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Skaudickas D, Lenčiauskas P, Skaudickas A, Undžytė G. Low intensity extracorporeal shockwave therapy for chronic pelvic pain syndrome: Long-term follow-up. Open Med (Wars) 2023; 18:20230832. [PMID: 37900960 PMCID: PMC10612526 DOI: 10.1515/med-2023-0832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 10/31/2023] Open
Abstract
Chronic prostatitis (CP) is one of the diseases that reduce the quality of life (QoL) of young men. To date, there is no consensus on the management of these patients. It is essential to continue research into the treatment of CP, despite the use of various therapies, including low-energy extracorporeal shockwave therapy (ESWT). The main objective of this study is to observe and record the clinical symptomatology of patients during a 48-week follow-up period after ESWT treatment. Between 2019 and 2021, 28 patients with type IIIB CP/chronic pelvic pain syndrome were enrolled. Patients underwent ESWT once weekly for 4 weeks (3,000 individual sessions, maximum total energy flux density 0.25 mJ/mm2, frequency 3 Hz). Participants were assessed at 0, 4, 12, 24, 36 and 48 weeks post-treatment using the visual analogue scale (VAS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), and International Index of Erectile Function (IIEF)-5. The mean age of patients was 47.1 ± 13.7 years (range 28-4 years). The positive effect of LI-ESWT was reflected in improvements in VAS, NIH-CPSI, and IIEF-5 scores. Regression of patients' symptoms was observed as early as 4 weeks after treatment. The greatest progress was achieved at week 24. In addition, a slight worsening was observed at week 36 and 48, with stable progress. The treatment significantly improved the QoL of the patients, with the most significant improvement in the VAS score. In conclusion, this treatment approach is safe, most effective in the first 6 months. Thereafter, the efficacy of the treatment diminishes, but is sustained over a longer period.
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Affiliation(s)
- Darijus Skaudickas
- Lithuania Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, 50161, Kaunas, Lithuania
| | - Povilas Lenčiauskas
- Lithuania Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, 50161, Kaunas, Lithuania
| | - Augustas Skaudickas
- Lithuania Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, 50161, Kaunas, Lithuania
| | - Greta Undžytė
- Lithuania Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, 50161, Kaunas, Lithuania
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Liu T, Shi J, Fu Y, Zhang Y, Bai Y, He S, Deng W, Jin Q, Chen Y, Fang L, He L, Li Y, Yang Y, Zhang L, Lv Q, Wang J, Xie M. New trends in non-pharmacological approaches for cardiovascular disease: Therapeutic ultrasound. Trends Cardiovasc Med 2023; 33:431-440. [PMID: 35461990 DOI: 10.1016/j.tcm.2022.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 04/05/2022] [Accepted: 04/19/2022] [Indexed: 11/30/2022]
Abstract
Significant advances in application of therapeutic ultrasound have been reported in the past decades. Therapeutic ultrasound is an emerging non-invasive stimulation technique. This approach has shown high potential for treatment of various disease including cardiovascular disease. In this review, application principle and significance of the basic parameters of therapeutic ultrasound are summarized. The effects of therapeutic ultrasound in myocardial ischemia, heart failure, myocarditis, arrhythmias, and hypertension are explored, with key focus on the underlying mechanism. Further, the limitations and challenges of ultrasound therapy on clinical translation are evaluated to promote application of the novel strategy in cardiovascular diseases.
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Affiliation(s)
- Tianshu Liu
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Jiawei Shi
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Yanan Fu
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Yichan Zhang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Ying Bai
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Shukun He
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Wenhui Deng
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Qiaofeng Jin
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Yihan Chen
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Lingyun Fang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Lin He
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Yuman Li
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Yali Yang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Li Zhang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Qing Lv
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Jing Wang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China.
| | - Mingxing Xie
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Medical Imaging, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China.
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Wu ZS, Wang HJ, Lee WC, Luo HL, Lin TK, Chuang YC. Low-Energy Shock Wave Suppresses Prostatic Pain and Inflammation by Modulating Mitochondrial Dynamics Regulators on a Carrageenan-Induced Prostatitis Model in Rats. Int J Mol Sci 2023; 24:ijms24043898. [PMID: 36835316 PMCID: PMC9968097 DOI: 10.3390/ijms24043898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
A low-energy shock wave (LESW) has therapeutic effects on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS); however, its mechanism of action remains unclear. We explored the effects of LESW on the prostate and mitochondrial dynamics regulators in a rat model of carrageenan-induced prostatitis. The imbalance of mitochondrial dynamics regulators may affect the inflammatory process and molecules and contribute to CP/CPPS. Male Sprague-Dawley rats received intraprostatic 3% or 5% carrageenan injections. The 5% carrageenan group also received LESW treatment at 24 h, 7 days, and 8 days. Pain behavior was evaluated at baseline, 1 week, and 2 weeks after a saline or carrageenan injection. The bladder and the prostate were harvested for immunohistochemistry and quantitative reverse-transcription polymerase chain reaction analysis. Intraprostatic carrageenan injection induced inflammatory reaction in the prostate and the bladder, decreased the pain threshold, and resulted in the upregulation of Drp-1, MFN-2, NLRP3 (mitochondrial integrity markers), substance P, and CGRP-RCP, whose effects were maintained for 1-2 weeks. LESW treatment suppressed carrageenan-induced prostatic pain, inflammatory reaction, mitochondrial integrity markers, and expression of sensory molecules. These findings support a link between the anti-neuroinflammatory effects of LESW in CP/CPPS and the reversal of cellular perturbations caused by imbalances in mitochondrial dynamics in the prostate.
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Affiliation(s)
- Zong-Sheng Wu
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
| | - Hung-Jen Wang
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
| | - Wei-Chia Lee
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
| | - Hou Lun Luo
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
| | - Tsu-Kung Lin
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung 833, Taiwan
- Center for Mitochondrial Research and Medicine, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Yao-Chi Chuang
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung 833, Taiwan
- Correspondence: ; Tel.: +886-7-7317123 (ext. 8094)
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Jia N, Zhang R, Liu B, Liu B, Qi X, Lan M, Liu J, Zeng P, Chen C, Li W, Guo Y, Yao Z, He Q. Efficacy and safety of cardiac shock wave therapy for patients with severe coronary artery disease: A randomized, double-blind control study. J Nucl Cardiol 2022; 29:2404-2419. [PMID: 34476776 DOI: 10.1007/s12350-021-02768-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 07/15/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND Previous studies proved the efficacy of cardiac shock wave therapy (CSWT) for coronary artery disease (CAD) patients who are not candidate for reperfusion therapy. Randomized control trials are limited. We try to explore the efficacy and safety of CSWT for patients with severe CAD. METHODS Thirty patients with severe CAD who had obvious ischemia on myocardial perfusion imaging (MPI) were enrolled and randomly assigned to the CSWT group or the control group. They had received optimal medication treatment for at least three months. Nine sessions of shock wave therapy were conducted over 3 months. CSWT group received the real treatment, while the control group received the pseudo-treatment. Clinical symptom, imaging outcomes and safety parameters were compared between two groups. RESULTS After treatment, regional stress score (P = .023), improvement rate (IR) of ischemic area (IA) stress (P < .001) and IR of IA difference (P < .001) were significantly favor CSWT group. The interaction of summed rest score (P < .001), summed stress score (P = .004), summed difference score (P = .036) were significantly improved in the CSWT group compared to the control group. Seattle angina questionnaire, quality of life (QOL) and the distance of six-minute walking test (6MWT) were improved in both groups without significant difference between them. Hemodynamic parameters were stable during procedure. Myocardial injury markers showed no changes in two groups. CONCLUSIONS Our study demonstrated CSWT could effectively and safely improve myocardial perfusion in patients with severe CAD. Clinical symptom, QOL and 6MWT were all improved after treatment, but no significant difference between two groups.
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Affiliation(s)
- Na Jia
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, 1 Dahua Road, Dongdan, Dongcheng, Beijing, 100730, People's Republic of China
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China
| | - Ruisheng Zhang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, 1 Dahua Road, Dongdan, Dongcheng, Beijing, 100730, People's Republic of China
| | - Baoyi Liu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, 1 Dahua Road, Dongdan, Dongcheng, Beijing, 100730, People's Republic of China
| | - Bing Liu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, 1 Dahua Road, Dongdan, Dongcheng, Beijing, 100730, People's Republic of China
| | - Xin Qi
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, 1 Dahua Road, Dongdan, Dongcheng, Beijing, 100730, People's Republic of China
| | - Ming Lan
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, 1 Dahua Road, Dongdan, Dongcheng, Beijing, 100730, People's Republic of China
| | - Junmeng Liu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, 1 Dahua Road, Dongdan, Dongcheng, Beijing, 100730, People's Republic of China
| | - Ping Zeng
- Department of Epidemiology, The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, National Center of Gerontology, National Health Commission, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Congxia Chen
- Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatrics, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Wenchan Li
- Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatrics, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yue Guo
- Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatrics, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Zhiming Yao
- Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatrics, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Qing He
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, 1 Dahua Road, Dongdan, Dongcheng, Beijing, 100730, People's Republic of China.
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China.
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5
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Chuangsuwanich A, Kongkunnavat N, Kamanamool M, Maipeng G, Kamanamool N, Tonaree W. Extracorporeal Shock Wave Therapy for Hypertrophic Scars. Arch Plast Surg 2022; 49:554-560. [PMID: 35919551 PMCID: PMC9340180 DOI: 10.1055/s-0042-1751027] [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] [Indexed: 11/30/2022] Open
Abstract
Background
Hypertrophic scars cause aesthetic concerns and negatively affect the quality of life. A gold standard treatment for hypertrophic scars has not been established due to various responses of modalities. Extracorporeal shock wave therapy (ESWT) is a noninvasive and affects scar remodeling by fibroblast regulation. This study investigated the effectiveness of ESWT for hypertrophic scars.
Methods
Twenty-nine patients were enrolled. All patients underwent ESWT once a week for 6 consecutive weeks. Their scars were assessed using the Patient and Observer Scar Assessment Scale (POSAS), erythema index, melanin index, and scar pliability before treatment and again 4 weeks after treatment completion.
Results
Thirty-four hypertrophic scars in this study had persisted for between 6 months and 30 years. Most scars developed after surgical incision (55.88%). The chest and upper extremities were the predominant areas of occurrence (35.29% each). Most of the POSAS subscales and total scores were significantly improved 4 weeks after treatment (
p
< 0.05). Furthermore, the pain, itching, and pigmentation subscale were improved. The pliability, melanin index, and erythema index were also improved, but without significance. The patients were satisfied with the results and symptoms alleviation, although subjective score changes were insignificant. No serious adverse events were found. The patients reported pruritus in 62.5% and good pain tolerance in 37.5%. Subgroup analyses found no differences in scar etiologies or properties at different parts of the body.
Conclusion
The ESWT is a modality for hypertrophic scar treatment with promising results. Most of POSAS subscales were significantly improved.
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Affiliation(s)
- Apirag Chuangsuwanich
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Natthapong Kongkunnavat
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Malika Kamanamool
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Gulradar Maipeng
- Perioperative Nurse Division, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nanticha Kamanamool
- Department of Preventive and Social Medicine, Faculty of Medicine Srinakharinwirot University, Ongkharak, Thailand
| | - Warangkana Tonaree
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Cheng YH, Tsai NC, Chen YJ, Weng PL, Chang YC, Cheng JH, Ko JY, Kang HY, Lan KC. Extracorporeal Shock Wave Therapy Combined with Platelet-Rich Plasma during Preventive and Therapeutic Stages of Intrauterine Adhesion in a Rat Model. Biomedicines 2022; 10:biomedicines10020476. [PMID: 35203684 PMCID: PMC8962268 DOI: 10.3390/biomedicines10020476] [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: 01/28/2022] [Revised: 02/15/2022] [Accepted: 02/15/2022] [Indexed: 11/16/2022] Open
Abstract
Intrauterine adhesion (IUA) is caused by artificial endometrial damage during intrauterine cavity surgery. The typical phenotype involves loss of spontaneous endometrium recovery and angiogenesis. Undesirable symptoms include abnormal menstruation and infertility; therefore, prevention and early treatment of IUA remain crucial issues. Extracorporeal shockwave therapy (ESWT) major proposed therapeutic mechanisms include neovascularization, tissue regeneration, and fibrosis. We examined the effects of ESWT and/or platelet-rich plasma (PRP) during preventive and therapeutic stages of IUA by inducing intrauterine mechanical injury in rats. PRP alone, or combined with ESWT, were detected an increased number of endometrial glands, elevated vascular endothelial growth factor protein expression (hematoxylin-eosin staining and immunohistochemistry), and reduced fibrosis rate (Masson trichrome staining). mRNA expression levels of nuclear factor-kappa B, tumor necrosis factor-α, transforming growth factor-β, interleukin (IL)-6, collagen type I alpha 1, and fibronectin were reduced during two stages. However, PRP alone, or ESWT combined with PRP transplantation, not only increased the mRNA levels of vascular endothelial growth factor (VEGF) and progesterone receptor (PR) during the preventive stage but also increased PR, insulin-like growth factor 1 (IGF-1), and IL-4 during the therapeutic stage. These findings revealed that these two treatments inhibited endometrial fibrosis and inflammatory markers, thereby inhibiting the occurrence and development of intrauterine adhesions.
