Klinedinst N Jennifer, Huang Weiliang, Nelson Amy K, Resnick Barbara, Renn Cynthia, Kane Maureen A, Dorsey Susan G
16112University of Maryland School of Nursing, Baltimore, MD, USA.
15513University of Maryland School of Pharmacy, Baltimore, MD, USA.
Biol Res Nurs. 2023 Jan;25(1):65-75. doi: 10.1177/10998004221117179. Epub 2022 Sep 1.
Knee osteoarthritis (KOA) affects 22.9% of individuals over the age of 40 and causes significant pain and disability. Pain is the most prevalent and troublesome symptom of KOA leading patients to seek medical interventions for relief. Knee osteoarthritis pain has both peripheral and central mechanisms that vary by individual. Non-pharmacological pain management strategies such as walking is the first step in reducing KOA pain. However, initiation of a walking regime can induce knee pain for some and the mechanism by which habitual walking reduces KOA pain is unclear. The purpose of this study was to use a discovery proteomics approach and quantitative sensory testing (QST) to determine the molecular changes that occur after habitual walking and their relationship to pain sensitivity. We conducted a pre-test/post-test study using QST to measure neurophysiological parameters at the knee and contralateral forearm and examined platelet protein signatures before and after 6 weeks of walking 3 days per week for 30 minutes among six adults with KOA and six healthy controls. Knee pain sensitivity did not change significantly after 6 weeks of walking among either KOA or healthy participants. However, forearm pressure pain sensitivity decreased for both groups after walking, indicating reduction in central pain pathways. Protein signatures showed downregulation of immune and inflammatory, pathways among KOA participants after walking which were upregulated in healthy controls. These differences may contribute differences in centralized pain thresholds seen between KOA and healthy participants.
膝关节骨关节炎（KOA）影响着22.9%的40岁以上人群，会导致严重疼痛和残疾。疼痛是KOA最常见且困扰人的症状，促使患者寻求医疗干预以缓解疼痛。KOA疼痛具有因人而异的外周和中枢机制。诸如步行等非药物疼痛管理策略是减轻KOA疼痛的第一步。然而，开始步行锻炼可能会使一些人引发膝关节疼痛，而且习惯性步行减轻KOA疼痛的机制尚不清楚。本研究的目的是采用发现蛋白质组学方法和定量感觉测试（QST）来确定习惯性步行后发生的分子变化及其与疼痛敏感性的关系。我们进行了一项前测/后测研究，使用QST测量膝关节和对侧前臂的神经生理参数，并在6名KOA成人患者和6名健康对照者中，对每周步行3天、每次30分钟，持续6周前后的血小板蛋白质特征进行了检测。在KOA患者或健康参与者中，步行6周后膝关节疼痛敏感性均未显著改变。然而，两组步行后前臂压力疼痛敏感性均降低，表明中枢疼痛通路有所减少。蛋白质特征显示，KOA参与者步行后免疫和炎症通路下调，而在健康对照者中这些通路上调。这些差异可能导致了KOA患者与健康参与者之间在中枢性疼痛阈值上的差异。
