Extracorporeal Shockwave Therapy Increases Growth Factor Release from Equine Platelet-Rich Plasma In Vitro

Abstract

IntroductionExtracorporeal shockwave therapy (ESWT) and platelet-rich plasma (PRP) are common treatments for soft tissue injuries in horses. Shockwave triggers cell specific responses to promote healing. Growth factors released from PRP also promote healing. It has been hypothesized that greater growth factor release would amplify the healing process. The combination of ESWT and PRP could promote healing in injured tendons and ligaments in the horse. The objective of this study was to determine if application of shockwaves to PRP samples increases the concentration of transforming growth factor-β1 (TGF-β1) and platelet-derived growth factor ββ (PDGF-ββ) released from the platelets in vitro.Materials and methodsPRP was produced from blood drawn from six horses. The PRP from each horse was exposed to the following treatments: (1) positive control (freeze-thaw cycle), (2) untreated negative control, or shockwaves with either (3) a “standard probe” (ESWT-S) with a 2 cm focal width and medium energy density or (4) a “power probe” (ESWT-P) with a 1 cm focal width and high energy density. After each treatment, the samples were centrifuged, and the supernatant was harvested. The supernatant was then used for growth factor quantification via commercially available ELISA kits for TGF-β1 and PDGF-ββ.ResultsConcentrations of TGF-β1 and PDGF-ββ in PRP that underwent a freeze-thaw cycle were significantly increased compared with all other treatments. Both ESWT-S and ESWT-P resulted in significantly increased TGF-β1 concentrations, 46 and 33%, respectively, when compared with the negative control. Both ESWT-S and ESWT-P resulted in significantly increased PDGF-ββ concentrations, 219 and 190%, respectively, when compared with the negative control.DiscussionThese data indicate that the application of ESWT to PRP increases the expression of growth factors in vitro. This suggests that the combination therapy of local PRP injection followed by ESWT may stimulate release of growth factors from platelets after they have been injected into the area of injury.ConclusionThe combination of PRP and ESWT might result in synergism of two modalities previously utilized individually for tendon and ligament injuries in horses.

Effects of Radial Extracorporeal Shock Wave Therapy on Flexor Spasticity of the Upper Limb in Post-stroke Patients: Study Protocol for A Randomized Controlled Trial

“…In the past, the mechanism by which ESWT acts on musculoskeletal diseases was assumed to be mechanical decomposition, just like extracorporeal shock wave lithotripsy. However, further clinical observations and experimental results, have suggested that ESWT can promote neovascularization, the release of growth factors, the differentiation of mesenchymal stem cells and the production of endogenous nitric oxides (NOs) [46][47][48], which can decrease the intrinsic stiffness of connective tissue, increase muscle elongation, improve tissue microcirculation and change the formation of neuromuscular junctions of the peripheral nervous system [49][50][51], in order to achieve encouraging clinical results.…”

Influencia Del Ph en La Liberación Del Factor De Crecimiento Derivado De Plaquetas (Pdgf-Bb) a Partir De Un Hidrogel a Base De Β-Quitosano

“…Este procedimiento permite la separación del plasma de los otros componentes sanguíneos, logrando obtener al finalizar un pool de plasma puro y rico en plaquetas, que para este trabajo tuvo una concentración de 1,5 X 10 6 plaquetas. (11) . Para la elaboración del hidrogel, se preparó la solución de β-quitosano 1,5% (p/v) en ácido acético 2% (v/v) 12,13 , luego se adicionó LP al 6 % o 12 % (v/v) hasta homogeneizar con ayuda de un agitador magnético.…”

“…Para esto, se congeló a -70 °C por 12 horas y descongeló a 37 °C (aproximadamente 10 minutos), lo que se denomina un ciclo. Después de tres ciclos, se centrifugó la muestra a 2500 rpm durante 15 minutos; el sobrenadante es el LP(11) . Plasma recolectado tras plasmaféresis por centrifugación de flujo discontinuo Para obtener el LP, se tomó 10 mL del PRP y sometió a un shock de temperatura para lisar de plaquetas.…”

Combination of Platelet Rich Plasma, Lowintensity Pulsed Ultrasound and Sildenafil Oral Spray in Treatment of Erectile Dysfunction

“…The biological effects of LIPUS and PRP presented in table 1. PRP-therapy can be combined with LNP and LIPUS resulting in augmentation of its effects due to the same target-effects and hypothetic phenomenon of ultrasonic intracavernous platelets activation [2,7]. Local negative pressure (LNP) therapy shall be considered as an auxiliary method to PRP and LIPUS due to its ability to slow down PRP outflow from injection zones.…”