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Snow F, O'Connell C, Yang P, Kita M, Pirogova E, Williams RJ, Kapsa RMI, Quigley A. Engineering interfacial tissues: The myotendinous junction. APL Bioeng 2024; 8:021505. [PMID: 38841690 PMCID: PMC11151436 DOI: 10.1063/5.0189221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
The myotendinous junction (MTJ) is the interface connecting skeletal muscle and tendon tissues. This specialized region represents the bridge that facilitates the transmission of contractile forces from muscle to tendon, and ultimately the skeletal system for the creation of movement. MTJs are, therefore, subject to high stress concentrations, rendering them susceptible to severe, life-altering injuries. Despite the scarcity of knowledge obtained from MTJ formation during embryogenesis, several attempts have been made to engineer this complex interfacial tissue. These attempts, however, fail to achieve the level of maturity and mechanical complexity required for in vivo transplantation. This review summarizes the strategies taken to engineer the MTJ, with an emphasis on how transitioning from static to mechanically inducive dynamic cultures may assist in achieving myotendinous maturity.
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Giovanni M, Angrit N, Jean Patrick B, Eduardo DM, Hugo P, Martin S, Martin A. Indications, contraindications, side effects, general assessment, and outlook for the future: An International Compression Club survey. Phlebology 2024; 39:342-352. [PMID: 38300926 PMCID: PMC11129525 DOI: 10.1177/02683555241228899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND The effectiveness of compression therapy (CT) and the best compression modality choice are questioned in many clinical stages of chronic venous disease (CVD). This work aims to obtain information on indications, contraindications, and the best treatment option for CT in different clinical scenarios of CVD. METHOD An online survey was made among members of the International Compression Club, experts in CT. RESULTS The experts apply CT in all clinical stages of CVD, even when evidence is missing. Regarding compression materials, experts use inelastic materials in the advanced stages of CVD and compression stockings in the early or chronic stages of CVD. CONCLUSION The authors highlight the gap between experts' practical use of CT and evidence-based medicine results. They also suggested that, given the cost of randomized clinical trials aimed at specifying specific indications for different devices, artificial intelligence could be used for large-scale practice surveys in the future.
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Affiliation(s)
- Mosti Giovanni
- Angiology Department, MD Barbantini Clinic, Lucca, Italy
| | - Namislo Angrit
- Clinical Regulatory Affairs, Lohmann & Rauscher GmbH & Co KG, Neuwied, Germany
| | | | - Da Matta Eduardo
- Pró Circulação - Clinic of Angiology and Vascular Surgery, Xanxerê, Brazil
| | | | | | - Abel Martin
- Clinical Regulatory Affairs, Lohmann & Rauscher GmbH & Co KG, Neuwied, Germany
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3
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Hanley M, Ryan DT, Hynes JP, Long NM, Eustace SJ, Kavanagh EC. Imaging of acute lower limb muscle injury and potential gender differences. Ir J Med Sci 2024; 193:1509-1513. [PMID: 37947993 DOI: 10.1007/s11845-023-03562-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES To assess the most common lower limb acute muscle injuries on MRI imaging in a national specialist centre for orthopaedics and sports medicine and to explore potential gender differences. METHODS Over a 3-year time period, all MRI lower limb studies with acute muscle injury (AMI) were reviewed. A British Athletics muscle injury classification (BAMIC) was given and a statistical analysis was performed. RESULTS A total of 195 AMIs were diagnosed: 177 (91%) male and 18 (9%) female injuries (M to F = 9.8:1). The most common lower limb AMIs were BAMIC grade 1a injuries (n = 48, 25%). The most commonly injured muscle was biceps femoris (n = 87, 45%), specifically grade 1b and grade 2b injuries. There was no significant difference in age between men and women with acute lower limb muscle injuries (p = 0.19). Females were 1.5 times more likely to have a lower grade AMI than males, although this did not reach statistical significance (p = 0.7) owing to a striking lower number of female patients. There was no significant difference between genders in the likelihood of sustaining a hamstring or quadricep AMI (hamstrings OR = 2.47, p = 0.14 and quadriceps OR = 0.926, p 0.99). CONCLUSIONS Grade 1a is the most common lower limb AMI grade in our institution, accounting for 25%. Biceps femoris is the most commonly injured muscle (45%) with grade 1b and grade 2b being the most frequently encountered grades of biceps femoris injuries. Lower-grade injuries are more common in females compared to males, although not significantly so. Further studies are required to explore possible reasons for this gender gap.
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Affiliation(s)
- Marion Hanley
- Radiology Department, National Orthopaedic Hospital Cappagh, Dublin, Ireland.
| | - David T Ryan
- Radiology Department, National Orthopaedic Hospital Cappagh, Dublin, Ireland
| | - John P Hynes
- Radiology Department, National Orthopaedic Hospital Cappagh, Dublin, Ireland
| | - Niamh M Long
- Radiology Department, National Orthopaedic Hospital Cappagh, Dublin, Ireland
| | - Stephen J Eustace
- Radiology Department, National Orthopaedic Hospital Cappagh, Dublin, Ireland
| | - Eoin C Kavanagh
- Radiology Department, National Orthopaedic Hospital Cappagh, Dublin, Ireland
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4
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Gulati A, Desai V. Return to Play in the Professional Athlete. Semin Musculoskelet Radiol 2024; 28:107-118. [PMID: 38484763 DOI: 10.1055/s-0043-1778028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
The management of any injury in elite athletes poses unique challenges distinct from the general population because the goal is rapid recovery and return to play (RTP) while simultaneously managing residual symptoms and minimizing risk of reinjury. The time required for treatment, recovery, and return to peak performance can have consequences for both the athlete and his or her team: financial implications, psychological stressors, team dynamics, and future performance. RTP after an injury in the professional athlete requires a complex decision-making process with many stakeholders. Several factors influence this decision, not the least of which is the type and mechanism of injury. This article provides an overview of the RTP process including nonmedical factors that may influence this decision, common injuries seen in professional athletes, injury patterns particular to certain popular sports, and imaging guidelines for such injuries.
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Affiliation(s)
- Aishwarya Gulati
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Vishal Desai
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
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5
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Siu WS, Ma H, Cheng W, Shum WT, Leung PC. Traditional Chinese Medicine for Topical Treatment of Skeletal Muscle Injury. Pharmaceuticals (Basel) 2023; 16:1144. [PMID: 37631059 PMCID: PMC10457816 DOI: 10.3390/ph16081144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
Muscle injuries are common musculoskeletal problems, but the pharmaceutical agent for muscle repair and healing is insufficient. Traditional Chinese Medicine (TCM) frequently uses topical treatments to treat muscle injuries, although scientific evidence supporting their efficacy is scarce. In this study, an in vitro assay was used to test the cytotoxicity of a topical TCM formula containing Carthami Flos, Dipsaci Radix, and Rhei Rhizoma (CDR). Then, a muscle contusion rat model was developed to investigate the in vivo effect and basic mechanisms underlying CDR on muscle regeneration. The in vitro assay illustrated that CDR was non-cytotoxic to immortalized rat myoblast culture and increased cell viability. Histological results demonstrated that the CDR treatment facilitated muscle repair by increasing the number of new muscle fibers and promoting muscle integrity. The CDR treatment also upregulated the expression of Pax7, MyoD and myogenin, as evidenced by an immunohistochemical study. A gene expression analysis indicated that the CDR treatment accelerated the regeneration and remodeling phases during muscle repair. This study demonstrated that topical CDR treatment was effective at facilitating muscle injury repair.
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Affiliation(s)
- Wing-Sum Siu
- Institute of Chinese Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China; (H.M.); (W.C.); (W.-T.S.); (P.-C.L.)
- State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Hui Ma
- Institute of Chinese Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China; (H.M.); (W.C.); (W.-T.S.); (P.-C.L.)
- State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Wen Cheng
- Institute of Chinese Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China; (H.M.); (W.C.); (W.-T.S.); (P.-C.L.)
- State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Wai-Ting Shum
- Institute of Chinese Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China; (H.M.); (W.C.); (W.-T.S.); (P.-C.L.)
- State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Ping-Chung Leung
- Institute of Chinese Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China; (H.M.); (W.C.); (W.-T.S.); (P.-C.L.)
- State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
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da Silva BR, Orsso CE, Gonzalez MC, Sicchieri JMF, Mialich MS, Jordao AA, Prado CM. Phase angle and cellular health: inflammation and oxidative damage. Rev Endocr Metab Disord 2022; 24:543-562. [PMID: 36474107 PMCID: PMC9735064 DOI: 10.1007/s11154-022-09775-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
Phase angle is a composite measure that combines two raw bioelectrical impedance analysis measures: resistance and reactance. Phase angle has been considered an indicator of cellular health, integrity, and hydration. As inflammation and oxidative stress can damage cellular structures, phase angle has potential utility in early detecting inflammatory and oxidative status. Herein, we aimed to critically review the current understanding on the determinants of phase angle and its relationship with markers of inflammation and oxidative stress. We also discussed the potential role of phase angle in detecting chronic inflammation and related adverse outcomes. Several factors have been identified as predictors of phase angle, including age, sex, extracellular to intracellular water ratio, and fat-free mass. In addition to these factors, body mass index (BMI) also seems to influence phase angle. Available data also show that lower phase angle values are correlated (negligible to high correlation coefficients) with higher c-reactive protein, tumour necrosis factor-α, interleukin-6, and interleukin-10 in studies involving the general and aging populations, as well as patients with chronic conditions. Although fewer studies have evaluated the relationship between phase angle and markers of oxidative stress, available data also suggest that phase angle has potential to be used as an indicator (for screening) of oxidative damage. Future studies including diverse populations and bioelectrical impedance devices are required to confirm the validity and accuracy of phase angle as a marker of inflammation and oxidative stress for clinical use.
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Affiliation(s)
- Bruna Ramos da Silva
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Canada
| | - Camila E Orsso
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Canada
| | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Juliana Maria Faccioli Sicchieri
- Department of Health Sciences, Division of Nutrition and Metabolism, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Mirele Savegnago Mialich
- Department of Health Sciences, Division of Nutrition and Metabolism, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alceu A Jordao
- Department of Health Sciences, Division of Nutrition and Metabolism, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Carla M Prado
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Canada.
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Pferdehirt L, Guo P, Lu A, Huard M, Guilak F, Huard J. In vitro analysis of genome-engineered muscle-derived stem cells for autoregulated anti-inflammatory and antifibrotic activity. J Orthop Res 2022; 40:2937-2946. [PMID: 35293626 PMCID: PMC9477979 DOI: 10.1002/jor.25311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/19/2022] [Accepted: 02/21/2022] [Indexed: 02/04/2023]
Abstract
Traumatic muscle injury leads to chronic and pathologic fibrosis in skeletal muscles, primarily driven through upregulation of transforming growth factor-β1 (TGF-β1). Cell-based therapies, such as injection of muscle-derived stem cells (MDSCs), have shown promise in muscle repair. However, injected MDSCs in injured skeletal muscle can differentiate into myofibroblasts under the influence of TGF-β1, and contribute to the development of fibrosis, limiting their regenerative potential. In this study, we created a "smart" cell-based drug delivery system using CRISPR-Cas9 to genetically engineer MDSCs capable of sensing TGF-β1 and producing an antifibrotic biologic, decorin. These gene-edited smart cells, capable of inhibiting fibrosis in a dose-dependent and autoregulating manner, show anti-inflammatory and antifibrotic properties in vitro, without changing the expression of myogenic and stem cell markers as well as their cell proliferation and myogenic differentiation. Additionally, differentiation down a fibrotic lineage is reduced or eliminated in response to TGF-β1. Our results show that gene editing can be used to successfully create smart stem cells capable of producing biologic drugs with antifibrotic capabilities in a controlled and localized manner. This system provides a tool for cell-based drug delivery as the basis for a novel therapeutic approach for a variety of diseases.
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Affiliation(s)
- Lara Pferdehirt
- Department of Orthopaedic Surgery, Washington University,
St. Louis, MO 63110, USA
- Shriners Hospitals for Children – St. Louis, St.
Louis, MO 63110, USA
- Department of Biomedical Engineering, Washington
University, St. Louis, MO 63110, USA
- Center of Regenerative Medicine, Washington University, St.
Louis, MO 63110, USA
| | - Ping Guo
- Center for Regenerative & Personalized Medicine,
Steadman Philippon Research Institute; Vail, CO, 81657, USA
| | - Aiping Lu
- Center for Regenerative & Personalized Medicine,
Steadman Philippon Research Institute; Vail, CO, 81657, USA
| | - Mathew Huard
- Center for Regenerative & Personalized Medicine,
Steadman Philippon Research Institute; Vail, CO, 81657, USA
| | - Farshid Guilak
- Department of Orthopaedic Surgery, Washington University,
St. Louis, MO 63110, USA
- Shriners Hospitals for Children – St. Louis, St.
