School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P.R. China.
Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, P.R. China.
Aging (Albany NY). 2022 Mar 15;14(5):2400-2417. doi: 10.18632/aging.203949.
With the increasing burden of a globally aging population, low back pain has become one of the most common musculoskeletal disorders, caused mainly by intervertebral disc (IVD) degeneration. There are currently several clinical methods to alleviate back pain, but there is scarce attention paid as to whether they can improve age-related IVD degeneration. It is therefore difficult to conduct an in-depth evaluation of these methods. A large number of clinical studies have shown that manual therapy (MT), a widely used comprehensive alternative method, has effects on pain, the mechanisms of which require further study. In this study, MT was performed on aging rats for 6 months, and their behaviors were compared with those of a non-intervention group of aging and young rats. After the intervention, all rats were examined by X-ray to observe lumbar spine degeneration, and the IVD tissues were dissected for detection, including pathological staining, immunofluorescence, Western bolt, etc. This study demonstrated the possibility that MT intervention delay the lumbar IVD degeneration in aging rats, specifically improving the motor function and regulating senescence-associated β-galactosidase, p53, p21, p16, and telomerase activity to retard the senescence of cells in IVDs. Moreover, MT intervention can modify oxidative stress, increase the expression of SIRT1 and FOXO1 in IVDs and decrease ac-FOXO1 expression, suggesting that MT can reduce oxidative stress through the SIRT1/FOXO1 pathway, thereby playing a role in delaying the aging of IVDs. This study shows that drug-free, non-invasive mechanical interventions could be of major significance in improving the physical function of the elderly.
随着全球人口老龄化负担的增加，下腰痛已成为最常见的肌肉骨骼疾病之一，主要由椎间盘（IVD）退变引起。目前有几种临床方法可以缓解背痛，但很少有人关注它们是否能改善与年龄相关的 IVD 退变。因此，很难对这些方法进行深入评估。大量临床研究表明，手动治疗（MT）作为一种广泛应用的综合替代方法，对疼痛有作用，其机制需要进一步研究。在这项研究中，对衰老大鼠进行了 6 个月的 MT 治疗，并将其行为与未干预的衰老和年轻大鼠组进行了比较。干预后，所有大鼠均接受 X 射线检查以观察腰椎退变，并对 IVD 组织进行解剖检测，包括病理染色、免疫荧光、Western bolt 等。这项研究表明，MT 干预可能延缓衰老大鼠的腰椎 IVD 退变，具体表现为改善运动功能和调节衰老相关的β-半乳糖苷酶、p53、p21、p16 和端粒酶活性，从而延缓 IVD 细胞衰老。此外，MT 干预可以修饰氧化应激，增加 IVD 中 SIRT1 和 FOXO1 的表达，减少 ac-FOXO1 的表达，表明 MT 可以通过 SIRT1/FOXO1 途径减少氧化应激，从而在延缓 IVD 衰老中发挥作用。这项研究表明，无药物、非侵入性的机械干预可能对改善老年人的身体功能具有重要意义。
