Research Digest
Study Tests Theory About Prolotherapy Injections for Knee Pain
© 2008 Jupiterimages Corporation
Ligament and tendon injuries—sprains and strains—are common, accounting for more than 5 million visits to hospital emergency departments in the United States each year. Often these injuries don't heal completely, and the result can be chronic pain, joint problems, and increased risk for osteoarthritis. Because people may not respond to standard treatments such as rest, nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroid injections, prolotherapy is becoming increasingly popular as an alternative treatment.
Prolotherapy involves injections of "proliferant" solutions at the pain site. The proliferants are thought to strengthen and "reorganize" injured tissue and decrease pain by creating an irritation that alters the inflammatory process. In an NCCAM-funded study, researchers at the University of Wisconsin investigated whether the three most commonly used proliferants—D-glucose (dextrose), phenol-glucose-glycerine (P2G), and sodium morrhuate—cause an inflammatory response in knee ligaments. They injected the substances into the knees of laboratory rats and examined the tissue after 6, 24, and 72 hours. They also examined tissue from animals in three control groups: no injection, needlesticks, and saline injection.
Compared with no-injection controls, prolotherapy injections produced an inflammatory response, but the response was about the same as that for the needlestick and saline-injection controls. The researchers conclude that the proliferants themselves may not be responsible for the inflammatory effect. They suggest that future studies of prolotherapy in animals and people control for the effects of the injection itself.
Reference
- Jensen KT, Rabago DP, Best TM, et al. Early inflammatory response of knee ligaments to prolotherapy in a rat model. Journal of Orthopaedic Research. 2008;26(6):816–823.
Prostate Genes Altered by Intensive Diet and Lifestyle Changes
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A recent pilot study, conducted by researchers at the University of California, San Francisco, suggests that intensive lifestyle and diet changes may alter gene expression (the way a gene acts) in the prostate—possibly affecting the progression of prostate cancer. Although the study's findings suggest directions for future research, such lifestyle and diet changes are not a substitute for proven prostate cancer therapies.
This pilot study, known as Gene Expression Modulation by Intervention with Nutrition and Lifestyle (GEMINAL) and funded in part by NCCAM, included a group of 31 men with low-risk prostate cancer. These men declined immediate surgery, hormonal therapy, or radiation, and participated in an intensive 3-month nutritional and lifestyle intervention while researchers monitored their tumor progression. The men stuck to a low-fat, plant-based diet and took dietary supplements including fish oil, selenium, and vitamins C and E. They also participated in stress management activities such as yoga-based stretching, breathing, meditation, imagery, and progressive relaxation; did moderate aerobic exercise; and attended group support sessions.
The researchers created "gene expression profiles" and took samples of the men's RNA before and after the intervention. They found that there were changes in the men's RNA following the lifestyle and diet modifications. Certain RNA transcripts that play a critical role in tumor formation had "up-regulated" (increased) and others "down-regulated" (decreased).
The researchers concluded that intensive nutrition and lifestyle changes may alter gene expression in the prostate. They believe that understanding how these changes affect the prostate may lead to more effective prevention and treatment for prostate cancer, and recommend larger, randomized controlled trials to confirm the results of this pilot study.
Reference
- Ornish D, Magbanua MJ, Weidner G, et al. Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. Proceedings of the National Academy of Sciences of the United States of America. 2008;105(24):8369–8374.
Additional Resource
- What you need to know about prostate cancer. National Cancer Institute Web site. Accessed on August 1, 2008.
"Research Digest" presents selections from recently published papers based on NCCAM-funded research. For more findings, see our Research Results.