Louis, MO 63110, USA
- Department of Biomedical Engineering, Washington
University, St. Louis, MO 63110, USA
- Center of Regenerative Medicine, Washington University, St.
Louis, MO 63110, USA
| | - Johnny Huard
- Center for Regenerative & Personalized Medicine,
Steadman Philippon Research Institute; Vail, CO, 81657, USA
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TECAR Therapy Associated with High-Intensity Laser Therapy (Hilt) and Manual Therapy in the Treatment of Muscle Disorders: A Literature Review on the Theorised Effects Supporting Their Use. J Clin Med 2022; 11:jcm11206149. [PMID: 36294470 PMCID: PMC9604865 DOI: 10.3390/jcm11206149] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background: It has been estimated that between 30 and 50 per cent of all injuries that take place throughout participation in a sport are the consequence of soft tissue injuries, and muscle injuries are the primary cause of physical disability. Methods: The current literature review was designed between October 2021 and April 2022, according to the PRISMA standards, using the PubMed, Scopus, and Web of Science databases. At the screening stage, we eliminated articles that did not fit into the themes developed in all subchapters of the study (n = 70), articles that dealt exclusively with orthopaedics (n = 34), 29 articles because the articles had only the abstract visible, and 17 articles that dealt exclusively with other techniques for the treatment of musculoskeletal disorders. The initial search revealed 343 titles in the databases, from which 56 duplicate articles were automatically removed, and 2 were added from other sources. Results: The combination of these three techniques results in the following advantages: It increases joint mobility, especially in stiff joints, it increases the range of motion, accelerates tissue repair, improves tissue stability, and extensibility, and it reduces soft tissue inflammation (manual therapy). In addition, it decreases the concentration of pro-inflammatory mediators and improves capillary permeability, resulting in the total eradication of inflammation (HILT). It warms the deep tissues, stimulates vascularity, promotes the repose of tissues (particularly muscle tissue), and stimulates drainage (TECAR). Conclusions: TECAR therapy, combined with manual therapy and High-Intensity Laser therapy in treating muscle diseases, presented optimal collaboration in the recovery process of all muscle diseases.
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9
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Epigenetic Alterations in Sports-Related Injuries. Genes (Basel) 2022; 13:genes13081471. [PMID: 36011382 PMCID: PMC9408207 DOI: 10.3390/genes13081471] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/11/2022] [Accepted: 08/15/2022] [Indexed: 11/17/2022] Open
Abstract
It is a well-known fact that physical activity benefits people of all age groups. However, highly intensive training, maladaptation, improper equipment, and lack of sufficient rest lead to contusions and sports-related injuries. From the perspectives of sports professionals and those performing regular–amateur sports activities, it is important to maintain proper levels of training, without encountering frequent injuries. The bodily responses to physical stress and intensive physical activity are detected on many levels. Epigenetic modifications, including DNA methylation, histone protein methylation, acetylation, and miRNA expression occur in response to environmental changes and play fundamental roles in the regulation of cellular activities. In the current review, we summarise the available knowledge on epigenetic alterations present in tissues and organs (e.g., muscles, the brain, tendons, and bones) as a consequence of sports-related injuries. Epigenetic mechanism observations have the potential to become useful tools in sports medicine, as predictors of approaching pathophysiological alterations and injury biomarkers that have already taken place.
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10
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Hu CF, Chen CPC, Tsui PH, Chen CN, Hsu CC. Stretch-Induced Healing of Injured Muscles Is Associated With Myogenesis and Decreased Fibrosis. Am J Sports Med 2022; 50:1679-1686. [PMID: 35315294 DOI: 10.1177/03635465221083995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Alghouth therapeutic stretching exercise has been applied to accelerate the healing of injured skeletal muscles, mechanisms behind the mechanical stretch-induced muscle recovery remain unclear. PURPOSE To examine stretch-associated antifibrotic and myogenic responses in injured muscles and to evaluate the feasibility of the ultrasonic Nakagami parametric index (NPI) in assessing muscle morphology during recovery. STUDY DESIGN Controlled laboratory study. METHODS Skeletal muscle fibrosis was induced in the right hind legs of 48 rats by making a posterior transverse incision in the gastrocnemius muscle; the left hind legs remained intact as a comparative normal reference. After surgery, the 48 rats were randomly divided into the stretch (S) and control (C) groups. The S group received stretching interventions on the injured hind leg from week 3 to week 7 after surgery, while the C group did not receive stretching throughout the study period. The muscle fibrosis percentage and the ultrasonic NPI were examined sequentially after surgery. Relative expressions of myogenesis-related proteins, including myoblast determination protein 1 (MyoD), myogenin, and embryonic myosin heavy chain (MHCemb), were also evaluated during the follow-up. RESULTS Mean fibrosis percentages in the injured hind leg were approximately 25% at week 3 in both groups, but they were significantly decreased by approximately 20% from week 4 to the end of the follow-up in the S group only (all, P < .05). Upon injury, the NPI values of injured hind legs in both groups dramatically dropped. Within the S group, stretching increased the NPI values of injured hind legs, which approached those of control hind legs at weeks 6 and 7. The highest MyoD, myogenin, and MHCemb levels were observed at week 6 in both groups. The NPI values corresponded to the MyoD expression in the S group during the follow-up. CONCLUSION Stretching induced a decrease in muscle fibrosis and an increase in myogenesis in injured muscles. The NPI values correspond to the myogenesis process. CLINICAL RELEVANCE The NPI may be capable of continuously monitoring the injured skeletal muscle morphology during the healing process in clinical settings.
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Affiliation(s)
- Ching-Fang Hu
- Department of Physical Medicine and Rehabilitation, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Carl Pai-Chu Chen
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Po-Hsiang Tsui
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chiao-Nan Chen
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Chin Hsu
- Department of Physical Medicine and Rehabilitation, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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D’Amico A, Cavarretta E, Fossati C, Borrione P, Pigozzi F, Frati G, Sciarretta S, Costa V, De Grandis F, Nigro A, Peruzzi M, Miraldi F, Saade W, Calogero A, Rosa P, Galardo G, Loffredo L, Pignatelli P, Nocella C, Carnevale R. Platelet Activation Favours NOX2-Mediated Muscle Damage in Elite Athletes: The Role of Cocoa-Derived Polyphenols. Nutrients 2022; 14:nu14081558. [PMID: 35458119 PMCID: PMC9030438 DOI: 10.3390/nu14081558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/25/2022] [Accepted: 04/06/2022] [Indexed: 11/16/2022] Open
Abstract
Mechanisms of exercise-induced muscle injury with etiopathogenesis and its consequences have been described; however, the impact of different intensities of exercise on the mechanisms of muscular injury development is not well understood. The aim of this study was to exploit the relationship between platelet activation, oxidative stress and muscular injuries induced by physical exercise in elite football players compared to amateur athletes. Oxidant/antioxidant status, platelet activation and markers of muscle damage were evaluated in 23 elite football players and 23 amateur athletes. Compared to amateurs, elite football players showed lower antioxidant capacity and higher oxidative stress paralleled by increased platelet activation and muscle damage markers. Simple linear regression analysis showed that sNOX2-dp and H2O2, sCD40L and PDGF-bb were associated with a significant increase in muscle damage biomarkers. In vitro studies also showed that plasma obtained from elite athletes increased oxidative stress and muscle damage in human skeletal muscle myoblasts cell line compared to amateurs’ plasma, an effect blunted by the NOX2 inhibitor or by the cell treatment with cocoa-derived polyphenols. These results indicate that platelet activation increased muscular injuries induced by oxidative stress. Moreover, NOX2 inhibition and polyphenol extracts treatment positively modulates redox status and reduce exercise-induced muscular injury.
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Affiliation(s)
- Alessandra D’Amico
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.D.); (C.F.); (P.B.); (F.P.)
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (E.C.); (G.F.); (S.S.); (A.C.); (P.R.)
- Mediterranea, Cardiocentro, 80122 Napoli, Italy; (M.P.); (P.P.)
| | - Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.D.); (C.F.); (P.B.); (F.P.)
| | - Paolo Borrione
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.D.); (C.F.); (P.B.); (F.P.)
| | - Fabio Pigozzi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.D.); (C.F.); (P.B.); (F.P.)
| | - Giacomo Frati
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (E.C.); (G.F.); (S.S.); (A.C.); (P.R.)
- IRCCS Neuromed, Località Camerelle, 86077 Pozzilli, Italy
| | - Sebastiano Sciarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (E.C.); (G.F.); (S.S.); (A.C.); (P.R.)
- IRCCS Neuromed, Località Camerelle, 86077 Pozzilli, Italy
| | - Vincenzo Costa
- AS Roma Football Club, Piazzale Dino Viola 1, 00128 Rome, Italy;
| | - Fabrizio De Grandis
- Villa Stuart Sport Clinic, FIFA Medical Center of Excellence, 00135 Rome, Italy; (F.D.G.); (A.N.)
| | - Antonia Nigro
- Villa Stuart Sport Clinic, FIFA Medical Center of Excellence, 00135 Rome, Italy; (F.D.G.); (A.N.)
| | - Mariangela Peruzzi
- Mediterranea, Cardiocentro, 80122 Napoli, Italy; (M.P.); (P.P.)
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (F.M.); (W.S.); (L.L.)
| | - Fabio Miraldi
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (F.M.); (W.S.); (L.L.)
| | - Wael Saade
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (F.M.); (W.S.); (L.L.)
| | - Antonella Calogero
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (E.C.); (G.F.); (S.S.); (A.C.); (P.R.)
| | - Paolo Rosa
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (E.C.); (G.F.); (S.S.); (A.C.); (P.R.)
| | | | - Lorenzo Loffredo
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (F.M.); (W.S.); (L.L.)
| | - Pasquale Pignatelli
- Mediterranea, Cardiocentro, 80122 Napoli, Italy; (M.P.); (P.P.)
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (F.M.); (W.S.); (L.L.)
| | - Cristina Nocella
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (F.M.); (W.S.); (L.L.)
- Correspondence: (C.N.); (R.C.)
| | - Roberto Carnevale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (E.C.); (G.F.); (S.S.); (A.C.); (P.R.)
- Mediterranea, Cardiocentro, 80122 Napoli, Italy; (M.P.); (P.P.)
- Correspondence: (C.N.); (R.C.)
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12
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Lee H, Han NR, Kim SJ, Yun JI, Lee ST. Development of a High-Yield Isolation Protocol Optimized for the Retrieval of Active Muscle Satellite Cells from Mouse Skeletal Muscle Tissue. Int J Stem Cells 2022; 15:283-290. [PMID: 35220284 PMCID: PMC9396018 DOI: 10.15283/ijsc21179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/26/2021] [Accepted: 01/04/2022] [Indexed: 12/03/2022] Open
Abstract
Background and Objectives Difficulties often encountered in separating and purifying active muscle satellite cells (MSCs) from skeletal muscle tissues have limited the supply of cells for muscle therapy and artificial meat production. Here, we report an effective isolation protocol to economically and conveniently retrieve active MSCs from skeletal muscle tissues in mice. Methods and Results We optimized an enzyme-based tissue digestion protocol for isolating skeletal muscle-derived primary cell population having a large number of active MSCs and described a method of differential plating (DP) for improving purity of active MSCs from skeletal muscle-derived primary cell population. Then, the age of the mouse appropriate to the isolation of a large number of active MSCs was elucidated. The best isolation yield of active MSCs from mouse skeletal muscle tissues was induced by the application of DP method to the primary cell population harvested from skeletal muscle tissues of 2-week-old mice digested in 0.2% (w/v) collagenase type II for 30 min at 37℃ and then in 0.1% (w/v) pronase for 5 min at 37℃. Conclusions The protocol we developed not only facilitates the isolation of MSCs but also maximizes the retrieval of active MSCs. Our expectation is that this protocol will contribute to the development of original technologies essential for muscle therapy and artificial meat industrialization in the future.
