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Ahmadi B, Duarte FCK, Srbely J, Bartlewski PM. Ultrasound-based assessment of the expression of inflammatory markers in the rectus femoris muscle of rats. Exp Biol Med (Maywood) 2024; 249:10064. [PMID: 38463389 PMCID: PMC10911122 DOI: 10.3389/ebm.2024.10064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/30/2024] [Indexed: 03/12/2024] Open
Abstract
Ultrasonographic characteristics of skeletal muscles are related to their health status and functional capacity, but they still provide limited information on muscle composition during the inflammatory process. It has been demonstrated that an alteration in muscle composition or structure can have disparate effects on different ranges of ultrasonogram pixel intensities. Therefore, monitoring specific clusters or bands of pixel intensity values could help detect echotextural changes in skeletal muscles associated with neurogenic inflammation. Here we compare two methods of ultrasonographic image analysis, namely, the echointensity (EI) segmentation approach (EI banding method) and detection of selective pixel intensity ranges correlated with the expression of inflammatory regulators using an in-house developed computer algorithm (r-Algo). This study utilized an experimental model of neurogenic inflammation in segmentally linked myotomes (i.e., rectus femoris (RF) muscle) of rats subjected to lumbar facet injury. Our results show that there were no significant differences in RF echotextural variables for different EI bands (with 50- or 25-pixel intervals) between surgery and sham-operated rats, and no significant correlations among individual EI band pixel characteristics and protein expression of inflammatory regulators studied. However, mean numerical pixel values for the pixel intensity ranges identified with the proprietary r-Algo computer program correlated with protein expression of ERK1/2 and substance P (both 86-101-pixel ranges) and CaMKII (86-103-pixel range) in RF, and were greater (p < 0.05) in surgery rats compared with their sham-operated counterparts. Our findings indicate that computer-aided identification of specific pixel intensity ranges was critical for ultrasonographic detection of changes in the expression of inflammatory mediators in neurosegmentally-linked skeletal muscles of rats after facet injury.
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Affiliation(s)
- Bahareh Ahmadi
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Felipe C. K. Duarte
- School of Health, Medical and Applied Sciences, Central Queensland University, Brisbane, QLD, Australia
| | - John Srbely
- Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, ON, Canada
| | - Pawel M. Bartlewski
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Duarte FCK, Chien R, Ghazinour G, Murnaghan K, West DWD, Kumbhare DA. Myofascial Pain as an Unseen Comorbidity in Osteoarthritis: A Scoping Review. Clin J Pain 2023; 39:188-201. [PMID: 36943163 DOI: 10.1097/ajp.0000000000001102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/25/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVE This review aimed to identify, summarize, and appraise the evidence supporting the coexistence of myofascial pain (MPS) and trigger points (MTrP) in osteoarthritis (OA), and the effectiveness of MTrPs treatments in OA-related pain and physical function outcomes. METHODS Three databases were searched from inception to June 2022. We included observational and experimental studies to fulfill our 2 study aims. Two independent reviewers conducted 2-phase screening procedures and risk of bias using checklist tools for cross-sectional, quasi-experimental, and randomized control trials. Patient characteristics, findings of active and latent MTrPs in relevant muscles, treatments, and pain and physical function outcomes were extracted from low-risk bias studies. RESULTS The literature search yielded 2898 articles, of which 6 observational and 7 experimental studies had a low bias risk and the data extracted. Active MTrPs in knee OA patients was more evident in the quadriceps and hamstring muscles than in healthy individuals. Dry needling on active MTrPs improved pain and physical function in the short term compared with sham treatment in hip OA patients. In knee OA, dry needling on latent or active MTrPs improved pain and functional outcomes compared with sham needling but did not result in better pain and physical outcomes when combined with a physical exercise program. DISCUSSION The presence of active versus latent MTrPs seems to be a more sensitive discriminating feature of OA given that latent is often present in OA and healthy individuals. Dry needling on active MTrPs improved pain and physical function in the short term compared with sham treatment in hip OA patients. However, the small sample size and the few number of studies limit any firm recommendation on the treatment. REGISTRY The study protocol was prospectively registered in Open Science Framework (https://doi.org/10.17605/OSF.IO/8DVU3).
