The role of cavitation in the in vitro stimulation of protein synthesis in human fibroblasts by ultrasound

Webster, David; Pond, John; Dyson, Mary; Harvey, W. Proctor

doi:10.1016/0301-5629(78)90023-6

Cited by 93 publications

(48 citation statements)

References 16 publications

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“…Thermal effects are used in physical therapy for the treatment of chronic sprains, strains, and pain relief. Nonthermal effects are used in the stimulation of tissue regeneration, 22 protein synthesis in fibroblasts, 23 and tendon repair. 24 Physiologically, pulsed ultrasound tends to produce nonthermal effects such as cavitation and microstreaming but less temperature rise in tissue than dose continuous ultrasound.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound stimulation of types I and III collagen expression of tendon cell and upregulation of transforming growth factor β

Tsai

Pang

Hsu

et al. 2006

Journal Orthopaedic Research

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Traumatic tendon injuries are commonly treated with ultrasound. However, previous research has not examined the molecular mechanism of this therapeutic effect on collagen synthesis of tendon cells. This study was designed to determine the effect of ultrasound on the expression of type I and type III collagen of tendon cells intrinsic to rat Achilles tendon. Whether a correlation exits between this effect and the expression of transforming growth factor b (TGF-b), which enhances collagen synthesis, was also investigated. Tendon cells after ultrasound treatment and protein expression of types I and III collagen were determined by immunocytochemistry. The mRNA expressions of a1(I) procollagen, a1(III) procollagen, and TGF-b were determined by reverse transcription-polymerase chain reaction (RT-PCR). Furthermore, the concentration of TGF-b in conditioned medium was evaluated by enzyme-linked immunosorbent assay (ELISA). Immunocytochemical staining revealed that ultrasound-treated tendon cells were stained more strongly for types I and III collagen than were control cells. Upregulation of procollagen a1(I) gene, procollagen a1(III) gene, and TGF-b at the mRNA level was confirmed by RT-PCR. A dose-dependent increase in the concentration of TGF-b in conditioned medium obtained from cells treated with ultrasound was demonstrated by ELISA assay (p ¼ 0.043). In conclusion, ultrasound stimulates the expression of type I and type III collagen in a process that is likely mediated by the upregulation of TGF-b. ß

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Section: Discussionmentioning

confidence: 99%

Ultrasound stimulation of types I and III collagen expression of tendon cell and upregulation of transforming growth factor β

Tsai

Pang

Hsu

et al. 2006

Journal Orthopaedic Research

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“…Non-skeletal cell types are known to increase protein synthesis in response to ultrasound exposure: fibroblasts have been shown to produce increased type I collagen and non-collagenous proteins after sonification [25,39,40]. The effect of ultrasound on enhancing wound healing and reducing inflammatory conditions is well recognized [2,9,11,25,39,40]. The tensile strength of surgically repaired Achilles tendon and skin has been shown to increase after ultrasound exposure [12].…”

Section: Discussionmentioning

confidence: 99%

Calcium signaling is required for ultrasound‐stimulated aggrecan synthesis by rat chondrocytes

Parvızı

Parpura

Bolander

2002

Journal Orthopaedic Research

142

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Low-intensity ultrasound accelerates fracture healing in humans. In rat femur fracture models, ultrasound advanced healing is associated with increased proteoglycan expression. Here we report that ultrasound stimulation of primary rat chondrocytes elevated the intracellular concentration of calcium [Ca2+],. The [Caz+], increase was rapid and transient at lower pressures (175-320 kPa), but rapid and sustained at higher ultrasound exposures (350-500 kPa). Chelating internal [Ca2+], with 1,2-bis(2-arninophenoxy) ethane-N-N-N',N'-tetraacetic acid (BAPTA-AM), stopping the Ca2+/ATP-ase induced mitochondria1 release of [Ca2+], with Thapsigargin, or removing [Ca2+], from the medium with EGTA inhibited the stimulatory effects of ultrasound on proteoglycan synthesis. These results imply that ultrasound-stimulated synthesis of cell matrix proteoglycan, associated with accelerated fracture healing, is mediated by intracellular calcium signaling.