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Affiliation(s)
- Hyun Lee
- Department of Animal Life Science, Kangwon National University, Chuncheon, Korea
| | | | - Seong Jae Kim
- Department of Animal Life Science, Kangwon National University, Chuncheon, Korea
| | | | - Seung Tae Lee
- Department of Animal Life Science, Kangwon National University, Chuncheon, Korea
- KustoGen Inc., Chuncheon, Korea
- Department of Applied Animal Science, Kangwon National University, Chuncheon, Korea
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13
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Rodrigues G, Moraes T, Elisei L, Malta I, Dos Santos R, Novaes R, Lollo P, Galdino G. Resistance Exercise and Whey Protein Supplementation Reduce Mechanical Allodynia and Spinal Microglia Activation After Acute Muscle Trauma in Rats. Front Pharmacol 2021; 12:726423. [PMID: 34858171 PMCID: PMC8631966 DOI: 10.3389/fphar.2021.726423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/31/2021] [Indexed: 12/30/2022] Open
Abstract
Muscle injury caused by direct trauma to the skeletal muscle is among the main musculoskeletal disorders. Non-pharmacological treatments have been effective in controlling muscle injury–induced pain; however, there are just a few studies in the literature investigating this response. Thus, the present study aimed to evaluate the effect of a resistance exercise training protocol combined or not with whey protein supplementation on mechanical allodynia induced by muscle injury. In addition, we also investigated the involvement of spinal glial cells in this process. For this purpose, male Wistar rats underwent a muscle injury model induced by direct trauma to the gastrocnemius muscle. Mechanical allodynia was measured by a digital von Frey algesimeter test. To evaluate the effect of exercise and/or supplementation on mechanical allodynia, the animals practiced exercises three times a week for 14 days and received supplementation daily for 14 days, respectively. Moreover, the effect of both the participation of spinal glial cells in the muscle injury and the resistance exercise training and/or whey protein supplementation on these cells was also investigated by the Western blot assay. The results demonstrated that resistance exercise training and whey protein supplementation, combined or alone, reduced mechanical allodynia. These treatments also reduced the number of interstitial cells and pro-inflammatory cytokine IL-6 levels in the injured muscle. It was also found that spinal microglia and astrocytes are involved in muscle injury, and that resistance exercise training combined with whey protein supplementation inhibits spinal microglia activation. The results suggest that both resistance exercise training and whey protein supplementation may be effective non-pharmacological treatments to control pain in the muscle after injury induced by acute trauma.
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Affiliation(s)
- Gusthavo Rodrigues
- Laboratory of Experimental Physical Therapy, Institute of Motricity Sciences, Federal University of Alfenas, Alfenas, Brazil.,Federal Institute of Education, Science and Technology of South of Minas Gerais, Advanced Campus Carmo de Minas, Carmo de Minas, Brazil
| | - Thamyris Moraes
- Laboratory of Experimental Physical Therapy, Institute of Motricity Sciences, Federal University of Alfenas, Alfenas, Brazil
| | - Lívia Elisei
- Laboratory of Experimental Physical Therapy, Institute of Motricity Sciences, Federal University of Alfenas, Alfenas, Brazil
| | - Iago Malta
- Laboratory of Experimental Physical Therapy, Institute of Motricity Sciences, Federal University of Alfenas, Alfenas, Brazil
| | - Rafaela Dos Santos
- Laboratory of Experimental Physical Therapy, Institute of Motricity Sciences, Federal University of Alfenas, Alfenas, Brazil
| | - Rômulo Novaes
- Laboratory of Experimental Physical Therapy, Institute of Motricity Sciences, Federal University of Alfenas, Alfenas, Brazil
| | - Pablo Lollo
- School of Physical Education, Federal University of Grande Dourados, Dourados, Brazil
| | - Giovane Galdino
- Laboratory of Experimental Physical Therapy, Institute of Motricity Sciences, Federal University of Alfenas, Alfenas, Brazil
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14
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Indirect Structural Muscle Injuries of Lower Limb: Rehabilitation and Therapeutic Exercise. J Funct Morphol Kinesiol 2021; 6:jfmk6030075. [PMID: 34564194 PMCID: PMC8482242 DOI: 10.3390/jfmk6030075] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 11/17/2022] Open
Abstract
Muscle injuries are the most common trauma in team and individual sports. The muscles most frequently affected are those of the lower limb, and in particular hamstrings, adductors, rectus femoris and calf muscles. Although several scientific studies have tried to propose different rehabilitation protocols, still too often the real rehabilitation process is not based on scientific knowledge, especially in non-elite athletes. Moreover, the growing use of physical and instrumental therapies has made it increasingly difficult to understand what can be truly effective. Therefore, the aim of the present paper is to review proposed therapeutic algorithms for muscle injuries, proposing a concise and practical summary. Following a three-phase rehabilitation protocol, this review aims to describe the conservative treatment of indirect structural muscle injuries, which are the more routinely found and more challenging type. For each phase, until return to training and return to sport are completed, the functional goal, the most appropriate practitioner, and the best possible treatment according to current evidence are expressed. Finally, the last section is focused on the specific exercise rehabilitation for the four main muscle groups with a structured explanatory timetable.
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15
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Lu A, Guo P, Pan H, Tseng C, Sinha KM, Yang F, Scibetta A, Cui Y, Huard M, Zhong L, Ravuri S, Huard J. Enhancement of myogenic potential of muscle progenitor cells and muscle healing during pregnancy. FASEB J 2021; 35:e21378. [PMID: 33565161 DOI: 10.1096/fj.202001914r] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/10/2020] [Accepted: 01/04/2021] [Indexed: 11/11/2022]
Abstract
The decline of muscle regenerative potential with age has been attributed to a diminished responsiveness of muscle progenitor cells (MPCs). Heterochronic parabiosis has been used as a model to study the effects of aging on stem cells and their niches. These studies have demonstrated that, by exposing old mice to a young systemic environment, aged progenitor cells can be rejuvenated. One interesting idea is that pregnancy represents a unique biological model of a naturally shared circulatory system between developing and mature organisms. To test this hypothesis, we evaluated the muscle regeneration potential of pregnant mice using a cardiotoxin (CTX) injury mouse model. Our results indicate that the pregnant mice demonstrate accelerated muscle healing compared to nonpregnant control mice following muscle injury based on improved muscle histology, superior muscle regeneration, and a reduction in inflammation and necrosis. Additionally, we found that MPCs isolated from pregnant mice display a significant improvement of myogenic differentiation capacity in vitro and muscle regeneration in vivo when compared to the MPCs from nonpregnant mice. Furthermore, MPCs from nonpregnant mice display enhanced myogenic capacity when cultured in the presence of serum obtained from pregnant mice. Our proteomics data from these studies provides potential therapeutic targets to enhance the myogenic potential of progenitor cells and muscle repair.
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Affiliation(s)
- Aiping Lu
- Steadman Philippon Research Institute, Vail, CO, USA
| | - Ping Guo
- Steadman Philippon Research Institute, Vail, CO, USA
| | - Haiying Pan
- Department of Orthopaedic Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Chieh Tseng
- Department of Orthopaedic Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Krishna M Sinha
- Department of Orthopaedic Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Fan Yang
- Department of Traumatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Alex Scibetta
- Steadman Philippon Research Institute, Vail, CO, USA
| | - Yan Cui
- Department of Orthopaedic Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Ling Zhong
- Department of Orthopaedic Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Johnny Huard
- Department of Orthopaedic Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA
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16
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The Combination of Electroacupuncture and Massage Therapy Alleviates Myofibroblast Transdifferentiation and Extracellular Matrix Production in Blunt Trauma-Induced Skeletal Muscle Fibrosis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5543468. [PMID: 34306140 PMCID: PMC8282377 DOI: 10.1155/2021/5543468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 06/17/2021] [Accepted: 06/30/2021] [Indexed: 11/24/2022]
Abstract
Complementary therapies, such as acupuncture and massage, had been previously reported to have therapeutic effects on skeletal muscle contusions. However, the recovery mechanisms on skeletal muscles after blunt trauma via the combination of electroacupuncture (EA) and massage therapy remain unclear. In the present study, a rat model of the skeletal muscle fibrosis following blunt trauma to rat skeletal muscle was established, and the potential molecular mechanisms of EA + massage therapy on the skeletal muscle fibrosis were investigated. The results suggested that EA + massage therapy could significantly decrease inflammatory cells infiltration and collagenous fiber content and ameliorate the disarrangement of sarcomeres within myofibrils compared to the model group. Further analysis revealed that EA + massage therapy could reduce the degree of fibrosis and increase the degree of myofibroblast apoptosis by downregulating the mRNA and protein expression of transforming growth factor- (TGF-) β1 and connective tissue growth factor (CTGF). Furthermore, the fibrosis of injured skeletal muscle was inhibited after treatment through the normalization of balance between matrix metalloproteinase- (MMP-) 1 and tissue inhibitor of matrix metalloproteinase (TIMP). These findings suggested that the combination of electroacupuncture and massage therapy could alleviate the fibrotic process by regulating TGF β1-CTGF-induced myofibroblast transdifferentiation and MMP-1/TIMP-1 balance for extracellular matrix production.
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17
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Return to Play After a Hamstring Strain Injury: It is Time to Consider Natural Healing. Sports Med 2021; 51:2067-2077. [PMID: 34143413 DOI: 10.1007/s40279-021-01494-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2021] [Indexed: 01/15/2023]
Abstract
Return to play (RTP) criteria after hamstring strain injuries (HSIs) help clinicians in deciding whether an athlete is ready to safely resume previous sport activities. Today, functional and sport-specific training tests are the gold standard in the decision-making process. These criteria lead to an average RTP time between 11 and 25 days after a grade 1 or 2 HSI. However, the high re-injury rates indicate a possible inadequacy of the current RTP criteria. A possible explanation for this could be the neglect of biological healing time. The present review shows that studies indicating time as a possible factor within the RTP-decision are very scarce. However, studies on biological muscle healing showed immature scar tissue and incomplete muscle healing at the average moment of RTP. Twenty-five percent of the re-injuries occur in the first week after RTP and at the exact same location as the index injury. This review supports the statement that functional recovery precedes the biological healing of the muscle. Based on basic science studies on biological muscle healing, we recommend a minimum period of 4 weeks before RTP after a grade 1 or 2 HSI. In conclusion, we advise a comprehensive RTP functional test battery with respect for the natural healing process. Before deciding RTP readiness, clinicians should reflect whether or not it is biologically possible for the injured tissue to have regained enough strength to withstand the sport-specific forces. In an attempt to reduce the detrimental injury-reinjury cycle, it is time to start considering (biological healing) time.
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18
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Brancaccio M, Mennitti C, Cesaro A, Fimiani F, Moscarella E, Caiazza M, Gragnano F, Ranieri A, D’Alicandro G, Tinto N, Mazzaccara C, Lombardo B, Pero R, Limongelli G, Frisso G, Calabrò P, Scudiero O. Dietary Thiols: A Potential Supporting Strategy against Oxidative Stress in Heart Failure and Muscular Damage during Sports Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249424. [PMID: 33339141 PMCID: PMC7765667 DOI: 10.3390/ijerph17249424] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 12/11/2022]
Abstract
Moderate exercise combined with proper nutrition are considered protective factors against cardiovascular disease and musculoskeletal disorders. However, physical activity is known not only to have positive effects. In fact, the achievement of a good performance requires a very high oxygen consumption, which leads to the formation of oxygen free radicals, responsible for premature cell aging and diseases such as heart failure and muscle injury. In this scenario, a primary role is played by antioxidants, in particular by natural antioxidants that can be taken through the diet. Natural antioxidants are molecules capable of counteracting oxygen free radicals without causing cellular cytotoxicity. In recent years, therefore, research has conducted numerous studies on the identification of natural micronutrients, in order to prevent or mitigate oxidative stress induced by physical activity by helping to support conventional drug therapies against heart failure and muscle damage. The aim of this review is to have an overview of how controlled physical activity and a diet rich in antioxidants can represent a “natural cure” to prevent imbalances caused by free oxygen radicals in diseases such as heart failure and muscle damage. In particular, we will focus on sulfur-containing compounds that have the ability to protect the body from oxidative stress. We will mainly focus on six natural antioxidants: glutathione, taurine, lipoic acid, sulforaphane, garlic and methylsulfonylmethane.
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Affiliation(s)
- Mariarita Brancaccio
- Department of Biology and Evolution of Marine Organisms, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Naples, Italy;
| | - Cristina Mennitti
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (C.M.); (N.T.); (C.M.); (B.L.); (R.P.)
| | - Arturo Cesaro
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (A.C.); (E.M.); (F.G.); (G.L.)
- Division of Clinical Cardiology, A.O.R.N. “Sant’Anna e San Sebastiano”, 81100 Caserta, Italy
| | - Fabio Fimiani
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 81100 Naples, Italy; (F.F.); (M.C.)
| | - Elisabetta Moscarella
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (A.C.); (E.M.); (F.G.); (G.L.)
- Division of Clinical Cardiology, A.O.R.N. “Sant’Anna e San Sebastiano”, 81100 Caserta, Italy
| | - Martina Caiazza
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 81100 Naples, Italy; (F.F.); (M.C.)
| | - Felice Gragnano
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (A.C.); (E.M.); (F.G.); (G.L.)
