Impact of radial extracorporeal shock wave therapy in post-laminectomy epidural fibrosis in a rat model

Haberal, Bahtiyar; Şimşek, Ekin Kaya; Akpınar, Koray; Şimşek, Duygu Türkbey; Şahintürk, Fikret

doi:10.5606/ehc.2021.77870

Cited by 6 publications

(6 citation statements)

References 20 publications

(42 reference statements)

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“…We have not studied the mechanisms involved in the reduction of interstitial collagen between muscle fibers after MAP therapy. Nevertheless, low-intensity extracorporeal shock wave therapy (Li-ESWT)-induced reduction of collagen fibers in liver fibrosis and spine surgery has been attributed to modulation of the TGFsignaling pathway and matrix metalloproteinases (46,47). Our current study is the first to examine the biomechanical effects of MAP on the PFM after simulated birth injury.…”

Section: Discussionmentioning

confidence: 94%

Microenergy acoustic pulse therapy restores function and structure of pelvic floor muscles after simulated birth injury

Lin¹,

Kuiken²,

Wang³

et al. 2022

Transl Androl Urol

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Background: The mechanisms of the microenergy acoustic pulse (MAP) therapy on restoring structure and function of pelvic floor muscles (PFM) after simulated birth injury are not well understood.Methods: A total 24 female Sprague-Dawley rats were randomly grouped into sham control (sham), vaginal balloon dilation and ovariectomy (VBDO), VBDO + β-aminopropionitrile (BAPN, an irreversible LOX inhibitor), and VBDO + BAPN and treated with MAP (n=6 in each group). The MAP therapy was administered 2 times per week for 4 weeks with 1-week washout, the functional and histological studies were conducted in all 24 rats. The viscoelastic behavior of the PFM, including iliococcygeus (IC) and pubococcygeus (PC), was examined with a biomechanical assay. The structure of the PFM was assessed by immunofluorescence and Masson's trichrome staining. Results:The leak point pressure (LPP) assay demonstrated that the MAP therapy group had higher LPPs compared to that of VBDO and BAPN groups. In the sham group, the muscular stiffness (K) of IC muscle was significantly higher than that of PC muscle while the pelvic floor muscle rebound activity (MRA) of PC muscle was stronger than that of IC muscle (291.26±45.33 and 241.18±14.23 N/cm 2 , respectively). Both VBDO and BAPN decreased the MRA and increased the K in both IC and PC. Histologic examination revealed increased fibrous tissue (collagen) and degeneration of muscle fibers in both VBDO and BAPN groups. MAP therapy significantly reduced the collagen content and improved the architecture of muscle fibers.Conclusions: MAP appears to restore the structure and function of PFM by regenerating muscular fibers and improving biomechanical properties in an animal model of simulated birth injury.

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Section: Discussionmentioning

confidence: 94%

Microenergy acoustic pulse therapy restores function and structure of pelvic floor muscles after simulated birth injury

Lin¹,

Kuiken²,

Wang³

et al. 2022

Transl Androl Urol

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show abstract

“…It is also a safe and effective non-invasive treatment for many fibrotic diseases such as myogenic contracture, pathological scars, epidural fibrosis, etc. [13][14][15][16][17][18][19][20]. In this study, extension knee joint contracture in rats was treated in different ways, to explore whether the treatment effect of SPS combined with ESWT is better than single treatment, and to guide clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…Relevant studies have shown that ESWT can reduce cell migration and effectively inhibit the expression of TGF-β1, alpha smooth muscle actin (α-SMA), type I collagen, and fibronectin [ 16 ], making it a feasible and cost-effective method for the treatment of pathological scars after burns [ 17 ]. In addition, ESWT can significantly and effectively reduce the fibrosis in the treatment of epidural fibrosis [ 18 ] and capsular fibrosis after insertion of silicone implants [ 19 ]. Huang et al [ 13 ] found that radial ESWT combined with ultrashort wave therapy could inhibit the high expression of TGF-β1 and hypoxia-inducible factor 1 alpha (HIF-1α), and radial ESWT could inhibit the NF-κB/HIF-1α signaling pathway [ 14 ], which could reduce the myogenic contracture after long-term immobilization.…”

Section: Introductionmentioning

confidence: 99%

Possible mechanism of static progressive stretching combined with extracorporeal shock wave therapy in reducing knee joint contracture in rats based on MAPK/ERK pathway