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Affiliation(s)
- Yin-Hua Cheng
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-H.C.); (Y.-J.C.); (P.-L.W.); (Y.-C.C.); (H.-Y.K.)
| | - Ni-Chin Tsai
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Obstetrics and Gynecology, Pingtung Christian Hospital, Pingtung 900, Taiwan
| | - Yun-Ju Chen
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-H.C.); (Y.-J.C.); (P.-L.W.); (Y.-C.C.); (H.-Y.K.)
| | - Pei-Ling Weng
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-H.C.); (Y.-J.C.); (P.-L.W.); (Y.-C.C.); (H.-Y.K.)
| | - Yun-Chiao Chang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-H.C.); (Y.-J.C.); (P.-L.W.); (Y.-C.C.); (H.-Y.K.)
| | - Jai-Hong Cheng
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (J.-H.C.); (J.-Y.K.)
- Medical Research, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
- Department of Leisure and Sports Management, Cheng Shiu University, Kaohsiung 833, Taiwan
| | - Jih-Yang Ko
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (J.-H.C.); (J.-Y.K.)
- Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Hong-Yo Kang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-H.C.); (Y.-J.C.); (P.-L.W.); (Y.-C.C.); (H.-Y.K.)
- Center for Menopause and Reproductive Medicine Research, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Kuo-Chung Lan
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (Y.-H.C.); (Y.-J.C.); (P.-L.W.); (Y.-C.C.); (H.-Y.K.)
- Center for Menopause and Reproductive Medicine Research, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
- Department of Obstetrics and Gynecology, Jen-Ai Hospital, Taichung 412, Taiwan
- Correspondence: ; Tel.: +886-7-7317123-8654; Fax: +886-7-7322915
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Extracorporeal shockwave relieves endothelial injury and dysfunction in steroid-induced osteonecrosis of the femoral head via miR-135b targeting FOXO1: in vitro and in vivo studies. Aging (Albany NY) 2022; 14:410-429. [PMID: 34996049 PMCID: PMC8791199 DOI: 10.18632/aging.203816] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/29/2021] [Indexed: 11/25/2022]
Abstract
Injury and dysfunction of endothelial cells (ECs) are closely related to the pathogenesis of steroid-induced osteonecrosis of the femoral head (ONFH), while MicroRNAs (miRNAs) play an essential role in the processes. Extracorporeal shockwave treatment (ESWT) has been used in the non-invasive treatment of various diseases including musculoskeletal and vascular disorders. In particular, ESWT with low energy levels showed a beneficial effect in ischemic tissues. However, there has been no comprehensive assessment of the effect of ESWT and miRNAs on steroid-induced ONFH. In the present study, we investigated the role and mechanism of ESWT and miRNAs both in vitro and in vivo. Using a steroid-induced ONFH rat model, we found that ESWT significantly enhances proliferation and angiogenesis as well as alleviates apoptosis. In two types of ECs, ESWT can promote cell proliferation and migration, enhance angiogenesis, and inhibit apoptosis. Notably, our study demonstrates that miR-135b is downregulated and modulated forkhead box protein O1 (FOXO1) in ECs treated with dexamethasone. Remarkably, both miR-135b knockdown and FOXO1 overexpression reversed the beneficial effect of ESWT on ECs. Additionally, our data suggest that ESWT activates the FOXO1-related pathway to impact proliferation, apoptosis, and angiogenesis. Taken together, this study indicates that ESWT relieves endothelial injury and dysfunction in steroid-induced ONFH via miR-135b targeting FOXO1.
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Merin U, Leitner G, Jacoby S, Gilad D. Management of high cows-share-contribution of SCC to the bulk milk tank by acoustic pulse technology (APT). PLoS One 2021; 16:e0255747. [PMID: 34424932 PMCID: PMC8382164 DOI: 10.1371/journal.pone.0255747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/23/2021] [Indexed: 11/18/2022] Open
Abstract
A cow with mastitis has a high somatic cell count (SCC) in its milk. Cow-share-contribution of somatic cells to the bulk milk tank (BMTSCC) refers to the relative addition made by each cow's milk to the bulk tank's SCC. Since bulk milk is graded and priced according to the BMTSCC, high-yielding cows with mastitis are the main contributors to penalizations in milk price. The benefits of acoustic pulse technology (APT) application to tissues are well documented, including its anti-inflammatory effect and restoration of tissue function by triggering natural healing processes. An APT-based device was developed specifically for treating mastitis in dairy cows. It enables rapid and deep penetration of the acoustic pulses over a large area of the udder in a single session. A study was performed on six farms with a total of 3,900 cows. One unit of cow-share-contribution equaled the addition of 1,000 cells to each mL of the bulk milk volume above the mean BMTSCC. A total of 206 cows were selected: 103 were treated with APT and 103 served as controls. All of the cows contributed over 1.5 units to the BMTSCC at the time of treatment. Seventy-five days after APT treatment, 2 of the 103 treated cows (1.9%) were culled, compared to 19 (18.5%) of the 103 control cows, as well as infected quarter dry-off in 5 others (4.85%). Overall success was defined as a decrease of >75% in cow-share-contribution from treatment time in two of the three monthly milk recordings following treatment. Results indicated 57.3% success for the APT-treated cows vs. 14.6% for the untreated control groups. Highest share-contribution provide an additional tool for the farmer's decision of how to control BMTSCC. Because the cow-share-contribution value is relative to herd size and BMTSCC, this study included a similar number of cows, with similar SCC and milk yield from each of the six herds.
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Affiliation(s)
- Uzi Merin
- Emeritus Senior Scientist, Department of Food Quality and Safety, Institute of Postharvest and Food Sciences, The Volcani Center, Bet Dagan, Israel
| | | | - Shamay Jacoby
- Institute of Animal Science, A.R.O., The Volcani Center, Bet Dagan, Israel
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Canguven O, Khalafalla K, Al Ansari A. Low-intensity extracorporeal shockwave therapy for erectile dysfunction. Arab J Urol 2021; 19:340-345. [PMID: 34552784 PMCID: PMC8451630 DOI: 10.1080/2090598x.2021.1948158] [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: 01/28/2021] [Accepted: 03/05/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives: To review the current evidence of clinical effectiveness of low-intensity extracorporeal shockwave therapy (LI-ESWT) treatment for erectile dysfunction (ED). METHODS A selective database search using Medical Subject Headings (MeSH) terms 'low intensity extracorporeal shock wave therapy' and 'erectile dysfunction' was conducted in accordance with the Preferred Reporting Items for Systemic Reviews and Meta Analyses (PRISMA) guidelines to review the effectiveness of LI-ESWT for ED. We performed a systematic search of publications using the PubMed and Web of Science databases (January 2010-December 2020) for prospective randomised clinical trials (RCTs). The success rate of LI-ESWT associated with ED were recorded and analysed. RESULTS A total of 106 articles were reviewed after searching for the keywords. Overall, 11 RCTs were included in this systematic review. A total of 920 male patients were treated in 11 RCTs. The patients' ages ranged from 18 to 80 years and they had ≥3 months of ED symptoms. Vasculogenic and neurogenic causes were addressed in 81% and 19% of patients, respectively. Of the 920 patients, 348 patients had a statistically significant improvement in their erectile function after LI-ESWT; however, 572 did not have a statistically significant improvement. CONCLUSIONS The present review found that LI-ESWT has a role in ED treatment in laboratory studies, but its role in human clinical trials is still controversial. Further good quality studies need to be conducted to properly assess its true potential in ED treatment.
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10
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Evaluation of immediate and short-term efficacy of DualStim therapy with and without intracavernosal umbilical cord-derived Wharton's jelly in patients with erectile dysfunction: Study protocol for a randomized controlled trial. Contemp Clin Trials Commun 2021; 23:100790. [PMID: 34278040 PMCID: PMC8267434 DOI: 10.1016/j.conctc.2021.100790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 04/21/2021] [Accepted: 05/16/2021] [Indexed: 01/22/2023] Open
Abstract
Introduction Erectile dysfunction (ED) affects a significant portion of the United States population and causes negative psychological burdens that affects men and their partner's quality of life and satisfaction. Extracorporeal shock therapy (ESWT) utilizing focused ESWT and radial ESWT in Low-intensity shock wave therapy has been used to treat ED with some success. Wharton's Jelly (WJ) is a biologic substance with large amounts of stem cells, growth factors, cytokines and extracellular components. The use of combined focused and radial ESWT (DualStim therapy) with injected WJ have potential uses in ED that may have advantages over current treatments. Materials A randomized, single-blinded, controlled clinical trial will be conducted to evaluate the efficacy and safety of DualStim therapy and intracavernosal injection of WJ in moderate to severe ED. A total of 60 patients with moderate to severe ED will be enrolled and treated with DualStim therapy with intracavernosal injection of WJ or saline for a period of 7 weeks. The International Index of Erectile Function – Erectile Function score will be used to gauge the treatment related changes in relation to the subject's baseline. The scores will be recorded at baseline and compared to follow-ups 1,3 and 6 months post-treatment. Any adverse events or severe adverse events will be recorded in the corresponding case report forms. Sexual Encounter Profile, as well as the Global Assessment Questionnaire and the Erection Hardness Score will be used to determine the sexual activity improvement from baseline leading to optimal penetration at follow-ups 1,3 and 6 months post-treatment. Discussion This clinical trial is one of the first studies to determine the immediate and short-term efficacy of DualStim therapy, with and without intracavernosal injection of formulated umbilical cord-derived WJ to improve and/or restore erectile function in patients with moderate to severe ED. This study will also provide insight into the safety and efficacy of WJ. We anticipate clinically significant improvement in patients suffering from moderate and severe ED treated with DualStim therapy with WJ compared to their baseline and DualStim with saline.
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11
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New Treatment Option for Clinical and Subclinical Mastitis in Dairy Cows Using Acoustic Pulse Technology (APT). DAIRY 2021. [DOI: 10.3390/dairy2020022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The effect of acoustic pulse technology (APT) on recovery, culling, milk yield, and economic benefits for 118 cows with subclinical mastitis was compared with a no-treatment control (59 vs. 59), and another 118 APT-treated cows with clinical mastitis were compared with antibiotic-treated controls (59 vs. 59). Recovery was defined as a decrease in somatic cell count (SCC) to <250 × 103 cells/mL in at least two out of three monthly milk recordings after treatments. For the subclinically infected cows, APT treatment resulted in 65.5% recovery, 0% culling, and additional milk yield of 2.74 L/cow per day compared to 35.6% recovery and 5.1% culling in the no-treatment controls. For the clinically infected cows, APT treatment resulted in 67.8% recovery, 6.8% culling, and additional milk yield of 3.9 L/cow per day compared to 35.6% recovery and 32.2% culling in the antibiotic-treated group. Bacteriological analysis was run for 95 (80%) cows with clinical mastitis (APT-46; AB-49). For cows with Escherichia coli infection, 85.7% (18/21) treated with APT recovered vs. 17.6% (3/17) in the antibiotic-treated group; for cows with streptococcal infection, 66.0% (12/18) in the APT-treated group recovered vs. 44.4% (8/18) in the antibiotic-treated group.
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12
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Ochoa A, Guillot-Tantay C, Misrai V, Rouprêt M. [Low-intensity extracorporeal shock wave therapy for erectile dysfunction: A systematic review]. Prog Urol 2021; 31:506-518. [PMID: 33941461 DOI: 10.1016/j.purol.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 08/13/2020] [Accepted: 11/10/2020] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Our purpose was to assess the efficacy of low intensity extracorporeal shock waves (SW) for the treatment of organic erectile dysfunction (ED). METHODS A systematic review of the literature published between 2000 and 2020 was conducted using the PRISMA methodology. We used Medline data with the following key words (MesH): "extracorporeal shock wave therapy"; "erectile dysfunction"; "sexuality". RESULTS Nineteen articles were selected: thirteen randomised controlled trial and six meta-analyses. Most of them studied vascular etiology. Low intensity SW is beneficial ED is evaluated by the IIEF, EHS scores and penile hemodynamic. CONCLUSION SW may have a theoretical impact on the vascular etiology of organic DE. Their use in this context is supported by the European Society of urology and the European Society of sexual medecine. However, there are discrepancies in current data to establish a protocol to follow in daily practice.
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Affiliation(s)
- A Ochoa
- Sorbonne université, GRC 5 onco-urologie prédictive, Assistance publique-Hôpitaux de Paris, hôpital La Pitié Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - C Guillot-Tantay
- Sorbonne université, GRC 5 onco-urologie prédictive, Assistance publique-Hôpitaux de Paris, hôpital La Pitié Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - V Misrai
- Service d'urologie, Clinique Pasteur, Toulouse, France
| | - M Rouprêt
- Sorbonne université, GRC 5 onco-urologie prédictive, Assistance publique-Hôpitaux de Paris, hôpital La Pitié Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
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Lee YC, Hsieh TJ, Tang FH, Jhan JH, Lin KL, Juan YS, Wang HS, Long CY. Therapeutic effect of Low intensity Extracorporeal Shock Wave Therapy (Li-ESWT) on diabetic bladder dysfunction in a rat model. Int J Med Sci 2021; 18:1423-1431. [PMID: 33628099 PMCID: PMC7893573 DOI: 10.7150/ijms.55274] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 01/06/2021] [Indexed: 12/14/2022] Open
Abstract
Objectives: Low intensity extracorporeal shock wave therapy (Li-ESWT) has proven to be effective and safe for the treatment of various urological disorders including erectile dysfunction and chronic pelvic pain syndrome. In this study, we elucidated the therapeutic effect and possible mechanisms of Li-ESWT on diabetic bladder dysfunction (DBD) in a rat model. Materials and Methods: In all, thirty-two female Sprague-Dawley rats were divided into three groups: normal control (NC), diabetes mellitus (DM) control, and DM Li-ESWT. The two DM groups were given high fat diets for one month, followed by 2 intraperitoneal injections of streptozotocin (STZ) 30 mg/kg separated by one week. Body weight and fasting blood glucose were monitored every week. Only rats with fasting blood glucose 140 mg/dL or more were considered diabetic and used in the subsequent portions of the study. The Li-ESWTs were applied toward the pelvis of the rats twice a week for 4 weeks with energy flux density (EFD) 0.02 mJ/mm2, 500 shocks, at 3Hz. All rats underwent plasma insulin tolerance test, conscious cystometry, leak-point pressure (LPP) assessment, and immunohistochemical studies. Results: DM groups had significantly lower insulin sensitivity and higher body weight. Conscious cystometry also revealed voiding dysfunctions. In the DM Li-ESWT group, the rats had significantly improved voiding functions that were reflected in longer micturition intervals and higher LPP compared to DM control. Immunofluorescence in DM control groups showed increased tyrosine hydroxylase (TH) expression and decreased neuronal nitric oxide synthase (nNOS) expression in the longitudinal urethral smooth muscles. Besides, rats had dilations and deformities of suburothelium capillary network of the bladder, revealing the deterioration of the nerve function of the urethra and destruction of the vascularization of the bladder. However, the DM Li-ESWT group exhibited recovery of the nerve expression of the urethra and vascularization of bladder. Conclusions: Li-ESWT ameliorates the bladder dysfunction and urinary continence in the DBD rat model, reflected in restoration of the nerve expression of the urethra and the vascularization of the bladder. Non-invasive Li-ESWT could be an alternative therapeutic option for DBD.