- Division of Clinical Cardiology, A.O.R.N. “Sant’Anna e San Sebastiano”, 81100 Caserta, Italy
| | | | - Giovanni D’Alicandro
- Department of Neuroscience and Rehabilitation, Center of Sports Medicine and Disability, AORN, Santobono-Pausillipon, 80122 Naples, Italy;
| | - Nadia Tinto
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (C.M.); (N.T.); (C.M.); (B.L.); (R.P.)
- Ceinge Biotecnologie Avanzate S. C. a R. L., 80131 Naples, Italy;
| | - Cristina Mazzaccara
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (C.M.); (N.T.); (C.M.); (B.L.); (R.P.)
| | - Barbara Lombardo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (C.M.); (N.T.); (C.M.); (B.L.); (R.P.)
- Ceinge Biotecnologie Avanzate S. C. a R. L., 80131 Naples, Italy;
| | - Raffaela Pero
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (C.M.); (N.T.); (C.M.); (B.L.); (R.P.)
- Task Force on Microbiome Studies, University of Naples Federico II, 80100 Naples, Italy
| | - Giuseppe Limongelli
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (A.C.); (E.M.); (F.G.); (G.L.)
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 81100 Naples, Italy; (F.F.); (M.C.)
| | - Giulia Frisso
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (C.M.); (N.T.); (C.M.); (B.L.); (R.P.)
- Ceinge Biotecnologie Avanzate S. C. a R. L., 80131 Naples, Italy;
- Correspondence: (G.F.); (P.C.); (O.S.); Tel.: +39-347-240-9595 (G.F.); +39-338-434-6963 (P.C.); +39-339-613-9908 (O.S.)
| | - Paolo Calabrò
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (A.C.); (E.M.); (F.G.); (G.L.)
- Division of Clinical Cardiology, A.O.R.N. “Sant’Anna e San Sebastiano”, 81100 Caserta, Italy
- Correspondence: (G.F.); (P.C.); (O.S.); Tel.: +39-347-240-9595 (G.F.); +39-338-434-6963 (P.C.); +39-339-613-9908 (O.S.)
| | - Olga Scudiero
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (C.M.); (N.T.); (C.M.); (B.L.); (R.P.)
- Ceinge Biotecnologie Avanzate S. C. a R. L., 80131 Naples, Italy;
- Task Force on Microbiome Studies, University of Naples Federico II, 80100 Naples, Italy
- Correspondence: (G.F.); (P.C.); (O.S.); Tel.: +39-347-240-9595 (G.F.); +39-338-434-6963 (P.C.); +39-339-613-9908 (O.S.)
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19
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Brewer BW, Van Brewer TP. A Visualization Template for the Graphical Representation of Sport Injury Antecedents and Consequences Models and Data. J Funct Morphol Kinesiol 2020; 5:E87. [PMID: 33467302 PMCID: PMC7739437 DOI: 10.3390/jfmk5040087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/19/2020] [Accepted: 11/24/2020] [Indexed: 12/12/2022] Open
Abstract
A template for visually representing factors affecting and affected by the occurrence of sport injury is presented. The visualization template is designed to facilitate comparison among graphic depictions of models and data pertaining to the antecedents and consequences of sport injury. Innovative aspects and limitations of the visualization template are highlighted, and future applications of the visualization template are discussed.
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Affiliation(s)
- Britton W. Brewer
- Department of Psychology, School of Social Work and Behavioral Sciences, Springfield College, 263 Alden Street, Springfield, MA 01109, USA
| | - Travis P. Van Brewer
- Department of Civil and Environmental Engineering, School of Engineering, Tufts University, 200 College Avenue, Medford, MA 02155, USA;
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20
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Tang D, Hu J, Liu H, Li Z, Shi Q, Zhao G, Gao B, Lou J, Yao C, Xu F. Diagnosis and prognosis for exercise-induced muscle injuries: from conventional imaging to emerging point-of-care testing. RSC Adv 2020; 10:38847-38860. [PMID: 35518400 PMCID: PMC9057463 DOI: 10.1039/d0ra07321k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/11/2020] [Indexed: 12/02/2022] Open
Abstract
With the development of modern society, we have witnessed a significant increase of people who join in sport exercises, which also brings significantly increasing exercise-induced muscle injuries, resulting in reduction and even cessation of participation in sports and physical activities. Although severely injured muscles can hardly realize full functional restoration, skeletal muscles subjected to minor muscle injuries (e.g., tears, lacerations, and contusions) hold remarkable regeneration capacity to be healed without therapeutic interventions. However, delayed diagnosis or inappropriate prognosis will cause exacerbation of the injuries. Therefore, timely diagnosis and prognosis of muscle injuries is important to the recovery of injured muscles. Here, in this review, we discuss the definition and classification of exercise-induced muscle injuries, and then analyze their underlying mechanism. Subsequently, we provide detailed introductions to both conventional and emerging techniques for evaluation of exercise-induced muscle injuries with focus on emerging portable and wearable devices for point-of-care testing (POCT). Finally, we point out existing challenges and prospects in this field. We envision that an integrated system that combines physiological and biochemical analyses is anticipated to be realized in the future for assessing muscle injuries.
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Affiliation(s)
- Deding Tang
- MOE Key Laboratory of Biomedical Information Engineering, School of Life Science and Technology, Xi'an Jiaotong University Xi'an 710049 P. R. China
- Maanshan Teachers College Ma Anshan 243041 P. R. China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University Xi'an 710049 P. R. China
| | - Jie Hu
- Suzhou DiYinAn Biotech Co., Ltd., Suzhou Innovation Center for Life Science and Technology Suzhou 215129 P. R. China
| | - Hao Liu
- MOE Key Laboratory of Biomedical Information Engineering, School of Life Science and Technology, Xi'an Jiaotong University Xi'an 710049 P. R. China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University Xi'an 710049 P. R. China
| | - Zedong Li
- MOE Key Laboratory of Biomedical Information Engineering, School of Life Science and Technology, Xi'an Jiaotong University Xi'an 710049 P. R. China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University Xi'an 710049 P. R. China
| | - Qiang Shi
- MOE Key Laboratory of Biomedical Information Engineering, School of Life Science and Technology, Xi'an Jiaotong University Xi'an 710049 P. R. China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University Xi'an 710049 P. R. China
- Anhui College of Traditional Chinese Medicine Wuhu 241000 P. R. China
| | - Guoxu Zhao
- School of Material Science and Chemical Engineering, Xi'an Technological University Xi'an 710021 P. R. China
| | - Bin Gao
- Department of Endocrinology, Tangdu Hospital, Air Force Military Medical University Xi'an 710038 P. R. China
| | - Jiatao Lou
- Department of Laboratory Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University Shanghai 200030 P. R. China
| | - Chunyan Yao
- Department of Transfusion Medicine, Southwest Hospital, Third Military Medical University Chongqing 400038 P. R. China
| | - Feng Xu
- MOE Key Laboratory of Biomedical Information Engineering, School of Life Science and Technology, Xi'an Jiaotong University Xi'an 710049 P. R. China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University Xi'an 710049 P. R. China
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21
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Beggs I. Biological Basis of Treatments of Acute Muscle Injuries: A Short Review. Semin Musculoskelet Radiol 2020; 24:256-261. [PMID: 32987424 DOI: 10.1055/s-0040-1708087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Muscle strains occur frequently in recreational and professional sports. This article considers various treatment options in a biological context and reviews evidence of their efficacy. Treatments reviewed include the PRICE principle (P: rotection, R: est, I: ce, C: ompression, E: levation), early mobilization, physical therapy, hematoma aspiration, platelet-rich plasma injections, use of nonsteroidal anti-inflammatory drugs, corticosteroids, and local anesthetics, cellular therapies, and surgery.
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Affiliation(s)
- Ian Beggs
- Analytic Imaging, Edinburgh, United Kingdom
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22
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Langendorf EK, Klein A, Drees P, Rommens PM, Mattyasovszky SG, Ritz U. Exposure to radial extracorporeal shockwaves induces muscle regeneration after muscle injury in a surgical rat model. J Orthop Res 2020; 38:1386-1397. [PMID: 31840830 DOI: 10.1002/jor.24564] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 12/04/2019] [Indexed: 02/04/2023]
Abstract
The leading cause of training interruption in sport is a muscle injury, for which the standard treatment is nonsteroidal anti-inflammatory drugs (NSAIDs). To find alternative treatments, we investigated whether the radial extracorporeal shockwave application (rESWT) could stimulate muscle regeneration. A lesion with complete rupture (grade III muscle tear) was set in the musculus rectus femoris of 12-week-old Wistar rats, and the NSAID diclofenac, rESWT, or a combined therapy were applied on day 0, 3, and 5 directly following the surgery. Rats were euthanized at 2, 4, and 7 days after surgery and the area of muscle lesion was excised for histological and gene expression analysis to determine the progress in the healing of damaged fibers and tissue regeneration. The best effect on muscle regeneration was observed in the group treated with rESWT alone. Monotherapy by diclofenac showed a smaller but still positive effect and lowest effects were detected when both therapies were applied. rESWT alone demonstrated a significant upregulation of the muscle markers MyoD and myosin. The presence of myosin gene expression indicated newly formed muscle fibers, which was confirmed by hematoxylin and eosin staining. Seven days after injury the amount of mononucleated cell decreased and regenerating fibers could be detected. This effect is most pronounced in the group treated with rESWT alone. In our study, shockwaves demonstrated the best effect on muscle regeneration. Therefore, we recommend prospective clinical studies to analyze the effect of rESWT after sports trauma to improve muscle regeneration and to shorten the rehabilitation.
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Affiliation(s)
- Eva K Langendorf
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Anja Klein
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Philipp Drees
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Pol M Rommens
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Stefan G Mattyasovszky
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Ulrike Ritz
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Mainz, Germany
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Chiu CH, Chang SS, Chang GJ, Chen ACY, Cheng CY, Chen SC, Chan YS. The Effect of Hyperbaric Oxygen Treatment on Myoblasts and Muscles After Contusion Injury. J Orthop Res 2020; 38:329-335. [PMID: 31531986 DOI: 10.1002/jor.24478] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 09/13/2019] [Indexed: 02/04/2023]
Abstract
The recommended treatment varies depending on the severity of muscle injuries. The aim of this study was to evaluate the in vitro myoblast proliferation and the in vivo histologic and physiologic effects of hyperbaric oxygen treatment on muscle healing after contusion. Cells from the C2C12 myoblast cell line were exposed to 100% O2 for 25 min then to air for 5 min at 2.5 atmospheres absolute in a hyperbaric chamber for a total treatment duration of 90 min per 48 h at intervals of 2, 4, 6 and 8 days. Cell growth measurements and western blot analysis of myogenin and actin were performed. Then, 18 mice aged 8-10 weeks were used in the muscle contusion model. The histologic and physiologic effects and muscle regeneration after hyperbaric oxygen treatment were evaluated. The myoblast growth rate was significantly higher (p < 0.05) after hyperbaric oxygen treatment. Densitometric evaluation demonstrated a 39% (p < 0.05) and 25% (p < 0.05) increase in myogenin and actin protein levels, respectively, in the cells treated with 1 dose of hyperbaric oxygen. Similarly, the myogenin and actin protein levels increased for samples receiving multiple hyperbaric oxygen treatments when compared with the control. Physiologic evaluation of fast twitch and tetanus strength revealed a significant difference between the control group and the 14-day hyperbaric oxygen group. In conclusion, hyperbaric oxygen treatment increases the myoblast growth rate and myogenin and actin production. Better histologic and physiologic performance were found after hyperbaric oxygen treatment in animal contusion model. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:329-335, 2020.
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Affiliation(s)
- Chih-Hao Chiu
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Shih-Sheng Chang
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Gwo-Jyh Chang
- Graduate Institute of Clinical and Medicinal Sciences, College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Alvin Chao-Yu Chen
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chun-Ying Cheng
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Su-Ching Chen
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yi-Sheng Chan
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
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Li K, Han W, Zhao Y, Qi Y, Li Y, Bi J, Wang Y, Dong G. Using complex II as an emerging therapeutic target for the treatment of muscle lesions. Saudi J Biol Sci 2020; 26:1943-1947. [PMID: 31889777 PMCID: PMC6923501 DOI: 10.1016/j.sjbs.2019.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 06/26/2019] [Accepted: 07/05/2019] [Indexed: 11/18/2022] Open
Abstract
After patients has been trapped into skeletal muscle injury, hypoxic and dysfunctional mitochondria brings about a crisis in energy supply that severely disrupts the repair of skeletal muscle. This study aims to elucidate injury-induced adaptations in the mitochondria and provide statistics for the role of complex II in instilling cells with energy under hypoxic conditions. Fifty-six male Wistar rats were divided into control, 12 h, 2 d, 5 d, 7 d, 10 d, 15 d, and 30 d postinjury groups. Contusion injury was made via an instrumented drop-mass technique delivering single impact to the posterior surface of the gastrocnemius of one limb of the rats. ROS levels, loss of mitochondrial membrane potential (MMP), activities of marker enzymes (miCK, LDH, and ALP), and activities of complexes I–III were determined. Our findings reveal that the first 2 d postinjury, especially at 12 h, is the period with most severe oxidative stress. After injury, the activities of mitochondrial complexes I–III display different behaviors based on time and various energy production mechanisms. Our results highlight that complex II participates in electron transport in the acute phase of blunt trauma. We proposed that CII could be a therapeutic target in muscle lesions.
