低能量體外震波對Capsaicin誘發非菌性攝護腺炎的發炎介質,疼痛行為與中樞致敏化作用影響之研究
王弘仁、莊燿吉
高雄長庚紀念醫院外科部 泌尿科
Effects of low intensity extracorporeal shockwave therapy (LESWT) on inflammatory mediators and central sensitization on capsaicin induced nonbacterial prostatitis model in rats
Hung-Jen Wang, Yao-Chi Chuang
Department of urology, Kaohsiung Chang Gung memorial hospital, Chang Gung university college of medicine, Kaohsiung, Taiwan
Purpose: Central sensitization might lead to persist pain. We hypothesize that LESWT might attenuate the NGF and related inflammasone expression in both prostate and spinal cord level.
Material and methods: Adult male S.D. rats were injected with vehicle or capsaicin (10 mM, 0.1 cc) into the prostate. Right after injection, various shock wave (0, 100, 200 or 300 shocks; 0.12 mJ/mm2) were applied into prostate. Three days after LESWT, the L6, S1 spinal cord and dorsal root ganglion at L6 spinal were removed for histology and NGF, BDNF, TRPV1 and COX-2 expression expression by using IHC staining and western blot.
Result: Capsaicin injection into prostate induced significant increase of Cox-2, NGF and BDNF-positive cells in the L6 DRG compared with vehicle injection. This was dose dependently ameliorated by LESWT especially in 200 shock wave group. In western blot analysis, LESWT could also downregulate expression of NGF, BDNF, TRPV1 and COX-2 expression. LESW decreased the signal intensity in Thalamus and periaquaduct in functional MRI. Intraprostatic capsaicin injection activates COX2, NGF and related inflammasone expression in the L6 level dorsal root ganglion. LESWT at prostate could also inhibit the capsaicin induced COX-2 and modulate neurotrophin expression at central nervous systems in a dose dependent fashion.
Conclusion: This finding suggests a potential clinical benefit of LESWT at the optimal dose for ameliorate chronic pain and its associated central sensitization.