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Affiliation(s)
- Yung-Chin Lee
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tusty-Jiuan Hsieh
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Fang-Hsiang Tang
- Department of Obstetrics and Gynecology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jhen-Hao Jhan
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kun-Ling Lin
- Department of Obstetrics and Gynecology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Shun Juan
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsun-Shuan Wang
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Cheng-Yu Long
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Obstetrics and Gynecology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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14
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Yang HT, Xie X, Hou XG, Xiu WJ, Wu TT. Cardiac Shock Wave Therapy for Coronary Heart Disease: an Updated Meta-analysis. Braz J Cardiovasc Surg 2020; 35:741-756. [PMID: 33118740 PMCID: PMC7598952 DOI: 10.21470/1678-9741-2019-0276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Introduction The aim of this article is to study the efficacy and safety of cardiac shock wave therapy (CSWT) in the treatment of coronary heart disease (CAD). Methods A comprehensive search of electronic databases and a manual search of conference papers and abstracts were performed until September 30, 2018. The studies using RevMan 5.3 and STATA 14.0 softwares were reviewed, and meta-analyses were performed on 13 indicators, such as a six-min walking distance test (6MWT), New York Heart Association (NYHA) functional class, Seattle Angina Questionnaire (SAQ) score, angina class (Canadian Cardiology Society [CCS]), etc. Results A total of 26 articles were included. The total patient population was 855, of which 781 patients were treated with CSWT. Meta-analyses indicated that 6MWT (mean difference [MD] 75.64, 95% confidence interval [CI] 49.03, 102.25, P<0.00001) and NYHA (MD -0.70, 95% CI -0.92) in the CSWT group were comparable to those in the conventional revascularization group (MD -0.70, 95% CI -0.92, -0.49, P<0.00001). SAQ (MD 10.75, 95% CI 6.66, 14.83, P<0.00001), CCS (MD -0.99, 95% CI -1.13, -0.84, P<0.00001), nitrate dosage (MD -1.84, 95% CI -2.77, -1.12, P<0.00001), LVEF (MD 3.77, 95% CI 2.17, 5.37, P<0.00001), and SSS (MD -4.29, 95% CI -5.61, -2.96, P<0.00001), SRS (MD -2.90, 95% CI -4.85, -0.95, P=0.004), and the exercise test (standard mean difference 0.57, 95% CI 0.12, 1.02, P=0.01) all showed significant differences. Conclusion CSWT may offer beneficial effects to patients with CAD, but more large-scale clinical studies are needed to further verify its therapeutic effect.
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Affiliation(s)
- Hai-Tao Yang
- Xinjiang Medical University First Affiliated Hospital Department of Cardiology Urumchi People's Republic of China Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumchi, People's Republic of China
| | - Xiang Xie
- Xinjiang Medical University First Affiliated Hospital Department of Cardiology Urumchi People's Republic of China Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumchi, People's Republic of China
| | - Xian-Geng Hou
- Changji Hui Autonomous Prefecture People's Hospital Department of Cardiology People's Republic of China Department of Cardiology, Changji Hui Autonomous Prefecture People's Hospital, People's Republic of China
| | - Wen-Juan Xiu
- Xinjiang Medical University First Affiliated Hospital Department of Cardiology Urumchi People's Republic of China Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumchi, People's Republic of China
| | - Ting-Ting Wu
- Xinjiang Medical University First Affiliated Hospital Department of Cardiology Urumchi People's Republic of China Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumchi, People's Republic of China
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15
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Dong W, Wu P, Qin M, Guo S, Liu H, Yang X, He W, Bouakaz A, Wan M, Zong Y. Multipotent miRNA Sponge-Loaded Magnetic Nanodroplets with Ultrasound/Magnet-Assisted Delivery for Hepatocellular Carcinoma Therapy. Mol Pharm 2020; 17:2891-2910. [PMID: 32678617 DOI: 10.1021/acs.molpharmaceut.0c00336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Gene therapy is likely to be the most promising way to tackle cancer, while defects in molecular strategies and delivery systems have led to an impasse in clinical application. Here, it is found that onco-miRNAs of the miR-515 and -449 families were upregulated in hepatocellular carcinoma (HCC), and the sponge targeting miR-515 family had a significant probability to suppress cancer cell proliferation. Then, we constructed non-toxic sponge-loaded magnetic nanodroplets containing 20% C6F14 (SLMNDs-20%) that are incorporated with fluorinated superparamagnetic iron oxide nanoparticles enhancing external magnetism-assisted targeting and enabling a direct visualization of SLMNDs-20% distribution in vivo via magnetic resonance imaging monitoring. SLMNDs-20% could be vaporized by programmable focused ultrasound (FUS) activation, achieving ∼45% in vitro sponge delivery efficiency and significantly enhancing in vivo sponge delivery without a clear apoptosis. Moreover, the sponge-1-carrying SLMNDs-20% could effectively suppress proliferation of xenograft HCC after FUS exposure because sponge-1-suppressing onco-miR-515 enhanced the expression of anti-oncogenes (P21, CD22, TIMP1, NFKB, and E-cadherin) in cancer cells. The current results indicated that ultrasonic cavitation-inducing sonoporation enhanced the intracellular delivery of sponge-1 using SLMNDs-20% after magnetic-assisted accumulation, which was a therapeutic approach to inhibit HCC progression.
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Affiliation(s)
- Wei Dong
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, China
| | - Pengying Wu
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, China
| | - Mengfan Qin
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, China
| | - Shifang Guo
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, China
| | - Huasheng Liu
- Department of Hematology, The First Affiliated Hospital, Xi'an Jiaotong University School of Medicine, Xi'an, Shaanxi 710061, China
| | - Xinxing Yang
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, China.,Department of Ultrasound, The First Affiliated Hospital of AFMU (Xijing Hospital), Air Force Medical University, Xi'an, Shaanxi 710032, China
| | - Wen He
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, China.,Department of Pharmacy, The First Affiliated Hospital, Xi'an Jiaotong University School of Medicine, Xi'an, Shaanxi 710061, China
| | - Ayache Bouakaz
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, China.,Inserm Imaging and Ultrasound, INSERM U930, Imagerie et Cerveau, Université François-Rabelais de Tours, Tours 37000, France
| | - Mingxi Wan
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, China
| | - Yujin Zong
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, China
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16
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Ujiie N, Nakano T, Yamada M, Sato C, Nakanishi C, Fujishima F, Ito K, Shindo T, Shimokawa H, Kamei T. Low-energy extracorporeal shock wave therapy for a model of liver cirrhosis ameliorates liver fibrosis and liver function. Sci Rep 2020; 10:2405. [PMID: 32051434 PMCID: PMC7016168 DOI: 10.1038/s41598-020-58369-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 01/06/2020] [Indexed: 12/02/2022] Open
Abstract
Low-energy extracorporeal shock waves (LESW) have been studied as a new treatment for angina pectoris and several ischemic diseases because of its effect on angiogenesis and inhibition of fibrosis of the heart. The effect of LESW on fibrosis in liver cirrhosis has not been studied. The aim of this study was to verify the amelioration of liver fibrosis by LESW and elucidate its mechanisms in a rat model of drug-induced liver cirrhosis. Male Wistar rats aged 7 weeks were injected with carbon tetrachloride intraperitoneally twice a week for 12 weeks. Eight rats underwent LESW therapy (0.25 mJ/mm2, 4 Hz, 1000 shots) under general anesthesia (shock wave group). Seven rats only underwent general anesthesia (control group). Quantitative analysis showed that the area of fibrosis in the shock wave group was significantly reduced compared with the control group (11,899.9 vs. 23,525.3 pixels per field, p < 0.001). In the shock wave group, the mRNA expression of transforming growth factor (TGF)-β1 was significantly suppressed (0.40-fold, p = 0.018) and vascular endothelial growth factor-B was significantly increased (1.77-fold, p = 0.006) compared with the control group. Serum albumin was significantly higher in the shock wave group than in the control group (3.0 vs. 2.4 g/dl, p = 0.025). Aspartate aminotransferase/alanine aminotransferase ratio decreased by LESW compared with the control group (1.49 vs. 2.04, p = 0.013). These results suggest that LESW therapy ameliorates liver fibrosis by reducing the expression of TGF-β1 and increasing the expression of angiogenic factors, and improves hepatic function.
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Affiliation(s)
- Naoto Ujiie
- Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Toru Nakano
- Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. .,Division of Gastroenterologic and Hepatobiliarypancreatic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Miyagi, Japan.
| | - Masato Yamada
- Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Chiaki Sato
- Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Chikashi Nakanishi
- Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Fumiyoshi Fujishima
- Department of Anatomic Pathology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Kenta Ito
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Tomohiko Shindo
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Takashi Kamei
- Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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Dong W, Wu P, Zhou D, Huang J, Qin M, Yang X, Wan M, Zong Y. Ultrasound-Mediated Gene Therapy of Hepatocellular Carcinoma Using Pre-microRNA Plasmid-Loaded Nanodroplets. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:90-107. [PMID: 31668943 DOI: 10.1016/j.ultrasmedbio.2019.09.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 09/19/2019] [Accepted: 09/20/2019] [Indexed: 05/19/2023]
Abstract
The PIK3 CA gene encodes the p110α protein subunit and is one of the most efficient cancer genes in solid and hematological tumors including hepatocellular carcinoma (HCC). There are currently ongoing therapies against tumors based on PIK3 CA inhibition. Because microRNAs (miRNAs) play an important role in post-transcriptional regulation and are also involved in the inhibition of PIK3 CA expression to suppress cancer cell proliferation, overexpression of tumor-suppressive miRNA is a promising therapeutic approach for HCC therapy. The successful and localized delivery of miRNA overexpression vectors (pre-miRNA plasmids) is very important in improving the therapeutic efficacy of this miRNA therapy strategy. In the study described here, submicron acoustic phase-shifted nanodroplets were used to efficiently deliver pre-miRNA plasmid in vitro and in vivo for HCC therapy under focused ultrasound (US) activation. Briefly, six miRNAs, inhibiting PIK3 CA and downregulated in HCC, were selected through summary and analysis of the currently existing literature data. Quantitative real-time polymerase chain reaction (qRT-PCR), Western blot and cell apoptosis assay revealed that pre-miR-139, -203a, -378a and -422a plasmids among the six miRNA overexpression vectors could suppress growth of the hepatoma cell line SMMC-7721. These four pre-miRNA plasmids were then electrostatically adhered to positively charged lipid-shelled nanodroplets to obtain plasmid-loaded nanodroplets (PLNDs). The PLND-generated microbubbles oscillated and even collapsed under US exposure to release the loaded pre-miRNA plasmids and enhance their cellular uptake through consequent sonoporation, that is, formation of small pores on the cell membrane induced by the mechanical effects of PLND cavitation. Fluorescence microscopy results revealed that PLNDs could effectively deliver the aforementioned four pre-miRNA plasmids into SMMC-7721 cells in vitro under 1.2-MHz 60-cycle sinusoid US exposure with a peak negative pressure >5.5 MPa at a 40-Hz pulse repetition frequency. Plasmid delivery efficiency and cell viability positively correlated with the inertial cavitation dose that was determined mainly by peak negative pressure. Furthermore, PLNDs combined with US were evaluated in vivo to deliver these four pre-miRNAs plasmids and verify their therapeutic efficacy in subcutaneous tumor of the mouse xenograft HCC model. The results revealed that the PLNDs loaded with pre-miR-139 and -378a plasmids could effectively suppress tumor growth after US treatment. Thus, combination of pre-miRNA PLNDs with US activation seems to constitute a potential strategy for HCC therapy.
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Affiliation(s)
- Wei Dong
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi' an, China
| | - Pengying Wu
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi' an, China
| | - Di Zhou
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi' an, China
| | - Jixiu Huang
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi' an, China
| | - Mengfan Qin
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi' an, China
| | - Xinxing Yang
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi' an, China; Department of Ultrasound, First Affiliated Hospital of AFMU (Xijing Hospital), Air Force Medical University, Xi' an, China
| | - Mingxi Wan
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi' an, China
| | - Yujin Zong
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi' an, China.
