Effect of Dry Needling on miR-939 and miR-25 Serum Levels in Myofascial Pain Syndrome With Shoulder Girdle Myofascial Trigger Points

Introduction So far, 820 micro-RNAs (miRs) were identified in the human body. They can control one-third of the human mRNAs; in other words, each miR can identify up to 200 of its target mRNAs. Numerous recent studies reported miRs as biomarkers for early diagnosis of the patients (1, 2). All body fluids such as serum, plasma, saliva, and urine contain miRs which can be used as a supplementary diagnostic means in various health problems like heart disease, cancers, and chronic pains (3, 4). These molecules are effective in expressing genes and controlling vital factors which regulate different pathways involved in growth, cell differentiation, reproduction, and apoptosis. Previous studies revealed that different miRs are expressed in a cell and different tissues. Any deviation in the expression of miR scan causes different diseases (5). Currently, treatment with miRs is being investigated. Pain due to myofascial trigger points (MTrPs) is one of the common causes of the patients’ referral to the treatment centers. The patients have symptoms such as severe pain, referral pain, as well as sensory and motor disorders associated with the involvement of the autonomic system (6-9). The pain can become acute or chronic by various mechanisms. In this regard, the role of miRs in regulating the proteins affecting the mechanism of inflammation and pain is highlighted (10). Research on various pain models indicates that miRs affect GABAα1, GABA and COX-2 molecules, along with sodium and calcium channels in order to regulate these mechanisms (11). Therefore, scientists confirm miR use as biomarkers in chronic pains. In different research studies on experimental animal and human models of patients who suffer from pain, higher or lower expression of miRs in neural tissues, Abstract Objectives: Micro-RNAs (miRs) affect the gene expression of the pain and inflammation mediators. Myofascial trigger points (MTrPs) are one of the most common causes of skeletal and muscle pain. In this regard, dry needling (DN) was favored by physiotherapists as an effective method of treatment for mucopolysaccharidosis. The present study aimed to assess the effectiveness of DN on serum concentration of miR-939 and miR-25 before and after the treatment in patients with muscular pain caused by MTrPs in their shoulder girdle muscles. Methods: Twenty patients with pain in their shoulders, upper limbs, along with heads and necks, who had 3-5 active MTrPs in their shoulder girdle muscles participated in the study. They were treated in 5 sessions with DN. One session was held per day every three days for 2 weeks. Before and after the treatment, the pain intensity of the patients was measured using the visual analogue scale (VAS), their peripheral blood samples were taken, and miR serum concentrations were estimated by real-time polymerase chain reaction. Results: Comparing pain intensity in patients revealed a significant reduction after the treatment (P<0.05). In addition, statistical analysis indicated up-regulation of miR-939 and miR-25 with a significant difference (P<0.05) after the treatment compared to the time before the treatment. Conclusion: According to the reduction in pain intensity and increased expression of miR-939 and miR-25 serum levels after treatment, it can be concluded that DN is an effective technique for treatment of mucopolysaccharidosis in shoulder girdle muscles.