Effects of extracorporeal shock wave therapy on spinal microglia and the P38 MAPK/NF-κB pathway in diabet-ic neuralgia rats

XIA Ming-zhong; YU Qian; ZHANG Bai-wei; YE Sheng-li; ZHANG Jie; ZOU Jin-feng; HE Chun-jing

doi:10.13820/j.cnki.gdyx.20243809

Abstract：Objective To investigate the effects of extracorporeal shock wave(ESW)therapy on central nervous system microglia and the P38 MAPK/NF-κB signaling pathway in rats with diabetic neuralgia(DN).Methods A total of 24 SPF-grade male Sprague-Dawley rats(200-250 g,2 months old)were randomly divided into three groups(n=8):control group(C),diabetic neuralgia group(D),and shock wave therapy group(E).Rats in groups D and E were fed a high-fat,high-sugar diet and injected intraperitoneally with streptozotocin(STZ,40 mg/kg).Successful DN modeling was confirmed by ≥15％reductions in mechanical withdrawal threshold(MWT)and thermal withdrawal latency(TWL)compared to baseline.Group C rats received a standard diet.Group E received ESW intervention once per week for 4 weeks(W1-W4)post-modeling,with 800 pulses per session at 6-8 Hz and 0.14-0.16 mJ/mm2.MWT and TWL were measured before modeling(W0)and weekly from W1 to W4.At the end of treatment,rats were euthanized un-der anesthesia,and lumbar spinal cord tissues were collected for immunohistochemistry and Western blot analysis of Iba-1,TNF-α,P38 MAPK,and NF-κB expression.Results At W1-W4,MWT and TWL values in group C were higher than in groups D and E;group E showed significantly increased MWT and TWL at W2-W4 compared to group D.Immu-nohistochemistry and Western blot revealed increased expression of the microglial marker Iba-1 in group D versus group C,which was reduced in group E(P＜0.05).Expression levels of P38 MAPK,NF-κB,and TNF-α were also signifi-cantly lower in group E compared to group D(P＜0.05).Conclusion ESW may alleviate pain in DN rats by inhibiting microglial activation,downregulating P38 MAPK/NF-κB pathway activity,and reducing TNF-α expression,indicating its therapeutic potential for diabetic neuralgia.