurense) on growth and maturation in adolescent female rats.

Methods

Female Sprague-Dawley rats (28 days old; n = 72) were divided into six daily treatment groups: control (distilled water), Huang Bai (100 and 300 mg/kg), recombinant human GH (rhGH; 20 μg/kg), estradiol (1 μg/kg), and triptorelin (100 μg). Body weight, food intake, and vaginal opening were measured daily from postnatal day (PND) 28 to PND 43. Tetracycline (20 mg/kg) was injected on PND 41. After sacrifice on PND 43, the ovaries and uterus were weighed, and the tibias were fixed in 4% paraformaldehyde. Decalcified and dehydrated tibias were sectioned at a thickness of 40 μm, and sectioned tissues were examined with a fluorescence microscope. Insulin-like growth factor (IGF)-1 and bone morphogenetic protein (BMP)-2 were detected using immunohistochemistry.

Results

Relative to controls, body weight was higher in the triptorelin group. Bone growth rate increased in the Huang Bai 100 mg/kg (354.00 ± 31.1 μm/day), rhGH (367.10 ± 27.11 μm/day), and triptorelin (374.50 ± 25.37 μm/day) groups. Expression of IGF-1 and BMP-2 in the hypertrophic zone was higher in all experimental groups. Vaginal opening occurred earlier in the estradiol group (PND 33.58 ± 1.62) than in controls and later in the triptorelin group (PND > 43). Ovarian and uterine weights were lower in the oestradiol and triptorelin groups. However, Huang Bai had nonsignificant effects on vaginal opening and the weights of ovaries and the uterus.

Conclusions

Huang Bai stimulated bone growth by upregulating IGF-1 and BMP-2 in the growth plate. However, it had no effect on pubertal development.