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Kim KS, Jeong HC, Choi SW, Choi YS, Cho HJ, Ha US, Hong SH, Lee JY, Lee SW, Ahn ST, Moon DG, Bae WJ, Kim SW. Electromagnetic Low-Intensity Extracorporeal Shock Wave Therapy in Patients with Erectile Dysfunction: A Sham-Controlled, Double-Blind, Randomized Prospective Study. World J Mens Health 2019; 38:236-242. [PMID: 31749340 PMCID: PMC7076310 DOI: 10.5534/wjmh.190130] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/31/2019] [Accepted: 10/31/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose The aim of the present study was to evaluate the efficacy and safety of the electromagnetic-type low-intensity extracorporeal shock wave therapy (Li-ESWT) in patients with erectile dysfunction (ED). Materials and Methods The randomized, sham-controlled, double-blind prospective study was performed at two referral hospitals. Participants were randomized in a 1:1 ratio to receive sham or Li-ESWT for 6 weeks. ED was evaluated at screening and at 4 and 7 weeks after treatment. Participants were asked to complete the international index of erectile function-erectile function (IIEF-EF) domain questionnaire, erection hardness scale (EHS), and sexual encounter profile questionnaire (SEPQ 2 and 3). The development of complications was investigated. Results Eighty-one of 96 patients completed the study. The median change in the IIEF-EF score in the Li-ESWT and sham groups was 5.1 and −2.2 (p<0.001), respectively, at the 7-week follow-up; 47.4% (18/38) patients had EHS <3, of which 77.8% (14/18) showed significant improvement in virtue of Li-ESWT treatment (p=0.001). A significant improvement was observed in the percentage of “Yes” responses to SEPQ 2 and 3 in the Li-ESWT group vs. sham group from baseline to 7-week follow-up (91.3% vs. 69.4%; p=0.008 and 50.0% vs. 14.3%; p=0.002, respectively). No patients reported pain or other adverse events during treatment or follow-up. Conclusions Thus, Li-ESWT could have a role in improving erectile function. Furthermore, it is safe. We believe that Li-ESWT is an attractive new treatment modality for patients with ED.
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Affiliation(s)
- Kang Sup Kim
- Department of Urology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Cheol Jeong
- Department of Urology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Sae Woong Choi
- Department of Urology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Sun Choi
- Department of Urology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyuk Jin Cho
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - U Syn Ha
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Hoo Hong
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Youl Lee
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung Wook Lee
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | - Sun Tae Ahn
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Du Geon Moon
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Woong Jin Bae
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Sae Woong Kim
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Alshihri A, Kämmerer PW, Heimes D, Niu W, Alnassar T, Spector M. Extracorporeal Shock Wave Stimulates Angiogenesis and Collagen Production in Facial Soft Tissue. J Surg Res 2019; 245:483-491. [PMID: 31446190 DOI: 10.1016/j.jss.2019.06.077] [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: 01/07/2019] [Revised: 05/05/2019] [Accepted: 06/19/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study investigated the efficacy of extracorporeal shock wave (ESW) application in stimulating dermal thickness, vascularity, and collagen synthesis of facial skin in a large animal model. MATERIALS AND METHODS The facial skin of the maxillary and mandibular areas of goats (n = 6 per group) was treated with ESWs of different intensities (0.15 and 0.45 mJ/mm2; 1000 pulses). After 4 d, histology and immunohistochemistry were used to evaluate the following: dermal thickness, total number and abundance of microvessels, amount of type 1 collagen, and α-smooth muscle actin expression. RESULTS Dermal thickness, number and abundance of microvessels, and collagen synthesis increased after ESW application at both intensities (each P < 0.05). When comparing ESW groups, the highest collagen abundance was seen after 0.15 mJ/mm2 (P = 0.034), whereas the highest number of microvessels was detected after treatment with 0.45 mJ/mm2 (P = 0.002). CONCLUSIONS A single-session application of focused low-energy ESWs to facial skin can increase dermal thickness by stimulating collagen production and local microcirculation. These findings commend the technique for future investigation for pretreatment of local or microvascular skin flaps to enhance tissue healing.
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Affiliation(s)
- Abdulmonem Alshihri
- College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia; Harvard School of Dental Medicine, Boston, Massachusetts; VA Boston Healthcare System, Boston, Massachusetts.
| | - Peer W Kämmerer
- VA Boston Healthcare System, Boston, Massachusetts; Department of Orthopedics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Oral, Maxillofacial and Plastic Surgery, University Medical Centre Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Diana Heimes
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Centre Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Wanting Niu
- VA Boston Healthcare System, Boston, Massachusetts; Department of Orthopedics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Talal Alnassar
- College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Myron Spector
- VA Boston Healthcare System, Boston, Massachusetts; Department of Orthopedics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Ince S. Hiroaki Shimokawa. Circ Res 2018; 123:641-644. [PMID: 30355235 DOI: 10.1161/circresaha.118.313803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Antonic V, Hartmann B, Balks P, Schaden W, Ottomann C. Extracorporeal shockwave therapy as supplemental therapy for closure of large full thickness defects—Rat full-thickness skin graft model. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.wndm.2017.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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22
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Wu AK, Zhang X, Wang J, Ning H, Zaid U, Villalta JD, Wang G, Banie L, Lin G, Lue TF. Treatment of stress urinary incontinence with low-intensity extracorporeal shock wave therapy in a vaginal balloon dilation induced rat model. Transl Androl Urol 2018; 7:S7-S16. [PMID: 29644165 PMCID: PMC5881209 DOI: 10.21037/tau.2017.12.36] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background To investigate the outcomes and mechanisms of low-intensity extracorporeal shock wave therapy (Li-ESWT) on stress urinary incontinence (SUI) in a vaginal balloon dilation (VBD) rat model. Methods Thirty Sprague-Dawley rats were randomly grouped into normal controls, VBD only, and VBD with Li-ESWT. Li-ESWT was administered twice per week for 3 weeks. Afterward, all 30 rats were assessed with functional and histological studies. To explore the acute effect of Li-ESWT, another 25 rats, given intraperitoneal 5-ethynyl-2-deoxyuridine (EdU) at birth, were treated with Li-ESWT followed by assessment of vascular endothelial growth factor (VEGF) expression and endogenous progenitor cells distribution at 24 hours or 1 week after the last Li-ESWT therapy. Additionally, rat myoblast L6 cells were used for myotube formation assay in vitro. Results Functional analysis with leak-point pressure (LPP) testing showed that rats treated with Li-ESWT following VBD had significantly higher LPP relative to those receiving VBD only (44.8±3.2 versus 27.0±2.9 cmH2O, P<0.01). Histological examinations showed increased urethral sphincter regeneration in Li-ESWT group. The rats treated with Li-ESWT also had increased vascularity, which was confirmed by immunohistochemistry of rat endothelial cell antigen, while reverse-transcriptase polymerase chain reaction (RT-PCR) showed VEGF expression was significantly enhanced. Additionally, there were significantly increased EdU+ cells in Li-ESWT treated rats at 24 hours. In vitro, Li-ESWT promoted myotube formation from L6 cells. Conclusions Li-ESWT ameliorated SUI by promoting angiogenesis, progenitor cell recruitment, and urethral sphincter regeneration in a rat model induced by VBD. Li-ESWT represents a potential novel non-invasive therapy for SUI.
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Affiliation(s)
- Alex K Wu
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, USA
| | - Xiaoyu Zhang
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, USA
| | - Jianwen Wang
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, USA
| | - Hongxiu Ning
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, USA
| | - Uwais Zaid
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, USA
| | - Jaqueline D Villalta
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, USA
| | - Guifang Wang
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, USA
| | - Lia Banie
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, USA
| | - Guiting Lin
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, USA
| | - Tom F Lue
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, USA
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Takakuwa Y, Sarai M, Kawai H, Yamada A, Shiino K, Takada K, Nagahara Y, Miyagi M, Motoyama S, Toyama H, Ozaki Y. Extracorporeal Shock Wave Therapy for Coronary Artery Disease: Relationship of Symptom Amelioration and Ischemia Improvement. ASIA OCEANIA JOURNAL OF NUCLEAR MEDICINE & BIOLOGY 2018; 6:1-9. [PMID: 29333461 PMCID: PMC5765327 DOI: 10.22038/aojnmb.2017.9899] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective(s): The current management of coronary artery disease (CAD) relies on three major therapeutic options, namely medication, percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG). However, severe CAD that is not indicated for PCI or CABG still bears a poor prognosis due to the lack of effective treatments. In 2006, extracorporeal cardiac shock wave (SW) therapy reported on human for the first time. This treatment resulted in better myocardial perfusion as evaluated by dipyridamole stress thallium scintigraphy, angina symptoms, and exercise tolerance. The aim of the present study was to investigate: myocardial perfusion images and evaluate the relationship between the ischemia improvement and symptom amelioration by SW therapy. Methods: We treated ten patients (i.e., nine males and one female) with cardiac SW therapy who had CAD but not indicated for PCI or CABG and aged 63–89 years old. After the SW therapy, all patients were followed up for three months to evaluate any amelioration of the myocardial ischemia based on symptoms, adenosine stress thallium scintigraphy, transthoracic echocardiography, and blood biochemical examinations. Results: The changes in various parameters were evaluated before and after cardiac SW therapy. The cardiac SW therapy resulted in a significant improvement in the symptoms as evaluated by the Canadian Cardiovascular Society [CCS] class score (P=0.016) and a tendency to improve in summed stress score (SSS) (P=0.068). However, no significant improvement was observed in the summed rest score (SRS), summed difference score (SDS), left ventricular wall motion score index (LVWMSI), N-terminal pro-brain natriuretic, and troponin I. The difference of CCS class score (ΔCCS) was significantly correlated with those of SSS (ΔSSS) and SDS (ΔSDS) (r=0.69, P=0.028 and r=0.70, P=0.025, respectively). There was no significant correlation between ΔCCS and other parameters. Furthermore, no significant difference was observed between the CCS improved and non-improved groups in terms of the baseline characteristics. Conclusion: The current study demonstrated the potential efficacy and safety of Cardiac SW therapy in CAD patients. As the findings indicated, symptom amelioration was associated with ischemia improvement by extracorporeal shock wave therapy for the CAD patients.
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Affiliation(s)
- Youko Takakuwa
- Department of Cardiology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Masayoshi Sarai
- Department of Cardiology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Hideki Kawai
- Department of Cardiology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Akira Yamada
- Department of Cardiology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Kenji Shiino
- Department of Cardiology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Kayoko Takada
- Department of Cardiology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Yasuomi Nagahara
- Department of Cardiology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Meiko Miyagi
- Department of Cardiology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Sadako Motoyama
- Department of Cardiology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Hiroshi Toyama
- Department of Radiology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Yukio Ozaki
- Department of Cardiology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
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Kalyvianakis D, Hatzichristou D. Low-Intensity Shockwave Therapy Improves Hemodynamic Parameters in Patients With Vasculogenic Erectile Dysfunction: A Triplex Ultrasonography-Based Sham-Controlled Trial. J Sex Med 2017; 14:891-897. [PMID: 28673433 DOI: 10.1016/j.jsxm.2017.05.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 05/18/2017] [Accepted: 05/19/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although several reports have documented the subjective improvement of erectile function after low-intensity extracorporeal shockwave therapy (LI-ESWT) in patients with vasculogenic erectile dysfunction (ED), objective assessment data of penile hemodynamics are lacking. AIM To assess penile hemodynamics before and 3 months after LI-ESWT in a group of patients with documented vasculogenic ED. METHODS This was a double-blinded, randomized, sham-controlled trial. Forty-six patients with ED were randomized; 30 underwent LI-ESWT and 16 had a sham procedure in double-blinded fashion. All patients underwent penile triplex ultrasonography by the same investigator immediately before and 3 months after treatment. Patient demographics, International Index of Erectile Function erectile function domain (IIEF-ED) score, and minimal clinically important difference were assessed at baseline and 1, 3, 6, 9, and 12 months after treatment. OUTCOMES Changes in peak systolic velocity and resistance index as measured by triplex ultrasonography at baseline and 3 months after treatment were the main outcomes of the study. Secondary outcomes were changes in the IIEF-EF score from baseline to 1, 3, 6, 9, and 12 months after treatment and the percentage of patients reaching a minimal clinically important difference during the same period for the two groups. RESULTS IIEF-EF minimal clinically important differences for the active vs sham group were observed for 56.7% vs 12.5% (P = .005) at 1 month, 56.7% vs 12.5% (P = .003) at 3 months, 63.3% vs 18.8% (P = .006) at 6 months, 66.7% vs 31.3% (P = .022) at 9 months, and 75% vs 25% (P = .008) at 12 months. Mean peak systolic velocity increased by 4.5 and 0.6 cm/s in the LI-ESWT and sham groups, respectively (P < .001). CLINICAL IMPLICATIONS Such results offer objective and subjective documentation of the value of this novel treatment modality for men with vasculogenic ED. STRENGTHS AND LIMITATIONS Strengths include the prospective, randomized, sham-controlled type of study and the assessment of penile hemodynamics. Limitations include the small sample and strict inclusion criteria that do not reflect everyday clinical practice. CONCLUSION The present study confirms the beneficial effect of LI-ESWT on penile hemodynamics and the beneficial effect of this treatment up to 12 months. Kalyvianakis D, Hatzichristou D. Low-Intensity Shockwave Therapy Improves Hemodynamic Parameters in Patients With Vasculogenic Erectile Dysfunction: A Triplex Ultrasonography-Based Sham-Controlled Trial. J Sex Med 2017;14:891-897.
