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Song Y, Che X, Li M, Wang Z, Zhang R, Shi Q. The application of extracorporeal shock wave therapy in the treatment of temporomandibular joint disorders in a preliminary, small sample study. J Oral Rehabil 2024; 51:1450-1458. [PMID: 38685720 DOI: 10.1111/joor.13721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/16/2024] [Accepted: 04/18/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the efficacy of low-intensity, high-frequency shock waves in the treatment of temporomandibular joint disorders. METHODS Twenty-six patients with temporomandibular joint disorder admitted to the Second Hospital of Shanxi Medical University from August 2022 to December 2022 were selected as study subjects and randomly divided into two groups, A and B, with 13 patients each. In Group A, there were 5 males and 8 females with an average age of 38.85 ± 11.03 years. In Group B, there were 4 males and 9 females with an average age of 39.15 ± 11.16 years. Group A was the control group, which received routine treatment (manual massage + transcutaneous electrical nerve stimulation + ultrashort wave therapy) plus sham shock wave therapy; Group B was the experimental group, which received routine treatment (manual massage + transcutaneous electrical nerve stimulation + ultrashort wave therapy) plus shock wave therapy. The routine treatment was administered once/day, five times per week for a total of 2 weeks of treatment. In addition, shock wave therapy was administered once every 5 days, and the treatment was administered three times. The treatment period was 2 weeks, and the two groups were compared before treatment, at the end of the treatment period, and 4 weeks after treatment. The pain level of the two groups was assessed by the visual analogue scale (VAS) before and after treatment, and the temporomandibular opening index (TOI) before and after treatment was compared between the two groups. VAS and TOI scores were evaluated using the Mann-Whitney U-test, the Kruskal-Wallis H-test and two-way ANOVA. RESULTS There was no significant difference in the VAS score and temporomandibular opening index between the two groups before treatment (p = .829 and .75, respectively). After 2 weeks of treatment, the VAS score and temporomandibular joint opening index of both groups were significantly improved compared to those before therapy. In addition, the VAS score and temporomandibular joint opening index in the experimental group were significantly better than those in the control group (p < .001 and <.001, respectively). There was a small increase in scores 4 weeks after the treatment compared to just after the treatment period, but the difference was not significant. CONCLUSION This is a preliminary small sample study that demonstrates the positive effect of using low-intensity, high-frequency shock waves on the treatment of temporomandibular joint disorders and is worthy of clinical promotion.
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Affiliation(s)
- Yufeng Song
- Division of Rehabilitation, Department of Medicine, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Xinle Che
- Second Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Mengshi Li
- Second Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Zheyun Wang
- Second Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Runjie Zhang
- Division of Rehabilitation, Department of Medicine, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Qiongfang Shi
- Division of Rehabilitation, Department of Medicine, Xinghualing District Central Hospital, Taiyuan, China
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Lin W, Wang Y, Chen Y. Efficacy Analysis of Physical Therapy in Treating Chronic Prostatitis: Unblocking Obstructed Glandular Ducts Could Be a Novel Treatment Strategy. Res Rep Urol 2023; 15:553-561. [PMID: 38145159 PMCID: PMC10742744 DOI: 10.2147/rru.s442844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/28/2023] [Indexed: 12/26/2023] Open
Abstract
Objective This study investigates the efficacy of physical therapy in treating chronic prostatitis grounded on the glandular duct blockage theory. Methods The study includes patients who were diagnosed and treated for chronic prostatitis between November 2022 and July 2023 at Renhui clinic in Jiangmen, Guangdong and Renhui frontline clinic in Shenzhen Guangdong. The recorded data includes the frequency of physical therapies including prostate massages, rectal probe high-frequency vibration treatment, and low-intensity extracorporeal shockwave therapy (Li-ESWT). Post-treatment urine sediment was collected for microscopic examination, and the scores of each patient on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the Premature Ejaculation Diagnostic Tool (PEDT) were recorded pre- and post-treatment in order to calculate the effectiveness rate. Results The study involved a total of 48 patients, of which 26 were diagnosed with premature ejaculation. On average, each patient received 2.1 prostate massages, underwent 4.1 rectal probe high-frequency vibration treatments, and 8.3 Li-ESWT sessions. Following treatment, the initial microscopic examination of the urine sediment revealed aged white blood cell clusters, prostate calculi clusters, and inactive sperm clusters, all appearing in the shape of glandular tubes. The mean NIH-CPSI scores pre- and post-treatment were 27.2±6.9 and 18.0±6.6, respectively, indicating an effectiveness rate of 81.3%. The average PEDT scores pre- and post-treatment were 14.5±3.5 and 10.5±4.2, respectively, with an effectiveness rate of 53.8%. Conclusion Unblocking obstructed glandular ducts might provide a novel therapeutic strategy for treating chronic prostatitis.
