Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.
Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.
Int J Mol Sci. 2022 Apr 25;23(9):4716. doi: 10.3390/ijms23094716.
Neurogenic inflammation and central sensitization play a role in chronic prostatitis/chronic pelvic pain syndrome. We explore the molecular effects of low-intensity shock wave therapy (Li-ESWT) on central sensitization in a capsaicin-induced prostatitis rat model. Male Sprague-Dawley rats underwent intraprostatic capsaicin (10 mM, 0.1 cm) injections. After injection, the prostate received Li-ESWT twice, one day apart. The L6 dorsal root ganglion (DRG)/spinal cord was harvested for histology and Western blotting on days 3 and 7. The brain blood oxygenation level-dependent (BOLD) functional images were evaluated using 9.4 T fMRI before the Li-ESWT and one day after. Intraprostatic capsaicin injection induced increased NGF-, BDNF-, and COX-2-positive neurons in the L6 DRG and increased COX-2, NGF, BDNF, receptor Trk-A, and TRPV1 protein expression in the L6 DRG and the dorsal horn of the L6 spinal cord, whose effects were significantly downregulated after Li-ESWT on the prostate. Intraprostatic capsaicin injection increased activity of BOLD fMRI responses in brain regions associated with pain-related responses, such as the caudate putamen, periaqueductal gray, and thalamus, whose BOLD signals were reduced after Li-ESWT. These findings suggest a potential mechanism of Li-ESWT on modulation of peripheral and central sensitization for treating CP/CPPS.
神经源性炎症和中枢敏化在慢性前列腺炎/慢性盆腔疼痛综合征中起作用。我们探讨了低强度冲击波治疗（Li-ESWT）对辣椒素诱导的前列腺炎大鼠模型中枢敏化的分子作用。雄性 Sprague-Dawley 大鼠接受前列腺内注射辣椒素（10mM，0.1cm）。注射后，前列腺接受 Li-ESWT 两次，间隔一天。第 3 天和第 7 天采集 L6 背根神经节（DRG）/脊髓进行组织学和 Western blot 分析。在 Li-ESWT 之前和之后一天，使用 9.4T fMRI 评估脑血氧水平依赖性（BOLD）功能图像。前列腺内注射辣椒素诱导 L6 DRG 中 NGF-、BDNF-和 COX-2 阳性神经元增加，L6 DRG 和 L6 脊髓背角中 COX-2、NGF、BDNF、受体 Trk-A 和 TRPV1 蛋白表达增加，Li-ESWT 后这些作用明显下调。前列腺内注射辣椒素增加了与疼痛相关反应相关的脑区（如尾状核、导水管周围灰质和丘脑）的 BOLD fMRI 反应活性，Li-ESWT 后这些 BOLD 信号减少。这些发现表明 Li-ESWT 调节外周和中枢敏化治疗 CP/CPPS 的潜在机制。