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Affiliation(s)
- Kefeng Li
- College of Sports and Health, Shandong Sport University, Jinan 250102, China
| | - Wei Han
- College of Sports and Health, Shandong Sport University, Jinan 250102, China
| | - Ying Zhao
- College of Sports and Health, Shandong Sport University, Jinan 250102, China
| | - Yujuan Qi
- College of Sports and Health, Shandong Sport University, Jinan 250102, China
| | - Yadan Li
- College of Sports and Health, Shandong Sport University, Jinan 250102, China
| | - Jun Bi
- College of Sports and Health, Shandong Sport University, Jinan 250102, China
| | - Yi Wang
- College of Sports and Health, Shandong Sport University, Jinan 250102, China
| | - Guijun Dong
- College of Sports and Health, Shandong Sport University, Jinan 250102, China
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Strateva M, Penchev G. HISTOLOGICAL, PHYSICOCHEMICAL AND MICROBIOLOGICAL CHANGES IN FRESH AND FROZEN/THAWED FISH. BULGARIAN JOURNAL OF VETERINARY MEDICINE 2020. [DOI: 10.15547/tjs.2020.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The production and supply of fish as food is constantly growing worldwide. Various methods are applied to extend its shelf life, one of them being freezing. According to European Union legislation, the state of the food and its treatment must be indicated on the label. If the food had been frozen prior to marketing and then sold thawed, this information must be provided to the consumer by labelling it. Otherwise, this is considered a fraud to the consumer since freezing significantly degrades the quality of fish. Histological, physicochemical and microbiological changes in the muscle tissue of frozen fish occur. Different methods may be applied to distinguish between fresh and frozen and them thawed fish, of which histological examination is a reliable method.
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Yoshida K, Itoigawa Y, Maruyama Y, Kaneko K. Healing Process of Gastrocnemius Muscle Injury on Ultrasonography Using B-Mode Imaging, Power Doppler Imaging, and Shear Wave Elastography. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:3239-3246. [PMID: 31165497 DOI: 10.1002/jum.15035] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/16/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Muscle injury often occurs in sports activity. To avoid reinjury, it is important to determine the appropriate period until return to play after injury. The purpose of this study was to evaluate characteristics of the healing process for gastrocnemius muscle injury by B-mode imaging, power Doppler (PD) imaging, and shear wave elastography (SWE). METHODS Twenty patients with acute calf musculotendinous injury were enrolled. Scar thickness on B-mode imaging, new vessels according to PD grades, and SWE values in the muscle, musculotendinous junction, and tendon of the medial head of gastrocnemius were measured at 4, 8, and 12 weeks after injury. RESULTS Scar thickness was significantly larger at 8 and 12 weeks compared with 4 weeks (P < .01 for both). Power Doppler grades at 4 and 8 weeks were significantly higher compared with 12 weeks (P < .01 for both). Shear wave elastographic values in the muscle on the injury side were significantly higher at 8 and 12 weeks compared with 4 weeks (P < .01 for both), whereas those in the musculotendinous junction on the injury side were significantly higher at 12 weeks compared with 4 and 8 weeks (P < .01; P = .01, respectively). CONCLUSIONS B-mode imaging, PD imaging, and SWE can measure the healing process after musculotendinous injury of the gastrocnemius medial head.
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Liao CH, Lin LP, Yu TY, Hsu CC, Pang JHS, Tsai WC. Ibuprofen inhibited migration of skeletal muscle cells in association with downregulation of p130cas and CrkII expressions. Skelet Muscle 2019; 9:23. [PMID: 31464636 PMCID: PMC6714350 DOI: 10.1186/s13395-019-0208-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 08/13/2019] [Indexed: 11/28/2022] Open
Abstract
Background Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat sports-related muscle injuries. However, NSAIDs were recently shown to impede the muscle healing process after acute injury. Migration of skeletal muscle cells is a crucial step during the muscle healing process. The present study was performed to investigate the effect and molecular mechanisms of action of ibuprofen, a commonly used NSAID, on the migration of skeletal muscle cells. Methods Skeletal muscle cells isolated from the gastrocnemius muscle of Sprague-Dawley rats were treated with ibuprofen. MTT assay (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) was used to evaluate cell viability, and cell apoptosis was evaluated by TUNEL assay, after ibuprofen treatment. Skeletal muscle cell migration and spreading were evaluated using the transwell filter migration assay and F-actin staining, respectively. The protein expression of p130cas and CrkII, which are cell migration facilitating genes, was determined by western blot analysis. The overexpression of p130cas of muscle cells was achieved by p130cas vector transfection. Results The results demonstrated that ibuprofen did not have a significant negative effect on cell viability and apoptosis. Ibuprofen inhibited the migration and spreading of skeletal muscle cells in a dose-dependent manner. Ibuprofen also dose-dependently decreased the protein expression of p130cas and CrkII. Furthermore, overexpression of p130cas resulted in the promotion of cell migration and spreading and counteracted ibuprofen-mediated inhibition. Conclusion This study suggested that ibuprofen exerts a potentially adverse effect on the migration of skeletal muscle cells by downregulating protein expression of p130cas and CrkII. These results indicate a possible mechanism underlying the possible negative effect of NSAIDs on muscle regeneration.
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Affiliation(s)
- Chih-Hao Liao
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, No.123, Dinghu Rd., Guishan Dist, Taoyuan City, 333, Taiwan
| | - Li-Ping Lin
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, No.123, Dinghu Rd., Guishan Dist, Taoyuan City, 333, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan City, Taiwan
| | - Tung-Yang Yu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, No.123, Dinghu Rd., Guishan Dist, Taoyuan City, 333, Taiwan
| | - Chih-Chin Hsu
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan.,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Jong-Hwei S Pang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, No.123, Dinghu Rd., Guishan Dist, Taoyuan City, 333, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan City, Taiwan
| | - Wen-Chung Tsai
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, No.123, Dinghu Rd., Guishan Dist, Taoyuan City, 333, Taiwan. .,College of Medicine, Chang Gung University, Taoyuan City, Taiwan.
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28
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Qazi TH, Duda GN, Ort MJ, Perka C, Geissler S, Winkler T. Cell therapy to improve regeneration of skeletal muscle injuries. J Cachexia Sarcopenia Muscle 2019; 10:501-516. [PMID: 30843380 PMCID: PMC6596399 DOI: 10.1002/jcsm.12416] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 01/27/2019] [Indexed: 12/14/2022] Open
Abstract
Diseases that jeopardize the musculoskeletal system and cause chronic impairment are prevalent throughout the Western world. In Germany alone, ~1.8 million patients suffer from these diseases annually, and medical expenses have been reported to reach 34.2bn Euros. Although musculoskeletal disorders are seldom fatal, they compromise quality of life and diminish functional capacity. For example, musculoskeletal disorders incur an annual loss of over 0.8 million workforce years to the German economy. Among these diseases, traumatic skeletal muscle injuries are especially problematic because they can occur owing to a variety of causes and are very challenging to treat. In contrast to chronic muscle diseases such as dystrophy, sarcopenia, or cachexia, traumatic muscle injuries inflict damage to localized muscle groups. Although minor muscle trauma heals without severe consequences, no reliable clinical strategy exists to prevent excessive fibrosis or fatty degeneration, both of which occur after severe traumatic injury and contribute to muscle degeneration and dysfunction. Of the many proposed strategies, cell-based approaches have shown the most promising results in numerous pre-clinical studies and have demonstrated success in the handful of clinical trials performed so far. A number of myogenic and non-myogenic cell types benefit muscle healing, either by directly participating in new tissue formation or by stimulating the endogenous processes of muscle repair. These cell types operate via distinct modes of action, and they demonstrate varying levels of feasibility for muscle regeneration depending, to an extent, on the muscle injury model used. While in some models the injury naturally resolves over time, other models have been developed to recapitulate the peculiarities of real-life injuries and therefore mimic the structural and functional impairment observed in humans. Existing limitations of cell therapy approaches include issues related to autologous harvesting, expansion and sorting protocols, optimal dosage, and viability after transplantation. Several clinical trials have been performed to treat skeletal muscle injuries using myogenic progenitor cells or multipotent stromal cells, with promising outcomes. Recent improvements in our understanding of cell behaviour and the mechanistic basis for their modes of action have led to a new paradigm in cell therapies where physical, chemical, and signalling cues presented through biomaterials can instruct cells and enhance their regenerative capacity. Altogether, these studies and experiences provide a positive outlook on future opportunities towards innovative cell-based solutions for treating traumatic muscle injuries-a so far unmet clinical need.
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Affiliation(s)
- Taimoor H Qazi
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Georg N Duda
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin-Brandenburg School for Regenerative Therapies, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Melanie J Ort
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin-Brandenburg School for Regenerative Therapies, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Carsten Perka
- Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sven Geissler
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Tobias Winkler
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Lee JE, Shah VK, Lee EJ, Oh MS, Choi JJ. Melittin - A bee venom component - Enhances muscle regeneration factors expression in a mouse model of skeletal muscle contusion. J Pharmacol Sci 2019; 140:26-32. [PMID: 31113730 DOI: 10.1016/j.jphs.2019.03.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 03/25/2019] [Accepted: 03/27/2019] [Indexed: 12/17/2022] Open
Abstract
Melittin is a major peptide component of sweet bee venom that possesses anti-allergic, anti-inflammatory, anti-arthritis, anti-cancer, and neuroprotective properties. However, the therapeutic effects of melittin on muscle injury have not been elucidated. We investigated the therapeutic effects of melittin on muscle injury in a mouse model of muscle contusion. The biceps femoris muscle of the mice was injured using drop mass method, and the animals were treated with melittin (4, 20, or 100 μg/kg) for 7 days. Melittin significantly increased: locomotor activity in open field test, and treadmill running activity in a dose-dependent manner to level comparable to the positive control, diclofenac (30 mg/kg). Melittin treatment attenuated the pro-inflammatory cytokine MCP-1, TNF-α and IL-6. The expression of muscle regeneration biomarkers, including MyoD (muscle differentiation marker), myogenin, smooth muscle actin, and myosin heavy chain was markedly increased in the injured muscle tissue of melittin-treated mice, as determined by western blotting and quantitative real-time polymerase chain reaction. These results demonstrate that melittin inhibits inflammatory response and improves muscle damage by regenerating muscles in a mouse model of muscle contusion. Taken together, the results of present study suggest that melittin is a promising candidate for the muscle injury treatment.
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Affiliation(s)
- Jae Eun Lee
- Department of Korean Rehabilitation Medicine, Cheonan Korean Medicine Hospital of Daejeon University, Cheonan, 31099, Republic of Korea
| | - Vikash Kumar Shah
- Laboratory of Molecular Medicine, College of Korean Medicine, Daejeon University, Daejeon, 34520, Republic of Korea
| | - Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daejeon, 34520, Republic of Korea
| | - Min-Seok Oh
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daejeon, 34520, Republic of Korea.
| | - Jeong June Choi
- Laboratory of Molecular Medicine, College of Korean Medicine, Daejeon University, Daejeon, 34520, Republic of Korea.
