Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease with poor prognosis. Adipose-derived stem cells (ADSC) have demonstrated regenerative properties in several tissues. The hypothesis of this study was that airway transplantation of ADSC could protect against bleomycin (BLM)-induced pulmonary fibrosis (PF). Fifty-eight lungs from 29 male Sprague-Dawley rats were analyzed. Animals were randomly divided into five groups: a) control (n=3); b) sham (n=6); c) BLM (n=6); d) BLM+ADSC-2d (n=6); and e) BLM+ADSC-14d (n=8). Animals received 500 µL saline (sham), 2.5 UI/kg BLM in 500 µL saline (BLM), and 2×10⁶ ADSC in 100 µL saline intratracheally at 2 (BLM+ADSC-2d) and 14 days (BLM+ADSC-14d) after BLM. Animals were sacrificed at 28 days. Blinded Ashcroft score was used to determine pulmonary fibrosis extent on histology. Hsp27, Vegf, Nfkβ, IL-1, IL-6, Col4, and Tgfβ1 mRNA gene expression were determined using real-time quantitative-PCR. Ashcroft index was: control=0; sham=0.37±0.07; BLM=6.55±0.34 vs sham (P=0.006). BLM vs BLM+ADSC-2d=4.63±0.38 (P=0.005) and BLM+ADSC-14d=3.77±0.46 (P=0.005). BLM vs sham significantly increased Hsp27 (P=0.018), Nfkβ (P=0.009), Col4 (P=0.004), Tgfβ1 (P=0.006) and decreased IL-1 (P=0.006). BLM+ADSC-2d vs BLM significantly decreased Hsp27 (P=0.009) and increased Vegf (P=0.006), Nfkβ (P=0.009). BLM+ADSC-14d vs BLM significantly decreased Hsp27 (P=0.028), IL-6 (P=0.013), Col4 (P=0.002), and increased Nfkβ (P=0.040) and Tgfβ1 (P=0.002). Airway transplantation of ADSC significantly decreased the fibrosis rate in both early and established pulmonary fibrosis, modulating the expression of Hsp27, Vegfa, Nfkβ, IL-6, Col4, and Tgfβ1. From a translational perspective, this technique could become a new adjuvant treatment for patients with IPF.

Background and Objectives: Postoperative pain after thoracic surgery is a multidimensional experience that includes both sensory, evaluative, and affective components. While transcutaneous electrical nerve stimulation (TENS) has demonstrated benefits for postoperative pain management, its association with affective pain outcomes remains less explored. This study aimed to explore the affective dimension of postoperative pain through a secondary analysis of data from a previously conducted randomized controlled trial. Materials and Methods: Data were derived from a randomized controlled trial investigating the effects of TENS on postoperative recovery after thoracic surgery. A total of 109 patients were included and allocated into three groups: experimental (TENS + physiotherapy, n = 37), placebo (sham TENS + physiotherapy, n = 37), and control (physiotherapy alone, n = 35). The main outcome of interest in this exploratory secondary analysis was the affective dimension of pain, assessed using the Pain Rating Index—Affective (PRI-A) subscale of the McGill Pain Questionnaire before and after the 3-week rehabilitation program. Results: Improvements were observed across several pain-related variables during the intervention period. For the affective dimension of pain, the experimental group demonstrated greater reduction in PRI-A scores than the placebo and control groups. The mean reduction in PRI-A was 0.97 in the experimental group, compared to 0.27 in the placebo group and 0.57 in the control group (p < 0.0001). Between-group comparisons showed moderate to large standardized effect sizes favoring the experimental group, although the absolute magnitude of PRI-A changes was modest. Conclusions: This secondary exploratory analysis suggests that TENS combined with physiotherapy may contribute to improvements in the affective dimension of postoperative pain following thoracic surgery. These findings support further investigation of multidimensional pain outcomes within postoperative rehabilitation settings.