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Low-Intensity Pulsed Ultrasound Regulates Th17/Treg Balance With Potential Association With the IL-1β/IL1R1/MyD88
Wang Zhou1, He-Xi Du2, Zi-Cheng Wang2
1Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China.
Background:
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common urinary tract disorder in males. Low-intensity pulsed ultrasound (LIPUS), a non-invasive therapeutic modality, has shown potential in alleviating inflammation associated with this condition. However, the underlying mechanisms through which LIPUS exerts its effects on CP/CPPS remain largely unknown. This study aimed to investigate the impact of LIPUS at varying intensities and durations on pain relief in a rat model of CP/CPPS.
Methods:
A CP/CPPS model was established by injecting 1% carrageenan into the prostate of rats. LIPUS at three different energy intensities (T1, T2 and T3: 0.5, 1.0 and 1.5 W/cm², respectively) was applied to the pelvic region for 10 min daily over a period of 2 or 4 weeks. Pain relief and prostate injury were evaluated to assess the therapeutic efficacy of LIPUS. The mechanism study focuses on the role of LIPUS in regulating the Th17/Treg balance (by detecting CD4+ T cells in the prostate through flow cytometry and the expression of Foxp3/interleukin-17A (IL-17A) in prostate tissue through immunohistochemistry) as well as its effects on the IL-1β/IL1R1/MyD88 signaling pathway in prostate tissue (by detecting pathway protein expression through Western blot and measuring inflammatory factor concentration using enzyme-linked immunosorbent assay).
Results:
To identify the optimal parameter of LIPUS for CP/CPPS, we treated model rats with LIPUS at intensities of 0.5, 1.0 or 1.5 W/cm² for 2 or 4 weeks, and evaluated the therapeutic effects using multiple endpoints. Among these intensities, LIPUS at 1.0 W/cm2 energy/4 weeks exhibited the most prominent efficacy: compared with the model group, it significantly alleviated pelvic pain and reduced prostate inflammation scores. Further mechanistic studies demonstrated that, relative to the model group, LIPUS at 1.0 W/cm2 energy/4 weeks could regulate Th17/Treg balance and downregulate the expression of related proteins, including IL-1β, IL1R1 and MyD88.
Conclusion:
LIPUS, when administered at 1.0 W/cm² for 4 weeks, showed superior efficacy in reducing pain in CP/CPPS rats. These findings suggest that LIPUS may offer a promising therapeutic approach for CP/CPPS and provide insights into its underlying mechanism of action.

