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      Electroacupuncture Reduces Fibromyalgia Pain by Attenuating the HMGB1, S100B, and TRPV1 Signalling Pathways in the Mouse Brain

      research-article
      1 , 2 , 1 , 3 ,
      Evidence-based Complementary and Alternative Medicine : eCAM
      Hindawi

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          Abstract

          Fibromyalgia is characterized by chronic and persistent widespread pain and generalized muscle tenderness, and it is refractory to treatment. The central nervous system (CNS) plays an important role, pain signalling, in fibromyalgia subjects. Electroacupuncture (EA) has been practiced for thousand years to treat many diseases that involve pain. We established fibromyalgia-like pain in mice using intermittent cold stress and investigated therapeutic effects and modes of action with EA. EA of 2 Hz and 1 mA was performed for 20 min at the ST36 acupoint in mice from Day 3 to Day 5. Our results showed that mechanical and thermal hyperalgesia were induced by intermittent cold stress (Day 5: mechanical: 1.43 ± 0.34 g; thermal: 3.98 ± 0.73 s) and were subsequently reversed by EA (Day 5: mechanical: 4.62 ± 0.48 g; thermal: 7.68 ± 0.68 s) or Trpv1 −/− (Day 5: mechanical: 4.38 ± 0.51 g; thermal: 7.48 ± 0.98 s). Activity in the HMGB1, S100B, and TRPV1 pathways was increased in the mouse prefrontal cortex, somatosensory cortex, thalamus, and amygdala with the stress treatment. This increase was attenuated by EA or Trpv1 −/−. These results suggest potential targets for the treatment of TRPV1-dependant fibromyalgia pain.

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          Most cited references35

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          The capsaicin receptor: a heat-activated ion channel in the pain pathway.

          Capsaicin, the main pungent ingredient in 'hot' chilli peppers, elicits a sensation of burning pain by selectively activating sensory neurons that convey information about noxious stimuli to the central nervous system. We have used an expression cloning strategy based on calcium influx to isolate a functional cDNA encoding a capsaicin receptor from sensory neurons. This receptor is a non-selective cation channel that is structurally related to members of the TRP family of ion channels. The cloned capsaicin receptor is also activated by increases in temperature in the noxious range, suggesting that it functions as a transducer of painful thermal stimuli in vivo.
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            Role of cytokines in intervertebral disc degeneration: pain and disc content.

            Degeneration of the intervertebral discs (IVDs) is a major contributor to back, neck and radicular pain. IVD degeneration is characterized by increases in levels of the proinflammatory cytokines TNF, IL-1α, IL-1β, IL-6 and IL-17 secreted by the IVD cells; these cytokines promote extracellular matrix degradation, chemokine production and changes in IVD cell phenotype. The resulting imbalance in catabolic and anabolic responses leads to the degeneration of IVD tissues, as well as disc herniation and radicular pain. The release of chemokines from degenerating discs promotes the infiltration and activation of immune cells, further amplifying the inflammatory cascade. Leukocyte migration into the IVD is accompanied by the appearance of microvasculature tissue and nerve fibres. Furthermore, neurogenic factors, generated by both disc and immune cells, induce expression of pain-associated cation channels in the dorsal root ganglion. Depolarization of these ion channels is likely to promote discogenic and radicular pain, and reinforce the cytokine-mediated degenerative cascade. Taken together, an enhanced understanding of the contribution of cytokines and immune cells to these catabolic, angiogenic and nociceptive processes could provide new targets for the treatment of symptomatic disc disease. In this Review, the role of key inflammatory cytokines during each of the individual phases of degenerative disc disease, as well as the outcomes of major clinical studies aimed at blocking cytokine function, are discussed.
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              The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity.

              To develop simple, practical criteria for clinical diagnosis of fibromyalgia that are suitable for use in primary and specialty care and that do not require a tender point examination, and to provide a severity scale for characteristic fibromyalgia symptoms. We performed a multicenter study of 829 previously diagnosed fibromyalgia patients and controls using physician physical and interview examinations, including a widespread pain index (WPI), a measure of the number of painful body regions. Random forest and recursive partitioning analyses were used to guide the development of a case definition of fibromyalgia, to develop criteria, and to construct a symptom severity (SS) scale. Approximately 25% of fibromyalgia patients did not satisfy the American College of Rheumatology (ACR) 1990 classification criteria at the time of the study. The most important diagnostic variables were WPI and categorical scales for cognitive symptoms, unrefreshed sleep, fatigue, and number of somatic symptoms. The categorical scales were summed to create an SS scale. We combined the SS scale and the WPI to recommend a new case definition of fibromyalgia: (WPI > or =7 AND SS > or =5) OR (WPI 3-6 AND SS > or =9). This simple clinical case definition of fibromyalgia correctly classifies 88.1% of cases classified by the ACR classification criteria, and does not require a physical or tender point examination. The SS scale enables assessment of fibromyalgia symptom severity in persons with current or previous fibromyalgia, and in those to whom the criteria have not been applied. It will be especially useful in the longitudinal evaluation of patients with marked symptom variability.
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                Author and article information

                Contributors
                Journal
                Evid Based Complement Alternat Med
                Evid Based Complement Alternat Med
                ECAM
                Evidence-based Complementary and Alternative Medicine : eCAM
                Hindawi
                1741-427X
                1741-4288
                2022
                15 March 2022
                15 March 2022
                : 2022
                : 2242074
                Affiliations
                1College of Chinese Medicine, Graduate Institute of Acupuncture Science, China Medical University, Taichung 40402, Taiwan
                2Department of Neurosurgery, China Medical University Hospital, Taichung 404332, Taiwan
                3Chinese Medicine Research Center, China Medical University, Taichung 40402, Taiwan
                Author notes

                Academic Editor: Manel Santafe

                Author information
                https://orcid.org/0000-0002-6245-9023
                https://orcid.org/0000-0001-7204-8837
                Article
                10.1155/2022/2242074
                8941543
                35341159
                591d0a43-4312-4646-9578-911c36efa73c
                Copyright © 2022 I-Han Hsiao and Yi-Wen Lin.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 November 2021
                : 16 February 2022
                : 28 February 2022
                Funding
                Funded by: Ministry of Education
                Award ID: CMU110-MF-60
                Funded by: MOST
                Award ID: 108-2320-B-039-028-MY3
                Categories
                Research Article

                Complementary & Alternative medicine
                Complementary & Alternative medicine

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