Chinese Tuina ameliorates muscle damage by regulating endoplasmic reticulum stress and autophagy in a rat model of skeletal muscle contusion

Chinese Tuina has been used to treat skeletal muscle contusion (SMC) for a long time in China, yet its efficacy and mechanisms remain unclear. Previous studies have shown the vital roles of endoplasmic reticulum (ER) stress and autophagy during injured skeletal muscle recovery, we postulated that Chinese Tuina could expedite the healing of SMC by fine-tuning these processes. In this study, we established a rat model of SMC through weight-dropping and divided the rats into three groups: SMC, SMC+Tuina, and SMC+Tuina+ 3-methyladenine (3-MA) groups, while using untreated normal SD rats as a control. We assessed gait and edema via CatWalk gait analysis and swelling measurements, respectively. Tumor necrosis factor-α (TNF-α) expression was determined by immunohistochemistry (IHC). Morphological and ultrastructural alterations in the damaged muscle tissue were examined using hematoxylin and eosin (HE) staining and transmission electron microscopy (TEM), respectively. Expression of GRP78, LC3B and FAM134b was determined by western blot, and Colocalization of LC3B and FAM134b was examined by immunofluorescence. SMC+Tuina exhibited significantly improved gait and reduced edema. SMC+Tuina showed improvements in morphology and ultrastructure of damaged muscles, as well as decreased expression of TNF-α. Additionally, in SMC+Tuina, expression of GRP78 was downregulated, while expressions of FAM134 and LC3B were upregulated, and colocalization of FAM134 and LC3B was also enhanced. However, autophagy inhibitor 3-MA weakened the aforementioned effects of Chinese Tuina. The obtained results indicated that Chinese Tuina has a positive therapeutic effect in rats with SMC, potentially by promoting autophagy to reduce inflammation and ER stress.