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Affiliation(s)
- Felipe C K Duarte
- Canadian Memorial Chiropractic College
- KITE Research, Toronto Rehabilitation Institute, University Health Network
- Discipline of Chiropractic, School of Health, Medical and Applied Sciences, CQUniversity, Brisbane, Australia
| | | | - Golnaz Ghazinour
- Faculty of Kinesiology and Physical Education, University of Toronto
| | | | - Daniel W D West
- Faculty of Kinesiology and Physical Education, University of Toronto
- Discipline of Chiropractic, School of Health, Medical and Applied Sciences, CQUniversity, Brisbane, Australia
| | - Dinesh A Kumbhare
- Faculty of Kinesiology and Physical Education, University of Toronto
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Discipline of Chiropractic, School of Health, Medical and Applied Sciences, CQUniversity, Brisbane, Australia
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Kumbhare D, Hassan S, Diep D, Duarte FCK, Hung J, Damodara S, West DWD, Selvaganapathy PR. Potential role of blood biomarkers in patients with fibromyalgia: a systematic review with meta-analysis. Pain 2022; 163:1232-1253. [PMID: 34966131 DOI: 10.1097/j.pain.0000000000002510] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 09/30/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Fibromyalgia (FM) is a complex chronic pain condition. Its symptoms are nonspecific, and to date, no objective test exists to confirm FM diagnosis. Potential objective measures include the circulating levels of blood biomarkers. This systematic review and meta-analysis aim to review studies assessing blood biomarkers' levels in patients with FM compared with healthy controls. We systematically searched the PubMed, MEDLINE, EMBASE, and PsycINFO databases. Fifty-four studies reporting the levels of biomarkers in blood in patients with FM were included. Data were extracted, and the methodological quality was assessed independently by 2 authors. The methodological quality of 9 studies (17%) was low. The results of most studies were not directly comparable given differences in methods and investigated target immune mediators. Thus, data from 40 studies only were meta-analyzed using a random-effects model. The meta-analysis showed that patients with FM had significantly lower levels of interleukin-1 β and higher levels of IL-6, IL-8, tumor necrosis factor-alpha, interferon gamma, C-reactive protein, and brain-derived neurotrophic factor compared with healthy controls. Nevertheless, this systematic literature review and meta-analysis could not support the notion that these blood biomarkers are specific biomarkers of FM. Our literature review, however, revealed that these same individual biomarkers may have the potential role of identifying underlying pathologies or other conditions that often coexist with FM. Future research is needed to evaluate the potential clinical value for these biomarkers while controlling for the various confounding variables.
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Affiliation(s)
- Dinesh Kumbhare
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Mechanical Engineering, McMaster School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
| | - Samah Hassan
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Dion Diep
- MD Program, University of Toronto, Toronto, ON, Canada
| | - Felipe C K Duarte
- Division of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Jasper Hung
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Sreekant Damodara
- Department of Mechanical Engineering, McMaster School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
| | - Daniel W D West
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - P Ravi Selvaganapathy
- Department of Mechanical Engineering, McMaster School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
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Duarte FCK, Funabashi M, Starmer D, Partata WA, West DWD, Kumbhare DA, Injeyan S. Effects of Distinct Force Magnitude of Spinal Manipulative Therapy on Blood Biomarkers of Inflammation: A Proof of Principle Study in Healthy Young Adults. J Manipulative Physiol Ther 2022; 45:20-32. [PMID: 35760595 DOI: 10.1016/j.jmpt.2022.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 03/16/2022] [Accepted: 03/16/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The purpose of this preliminary study was to determine the influence of thoracic spinal manipulation therapy (SMT) of different force magnitudes on blood biomarkers of inflammation in healthy adults. METHODS Nineteen healthy young adults (10 female, age: 25.6 ± 1.2 years) were randomized into the following 3 groups: (1) control (preload only), (2) single thoracic SMT with a total peak force of 400N, and (3) single thoracic SMT with a total peak force of 800N. SMT was performed by an experienced chiropractor, and a force-plate embedded treatment table (Force Sensing Table Technology) was used to determine the SMT force magnitudes applied. Blood samples were collected at pre intervention (baseline), immediately post intervention, and 20 minutes post intervention. A laboratory panel of 14 different inflammatory biomarkers (pro, anti, dual role, chemokine, and growth factor) was assessed by multiplex array. Change scores from baseline of each biomarker was used for statistical analysis. Two-way repeated-measures analysis of variance was used to investigate the interaction and main effects of intervention and time on cytokines, followed by Tukey's multiple comparison test (P ≤ .05). RESULTS A between-group (800N vs 400N) difference was observed on interferon-gamma, interleukin (IL)-5, and IL-6, while a within-group difference (800N: immediately vs 20 minutes post-intervention) was observed on IL-6 only. CONCLUSION In this study, we measured short-term changes in plasma cytokines in healthy young adults and found that select plasma pro-inflammatory and dual-role cytokines were elevated by higher compared to lower SMT force. Our findings aid to advance our understanding of the potential relationship between SMT force magnitude and blood cytokines and provide a healthy baseline group with which to compare similar studies in clinical populations in the future.
