Luan Shuo, Wan Qing, Luo Haijie, Li Xiao, Ke Songjian, Lin Caina, Wu Yuanyuan, Wu Shaoling, Ma Chao
Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
Int J Mol Sci. 2015 Jan 19;16(1):2130-44. doi: 10.3390/ijms16012130.
Chronic low back pain accompanied by intervertebral disk degeneration is a common musculoskeletal disorder. Physical exercise, which is clinically recommended by international guidelines, has proven to be effective for degenerative disc disease (DDD) patients. However, the mechanism underlying the analgesic effects of physical exercise on DDD remains largely unclear. The results of the present study showed that mechanical withdrawal thresholds of bilateral hindpaw were significantly decreased beginning on day three after intradiscal complete Freund's adjuvant (CFA) injection and daily running exercise remarkably reduced allodynia in the CFA exercise group beginning at day 28 compared to the spontaneous recovery group (controls). The hindpaw withdrawal thresholds of the exercise group returned nearly to baseline at the end of experiment, but severe pain persisted in the control group. Histological examinations performed on day 70 revealed that running exercise restored the degenerative discs and increased the cell densities of the annulus fibrosus (AF) and nucleus pulposus (NP). Furthermore, immunofluorescence labeling revealed significantly higher numbers of 5-bromo-2-deoxyuridine (BrdU)-positive cells in the exercise group on days 28, 42, 56 and 70, which indicated more rapid proliferation compared to the control at the corresponding time points. Taken together, these results suggest that running exercise might alleviate the mechanical allodynia induced by intradiscal CFA injection via disc repair and cell proliferation, which provides new evidence for future clinical use.
伴有椎间盘退变的慢性下腰痛是一种常见的肌肉骨骼疾病。国际指南临床推荐的体育锻炼已被证明对椎间盘退变疾病(DDD)患者有效。然而,体育锻炼对DDD镇痛作用的潜在机制仍不清楚。本研究结果表明,在椎间盘内注射完全弗氏佐剂(CFA)后第三天开始,双侧后爪的机械撤针阈值显著降低,与自发恢复组(对照组)相比,每日跑步锻炼从第28天开始显著减轻了CFA锻炼组的异常性疼痛。锻炼组后爪撤针阈值在实验结束时几乎恢复到基线水平,但对照组仍存在严重疼痛。在第70天进行的组织学检查显示,跑步锻炼恢复了退变的椎间盘,并增加了纤维环(AF)和髓核(NP)的细胞密度。此外,免疫荧光标记显示,在第28、42、56和70天,锻炼组中5-溴-2-脱氧尿苷(BrdU)阳性细胞数量显著增加,这表明在相应时间点与对照组相比增殖更快。综上所述,这些结果表明,跑步锻炼可能通过椎间盘修复和细胞增殖减轻椎间盘内注射CFA诱导的机械性异常性疼痛,为未来临床应用提供了新的证据。