Abstract
OBJECTIVE: This study demonstrated that transcutaneous electrical nerve stimulation (TENS) and its induced fecal microbiota transplantation (FMT) could treat anterior talo-fibular ligament (ATFL) injury rat and modify the intestinal microbiota via the gut-joint axis. METHODS: An ATFL injury model was duplicated and treated with low, medium, or high-intensity of TENS. After 1, 2, and 3 weeks of TENS treatment, the improvements and the expression levels of NOD2/IL-6/NF-κB/BMP-2/TGF-β were measured. The intestinal microbiota was analyzed via 16S rDNA sequencing. After FMT which induced by TENS, the improvement of ATFL injury rat was analyzed. RESULTS: After TENS treatment, compared with the model control group, the bio-mechanical, gait, bone mineral density (BMD), etc. parameters were elevated in the TENS groups (p < 0.05); the expression of NOD2/IL-6 decreased and the BMP-2/TGF-β increased in the TENS groups (p < 0.05). The intestinal microbiota was altered, including increases in the abundances of Erysipelotrichaceae, Lachnospira, Eubacterium, Phascolarctobacterium, and Alloprevotella. After FMT, similar improvements were found in ATFL injury rats. CONCLUSION: TENS ameliorated ATFL injury rat by regulating the NOD2/IL-6/NF-κB/BMP-2/TGF-β and changed the intestinal microbiota through the gut-joint axis. Dominant intestinal microbiota was associated with FMT and could improve ATFL injury rat.