{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T07:06:31Z","timestamp":1771830391168,"version":"3.50.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Joint Foundation of Department of Science and Technology of Yunnan Province","award":["202401AY070001-091"],"award-info":[{"award-number":["202401AY070001-091"]}]},{"name":"Joint Foundation of Department of Science and Technology of Yunnan Province","award":["202201AY070001-225"],"award-info":[{"award-number":["202201AY070001-225"]}]},{"name":"Joint Foundation of Department of Science and Technology of Yunnan Province","award":["202201AY070001-008"],"award-info":[{"award-number":["202201AY070001-008"]}]},{"DOI":"10.13039\/100007471","name":"Applied Basic Research Foundation of Yunnan Province","doi-asserted-by":"publisher","award":["2025AY07000000"],"award-info":[{"award-number":["2025AY07000000"]}],"id":[{"id":"10.13039\/100007471","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An ATFL injury model was duplicated and treated with low, medium, or high-intensity of TENS. After 1, 2, and 3\u202fweeks of TENS treatment, the improvements and the expression levels of NOD2\/IL-6\/NF-\u03baB\/BMP-2\/TGF-\u03b2 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05); the expression of NOD2\/IL-6 decreased and the BMP-2\/TGF-\u03b2 increased in the TENS groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). The intestinal microbiota was altered, including increases in the abundances of\n                      <jats:italic>Erysipelotrichaceae<\/jats:italic>\n                      ,\n                      <jats:italic>Lachnospira<\/jats:italic>\n                      ,\n                      <jats:italic>Eubacterium<\/jats:italic>\n                      ,\n                      <jats:italic>Phascolarctobacterium<\/jats:italic>\n                      , and\n                      <jats:italic>Alloprevotella<\/jats:italic>\n                      . After FMT, similar improvements were found in ATFL injury rats.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TENS ameliorated ATFL injury rat by regulating the NOD2\/IL-6\/NF-\u03baB\/BMP-2\/TGF-\u03b2 and changed the intestinal microbiota through the gut-joint axis. Dominant intestinal microbiota was associated with FMT and could improve ATFL injury rat.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2026.1770614","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T06:30:19Z","timestamp":1771828219000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Transcutaneous electrical nerve stimulation treated anterior talo-fibular ligament injured rat through the gut-joint axis and intestinal microbiota"],"prefix":"10.3389","volume":"17","author":[{"given":"Nan","family":"Chen","sequence":"first","affiliation":[{"name":"Trauma Center, First Affiliated Hospital of Kunming Medical University, Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tong","family":"Ma","sequence":"additional","affiliation":[{"name":"Key Laboratory of Pharmacology for Natural Products of Yunnan Province, Pharmaceutical College, Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ran","family":"Chen","sequence":"additional","affiliation":[{"name":"Clinical Lab, Second Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Trauma Center, First Affiliated Hospital of Kunming Medical University, Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xun","family":"Tang","sequence":"additional","affiliation":[{"name":"CAS Key Laboratory of Animal Models and Human Disease Mechanisms, KIZ-SU Joint Laboratory of Animal Model and Drug Development, Laboratory of Learning and Memory, Kunming Institute of Zoology, The Chinese Academy of Sciences","place":["Kunming, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Sun","sequence":"additional","affiliation":[{"name":"Trauma Center, First Affiliated Hospital of Kunming Medical University, Kunming Medical University","place":["Kunming, Yunnan, China"]},{"name":"Key Laboratory of Pharmacology for Natural Products of Yunnan Province, Pharmaceutical College, Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"282","DOI":"10.14744\/AnatolJCardiol.2025.5048","article-title":"Modulation of gut microbiota using VSL#3 and its impact on aortic parameters in a rat model","volume":"29","author":"Altun","year":"2025","journal-title":"Anatol. J. Cardiol."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1111\/omi.12467","article-title":"NOD2 contributes to Parvimonas micra-induced bone resorption in diabetic rats with experimental periodontitis","volume":"39","author":"Chen","year":"2024","journal-title":"Mol. Oral Microbiol."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"3395","DOI":"10.12998\/wjcc.v11.i15.3395","article-title":"Progress in diagnosis and treatment of acute injury to the anterior talofibular ligament","volume":"11","author":"Chen","year":"2023","journal-title":"World J. Clin. Cases"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1093\/ptj\/pzy030","article-title":"A mechanism-based approach to physical therapist management of pain","volume":"98","author":"Chimenti","year":"2018","journal-title":"Phys. Ther."