Auburn Research Day 2022

Jos Edison, DO CAQSM [1]; Pao-Feng Tsai, PhD, MPH, RN, FAAN [2]; Chih-Hsuan Wang, PhD [3], Wei-Shinn Ku, PhD [4]; Claire Goode, OMS-II [1]; Tyler Reese, OMS-II [1] Edward Via College of Osteopathic Medicine-Auburn Campus [1]; Auburn University School of Nursing [2]; Auburn University College of Education [3]; Auburn University Samuel Ginn College of Engineering [4] Cl i n i ca l Resea rch | Med i ca l St udent Exploration of Objective Diagnosis of Myofascial Pain Syndrome of the Low Back and Development of a Home Intervention Program 48

Myofascial pain syndrome (MPS) is a regional pain disorder that is most commonly a result of muscle injury or overuse. The estimated prevalence of MPS is estimated to be between 30 and 85% of patients visiting primary care clinics and pain clinics. A contributing factor to the wide range of prevalence is the inability to objectively measure and diagnose MPS outside of physical examination and patient’s subjective reporting of pain. The use of ultrasound has been utilized to identify trigger points (TrPs), a common presenting feature of MPS; however, the lack of standardized guidelines makes identification difficult. Additionally, there are limitations in sensitivity of ultrasound in distinguishing between active and latent TrPs, a chronic pain disorder that does not present with spontaneous pain sensation. This limitation imposes a barrier in early identification and treatment of latent TrPs in the effort to prevent the worsening of MPS. Furthermore, many MPS patients are under-treated due to expense and limited access to health care services. Therefore, it is of critical importance to establish diagnostic protocols and at-home intervention to reduce the pain caused by MPS and improve overall quality of life. Subjects will consist of recruiting 24 total patients, 12 of which have active TrPs and 12 of which have latent TrPs, from the Auburn University clinics

that meet our study parameters based on inclusion/exclusion criteria. Upon these patients’ arrival, they will be screened for demographics, medical history, quality of life, etc. Using an osteopathic physical examination, identification of site and number of active or latent TrPs will be determined. An algometer will then be used to determine the pressure pain threshold and level of tenderness. Tissue strain, strain ratio, and level of stiffness will be evaluated using ultrasound with the vibration sonoelastography (VSE) procedure. For development of an at-home intervention for MPS, a panel of experts will be given surveys about a proposed at-home protocol that will undergo multiple rounds of revision based on the qualitative and quantitative feedback received. Developing a better objective measurement of MPS and standardized guidelines to use ultrasound will improve diagnosis and treatment of MPS patients. Improvements can lead to better positive diagnosis rates, decreased costs to patients, making their treatment more affordable, as well as bettering an at-home treatment plan to maintain low pain levels and improve quality of life.

B i omed i ca l Resea rch | Med i ca l St udent The Role of Osteopontin in Pulmonary Arterial Hypertension

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Stephanie Lazo; Aditi Patel; Rebekah L. Morrow; K. Adam Morrow Edward Via College of Osteopathic Medicine – Louisiana Campus

Background: Pulmonary arterial hypertension (PAH) is a progressively debilitating disorder characterized by sustained increases in pulmonary vascular resistance and pulmonary arterial pressure, which eventually leads to right-sided heart failure. Current therapies for PAH work predominately as vasodilators to target symptoms, rather than focusing on the initial signals that promote disease progression. These therapies have proved ineffective at improving patient outcomes, with a 50 – 60% three-year survival rate post-diagnosis. Therefore, identifying early changes in the pathophysiology of PAH is essential for designing more effective therapeutics. Endothelial–to–mesenchymal transition (EndMT), a process implicated in PAH progression and severity, contributes to the loss of endothelial markers and a concomitant increase in mesenchymal markers. EndMT leads to endothelial dysfunction, involving aberrant cell proliferation, enhanced migration and invasion, and a pro-inflammatory phenotype. However, the mechanisms driving this process have yet to be fully elucidated. Recently, intracellular osteopontin (iOPN) has been shown to reverse the effects of epithelial–to–mesenchymal transition (EMT). EMT is well-studied, particularly in cancer, and evidence is mounting that EndMT parallels EMT in multiple ways. Therefore, we sought to determine whether

we could alter iOPN protein levels in wild-type pulmonary arterial endothelial cells (WT-PAECs) and PAECs derived from a Sugen hypoxia rat (SURAT) model of PAH as a means to impact the EndMT process. Methods: Pulmonary artery endothelial cells came from both control Fischer rats and rats exposed to the Sugen hypoxia model of PAH. Cells were transiently transfected with siRNA against OPN for 24-48 hours. RNA was isolated and cell lysates were collected, and OPN levels were assessed using western blot analysis and band densitometries were quantified using ImageJ. Additional endothelial and mesenchymal markers will be assessed via western blot and RT- PCR. Results: Western blot analysis revealed that 48-hour siRNA transfection achieved approximately 50% OPN knockdown in both WT- and SURAT-PAECs. Conclusions: We conclude that siRNA transfection of pulmonary artery endothelial cells is an effective method of altering intracellular osteopontin levels.

29 2022 Via Research Recognit ion Day