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Affiliation(s)
- Felipe C K Duarte
- Division of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada; KITE Research, Toronto Rehabilitation Institute, University of Health Network, Toronto, Ontario, Canada.
| | - Martha Funabashi
- Division of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada; Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
| | - David Starmer
- Division of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Wania A Partata
- Department of Physiology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Daniel W D West
- KITE Research, Toronto Rehabilitation Institute, University of Health Network, Toronto, Ontario, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Dinesh A Kumbhare
- KITE Research, Toronto Rehabilitation Institute, University of Health Network, Toronto, Ontario, Canada; Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Ontario, Canada
| | - Stephen Injeyan
- Division of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
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Funabashi M, Wang S, Lee AD, C K Duarte F, Budgell B, Stilwell P, Hogg-Johnson S. Discomfort, pain and stiffness: what do these terms mean to patients? A cross-sectional survey with lexical and qualitative analyses. BMC Musculoskelet Disord 2022; 23:283. [PMID: 35331201 PMCID: PMC8944041 DOI: 10.1186/s12891-022-05214-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While pain is often the focus of clinical interventions, other clinical outcomes (e.g., discomfort, stiffness) might also contribute to patients' functionality and well-being. Although researchers and clinicians may view discomfort, pain and stiffness as different constructs, it remains unclear how patients perceive and differentiate between these constructs. Therefore, the purpose of this study was to explore patients' perceptions of pain, discomfort, and stiffness. METHODS Chiropractic patients were invited to complete an online cross-sectional survey and describe what 'discomfort', 'pain' and 'stiffness' meant to them using their own words. Lexical and inductive qualitative content analyses were conducted independently and then triangulated. RESULTS Fifty-three chiropractic patients (47.2% female, mean age: 39.1 ± 15.1 years) responded. The most common combinations of words to describe discomfort were "can be ignored" and "less severe than". "Cannot be ignored" and "sharp shooting" were used to describe pain. "Limited range of motion" was used to describe stiffness. Qualitatively, five themes were developed: impact, character, feeling, intensity and temporality. Stiffness was described as limited movement/mobility. Although discomfort and stiffness impacted patients' activities, patients remained functional; pain was described as stopping/limiting activities. Discomfort was described as dull and tingling, pain as sharp and shooting, and stiffness as tight and restricted. Patients felt displeased and annoyed when experiencing discomfort and stiffness but hurt and in danger of harm when experiencing pain. Discomfort and stiffness were described as less intense than pain, with shorter/intermittent duration; however, all constructs could be experienced constantly. CONCLUSION Patients perceived discomfort, pain and stiffness as different, yet overlapping constructs. This preliminary work advances our knowledge of how patients conceptualize these constructs, contributing to better understanding of what patients mean when reporting these experiences, potentially improving the clinician-patient communication.
