The Combination of Electroacupuncture and Massage Therapy Alleviates Myofibroblast Transdifferentiation and Extracellular Matrix Production in Blunt Trauma-Induced Skeletal Muscle Fibrosis.

Na Zhao,Bo Liu,Wei Zhang,Hua-Nan Li,Hongcai Shang,Geng Pang,Jin-Gui Wang,Si-Wen Liu,Xiong-Fei Luo

doi:10.1155/2021/5543468

Abstract

Complementary therapies, such as acupuncture and massage, had been previously reported to have therapeutic effects on skeletal muscle contusions. However, the recovery mechanisms on skeletal muscles after blunt trauma via the combination of electroacupuncture (EA) and massage therapy remain unclear. In the present study, a rat model of the skeletal muscle fibrosis following blunt trauma to rat skeletal muscle was established, and the potential molecular mechanisms of EA + massage therapy on the skeletal muscle fibrosis were investigated. The results suggested that EA + massage therapy could significantly decrease inflammatory cells infiltration and collagenous fiber content and ameliorate the disarrangement of sarcomeres within myofibrils compared to the model group. Further analysis revealed that EA + massage therapy could reduce the degree of fibrosis and increase the degree of myofibroblast apoptosis by downregulating the mRNA and protein expression of transforming growth factor- (TGF-) β1 and connective tissue growth factor (CTGF). Furthermore, the fibrosis of injured skeletal muscle was inhibited after treatment through the normalization of balance between matrix metalloproteinase- (MMP-) 1 and tissue inhibitor of matrix metalloproteinase (TIMP). These findings suggested that the combination of electroacupuncture and massage therapy could alleviate the fibrotic process by regulating TGF β1-CTGF-induced myofibroblast transdifferentiation and MMP-1/TIMP-1 balance for extracellular matrix production.

Highlights

Skeletal muscle injury is one of the common types of exercise-related injuries in sports medicine, and its effective treatment is rather challenging. e regeneration process of skeletal muscle injury is similar in most types of muscle injuries
Effect of the Combination of Massage and Electroacupuncture erapy on Histological Change and the Degree of Fibrosis in the Skeletal Muscle Fibrosis Rats. e results of H&E staining are shown in Figure 1. e myofibrous tissue of normal rats showed polygonal, regular, and tight distribution, and no edema, hyperaemia, and inflammation were observed (Figure 1(a))
In the model of the skeletal muscle fibrosis group, the skeletal muscle cells tend to be round, and there were more inflammatory cells infiltrating in damaged skeletal muscle than those in the normal cells (Figure 1(b))

Summary

Introduction

Skeletal muscle injury is one of the common types of exercise-related injuries in sports medicine, and its effective treatment is rather challenging. e regeneration process of skeletal muscle injury is similar in most types of muscle injuries. Physical therapy approaches such as limb elevation and local cooling had been used to improve muscle repair [4] Another alternative treatment of enhancing muscle healing includes pharmacological therapies with nonsteroidal anti-inflammatory drugs (NSAIDs) being the Evidence-Based Complementary and Alternative Medicine most common drug [5]. The NSAIDs could reduce the early inflammatory responses, there were some side effects such as hypertension, gastrointestinal disorders, and renal toxicity. Complementary therapies such as acupuncture and massage therapy had gained increasing attention for the treatment of skeletal muscle injuries [6]

Results

Discussion

Conclusion