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"279","DOI":"10.3390\/ph18020279","article-title":"Natural bioactive compounds in the management of type 2 diabetes and metabolic (dysfunction)-associated steatotic liver disease","volume":"18","author":"Ciob\u00e2rc\u0103","year":"2025","journal-title":"Pharmaceuticals"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1177\/10815589241251695","article-title":"Relationship between gut microbiome and bone deficits in primary hyperparathyroidism: a proof-of-concept pilot study","volume":"72","author":"Coskun","year":"2024","journal-title":"J. Investig. Med."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1007\/s00784-025-06341-1","article-title":"Evaluation of the anti-inflammatory, antioxidant and regenerative effects of microbiota-derived postbiotics in human periodontal ligament mesenchymal stromal cells","volume":"29","author":"Demirhan","year":"2025","journal-title":"Clin. Oral Investig."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1204S","DOI":"10.1177\/1947603519841674","article-title":"Protective actions of oral administration of Bifidobacterium longum CBi0703 in spontaneous osteoarthritis in Dunkin Hartley guinea pig model","volume":"13","author":"Henrotin","year":"2021","journal-title":"Cartilage"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1153360","DOI":"10.3389\/fmed.2023.1153360","article-title":"The mechanism of palmatine-mediated intestinal flora and host metabolism intervention in OA-OP comorbidity rats","volume":"10","author":"Jie","year":"2023","journal-title":"Front. Med."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1038\/nature17631","article-title":"NOD1 and NOD2 signaling links ER stress with inflammation","volume":"532","author":"Keestra-Gounder","year":"2016","journal-title":"Nature"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2432","DOI":"10.1177\/03635465211018645","article-title":"Evaluation of the intact anterior talofibular and calcaneofibular ligaments, injuries, and repairs with and without augmentation: a biomechanical robotic study","volume":"49","author":"Larkins","year":"2021","journal-title":"Am. J. Sports Med."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"23259671231218649","DOI":"10.1177\/23259671231218649","article-title":"Comparison of knot-tying techniques during the arthroscopic Brostr\u00f6m-Gould procedure: semiconstrained freehand versus knot pusher techniques","volume":"12","author":"Lee","year":"2024","journal-title":"Orthop. J. Sports Med."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"4266","DOI":"10.7150\/thno.84971","article-title":"Engineering strategies and optimized delivery of exosomes for theranostic application in nerve tissue","volume":"13","author":"Li","year":"2023","journal-title":"Theranostics"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"155","DOI":"10.3233\/SHTI230836","article-title":"Alloprevotella can be considered as a potential oral biomarker in intestinal metaphase of gastric patients","volume":"308","author":"Liu","year":"2023","journal-title":"Stud. Health Technol. Inform."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1618","DOI":"10.3390\/biomedicines11061618","article-title":"The role of the microbiome in the pathogenesis and treatment of asthma","volume":"11","author":"Logo\u0144","year":"2023","journal-title":"Biomedicine"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"3242","DOI":"10.3390\/ijms25063242","article-title":"Role of the gut microbiota in osteoarthritis, rheumatoid arthritis, and spondylarthritis: an update on the gut-joint axis","volume":"25","author":"Longo","year":"2024","journal-title":"Int. J. Mol. Sci."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1186\/s13018-025-05780-6","article-title":"All-inside arthroscopic repair of ATFL and CFL separately for chronic lateral ankle instability in conjunction with subtalar instability","volume":"20","author":"Mao","year":"2025","journal-title":"J. Orthop. Surg. Res."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1186\/s12887-024-04639-9","article-title":"Risk factors of multidrug-resistant organisms neonatal sepsis in Surabaya tertiary referral hospital: a single-center study","volume":"24","author":"Miranda","year":"2024","journal-title":"BMC Pediatr."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1544","DOI":"10.1002\/jmri.28649","article-title":"Deep learning approach for MRI in the classification of anterior talofibular ligament injuries","volume":"58","author":"Ni","year":"2023","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1186\/s40478-024-01877-x","article-title":"Host genetics and gut microbiota influence lipid metabolism and inflammation: potential implications for ALS pathophysiology in SOD1G93A mice","volume":"12","author":"Niccolai","year":"2024","journal-title":"Acta Neuropathol. Commun."