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Affiliation(s)
- Martha Funabashi
- Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, ON, M2H 3J1, Canada. .,Université du Québec À Trois-Rivières, 3351 boulevard des Forges, Trois-Rivières, QC, Canada.
| | - Simon Wang
- Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, ON, M2H 3J1, Canada
| | - Alexander D Lee
- Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, ON, M2H 3J1, Canada
| | - Felipe C K Duarte
- Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, ON, M2H 3J1, Canada
| | - Brian Budgell
- Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, ON, M2H 3J1, Canada
| | - Peter Stilwell
- McGill University, 845 Sherbrooke St W, Montreal, QC, Canada
| | - Sheilah Hogg-Johnson
- Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, ON, M2H 3J1, Canada.,University of Toronto, 27 King's College Circle, Toronto, ON, Canada.,Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON, Canada
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Duarte FCK, West DWD, Linde LD, Hassan S, Kumbhare DA. Re-Examining Myofascial Pain Syndrome: Toward Biomarker Development and Mechanism-Based Diagnostic Criteria. Curr Rheumatol Rep 2021; 23:69. [PMID: 34236529 DOI: 10.1007/s11926-021-01024-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW We discuss the need for a mechanism-based diagnostic framework with a focus on the development of objective measures (e.g., biomarkers) that can potentially be added to the diagnostic criteria of the syndrome. Potential biomarkers are discussed in relation to current knowledge on the pathophysiology of myofascial pain syndrome (MPS), including alterations in redox status, inflammation, and the myofascial trigger point (MTrP) biochemical milieu, as well as imaging and neurophysiological outcomes. Finally, we discuss the long-term goal of conducting a Delphi survey, to assess the influence of putative MPS biomarkers on clinician opinion, in order to ultimately develop new criteria for the diagnosis of MPS. RECENT FINDINGS Myofascial pain syndrome (MPS) is a prevalent healthcare condition associated with muscle weakness, impaired mood, and reduced quality of life. MPS is characterized by the presence of myofascial trigger points (MTrPs): stiff and discrete nodules located within taut bands of skeletal muscle that are painful upon palpation. However, physical examination of MTrPs often yields inconsistent results, and there is no gold standard by which to diagnose MPS. The current MPS diagnostic paradigm has an inherent subjectivity and the absence of correlation with the underlying pathophysiology. Recent advancements in ultrasound imaging, systemic biomarkers, MTrP-specific biomarkers, and the assessment of dysfunction in the somatosensorial system may all contribute to improved diagnostic effectiveness of MPS.
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Affiliation(s)
- Felipe C K Duarte
- Division of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Daniel W D West
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Lukas D Linde
- Inernational Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada.,Department of Anesthesiology, Pharmacology & Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Djavid Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Samah Hassan
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Dinesh A Kumbhare
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada. .,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada. .,Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, 550 University Ave, Toronto, Ontario, M5G 2A2, Canada.
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Evans V, Koh RGL, Duarte FCK, Linde L, Amiri M, Kumbhare D. A randomized double blinded placebo controlled study to evaluate motor unit abnormalities after experimentally induced sensitization using capsaicin. Sci Rep 2021; 11:13793. [PMID: 34215800 PMCID: PMC8253857 DOI: 10.1038/s41598-021-93188-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/17/2021] [Indexed: 12/02/2022] Open
Abstract
Central sensitization is a condition that represents a cascade of neurological adaptations, resulting in an amplification of nociceptive responses from noxious and non-noxious stimuli. However, whether this abnormality translates into motor output and more specifically, ventral horn abnormalities, needs to be further explored. Twenty healthy participants aged 20-70 were randomly allocated to topical capsaicin or a placebo topical cream which was applied onto their left upper back to induce a transient state of sensitization. Visual analogue scale (VAS) ratings of pain intensity and brush allodynia score (BAS) were used to determine the presence of pain and secondary allodynia. Surface electromyography (sEMG) and intramuscular electromyography (iEMG) were used to record motor unit activity from the upper trapezius and infraspinatus muscles before and twenty minutes after application of capsaicin/placebo. Motor unit recruitment and variability were analyzed in the sEMG and iEMG, respectively. An independent t-test and Kruskal-Wallis H test were performed on the data. The sEMG results demonstrated a shift in the motor unit recruitment pattern in the upper trapezius muscle, while the iEMG showed a change in motor unit variability after application of capsaicin. These results suggest that capsaicin-induced central sensitization may cause changes in ventral horn excitability outside of the targeted spinal cord segment, affecting efferent pathway outputs. This preclinical evidence may provide some explanation for the influence of central sensitization on changes in movement patterns that occur in patients who have pain encouraging of further clinical investigation.Clinical Trials registration number: NCT04361149; date of registration: 24-Apr-2020.
