Redução da dor muscular inflamatória através do tratamento com fonoforese usando gel enriquecido com extrato aquoso de ilex paraguariensis em ratos

Abstract

Muscle injuries are common in daily activities and sports. In physical therapy, the therapeutic ultrasound (US) is used associated with topical drugs or plant derived of substances (phonophoresis) that could act in inflammatory conditions. Ilex paraguariensis (Ilex) is a plant used in a popular drink in Southern America known as "chimarrão". It has antioxidant, anti-inflammatory and antimutagenic activities that could be associated with the effects of the US. The aim of this study was to verify the effect of phonophoresis with enriched gel with Ilex paraguariensis extract on muscle inflammation in rats. For this, muscle inflammation was induced by injection of carrageenan into the gastrocnemius muscle of the right paw of Wistar rats. Groups of rats were divided into: intramuscular saline (i.m.); carrageenan i.m .; carrageenan i.m. + US; carrageenan i.m. + phonophoresis - three groups with three different doses of Ilex; carrageenan + topical Ilex. The animals were treated for 10 consecutive days, initiating the first treatment 24 h after the injection of carrageenan. During this period, behavioral tests (mechanical and thermal hyperalgesia) and evaluation of muscular edema were performed. The dose of Ilex with better results at this stage was later used for analysis of muscle oxidative substances (thiobarbituric acid reactive substance - TBARS and reactive oxygen species - ROS) and antioxidant parameters (ferric reduction oxidant potential - FRAP); proinflammatory amount (tumor necrosis factor alpha-TNF-α and interleukin-6-IL-6) and anti-inflammatory cytokines (IL-4 and IL-10) in muscle and spinal cord; as well as muscle histology. At this stage, the behavioral response of the rats was observed 24 hours after carrageenan and two hours after the US treatment or phonophoresis. It was obtained as a result that the US reduced mechanical hyperalgesia from the third day of treatment. There was also a decrease in mechanical hyperalgesia of the rats in the Ilex phonophoresis group during the 10 days of treatment. Both treatments significantly reduced muscle edema. In the second step, the proinflammatory cytokines (TNF-α and IL-6) were found to be reduced both in phonophoresis and in the US group compared to the carrageenan group. There was a reduction of lipid peroxidation (TBARS) in both treated groups, but the phonophoresis group presented increased antioxidant capacity (FRAP). The anti- inflammatory effects of US and phonophoresis were confirmed by histological analysis. Our results demonstrated that US reduced mechanical hyperalgesia and decreased edema. However, phonophoresis with Ilex showed a greater anti-hyperalgesic and antidematogenic effect, better than only US treatment. In addition, our data demonstrated that the effects of the US and US associated with Ilex paraguariensis may be, at least in part, due to the fact that both treatments decrease inflammatory cytokines, in addition to reducing TBARS. In addition, phonophoresis presented an antioxidant effect that may also be responsible for the inflammatory reduction response.