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Affiliation(s)
- Dimitrios Kalyvianakis
- Center for Sexual and Reproductive Health, Aristotle University of Thessaloniki Greece, Thessaloniki, Greece
| | - Dimitrios Hatzichristou
- Center for Sexual and Reproductive Health, Aristotle University of Thessaloniki Greece, Thessaloniki, Greece.
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Ortaç M, Küçükergin C, Salabaş E, Seçkin Ş, Kadıoğlu A. Effect of low-energy shockwave therapy on angiogenic factors in the penile tissue of diabetic rats. Turk J Urol 2017; 43:130-134. [PMID: 28717534 DOI: 10.5152/tud.2017.35002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 12/19/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this study is to investigate the effect of low-energy shock wave therapy (LESWT) on angiogenesis factors at penile tissue in a diabetic rat model. MATERIAL AND METHODS A total of 30 male Sprague-Dawley rats which were allocated into three equal groups were included study. Group 1 (control group) included 10 male rats which did not receive any treatment were randomly chosen to serve as normal control. The remaining rats were injected intraperitoneally with 60 mg/kg of streptozotocin (STZ) to induce diabetes. Diabetic rats were divided into two equal group which constituted diabetic control, and LESWT treatment (DM+LESWT) group. Each rat in the DM+LESWT group received L-ESWT therapy. Endothelial nitric oxide synthase (eNOS) and vascular endothelial growth factor (VEGF) mRNA expression levels of penile tissue were evaluated. RESULTS Following STZ dosing eNOS level dropped in the diabetic control group relative to the control group. Statistically significant increase in eNOS levels were seen in the LESWT+DM group. Similarly, in the diabetic control group STZ treatment decreased VEGF levels, while in the LESWT+DM group VEGF nearly approached to baseline levels. However variations in VEGF levels were not statistically significant. CONCLUSION Mechanism action of ESWT in the penile tissue seems to involve angiogenic factors.
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Affiliation(s)
- Mazhar Ortaç
- Department of Urology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Canan Küçükergin
- Department of Biochemistry, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Emre Salabaş
- Department of Urology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Şule Seçkin
- Department of Biochemistry, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Ateş Kadıoğlu
- Department of Urology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
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Matskeplishvili ST, Borbodoeva BM, Asymbekova EU, Rakhimov AZ, Akhmedyarova NK, Kataeva KB, Buziashvili YI. Impact of shock-wave therapy on the clinical and functional status of patients with coronary heart disease. TERAPEVT ARKH 2017; 89:22-28. [DOI: 10.17116/terarkh201789422-28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Aim. To study of the impact of shock-wave therapy (SWT) on the functional status of patients with coronary heart disease (CHD). Subjects and methods. Thirty-four CHD patients (including 33 men) with left ventricular (LV) asynergic segments, as evidenced by echocardiography (EchoCG), were examined. Their mean age was 60.1±1.76 years. All the patients received a SWT cycle according to the standard scheme. The patient examination protocol involved EchoCG, dobutamine EchoCG, treadmill exercise EchoCG, and tissue Doppler EchoCG, which were performed at baseline, immediately and one month after the end of a SWT cycle. Results. Following a SWT cycle, all the patients were noted to have a significant decrease in mean angina pectoris and heart failure functional classes and in the frequency of daily intake of nitrates. EchoCG showed that at baseline the LV ejection fraction (EF) was 51.1±1.02%; end- diastolic volume index, 71.5±3.6 ml/m2; end-systolic volume index, 34.4±2.2 ml/m2. According to exercise EchoCG, the tolerance threshold was 6.4±0.1 Меts (Bruce protocol); the total exercise time of 5.05±0.23 min was achieved in an average of 75.2±1.32%. Immediately and one month after a SWT cycle, there was an increment in EF from 51.1±1.02 to 55±0.8 and 57±1.7%, respectively; a substantial increase in the tolerance threshold to 8.17±0.24 and 9.45±0.34 Меts, as compared to the baseline values. The exercise time increased up to 6.41±0.17 and 7.7±0.29 min immediately and one month after SWT, respectively. The increment in EF in response to exercise was 8.54±2.12, 14±1.5, and 16±1.2% at baseline, immediately and one month after SWT, respectively. Moreover, myocardial relaxation and diastolic function improved. Conclusion. Shock-wave therapy in patients with CHD is accompanied by their improved functional status, which is manifested by increased tolerance threshold and exercise duration, a rise in rest and exercise LV EF, better relaxation of LV, and its diminished stiffness.
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Lin G, Reed-Maldonado AB, Wang B, Lee YC, Zhou J, Lu Z, Wang G, Banie L, Lue TF. In Situ Activation of Penile Progenitor Cells With Low-Intensity Extracorporeal Shockwave Therapy. J Sex Med 2017; 14:493-501. [PMID: 28258952 DOI: 10.1016/j.jsxm.2017.02.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 01/28/2017] [Accepted: 02/03/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND We previously reported that progenitor cells, or stem cells, exist within penile tissue. We hypothesized that acoustic wave stimulation by low-intensity extracorporeal shockwave therapy (Li-ESWT) would activate local stem or progenitor cells within the penis, producing regenerative effects. AIMS To study the feasibility of in situ penile progenitor cell activation by Li-ESWT. METHODS We performed a cohort analysis of young and middle-age male Sprague-Dawley rats treated with 5-ethynyl-2'-deoxyuridine (EdU) pulse followed by Li-ESWT. In addition, Li-ESWT was applied to cultured Schwann cells and endothelial cells to study the molecular mechanism involved in cell proliferation. Thirty minutes before Li-ESWT, each rat received an intraperitoneal injection of EdU. Li-ESWT was applied to the penis at very low (0.02 mJ/mm2 at 3 Hz for 300 pulses) or low (0.057 mJ/mm2 at 3 Hz for 500 pulses) energy levels. The endothelial and Schwann cells were treated with very low energy (0.02 mJ/mm2 at 3 Hz for 300 pulses) in vitro. OUTCOMES At 48 hours or 1 week after Li-ESWT, penile tissues were harvested for histologic study to assess EdU+ and Ki-67+ cells, and cell proliferation, Ki-67 expression, Erk1/2 phosphorylation, translocation, and angiogenesis were examined in cultured Schwann and endothelial cells after Li-ESWT. RESULTS Li-ESWT significantly increased EdU+ cells within penile erectile tissues (P < .01) at 48 hours and 1 week. There were more cells activated in young animals than in middle-age animals, and the effect depended on dosage. Most activated cells were localized within subtunical spaces. In vitro studies indicated that Li-ESWT stimulated cell proliferation through increased phosphorylation of Erk1/2. CLINICAL TRANSLATION The present results provide a possible explanation for the clinical benefits seen with Li-ESWT. STRENGTHS AND LIMITATIONS The main limitation of the present project was the short period of study and the animal model used. Li-ESWT could be less effective in improving erectile function in old animals because of the decreased number and quality of penile stem or progenitor cells associated with aging. CONCLUSION Li-ESWT activation of local penile progenitor cells might be one of the mechanisms that contribute to the beneficial effects of shockwave treatment for erectile dysfunction, which represents a non-invasive alternative to exogenous stem cell therapy. Lin G, Reed-Maldonado AB, Wang B, et al. In Situ Activation of Penile Progenitor Cells With Low-Intensity Extracorporeal Shockwave Therapy. J Sex Med 2017;14:493-501.
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Affiliation(s)
- Guiting Lin
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California-San Francisco, San Francisco, CA, USA
| | - Amanda B Reed-Maldonado
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California-San Francisco, San Francisco, CA, USA
| | - Bohan Wang
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California-San Francisco, San Francisco, CA, USA; Department of Urology, The Second Hospital, Zhejiang University, Zhejiang, China
| | - Yung-Chin Lee
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California-San Francisco, San Francisco, CA, USA; Department of Urology, Kaohsiung Medical University Hospital, and Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jun Zhou
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California-San Francisco, San Francisco, CA, USA; Department of Urology, The Third XiangYa Hospital, Central South University, Changsha, China
| | - Zhihua Lu
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California-San Francisco, San Francisco, CA, USA; Department of Urology, The First Hospital of Jilin University, Changchun, China
| | - Guifang Wang
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California-San Francisco, San Francisco, CA, USA
| | - Lia Banie
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California-San Francisco, San Francisco, CA, USA
| | - Tom F Lue
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California-San Francisco, San Francisco, CA, USA.
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Wang B, Ning H, Reed-Maldonado AB, Zhou J, Ruan Y, Zhou T, Wang HS, Oh BS, Banie L, Lin G, Lue TF. Low-Intensity Extracorporeal Shock Wave Therapy Enhances Brain-Derived Neurotrophic Factor Expression through PERK/ATF4 Signaling Pathway. Int J Mol Sci 2017; 18:ijms18020433. [PMID: 28212323 PMCID: PMC5343967 DOI: 10.3390/ijms18020433] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 01/23/2017] [Accepted: 02/13/2017] [Indexed: 12/12/2022] Open
Abstract
Low-intensity extracorporeal shock wave therapy (Li-ESWT) is used in the treatment of erectile dysfunction, but its mechanisms are not well understood. Previously, we found that Li-ESWT increased the expression of brain-derived neurotrophic factor (BDNF). Here we assessed the underlying signaling pathways in Schwann cells in vitro and in penis tissue in vivo after nerve injury. The result indicated that BDNF were significantly increased by the Li-ESWT after nerve injury, as well as the expression of BDNF in Schwann cells (SCs, RT4-D6P2T) in vitro. Li-ESWT activated the protein kinase RNA-like endoplasmic reticulum (ER) kinase (PERK) pathway by increasing the phosphorylation levels of PERK and eukaryotic initiation factor 2a (eIF2α), and enhanced activating transcription factor 4 (ATF4) in an energy-dependent manner. In addition, GSK2656157—an inhibitor of PERK—effectively inhibited the effect of Li-ESWT on the phosphorylation of PERK, eIF2α, and the expression of ATF4. Furthermore, silencing ATF4 dramatically attenuated the effect of Li-ESWT on the expression of BDNF, but had no effect on hypoxia-inducible factor (HIF)1α or glial cell-derived neurotrophic factor (GDNF) in Schwann cells. In conclusion, our findings shed new light on the underlying mechanisms by which Li-ESWT may stimulate the expression of BDNF through activation of PERK/ATF4 signaling pathway. This information may help to refine the use of Li-ESWT to further improve its clinical efficacy.
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Affiliation(s)
- Bohan Wang
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA 94143, USA.
| | - Hongxiu Ning
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA 94143, USA.
| | - Amanda B Reed-Maldonado
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA 94143, USA.
| | - Jun Zhou
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA 94143, USA.
| | - Yajun Ruan
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA 94143, USA.
| | - Tie Zhou
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA 94143, USA.
| | - Hsun Shuan Wang
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA 94143, USA.
| | - Byung Seok Oh
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA 94143, USA.
| | - Lia Banie
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA 94143, USA.
| | - Guiting Lin
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA 94143, USA.
| | - Tom F Lue
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA 94143, USA.
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López-Marín LM, Millán-Chiu BE, Castaño-González K, Aceves C, Fernández F, Varela-Echavarría A, Loske AM. Shock Wave-Induced Damage and Poration in Eukaryotic Cell Membranes. J Membr Biol 2016; 250:41-52. [DOI: 10.1007/s00232-016-9921-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 08/09/2016] [Indexed: 11/30/2022]
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Low-energy Shock Wave Therapy Ameliorates Erectile Dysfunction in a Pelvic Neurovascular Injuries Rat Model. J Sex Med 2016; 13:22-32. [PMID: 26755082 DOI: 10.1016/j.jsxm.2015.11.008] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 11/13/2015] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Erectile dysfunction (ED) caused by pelvic injuries is a common complication of civil and battlefield trauma with multiple neurovascular factors involved, and no effective therapeutic approach is available. AIMS To test the effect and mechanisms of low-energy shock wave (LESW) therapy in a rat ED model induced by pelvic neurovascular injuries. METHODS Thirty-two male Sprague-Dawley rats injected with 5-ethynyl-2'-deoxyuridine (EdU) at newborn were divided into 4 groups: sham surgery (Sham), pelvic neurovascular injury by bilateral cavernous nerve injury and internal pudendal bundle injury (PVNI), PVNI treated with LESW at low energy (Low), and PVNI treated with LESW at high energy (High). After LESW treatment, rats underwent erectile function measurement and the tissues were harvested for histologic and molecular study. To examine the effect of LESW on Schwann cells, in vitro studies were conducted. MAIN OUTCOME MEASUREMENTS The intracavernous pressure (ICP) measurement, histological examination, and Western blot (WB) were conducted. Cell cycle, Schwann cell activation-related markers were examined in in vitro experiments. RESULTS LESW treatment improves erectile function in a rat model of pelvic neurovascular injury by leading to angiogenesis, tissue restoration, and nerve generation with more endogenous EdU(+) progenitor cells recruited to the damaged area and activation of Schwann cells. LESW facilitates more complete re-innervation of penile tissue with regeneration of neuronal nitric oxide synthase (nNOS)-positive nerves from the MPG to the penis. In vitro experiments demonstrated that LESW has a direct effect on Schwann cell proliferation. Schwann cell activation-related markers including p-Erk1/2 and p75 were upregulated after LESW treatment. CONCLUSION LESW-induced endogenous progenitor cell recruitment and Schwann cell activation coincides with angiogenesis, tissue, and nerve generation in a rat model of pelvic neurovascular injuries.