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Affiliation(s)
- Valerie Evans
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Medicine, Institute of Biomaterials and Biomedical Engineering (IBBME), University of Toronto, 550 University Ave, Suite 7-131, Toronto, ON, M5G 2A2, Canada
| | - Ryan G L Koh
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Felipe C K Duarte
- Division of Research and Innovation, Canadian Memorial of Chiropractic College, Toronto, ON, Canada
| | - Lukas Linde
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Mohammadreza Amiri
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Dinesh Kumbhare
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
- Department of Medicine, Institute of Biomaterials and Biomedical Engineering (IBBME), University of Toronto, 550 University Ave, Suite 7-131, Toronto, ON, M5G 2A2, Canada.
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada.
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da Silva FBO, Santos MDCQ, Borella da Silva TC, Facchini D, Kolberg A, Barros RR, Silveira EMS, Kroth A, Duarte FCK, Vassoler JM, Kolberg C, Partata WA. Spine adjusting instrument (Impulse®) attenuates nociception and modulates oxidative stress markers in the spinal cord and sciatic nerve of a rat model of neuropathic pain. Pain Med 2021; 23:761-773. [PMID: 33993301 DOI: 10.1093/pm/pnab167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Oxidative stress plays an important role in neuropathic pain. Spinal manipulative therapy (SMT) can exert beneficial effects in pain outcomes in humans and animal models. SMT can also modulate oxidative stress markers in both humans and animals. We aimed to determine the effect of Impulse®-assisted SMT (ISMT) on nociception and oxidative stress biomarkers in the spinal cord and sciatic nerve of rats with neuropathic pain (NP). METHODS NP was induced by chronic constriction injury (CCI) of the sciatic nerve. Animals were randomly assigned to naive, sham (rats with sciatic nerve exposure but without ligatures) and CCI, with and without ISMT. ISMT was applied onto the skin area corresponding to the spinous process of L4-L5, 3 times/week, for 2 weeks. Mechanical threshold, latency to paw withdrawal to thermal stimulus and oxidative stress biomarkers in spinal cord and sciatic nerve were the main outcomes evaluated. RESULTS ISMT significantly increased mechanical threshold and withdrawal latency after CCI. In the spinal cord, ISMT prevented the increase of pro-oxidative superoxide anion generation and hydrogen peroxide levels. Lipid hydroperoxide levels both in the spinal cord and in the sciatic nerve were attenuated by ISMT. Total antioxidant capacity increased in the spinal cord and sciatic nerve of CCI rats with and without ISMT. CCI and ISMT did not significantly change the total thiol content of the spinal cord. CONCLUSIONS Our findings suggest reduced oxidative stress in the spinal cord and/or nerve may be an important mechanism underlying a therapeutic effect of SMT to manage NP non-pharmacologically.