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Affiliation(s)
- Weiguang Lin
- Department of Urology, Renhui Clinic, Jiangmen, 529099, People’s Republic of China
- Department of Urology, Renhui Frontline Clinic, Shenzhen, 518038, People’s Republic of China
| | - Yunlong Wang
- Department of Urology, Renhui Clinic, Jiangmen, 529099, People’s Republic of China
- Department of Urology, Renhui Frontline Clinic, Shenzhen, 518038, People’s Republic of China
| | - Yanxiong Chen
- Department of Urology, Renhui Clinic, Jiangmen, 529099, People’s Republic of China
- Department of Urology, Renhui Frontline Clinic, Shenzhen, 518038, People’s Republic of China
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Liang H, Chen K, Xie J, Yao L, Liu Y, Hu F, Li H, Lei Y, Wang Y, Lv L, Chen Z, Liu S, Liu Q, Wang Z, Li J, Chang YN, Li J, Yuan H, Xing G, Xing G. A Bone-Penetrating Precise Controllable Drug Release System Enables Localized Treatment of Osteoporotic Fracture Prevention via Modulating Osteoblast-Osteoclast Communication. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023:e2207195. [PMID: 36971278 DOI: 10.1002/smll.202207195] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Improving local bone mineral density (BMD) at fracture-prone sites of bone is a clinical concern for osteoporotic fracture prevention. In this study, a featured radial extracorporeal shock wave (rESW) responsive nano-drug delivery system (NDDS) is developed for local treatment. Based on a mechanic simulation, a sequence of hollow zoledronic acid (ZOL)-contained nanoparticles (HZNs) with controllable shell thickness that predicts various mechanical responsive properties is constructed by controlling the deposition time of ZOL and Ca2+ on liposome templates. Attributed to the controllable shell thickness, the fragmentation of HZNs and the release of ZOL and Ca2+ can be precisely controlled with the intervention of rESW. Furthermore, the distinct effect of HZNs with different shell thicknesses on bone metabolism after fragmentation is verified. In vitro co-culture experiments demonstrate that although HZN2 does not have the strongest osteoclasts inhibitory effect, the best pro-osteoblasts mineralization results are achieved via maintaining osteoblast-osteoclast (OB-OC) communication. In vivo, the HZN2 group also shows the strongest local BMD enhancement after rESW intervention and significantly improves bone-related parameters and mechanical properties in the ovariectomy (OVX)-induced osteoporosis (OP) rats. These findings suggest that an adjustable and precise rESW-responsive NDDS can effectively improve local BMD in OP therapy.
