Eagan Thomas S, Meltzer Kate R, Standley Paul R
OMS IV, Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA.
J Manipulative Physiol Ther. 2007 Oct;30(8):584-92. doi: 10.1016/j.jmpt.2007.07.013.
Manual medicine treatments (MMTs) rely on biophysical techniques that use manually guided forces in numerous strain directions to treat injuries and somatic dysfunctions. Although clinical outcomes post-MMT are positive, the underlying cellular mechanisms responsible remain elusive. We previously described an in vitro model of strain-induced tissue injury and MMTs. Using this model, the current study sought to determine if strain direction (equibiaxial [EQUI] vs heterobiaxial [HETERO]) differentially regulates human fibroblast function.
Fibroblasts were strained EQUI at 10% beyond their resting length for 48 hours followed by assessment of cell morphology, proliferation, and cytokine secretion via protein cytokine array and enzyme-linked immunosorbent assay (ELISA). These observations were then compared with those obtained previously for HETERO fibroblasts.
No alterations in cell morphology were seen in EQUI fibroblasts despite our report of such changes in HETERO cells. Fibroblasts secretion profiles for 60 cytokines (via cytokine protein array) showed that in EQUI strained cells, fractalkine significantly increased (121%), whereas macrophage-derived chemoattractant/chemokine and pulmonary and activation-regulated chemokine significantly decreased (32% and 10%, respectively) compared with nonstrained cells (P < .05). The EQUI fibroblasts when compared with HETERO fibroblasts exhibited a significant decrease in proliferation (22%), inflammatory interleukin 6 secretion (75%, measured by ELISA), and macrophage-derived chemoattractant/chemokine secretion (177%, measured by ELISA, P < .05).
These divergent observations in HETERO vs EQUI strained fibroblasts may underlie the relative efficacies of MMTs carried out in different tissue strain directions. We are currently modeling MMTs such as myofascial release to further investigate this.
手法医学治疗（MMTs）依赖生物物理技术，该技术在多个应变方向上使用手动引导力来治疗损伤和躯体功能障碍。尽管手法医学治疗后的临床结果是积极的，但其潜在的细胞机制仍不清楚。我们之前描述了一种应变诱导组织损伤和手法医学治疗的体外模型。利用该模型，本研究旨在确定应变方向（等双轴[EQUI]与异双轴[HETERO]）是否对人类成纤维细胞功能有不同的调节作用。
将成纤维细胞等双轴拉伸至超过其静息长度10%并持续48小时，随后通过蛋白质细胞因子阵列和酶联免疫吸附测定（ELISA）评估细胞形态、增殖和细胞因子分泌。然后将这些观察结果与之前对异双轴成纤维细胞的观察结果进行比较。
等双轴拉伸的成纤维细胞未观察到细胞形态改变，尽管我们之前报道过异双轴细胞有此类变化。60种细胞因子的成纤维细胞分泌谱（通过细胞因子蛋白质阵列）显示，与未拉伸细胞相比，等双轴拉伸的细胞中， fractalkine显著增加（121%），而巨噬细胞衍生的趋化因子/趋化因子和肺及激活调节趋化因子显著减少（分别为32%和10%，P <.05）。与异双轴成纤维细胞相比，等双轴成纤维细胞的增殖显著降低（22%）、炎性白细胞介素6分泌显著降低（通过ELISA测量为75%）以及巨噬细胞衍生的趋化因子/趋化因子分泌显著降低（通过ELISA测量为177%，P <.05）。
异双轴与等双轴拉伸成纤维细胞中的这些不同观察结果可能是在不同组织应变方向上进行手法医学治疗相对疗效的基础。我们目前正在模拟诸如肌筋膜松解等手法医学治疗，以进一步研究这一点。
