Volume 2 Issue 3
Authors: Saud Mohamad Al-Obaidi; Fadia Fouad Mahmoud
Abstract: The purpose of this study was to explore the influence of McKenzie (McK) exercise, topical sour cherry seed extract analgesia (SCE), or the combination of pro-inflammatory and regulatory cytokines in individuals with acute low back pain (ALBP). Forty patients with (ALBP) were randomly assigned to 4 treatments groups: 1) McK; 2) Topical analgesic biflavones extracted from seeds of sour cherry; 3) McK plus SCE; and 4) placebo group. Pain scores, peripheral blood lymphocyte (PBL), chemokine receptor 5 (CCR5), subpopulation frequencies, and phorbol 12-myristate 13-acetate (PMA) and ionomycin (IOM) -stimulated peripheral blood mononuclear cell (PBMC) cytokine expression phenotypes were evaluated before and after 4 weeks of interventions. The pain score was significantly reduced in all the study groups after intervention (p<0.001) except for the placebo group. The percentage of CD4+T cells expressing CCR5 was reduced among patients treated with SCE and the McK plus SCE groups (p<0.05, 0.01 respectively). Patients treated with McK exhibited a significant elevation in the percentages of CD3+T cells expressing interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α) and interleukin-4 (IL-4), which were not observed in the other groups. CD3+IL-8+ T cells were significantly reduced in the SCE group (p<0.05) but not in the other groups. The inflammatory responses were reduced in all groups but not in the placebo group. McK treatment has induced upregulation of the anti-inflammatory cytokine IL-4, while SEC alone or combined with McK has reduced the inflammatory markers CCR5 and/or IL8. SCE may have a potential role as a supplementary therapy to promote anti-inflammatory reactions when combined with McKenzie exercise for treatment of ALBP.
Keywords: Exercise; Sour Cherry Extract; Inflammation; Cytokines; Low Back Pain