Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria.
J Thorac Cardiovasc Surg. 2013 Oct;146(4):971-8. doi: 10.1016/j.jtcvs.2013.01.017. Epub 2013 Feb 8.
Shock waves have been shown to induce recruitment of intravenously injected endothelial progenitor cells to ischemic hind limbs in rats. We hypothesized that shock wave treatment as sole therapy would induce angiogenesis in this ischemia model and would lead to mobilization of endogenous endothelial (progenitor) cells.
A total of 18 rats, aged 5 weeks old, were subdivided into 3 groups: sham (n = 6), ischemic muscle with shock wave treatment (shock wave treatment group, n = 6), and without shock wave treatment (control, n = 6). Hind limb ischemia was induced by ligation of the femoral artery. Three weeks later, shock wave treatment (300 impulses at 0.1 mJ/mm(2)) was applied to the adductor muscle; the controls were left untreated. Muscle samples were analyzed using real-time polymerase chain reaction for angiogenic factors and chemoattractants for endothelial progenitor cell mobilization. Fluorescence activated cell sorting analysis of the peripheral blood was performed for CD31/CD34-positive cells. Perfusion was measured using laser Doppler imaging. Functional improvement was evaluated by walking analysis.
Angiogenic factors/endothelial progenitor cell chemoattractants, stromal cell-derived factor-1 and vascular endothelial growth factor, were increased in the treatment group, as shown by real-time polymerase chain reaction, indicating the mobilization of endothelial progenitor cells. Fluorescence activated cell sorting analysis of the peripheral blood revealed high numbers of CD31/CD34-positive cells in the treatment group. Greater numbers of capillaries were found in the treated muscles. Blood perfusion increased markedly in the treatment group and led to functional restoration, as shown by the results from the walking analysis.
Shock wave therapy therefore could develop into a feasible alternative to stem cell therapy in regenerative medicine, in particular for ischemic heart and limb disease.
研究表明冲击波可诱导静脉内注射的内皮祖细胞募集到大鼠缺血后肢。我们假设冲击波治疗作为单一疗法，将在该缺血模型中诱导血管生成，并导致内源性内皮（祖细胞）的动员。
将 18 只 5 周龄大鼠分为 3 组：假手术组（n=6）、缺血肌肉冲击波治疗组（冲击波治疗组，n=6）和无冲击波治疗组（对照组，n=6）。通过结扎股动脉诱导后肢缺血。3 周后，向收肌施加冲击波治疗（300 次冲击，0.1 mJ/mm²）；对照组未接受治疗。使用实时聚合酶链反应分析肌肉样本中的血管生成因子和内皮祖细胞动员趋化因子。对外周血进行 CD31/CD34 阳性细胞的荧光激活细胞分选分析。使用激光多普勒成像测量灌注。通过行走分析评估功能改善。
实时聚合酶链反应显示，治疗组中血管生成因子/内皮祖细胞趋化因子基质细胞衍生因子-1 和血管内皮生长因子增加，表明内皮祖细胞的动员。外周血的荧光激活细胞分选分析显示，治疗组中 CD31/CD34 阳性细胞数量较多。处理过的肌肉中发现更多的毛细血管。治疗组的血液灌注明显增加，导致行走分析的功能恢复。
因此，冲击波治疗可能成为再生医学中干细胞治疗的可行替代方法，特别是用于缺血性心脏病和肢体疾病。
