Taraxasterol mitigates Con A-induced hepatitis in mice by suppressing interleukin-2 expression and its signaling in T lymphocytes.

Discovery of anti-inflammatory drugs that can suppress T lymphocyte activation and proliferation by inhibiting TCR/CD3 and IL-2/IL-2R signaling is still needed in clinic, though rapamycin and other related reagents have made great success. Taraxasterol (TAS) is an active ingredient of dandelion, an anti-inflammatory medicinal herb with low in vivo toxicity that has long been used in China. Yet the action mechanism of TAS on lymphocytes remains elusive. The anti-inflammatory effects of TAS were evaluated in C57BL/6 mouse primary lymphocytes stimulated with concanavalin A (Con A) in vitro and in mouse model of Con A-induced acute hepatitis in vivo. Our results showed that TAS significantly suppressed Con A-induced acute hepatitis in a mouse model, reducing the hepatic necrosis areas, the release of aminotransferases, and the production of IL-2 and other inflammatory cytokines. Supporting this, in vitro study also showed that TAS reduced the production of IL-2 and the expression of IL-2 receptor subunit α (CD25) upon the stimulation of Con A, which was likely mediated by suppressing NF-κB activation. The downstream pathways of IL-2/IL-2R signaling, including the activation of PI3K/PDK1/mTOR, STAT3 and STAT5, were also suppressed by TAS. Consistently, Con A-induced T cell proliferation was also inhibited by TAS in vitro. Our data indicate that TAS can suppress both T lymphocyte activation and cell proliferation by down-regulating IL-2 expression and its signaling pathway thereby ameliorating Con A-induced acute hepatitis, highlighting TAS as a potential drug candidate for treating inflammatory diseases including autoimmune hepatitis.

Comparisons of prediction models of myofascial pain control after dry needling: a prospective study.

Background. This study purposed to validate the use of artificial neural network (ANN) models for predicting myofascial pain control after dry needling and to compare the predictive capability of ANNs with that of support vector machine (SVM) and multiple linear regression (MLR). Methods. Totally 400 patients who have received dry needling treatments completed the Brief Pain Inventory (BPI) at baseline and at 1 year postoperatively. Results. Compared to the MLR and SVM models, the ANN model generally had smaller mean square error (MSE) and mean absolute percentage error (MAPE) values in the training dataset and testing dataset. Most ANN models had MAPE values ranging from 3.4% to 4.6% and most had high prediction accuracy. The global sensitivity analysis also showed that pretreatment BPI score was the best parameter for predicting pain after dry needling. Conclusion. Compared with the MLR and SVM models, the ANN model in this study was more accurate in predicting patient-reported BPI scores and had higher overall performance indices. Further studies of this model may consider the effect of a more detailed database that includes complications and clinical examination findings as well as more detailed outcome data.

Dry needling for myofascial pain: prognostic factors.

OBJECTIVES: The study objectives were to evaluate outcomes in patients who have received dry needling treatments and to identify predictors of pain and disability. DESIGN: The study was a prospective cohort follow-up design. SETTING: The study was conducted at the Pain Clinic at Pingtung Christian Hospital, Taiwan. SUBJECTS: Ninety-two (92) patients sick-listed for 3 months or longer for myofascial pain syndrome. INTERVENTIONS: From February to October 2008, participants were treated at the pain clinic with dry needling of trigger points and muscle stretches of the involved muscles. OUTCOME MEASURES: Data were collected by self-administered questionnaires to assess changes in pain intensity and pain interference. Data collection was performed at baseline and after 2, 4, and 8 weeks. Sociodemographic variables, symptom characteristics, and baseline outcome measures were analyzed using generalized estimating equation methodology. RESULTS: The proposed dry-needling protocol reduced pain intensity and pain interference. Long duration of pain symptoms, high pain intensity, poor quality of sleep, and repetitive stress were associated with poor outcomes. CONCLUSIONS: Dry needling is an effective treatment for reducing pain and pain interference. However, long pain duration, high pain intensity, poor quality of sleep, and repetitive stress are associated with poor outcomes. Treatment outcome depends not only on the dry needling protocol, but also on disease characteristics and patient demographic profile.

Educational program for myofascial pain syndrome.

OBJECTIVE: The objective of this study was to evaluate a program for managing myofascial pain syndrome (MPS). DESIGN: The study design was a randomized controlled trial. SETTING: The setting was the pain clinic of an academic hospital in Taiwan. PARTICIPANTS: Sixty-two (62) patients with a 3-month or longer history of MPS who were treated at this institution from July to November 2007 were included in the study. INTERVENTIONS: The participants were randomized to an experimental group (n = 32) or a control group (n = 30). Both groups underwent trigger-point dry needling and muscle-stretch exercise regimen for passively stretching the affected muscles to their normal lengths; the experimental group then watched an 8-minute multimedia instructional video about MPS with supplemental handouts. MAIN OUTCOME MEASURES: The Brief Pain Inventory-Taiwan was administered at baseline and 1 month thereafter. The effect size model was used to measure the effects of Brief Pain Inventory-Taiwan. Bootstrap estimation was used to derive 95% confidence intervals for group differences. RESULTS: Compared to the control group, the experimental group had significantly less interference of pain, lower intensity of present pain, and least pain (p < 0.05). Multiple regression analysis of patients with shoulder pain revealed significantly improved pain intensity and interference of pain (p < 0.05). CONCLUSIONS: The findings emphasize the importance of including patient education programs in MPS intervention.