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Fernando CA, Pangan AM, Cornelison D, Segal SS. Recovery of blood flow regulation in microvascular resistance networks during regeneration of mouse gluteus maximus muscle. J Physiol 2019; 597:1401-1417. [PMID: 30575953 DOI: 10.1113/jp277247] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 12/17/2018] [Indexed: 12/11/2022] Open
Abstract
KEY POINTS Skeletal muscle regenerates after injury, however the recovery of its microvascular supply is poorly understood. We injured the gluteus maximus muscle in mice aiming to investigate the recovery of blood flow regulation in microvascular resistance networks. We hypothesized that blood flow regulation recovers in concert with myofibre regeneration. Microvascular perfusion ceased within 1 day post injury and was restored at 5 days coincident with the appearance of new myofibres; however, the resistance network was dilated and unresponsive to vasoactive agents. Spontaneous vasomotor tone, endothelium-dependent dilatation and adrenergic vasoconstriction increased at 10 days in concert with myofibre regeneration. Vasomotor control recovered at 21 days, when regenerated myofibres matured and active force production stabilized. Functional vasodilatation in response to muscle contraction recovered at 35 days. Physiological integrity of microvascular smooth muscle and endothelium recovers in parallel with myofibre regeneration. Additional time is required to restore the efficacy of signalling between myofibres and microvascular networks controlling their oxygen supply. ABSTRACT Myofibre regeneration after skeletal muscle injury is well-studied, although little is known about how microvascular perfusion is restored. The present study aimed to evaluate the recovery of blood flow regulation during skeletal muscle regeneration. In anaesthetized male C57BL/6J mice (aged 4 months), the gluteus maximus muscle (GM) was injured by local injection of barium chloride solution (1.2%, 75 μL). Functional integrity of the resistance network was evaluated at 5, 10, 21 and 35 days post-injury vs. Control by measuring internal diameter of feed arteries, first-, second- and third-order arterioles supplying the GM using intravital microscopy. The resting diameters of all branch orders were significantly greater (P < 0.05) than Control at 5 and 10 days and recovered to Control by 21 days, as did spontaneous vasomotor tone. Vasodilatation to ACh and vasoconstriction to phenylephrine (10-9 to 10-5 m) were absent at 5 days, increased at 10 days and recovered to Control by 21 days; reactivity improved in a distal-to-proximal gradient. Across branch orders, functional vasodilatation to single tetanic contraction (100 Hz, 500 ms) and to rhythmic twitch contractions (4 Hz, 30 s) was impaired at 5 days, improved through 21 days and was not different from Control at 35 days. Peak force development (g) was 60% of Control at 10 days and recovered by 21 days. Diminished vasomotor tone during the initial stages of regeneration promotes tissue perfusion as myofibre recovery begins. Recovery of tone and vasomotor responses to agonists occur in concert with myofibre regeneration. Delayed recovery of functional vasodilatation indicates that additional time is required to restore signalling between contracting myofibres and their vascular supply.
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Affiliation(s)
| | - Aaron M Pangan
- Department of Biomedical, Biological and Chemical Engineering
| | - Ddw Cornelison
- Division of Biological Sciences.,Christopher S. Bond Life Sciences Center
| | - Steven S Segal
- Department of Medical Pharmacology and Physiology.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, USA
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Alsousou J, Harrison P. Therapeutic Platelet-Rich Plasma in Wound Healing. Platelets 2019. [DOI: 10.1016/b978-0-12-813456-6.00065-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Abstract
PURPOSE OF REVIEW This review discusses the current literature regarding the use of platelet-rich plasma (PRP) in the treatment of muscle strain injuries. Case series as well as experimental trials for both human and animal models are covered. RECENT FINDINGS Multiple studies have examined outcomes for the use of PRP in the treatment of muscle strain injuries. PRP has been shown to promote muscle recovery via anabolic growth factors released from activated platelets, and in doing so, potentially reduces pain, swelling, and time for return to play. In vitro studies support the regenerative potential of PRP for acute soft tissue injuries. Multiple clinical case series for PRP injections in the setting of muscle strains demonstrate imaging evidence for faster healing, less swelling, which can decrease time for return to play. These studies, however, are retrospective in nature, and few randomized controlled studies exist to demonstrate a clear clinical benefit. Additionally, there is tremendous heterogeneity regarding the injectant preparation, optimum platelet concentration, presence of leukocytes, and volume of PRP which should be administered as well as number of and timing of treatments.
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Lee H, Lim JY, Choi SJ. Role of l-carnitine and oleate in myogenic differentiation: implications for myofiber regeneration. J Exerc Nutrition Biochem 2018; 22:36-42. [PMID: 30149425 PMCID: PMC6058066 DOI: 10.20463/jenb.2018.0015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 06/18/2018] [Indexed: 01/07/2023] Open
Abstract
[Purpose] Myogenic progenitors play a critical role in injury-induced myofiber regeneration. The purpose of this study was to characterize the effects of oleate and L-carnitine on the overall behavior of proliferating myogenic progenitors (myoblasts) and its link to the mitochondrial biogenic process. [Methods] C2C12 myoblasts were cultured either with no treatment, oleate, L-carnitine, or their mixture. Proliferating myoblasts were investigated under a phase-contrast microscope. Myonuclei and myosin heavy chain were stained with DAPI and MF20 antibody, respectively, in differentiated myotubes and visualized under florescence microscopy. Mitochondrial biogenic markers and porin were assessed by qRT-PCR or immunoblotting. [Results] Increased proliferation rate was observed in myoblasts conditioned with oleate or a mixture of oleate and L-carnitine in contrast to that in non-treated (NT) and L-carnitine-treated myoblasts. Myoblast viability was not statistically different among all tested groups. Fusion index and myotube width were greater in oleate- or L-carnitine-conditioned myotubes than those in NT myotubes, with the greatest effect seen in myotubes conditioned with the mixture. The gene expressions of Pgc1-α, Nrf1, and Tfam were the greatest in myotubes conditioned with the mixture, whereas the level of Ncor1 expression was lower compared to those of the other groups. Protein level of porin was the greatest in myotubes conditioned with the mixture, followed by that of individually treated myotubes with oleate and L-carnitine. [Conclusion] These results provide a critical piece of cellular evidence that combined treatment of oleate and L-carnitine could serve as a potential therapeutic strategy to facilitate biological activation of myogenic progenitors.
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Hotfiel T, Seil R, Bily W, Bloch W, Gokeler A, Krifter RM, Mayer F, Ueblacker P, Weisskopf L, Engelhardt M. Nonoperative treatment of muscle injuries - recommendations from the GOTS expert meeting. J Exp Orthop 2018; 5:24. [PMID: 29931565 PMCID: PMC6013414 DOI: 10.1186/s40634-018-0139-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/11/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Muscle injuries are some of the most common injuries in sports; they have a high recurrence rate and can result in the loss of ability to participate in training or competition. In clinical practice, a wide variety of treatment strategies are commonly applied. However, a limited amount of evidence-based data exists, and most therapeutic approaches are solely based on "best practice". Thus, there is a need for consensus to provide strategies and recommendations for the treatment of muscle injuries. METHODS The 2016 GOTS Expert Meeting, initiated by the German-Austrian-Swiss Society for Orthopaedic Traumatologic Sports Medicine (GOTS), focused on the topic of muscle and tendon injuries and was held in Spreewald/Berlin, Germany. The committee was composed of twenty-two medical specialists. Nine of them were delegated to a subcommittee focusing on the nonoperative treatment of muscle injuries. The recommendations and statements that were developed were reviewed by the entire consensus committee and voted on by the members. RESULTS The committee reached a consensus on the utility and effectiveness of the management of muscle injuries. MAIN RESULTS the "PRICE" principle to target the first inflammatory response is one of the most relevant steps in the treatment of muscle injuries. Haematoma aspiration may be considered in the early stages after injury. There is presently no clear evidence that intramuscular injections are of use in the treatment of muscle injuries. The ingestion of non-steroidal anti-inflammatory drugs (NSAIDs) should be regarded critically because there is currently no hard evidence to support their use, although they are appropriate in exceptional cases. CONCLUSIONS The present work provides a structured overview of the various nonoperative treatment strategies of muscle injuries and evaluates their effectiveness with respect to the existing scientific evidence and clinical expertise in the context of basic science on the healing process of muscle injuries. The committee agreed that there is a compelling need for further studies, including high-quality randomized investigations to completely evaluate the effectiveness of the existing therapeutic approaches. The given recommendations may be updated and adjusted as further evidence will be generated.
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Affiliation(s)
- T Hotfiel
- Department of Orthopaedic Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Rathsbergerstraße 57, D-91054, Erlangen, Germany.
| | - R Seil
- Department of Orthopaedic Surgery, Clinique d'Eich - Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - W Bily
- Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria
| | - W Bloch
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - A Gokeler
- Luxembourg Institute of Research in Orthopedics, Sports Medicine and Science, Luxembourg City, Luxembourg
- Exercise Science and Neuroscience, Department Exercise & Health Faculty of Science, Paderborn University, Paderborn, Germany
| | - R M Krifter
- ORTHOFOCUS-Orthopedic Competence Center, Graz-Salzburg, Austria
| | - F Mayer
- Outpatient Clinic Potsdam, Sports Medicine & Sports Orthopaedics, University of Potsdam, Potsdam, Germany
| | - P Ueblacker
- MW Center of Orthopedics and Sports Medicine, Munich, Germany
| | - L Weisskopf
- Altius Swiss Sportmed Center, Rheinfelden, Switzerland
| | - M Engelhardt
- Department of Trauma and Orthopedic Surgery, Klinikum Osnabrück, Osnabrück, Germany
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35
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Bisciotti GN, Volpi P, Amato M, Alberti G, Allegra F, Aprato A, Artina M, Auci A, Bait C, Bastieri GM, Balzarini L, Belli A, Bellini G, Bettinsoli P, Bisciotti A, Bisciotti A, Bona S, Brambilla L, Bresciani M, Buffoli M, Calanna F, Canata GL, Cardinali D, Carimati G, Cassaghi G, Cautero E, Cena E, Corradini B, Corsini A, D'Agostino C, De Donato M, Delle Rose G, Di Marzo F, Di Pietto F, Enrica D, Eirale C, Febbrari L, Ferrua P, Foglia A, Galbiati A, Gheza A, Giammattei C, Masia F, Melegati G, Moretti B, Moretti L, Niccolai R, Orgiani A, Orizio C, Pantalone A, Parra F, Patroni P, Pereira Ruiz MT, Perri M, Petrillo S, Pulici L, Quaglia A, Ricciotti L, Rosa F, Sasso N, Sprenger C, Tarantola C, Tenconi FG, Tosi F, Trainini M, Tucciarone A, Yekdah A, Vuckovic Z, Zini R, Chamari K. Italian consensus conference on guidelines for conservative treatment on lower limb muscle injuries in athlete. BMJ Open Sport Exerc Med 2018; 4:e000323. [PMID: 29862040 PMCID: PMC5976114 DOI: 10.1136/bmjsem-2017-000323] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 02/14/2018] [Accepted: 03/02/2018] [Indexed: 02/07/2023] Open
Abstract
Provide the state of the art concerning (1) biology and aetiology, (2) classification, (3) clinical assessment and (4) conservative treatment of lower limb muscle injuries (MI) in athletes. Seventy international experts with different medical backgrounds participated in the consensus conference. They discussed and approved a consensus composed of four sections which are presented in these documents. This paper represents a synthesis of the consensus conference, the following four sections are discussed: (i) The biology and aetiology of MIs. A definition of MI was formulated and some key points concerning physiology and pathogenesis of MIs were discussed. (ii) The MI classification. A classification of MIs was proposed. (iii) The MI clinical assessment, in which were discussed anamnesis, inspection and clinical examination and are provided the relative guidelines. (iv) The MI conservative treatment, in which are provided the guidelines for conservative treatment based on the severity of the lesion. Furthermore, instrumental therapy and pharmacological treatment were discussed. Knowledge of the aetiology and biology of MIs is an essential prerequisite in order to plan and conduct a rehabilitation plan. Another important aspect is the use of a rational MI classification on prognostic values. We propose a classification based on radiological investigations performed by ultrasonography and MRI strongly linked to prognostic factors. Furthermore, the consensus conference results will able to provide fundamental guidelines for diagnostic and rehabilitation practice, also considering instrumental therapy and pharmacological treatment of MI. Expert opinion, level IV.
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Affiliation(s)
- Gian Nicola Bisciotti
- Qatar Orthopaedic and Sport Medicine Hospital, Doha, Qatar
- Centro Studi Kinemove Rehabilitation Centers, Pontremoli, Italy
| | - Piero Volpi
- Istituto Clinico Humanitas, Milano, Italy
- FC Internazionale, Milano, Italy
| | | | | | | | | | | | - Alessio Auci
- UOS Angiografia e Radiologia Interventistica, Ospedale delle Apuane, Massa-Carrara, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Emanuele Cena
- Qatar Orthopaedic and Sport Medicine Hospital, Doha, Qatar
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Biagio Moretti
- Azienda Ospedaliero-Universitaria “Policlinico”, Bari, Italy
| | - Lorenzo Moretti
- Azienda Ospedaliero-Universitaria “Policlinico”, Bari, Italy
| | | | | | | | | | - Federica Parra
- Centro Studi Kinemove Rehabilitation Centers, Pontremoli, Italy
| | | | | | | | | | - Luca Pulici
- Istituto Ortopedico Gaetano Pini, Milano, Italy
| | | | - Luca Ricciotti
- Centro Studi Kinemove Rehabilitation Centers, Pontremoli, Italy
| | | | | | | | | | | | - Fabio Tosi
- Centro Studi Kinemove Rehabilitation Centers, Pontremoli, Italy
| | | | | | - Ali Yekdah
- FAF Jenia Centre Med Sport, Algeri, Algeria
| | - Zarko Vuckovic
- Qatar Orthopaedic and Sport Medicine Hospital, Doha, Qatar
| | - Raul Zini
- Maria Cecilia Hospital, Cotignola, Italy
| | - Karim Chamari
- Qatar Orthopaedic and Sport Medicine Hospital, Doha, Qatar
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36
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An aPPARent Functional Consequence in Skeletal Muscle Physiology via Peroxisome Proliferator-Activated Receptors. Int J Mol Sci 2018; 19:ijms19051425. [PMID: 29747466 PMCID: PMC5983589 DOI: 10.3390/ijms19051425] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 05/05/2018] [Accepted: 05/08/2018] [Indexed: 12/12/2022] Open
Abstract
Skeletal muscle comprises 30–40% of the total body mass and plays a central role in energy homeostasis in the body. The deregulation of energy homeostasis is a common underlying characteristic of metabolic syndrome. Over the past decades, peroxisome proliferator-activated receptors (PPARs) have been shown to play critical regulatory roles in skeletal muscle. The three family members of PPAR have overlapping roles that contribute to the myriad of processes in skeletal muscle. This review aims to provide an overview of the functions of different PPAR members in energy homeostasis as well as during skeletal muscle metabolic disorders, with a particular focus on human and relevant mouse model studies.
