Assuntos
Neurônios/citologia , Traumatismos da Medula Espinal/fisiopatologia , Células-Tronco/citologia , Terapia por Acupuntura , Diferenciação Celular , Células Cultivadas , Humanos , Nestina/metabolismo , Neurônios/metabolismo , Receptores de Fator de Crescimento Neural/metabolismo , Medula Espinal/citologia , Medula Espinal/metabolismo , Células-Tronco/metabolismoRESUMO
Acupuncture can alleviate symptoms of spinal cord injuries (SCI). The underlying mechanism, however, is unknown. We hypothesized that stem cells could be mobilized by acupuncture. Therefore, we enrolled 14 healthy study participants using acupuncture points for the treatment of SCI. The frequency of CD133 and CD34 cells in peripheral blood and the serum concentrations of matrix metalloproteinase (MMP)-9, brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and interleukin-6 were determined before and after acupuncture (<1 hr, 24 hr, and 48 hr). CD133(+)34(-) cells were doubled 48 hr after acupuncture, with concomitant decreases in BDNF and MMP-9 levels. Interleukin-6 remained below detectable levels, eliminating a stress-induced cell release. Individuals acupunctured on control counterpoints showed no changes in CD133(+) cells. Our results indicate that acupuncture for SCI can mobilize human CD133(+)34(-) cells. (c) 2009 Wiley-Liss, Inc.
Assuntos
Acupuntura , Antígenos CD/metabolismo , Células Sanguíneas/fisiologia , Movimento Celular/fisiologia , Glicoproteínas/metabolismo , Peptídeos/metabolismo , Antígeno AC133 , Pontos de Acupuntura , Adulto , Antígenos CD34/metabolismo , Fator Neurotrófico Derivado do Encéfalo/sangue , Feminino , Citometria de Fluxo , Humanos , Masculino , Metaloproteinase 9 da Matriz/sangue , Pessoa de Meia-Idade , Fator de Crescimento Neural/sangue , Traumatismos da Medula Espinal , Adulto JovemRESUMO
BACKGROUND: Dobutamine-atropine stress echocardiography (DASE) is an established test for the diagnosis and risk stratification of patients with coronary artery disease. Atropine use to attain target heart rate prolongs test time. HYPOTHESIS: The aim of this study was to assess the utility of isometric handgrip exercise (33% maximal voluntary contraction x 4 min) with DASE. METHODS: We prospectively evaluated 131 patients undergoing DASE randomized to handgrip exercise or no handgrip. Effect of handgrip exercise on endpoints: time to target heart rate (85% maximum predicted), recovery time, total test time, mean dobutamine and atropine dosage, and the number of ischemic responses were assessed. Effect of current beta-blocker medication use was also evaluated. RESULTS: Heart rate rose more quickly in the handgrip group. At 6-10 min (peak handgrip), mean heart rate rose 51 +/- 14 beats/min in the handgrip group compared with 38 +/- 18 beats/min in the no handgrip group (p < 0.0001). With handgrip, overall dobutamine study time was reduced by a mean of 4.3 min (16.4 +/- 6.9 vs. 20.7 +/- 8.4, p = 0.004) in all patients, and by a mean of 5.9 min in patients not on beta-blocker medication (p = 0.001). The handgrip group also had a lower mean dose of dobutamine (25.8 +/- 13.5 vs. 32.4 +/- 16.4 mg, p = 0.025). The mean atropine dose was also lower (0.2 +/- 0.4 vs. 0.4 +/- 0.5 mg, p = 0.04). Handgrip exercise, however, did not decrease endpoints in patients on beta-blocker medication. CONCLUSIONS: Use of isometric handgrip exercise with DASE decreases time to target heart rate, recovery time, overall study time, and mean dosage of dobutamine and atropine. In patients not on beta-blocker medication, handgrip exercise should be routinely incorporated into all DASE protocols.