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Affiliation(s)
- Haojun Liang
- Department of Orthopedic, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, P. R. China
| | - Kui Chen
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Jing Xie
- State Key Laboratory of Explosion Science and Technology, Beijing Institute of Technology, Beijing, 100081, P. R. China
| | - Lei Yao
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Yunpeng Liu
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Fan Hu
- Department of Orthopedic, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, P. R. China
| | - Hao Li
- Department of Orthopedic, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, P. R. China
| | - Yinze Lei
- State Key Laboratory of Explosion Science and Technology, Beijing Institute of Technology, Beijing, 100081, P. R. China
| | - Yujiao Wang
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Linwen Lv
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Ziteng Chen
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Sen Liu
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Qiuyang Liu
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Zhijie Wang
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Jiacheng Li
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Ya-Nan Chang
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Juan Li
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Hui Yuan
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Gengyan Xing
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Gengmei Xing
- Department of Orthopedic, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, P. R. China
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Ge R, Zhu Q, Liu D, Zhang Q, Jiang S, Yu X, Shu J, Gao F, Guo J, Chen S, Gao B. Quantitative proteomics reveals potential anti-inflammatory protein targets of radial extracorporeal shock wave therapy in TNF-α-induced model of acute inflammation in primary human tenocytes. Heliyon 2022; 8:e12008. [PMID: 36506366 PMCID: PMC9732318 DOI: 10.1016/j.heliyon.2022.e12008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/12/2022] [Accepted: 11/23/2022] [Indexed: 12/03/2022] Open
Abstract
Tendinopathy refers to a type of tendon disease with a multifactorial spectrum. Recent research has begun to reveal the effects of inflammation on the tendinopathic process, especially in the first stage of tendinopathy. Radial extracorporeal shock wave therapy (rESWT) has been successfully used to treat orthopedic diseases. However, the molecular mechanisms underlying the anti-inflammatory effects of rESWT on tumor necrosis factor-α treated tenocytes have not been fully elucidated. In this study, we applied total protein tandem mass tag-labeled quantitative proteomics with liquid chromatography-mass spectrometer/mass spectrometer technology to identify differentially expressed proteins (DEPs) among inflammatory tenocytes, rESWT inflammatory tenocytes, and controls using three biological replicates. Human tenocytes were used and they were cultured in vitro. In total, 1028 and 40 DEPs were detected for control versus inflammatory tenocytes and for inflammatory tenocytes versus rESWT inflammatory tenocytes, respectively. Further, we identified integrin α2, selenoprotein S, and NLR family CARD domain-containing protein 4 as pivotal molecular targets of the anti-inflammatory effects of rESWT. This is the first study to provide a reference proteomic map for inflammatory tenocytes and rESWT inflammatory tenocytes. Our findings provide crucial insight into the molecular mechanisms underscoring the anti-inflammatory effects of rESWT in tendinopathy.
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Affiliation(s)
- Ruidong Ge
- Department of Rehabilitation Medicine, China-Japan Friendship Hospital, Beijing, 100029, China,School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, 100084, China
| | - Qianzheng Zhu
- Department of Orthopedics Trauma, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Die Liu
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Qi Zhang
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, 100029, China,Corresponding author.
| | - Shan Jiang
- Department of Rehabilitation Medicine, China-Japan Friendship Hospital, Beijing, 100029, China,Corresponding author.
| | - Xueying Yu
- Clinical Laboratory, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Jun Shu
- Institute of Clinical Medicine, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Fuqiang Gao
- Department of Orthopedics, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Jingwei Guo
- Department of Rehabilitation Medicine, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Shengxuan Chen
- Department of Rehabilitation Medicine, The Gulou Hospital of Traditional Chinese Medicine, Beijing, 100009, China
| | - Beiyao Gao
- Department of Rehabilitation Medicine, China-Japan Friendship Hospital, Beijing, 100029, China
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Guo J, Hai H, Ma Y. Application of extracorporeal shock wave therapy in nervous system diseases: A review. Front Neurol 2022; 13:963849. [PMID: 36062022 PMCID: PMC9428455 DOI: 10.3389/fneur.2022.963849] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/21/2022] [Indexed: 11/29/2022] Open
Abstract
Neurological disorders are one of the leading causes of morbidity and mortality worldwide, and their therapeutic options remain limited. Recent animal and clinical studies have shown the potential of extracorporeal shock wave therapy (ESWT) as an innovative, safe, and cost-effective option to treat neurological disorders. Moreover, the cellular and molecular mechanism of ESWT has been proposed to better understand the regeneration and repairment of neurological disorders by ESWT. In this review, we discuss the principles of ESWT, the animal and clinical studies involving the use of ESWT to treat central and peripheral nervous system diseases, and the proposed cellular and molecular mechanism of ESWT. We also discuss the challenges encountered when applying ESWT to the human brain and spinal cord and the new potential applications of ESWT in treating neurological disorders.
