Effect of Li-ESWT on Testicular Tissue and Function in Androgen-Deficient Rat Model

Abstract

Low-intensity extracorporeal shockwave therapy (Li-ESWT), as a microenergy therapy, has the effects of inhibiting oxidative stress, antiapoptosis, and tissue repair, which is increasingly applied to a variety of diseases. Our research aims to explore the protective effects of Li-ESWT in the aging rat model and its possible molecular mechanism through in vivo and in vitro experiments. In vitro, TM3 Leydig cells incubated with H2O2 were treated with Li-ESWT at 4 energy levels (0.01, 0.05, 0.1, and 0.2 mJ/mm2). In vivo, we employed an androgen-deficient rat model to simulate male aging and treated it with Li-ESWT at three different energy levels (0.01, 0.05, and 0.2 mJ/mm2). Li-ESWT increased the expression of vascular endothelial growth factor (VEGF) in TM3 cells, improved antioxidant capacity, and reduced apoptosis, with the effect being most significant at 0.05 mJ/mm2 energy level. In androgen-deficient rat model, LI-ESWT can improve sperm count, motility, and serum testosterone level, enhancing tissue antioxidant capacity and antiapoptotic ability, and the effect is most significant at 0.05 mJ/mm2 energy level. Therefore, Li-ESWT at an appropriate energy level can improve sperm count, motility, and serum testosterone levels in androgen-deficient rat models, reduce oxidative stress in the testis, and increase antioxidant capacity and antiapoptotic abilities. The mechanism of this condition might be related to the increased VEGF expression in Leydig cells by Li-ESWT.

Impact of extracorporeal shockwave therapy for erectile dysfunction and Peyronie's disease on reproductive and hormonal testicular function

“…Despite this noteworthy background, it is essential to underline that energy settings, protocols, and sites of application of ESWL for distal ureteral stones and ESWT for ED and PD differ substantially 4,5,26 ; therefore, it was not possible to extend the conclusions of the ESWL studies to patients undergoing shock waves for andrological purposes. Currently, only a few articles are available on the impact of Li‐ESWT on the testis, all being pre‐clinical studies on rat models 8,27,29,30 . The first paper on the topic was published by Zang et al.…”

“…The authors found that Li‐ESWT can improve sperm count, motility, and serum testosterone level, enhancing tissue antioxidant capacity and antiapoptotic ability, with the most significant effect at 0.05 mJ/mm 2 . Moreover, they proposed that these effects might be related to the increased vascular endothelial growth factor (VEGF) expression in Leydig cells 30 . The reported pre‐clinical studies appear to be methodologically heterogeneous, providing limited and somewhat contradictory evidence.…”

“…Currently, only a few articles are available on the impact of Li-ESWT on the testis, all being pre-clinical studies on rat models. 8,27,29,30 The first paper on the topic was published by Zang greater testicular changes (dose-dependent effect). The energy of 0.02 mJ/mm 2 for 500 impulses was not associated with adverse effects on the testes.…”

“…Moreover, they proposed that these effects might be related to the increased vascular endothelial growth factor (VEGF) expression in Leydig cells. 30 The reported pre-clinical studies appear to be methodologically heterogeneous, providing limited and somewhat contradictory evidence. Furthermore, it should be noted that some of these articles described the application of shock waves directly to the testes via the scrotal skin, 27,29 but this modality is not part of human clinical practice.…”

A Comprehensive Review of the Effects of Extracorporeal Shock Wave Therapy on Stroke Patients: Balance, Pain, Spasticity

“…ESWT may help improve muscle strength and endurance in stroke patients by enhancing blood flow, promoting tissue repair, and stimulating neuromuscular re-education. The mechanical stimulation induced by ESWT can also increase the production of growth factors [ 49 ] and cytokines [ 50 ], which may contribute to muscle repair and regeneration. Clinical trials and systematic reviews investigating the effects of ESWT on muscle spasticity and control in stroke patients have shown promising results ( Table 3 ).…”