Department of Tuina, Wuhan Traditional Chinese Medicine Hospital, Wuhan, China.
College of Acupuncture and Bone Injury, Hubei University of Chinese Medicine, Wuhan, China.
J Orthop Surg (Hong Kong). 2024 Jan-Apr;32(1):10225536241238638. doi: 10.1177/10225536241238638.
Lumbar disc herniation (LDH) is a common spinal disease that can cause severe radicular pain. Massage, also known as in Chinese, has been indicated to exert an analgesic effect in patients with LDH. Nonetheless, the mechanism underlying this effect of massage on LDH remains unclarified.
Forty Sprague-Dawley rats were randomly divided into four groups. A rat LDH model was established by autologous nucleus pulpous (NP) implantation, followed by treatment with or without massage. A toll-like receptor 4 (TLR4) antagonist TAK-242 was administrated to rats for blocking TLR4. Behavioral tests were conducted to examine rat mechanical and thermal sensitivities. Western blotting was employed for determining TLR4 and NLRP3 inflammasome-associated protein levels in the spinal dorsal horn (SDH). Immunofluorescence staining was implemented for estimating the microglial marker Iba-1 expression in rat SDH tissue.
NP implantation induced mechanical allodynia and thermal hyperalgesia in rat ipsilateral hindpaws and activated TLR4/NLRP3 inflammasome signaling transduction in the ipsilateral SDH. Massage therapy or TAK-242 administration relieved NP implantation-triggered pain behaviors in rats. Massage or TAK-242 hindered microglia activation and blocked TLR4/NLRP3 inflammasome activation in ipsilateral SDH of LDH rats.
Massage ameliorates LDH-related radicular pain in rats by suppressing microglia activation and TLR4/NLRP3 inflammasome signaling transduction.
腰椎间盘突出症（LDH）是一种常见的脊柱疾病，可引起严重的神经根痛。按摩，在中国也被称为推拿，已被证明对 LDH 患者具有镇痛作用。然而，按摩对 LDH 产生这种效果的机制尚不清楚。
将 40 只 Sprague-Dawley 大鼠随机分为四组。通过自体髓核（NP）植入建立大鼠 LDH 模型，然后进行按摩或不进行按摩治疗。用 Toll 样受体 4（TLR4）拮抗剂 TAK-242 对大鼠进行 TLR4 阻断。进行行为学测试以检查大鼠的机械和热敏性。采用 Western blot 检测 TLR4 和 NLRP3 炎性小体相关蛋白在脊髓背角（SDH）中的水平。免疫荧光染色用于评估大鼠 SDH 组织中小胶质细胞标志物 Iba-1 的表达。
NP 植入诱导大鼠同侧后足机械性痛觉过敏和热痛觉过敏，并激活 TLR4/NLRP3 炎性小体信号转导。按摩疗法或 TAK-242 给药缓解了 NP 植入诱导的大鼠疼痛行为。按摩或 TAK-242 抑制了 LDH 大鼠同侧 SDH 中的小胶质细胞激活，并阻断了 TLR4/NLRP3 炎性小体的激活。
按摩通过抑制小胶质细胞激活和 TLR4/NLRP3 炎性小体信号转导，改善了 LDH 相关的神经根痛大鼠的疼痛。