Zhang

Zhou

et al. 2022

Bosn J of Basic Med Sci

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The study aimed to observe the therapeutic effect of static progressive stretching (SPS) combined with extracorporeal shock wave therapy (ESWT) on extension knee joint contracture in rats and the effect on the MAPK/ERK pathway in the development of joint capsule fibrosis. Thirty-six Sprague Dawley rats were randomly divided into blank control group, immobilization model group, natural recovery group, ESWT intervention group, SPS intervention group, and SPS combined with ESWT intervention group. The left knee joints of the rats, except for the control group, were fixed with an external fixation brace for four weeks at full extension to form joint contractures. The therapeutic effect of each intervention was assessed by evaluating total and arthrogenic contracture, the number of total cells and collagen deposition in the anterior joint capsule, the protein levels of TGF-β1, FGF-2, and ERK2 in the anterior joint capsule, the mean optical density of upstream RAS and downstream ERK2 positive expression in the MAPK/ERK pathway. SPS in combination with ESWT was more effective in relieving joint contracture, improving the histopathological changes in the anterior joint capsule, and suppressing the high expression of target proteins and the overactivated MAPK/ERK pathway. The overactivated MAPK/ERK pathway was involved in the formation of extension knee joint contracture in rats. SPS in combination with ESWT was effective in relieving joint contracture and fibrosis of joint capsule. Moreover, the inhibition of the overactivated MAPK/ERK pathway may be the potential molecular mechanism for its therapeutic effect.

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“…More intriguingly, in an experimental study of rats with spinal cord damage, low-energy ESW application increased angiogenesis by increasing vascular endothelial growth factor expression in nerve cells, thus improving locomotor and sensory functions. [ 37 ] Finally, in an in vivo study, Haberal et al[ 38 ] reported that shock wave therapy applied in rats with lumbar laminectomy reduced epidural fibrosis. The reason for the decrease in epidural fibrosis in this study may be the fibroblast death due to the genotoxic damage observed in the current study, and the possible effect of inflammation triggered by this cytotoxic effect on wound healing.…”

Section: Discussionmentioning

confidence: 99%

Could radial extracorporeal shock wave therapy have an effect on wound healing in clinical practice by creating genotoxic damage? An in-vitro study in mouse fibroblasts

et al. 2021

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Objectives: This study aims to evaluate wound healing effects of in vitro radial extracorporeal shock wave (rESW) application on mouse fibroblasts and whether the cytotoxic effect of extracorporeal shock wave (ESW) was due to a possible genotoxic effect. Patients and methods: After creating an in vitro wound healing model in L929 mouse fibroblast culture, fibroblasts were stimulated with a frequency of 3 Hz, and 100, 250, 500, 1,000 and 1,500 pulses shock waves were applied. Energy flux densities ranging from 0.01 to 0.23 mJ/mm2 (14.3 MPa) at a constant pressure level of 0.5 and 1 bar were applied. Wound healing, cell viability, and genotoxicity were evaluated at 24 and 48 h. Results: All shot numbers for both pressures significantly reduced cell viability (p<0.05). For both 0.5 and 1 bar pressures, in both intervals, the rate of wound healing decreased, regardless of the number of shots (p<0.05). In vitro genotoxic damage was detected at both 0.5 and 1 bar pressures, in both time intervals, regardless of the number of shots. The genotoxic damage increased from 24 to 48 h. Conclusion: The study results suggest that, when ESWT is applied in this in vitro experimental setup, cell viability decreases and wound healing is delayed under all conditions. Furthermore, genotoxic damage can be prevented by using shots below 1,000 pulses. Therefore, while investigating the therapeutic effect of ESW therapy in vitro , the upper limit for the number of shots should be 1,000 pulses.

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Impact of radial extracorporeal shock wave therapy in post-laminectomy epidural fibrosis in a rat model

Cited by 6 publications

References 20 publications

Microenergy acoustic pulse therapy restores function and structure of pelvic floor muscles after simulated birth injury

Microenergy acoustic pulse therapy restores function and structure of pelvic floor muscles after simulated birth injury

Possible mechanism of static progressive stretching combined with extracorporeal shock wave therapy in reducing knee joint contracture in rats based on MAPK/ERK pathway

Could radial extracorporeal shock wave therapy have an effect on wound healing in clinical practice by creating genotoxic damage? An in-vitro study in mouse fibroblasts

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