Extracorporeal shockwave-induced expression of lubricin in tendons and septa

Abstract

Lubricin, a lubricating glycoprotein that facilitates tendon gliding, is upregulated by mechanical as well as biochemical stimuli, prompting this study of its induction by extracorporeal shockwave therapy (ESWT). The objective of this study was to characterize and quantify the effect of ESWT on lubricin expression in tendons and septa in a rat model. Hindlimbs of six rats were treated with low-dose ESWT and those of another six with high-dose ESWT, using contralateral limbs as controls. After 4 days, resected samples were processed for immunolocalization of lubricin using a purified monoclonal antibody. ESWT was found to increase lubricin expression in both low-dose and high-dose ESWT-treated tendons and also in septa. Lubricin expression generally increased with increasing dose of ESWT. Increased lubricin expression may contribute to the beneficial effects of ESWT in providing pain and symptom relief in musculoskeletal disorders by decreasing erosive wear.

Efficacy and safety of treating symptomatic, primary focal osteochondral lesions of the patella with a combination of intra-articular injection of hyaluronic acid (HAi) and radial extracorporeal shock wave therapy (rESWT) or HAi alone: A retrospective two-cohort study

“…As such, ESWT and HAi may have mutually bene cial effects in the treatment of sPFOLP. Whether ESWT can induce gene expression of HA (as demonstrated for lubricin [45], another molecule that serves as lubricant in synovial uid and is decreased in OA [46]) is currently unknown.…”

Experimental studies on the biological effects of extracorporeal shock wave therapy on tendon models. A review of the literature

“…However, considering the early collagen-degradation effects on exposed tissues, the shock wave exposure on non injured tissue is matter of debate, and the authors stated that it may be advisable to consider a temporary restriction of the physical activities in recently treated patients. In 2011 Zhang et al 19 demonstrated, in a rat model study, that ESWT stimulates endogenous lubricin production in tendons and septa exposed. Clinically, an increased lubricin deposition in tendons and septa following ESWT may contribute to the beneficial effects of ESWT.…”

Update of Extracorporeal Shockwave Therapy in Myofascial Pain Syndrome

“…Animal studies show that ESWT has an influence on pain transmission by acting on substance P, calcitonin gene-related peptide (CGRP) expression in the dorsal root ganglion and on neurovascular sprouting. [9][10][11][12][13][14][18][19][20][21][22][23] ESWT uses biphasic acoustic energy that goes from positive high peak pressures (10-100 MPa (mega pascals) for fESWT;0.1-1 MPa for rESWT) to negative phase (10 MPa); short rise times (10-100 ns for F-ESWT;0.5-1 ms for rESWT), short duration (0.2-0.5 ms for fESWT;0.2-0.5 ms for rESWT). Focused and radial shockwaves are generated in different ways.…”

“…Focused shockwaves are generated electrically, either within the applicator (electrohydraulic technique), or externally to it in the focal zone (electromagnetic or piezoelectric techniques), and then propagate to a designated focal point in order to treat it. Radial shockwaves are ballistic pressure waves generated at lower pressures over a longer time and propagate divergently within the tissue [9][10][11][12][13][14][18][19][20][21][22][23] The induced energy is propagating in the tissue and converges into a focal or radial area, depending on the equipment used and the settings selected for intensity, angle and other parameters. The effect varies, depending on the tissue through which the wave passes and how it absorbs, reflects, refracts or transmits the energy, depending on the specific impedance.…”