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Giraudo C, Motyka S, Weber M, Karner M, Resinger C, Feiweier T, Trattnig S, Bogner W. Normalized STEAM-based diffusion tensor imaging provides a robust assessment of muscle tears in football players: preliminary results of a new approach to evaluate muscle injuries. Eur Radiol 2018; 28:2882-2889. [PMID: 29423575 PMCID: PMC5986840 DOI: 10.1007/s00330-017-5218-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/27/2017] [Accepted: 11/28/2017] [Indexed: 12/20/2022]
Abstract
Objectives To assess acute muscle tears in professional football players by diffusion tensor imaging (DTI) and evaluate the impact of normalization of data. Methods Eight football players with acute lower limb muscle tears were examined. DTI metrics of the injured muscle and corresponding healthy contralateral muscle and of ROIs drawn in muscle tears (ROItear) in the corresponding healthy contralateral muscle (ROIhc_t) in a healthy area ipsilateral to the injury (ROIhi) and in a corresponding contralateral area (ROIhc_i) were compared. The same comparison was performed for ratios of the injured (ROItear/ROIhi) and contralateral sides (ROIhc_t/ROIhc_i). ANOVA, Bonferroni-corrected post-hoc and Student’s t-tests were used. Results Analyses of the entire muscle did not show any differences (p>0.05 each) except for axial diffusivity (AD; p=0.048). ROItear showed higher mean diffusivity (MD) and AD than ROIhc_t (p<0.05). Fractional anisotropy (FA) was lower in ROItear than in ROIhi and ROIhc_t (p<0.05). Radial diffusivity (RD) was higher in ROItear than in any other ROI (p<0.05). Ratios revealed higher MD and RD and lower FA and reduced number and length of fibre tracts on the injured side (p<0.05 each). Conclusions DTI allowed a robust assessment of muscle tears in athletes especially after normalization to healthy muscle tissue. Key Points • STEAM-based DTI allows the investigation of muscle tears affecting professional football players. • Fractional anisotropy and mean diffusivity differ between injured and healthy muscle areas. • Only normalized data show differences of fibre tracking metrics in muscle tears. • The normalization of DTI-metrics enables a more robust characterization of muscle tears.
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Affiliation(s)
- Chiara Giraudo
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Stanislav Motyka
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Michael Weber
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Manuela Karner
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | | | | | - Siegfried Trattnig
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular MR Imaging, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Bogner
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
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38
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Oyaizu T, Enomoto M, Yamamoto N, Tsuji K, Horie M, Muneta T, Sekiya I, Okawa A, Yagishita K. Hyperbaric oxygen reduces inflammation, oxygenates injured muscle, and regenerates skeletal muscle via macrophage and satellite cell activation. Sci Rep 2018; 8:1288. [PMID: 29358697 PMCID: PMC5778072 DOI: 10.1038/s41598-018-19670-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/04/2018] [Indexed: 12/17/2022] Open
Abstract
Hyperbaric oxygen treatment (HBO) promotes rapid recovery from soft tissue injuries. However, the healing mechanism is unclear. Here we assessed the effects of HBO on contused calf muscles in a rat skeletal muscle injury model. An experimental HBO chamber was developed and rats were treated with 100% oxygen, 2.5 atmospheres absolute for 2 h/day after injury. HBO reduced early lower limb volume and muscle wet weight in contused muscles, and promoted muscle isometric strength 7 days after injury. HBO suppressed the elevation of circulating macrophages in the acute phase and then accelerated macrophage invasion into the contused muscle. This environment also increased the number of proliferating and differentiating satellite cells and the amount of regenerated muscle fibers. In the early phase after injury, HBO stimulated the IL-6/STAT3 pathway in contused muscles. Our results demonstrate that HBO has a dual role in decreasing inflammation and accelerating myogenesis in muscle contusion injuries.
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Affiliation(s)
- Takuya Oyaizu
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8519, Japan.,Hyperbaric Medical Center, Medical Hospital, Tokyo Medical and Dental University, Tokyo, 113-8519, Japan
| | - Mitsuhiro Enomoto
- Hyperbaric Medical Center, Medical Hospital, Tokyo Medical and Dental University, Tokyo, 113-8519, Japan. .,Sports Medicine Clinical Center, Medical Hospital, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8519, Japan.
| | - Naoki Yamamoto
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8519, Japan.,Hyperbaric Medical Center, Medical Hospital, Tokyo Medical and Dental University, Tokyo, 113-8519, Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Masaki Horie
- Hyperbaric Medical Center, Medical Hospital, Tokyo Medical and Dental University, Tokyo, 113-8519, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Atsushi Okawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Kazuyoshi Yagishita
- Hyperbaric Medical Center, Medical Hospital, Tokyo Medical and Dental University, Tokyo, 113-8519, Japan.,Sports Medicine Clinical Center, Medical Hospital, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8519, Japan
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Maarman GJ, Reiter RJ. Melatonin therapy for blunt trauma and strenuous exercise: A mechanism involving cytokines, NFκB, Akt, MAFBXand MURF-1. J Sports Sci 2018; 36:1897-1901. [DOI: 10.1080/02640414.2018.1424491] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Gerald J. Maarman
- Hatter Institute for Cardiovascular Disease in Africa (HICRA), Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Russel J. Reiter
- Department of Cellular and Structural Biology, UT Health San Antonio, San Antonio, TX, USA
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Orava S, Sinikumpu JJ, Sarimo J, Lempainen L, Mann G, Hetsroni I. Surgical excision of symptomatic mature posttraumatic myositis ossificans: characteristics and outcomes in 32 athletes. Knee Surg Sports Traumatol Arthrosc 2017; 25:3961-3968. [PMID: 28780628 DOI: 10.1007/s00167-017-4667-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 07/31/2017] [Indexed: 01/15/2023]
Abstract
PURPOSE The purpose of this study was to report characteristics and outcomes of surgical excision of symptomatic mature posttraumatic myositis ossificans in adult athletes. The hypothesis was that surgical excision of the ossified mass in these circumstances can effectively relief symptoms and result in return to high-level sports with minimal postoperative complications. METHODS All operations involving excision of posttraumatic heterotopic ossifications performed between 1987 and 2015 were reviewed. Included cases had isolated excision of posttraumatic myositis ossificans, whereas excluded cases had: (1) concomitant reattachment of tendon to bone; (2) chronic overuse injuries which preceded the development of the heterotopic mass or large calcifications which were excised from tendon-to-bone insertions; and (3) excision of heterotopic ossification from a ligament, capsule, or tendon insertion following avulsion injury without tendon-to-bone repair. After surgery, return to sports was allowed at 4-6 weeks. RESULTS Of 57 athletes undergoing excision of heterotopic ossifications, 32 were eligible as isolated excision of posttraumatic myositis ossificans. Twenty-four (75%) were ice hockey or soccer players. Median age was 23 years. Prior to surgery, patients were unable to continue their sports. At surgery, the ossification was excised from a thigh muscle in 27 (84%) cases. Median follow-up was 2 years (range 1-20 years). Outcome was Good/Excellent in 26 (81%) patients, corresponding to return to preinjury sports with minimal symptoms at sports activities. Preinjury Tegner activity level was resumed after surgery in 30 of 32 (94%) athletes, of whom 28 (94%) were involved in high-level sports corresponding to Tegner levels 8-10. No postoperative complications were recorded other than minimal insensitive areas at the periphery of skin incisions. CONCLUSION In high-level athletes who present chronic disabling mature posttraumatic myositis ossificans that interferes with their sports career, surgical excision of the heterotopic mass results in effective clinical improvement with return to sports and minimal postoperative risks. LEVEL OF EVIDENCE Case series, Level IV.
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Affiliation(s)
- Sakari Orava
- Sports Injury Research Center, Hospital NEO, Turku, Finland
| | - Juha-Jaakko Sinikumpu
- Department of Pediatric Surgery and Orthopedics, Oulu University Hospital, Oulu, Finland.,Pedego Research Group, MRC, Oulu University, Oulu, Finland.,Mehiläinen Sports Clinic, Oulu, Finland
| | - Janne Sarimo
- Sports Injury Research Center, Hospital NEO, Turku, Finland
| | | | - Gideon Mann
- Department of Orthopedic Surgery, Meir General Hospital, Kfar Saba, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Iftach Hetsroni
- Department of Orthopedic Surgery, Meir General Hospital, Kfar Saba, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Zissler A, Steinbacher P, Zimmermann R, Pittner S, Stoiber W, Bathke AC, Sänger AM. Extracorporeal Shock Wave Therapy Accelerates Regeneration After Acute Skeletal Muscle Injury. Am J Sports Med 2017; 45:676-684. [PMID: 27729321 DOI: 10.1177/0363546516668622] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Muscle injuries are among the most common sports-related lesions in athletes; however, optimal treatment remains obscure. Extracorporeal shock wave therapy (ESWT) may be a promising approach in this context, because it has gained increasing importance in tissue regeneration in various medical fields. HYPOTHESIS ESWT stimulates and accelerates regenerative processes of acute muscle injuries. STUDY DESIGN Controlled laboratory study. METHODS Adult Sprague-Dawley rats were divided into 4 experimental groups (2 ESWT+ groups and 2 ESWT- groups) as well as an uninjured control group (n ≥ 6 in each group). An acute cardiotoxin-induced injury was set into the quadriceps femoris muscle of rats in the experimental groups. A single ESWT session was administered to injured muscles of the ESWT+ groups 1 day after injury, whereas ESWT- groups received no further treatment. At 4 and 7 days after injury, 1 each of the ESWT+ and ESWT- groups was euthanized. Regenerating lesions were excised and analyzed by histomorphometry and immunohistochemistry to assess fiber size, myonuclear content, and recruitment of satellite cells. RESULTS The size and myonuclear content of regenerating fibers in ESWT+ muscle was significantly increased compared with ESWT- muscle fibers at both 4 and 7 days after injury. Similarly, at both time points, ESWT+ muscles exhibited significantly higher contents of pax7-positive satellite cells, mitotically active H3P+ cells, and, of cells expressing the myogenic regulatory factors, myoD and myogenin, indicating enhanced proliferation and differentiation rates of satellite cells after ESWT. Mitotic activity at 4 days after injury was doubled in ESWT+ compared with ESWT- muscles. CONCLUSION ESWT stimulates regeneration of skeletal muscle tissue and accelerates repair processes. CLINICAL RELEVANCE We provide evidence for accelerated regeneration of damaged skeletal muscle after ESWT. Although further studies are necessary, our findings support the view that ESWT is an effective method to improve muscle healing, with special relevance to sports injuries.