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Yang Y, Kang J, Jiang T, Schmitz C, Weng C, Zhang L. Safety and efficacy of treating post-burn pathological scars with extracorporeal shock wave therapy: A meta-analysis of randomised controlled trials. Wound Repair Regen 2022; 30:595-607. [PMID: 35691021 DOI: 10.1111/wrr.13037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/17/2022] [Accepted: 06/06/2022] [Indexed: 11/28/2022]
Abstract
The clinical application of shockwave therapy has expanded to the treatment of pathological scars. The objective of this systematic review and meta-analysis is to quantitatively evaluate the efficacy and safety of extracorporeal shockwave therapy combined with comprehensive rehabilitation therapy on post-burn pathological scars compared to comprehensive rehabilitation therapy alone. The randomised controlled trials of extracorporeal shockwave therapy for post-burn pathological scars published in English and Chinese languages before October 2021 were included. The methodological quality and risk of bias of the selected articles were assessed with the Cochrane Collaboration's 'risk of bias' tool. RevMan software was applied for data analysis. This is the first systematic review and meta-analysis considering the effectiveness and safety of extracorporeal shockwave therapy on post-burn pathological scars. And nine randomised controlled trials involving 422 patients were included in this meta-analysis. The meta-analysis results showed that, compared with comprehensive rehabilitation therapy alone, extracorporeal shockwave therapy combined with comprehensive rehabilitation therapy was more effective in relieving pain (standardized mean difference [SMD] = -0.59, 95% confidence interval [CI]: [-0.87 to -0.31], p < 0.0001) and pruritus related to pathological scars (SMD = -0.94; 95% CI: [-1.25 to -0.63], p = 0.004), improving scars' appearance (SMD = -1.78, 95% CI: [-3.37 to -0.19], p = 0.03) and elasticity (SMD = 0.25, 95% CI: [0.29-0.21], p < 0.00001), decreasing scars thickness (SMD = -0.13, 95% CI: [-0.25 to -0.01], p = 0.04) and promoting the maturation status of scars (SMD = -2.86, 95% CI: [-3.96 to -1.76], p < 0.00001). There were no reported serious adverse events during and after extracorporeal shockwave therapy in the included studies. Available data preliminarily suggested that the combination of extracorporeal shockwave therapy and comprehensive rehabilitation therapy had better therapeutic effect on post-burn pathological scars than comprehensive rehabilitation therapy alone, without obvious side effects. However, further clinical well-controlled randomised controlled trials are needed. Systematic review registration ID: PROSPERO CRD42022297573.
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Affiliation(s)
- Yanhui Yang
- Department of Cardiology, the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Haidian District, Beijing, China.,Chinese PLA Medical School, Chinese PLA General Hospital, Haidian District, Beijing, China
| | - Jingwen Kang
- Department of Rehabilitation Medicine, the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Haidian District, Beijing, China
| | - Tianyu Jiang
- Department of Rehabilitation Medicine, the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Haidian District, Beijing, China
| | - Christoph Schmitz
- Extracorporeal Shock Wave Research Unit, Institute of Anatomy, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Changshui Weng
- Department of Rehabilitation Medicine, the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Haidian District, Beijing, China
| | - Li Zhang
- Department of Rehabilitation Medicine, the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Haidian District, Beijing, China
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Numerical Modeling of Shockwave Treatment of Knee Joint. MATERIALS 2021; 14:ma14247678. [PMID: 34947273 PMCID: PMC8707368 DOI: 10.3390/ma14247678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/03/2021] [Accepted: 12/09/2021] [Indexed: 12/20/2022]
Abstract
Arthritis is a degenerative disease that primarily affects the cartilage and meniscus of the knee joint. External acoustic stimulation is used to treat this disease. This article presents a numerical model of the knee joint aimed at the computer-aided study of the regenerative effects of shockwave treatment. The presented model was verified and validated. A numerical analysis of the conditions for the regeneration of the tissues of the knee joint under shockwave action was conducted. The results allow us to conclude that to obtain the conditions required for the regeneration of cartilage tissues and meniscus (compressive stresses above the threshold value of 0.15 MPa to start the process of chondrogenesis; distortional strains above the threshold value of 0.05% characterized by the beginning of the differentiation of the tissues in large volumes; fluid pressure corresponding to the optimal level of 68 kPa to transfer tissue cells in large volumes), the energy flux density of therapeutic shockwave loading should exceed 0.3 mJ/mm2.