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Affiliation(s)
- Francielle B O da Silva
- Laboratório de Neurobiologia Comparada, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande, do Sul
| | - Maria do Carmo Q Santos
- Laboratório de Neurobiologia Comparada, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande, do Sul
| | - Thaisla Cristiane Borella da Silva
- Laboratório de Neurobiologia Comparada, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande, do Sul
| | | | - Angela Kolberg
- Laboratório de Neurobiologia Comparada, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande, do Sul
| | - Rodrigo R Barros
- Departamento de Engenharia Mecânica, Faculdade de Engenharia Mecânica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande, do Sul
| | - Elza M S Silveira
- Laboratório de Neurobiologia Comparada, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande, do Sul
| | - Adarly Kroth
- Área Ciências da Vida, Universidade do Oeste de Santa Catarina, Joaçaba, Santa Catarina
| | - Felipe C K Duarte
- Division of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Jakson M Vassoler
- Departamento de Engenharia Mecânica, Faculdade de Engenharia Mecânica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande, do Sul
| | - Carolina Kolberg
- Laboratório de Neurobiologia Comparada, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande, do Sul
| | - Wania A Partata
- Laboratório de Neurobiologia Comparada, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande, do Sul
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Duarte FCK, Zwambag DP, Brown SHM, Clark A, Hurtig M, Srbely JZ. Increased Substance P Immunoreactivity in Ipsilateral Knee Cartilage of Rats Exposed to Lumbar Spine Injury. Cartilage 2020; 11:251-261. [PMID: 30461296 PMCID: PMC7097978 DOI: 10.1177/1947603518812568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE The present study aimed to investigate whether experimentally induced lumbar facet-joint OA lead to degenerative changes and enhanced SP expression within the ipsilateral neurosegmentally linked tibiofemoral cartilage. METHODS Adult male Sprague-Dawley rats were assigned to left side L5-L6 facet mechanical compression injury (surgery) (n = 6), L5-L6 facet exposure with no compression (sham) (n = 5), or naïve (no surgery) (n = 4) groups. The morphology of the tibiofemoral articular cartilage was assessed using a modified Mankin scoring system. Immunohistochemistry was used to examine the density of chondrocytes stained positive for SP (cells/cm2) in the ipsilateral tibiofemoral cartilage at 28 days postintervention. RESULTS Tibiofemoral cartilage in the surgery group showed consistent loss of superficial zone chondrocytes, mild roughening of the articular surface and occasional chondrocyte clusters as well as a greater density of SP mainly in the superficial cartilage zone compared with sham and naïve groups, although they also had a basic SP-expression. CONCLUSION Our results support the hypothesis that neurogenic mechanisms may mediate the spread of SP to neurosegmentally linked heterologous joints affecting the distal cartilage homeostasis. These findings contribute additional insight into the potential role of neurogenic inflammation with implications in the pathophysiology of chronic inflammatory joint disease and OA.
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Affiliation(s)
- Felipe C. K. Duarte
- Human Health and Nutritional Science, University of Guelph, Guelph, Ontario, Canada
| | - Derek P. Zwambag
- Human Health and Nutritional Science, University of Guelph, Guelph, Ontario, Canada
| | - Stephen H. M. Brown
- Human Health and Nutritional Science, University of Guelph, Guelph, Ontario, Canada
| | - Andrea Clark
- Human Health and Nutritional Science, University of Guelph, Guelph, Ontario, Canada
| | - Mark Hurtig
- Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - John Z. Srbely
- Human Health and Nutritional Science, University of Guelph, Guelph, Ontario, Canada
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Duarte FCK, Kolberg C, Riffel APK, Souza JA, Belló-Klein A, Partata WA. Spinal Manipulation Therapy Improves Tactile Allodynia and Peripheral Nerve Functionality and Modulates Blood Oxidative Stress Markers in Rats Exposed to Knee-Joint Immobilization. J Manipulative Physiol Ther 2019; 42:385-398. [PMID: 31371096 DOI: 10.1016/j.jmpt.2018.11.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 06/13/2018] [Accepted: 11/28/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The purpose of our study was to evaluate the effect of manually assisted lumbar spinal manipulation therapy on tactile allodynia, peripheral nerve functional recovery, and oxidative markers in rats exposed to knee immobilization-inducing hypersensitivity. METHODS Tactile allodynia and sciatic, tibial, and peroneal functional indices were assessed before the knee joint immobilization, 24 hours after the knee cast removal, and 24 hours after 3 weeks of lumbar therapy with the Activator Adjusting Instrument, model 4 (AAI 4). Subsequently, the blood was collected from each rat, and oxidative markers such as lipid hydroperoxide levels; nitric oxide metabolites; and superoxide dismutase, catalase, and glutathione peroxidase activities were assessed. RESULTS The AAI 4 improved the immobilization-induced allodynia and recovered the peripheral nerve functional indices impaired after knee immobilization. Immobilized rats treated with AAI 4 therapy presented a lack of significant changes in lipid hydroperoxides and nitric oxide metabolites in the plasma contrasting with rats that were kept freely in their cages, with no therapy applied, which presented elevated lipid hydroperoxides levels. Also, the antioxidant catalase enzymatic activity decreased in the blood of rats immobilized and treated with AAI 4. CONCLUSION These results suggest that manually assisted lumbar spinal manipulation therapy modulates systemic oxidative stress, which possibly contributes to the analgesia and recovery of peripheral nerve functionality.
