An experimental study of muscular injury repair in a mouse model of notexin-induced lesion with EPI® technique

Abstract

BackgroundThe mechanisms of muscle injury repair after EPI® technique, a treatment based on electrical stimulation, have not been described. This study determines whether EPI® therapy could improve muscle damage.MethodsTwenty-four rats were divided into a control group, Notexin group (7 and 14 days) and a Notexin + EPI group. To induce muscle injury, Notexin was injected in the quadriceps of the left extremity of rats. Pro-inflammatory interleukin 1-beta (IL-1beta) and tumoral necrosis factor-alpha (TNF-alpha) were determined by ELISA. The expression of receptor peroxisome gamma proliferator activator (PPAR-gamma), vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor-1 (VEGF-R1) were determined by western-blot.ResultsThe plasma levels of TNF-alpha and IL-1beta in Notexin-injured rats showed a significant increase compared with the control group. EPI® produced a return of TNF-alpha and IL-1beta values to control levels. PPAR-gamma expression diminished injured quadriceps muscle in rats. EPI® increased PPAR-gamma, VEGF and VEGF-R1 expressions. EPI® decreased plasma levels of pro-inflammatory TNF-alpha and IL-1beta and increased anti-inflammatory PPAR-gamma and proangiogenic factors as well as VEGF and VEGF-R1 expressions.ConclusionThe EPI® technique may affect inflammatory mediators in damaged muscle tissue and influences the new vascularization of the injured area. These results suggest that EPI® might represent a useful new therapy for the treatment of muscle injuries. Although our study in rats may represent a valid approach to evaluate EPI® treatment, studies designed to determine how the EPI® treatment may affect recovery of injury in humans are needed.

Ultrasound-Guided EPI® Technique and Eccentric Exercise, New Treatment for Achilles and Patellar Tendinopathy Focused on the Region-Specific of the Tendon

“…This, in turn, results in an increase of the expression of vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor 2 (VEGFR-2), mediators responsible for angiogenesis anti-inflammatory response. The EPI ® technique makes for the activation of molecular and cellular mechanisms of the tendon responsible for phagocytosis and the regeneration of degenerated tissue [33,36].…”

“…This leads to a controlled local inflammatory reaction that leads to the regeneration of damaged tissue [33,36].…”

New Treatments for Degenerative Tendinopathy, focused on the Region-Specific of the Tendon

“…The application of ultrasound-guided EPI® technique produces a non-thermal electrochemical reaction centered on degenerated tissue (tendinosis). This leads to a controlled local inflammatory reaction that leads to the regeneration of damaged tissue [48,51].…”

Comparative study of treatment interventions for patellar tendinopathy: a protocol for a randomised controlled trial

“…DN consists of the insertion of a needle (filiform and solid, non-bevelled) with the aim of provoking a local injury leading to an inflammatory response and the subsequent regeneration of the injured area in approximately 1 week. A study performed by Abat et al reported that DN induced histological and mechanical changes in rat Achilles tendons at week 1, with changes persisting at week 4 18. Percutaneous needle electrolysis (PNE) is an ultrasound-guided technique used by physiotherapists consisting of causing localised lysis in the damaged and/or degenerated tissue by means of a galvanic current transmitted through an acupuncture needle.…”

“…Percutaneous needle electrolysis (PNE) is an ultrasound-guided technique used by physiotherapists consisting of causing localised lysis in the damaged and/or degenerated tissue by means of a galvanic current transmitted through an acupuncture needle. This technique may affect inflammatory mediators in damaged muscle tissue and influence the new vascularisation of the injured area in rats 18. James et al 11 carried out a cohort study in humans analysing one group treated with DN and another treated with autologous blood injections.…”