Alterações nos níveis plasmáticos de biomarcadores de pacientes com dor crônica

JUSTIFICATIVA E OBJETIVOS: Analisar as evidências científicas sobre alterações nos níveis plasmáticos de interleucinas, óxido nítrico, metaloproteinases de matriz extracelular, bradicinina e cortisol em pacientes com dor crônica. CONTEÚDO: Os estudos foram identificados por meio das bases de dados eletrônicas: Pubmed/Medline, Scopus, LILACS e Web of Science, publicados no período de junho a dezembro de 2016. Os artigos selecionados foram classificados em ficha de identificação, seleção dos participantes, elegibilidade, critérios de inclusão e exclusão. Os artigos selecionados foram avaliados por meio de análise de conteúdo, buscando identificar os biomarcadores presentes nos pacientes com dor crônica. Foram selecionados 13 artigos que abordavam a dosagem plasmática de biomarcadores em humanos com dor crônica. A maior parte dos artigos apresentou a dose de citocinas, seguidos pelo cortisol. Apenas um artigo apresentou a dose de óxido nítrico e nenhum artigo identificou a dosagem de níveis plasmáticos de metaloproteinases de matriz extracelular e bradicinina. CONCLUSÃO: Pôde-se verificar modificações nos níveis plasmáticos de citocinas inflamatórias e anti-inflamatórias, e que os níveis plasmáticos de cortisol estão relacionados com os sintomas de ansiedade e depressão nos pacientes com dor crônica. No entanto, não foi possível verificar as alterações nos níveis de plasma do óxido nítrico, bradicinina e metaloproteinase de matriz extracelular devido à ausência de evidências científicas.BACKGROUND AND OBJECTIVES: To analyze the scientific evidence on the changes in plasma levels of interleukins, nitric oxide, extracellular matrix metalloproteinases, bradykinins, and cortisol in patients with chronic pain. CONTENTS: The studies were identified by searching the following electronic databases: Pubmed/Medline, Scopus, LILACS, and Web of Science, published from June of 2016 to December of 2016. The selected articles were presented in a flow chart based on their identification, selection, eligibility and inclusion and exclusion criteria. The content of the articles included in the study was analyzed to identify the biomarkers present in patients with chronic pain. Thirteen articles that addressed the plasma biomarkers levels in humans with chronic pain were selected. Most of the articles presented the cytokines levels, followed by cortisol. Only one article mentioned the nitric oxide, and none mentioned what plasma levels of extracellular matrix metalloproteinases and bradykinins were identified. CONCLUSION: Changes were observed in inflammatory and anti-inflammatory cytokine plasma levels, and that cortisol is related to anxiety and depression symptoms in patients with chronic pain. However, it was not possible to identify the changes in plasma levels of nitric oxide, bradykinin, and extracellular matrix metalloproteinases due to the absence of scientific evidence

Aquatic Plyometric Training Associated with Androgenic Anabolic Steroids do not Increase Muscle Mass in Rats

To improve athletic performance or for aesthetic reasons, athletes and no athletes may use androgenic anabolic steroids (AAS). Numerous studies have reported that aquatic plyometric training (APT) can improve muscular strength and vertical jump; however the effect of these training protocols on muscular mass are poorly investigated. The aim of this study was to investigate the effects of APT associated with AAS in the soleus, gastrocnemius (Gastro), extensor digitorium longus (EDL) and tibialis anterior (TA) skeletal muscles in rats. Animals were grouped into: sedentary (S); S with AAS (AAS); trained (T); and T with AAS (AAST). Exercised groups performed jumps in water: 4 series of 10 jumps each and 30-second rest interval between series, for 7 weeks with a progressive overload of 50 to 80% of body weight and were killed after the last exercise session. Nandrolone decanoate (5 mg/kg – supraphysiological dose) was injected subcutaneously twice a week. One way analyses of variance was performed and there was no statistically significant difference between groups in EDL (p=0.169), TA (p=0.739), Gastro (p=0.722) and Soleus (p=1.000) muscles. AAS, training or their association induced no alterations in the weight of the studied muscles. In conclusion, the APT did not increase the muscle weight as well as the association with AAS treatment

Nandrolone Decanoate associated with exercise training inhibit vascular endothelial growth factor (VEGF) mRNA expression in rat soleus muscle

