Abstract Chronic nonspecific low back pain (CNLBP) is a problem faced by a significant portion of the world population. However, among the strategies for treating these patients, there are pharmacological and nonpharmacological options. However, noninvasive therapies are options that have been gaining prominence. Among them, electroacupuncture (EA) stands out, which can be used to treat this type of pain. Thus, the objective of our study is to investigate whether only one session with an EA protocol in patients with NCLBP could modulate the purinergic system and the levels of inflammatory cytokines. For this study, a total of 23 patients with CNLBP, of both sexes, were treated and underwent an EA session lasting 20 min. The EA protocol was performed with a needling depth of 5 mm at the acupoints (BL23, bilateral), (BL25, bilateral), (BL40, bilateral), (SP6, bilateral) and (GB-39, bilateral) with intermittent waves, low frequency of 2 Hz and pulse width of 10 mA. Blood samples were collected for analysis before and after the EA protocol. Our results, after only one session, showed a significant increase in AMP hydrolysis by ecto-5'-nucleotidase/CD73 enzyme ( p = 0.0002), adenosine deaminase activity ( p = 0.0382) and extracellular ATP levels ( p = 0.0036). Furthermore, the EA protocol increased the expression of NTPDase/CD39 ( p = 0.0287) and ecto-5'-nucleotidase/CD73 ( p = 0.0007) after the 20-min treatment. Furthermore, regarding inflammatory markers, there was a significant decrease in INF-γ ( p = 0.0192), IL-4 ( p = 0.0011) and IL-6 ( p = 0.0156) associated with an increase in IL-10 ( p = 0.0031). Moreover, after one EA session increased of the CD73 expression and adenosine deaminase were strong negative correlated with inflammatory cytokines TNF-α and IL-6, respectively. The upregulation of the purinergic system, likely associated with an indirect increase in adenosine levels, may promote a shift toward an anti-inflammatory profile, characterized by increased anti-inflammatory interleukins and reduced pro-inflammatory cytokines. Thus, our results demonstrate that the beneficial effects associated with EA can be evidenced from its first session due to the ability of this therapy to modulate the purinergic system and directly or indirectly modify the levels of pro- and anti-inflammatory interleukins. Graphical Abstract
Ecco et al. (Thu,) studied this question.