Assessment of the effects of ischaemia/ hypoxia on angiogenesis in rat myofascial trigger points using colour Doppler flow imaging

Abstract

Background & Aims Myofascial pain syndrome (MPS) is a common non-articular disorder of the musculoskeletal system that is characterized by the presence of myofascial trigger points (MTrPs). Despite the high prevalence of MPS, its pathogenesis, which induces the onset and maintenance of MTrPs, is still not completely understood. To date, no studies have investigated the changes in the biochemical milieu caused by ischaemia/hypoxia in the MTrP regions of muscle that are proposed in the integrated hypothesis. Therefore, this study investigated whether ischaemic/hypoxic conditions participate in the formation of active MTrPs and affect angiogenesis using colour Doppler flow imaging (CDFI). Methods Twenty-five Sprague-Dawley rats were randomly divided into a model group and a normal control group. A model of active MTrPs was established by a blunt strike combined with eccentric exercise. Enzyme-linked immunosorbent assays (ELISAs) were employed to detect the levels of HIF-1α and VEGF. Microvessel density (MVD) was evaluated using immunohistochemistry. CDFI was applied to observe the blood flow signals in the MTrPs, which were classified into four grades based on their strengths. Results Compared with the control group, the active MTrP group exhibited significantly higher HIF-1α and VEGF levels and MVD values. These differences were accompanied by increased blood flow signals. In the active MTrP group, the blood flow signal grade was positively correlated with the MVD (P < 0.05) and independently correlated with the VEGF level (P < 0.05) but was not correlated with the expression of HIF-1α (P > 0.05). Conclusion Ischaemic/hypoxic conditions may be involved in the formation of MTrPs. CDFI is useful for detection of the features of angiogenesis in or surrounding MTrPs via assessment of blood flow signals.

Assessment of the effects of transforming growth factor beta1 (TGF-β1)-Smad2/3 on fibrosis in rat myofascial trigger points using point shear wave elastography

“…6 ). These results are consistent with those of previous studies on stiffness ( Jiang et al, 2020 ; Liang, Guo & Li, 2021 ). Those studies confirmed that the stiffness of MTrPs tissue or the surrounding tissue is greater than that of normal tissue from the same location.…”

“…Therefore, there is a high demand for imaging techniques that provide quantitative and objective measurements for tense belts and MTrPs. Magnetic resonance imaging (MRI) and ultrasound (US) have been used to identify MTrPs for diagnosis and treatment evaluation ( Jiang et al, 2020 ; Liang, Guo & Li, 2021 ; Sikdar et al, 2009 ; Yu et al, 2021 ). Although both are noninvasive examination techniques, US has faster data acquisition and a lower cost than MRI.…”

Effect of Manual Therapy Compared to Ibuprofen on Primary Dysmenorrhea in Young Women—Concentration Assessment of C-Reactive Protein, Vascular Endothelial Growth Factor, Prostaglandins and Sex Hormones

“…In studies regarding the influence of NSAIDs on VEGF, it was demonstrated that NSAIDs could block the suppression of VEGF [ 46 , 47 ], which is in line with our research. Based on the latest reports from Jiang et al [ 48 ], who showed higher HIF-1α and VEGF concentrations in rats with active trigger points compared to control rats, we suggest that the tendency to lower VEGF after manual therapy, measured in our patients, might indicate a lower hypoxia occurrence [ 11 ].…”

Combined T2 Mapping and Diffusion Tensor Imaging: A Sensitive Tool to Assess Myofascial Trigger Points in a Rat Model

“… 21 It was proposed that MTrPs may represent an ischemia-induced inflammatory microenvironment. 22 , 23 MRI-based measurements of cerebral edema, synovitis and tendinopathy have been suggested to correlate with inflammatory cytokines in previous findings. 24–26 Taking a lead from the above-mentioned studies, we hypothesize that the active MTrPs should generate changes on DTI indices and T2 values, which may reflect an inflammatory process at the level of MTrPs.…”

“…Data were collected as previously described by Fangyan Jiang. 23 Since this study requires post-mortem elements at high cost, all efforts were made to minimize the number of animals sacrificed based on common sense to choose a suitable sample size. A total of 25 male Sprague-Dawley rats weighing 200–220g were obtained from the Animal Experiment Center of Guangxi Medical University (Nanning, China) and were 7 weeks old at the start of experiments.…”