Androgenic-anabolic steroids (AAS) have been used for both performance improvement and aesthetic reasons. It is well know that high doses of AAS induce serious adverse effects such as skeletal muscle injuries, including increase in the rate of muscle strains/ruptures. Vascular endothelial growth factor (VEGF) is a key factor in angiogenesis induction on both physiological and pathological conditions The aim of this study was to investigate VEGF mRNA expression in rat soleus muscle after jumping training associated with AAS administration. Wistar rats were grouped into: sedentary (S); trained without AAS (T); sedentary nandrolone decanoate (ND)-treated (AAS); and trained with AAS (AAST). The trained groups carried out jumps in water at 32°C.: 4 series of 10 jumps each, with a 30-second interval among series, for 7 weeks, with 50-80% overload of the animal corporal mass. The AAS (Decadurabolin® - 5mg/kg) was injected subcutaneously in the animal’s back twice a week. Real-time PCR analyses showed that training significantly increased VEGF mRNA expression in comparison with the S and AAS groups. When exercise training was associated with nandrolone decanoate, the VEGF mRNA expression was inhibited compared with T group. The inhibition of VEGF expression by AAS administration can decrease angiogenesis in skeletal muscle. These results suggest that the AAS may be strongly prejudicial to muscle remodeling and performance

Strength training and nandrolone decanoate decreased myostatin expression

Nandrolone decanoate is a androgenic anabolic steroid (AAS) which targets the satellite cells in skeletal muscles. These cells are considered the stem cells of skeletal muscle, and they are essential for muscle growth and repair. Myostatin is a negative regulator of muscle mass that inhibits myoblast proliferation and differentiation. Recognizing the mechanisms related to AAS action in skeletal muscle is critical for a better understand of muscular physiology under AAS use. The aim of this study was to investigate the effects of aquatic plyometric training (APT) with overload associated with AAS on the gastrocnemius muscle of rats. Animals were grouped into: sedentary (S); S with AAS (AAS); trained (T); and T with AAS (AAST). Exercised groups performed jumps in water: 4 sets of 10 jumps each and 30-second rest interval between series, for 7 weeks with a progressive overload of 50 to 80% of body weight and were killed after the last exercise session. AAS (5 mg/kg – supraphysiological dose) was injected subcutaneously. One-way Anova and Turkey post hoc tests were used. Myostatin mRNA expression was determined by real-time RT-PCR. p\u3c0.05 was considered statistically significant. APT did not change myostatin expression (p=0.873). However, the interaction with AAS downregulated myostatin (p=0.039). EAA and EAAT groups expressed less myostatin than the group T (p=0.013 and p=0.009, respectively). These results should be taken with care, since other variables related to muscle remodeling should be evaluated

Modificações dos papéis ocupacionais de mulheres com dor crônica e Artrite Reumatoide, comparada a mulheres saudáveis

O objetivo deste estudo foi compreender os papéis ocupacionais de mulheres com dor crônica causada pela Artrite Reumatoide (AR) e comparar estes padrões de desempenho com os de sujeitos saudáveis. Trata-se de um estudo transversal, exploratório e comparativo. Os participantes foram divididos em 2 grupos. Para o grupo AR, foram aplicados dois instrumentos validados: Escala Visual Analógica e as Lista de Papéis Ocupacionais, dados pessoais, clínicos e sociodemográficos. No grupo controle, foram aplicados a ficha de informações pessoais e a Lista de Papéis Ocupacionais. O grupo controle era pareado em idade e nível sociodemográfico. Participaram deste estudo 164 mulheres, sendo 82 mulheres com dor crônica e artrite reumatoide, com média de idade de 55,9 ± 11,2 anos, e 82 mulheres pareadas e sem dor crônica e sem AR. No grupo AR, 48% das participantes perderam as atividades laborais, porém os papéis de cuidador (68%), serviços domésticos (89%), amigo (74%), membro da família (93%) e religioso (60%), se mantiveram mesmo com o processo de adoecimento. Já no Grupo controle (GC), observa-se a manutenção da maioria dos papéis ocupacionais. Na comparação entre os grupos GAR e GC, encontrou-se diferença estatisticamente significante nos papéis de estudante, trabalhador, voluntário, amigo e passatempo/amador. Os papéis ocupacionais de mulheres com dor crônica causada pela AR são modificados pelo adoecimento e pela dor. Quando comparadas com mulheres saudáveis, observa-se que os papéis de estudante, trabalhador, voluntário e passatempo/amador, deixam de ser realizados devido ao adoecimento. Esta influência não é dependente da intensidade da dor, já que não foi encontrada diferença entre as participantes com AR e níveis de severidade diferentes da dor.The objective of this study was to understand the occupational roles of women with chronic pain caused by Rheumatoid Arthritis (RA) and to compare these performance standards with those of healthy subjects. It is a cross-sectional, exploratory and comparative study. Participants were divided into 2 groups. For the RA group, two validated questionnaires were applied: Visual Analog Scale and the Occupational Roles List, clinical and demographic data. In the control group, the personal information sheet and the Occupational Role List were applied. The control group was matched in age and sociodemographic level. A total of 164 women participated in the study, of which 82 were women with chronic pain and rheumatoid arthritis, with a mean age of 55.9 ± 11.2 years, and 82 healthy and matched women. In the RA group (GAR), 48% of the participants in the work activities were lost, but the roles of caregiver (68%), household chores (89%), friend (74%), family member (93%), and religious (60%), remained in the process of becoming ill. In the control group (CG), the maintenance of most occupational roles is observed. In the comparison between both groups, a statistically significant difference was found in student, worker, volunteer, friend and passer/amateur roles. The occupational roles of women with chronic pain caused by RA are modified by illness and pain. When compared to healthy women, it is observed that the student, worker, volunteer and hobby/amateur roles are no longer performed due to illness. This influence is not dependent on pain intensity since no difference was found between participants with RA and levels of severity other than pain

