Based on HPA axis to explore the mechanism of waist-rubbing therapy in the treatment of lumbar disc herniation model rats

Abstract Background lumbar disc herniation (LDH) is a high-risk species in the world with serious harm. Traditional Chinese Tuina is the first choice in the treatment of LDH. In the past clinical studies, we have achieved good results in the treatment of LDH with the waist-rubbing method recorded in an ancient Chinese medical book of Qing Dynasty. Now we further explore its internal mechanism of action from the perspective of animal experiments. Waist-rubbing is a frictional heat-generating stimulus that acts on the surface of the skin. It does not relieve the compression in spinal canal, but can effectively eliminate the symptoms of LDH patients. This suggests that waist-rubbing may play a therapeutic role by interfering the autoimmunity of LDH. For a long time, the treatment of LDH mainly focused on how to relieve the mechanical compression caused by lumbar disc herniation, but little attention was paid to the autoimmune inflammation of LDH. In this study, from the point of view of regulating LDH's autoimmunity, the waist-rubbing method was taken as the treatment measure, and the lumbar strain rats in upright position were taken as the model. The neuroendocrine immunology mechanism of waist-rubbing method in treating LDH was revealed, which provided new ideas and scientific basis for Tuina clinical treatment of LDH, and also provided strong evidence for the theory of LDH's autoimmunity. Methods 30 SD rats were randomly divided into three groups of the blank, the model and the waist wiping. The LDH model of the forelimb-free standing rats was established. Each group was treated according to the corresponding method. The waist-rubbing group was treated once a day for 15 days. After the experiment, the blood and lumbar spinal cord samples were collected after rats been killed. The contents of the CRH(Corticotropin releasing hormone), ACTH(Adrenocorticotropic hormone), CORT(Cortisol), IL-17(Interleukin-17), IL-6(Interleukin-6), TGF-β1(Transforming growth factor-β1) and IL-10(Interleukin-10) in peripheral blood and the GRα(Glucocorticoid receptor α) and 5-HT1A(Five hydroxytryptamine 1A) receptor in L4-L6 segment of rat lumbar spinal cord were detected by ELISA(Enzyme-linked immunoSorbent assay). Results Compared with the blank group, the contents of CRH, ACTH, CORT, GRα, 5-HT1A receptor, TGF-β1 and IL-10 in the model group were significantly decreased (P < 0.05), while the contents of IL-17 and IL-6 were significantly increased (P < 0.05). Compared with the model group, the contents of CRH, ACTH, CORT, GRα, 5-HT1A receptor, TGF-β1 and IL-10 in the waist-rubbing group were significantly increased (P < 0.05), while the contents of IL-17 and IL-6 were significantly decreased (P < 0.05). Conclusion The waist-rubbing method may eliminate the autoimmune inflammatory reaction of LDH by correcting the hypofunction of HPA axis, so as to achieve the therapeutic effect of LDH.

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Surgical treatment of the lumbar disc herniation complicated by lumbar spinal stenosis

Ukrainian Neurosurgical Journal ◽

10.25305/unj.182625 ◽

2020 ◽

Vol 26 (1) ◽

pp. 5-12 ◽

Cited By ~ 1

Author(s):

Mykhaylo V. Khyzhnyak ◽

Artur Yu. Ksenzov ◽

Tymur A. Ksenzov

Keyword(s):

Surgical Treatment ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Lumbar Spinal

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Low-Concentration Oxygen/Ozone Treatment Attenuated Radiculitis and Mechanical Allodynia via PDE2A-cAMP/cGMP-NF-κB/p65 Signaling in Chronic Radiculitis Rats

Pain Research and Management ◽

10.1155/2018/5192814 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Junnan Wang ◽

Mingyi Wu ◽

Xiaowen Lin ◽

Yun Li ◽

Zhijian Fu

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Mechanical Allodynia ◽

Lumbar Disc ◽

Intrathecal Administration ◽

Guanosine Monophosphate ◽

Ozone Treatment ◽

Invasive Technique ◽

Enzyme Linked Immunosorbent Assay ◽

Low Concentration

Background. Oxygen/ozone therapy is a minimally invasive technique for the treatment of radiculitis from lumbar disc herniation. This study aimed at investigating whether intrathecal administration of low-concentration oxygen/ozone could attenuate chronic radiculitis and mechanical allodynia after noncompressive lumbar disc herniation and at elucidating the underlying mechanisms. Methods. First, we transplanted autologous nucleus pulposus into dorsal root ganglions to establish chronic radiculitis in rats. Then, filtered oxygen or oxygen/ozone (10, 20, or 30 μg/mL) was intrathecally injected on day 1 after surgery. The ipsilateral paw withdrawal thresholds (PWTs) to mechanical stimuli were tested daily with von Frey filaments. The expression of the tumor necrosis factor- (TNF-) α, interleukin- (IL-) 1β, IL-6, cyclic adenosine monophosphate (cAMP), cyclic guanosine monophosphate (cGMP), phosphodiesterase 2A (PDE2A), and nuclear factor- (NF-) κB/p65 in spinal dorsal horns was measured by enzyme-linked immunosorbent assay, polymerase chain reaction, and western blot on day 7 after surgery. Results. Chronic radiculitis was established in rats. Intrathecal administration of 10 μg/mL, 20 μg/mL, or 30 μg/mL oxygen/ozone significantly attenuated the decreased mechanical PWTs, downregulated the overexpression of spinal TNF-α, IL-1β, and IL-6, and increased the expression of cGMP and cAMP in chronic radiculitis rats. In addition, the effects of treatment with 20 μg/mL oxygen/ozone were greater than the effects of the 10 μg/mL or 30 μg/mL doses. Moreover, intrathecal administration of 20 μg/mL oxygen/ozone reversed the increased levels of spinal PDE2A and NF-κB/p65 mRNA and protein expressions in rats with chronic radiculitis. Conclusion. Intrathecal administration of low-concentration oxygen/ozone alleviated mechanical allodynia and attenuated radiculitis, likely by a PDE2A-cGMP/cAMP-NF-κB/p65 signaling pathway in chronic radiculitis rats.

