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大鼠模型中膝关节韧带对注射疗法的早期炎症反应

Early inflammatory response of knee ligaments to prolotherapy in a rat model.

作者信息

Jensen Kristina T, Rabago David P, Best Thomas M, Patterson Jeffrey J, Vanderby Ray

机构信息

Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin, USA.

出版信息

J Orthop Res. 2008 Jun;26(6):816-23. doi: 10.1002/jor.20600.

Abstract

Prolotherapy is an alternative injection-based therapy for chronic musculoskeletal pain. Three different proliferants, D-glucose (dextrose), phenol-glucose-glycerine (P2G), and sodium morrhuate, used in prolotherapy are hypothesized to strengthen and reorganize chronically injured soft tissue and decrease pain through modulation of the inflammatory process. Our hypothesis is that commonly used prolotherapy solutions will induce inflammation (leukocyte and macrophage infiltration) in medial collateral ligaments (MCLs) compared to needlestick, saline injection, and no-injection controls. MCLs of 84 Sprague- Dawley rats were injected one time at both the tibial and femoral insertions. Immunohistochemistry (IHC) was used to determine the inflammatory response at three locations (tibial and femoral insertions and midsubstance) 6, 24, and 72 h after dextrose injection compared to saline- and no-injection controls and collagenase (positive control) (n = 4). qPCR was used to analyze gene expression 24 h postinjection (n = 4). Sodium morrhuate, P2G, and needlestick control were also investigated after 24 h (n = 4). In general, inflammation (CD43+, ED1+, and ED2+ cells) increased after prolotherapy injection compared to no-injection control but did not increase consistently compared to saline and needlestick control injections. This response varied by both location and proliferant. Inflammation was observed at 6 and 24 h postinjection but was resolved by 72 h compared to no-injection controls (p < 0.05). CD43+ leukocytes and ED2+ macrophages increased compared to needlestick and saline-injection control, respectively, 24 h postinjection (p < 0.05). Prolotherapy injections created an inflammatory response, but this response was variable and overall, not uniformly different from that caused by saline injections or needlestick procedures.

摘要

注射增殖疗法是一种用于治疗慢性肌肉骨骼疼痛的替代性注射疗法。注射增殖疗法中使用的三种不同增殖剂,即D - 葡萄糖(右旋糖)、苯酚 - 葡萄糖 - 甘油(P2G)和鱼肝油酸钠,据推测可通过调节炎症过程来强化和重组长期受损的软组织并减轻疼痛。我们的假设是,与针刺、盐水注射及不注射对照相比,常用的注射增殖疗法溶液会在内侧副韧带(MCL)中引发炎症(白细胞和巨噬细胞浸润)。对84只Sprague - Dawley大鼠的MCL在胫骨和股骨附着处各注射一次。与盐水注射、不注射对照及胶原酶(阳性对照)相比,在注射右旋糖后6、24和72小时,采用免疫组织化学(IHC)法测定三个部位(胫骨和股骨附着处及韧带中部)的炎症反应(n = 4)。采用qPCR法分析注射后24小时的基因表达(n = 4)。24小时后还对鱼肝油酸钠、P2G及针刺对照进行了研究(n = 4)。总体而言,与不注射对照相比,注射增殖疗法后炎症(CD43 +、ED1 +和ED2 +细胞)增加,但与盐水注射和针刺对照相比,炎症并非持续增加。这种反应因部位和增殖剂而异。与不注射对照相比,注射后6和24小时观察到炎症,但72小时时炎症消退(p < 0.05)。与针刺和盐水注射对照相比,注射后24小时CD43 +白细胞和ED2 +巨噬细胞分别增加(p < 0.05)。注射增殖疗法引发了炎症反应,但这种反应是可变的,总体而言,与盐水注射或针刺操作引起的反应并无一致的差异。

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