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Hatanaka K, Ito K, Shindo T, Kagaya Y, Ogata T, Eguchi K, Kurosawa R, Shimokawa H. Molecular mechanisms of the angiogenic effects of low-energy shock wave therapy: roles of mechanotransduction. Am J Physiol Cell Physiol 2016; 311:C378-85. [PMID: 27413171 DOI: 10.1152/ajpcell.00152.2016] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 07/07/2016] [Indexed: 12/27/2022]
Abstract
We have previously demonstrated that low-energy extracorporeal cardiac shock wave (SW) therapy improves myocardial ischemia through enhanced myocardial angiogenesis in a porcine model of chronic myocardial ischemia and in patients with refractory angina pectoris. However, the detailed molecular mechanisms for the SW-induced angiogenesis remain unclear. In this study, we thus examined the effects of SW irradiation on intracellular signaling pathways in vitro. Cultured human umbilical vein endothelial cells (HUVECs) were treated with 800 shots of low-energy SW (1 Hz at an energy level of 0.03 mJ/mm(2)). The SW therapy significantly upregulated mRNA expression and protein levels of vascular endothelial growth factor (VEGF) and endothelial nitric oxide synthase (eNOS). The SW therapy also enhanced phosphorylation of extracellular signal-regulated kinase 1/2 (Erk1/2) and Akt. Furthermore, the SW therapy enhanced phosphorylation of caveolin-1 and the expression of HUTS-4 that represents β1-integrin activity. These results suggest that caveolin-1 and β1-integrin are involved in the SW-induced activation of angiogenic signaling pathways. To further examine the signaling pathways involved in the SW-induced angiogenesis, HUVECs were transfected with siRNA of either β1-integrin or caveolin-1. Knockdown of either caveolin-1 or β1-integrin suppressed the SW-induced phosphorylation of Erk1/2 and Akt and upregulation of VEGF and eNOS. Knockdown of either caveolin-1 or β1-integrin also suppressed SW-induced enhancement of HUVEC migration in scratch assay. These results suggest that activation of mechanosensors on cell membranes, such as caveolin-1 and β1-integrin, and subsequent phosphorylation of Erk and Akt may play pivotal roles in the SW-induced angiogenesis.
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Affiliation(s)
- Kazuaki Hatanaka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; and Department of Innovative Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kenta Ito
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; and Department of Innovative Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomohiko Shindo
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; and
| | - Yuta Kagaya
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; and
| | - Tsuyoshi Ogata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; and
| | - Kumiko Eguchi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; and
| | - Ryo Kurosawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; and
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; and Department of Innovative Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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Yahata K, Kanno H, Ozawa H, Yamaya S, Tateda S, Ito K, Shimokawa H, Itoi E. Low-energy extracorporeal shock wave therapy for promotion of vascular endothelial growth factor expression and angiogenesis and improvement of locomotor and sensory functions after spinal cord injury. J Neurosurg Spine 2016; 25:745-755. [PMID: 27367940 DOI: 10.3171/2016.4.spine15923] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Extracorporeal shock wave therapy (ESWT) is widely used to treat various human diseases. Low-energy ESWT increases expression of vascular endothelial growth factor (VEGF) in cultured endothelial cells. The VEGF stimulates not only endothelial cells to promote angiogenesis but also neural cells to induce neuroprotective effects. A previous study by these authors demonstrated that low-energy ESWT promoted expression of VEGF in damaged neural tissue and improved locomotor function after spinal cord injury (SCI). However, the neuroprotective mechanisms in the injured spinal cord produced by low-energy ESWT are still unknown. In the present study, the authors investigated the cell specificity of VEGF expression in injured spinal cords and angiogenesis induced by low-energy ESWT. They also examined the neuroprotective effects of low-energy ESWT on cell death, axonal damage, and white matter sparing as well as the therapeutic effect for improvement of sensory function following SCI. METHODS Adult female Sprague-Dawley rats were divided into the SCI group (SCI only) and SCI-SW group (low-energy ESWT applied after SCI). Thoracic SCI was produced using a New York University Impactor. Low-energy ESWT was applied to the injured spinal cord 3 times a week for 3 weeks after SCI. Locomotor function was evaluated using the Basso, Beattie, and Bresnahan open-field locomotor score for 42 days after SCI. Mechanical and thermal allodynia in the hindpaw were evaluated for 42 days. Double staining for VEGF and various cell-type markers (NeuN, GFAP, and Olig2) was performed at Day 7; TUNEL staining was also performed at Day 7. Immunohistochemical staining for CD31, α-SMA, and 5-HT was performed on spinal cord sections taken 42 days after SCI. Luxol fast blue staining was performed at Day 42. RESULTS Low-energy ESWT significantly improved not only locomotion but also mechanical and thermal allodynia following SCI. In the double staining, expression of VEGF was observed in NeuN-, GFAP-, and Olig2-labeled cells. Low-energy ESWT significantly promoted CD31 and α-SMA expressions in the injured spinal cords. In addition, low-energy ESWT significantly reduced the TUNEL-positive cells in the injured spinal cords. Furthermore, the immunodensity of 5-HT-positive axons was significantly higher in the animals treated by low-energy ESWT. The areas of spared white matter were obviously larger in the SCI-SW group than in the SCI group, as indicated by Luxol fast blue staining. CONCLUSIONS The results of this study suggested that low-energy ESWT promotes VEGF expression in various neural cells and enhances angiogenesis in damaged neural tissue after SCI. Furthermore, the neuroprotective effect of VEGF induced by low-energy ESWT can suppress cell death and axonal damage and consequently improve locomotor and sensory functions after SCI. Thus, low-energy ESWT can be a novel therapeutic strategy for treatment of SCI.
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Affiliation(s)
| | | | | | | | | | - Kenta Ito
- Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Eiji Itoi
- Departments of 1 Orthopaedic Surgery and
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Shindo T, Ito K, Ogata T, Hatanaka K, Kurosawa R, Eguchi K, Kagaya Y, Hanawa K, Aizawa K, Shiroto T, Kasukabe S, Miyata S, Taki H, Hasegawa H, Kanai H, Shimokawa H. Low-Intensity Pulsed Ultrasound Enhances Angiogenesis and Ameliorates Left Ventricular Dysfunction in a Mouse Model of Acute Myocardial Infarction. Arterioscler Thromb Vasc Biol 2016; 36:1220-9. [DOI: 10.1161/atvbaha.115.306477] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 04/03/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Tomohiko Shindo
- From the Department of Cardiovascular Medicine, Graduate School of Medicine (T. Shindo, K.T., T.O., K. Hatanaka, R.K., K.E., Y.K., K. Hanawa, K.A., T. Shiroto, S.K., S.M., H.S.) and Department of Electronic Engineering, Graduate School of Engineering and Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering (H.T., H.H., H.K.), Tohoku University, Sendai, Japan
| | - Kenta Ito
- From the Department of Cardiovascular Medicine, Graduate School of Medicine (T. Shindo, K.T., T.O., K. Hatanaka, R.K., K.E., Y.K., K. Hanawa, K.A., T. Shiroto, S.K., S.M., H.S.) and Department of Electronic Engineering, Graduate School of Engineering and Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering (H.T., H.H., H.K.), Tohoku University, Sendai, Japan
| | - Tsuyoshi Ogata
- From the Department of Cardiovascular Medicine, Graduate School of Medicine (T. Shindo, K.T., T.O., K. Hatanaka, R.K., K.E., Y.K., K. Hanawa, K.A., T. Shiroto, S.K., S.M., H.S.) and Department of Electronic Engineering, Graduate School of Engineering and Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering (H.T., H.H., H.K.), Tohoku University, Sendai, Japan
| | - Kazuaki Hatanaka
- From the Department of Cardiovascular Medicine, Graduate School of Medicine (T. Shindo, K.T., T.O., K. Hatanaka, R.K., K.E., Y.K., K. Hanawa, K.A., T. Shiroto, S.K., S.M., H.S.) and Department of Electronic Engineering, Graduate School of Engineering and Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering (H.T., H.H., H.K.), Tohoku University, Sendai, Japan
| | - Ryo Kurosawa
- From the Department of Cardiovascular Medicine, Graduate School of Medicine (T. Shindo, K.T., T.O., K. Hatanaka, R.K., K.E., Y.K., K. Hanawa, K.A., T. Shiroto, S.K., S.M., H.S.) and Department of Electronic Engineering, Graduate School of Engineering and Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering (H.T., H.H., H.K.), Tohoku University, Sendai, Japan
| | - Kumiko Eguchi
- From the Department of Cardiovascular Medicine, Graduate School of Medicine (T. Shindo, K.T., T.O., K. Hatanaka, R.K., K.E., Y.K., K. Hanawa, K.A., T. Shiroto, S.K., S.M., H.S.) and Department of Electronic Engineering, Graduate School of Engineering and Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering (H.T., H.H., H.K.), Tohoku University, Sendai, Japan
| | - Yuta Kagaya
- From the Department of Cardiovascular Medicine, Graduate School of Medicine (T. Shindo, K.T., T.O., K. Hatanaka, R.K., K.E., Y.K., K. Hanawa, K.A., T. Shiroto, S.K., S.M., H.S.) and Department of Electronic Engineering, Graduate School of Engineering and Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering (H.T., H.H., H.K.), Tohoku University, Sendai, Japan
| | - Kenichiro Hanawa
- From the Department of Cardiovascular Medicine, Graduate School of Medicine (T. Shindo, K.T., T.O., K. Hatanaka, R.K., K.E., Y.K., K. Hanawa, K.A., T. Shiroto, S.K., S.M., H.S.) and Department of Electronic Engineering, Graduate School of Engineering and Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering (H.T., H.H., H.K.), Tohoku University, Sendai, Japan
| | - Kentaro Aizawa
- From the Department of Cardiovascular Medicine, Graduate School of Medicine (T. Shindo, K.T., T.O., K. Hatanaka, R.K., K.E., Y.K., K. Hanawa, K.A., T. Shiroto, S.K., S.M., H.S.) and Department of Electronic Engineering, Graduate School of Engineering and Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering (H.T., H.H., H.K.), Tohoku University, Sendai, Japan
| | - Takashi Shiroto
- From the Department of Cardiovascular Medicine, Graduate School of Medicine (T. Shindo, K.T., T.O., K. Hatanaka, R.K., K.E., Y.K., K. Hanawa, K.A., T. Shiroto, S.K., S.M., H.S.) and Department of Electronic Engineering, Graduate School of Engineering and Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering (H.T., H.H., H.K.), Tohoku University, Sendai, Japan
| | - Sachie Kasukabe
- From the Department of Cardiovascular Medicine, Graduate School of Medicine (T. Shindo, K.T., T.O., K. Hatanaka, R.K., K.E., Y.K., K. Hanawa, K.A., T. Shiroto, S.K., S.M., H.S.) and Department of Electronic Engineering, Graduate School of Engineering and Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering (H.T., H.H., H.K.), Tohoku University, Sendai, Japan
| | - Satoshi Miyata
- From the Department of Cardiovascular Medicine, Graduate School of Medicine (T. Shindo, K.T., T.O., K. Hatanaka, R.K., K.E., Y.K., K. Hanawa, K.A., T. Shiroto, S.K., S.M., H.S.) and Department of Electronic Engineering, Graduate School of Engineering and Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering (H.T., H.H., H.K.), Tohoku University, Sendai, Japan
| | - Hirofumi Taki
- From the Department of Cardiovascular Medicine, Graduate School of Medicine (T. Shindo, K.T., T.O., K. Hatanaka, R.K., K.E., Y.K., K. Hanawa, K.A., T. Shiroto, S.K., S.M., H.S.) and Department of Electronic Engineering, Graduate School of Engineering and Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering (H.T., H.H., H.K.), Tohoku University, Sendai, Japan
| | - Hideyuki Hasegawa
- From the Department of Cardiovascular Medicine, Graduate School of Medicine (T. Shindo, K.T., T.O., K. Hatanaka, R.K., K.E., Y.K., K. Hanawa, K.A., T. Shiroto, S.K., S.M., H.S.) and Department of Electronic Engineering, Graduate School of Engineering and Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering (H.T., H.H., H.K.), Tohoku University, Sendai, Japan
| | - Hiroshi Kanai
- From the Department of Cardiovascular Medicine, Graduate School of Medicine (T. Shindo, K.T., T.O., K. Hatanaka, R.K., K.E., Y.K., K. Hanawa, K.A., T. Shiroto, S.K., S.M., H.S.) and Department of Electronic Engineering, Graduate School of Engineering and Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering (H.T., H.H., H.K.), Tohoku University, Sendai, Japan
| | - Hiroaki Shimokawa
- From the Department of Cardiovascular Medicine, Graduate School of Medicine (T. Shindo, K.T., T.O., K. Hatanaka, R.K., K.E., Y.K., K. Hanawa, K.A., T. Shiroto, S.K., S.M., H.S.) and Department of Electronic Engineering, Graduate School of Engineering and Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering (H.T., H.H., H.K.), Tohoku University, Sendai, Japan
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Zambon J. Editorial Comment on “Low Energy Shock Wave Therapy Ameliorates Erectile Dysfunction in a Pelvic Neurovascular Injuries Rat Model”. J Sex Med 2016; 13:33. [DOI: 10.1016/j.jsxm.2015.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 11/28/2015] [Indexed: 11/16/2022]
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Wang L, Jiang Y, Jiang Z, Han L. Effect of low-energy extracorporeal shock wave on vascular regeneration after spinal cord injury and the recovery of motor function. Neuropsychiatr Dis Treat 2016; 12:2189-98. [PMID: 27621630 PMCID: PMC5012600 DOI: 10.2147/ndt.s82864] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Latest studies show that low-energy extracorporeal shock wave therapy (ESWT) can upregulate levels of vascular endothelial growth factor (VEGF). VEGF can ease nervous tissue harm after spinal cord injury (SCI). This study aims to explore whether low-energy ESWT can promote expression of VEGF, protect nervous tissue after SCI, and improve motor function. METHODS Ninety adult female rats were divided into the following groups: Group A (simple laminectomy), Group B (laminectomy and low-energy ESWT), Group C (spinal cord injury), and Group D (spinal cord injury and low-energy ESWT). Impinger was used to cause thoracic spinal cord injury. Low-energy ESWT was applied as treatment after injury three times a week, for 3 weeks. After SCI, the Basso, Beattie, and Bresnahan (BBB) scale was used to evaluate motor function over a period of 42 days at different time points. Hematoxylin and eosin (HE) staining was used to evaluate nerve tissue injury. Neuronal nuclear antigen (NeuN) staining was also used to evaluate loss of neurons. Polymerase chain reaction was used to detect messenger RNA (mRNA) expression of VEGF and its receptor fms-like tyrosine kinase 1 (Flt-1). Immunostaining was used to evaluate VEGF protein expression level in myeloid tissue. RESULTS BBB scores of Groups A and B showed no significant result related to dyskinesia. HE and NeuN staining indicated that only using low-energy ESWT could not cause damage of nervous tissue in Group B. Recovery of motor function at 7, 35, and 42 days after SCI in Group D was better than that in Group C (P<0.05). Compared with Group C, number of NeuN-positive cells at 42 days after SCI increased significantly (P<0.05). The mRNA levels of VEGF and Flt-1 and VEGF expression at 7 days after SCI in Group D were significantly higher than those in Group C (P<0.05). CONCLUSION Low-energy ESWT promotes expression of VEGF, decreases secondary damage of nerve tissue, and improves recovery of motor function. It can be regarded as one mode of clinical routine adjunctive therapy for spinal injury.