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Preoperative retrolisthesis as a risk factor of postdecompression lumbar disc herniation

Journal of Neurosurgery Spine ◽

10.3171/2015.6.spine15288 ◽

2016 ◽

Vol 24 (4) ◽

pp. 592-601 ◽

Cited By ~ 4

Author(s):

Shota Takenaka ◽

Kosuke Tateishi ◽

Noboru Hosono ◽

Yoshihiro Mukai ◽

Takeshi Fuji

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Area Under The Curve ◽

Lumbar Spinal ◽

Acute Sciatica

OBJECT In this study, the authors aimed to identify specific risk factors for postdecompression lumbar disc herniation (PDLDH) in patients who have not undergone discectomy and/or fusion. METHODS Between 2007 and 2012, 493 patients with lumbar spinal stenosis underwent bilateral partial laminectomy without discectomy and/or fusion in a single hospital. Eighteen patients (herniation group [H group]: 15 men, 3 women; mean age 65.1 years) developed acute sciatica as a result of PDLDH within 2 years after surgery. Ninety patients who did not develop postoperative acute sciatica were selected as a control group (C group: 75 men, 15 women; mean age 65.4 years). Patients in the C group were age and sex matched with those in the H group. The patients in the groups were also matched for decompression level, number of decompression levels, and surgery date. The radiographic variables measured included percentage of slippage, intervertebral angle, range of motion, lumbar lordosis, disc height, facet angle, extent of facet removal, facet degeneration, disc degeneration, and vertebral endplate degeneration. The threshold for PDLDH risk factors was evaluated using a continuous numerical variable and receiver operating characteristic curve analysis. The area under the curve was used to determine the diagnostic performance, and values greater than 0.75 were considered to represent good performance. RESULTS Multivariate analysis revealed that preoperative retrolisthesis during extension was the sole significant independent risk factor for PDLDH. The area under the curve for preoperative retrolisthesis during extension was 0.849; the cutoff value was estimated to be a retrolisthesis of 7.2% during extension. CONCLUSIONS The authors observed that bilateral partial laminectomy, performed along with the removal of the posterior support ligament, may not be suitable for lumbar spinal stenosis patients with preoperative retrolisthesis greater than 7.2% during extension.

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Melanocortin 4 Receptor Mediates Neuropathic Pain Through p38MAPK in Spinal Cord

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100013962 ◽

2012 ◽

Vol 39 (4) ◽

pp. 458-464 ◽

Cited By ~ 9

Author(s):

Haichen Chu ◽

Jiangling Xia ◽

Hongmei Xu ◽

Zhao Yang ◽

Jie Gao ◽

...

Keyword(s):

Spinal Cord ◽

Neuropathic Pain ◽

Time Course ◽

Lumbar Spinal Cord ◽

Enzyme Linked Immunosorbent Assay ◽

Melanocortin 4 Receptor ◽

Male Wistar Rats ◽

Underlying Mechanisms ◽

Lumbar Spinal ◽

Somatosensory Nervous System

Background:Neuropathic pain is characterised by spontaneous ongoing or shooting pain and evoked amplified pain responses after noxious or non-noxious stimuli. Neuropathic pain develops as a result of lesions or disease affecting the somatosensory nervous system either in the periphery or centrally. Melanocortin 4 receptor (MC4R) plays an important role in the initiation of neuropathic pain but the underlying mechanisms are still unclear.Methods:Adult male Wistar rats were given chronic constriction injury (CCI) or sham operations. Part of CCI rats were intrathecally treated with HS014 (MC4R antagonist) or SB203580 (p38MAPK inhibitor). On the third, seventh and fourteenth day, the thermal threshold of operated paws was tested. In addition, the MC4R or phosphorylated p38MAPK (p-p38MAPK) levels of lumbar spinal cord were tested with ELISA (enzyme-linked immunosorbent assay), western blot and immunohistochemistry.Results:Here we demonstrate that (1) both HS014 and SB203580 reduced CCI reduced hyperalgesia (2) p-p38MAPK was increased after CCI with a time course parallel to that of the MC4R change, (3) The p38 activation was prevented by blocking MC4R with an antagonist HS014, but MC4R-IR was not prevented by SB203580. (4) MC4R and p-p38MAPK were located in the same cells.Conclusion:The mechanisms of neuropathic pain mediated by MC4R is related to the inhibition of p38MAPK activation. P38MAPK may be a downstream of MC4R.

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