Mecanotransdução: Importância de Impor Stress na Reparação Tecidual

Luís Lima, Diva Jesus, Ana Lima, Vera Ermida, Adriana Pacheco, Ivan Pacheco, Jorge Caldas

Resumo


É recorrente observar na prática clínica o aconselhamento médico de repouso por vários dias a semanas após uma lesão desportiva. O atleta é frequentemente aconselhado a manter-se inativo além do período inflamatório agudo, por vezes iniciando a reabilitação apenas várias semanas após lesão. A inatividade prolongada não é geralmente o tratamento mais adequado para lesões musculares, tendinosas, ligamentares e de cartilagem, sejam agudas ou crónicas. Um período prolongado de suspensão total do nível habitual de stress mecânico diminui a resistência estrutural dos tecidos e pode induzir situações de patologia aguda ou crónica após retorno à atividade desportiva habitual.

Importa introduzir precocemente uma carga benéfica na patologia do sistema músculo-esquelético, sendo que carga excessiva ou insuficiente pode ser prejudicial. Na lesão aguda, o stress mecânico deve ser iniciado logo após o controlo da hemorragia e a fase inflamatória inicial. O papel do estímulo mecânico na regulação da proliferação e manutenção celular e da matriz é importante não apenas no osso (conforme descrito há mais de um século pela lei de Wolff), estando demonstrado em todos os tecidos vivos, incluindo pele, tecido neuronal, sistema hematopoiético e sistema músculo-esquelético. A atividade anabólica e catabólica celular é também regulada pelo stress mecânico sobre a superfície celular. O processo de conversão de um sinal mecânico numa resposta química ou biológica denomina-se mecanotransdução.

Os autores realizam uma revisão narrativa onde abordam várias lesões desportivas típicas dos diferentes tecidos do sistema músculo-esquelético, nas quais se demonstrou que o repouso prolongado, apesar de frequentemente aconselhado, não será o tratamento mais adequado. Por fim, apresentam ainda orientações gerais para a aplicação do stress mecânico na abordagem de algumas patologias, em que o repouso inicial é substituído pela carga benéfica, à luz dos princípios da mecanotransdução.


Palavras-chave


Lesões; Mecanotransdução Celular; Regeneração; Stresse Mecânico

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DOI: http://dx.doi.org/10.25759/spmfr.254

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