Alteration of inflammatory response by shock wave therapy leads to reduced calcification of decellularized aortic xenografts in mice†

Abstract

SWs reduce the calcification of subcutaneously implanted decellularized xenografts via the modulation of the acute macrophage-mediated inflammatory response and improves the in vitro repopulation of decellularized grafts. It may therefore serve as a feasible adjunct to heart valve tissue engineering.

Effect of shock waves on macrophages: A possible role in tissue regeneration and remodeling

“…The body of scientific data demonstrating that ESWT can induce tissue healing and regeneration through mechanotransduction has brought to the present view of SW as immunomodulators during the wound healing process [7,25], which is also well in line with recent evidence indicating that SW influence the TLR3 pathway .…”

“…The mechanisms of action of SW is associated to mechanotransduction, a process by which physical forces are sensed, transduced, and then transformed into intracellular biochemistry and gene expression [8,14]. A rapidly increasing body of evidence demonstrates that mechanotransduction events after exposure to SW are not only dose-dependent but also can be different in different cell types, as osteoblasts, endothelial cells, tenocytes, and stem cells at different levels of differentiation have all been demonstrated to be responsive to SW but have different optimal pattern and range of mechanical stimulation and develop different biological answers, including upregulation of TGF-β1 expression and NO production, suppression of NF-kB activity and pro-inflammatory cytokines production [7,8,14,25]. More recently, SW application in an experimental setting based on intramuscular silicone injection resulted in a lesser dense fibrous capsule and, when applied in multiple sessions, in active degradation of the fibrous envelope accompanied by synergistic alterations in pro-and anti-fibrotic proteins (TGF-β1 and matrix metalloproteinase 2, respectively),…”

“…More recently, the positive effects of ESWT on soft tissues and the vascular bed has made it possible its application in clinical practice also for some andrologic disturbances (induratio penis plastic, erectyle disfunctions) [5]. Regenerative and trophic effects have also been demonstrated in ischemic and related heart diseases, although at present ESWT application in this field is still experimental [6] [7].…”

Extracorporeal Shock Wave Therapy in Chronic Wound Care

“…ESWT influences the toll-like receptor 3 (TLR3) pathway [43], which plays a fundamental role in pathogen recognition and activation of innate immunity, so ESWT modulates the inflammatory responses related to immunology pathway [44][45][46][47][48][49].…”

Small Diameter Xenogeneic Extracellular Matrix Scaffolds for Vascular Applications

“…88,116 Antigens left in the tissue by ineffective tissue processing methods stimulating adaptive responses, while disruption of native ECM protein macromolecular structure promotes detrimental innate immune responses. 88,89,91,116,[136][137][138] Residual antigenic epitopes in ECM scaffolds are subject to recipient antigen-specific T and/or B cell recognition. Once activated, cells of the adaptive immune system produce cytokines, chemokines, and antibodies, promoting recruitment and activation of both additional adaptive and innate (e.g., macrophages) immune cells.…”