Department of Internal Medicine and Public Medicine, University of Bari, Italy.
Clin Exp Rheumatol. 2009 Sep-Oct;27(5):794-9.
Extra corporeal shock waves (ESW) have been proposed as additional therapy in bone fracture repair and osteoarthrtitis (OA). However, little is known on the effects of ESW on osteoblast metabolism. The aim of this study was to evaluate phenotype changes of healthy and OA human osteoblasts following ESW treatment.
Osteoblasts were isolated from subchondral bone of 13 OA patients and 7 healthy donors. Osteoblasts were treated or not with ESW at different levels of energy and impulses. IL-10, TNF-alpha, CD29/Beta1 integrin, and CD105/endoglin expression was evaluated by flowcytometry.
Intracellular IL-10 significantly increased using 1000 impulses at 0.055 mJ/mm2 in both healthy and OA osteoblasts in comparison with untreated osteoblasts (p<0.01). Only in the OA osteoblasts CD29 and CD105 expression significantly increased at 500 impulses and 0.17 mJ/mm2 ESW treatment (p<0.05).
ESW are capable of modifying IL-10 expression in osteoblasts. There is evidence that IL-10 can play a role in bone remodelling by inhibiting osteoclast differentiation and this suggests that ESW may favour bone growth and healing. This further supports the use of ESW in treating bone fracture to promote callus formation. However, the possible use of ESW in OA therapy needs further studies since in OA, osteoblast metabolism is already enhanced with bone sclerosis and ESW application may further increase bone deposition and osteophyte formation, leading to a subsequent worsening of the disease.
体外冲击波 (ESW) 已被提议作为骨骨折修复和骨关节炎 (OA) 的附加治疗方法。然而,对于 ESW 对成骨细胞代谢的影响知之甚少。本研究旨在评估 ESW 治疗后健康和 OA 人成骨细胞表型的变化。
从 13 名 OA 患者和 7 名健康供体的软骨下骨中分离出成骨细胞。用不同能量和脉冲的 ESW 对成骨细胞进行处理或不处理。通过流式细胞术评估 IL-10、TNF-α、CD29/β1 整联蛋白和 CD105/内格林的表达。
与未处理的成骨细胞相比,在健康和成骨细胞中,使用 0.055 mJ/mm2 的 1000 个脉冲时,细胞内 IL-10 显着增加(p<0.01)。只有在 OA 成骨细胞中,在 500 个脉冲和 0.17 mJ/mm2 ESW 处理时,CD29 和 CD105 的表达显着增加(p<0.05)。
ESW 能够改变成骨细胞中 IL-10 的表达。有证据表明,IL-10 通过抑制破骨细胞分化在骨重塑中发挥作用,这表明 ESW 可能有利于骨生长和愈合。这进一步支持在治疗骨折时使用 ESW 来促进骨痂形成。然而,在 OA 治疗中使用 ESW 的可能性需要进一步研究,因为在 OA 中,成骨细胞代谢已经因骨硬化而增强,ESW 的应用可能会进一步增加骨沉积和骨赘形成,从而导致疾病的进一步恶化。