Adipose tissue extracellular matrix remodeling in response to dietary patterns and exercise : molecular landscape, mechanistic insights, and therapeutic approaches

The extracellular matrix (ECM) is a 3-dimensional network of molecules that play a central role in differentiation, migration, and survival for maintaining normal homeostasis. It seems that ECM remodeling is required for adipose tissue expansion. Despite evidence indicating that ECM is an essential component of tissue physiology, adipose tissue ECM has received limited attention. Hence, there is great interest in approaches to neutralize the harmful effects of ECM enlargement. This review compiles and discusses the current literature on adipose tissue ECM remodeling in response to different dietary patterns and exercise training. High-calorie diets result in substantial adipose tissue ECM remodeling, which in turn could lead to fibrosis (excess deposition of collagens, elastin, and fibronectin), inflammation, and the onset of metabolic dysfunction. However, combining a nutritionally balanced diet with exercise is a remarkable potential strategy for lipolytic activity, preventing rapid ECM expansion in different adipose tissue depots. Despite the distinct exercise modalities (aerobic or resistance exercise) reversing adipose tissue fibrosis in animal models, the beneficial effect on humans remains controversial. Defining molecular pathways and specific mechanisms that mediate the positive effects on adipose tissue, ECM is essential in developing optimized interventions to improve health and clinical outcomes

The effect of quadriceps muscle length on maximum neuromuscular electrical stimulation evoked contraction, muscle rchitecture, and tendon-aponeurosis stiffness

Muscle-tendon unit length plays a crucial role in quadriceps femoris muscle (QF) physiological adaptation, but the influence of hip and knee angles during QF neuromuscular electrical stimulation (NMES) is poorly investigated. We investigated the effect of muscle length on maximum electrically induced contraction (MEIC) and current efficiency. We secondarily assessed the architecture of all QF constituents and their tendon-aponeurosis complex (TAC) displacement to calculate a stiffness index. This study was a randomized, repeated measure, blinded design with a sample of twenty healthy men aged 24.0 ± 4.6. The MEIC was assessed in four different positions: supine with knee flexion of 60◦ (SUP60); seated with knee flexion of 60◦ (SIT60); supine with knee flexion of 20◦ (SUP20), and seated with knee flexion of 20◦ (SIT20). The current efficiency (MEIC/maximum tolerated current amplitude) was calculated. Ultrasonography of the QF was performed at rest and during NMES to measure pennation angle (θp) and fascicle length (Lf ), and the TAC stiffness index. MEIC and current efficiency were greater for SUP60 and SIT60 compared to SUP20 and SIT20. The vastus lateralis and medialis showed lower θp and higher Lf at SUP60 and SIT60, while for the rectus femoris, in SUP60 there were lower θp and higher Lf than in all positions. The vastus intermedius had a similar pattern to the other vastii, except for lack of difference in θp between SIT60 compared to SUP20 and SIT20. The TAC stiffness index was greater for SUP60. We concluded that NMES generate greater torque and current efficiency at 60◦ of knee flexion, compared to 20◦ . For these knee angles, lengthening the QF at the hip did not promote significant change. Each QF constituent demonstrated muscle physiology patterns according to hip and/or knee angles, even though a greater Lf and lower θp were predominant in SUP60 and SIT60. QF TAC index stiffened in more elongated positions, which probably contributed to enhanced force transmission and slightly higher torque in SUP60. Our findings may help exercise physiologist better understand the impact of hip and knee angles on designing more rational NMES stimulation strategies