Effect of early treatment with transcutaneous electrical diaphragmatic stimulation (TEDS) on pulmonary inflammation induced by bleomycin

Abstract

BackgroundBleomycin (B) is an antineoplastic drug that has pulmonary fibrosis as a side effect. There are few experimental studies about the effects of physical therapy treatment in this case.ObjectiveThe objective was to study rat lungs treated with B and precocious intervention by transcutaneous electrical diaphragmatic stimulation (TEDS).MethodWistar rats were divided into 4 groups (n=5): a control group (C); a stimulated group (TEDS); a group treated with a single dose of B (intratracheally, 2.5 mg/kg) (B); and a group treated with B and electric stimulation (B + TEDS). After the B instillation, the electrical stimulation was applied for 7 days, for a duration of 20 minutes. Lung fragments were histologically processed with hematoxylin and eosin (HE) and 8-isoprostane-PGF2α (8-iso-PGF2α). The density of the alveolar area was determined by planimetry, the inflammatory profile was defined by the number of cells, and the level of oxidative stress in the pulmonary tissue was evaluated by 8-iso-PGF2α. For statistical analysis of the data, the Shapiro-Wilk test was used, followed by a one-way ANOVA with the post-hoc Bonferroni test (p≤0.05).ResultsThe B group exhibited a significant reduction in the area density, and the acute treatment with B + TEDS prevented this reduction. There were increased numbers of fibroblasts, leukocytes, and macrophages in the B group, as well as increased lipid peroxidation, which was observed only in this group.ConclusionB promoted a reduction in the alveolar density area, thereby inducing the inflammatory process and increasing the production of free radicals. These effects were minimized by the application of TEDS at the initial treatment stage.

Suppression of Ventilation-Induced Diaphragm Fibrosis through the Phosphoinositide 3-Kinase-γ in a Murine Bleomycin-Induced Acute Lung Injury Medel

“…We have previously demonstrated that MV induced TGF-β1 production as well as type I and III procollagen, lumican, and α-SMA gene expression in the diaphragm [30]. Other studies have reported increased oxidative stress and impaired energetic metabolism in the diaphragm in bleomycin-induced pulmonary inflammation [31] and lower glycogen content in the diaphragm in bleomycin-induced lung fibrosis [33]. However, our study is the first to investigate the mechanism underlying diaphragm fibrogenesis; we observed that bleomycin augments MV-induced diaphragmatic injury and contributes to diaphragm fibrosis in an animal model simulating critically ill patients receiving MV following ALI.…”

Suppression of Ventilation-Induced Diaphragm Fibrosis through the Phosphoinositide 3-Kinase-γ in a Murine Bleomycin-Induced Acute Lung Injury Model

“…We have previously demonstrated that MV induced TGF-β1 generation as well as type I and III procollagen, lumican, and α-SMA gene expression in the diaphragm [ 32 ]. Other studies have reported increased oxidative stress and impaired energetic metabolism in the diaphragm in bleomycin-induced pulmonary inflammation [ 33 ] and lower glycogen content in the diaphragm in bleomycin-induced lung fibrosis [ 34 ]. However, our study is the first to investigate the mechanism underlying diaphragm fibrogenesis; we observed that bleomycin augments MV-induced diaphragmatic injury and contributes to diaphragm fibrosis in an animal model simulating critically ill patients receiving MV following ALI.…”

Impacto de dois protocolos de estimulação diafragmática elétrica transcutânea nos parâmetros ventilométricos de pacientes críticos

“…Ainda de acordo com Cancelliero et al 8 a EDET tende a produzir uma contração por meio de uma corrente elétrica, com resposta sincrônica em todas as unidades motoras do músculo, provocando o recrutamento de fibras musculares diafragmáticas antes inativas. Devido a isso, este recurso fisioterapêutico é uma especificidade utilizada para melhorar a função ventilatória, auxiliando pacientes com fraqueza dos músculos respiratórios ou submetidos à VM 14 .…”