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胸部共振下的全身振动会在大鼠体内引发持续性疼痛和广泛的颈部神经炎症。

Whole-body Vibration at Thoracic Resonance Induces Sustained Pain and Widespread Cervical Neuroinflammation in the Rat.

作者信息

Zeeman Martha E, Kartha Sonia, Jaumard Nicolas V, Baig Hassam A, Stablow Alec M, Lee Jasmine, Guarino Benjamin B, Winkelstein Beth A

机构信息

Department of Bioengineering, University of Pennsylvania, 240 Skirkanich Hall, 210 S 33rd Street, Philadelphia, PA, 19104-6321, USA.

出版信息

Clin Orthop Relat Res. 2015 Sep;473(9):2936-47. doi: 10.1007/s11999-015-4315-9.

Abstract

BACKGROUND

Whole-body vibration (WBV) is associated with back and neck pain in military personnel and civilians. However, the role of vibration frequency and the physiological mechanisms involved in pain symptoms are unknown.

QUESTIONS/PURPOSES: This study asked the following questions: (1) What is the resonance frequency of the rat spine for WBV along the spinal axis, and how does frequency of WBV alter the extent of spinal compression/extension? (2) Does a single WBV exposure at resonance induce pain that is sustained? (3) Does WBV at resonance alter the protein kinase C epsilon (PKCε) response in the dorsal root ganglia (DRG)? (4) Does WBV at resonance alter expression of calcitonin gene-related peptide (CGRP) in the spinal dorsal horn? (5) Does WBV at resonance alter the spinal neuroimmune responses that regulate pain?

METHODS

Resonance of the rat (410 ± 34 g, n = 9) was measured by imposing WBV at frequencies from 3 to 15 Hz. Separate groups (317 ± 20 g, n = 10/treatment) underwent WBV at resonance (8 Hz) or at a nonresonant frequency (15 Hz). Behavioral sensitivity was assessed throughout to measure pain, and PKCε in the DRG was quantified as well as spinal CGRP, glial activation, and cytokine levels at Day 14.

RESULTS

Accelerometer-based thoracic transmissibility peaks at 8 Hz (1.86 ± 0.19) and 9 Hz (1.95 ± 0.19, mean difference [MD] 0.290 ± 0.266, p < 0.03), whereas the video-based thoracic transmissibility peaks at 8 Hz (1.90 ± 0.27), 9 Hz (2.07 ± 0.20), and 10 Hz (1.80 ± 0.25, MD 0.359 ± 0.284, p < 0.01). WBV at 8 Hz produces more cervical extension (0.745 ± 0.582 mm, MD 0.242 ± 0.214, p < 0.03) and compression (0.870 ± 0.676 mm, MD 0.326 ± 0.261, p < 0.02) than 15 Hz (extension, 0.503 ± 0.279 mm; compression, 0.544 ± 0.400 mm). Pain is longer lasting (through Day 14) and more robust (p < 0.01) after WBV at the resonant frequency (8 Hz) compared with 15 Hz WBV. PKCε in the nociceptors of the DRG increases according to the severity of WBV with greatest increases after 8 Hz WBV (p < 0.03). However, spinal CGRP, cytokines, and glial activation are only evident after painful WBV at resonance.

CONCLUSIONS

WBV at resonance produces long-lasting pain and widespread activation of a host of nociceptive and neuroimmune responses as compared with WBV at a nonresonance condition. Based on this work, future investigations into the temporal and regional neuroimmune response to resonant WBV in both genders would be useful.

CLINICAL RELEVANCE

Although WBV is a major issue affecting the military population, there is little insight about its mechanisms of injury and pain. The neuroimmune responses produced by WBV are similar to other pain states, suggesting that pain from WBV may be mediated by similar mechanisms as other neuropathic pain conditions. This mechanistic insight suggests WBV-induced injury and pain may be tempered by antiinflammatory intervention.

摘要

背景

全身振动(WBV)与军事人员和平民的背部和颈部疼痛有关。然而,振动频率的作用以及疼痛症状所涉及的生理机制尚不清楚。

问题/目的:本研究提出了以下问题:(1)大鼠脊柱沿脊柱轴进行WBV时的共振频率是多少,WBV频率如何改变脊柱压缩/伸展的程度?(2)在共振频率下单次WBV暴露是否会引发持续的疼痛?(3)共振频率下的WBV是否会改变背根神经节(DRG)中的蛋白激酶Cε(PKCε)反应?(4)共振频率下的WBV是否会改变脊髓背角中降钙素基因相关肽(CGRP)的表达?(5)共振频率下的WBV是否会改变调节疼痛的脊髓神经免疫反应?

方法

通过在3至15Hz频率施加WBV来测量大鼠(410±34g,n = 9)的共振。另外的组(317±20g,n = 10/处理)在共振频率(8Hz)或非共振频率(15Hz)下进行WBV。在整个过程中评估行为敏感性以测量疼痛,并在第14天对DRG中的PKCε以及脊髓CGRP、胶质细胞活化和细胞因子水平进行定量。

结果

基于加速度计的胸部传递率在8Hz(1.86±0.19)和9Hz(1.95±0.19,平均差异[MD] 0.290±0.266,p < 0.03)时达到峰值,而基于视频的胸部传递率在8Hz(1.90±0.27)、9Hz(2.07±0.20)和10Hz(1.80±0.25,MD 0.359±0.284,p < 0.01)时达到峰值。与15Hz(伸展,0.503±0.279mm;压缩,0.544±0.400mm)相比,8Hz的WBV产生更多的颈椎伸展(0.745±0.582mm,MD 0.242±0.214,p < 0.03)和压缩(0.870±0.676mm,MD 0.326±0.261,p < 0.02)。与15Hz的WBV相比,共振频率(8Hz)的WBV后疼痛持续时间更长(直至第14天)且更强烈(p < 0.01)。DRG伤害感受器中的PKCε根据WBV的严重程度增加,在8Hz的WBV后增加最大(p < 0.03)。然而,脊髓CGRP、细胞因子和胶质细胞活化仅在共振频率下疼痛性WBV后才明显。

结论

与非共振条件下的WBV相比,共振频率下的WBV会产生持久的疼痛,并广泛激活一系列伤害性和神经免疫反应。基于这项工作,未来对两性中共振WBV的时间和区域神经免疫反应的研究将是有用且重要的。

临床意义

尽管WBV是影响军事人员的一个主要问题,但对其损伤和疼痛机制了解甚少。WBV产生的神经免疫反应与其他疼痛状态相似,这表明WBV引起其疼痛可能由与其他神经性疼痛状况类似的机制介导。这种机制性见解表明,WBV引起的损伤和疼痛可能通过抗炎干预得到缓解。

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