Chen Yu-Wen, Tzeng Jann-Inn, Lin Min-Fei, Hung Ching-Hsia, Wang Jhi-Joung
Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan; Department of Medical Research, Chi-Mei Medical Center, Yongkang, Tainan City, Taiwan.
Department of Food Sciences and Technology, Chia Nan University of Pharmacy and Science, Tainan City, Taiwan; Department of Anesthesiology, Chi-Mei Medical Center, Yongkang, Tainan City, Taiwan.
J Pain. 2014 Aug;15(8):827-34. doi: 10.1016/j.jpain.2014.04.010. Epub 2014 May 20.
Exercise causes a variety of psychophysical effects (eg, alterations in pain sensation). Tissue injury induces mediator releases in the spinal cord resulting in pain hypersensitivity; however, the contribution of the dorsal root ganglion (DRG) is poorly understood. In this study, we tested if forced treadmill running can attenuate postoperative pain and alter substance P (SP) or proinflammatory cytokine level in the DRG by using a rat model of skin/muscle incision and retraction (SMIR). We evaluated mechanical sensitivity to von Frey stimuli (6 and 15 g) and expression of SP, interleukin-1β, and interleukin-6 in the DRG of sham-operated sedentary rats, SMIR sedentary rats, sham-operated rats with forced treadmill running, and SMIR rats with forced treadmill running. At postoperative day 8, trained rats ran for 5 days per week for 4 weeks on a treadmill 70 minutes/d with an intensity of 18 m/min. On postoperative day 6, SMIR sedentary rats displayed a significant mechanical hypersensitivity that persisted until postoperative day 35. By comparison, SMIR-operated rats, which received forced treadmill running, exhibited a quick recovery from mechanical hypersensitivity. SMIR sedentary rats showed an upregulation of SP, interleukin-1β, and interleukin-6 in the DRG at postoperative days 14 and 28, whereas SMIR-operated rats receiving forced treadmill running reversed this upregulation at postoperative day 28. We concluded that forced treadmill running alleviated persistent postincisional pain caused by SMIR surgery. This appears to be protective against postoperative pain, which probably relates to the downturn in excess SP, interleukin-1β, and interleukin-6 in the DRG.
Controlling the expression of SP, interleukin-6, and interleukin-1β in the DRG can help manage postoperative pain. This finding could potentially help clinicians and physical therapists who seek to examine how exercise may attenuate postsurgical pain and its mechanism.
运动可引起多种心理生理效应(如痛觉改变)。组织损伤会诱导脊髓中介质释放,导致疼痛超敏;然而,背根神经节(DRG)的作用却知之甚少。在本研究中,我们通过使用皮肤/肌肉切开和牵张(SMIR)大鼠模型,测试强迫跑步机跑步是否能减轻术后疼痛,并改变DRG中P物质(SP)或促炎细胞因子水平。我们评估了假手术久坐大鼠、SMIR久坐大鼠、强迫跑步机跑步的假手术大鼠以及强迫跑步机跑步的SMIR大鼠对von Frey刺激(6克和15克)的机械敏感性,以及DRG中SP、白细胞介素-1β和白细胞介素-6的表达。术后第8天,训练大鼠每周在跑步机上以18米/分钟的强度跑5天,持续4周,每次70分钟。术后第6天,SMIR久坐大鼠表现出明显的机械超敏反应,这种反应一直持续到术后第35天。相比之下,接受强迫跑步机跑步的SMIR手术大鼠从机械超敏反应中快速恢复。SMIR久坐大鼠在术后第14天和28天DRG中SP、白细胞介素-1β和白细胞介素-6上调,而接受强迫跑步机跑步的SMIR手术大鼠在术后第28天逆转了这种上调。我们得出结论,强迫跑步机跑步减轻了SMIR手术引起的持续性切口后疼痛。这似乎对术后疼痛具有保护作用,这可能与DRG中过量的SP、白细胞介素-1β和白细胞介素-6减少有关。
控制DRG中SP、白细胞介素-6和白细胞介素-1β的表达有助于管理术后疼痛。这一发现可能有助于临床医生和物理治疗师,他们试图研究运动如何减轻术后疼痛及其机制。