Can these encouraging findings be extrapolated to massage-like treatments with

humans? A new clinical massage study – using for the first time biopsies from healthy human patients – selleckchem Wortmannin suggests a positive answer: a 10 minute massage treatment applied to 11 young males, performed after exercise induced muscle damage, was shown to activate the mechanotransduction signalling pathways focal adhesion kinase (FAK) and extracellular signal-regulated kinase ½ (ERK1/2). It potentiated mitochondrial biogenesis signalling and altered the behaviour Inhibitors,research,lifescience,medical of NF-κB, causing less of this key inflammatory mediator to accumulate in the nucleus. Consequently, the NF-κBregulated heat shock proteins and immune cytokines IL-6 and TNF-α were less active, a sign of less cellular stress and inflammation (69). While massage has commonly been advised for other purposes in the Inhibitors,research,lifescience,medical field of musculoskeletal

medicine, these newly reported anti-inflammatory effects suggest that massage therapy Inhibitors,research,lifescience,medical could possibly be used as an alternative to NSAIDs in some selleck chemical Seliciclib circumstances. Further studies are nevertheless needed for clarification as to whether such massage-induced anti-inflammatory effects can be utilised in the treatment of fibrotic pathologies such as in muscular dystrophies. If mechanostimulation provides an important access point for influencing fibrosis development, then mechanical traction, such as in therapeutic

stretching, could possibly be used as well. A rodent study using in vivo as well as ex vivo examination of a 10 minute static stretch Inhibitors,research,lifescience,medical application showed that this stretch attenuated the increase in both soluble TGF-β1 (ex vivo) and type-1 procollagen Inhibitors,research,lifescience,medical (in vivo) following tissue injury. The investigators interpreted this as an indication for a potential anti-fibrotic effect of static stretching (70). A subsequent in vivo study by the same group, also conducted with rodents, showed that a yogalike stretch application of 10 minutes – conducted twice a day over a period of 12 days – clearly decreased the inflammatory responses induced by previous Carfilzomib injection of carragean into the subcutaneous connective tissues. Congruently this response included a reduction of macrophage expression in the respective soft connective tissues (71). Further research is required to clarify to what extend (if at all) the reported anti-inflammatory and/or antifibrotic effects of massage or stretching can be applied in DMD patients. Nevertheless, for potential future clinical application the following considerations can already be made concerning the adequate sequencing of these modalities, based on the above reported insights regarding general physiological dynamics around thermostimulation and mechanostimulation.