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1186\/s12891-025-08881-9","article-title":"Heel kicking exercise rapidly improves pain and function in patients with acute lateral ankle sprain: a randomized controlled trial","volume":"26","author":"Qin","year":"2025","journal-title":"BMC Musculoskelet. Disord."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"8090","DOI":"10.3390\/ijms25158090","article-title":"Experimental inoculation of Aggregatibacter actinomycetemcomitans and Streptococcus gordonii and its impact on alveolar bone loss and oral and gut microbiomes","volume":"25","author":"Rocha","year":"2024","journal-title":"Int. J. Mol. Sci."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"103647","DOI":"10.1016\/j.otsr.2023.103647","article-title":"Biomechanical evaluation of the anterior talo-fibular and calcaneo-fibular ligaments using shear wave elastography in young healthy adults","volume":"110","author":"Rougereau","year":"2024","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e44979","DOI":"10.7759\/cureus.44979","article-title":"Anterior talo-fibular ligament reconstruction with InternalBrace\u2122 for chronic lateral ankle instability in Pediatric patients","volume":"15","author":"Sethi","year":"2023","journal-title":"Cureus"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"897","DOI":"10.3390\/foods12040897","article-title":"Protective effect of Lactiplantibacillus plantarum subsp. plantarum SC-5 on dextran sulfate sodium-induced colitis in mice","volume":"12","author":"Shi","year":"2023","journal-title":"Foods"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"10624","DOI":"10.1038\/s41598-021-90191-w","article-title":"The effect of liraglutide and sitagliptin on oxidative stress in persons with type 2 diabetes","volume":"11","author":"Sivalingam","year":"2021","journal-title":"Sci. Rep."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1063","DOI":"10.17219\/acem\/159703","article-title":"Application and efficacy of transcutaneous electrical acupoint stimulation (TEAS) in clinical practice: a systematic review","volume":"32","author":"Szmit","year":"2023","journal-title":"Adv. Clin. Exp. Med."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1186\/s12881-020-01115-w","article-title":"Associations of NOD2 polymorphisms with Erysipelotrichaceae in stool of in healthy first degree relatives of Crohn's disease subjects","volume":"21","author":"Turpin","year":"2020","journal-title":"BMC Med. Genet."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"573","DOI":"10.3390\/microorganisms8040573","article-title":"The controversial role of human gut Lachnospiraceae","volume":"8","author":"Vacca","year":"2020","journal-title":"Microorganisms"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.3390\/medicina58101332","article-title":"Using TENS for pain control: update on the state of the evidence","volume":"58","author":"Vance","year":"2022","journal-title":"Medicina"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"2200840","DOI":"10.1183\/13993003.00840-2022","article-title":"Gut microbiota-derived succinate aggravates acute lung injury after intestinal ischaemia\/reperfusion in mice","volume":"61","author":"Wang","year":"2023","journal-title":"Eur. Respir. J."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"101016","DOI":"10.1016\/j.mtbio.2024.101016","article-title":"A review on gold nanoparticles as an innovative therapeutic cue in bone tissue engineering: prospects and future clinical applications","volume":"26","author":"Yang","year":"2024","journal-title":"Mater. Today Bio"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"5127157","DOI":"10.1155\/2023\/5127157","article-title":"The role of gut microbiota in various neurological and psychiatric disorders-an evidence mapping based on quantified evidence","volume":"2023","author":"Zang","year":"2023","journal-title":"Mediat. Inflamm."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"14305","DOI":"10.1038\/s41598-018-32675-w","article-title":"Detection and characterization of bacterial nucleic acids in culture-negative synovial tissue and fluid samples from rheumatoid arthritis or osteoarthritis patients","volume":"8","author":"Zhao","year":"2018","journal-title":"Sci. Rep."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1128","DOI":"10.1038\/labinvest.2013.99","article-title":"NOD2 deletion promotes cardiac hypertrophy and fibrosis induced by pressure overload","volume":"93","author":"Zong","year":"2013","journal-title":"Lab. Investig."}],"container-title":["Frontiers in Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2026.1770614\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T06:30:20Z","timestamp":1771828220000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2026.1770614\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,23]]},"references-count":35,"alternative-id":["10.3389\/fmicb.2026.1770614"],"URL":"https:\/\/doi.org\/10.3389\/fmicb.2026.1770614","relation":{},"ISSN":["1664-302X"],"issn-type":[{"value":"1664-302X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,23]]},"article-number":"1770614"}}