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Lymphatic Pump Treatment of Inflammation in Rat Adjuvant-Induced Arthritis

Journal: Journal of Osteopathic Medicine Date: 2017/11, 117(11):Pages: e62-e63. doi: Subito , type of study: animal experiment

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2017.141/html)

Keywords:

animal experiment [36]
arthritis [48]
inflammation [22]
LPT [3]
lymphatic pump technique [21]

Abstract:

Context: Rheumatoid arthritis (RA) is an immune-inflammatory disorder characterized by chronic inflammation. Rat adjuvant-induced arthritis (AIA) is a rodent model of RA that is well characterized to have many similarities with human RA, including dysfunctional lymphatics and aberrant cell mediated immunity. Lymphatic pump treatment (LPT) is an osteopathic manipulative treatment used with the intent to increase lymphatic flow and alleviate edema. We hypothesized that LPT for rats with AIA would enhance lymphatic function by increasing the number of synovial lymphatic vessels resulting in normalization of lymphatic flow and decreased clinical parameters of arthritis. We expected these outcomes when lymphatic pump treatment was used either as a preventive measure before arthritis developed or as a therapeutic modality. Methods: Rats were injected with an adjuvant at the base of their tail (day 0), which typically results in arthritis in their hind limbs starting around day 9, with inflammation peaking in severity around days 14 to 18. All animal experiments were performed with approval from the Midwestern University Animal Care and Use Committee. For the therapeutic study, 24 female Lewis rats were placed into 2 groups. Starting on day 14 through day 20, one group was treated 3 times per day for 30 seconds with LPT and the sham group was held for the same amount. For the preventive study, 24 female Lewis rats were placed into 2 groups. Starting on day 4 and continuing through day 10, 1 group was treated 3 times per day for 30 seconds with LPT and the sham group was held the same amount. LPT was performed by rhythmically pressing below the rib cage 30 times over a 30-second period, while the sham control group was held for 30 seconds. Articular index scoring and caliper measurements were taken on hind ankles through the course of the study. Hind ankles and peripheral blood were collected for study. Statistical significance was determined using ANOVA and a post-hoc t test. Results: In the therapeutic study, the animals treated with LPT started by day 15 to have smaller ankle circumferences and by day 16 to have lesser articular index scores, indicating reduced ankle swelling. This reduction in swelling with LPT persisted as the study continued, reducing ankle circumference increase as much as 24% and articular index score by a quarter point, but it did not reach statistical significance. In the preventive study, the animals treated with LPT by day 8 had smaller ankle circumferences and lesser articular index scores indicating reduced ankle swelling. This reduction in swelling with LPT became greater as the study continued until the final day of the study, day 11, when LPT-treated animals had significantly reduced swelling compared with the sham-treated group (average ankle circumference on day 11 for sham group 21.35 mm2 vs LPT group 20.48mm2, P<.05). Additionally, by day 11 the LPT group had a reduced articular index score of 0.2 vs the sham 0.5 (P=.08), indicating reduced signs of inflammation, such as redness and swelling. Conclusion: The results of these experiments suggest LPT given 3 times a day for 30 seconds starting on day 14, after the establishment of arthritis, can reduce swelling and signs of inflammation and that LPT given 3 times per day for 30 seconds starting on day 4, several days before the expected first signs of arthritis, can significantly reduce and delay the onset of arthritis as seen in the rat AIA model of rheumatoid arthritis.


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