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Sugawara AT, Lima MDC, Dias CB. Predictive factors of response in radial Extracorporeal Shock-waves Therapy for Myofascial and Articular Pain: A retrospective cohort study. J Back Musculoskelet Rehabil 2021; 34:485-490. [PMID: 33492278 DOI: 10.3233/bmr-200152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Myofascial Pain Syndrome causes disability in daily life activities and despite all efforts, it continues to be a challenge, perpetuating suffering, overloading services and costs. New treatment options need to be tested. OBJECTIVE We aimed to quantify the rESWT short-term analgesic effect and identify the predictors of success through comparing results achieved in MPS and Articular Pain (AP). METHOD Retrospective cohort study of 1,580 patients with Myofascial Pain Syndrome or Articular Pain underwent two weekly radial Extracorporeal Shock-wave Therapy sessions. The pain intensity was measured by Visual Analog Scale before and one week after the end of the treatment (3 weeks). RESULTS The therapy decreases pain by 62.50% (p< 0.0001), with a high success rate (91.59%) and a low worsening of baseline conditions rate (2.1%). The best recommendation is for patients with intense myofascial pain (Visual Analog Scale ⩾ 70 mm), using high shock-wave frequency (⩾ 15 Hz). CONCLUSIONS Two rESWT sessions promote pain relief, with a high success rate and low rates of treatment abandonment and worsening. The best results are obtained in myofascial pain patients with high pain intensity, treated with high-frequency dosage.
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Affiliation(s)
- André Tadeu Sugawara
- Department of Physical and Rehabilitation Medicine, Hospital do Servidor Publico Estadual, Sao Paulo, Brazil
| | - Moises da Cunha Lima
- Department of Physical and Rehabilitation Medicine, Hospital do Servidor Publico Estadual, Sao Paulo, Brazil
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Yin C, Wang S, Ren Q, Shen X, Chen X, Liu Y, Liu S. Radial extracorporeal shock wave promotes the enhanced permeability and retention effect to reinforce cancer nanothermotherapeutics. Sci Bull (Beijing) 2019; 64:679-689. [PMID: 36659650 DOI: 10.1016/j.scib.2019.04.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/07/2019] [Accepted: 04/08/2019] [Indexed: 01/21/2023]
Abstract
Since most cancer nanomedicine relies on the enhanced permeability and retention (EPR) effect to eradicate tumors, strategies that are able to promote nanoparticle (NP) delivery and extravasation are presupposed to elevate the EPR effect for more effective cancer therapeutics. However, nanothermotherapeutics still suffers from limited drug delivery into tumor sites, for even though numerous efforts have been made to enhance the selective tumor targeting of NPs. In this study, we uncovered that radial extracorporeal shock wave therapy (rESWT), an important approach in physical therapy that has been overlooked in cancer treatment in the past, can largely improve the EPR-dependent tumor uptake of NPs. We here defined the optimal low dosage and desirable combinatory manner for rESWT in driving NP accumulation towards tumors. Two underlying biophysical mechanisms responsible for the rESWT-enhanced EPR effect were proposed. On one hand, rESWT-conducted compressive and tensile forces could relieve high intra-tumoral pressure; on the other hand, rESWT-induced cavitation bubbles could directly distend and disrupt tumor blood vessels. All these together synergistically promoted vessel vasodilation, tumor perfusion and NP extravasation. Further experiments revealed that the combinatory therapeutics between rESWT and nanothermotherapeutics greatly improved the tumor-killing efficacy. Thus, our findings open a new path to improve EPR-mediated drug delivery with the assistance of rESWT.
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Affiliation(s)
- Chunyang Yin
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Shunhao Wang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Quanzhong Ren
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xinming Shen
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xiaodong Chen
- School of Aerospace Engineering, Beijing Institute of Technology, Beijing 100081, China
| | - Yajun Liu
- Orthopedic Shock Wave Treatment Center, Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
| | - Sijin Liu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China.
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