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Affiliation(s)
- Felipe C K Duarte
- Department of Life Sciences, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada; Department of Physiology, Institute of Basic Health Science, Federal University of Rio Grande do Sul/UFRGS, Porto Alegre, RS, Brazil.
| | - Carolina Kolberg
- Department of Physiology, Institute of Basic Health Science, Federal University of Rio Grande do Sul/UFRGS, Porto Alegre, RS, Brazil; America Latina College, Caxias do Sul, RS, Brazil
| | - Ana Paula K Riffel
- Department of Physiology, Institute of Basic Health Science, Federal University of Rio Grande do Sul/UFRGS, Porto Alegre, RS, Brazil
| | - Jessica A Souza
- Department of Physiology, Institute of Basic Health Science, Federal University of Rio Grande do Sul/UFRGS, Porto Alegre, RS, Brazil
| | - Adriane Belló-Klein
- Department of Physiology, Institute of Basic Health Science, Federal University of Rio Grande do Sul/UFRGS, Porto Alegre, RS, Brazil
| | - Wania A Partata
- Department of Physiology, Institute of Basic Health Science, Federal University of Rio Grande do Sul/UFRGS, Porto Alegre, RS, Brazil
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Duarte FCK, Hurtig M, Clark A, Simpson J, Srbely JZ. Association between naturally occurring spine osteoarthritis in geriatric rats and neurogenic inflammation within neurosegmentally linked skeletal muscle. Exp Gerontol 2019; 118:31-38. [PMID: 30615897 DOI: 10.1016/j.exger.2019.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/12/2018] [Accepted: 01/02/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study aimed to investigate the association between naturally occurring spinal osteoarthritis (OA) (L3-L5), the expression of substance P (SP) centrally (L4-L5) and the presence of neurogenic inflammation within the neurosegmentally linked quadriceps (L2-L5) in elderly rats versus young controls. DESIGN Eight aged (27 ± 3.2 months) and six young (4 ± 0.0 months) male Wistar Kyoto rats were euthanized and submitted to micro-computerized tomography for determination of spine OA. SP expression (% area) at the dorsal horn of the spinal cord as well as the relative expression of SP and protease-activated receptor 2 (PAR2) to alpha-tubulin within quadriceps muscle were determined by immunohistochemistry and Western Blot. RESULTS Spine osteoarthritis was confirmed in all aged rats but no young controls. Aged rats expressed significant increase of SP protein expression within the dorsal horn (MD = 0.086; 95% CI [0.026 to 0.145]; p = 0.0094) and quadriceps (MD = 1.209; 95% CI [0.239 to 2.179]; p = 0.0191) and PAR2 (MD = 0.797; 95% CI [0.160 to 1.435]; p = 0.0187) compared to young controls. CONCLUSION These observations provide novel insight into the potential role of neurogenic inflammation in the pathophysiology of myofascial pain syndrome in the naturally occurring spinal OA in elderly population.
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Affiliation(s)
- Felipe C K Duarte
- Department of Human Health and Nutritional Science, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada.
| | - Mark Hurtig
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 McGilvray Lane, Guelph, ON N1G 2W1, Canada.
| | - Andrea Clark
- Department of Human Health and Nutritional Science, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada.
| | - Jeremy Simpson
- Department of Human Health and Nutritional Science, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada.
| | - John Z Srbely
- Department of Human Health and Nutritional Science, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada.
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