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“…[1][2][3][4][5][6] The combined effects of stable cavitation and microstreaming associated with 1-and 3-MHz US that may impact wound healing include a temporarily increase in uptake of calcium ions by fibroblasts exposed to therapeutic levels of ultrasound. 7,8 In addition, with ultrasound pulsed at a 20% duty cycle and a frequency of 1 MHz, intensity levels as low as 0.5 W per square centimeter have been shown to increase collagen synthesis by fibroblasts. 8 This effect is highly significant for cell membrane permeability changes.…”

mentioning

confidence: 99%

“…7,8 In addition, with ultrasound pulsed at a 20% duty cycle and a frequency of 1 MHz, intensity levels as low as 0.5 W per square centimeter have been shown to increase collagen synthesis by fibroblasts. 8 This effect is highly significant for cell membrane permeability changes. In particular, the important second messenger, calcium, could act as an intracellular signal for some of the events that lead to ultrasound-induced stimulation of tissue repair.…”

mentioning

confidence: 99%

“…In particular, the important second messenger, calcium, could act as an intracellular signal for some of the events that lead to ultrasound-induced stimulation of tissue repair. 9 Possible examples include the stimulation of protein synthesis by fibroblasts 8 and the increased release of growth factors from mast cells 10 and macrophages. 11 Another clinically significant change in membrane function resulting from acoustic streaming is serotonin release from platelets.…”

mentioning

confidence: 99%

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Roles of Physical Therapists in Wound Management, Part III: Select Biophysical Technologies and Management of Patients With Diabetic Foot Ulceration

Kloth

2009

The Journal of the American College of Certified Wound Speciali

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Physical therapists (PTs) have several decades of history of using high-frequency (1-and 3-MHz) ultrasound (US) to facilitate healing of musculoskeletal tissues (eg muscle, fascia, tendon, ligament, joint capsule) that become wounded or inflamed following many accidents or sports injuries, but not exposed, because the trauma leaves the skin intact. These US frequencies (often referred to as therapeutic US) transmit acoustic energy, which delivers the nonthermal physical properties of stable cavitation and microstreaming to the closed wound tissues via direct contact gel or water coupling to the skin. With megahertz US, the acoustic pressure waves created by stable cavitation and microstreaming are less forceful than the pressure waves created by unstable cavitation that is associated with low-frequency (kilohertz) US. This is because acoustic pressure is inversely proportional to frequency, and since higher frequencies have shorter wavelengths, at the power (wattage) levels used for megahertz US, less acoustic energy is transmitted to tissues per unit of time. The more prominent unstable cavitation produced by low-frequency US (eg 22.5, 25, and 35 kHz) is a major contributing source of energy by which contact US debrides nonviable, adherent fibrin and slough via fragmentation, emulsification, or a combination. The combination of stable cavitation and microstreaming that are characteristic of megahertz US do not generate the destructive energy levels that are associated with kilohertz US frequencies. Owing to the lower level nonthermal effects that 1-and 3-MHz acoustic energy has on tissues and cells, these frequencies are also used to treat open wounds by applying the US to the periwound skin with either aqueous gel or water as the coupling medium. Bear in mind that megahertz US is also capable of generating thermal energy in soft tissues. Although mild heating of closed and open wounds may be desirable when the objective is to enhance blood flow, generally the nonthermal effects of US on wound healing are considered more desirable and are supported by more research evidence. Essentially, the combined effects of stable cavitation and acoustic streaming excite or upregulate the cell membrane, thereby increasing the activity levels of the entire cell. The US energy acts as a trigger for this process, but it is the increased cellular activity that is in effect responsible for the therapeutic benefits of the modality.

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The role of cavitation in the in vitro stimulation of protein synthesis in human fibroblasts by ultrasound

Cited by 93 publications

References 16 publications

Ultrasound stimulation of types I and III collagen expression of tendon cell and upregulation of transforming growth factor β

Ultrasound stimulation of types I and III collagen expression of tendon cell and upregulation of transforming growth factor β

Calcium signaling is required for ultrasound‐stimulated aggrecan synthesis by rat chondrocytes

Roles of Physical Therapists in Wound Management, Part III: Select Biophysical Technologies and Management of Patients With Diabetic Foot Ulceration

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