Microdialysis/Acupuncture Needle to Assess Local Tissue

微透析/针灸针评估局部组织

• 批准号: 7006030
• 负责人: Jay Shah
• 金额: --
• 依托单位: CLINICAL CENTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7006030
• 关键词: acupuncture /acupressure; alternative medicine; bradykinin; calcitonin gene related peptide; clinical biomedical equipment; clinical chemistry; clinical research; human subject; interleukin 1; microdialysis; norepinephrine; pain; serotonin; striated muscles; tumor necrosis factor alpha

The purpose of this study is to explore the use of a novel 'microdialysis/acupuncture' needle, designed, fabricated, and tested by the investigators, to determine if this device and technique can successfully sample the chemical milieu of the soft tissue. Specifically, it will be used to measure and compare the quantity of small substances (electrolytes, muscle metabolites, inflammatory mediators, neurotransmitters, cytokines, and arachidonic acid derivatives) in three groups of subjects using a standardized anatomical location (trigger point 1) of the upper trapezius muscle, an area that is recognized as the most common location of myofascial trigger points (MTrPs) in that muscle. These substances are believed to play a critical role in the biochemistry and pathophysiology of soft tissue pain. Subjects will be drawn from a range of ages and both sexes. Trigger point 1is selected specifically to standardize the location of a sampling point in three carefully selected groups: 1) healthy subjects without neck pain who have no MTrPs identified by palpation bilaterally in triggr point 1(no pathological process, no symptoms)- Normal 2) healthy subjects without neck pain in whom latent MTrPs are identified by palpation in trigger point 1 in one of the upper trapezius muscles (pathological process, no symptoms)- Latent 3) healthy subjects complaining of neck pain of less than 3 months duration with active MTrPs identified by palpation in trigger point 1 in one of the upper trapezius muscles (pathological process with symptoms)- Active This is not a treatment study. Rather, the primary goal of this study is to learn whether this device and technique can successfully sample the chemical milieu in healthy subjects who 1) have pain and those who don't 2) have MTrPs and those who don?t and 3) have active MTrPs versus those who have latent MTrPs. Description of protocol progress: We have thus far recruited 24 subjects (14 women and 10 men), ranging in age from 23 to 66 years old. With our microanalytical sampling technique, we have successfully collected samples at trigger point 1 in the upper trapezius muscle from each subject without any untoward events. We have successfully measured 8 of the 21 analytes in 9 (with 3 in each group) subjects. Results: Overall, the amounts of SP, CGRP, bradykinin, serotonin, norepinephrine, TNF-alpha and IL-1beta were significantly higher in the Active group than either of the other two groups (p<.01). Overall, pH was significantly lower in the Active group than the other two groups (p<.03). In the Active group, the amounts of SP and CGRP were significantly lower at the end of sampling (post twitch) than at baseline (p<.02). Conclusions: Our novel microanalytical technique enables continuous, real-time sampling of extremely small quantities of very small substances directly from soft tissue, with minimal system perturbation. There are significant differences in pH, SP, CGRP, bradykinin, serotonin, norepinephrine, TNF-alpha and IL-1beta among the three groups. The local biochemical milieu does appear to change with a LTR. Exploration of the biochemical profile of MTrPs and normal muscle may

本研究的目的是探索使用一种新的“微透析/针灸”针，设计，制造和测试的研究人员，以确定这种设备和技术是否可以成功地采样软组织的化学环境。具体而言，它将用于测量和比较三组受试者中的小物质（电解质、肌肉代谢物、炎症介质、神经递质、细胞因子和花生四烯酸衍生物）的量，使用上阔肌的标准化解剖位置（触发点1），该区域被认为是该肌肉中肌筋膜触发点（MTrP）的最常见位置。这些物质被认为在软组织疼痛的生物化学和病理生理学中起关键作用。受试者将从不同年龄和性别中抽取。触发点1的选择是为了将采样点的位置标准化，分为三个精心选择的组： 1)无颈部疼痛的健康受试者，通过双侧触诊在第1点（无病理过程，无症状）中未发现MTRP-正常 2)无颈部疼痛的健康受试者，其中通过触诊上肌之一中的触发点1来识别潜伏性MTRP（病理过程，无症状）-潜伏性 3)健康受试者主诉持续时间少于3个月的颈痛，通过触诊上肌之一中的触发点1（病理性）鉴定出活动性MTrP 有症状的过程）-活动 这不是一项治疗研究。相反，本研究的主要目标是了解这种设备和技术是否可以成功地对健康受试者的化学环境进行采样，这些受试者1）有疼痛，2）没有MTRP，2）没有？t和3）具有活跃的MTrPs与具有潜伏性MTrPs的那些。 方案进展描述： 到目前为止，我们招募了24名受试者（14名女性和10名男性），年龄从23岁到66岁不等。通过我们的微量分析采样技术，我们成功地从每个受试者的上睑肌中的触发点1处收集了样本，没有任何不良事件。我们已经成功地测量了9个（每组3个）受试者的21种分析物中的8种。结果如下： 总的来说，活性组中SP、CGRP、缓激肽、5-羟色胺、去甲肾上腺素、TNF-α和IL-1 β的量显著高于其他两组（p<0.01）。总体而言，活性组的pH值显著低于其他两组（p<0.03）。在活动组中，SP和CGRP的量在采样结束时（抽搐后）显著低于基线（p<0.02）。结论：我们的新型微量分析技术可以直接从软组织中连续、实时地对极少量的极微小物质进行采样，同时系统干扰最小。三组间pH、SP、CGRP、缓激肽、5-羟色胺、去甲肾上腺素、TNF-α和IL-1 β差异有统计学意义。局部的生化环境似乎确实随着LTR而改变。探讨肌钙蛋白磷酸酶和正常肌肉的生化特征可能