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Affiliation(s)
- Angela Zissler
- Department of Cell Biology, University of Salzburg, Salzburg, Austria
| | - Peter Steinbacher
- Department of Cell Biology, University of Salzburg, Salzburg, Austria
| | - Reinhold Zimmermann
- Department of Urology and Andrology, Salzburg General Hospital, Salzburg, Austria
| | - Stefan Pittner
- Department of Cell Biology, University of Salzburg, Salzburg, Austria
| | - Walter Stoiber
- Department of Cell Biology, University of Salzburg, Salzburg, Austria
| | - Arne C Bathke
- Department of Mathematics, University of Salzburg, Salzburg, Austria
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Abstract
Clinical Scenario: Even though chronological aging is an inevitable phenomenological consequence occurring in every living organism, it is biological aging that may be the most significant factor challenging our quality of life. Development of functional limitations, resulting from improper maintenance and restoration of various organ systems, ultimately leads to reduced health and independence. Skeletal muscle is an organ system that, when challenged, is often injured in response to varying stimuli. Overt muscle-strain injury can be traumatic, clinically diagnosable, properly managed, and a remarkably common event, yet our contemporary understanding of how age and environmental stressors affect the initial and subsequent induction of injury and how the biological processes resulting from this event are modifiable and, eventually, lead to functional restoration and healing of skeletal muscle and adjacent tissues is presently unclear. Even though the secondary injury response to and recovery from "contraction-induced" skeletal-muscle injury are impaired with aging, there is no scientific consensus as to the exact mechanism responsible for this event. Given the multitude of investigative approaches, particular consideration given to the appropriateness of the muscle-injury model, or research paradigm, is critical so that outcomes may be physiologically relevant and translational. In this case, methods implementing stretch-shortening contractions, the most common form of muscle movements used by all mammals during physical movement, work, and activity, are highlighted. CLINICAL RELEVANCE Understanding the fundamental evidence regarding how aging influences the responsivity of skeletal muscle to strain injury is vital for informing how clinicians approach and implement preventive strategies, as well as therapeutic interventions. From a practical perspective, maintaining or improving the overall health and tissue quality of skeletal muscle as one ages will positively affect skeletal muscle's safety threshold and responsivity, which may reduce incidence of injury, improve recovery time, and lessen overall fiscal burdens.
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43
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Aurora A, Corona BT, Walters TJ. A Porcine Urinary Bladder Matrix Does Not Recapitulate the Spatiotemporal Macrophage Response of Muscle Regeneration after Volumetric Muscle Loss Injury. Cells Tissues Organs 2016; 202:189-201. [PMID: 27825152 DOI: 10.1159/000447582] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2016] [Indexed: 11/19/2022] Open
Abstract
Volumetric muscle loss (VML) results in irrecoverable loss of muscle tissue making its repair challenging. VML repair with acellular extracellular matrix (ECM) scaffolds devoid of exogenous cells has shown improved muscle function, but limited de novo muscle fiber regeneration. On the other hand, studies using minced autologous and free autologous muscle grafts have reported appreciable muscle regeneration. This raises the fundamental question whether an acellular ECM scaffold can orchestrate the spatiotemporal cellular events necessary for appreciable muscle fiber regeneration. This study compares the macrophage and angiogenic responses including the remodeling outcomes of a commercially available porcine urinary bladder matrix, MatriStem™, and autologous muscle grafts. The early heightened and protracted M1 response of the scaffold indicates that the scaffold does not recapitulate the spatiotemporal macrophage response of the autograft tissue. Additionally, the scaffold only supports limited de novo muscle fiber formation and regressing vessel density. Furthermore, scaffold remodeling is accompanied by increased presence of transforming growth factor and α-smooth muscle actin, which is consistent with remodeling of the scaffold into a fibrotic scar-like tissue. The limited muscle formation and scaffold-mediated fibrosis noted in this study corroborates the findings of recent studies that investigated acellular ECM scaffolds (devoid of myogenic cells) for VML repair. Taken together, acellular ECM scaffolds when used for VML repair will likely remodel into a fibrotic scar-like tissue and support limited de novo muscle fiber regeneration primarily in the proximity of the injured musculature. This is a work of the US Government and is not subject to copyright protection in the USA. Foreign copyrights may apply. Published by S. Karger AG, Basel.
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Belair JA, Hegazi TM, Roedl JB, Zoga AC, Omar IM. Core Injuries Remote from the Pubic Symphysis. Radiol Clin North Am 2016; 54:893-911. [PMID: 27545427 DOI: 10.1016/j.rcl.2016.04.009] [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: 10/21/2022]
Abstract
The core, or central musculoskeletal system of the torso, is essential for participating in sports and other physical activities. Core injuries are commonly encountered in athletes and active individuals. The importance of the midline pubic plate and rectus abdominis-adductor aponeurosis for core stability and function is discussed in the literature. This review article examines other important core injuries remote from the pubic symphysis, relevant clinical features, and preferred approaches to imaging. Several specific syndromes encountered in the core are reviewed. By protocoling imaging studies and identifying pathology, radiologists can add value to the clinical decision-making process and help guide therapeutic options.
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Affiliation(s)
- Jeffrey A Belair
- Division of Musculoskeletal Imaging and Interventions, Department of Radiology, Jefferson Medical College, Thomas Jefferson University Hospital, Thomas Jefferson University, 132 South 10th Street, Suite 1096, 1087 Main Building, Philadelphia, PA 19107, USA.
| | - Tarek M Hegazi
- Division of Musculoskeletal Imaging and Interventions, Department of Radiology, Jefferson Medical College, Thomas Jefferson University Hospital, Thomas Jefferson University, 132 South 10th Street, Suite 1096, 1087 Main Building, Philadelphia, PA 19107, USA; Department of Radiology, University of Dammam, PO Box 2114, Dammam 31451, Saudi Arabia
| | - Johannes B Roedl
- Division of Musculoskeletal Imaging and Interventions, Department of Radiology, Jefferson Medical College, Thomas Jefferson University Hospital, Thomas Jefferson University, 132 South 10th Street, Suite 1096, 1087 Main Building, Philadelphia, PA 19107, USA
| | - Adam C Zoga
- Division of Musculoskeletal Imaging and Interventions, Department of Radiology, Jefferson Medical College, Thomas Jefferson University Hospital, Thomas Jefferson University, 132 South 10th Street, Suite 1096, 1087 Main Building, Philadelphia, PA 19107, USA
| | - Imran M Omar
- Department of Radiology, Northwestern Memorial Hospital, 676 North Saint Clair Street, Suite 800, Chicago, IL 60611, USA
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45
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Orlandi D, Corazza A, Arcidiacono A, Messina C, Serafini G, Sconfienza LM, Silvestri E. Ultrasound-guided procedures to treat sport-related muscle injuries. Br J Radiol 2015; 89:20150484. [PMID: 26562097 DOI: 10.1259/bjr.20150484] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Ultrasound is well known as a low-cost, radiation-free and effective imaging technique to guide percutaneous procedures. The lower limb muscles represent a good target to perform such procedures under ultrasound guidance, thus allowing for clear and precise visualization of the needle during the whole procedure. The knowledge of guidelines and technical aspects is mandatory to act in the most safe and accurate way on target tissues that can be as small as a few millimetres. This review will focus above the local treatments of traumatic lower limb muscle injuries described in literature, focusing on new and promising approaches, such as platelet-rich plasma treatment of muscle tears in athletes. For each procedure, a brief how-to-do practical guide will be provided, emphasizing precautions and tricks based on day-by-day experience that may help to improve the outcome of percutaneous ultrasound-guided procedures around the lower limb muscles.
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Affiliation(s)
- Davide Orlandi
- 1 Department of Radiology, Genoa University, Genova, Italy
| | - Angelo Corazza
- 1 Department of Radiology, Genoa University, Genova, Italy
| | | | - Carmelo Messina
- 2 Department of Radiology, IRCCS Policlinico San Donato, Milano, Italy
| | - Giovanni Serafini
- 3 Department of Radiology, Ospedale Santa Corona, Pietra Ligure, Savona, Italy
| | - Luca M Sconfienza
- 2 Department of Radiology, IRCCS Policlinico San Donato, Milano, Italy.,4 Department of Biomedical Sciences for Health, Università degli Studi di Milano, Italy
| | - Enzo Silvestri
- 5 Department of Radiology, Ospedale Evangelico Internazionale, Genoa, Italy
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46
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Tiidus PM. Alternative treatments for muscle injury: massage, cryotherapy, and hyperbaric oxygen. Curr Rev Musculoskelet Med 2015; 8:162-7. [PMID: 25724774 DOI: 10.1007/s12178-015-9261-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Current evidence suggests that popular alternative therapies such as massage, cryotherapy, and hyperbaric oxygen exposure as currently practiced on humans have little effect on recovery from minor muscle damage such as induced by exercise. While further research is still needed, hyperbaric oxygen exposure shows clear promise for potentially being a successful adjunct treatment for enhancing muscle repair and recovery from more severe crush on contusion injury in humans. Cryotherapy or icing, as currently practiced, will not likely be successful in cooling muscle sufficiently to have any significant influence on muscle repair regardless of the degree of injury. However, based on studies in animal models, it may be that if sufficient muscle cooling could be achieved in humans, it could actually delay recovery and increase muscle scarring following significant muscle damage. Conclusions about the effectiveness of massage on influencing muscle recovery from more severe injury cannot yet be made due to a lack of experimental evidence with a more significant muscle damage model.
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Affiliation(s)
- Peter M Tiidus
- Health Sciences Program & Department of Kinesiology, Wilfrid Laurier University, Waterloo, ON, N2L 3C5, Canada,
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Abstract
Skeletal muscle injuries are among the most common sports-related injuries that result in time lost from practice and competition. The cellular response to muscle injury can often result in changes made to the muscle fibers as well as the surrounding extracellular matrix during repair. This can negatively affect the force and range of the injured muscle even after the patient's return to play. Diagnosis of skeletal muscle injury involves both history and physical examinations; imaging modalities including ultrasound and magnetic resonance imaging (MRI) can also be used to assess the extent of injury. Current research is investigating potential methods, including clinical factors and MRI, by which to predict a patient's return to sports. Overall, function of acutely injured muscles seems to improve with time. Current treatment methods for skeletal muscle injuries include injections of steroids, anesthetics, and platelet-rich plasma (PRP). Other proposed methods involve inhibitors of key players in fibrotic pathways, such as transforming growth factor (TGF)-ß and angiotensin II, as well as muscle-derived stem cells.
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Affiliation(s)
- Stephanie Wong
- Department of Orthopaedic Surgery, University of California, 1500 Owens Ave, Box 3004, San Francisco, CA, 94127, USA
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Delos D, Leineweber MJ, Chaudhury S, Alzoobaee S, Gao Y, Rodeo SA. The effect of platelet-rich plasma on muscle contusion healing in a rat model. Am J Sports Med 2014; 42:2067-74. [PMID: 25056987 DOI: 10.1177/0363546514540272] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Current therapy for muscle contusions is usually limited to nonsteroidal anti-inflammatory drugs and/or use of the RICE principle (rest, ice, compression, elevation); thus, other forms of treatment that can potentially accelerate the rate of healing are desirable. HYPOTHESES A local injection of platelet-rich plasma (PRP) would lead to accelerated healing rates compared with controls; also, delayed administration of PRP would lead to a blunted response compared with immediate treatment. STUDY DESIGN Controlled laboratory study. METHODS Forty-six male Lewis rats each underwent a single blunt, nonpenetrating impact to the gastrocnemius muscle via a drop-mass technique and subsequently received either a single injection of saline into the area of injury immediately after injury (controls, n = 11) or rat PRP (either immediately after injury [PRP day 0, n = 12], the first day after injury [PRP day 1, n = 12], or the third day after injury [PRP day 3, n = 11]). The primary outcome was maximal isometric torque strength of the injured muscle, which was assessed before injury as well as on postinjury days 1, 4, 7, 10, and 14. All animals were sacrificed on postinjury day 15. Histological and immunohistochemical analyses were performed on 6 specimens from each group after sacrifice. RESULTS The mean platelet concentration in the PRP was 2.19 × 10(6) (±2.69 × 10(5))/μL. The mean white blood cell count in the PRP was 22.54 × 10(3)/μL. Each group demonstrated statistically significant decreases in maximal isometric torque strength after injury when compared with preinjury levels, followed by significant increases back toward baseline values by postinjury day 14 (controls, 90.6% ± 7.90%; PRP day 0, 105.0% ± 7.60%; PRP day 1, 92.4% ± 7.60%; PRP day 3, 77.8% ± 7.90%) (P = .121). There were no statistically significant differences between the treatment and control groups at any of the time points. There were also no statistically significant differences between any of the groups in the percentage of centronucleated fibers (controls, 3.31% ± 5.10%; PRP day 0, 0.62% ± 1.59%; PRP day 1, 3.24% ± 5.77%; PRP day 3, 2.13% ± 3.26%) (P = .211) or the presence of inflammatory cells and macrophages. CONCLUSION In this rat contusion model, a local injection of PRP into the injured gastrocnemius muscle resulted in no significant differences in functional or histological outcomes, indicating no likely benefit to healing. Additionally, there was no significant difference between immediate or delayed administration of PRP. CLINICAL RELEVANCE Before PRP can be recommended for the treatment of muscle contusion injuries, further translational and clinical investigations need to be performed.
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Affiliation(s)
- Demetris Delos
- Orthopaedic and Neurosurgery Specialists, Greenwich, Connecticut, USA
| | - Matthew J Leineweber
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York, USA
| | - Salma Chaudhury
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Saif Alzoobaee
- Weill Medical College, Cornell University, New York, New York, USA
| | - Yingxin Gao
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York, USA
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