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Affiliation(s)
- Lei Wang
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, People's Republic of China
| | - Yuquan Jiang
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, People's Republic of China
| | - Zheng Jiang
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, People's Republic of China
| | - Lizhang Han
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, People's Republic of China
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Wang J, Zhou C, Liu L, Pan X, Guo T. Clinical effect of cardiac shock wave therapy on patients with ischaemic heart disease: a systematic review and meta-analysis. Eur J Clin Invest 2015; 45:1270-85. [PMID: 26444429 DOI: 10.1111/eci.12546] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 10/02/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND After several years of study, CSWT has been initially applied to IHD treatment, but the actual effectiveness has never been well evaluated with a meta-analysis. METHODS MEDLINE, EMBASE, Science Direct, Cochrane Controlled Trials Register database and Chinese database were searched. The randomized controlled trials, and single-arm and cohort study related to in patients with IHD undergoing CSWT were included and 14 articles were finally analysed. The data related to the study design, patient characteristics and outcomes were extracted. All the selected data were calculated with random-effects models in weighted mean differences, and heterogeneity was carefully evaluated as well. RESULTS (i) Cardiac shock wave therapy improves the angina pectoris symptom (including the decrease of Canadian Cardiovascular Society class [-0·86 (-1·12, -0·65), P < 0·00001], nitroglycerin dosage (times/weeks) [-0·71 (-1·08, -0·33), P = 0·0002] and a increase of Seattle Angina Questionnaire score [5·64 (3·12, 8·15), P < 0·0001)]); (ii) CSWT leads to a reduce in heart failure (including a reduction of New York Heart Association functional class [-0·49 (-0·62, -0·37), P < 0·00001], a stable rise in 6-min walking distance [68·38 (39·70, 97·05), P < 0·00001] and a growth in left ventricular ejection fraction with echocardiography screening [6·73 (4·67,8·80), P < 0·00001]); (iii) CSWT improves myocardial viability within improving in total score of perfusion imaging [-5·19 (-8·08, -2·30), P = 0·0004] and total score of metabolism imaging [-5·33 (-7·77, -2·90), P < 0·0001]. CONCLUSIONS The meta-analysis suggests that CSWT may offer beneficial effects to patients with IHD, although there was significant heterogeneity across the studies.
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Affiliation(s)
- Jing Wang
- Yunnan Provincial Cardiovascular Institute, Kunming, China.,Department of Cardiology, 1st Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Chao Zhou
- Yunnan Provincial Cardiovascular Institute, Kunming, China.,Department of Cardiology, 1st Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lin Liu
- Department of Clinical Laboratory, 1st Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xizhuo Pan
- Yunnan Provincial Cardiovascular Institute, Kunming, China.,Department of Cardiology, 1st Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Tao Guo
- Yunnan Provincial Cardiovascular Institute, Kunming, China.,Department of Cardiology, 1st Affiliated Hospital of Kunming Medical University, Kunming, China
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Shock wave as biological therapeutic tool: From mechanical stimulation to recovery and healing, through mechanotransduction. Int J Surg 2015; 24:147-53. [PMID: 26612525 DOI: 10.1016/j.ijsu.2015.11.030] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 09/28/2015] [Accepted: 11/09/2015] [Indexed: 02/07/2023]
Abstract
Extracorporeal Shock Wave Therapy (ESWT) is a form of "mechanotherapy", that, from its original applications as urological lithotripsy, gained the field of musculo-skeletal diseases as Orthotripsy (mainly tendinopaties and bone regenerative disorders) and Regenerative Medicine as well. The mechanisms of action of Shock Waves (SW), when applied in non-urological indications, are not related to the direct mechanical effect, but to the different pathways of biological reactions, that derive from that acoustic stimulations, through "mechano-transduction". So, the "mechanical model" of urological lithotripsy has been substituted by a "biological model", also supported by current knowledge in "mechanobiology", the emerging multidisciplinary field of science that investigates how physical forces and changes in cell/tissue mechanics can influence the tissue development, physiology and diseases. Although some details are still under study, it is known that SW are able to relief pain, as well to positively regulate inflammation (probably as immunomodulator), to induce neoangiogenesis and stem cells activities, thus improving tissue regeneration and healing. ESWT can be nowadays considered an effective, safe, versatile, repeatable, noninvasive therapy for the treatment of many musculo-skeletal diseases, and for some pathological conditions where regenerative effects are desirable, especially when some other noninvasive/conservative therapies have failed. Moreover, based on the current knowledge in SW mechanobiology, it seems possible to foresee new interesting and promising applications in the fields of Regenerative Medicine, tissue engineering and cell therapies.
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Hisasue SI, China T, Horiuchi A, Kimura M, Saito K, Isotani S, Ide H, Muto S, Yamaguchi R, Horie S. Impact of aging and comorbidity on the efficacy of low-intensity shock wave therapy for erectile dysfunction. Int J Urol 2015; 23:80-4. [DOI: 10.1111/iju.12955] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 09/03/2015] [Indexed: 01/28/2023]
Affiliation(s)
- Shin-ichi Hisasue
- Department of Urology; Juntendo University Graduate School of Medicine; Tokyo Japan
| | - Toshiyuki China
- Department of Urology; Juntendo University Graduate School of Medicine; Tokyo Japan
| | - Akira Horiuchi
- Department of Urology; Teikyo University School of Medicine; Tokyo Japan
| | - Masaki Kimura
- Department of Urology; Teikyo University School of Medicine; Tokyo Japan
| | - Keisuke Saito
- Department of Urology; Teikyo University School of Medicine; Tokyo Japan
| | - Shuji Isotani
- Department of Urology; Teikyo University School of Medicine; Tokyo Japan
| | - Hisamitsu Ide
- Department of Urology; Teikyo University School of Medicine; Tokyo Japan
| | - Satoru Muto
- Department of Urology; Teikyo University School of Medicine; Tokyo Japan
| | - Raizo Yamaguchi
- Department of Urology; Teikyo University School of Medicine; Tokyo Japan
| | - Shigeo Horie
- Department of Urology; Juntendo University Graduate School of Medicine; Tokyo Japan
- Department of Urology; Teikyo University School of Medicine; Tokyo Japan
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Mu HM, Wang LY. Effect of therapeutic ultrasound on brain angiogenesis following intracerebral hemorrhage in rats. Microvasc Res 2015; 102:11-8. [PMID: 26265191 DOI: 10.1016/j.mvr.2015.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 08/04/2015] [Accepted: 08/04/2015] [Indexed: 11/29/2022]
Abstract
Intracerebral hemorrhage (ICH) can produce severe neurological deficits in stroke survivors. However, few effective approaches are available to improve the recovery from ICH. Given that therapeutic ultrasound exposure can enhance on angiogenesis in peripheral tissues, the present study was designed to examine the effects of therapeutic ultrasound exposure on the brain angiogenesis following ICH. To this end, we applied once daily therapeutic ultrasound treatment to rats for 7 consecutive days after intracranial infusion of vehicle (Sham control) or collagenase (ICH). Repeated exposure to the low intensity of therapeutic ultrasound decreased behavioral scores in ICH rats, but not in sham control rats. Such an effect was correlated with an increased number of vessel-like structures and microvessels and PCNA positive cells in vWF-positive blood vessels in perihematomal brain tissues at post-ICH day 7. Furthermore, immunohistochemistry and western blotting results showed that ICH trigged the expression of extracellular matrix (ECM)-related molecules, including collagen Is, III, and IV, as well as integrins αvβ3 and α5β1, and exposure to therapeutic ultrasound increased the expression of these molecules. Therefore, our results indicated that repeated exposure to a low intensity of therapeutic ultrasound can increase the expression of collagen and integrins of ECM-related molecules, promote the formation of a large number of vessel-like structure and capillaries around the hematoma, and accelerate the recovery of neurological function impaired by ICH.
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Affiliation(s)
- Hong-Mei Mu
- Department of Ultrasonography, Cangzhou Central Hospital, Cangzhou 061000, Hebei, China
| | - Li-Yong Wang
- Department of Neurology, Cangzhou People's Hospital, Cangzhou 061000, Hebei, China.
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Sheu JJ, Lee FY, Yuen CM, Chen YL, Huang TH, Chua S, Chen YL, Chen CH, Chai HT, Sung PH, Chang HW, Sun CK, Yip HK. Combined therapy with shock wave and autologous bone marrow-derived mesenchymal stem cells alleviates left ventricular dysfunction and remodeling through inhibiting inflammatory stimuli, oxidative stress & enhancing angiogenesis in a swine myocardial infarction model. Int J Cardiol 2015; 193:69-83. [PMID: 26025755 DOI: 10.1016/j.ijcard.2015.03.044] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 01/06/2015] [Accepted: 03/03/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND We hypothesized that combined therapy with shock wave (SW) and autologous bone marrow-derived mesenchymal stem cells (BMDMSCs) is superior to either therapy alone for alleviating left ventricular (LV) dysfunction. METHODS AND RESULTS Male mini-pigs (n=30) equally divided into group 1 (sham control), group 2 [acute myocardial infarction (AMI) by left coronary artery ligation], group 3 (AMI-SW), group 4 (AMI-BMDMSC), and group 5 (AMI-SW-BMDMSC) were sacrificed by day 60 and the hearts were collected for studies. Baseline LV injection fraction [LVEF (%)] and LV chamber size did not differ among the five groups (p>0.5). By day 60, LVEF was highest in group 1 and lowest in group 2, significantly higher in group 5 than that in groups 3 and 4, and significantly higher in group 4 than that in group 3 (p<0.001). Cellular and protein levels of VEGF, CXCR4, and SDF-1α were significantly increased progressively from groups 1 to 5 (all p<0.05). Small vessel number and protein expressions of CD31 and eNOS were highest in groups 1 and 5, lowest in group 2, and significantly higher in group 4 than those in group 3 (p<0.001). Protein (MMP-9, TNF-1α and NF-κB) and cellular (CD14+, CD40+) levels of inflammatory biomarkers, protein expressions of oxidative stress (oxidized protein, NOX-1, NOX-2), apoptosis (Bax, caspase-3, PARP), infarct size, and LV dimensions showed a pattern opposite to that of LVEF among all groups (all p<0.001). CONCLUSIONS Combined SW-BMDMSC therapy is superior to either therapy alone for improving LVEF, reducing infarct size, and inhibiting LV remodeling.
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Affiliation(s)
- Jiunn-Jye Sheu
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Fan-Yen Lee
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chun-Man Yuen
- Division of Neurosurgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Ling Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tien-Hung Huang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Sarah Chua
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yung-Lung Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Hung Chen
- Divisions of General Medicine, Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Han-Tan Chai
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pei-Hsun Sung
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsueh-Wen Chang
- Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Hon-Kan Yip
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Center for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Institute of Shock Wave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.
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Yamaya S, Ozawa H, Kanno H, Kishimoto KN, Sekiguchi A, Tateda S, Yahata K, Ito K, Shimokawa H, Itoi E. Low-energy extracorporeal shock wave therapy promotes vascular endothelial growth factor expression and improves locomotor recovery after spinal cord injury. J Neurosurg 2014; 121:1514-25. [DOI: 10.3171/2014.8.jns132562] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Object
Extracorporeal shock wave therapy (ESWT) is widely used for the clinical treatment of various human diseases. Recent studies have demonstrated that low-energy ESWT upregulates the expression of vascular endothelial growth factor (VEGF) and promotes angiogenesis and functional recovery in myocardial infarction and peripheral artery disease. Many previous reports suggested that VEGF produces a neuroprotective effect to reduce secondary neural tissue damage after spinal cord injury (SCI). The purpose of the present study was to investigate whether lowenergy ESWT promotes VEGF expression and neuroprotection and improves locomotor recovery after SCI.
