A model for radiating leg pain of endometriosis.
A model for radiating leg pain of endometriosis.
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DOI：
10.1016/j.jbmt.2016.04.013
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发表时间：
2016-10
影响因子：
1.4
通讯作者：
Bove, Geoffrey M
中科院分区：
文献类型：
--
作者：
Bove, Geoffrey M
子宫内膜异位症是一种常见的女性健康疾病，通常会导致背痛和放射性腿痛。患有这种疼痛的患者经常寻求多名医疗保健专业人员的护理，包括手动治疗师。我们假设子宫内膜异位症可以引起神经炎症，从而引起子宫内膜异位症经常伴随的放射性腿部疼痛。为了建立雌性Wistar大鼠坐骨神经子宫内膜异位症模型，将一段子宫角自体移植到坐骨神经中。将子宫内膜切除并自体移植到坐骨神经的子宫切片作为对照。在1、3和15个月后，收获神经并处理免疫细胞存在和神经元件。4个月后收集对照神经。所有自体移植物均存活，导致子宫部分与神经融合。大体上，肿胀的囊肿对神经的特点的复合体。显微镜下，复合物含有募集的巨噬细胞，表明持续性炎症，并由小直径轴突支配。8只对照组大鼠中仅1只出现小囊肿，推测是由于残留的子宫内膜所致。持续的免疫反应和神经支配表明神经-子宫复合体是炎症和持续神经放电的来源，因此疼痛。这个模型可以揭示经常伴随子宫内膜异位症的放射性腿部疼痛。手法治疗师应该意识到子宫内膜异位症引起的症状和检查结果可能与肌肉骨骼病因相似。
Endometriosis is a prevalent female health disorder that often leads to back pain and radiating leg pain. Patients with such pain often seek care from multiple health care professionals, including manual therapists. We hypothesized that endometrioma can induce nerve inflammation thus the radiating leg pain that often accompanies endometriosis. To model sciatic endometriosis in female Wistar rats, a section of uterine horn was autotransplanted to the sciatic nerve. Uterus sections with the endometrium removed and autotransplanted to the sciatic nerve served as controls. After 1, 3, and 15 months the nerves were harvested and processed for immune cell presence and for neural elements. Control nerves were harvested after 4 months. All autotransplants survived, resulting in a fusion of the uterus sections to the nerves. Macroscopically, turgid cysts apposed to the nerves characterized the complexes. Microscopically, the complexes contained recruited macrophages, indicating persistent inflammation, and were innervated by small diameter axons. Only 1 of 8 control rats developed a small cyst, presumably due to residual endometrium. The persistent immune response and innervation suggest the nerve-uterus complexes as sources of inflammation and persistent neural discharge, and thus pain. This model could shed light upon the radiating leg pain that often accompanies endometriosis. Manual therapists should be aware of the possibility of endometriosis causing symptoms and examination findings that mimic musculoskeletal etiologies.