The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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The proper concentrations of dextrose and lidocaine in regenerative injection therapy: in vitro study

  • Woo, Min Seok (Department of Convergence Medical Science, Gyeongsang National University) ;
  • Park, Jiyoung (Department of Anesthesiology and Pain Medicine, Gyeongsang National University Changwon Hospital) ;
  • Ok, Seong-Ho (Department of Anesthesiology and Pain Medicine, Gyeongsang National University Changwon Hospital) ;
  • Park, Miyeong (Department of Anesthesiology and Pain Medicine, Gyeongsang National University Changwon Hospital) ;
  • Sohn, Ju-Tae (Department of Anesthesiology and Pain Medicine, Gyeongsang National University Hospital) ;
  • Cho, Man Seok (Department of Anesthesiology and Pain Medicine, Gyeongsang National University College of Medicine) ;
  • Shin, Il-Woo (Department of Anesthesiology and Pain Medicine, Gyeongsang National University Hospital) ;
  • Kim, Yeon A (Department of Anesthesiology and Pain Medicine, Gyeongsang National University Changwon Hospital)
  • Received : 2020.06.19
  • Accepted : 2020.10.07
  • Published : 2021.01.01
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Abstract

Background: Prolotherapy is a proliferation therapy as an alternative medicine. A combination of dextrose solution and lidocaine is usually used in prolotherapy. The concentrations of dextrose and lidocaine used in the clinical field are very high (dextrose 10%-25%, lidocaine 0.075%-1%). Several studies show about 1% dextrose and more than 0.2% lidocaine induced cell death in various cell types. We investigated the effects of low concentrations of dextrose and lidocaine in fibroblasts and suggest the optimal range of concentrations of dextrose and lidocaine in prolotherapy. Methods: Various concentrations of dextrose and lidocaine were treated in NIH-3T3. Viability was examined with trypan blue exclusion assay and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Migration assay was performed for measuring the motile activity. Extracellular signal-regulated kinase (Erk) activation and protein expression of collagen I and α-smooth muscle actin (α-SMA) were determined with western blot analysis. Results: The cell viability was decreased in concentrations of more than 5% dextrose and 0.1% lidocaine. However, in the concentrations 1% dextrose (D1) and 0.01% lidocaine (L0.01), fibroblasts proliferated mildly. The ability of migration in fibroblast was increased in the D1, L0.01, and D1 + L0.01 groups sequentially. D1 and L0.01 increased Erk activation and the expression of collagen I and α-SMA and D1 + L0.01 further increased. The inhibition of Erk activation suppressed fibroblast proliferation and the synthesis of collagen I. Conclusions: D1, L0.01, and the combination of D1 and L0.01 induced fibroblast proliferation and increased collagen I synthesis via Erk activation.

Keywords

Acknowledgement

This study was funded by National Research Foundation of Korea (NRF-2011-0021216).

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