The shear wave elastic modulus and the increased nuclear factor kappa B (NF-kB/p65) and cyclooxygenase-2 (COX-2) expression in the area of myofascial trigger points activated in a rat model by blunt trauma to the vastus medialis

Abstract

We aimed to elucidate the increased inflammatory cytokines expression such as nuclear factor kappa B (NF-kB/p65), cyclooxygenase-2 (COX-2), and voltage-gated calcium channels (VGCC) in the area of activated myofascial trigger points (MTrPs) in a rat model by blunt trauma to the vastus medialis and to evaluate the feasibility of a quantitative analysis of muscle elastic modulus using shear wave elastography (SWE). Twelve 7-week-old male SD rats were divided into normal (NM, n = 6) and model groups (MO, n = 6). In the MO group, MTrPs were activated with a blunt strike to the left vastus medialis and subsequent eccentric exercise for 8 weeks. After 4 weeks of rest, the elastic modulus in the focal site was evaluated using SWE. Electromyography (EMG) data were collected at MTrPs and muscle tissues were evaluated for expression of nuclear factor kappa B (NF-kB/p65), cyclooxygenase-2 (COX-2) protein, and voltage-gated calcium channels (VGCC). The number of the palpable taut bands; EMG frequency and amplitude; elastic modulus values; and NFkB/p65, COX-2, and VGCC expression levels were significantly higher for the left focal area in the MO group compared to those for the NM group (p's < 0.05). These findings suggest that elastic modulus measurement using ultrasound SWE may be effective in evaluating MPS. In addition, increased COX-2, NFkB/p65, and VGCC expression may expand the integrated hypothesis of trigger points.

Keywords: Elastic modulus; Inflammatory cytokines; Myofascial trigger points; Shear wave elastography.