Methods
Sixty adult female Sprague-Dawley rats were randomly divided into 4 groups: sham group (laminectomy only), sham-SW group (low-energy ESWT applied after laminectomy), SCI group (SCI only), and SCI-SW group (low-energy ESWT applied after SCI). Thoracic spinal cord contusion injury was inflicted using an impactor. Low-energy ESWT was applied to the injured spinal cord 3 times a week for 3 weeks. Locomotor function was evaluated using the Basso, Beattie, and Bresnahan (BBB) Scale (open field locomotor score) at different time points over 42 days after SCI. Hematoxylin and eosin staining was performed to assess neural tissue damage in the spinal cord. Neuronal loss was investigated by immunostaining for NeuN. The mRNA expressions of VEGF and its receptor, Flt-1, in the spinal cord were assessed using real-time polymerase chain reaction. Immunostaining for VEGF was performed to evaluate VEGF protein expression in the spinal cord.
Results
In both the sham and sham-SW groups, no animals showed locomotor impairment on BBB scoring. Histological analysis of H & E and NeuN stainings in the sham-SW group confirmed that no neural tissue damage was induced by the low-energy ESWT. Importantly, animals in the SCI-SW group demonstrated significantly better locomotor improvement than those in the SCI group at 7, 35, and 42 days after injury (p < 0.05). The number of NeuN-positive cells in the SCI-SW group was significantly higher than that in the SCI group at 42 days after injury (p < 0.05). In addition, mRNA expressions of VEGF and Flt-1 were significantly increased in the SCI-SW group compared with the SCI group at 7 days after injury (p < 0.05). The expression of VEGF protein in the SCI-SW group was significantly higher than that in the SCI group at 7 days (p < 0.01).
Conclusions
The present study showed that low-energy ESWT significantly increased expressions of VEGF and Flt-1 in the spinal cord without any detrimental effect. Furthermore, it significantly reduced neuronal loss in damaged neural tissue and improved locomotor function after SCI. These results suggested that low-energy ESWT enhances the neuroprotective effect of VEGF in reducing secondary injury and leads to better locomotor recovery following SCI. This study provides the first evidence that low-energy ESWT can be a safe and promising therapeutic strategy for SCI.
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Affiliation(s)
| | | | | | | | | | | | | | - Kenta Ito
- 2Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- 2Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Eiji Itoi
- 1Departments of Orthopaedic Surgery and
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Hanawa K, Ito K, Aizawa K, Shindo T, Nishimiya K, Hasebe Y, Tuburaya R, Hasegawa H, Yasuda S, Kanai H, Shimokawa H. Low-intensity pulsed ultrasound induces angiogenesis and ameliorates left ventricular dysfunction in a porcine model of chronic myocardial ischemia. PLoS One 2014; 9:e104863. [PMID: 25111309 PMCID: PMC4128732 DOI: 10.1371/journal.pone.0104863] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 07/11/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although a significant progress has been made in the management of ischemic heart disease (IHD), the number of severe IHD patients is increasing. Thus, it is crucial to develop new, non-invasive therapeutic strategies. In the present study, we aimed to develop low-intensity pulsed ultrasound (LIPUS) therapy for the treatment of IHD. METHODS AND RESULTS We first confirmed that in cultured human endothelial cells, LIPUS significantly up-regulated mRNA expression of vascular endothelial growth factor (VEGF) with a peak at 32-cycle (P<0.05). Then, we examined the in vivo effects of LIPUS in a porcine model of chronic myocardial ischemia with reduced left ventricular ejection fraction (LVEF) (n = 28). The heart was treated with either sham (n = 14) or LIPUS (32-cycle with 193 mW/cm2 for 20 min, n = 14) at 3 different short axis levels. Four weeks after the treatment, LVEF was significantly improved in the LIPUS group (46±4 to 57±5%, P<0.05) without any adverse effects, whereas it remained unchanged in the sham group (46±5 to 47±6%, P = 0.33). Capillary density in the ischemic region was significantly increased in the LIPUS group compared with the control group (1084±175 vs. 858±151/mm2, P<0.05). Regional myocardial blood flow was also significantly improved in the LIPUS group (0.78±0.2 to 1.39±0.4 ml/min/g, P<0.05), but not in the control group (0.84±0.3 to 0.97±0.4 ml/min/g). Western blot analysis showed that VEGF, eNOS and bFGF were all significantly up-regulated only in the LIPUS group. CONCLUSIONS These results suggest that the LIPUS therapy is promising as a new, non-invasive therapy for IHD.
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Affiliation(s)
- Kenichiro Hanawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kenta Ito
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kentaro Aizawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomohiko Shindo
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kensuke Nishimiya
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yuhi Hasebe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryuji Tuburaya
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hideyuki Hasegawa
- Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan
- Department of Electronic Engineering, Graduate School of Engineering, Tohoku University, Sendai, Japan
| | - Satoshi Yasuda
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hiroshi Kanai
- Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan
- Department of Electronic Engineering, Graduate School of Engineering, Tohoku University, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- * E-mail:
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Abe Y, Ito K, Hao K, Shindo T, Ogata T, Kagaya Y, Kurosawa R, Nishimiya K, Satoh K, Miyata S, Kawakami K, Shimokawa H. Extracorporeal Low-Energy Shock-Wave Therapy Exerts Anti-Inflammatory Effects in a Rat Model of Acute Myocardial Infarction. Circ J 2014; 78:2915-25. [DOI: 10.1253/circj.cj-14-0230] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yuzuru Abe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
- Department of Medical Microbiology, Mycology and Immunology, Tohoku University Graduate School of Medicine
| | - Kenta Ito
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Kiyotaka Hao
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Tomohiko Shindo
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Tsuyoshi Ogata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Yuta Kagaya
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Ryo Kurosawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Kensuke Nishimiya
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Kimio Satoh
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Satoshi Miyata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Kazuyoshi Kawakami
- Department of Medical Microbiology, Mycology and Immunology, Tohoku University Graduate School of Medicine
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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Becker M, Goetzenich A, Roehl AB, Huebel C, de la Fuente M, Dietz-Laursonn K, Radermacher K, Rossaint R, Hein M. Myocardial effects of local shock wave therapy in a Langendorff model. ULTRASONICS 2014; 54:131-136. [PMID: 23896623 DOI: 10.1016/j.ultras.2013.07.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2012] [Revised: 05/08/2013] [Accepted: 07/06/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Applying shock waves to the heart has been reported to stimulate the heart and alter cardiac function. We hypothesized that shock waves could be used to diagnose regional viability. METHOD We used a Langendorff model to investigate the acute effects of shock waves at different energy levels and times related to systole, cycle duration and myocardial function. RESULTS We found only a small time window to use shock waves. Myocardial fibrillation or extrasystolic beats will occur if the shock wave is placed more than 15 ms before or 30 ms after the onset of systole. Increased contractility and augmented relaxation were observed after the second beat, and these effects decreased after prolonging the shock wave delay from 15 ms before to 30 ms after the onset of systole. An energy dependency could be found only after short delays (-15 ms). The involved processes might include post-extrasystolic potentiation and simultaneous pacing. CONCLUSION In summary, we found that low-energy shock waves can be a useful tool to stimulate the myocardium at a distance and influence function.
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Affiliation(s)
- M Becker
- Medical Clinic of Cardiology and Pulmonology, RWTH Aachen University Hospital, Pauwelstrasse 30, 52074 Aachen, Germany
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Liu J, Zhou F, Li GY, Wang L, Li HX, Bai GY, Guan RL, Xu YD, Gao ZZ, Tian WJ, Xin ZC. Evaluation of the effect of different doses of low energy shock wave therapy on the erectile function of streptozotocin (STZ)-induced diabetic rats. Int J Mol Sci 2013; 14:10661-73. [PMID: 23698784 PMCID: PMC3676859 DOI: 10.3390/ijms140510661] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 05/04/2013] [Accepted: 05/08/2013] [Indexed: 12/21/2022] Open
Abstract
To investigate the therapeutic effect of different doses of low energy shock wave therapy (LESWT) on the erectile dysfunction (ED) in streptozotocin (STZ) induced diabetic rats. SD rats (n = 75) were randomly divided into 5 groups (normal control, diabetic control, 3 different dose LESWT treated diabetic groups). Diabetic rats were induced by intra-peritoneal injection of STZ (60 mg/kg) and rats with fasting blood glucose ≥ 300 mg/dL were selected as diabetic models. Twelve weeks later, different doses of LESWT (100, 200 and 300 shocks each time) treatment on penises were used to treat ED (7.33 MPa, 2 shocks/s) three times a week for two weeks. The erectile function was evaluated by intracavernous pressure (ICP) after 1 week washout period. Then the penises were harvested for histological study. The results showed LESWT could significantly improve the erectile function of diabetic rats, increase smooth muscle and endothelial contents, up-regulate the expression of α-SMA, vWF, nNOS and VEGF, and down- regulate the expression of RAGE in corpus cavernosum. The therapeutic effect might relate to treatment dose positively, and the maximal therapeutic effect was noted in the LESWT300 group. Consequently, 300 shocks each time might be the ideal LESWT dose for diabetic ED treatment.
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Affiliation(s)
- Jing Liu
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China; E-Mails: (J.L.); (L.W.); (H.-X.L.); (G.-Y.B.); (R.-L.G.); (Y.-D.X.); (Z.-Z.G.)
| | - Feng Zhou
- Department of Urology, First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, China; E-Mail:
| | - Guang-Yong Li
- Department of Urology, General Hospital of Ningxia Medical University, Yinchuan 750004, Ningxia, China; E-Mail:
| | - Lin Wang
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China; E-Mails: (J.L.); (L.W.); (H.-X.L.); (G.-Y.B.); (R.-L.G.); (Y.-D.X.); (Z.-Z.G.)
| | - Hui-Xi Li
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China; E-Mails: (J.L.); (L.W.); (H.-X.L.); (G.-Y.B.); (R.-L.G.); (Y.-D.X.); (Z.-Z.G.)
| | - Guang-Yi Bai
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China; E-Mails: (J.L.); (L.W.); (H.-X.L.); (G.-Y.B.); (R.-L.G.); (Y.-D.X.); (Z.-Z.G.)
| | - Rui-Li Guan
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China; E-Mails: (J.L.); (L.W.); (H.-X.L.); (G.-Y.B.); (R.-L.G.); (Y.-D.X.); (Z.-Z.G.)
| | - Yong-De Xu
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China; E-Mails: (J.L.); (L.W.); (H.-X.L.); (G.-Y.B.); (R.-L.G.); (Y.-D.X.); (Z.-Z.G.)
| | - Ze-Zhu Gao
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China; E-Mails: (J.L.); (L.W.); (H.-X.L.); (G.-Y.B.); (R.-L.G.); (Y.-D.X.); (Z.-Z.G.)
| | - Wen-Jie Tian
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin, China; E-Mail:
| | - Zhong-Cheng Xin
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China; E-Mails: (J.L.); (L.W.); (H.-X.L.); (G.-Y.B.); (R.-L.G.); (Y.-D.X.); (Z.-Z.G.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel./Fax: +86-10-8322-2822
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Mense S, Hoheisel U. Shock wave treatment improves nerve regeneration in the rat. Muscle Nerve 2013; 47:702-10. [DOI: 10.1002/mus.23631] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2012] [Indexed: 01/01/2023]
Affiliation(s)
- Siegfried Mense
- Department of Neurophysiology; Centre for Biomedicine and Medical Technology Mannheim; Ruprecht Karls University Heidelberg; Ludolf Krehl Strasse 13-17 68167 Mannheim Germany
| | - Ulrich Hoheisel
- Department of Neurophysiology; Centre for Biomedicine and Medical Technology Mannheim; Ruprecht Karls University Heidelberg; Ludolf Krehl Strasse 13-17 68167 Mannheim Germany
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48
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Hayashi D, Kawakami K, Ito K, Ishii K, Tanno H, Imai Y, Kanno E, Maruyama R, Shimokawa H, Tachi M. Low-energy extracorporeal shock wave therapy enhances skin wound healing in diabetic mice: a critical role of endothelial nitric oxide synthase. Wound Repair Regen 2012; 20:887-95. [PMID: 23110611 DOI: 10.1111/j.1524-475x.2012.00851.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 07/19/2012] [Indexed: 01/03/2023]
Abstract
Low-energy extracorporeal shock wave (LE-ESW) treatment has been shown to accelerate wound repair; however, the mechanisms of treatment remain unclear. In the present study, we addressed the role of endothelial nitric oxide synthase (eNOS). A single LE-ESW treatment accelerated the healing of wounds in diabetic mice caused by the injection of streptozotocin. This accelerated healing was accompanied by the increased expression of eNOS and vascular endothelial growth factor (VEGF) and the generation of new vessels at the wound tissues. These results raised the possibility that eNOS may be involved in the beneficial effects of LE-ESW treatment. To address this possibility, we compared the effects of this treatment between mice with a genetic disruption of eNOS knockout (eNOS-KO mice) and wild-type (WT) control mice. Interestingly, the LE-ESW-induced acceleration of wound closure and the increase in VEGF expression and neovascularization was significantly attenuated in eNOS-KO mice compared with WT mice. Considered collectively, these results showed that eNOS was induced at the wound tissues by LE-ESW treatment and played a critical role in the therapeutic effects of this treatment by accelerating the wound healing by promoting VEGF expression and neovascularization.
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Affiliation(s)
- Denso Hayashi
- Department of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
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