Intervention Effect Of Low-Intensity Extracorporeal Shock Wave Therapy On NGF/TRPV1 Signaling Pathway Expression In Rats With Chronic Prostatitis Model

Background : Chronic prostatitis / chronic pelvic pain syndrome(CP / CPPS)is a common disease in urological and andrological clinics in China even worldwide.The incidence of CP / CPPS is about 3 %-16 % worldwide.It seriously affects the quality of life,physical health and mental health of patients.At present,CP / CPPS has many treatment methods,but because its pathogenesis and pathological changes have not been studied,the treatment effect in clinical diagnosis and treatment is not good,and it is urgent to develop a new treatment method.Low-energy extracorporeal shock wave therapy(Li-ESWT)has now been shown to be effective in the treatment of CP / CPPS,and its efficacy is satisfactory,but its therapeutic mechanism and involved signaling pathways remain to be further studied.Objective : To further explore the pathogenesis of CP / CPPS and related signaling pathways,and to explore the efficacy and mechanism of Li-ESWT.Methods : The CPPS rat model was established by in situ injection of complete Freund ’s adjuvant(CFA)into the prostate of SD rats.The rats were divided into chronic prostatitis group,low-energy extracorporeal shock wave intervention group and control group.Seven days after modeling,rats in the low-energy extracorporeal shock wave intervention group were subjected to low-energy shock wave with an energy density of 0.20 m J / mm2,once every 3 days for 30 days.Von Frey filament pain threshold was measured on 7 days and 37 days after modeling.After 37 days of modeling,the rats were sacrificed and the prostate tissue and bladder tissue were taken.The inflammatory infiltration of prostate tissue and bladder tissue in each group was observed by HE staining.The expression of NGF,TRPV1 and other cytokines in prostate tissue was observed by immunohistochemical staining and Western blot.The expression of IL-1,IL-6 and TNF-α in prostate tissue was analyzed by Elisa.Results : Von Frey filament pain threshold test showed that the pain threshold of the Li-ESWT group was significantly higher than that of the CPPS group,and the pain threshold of the control group was always at the baseline level.HE staining of prostate tissue showed that Li-ESWT could significantly improve the inflammatory infiltration of prostate tissue in CPPS rats.The results of immunohistochemistry showed that the expression of NGF and TRPV1 in prostate tissue of Li-ESWT group was lower than that of CPPS group.The results of Western blot showed that the expression of NGF,TRKA,TRPV1 and IL1-β protein in the prostate tissue of CPPS rats was higher than that in the control group,and the expression trend of the above protein in the Li-ESWT group was lower than that in the CPPS group.Conclusion : Li-ESWT is effective in the treatment of CP / CPPS,which may play an anti-inflammatory and anti-pain role in the process of chronic prostatitis by inhibiting the NGF / TRPV1 signaling pathway.In animal models,Li-ESWT can be used as a new method to treat CP / CPPS and relieve pelvic pain.