Department of Orthopedics, Sixth People's Hospital, Shanghai JiaoTong University, Shanghai, China.
J Surg Res. 2014 Jan;186(1):484-92. doi: 10.1016/j.jss.2013.08.013. Epub 2013 Sep 3.
Extracorporeal shock wave therapy (ESWT) has been demonstrated to have the angiogenic effect on ischemic tissue. We hypothesize that ESWT exerts the proangiogenesis effect with an energy density-dependent mode on the target cells.
Endothelial progenitor cells (EPCs) of rats were obtained by cultivation of bone marrow-derived mononuclear cells. EPCs were divided into five groups of different energy densities, and each group was furthermore subdivided into four groups of different shock numbers. Thus, there were 20 subgroups in total. The expressions of angiogenic factors, apoptotic factors, inflammation mediators, and chemotactic factors were examined, and the proliferation activity was measured after ESWT.
When EPCs were treated with low-energy (0.04-0.13 mJ/mm(2)) shock wave, the expressions of endothelial nitric oxide synthase, angiopoietin (Ang) 1, Ang-2, and B-cell lymphoma 2 increased and those of interleukin 6, fibroblast growth factor 2, C-X-C chemokine receptor type 4, vascular endothelial growth factor a, Bcl-2-associated X protein, and caspase 3 decreased. stromal cell-derived factor 1 changed without statistical significance. When cells were treated with high-energy (0.16 mJ/mm(2)) shock wave, most of the expressions of cytokines declined except the apoptotic factors and fibroblast growth factor 2, and cells lead to apoptosis. The proliferation activity and the ratio of Ang-1/Ang-2 reached their peak values, when cells were treated with ESWT with the intensity ranging from 0.10-0.13 mJ/mm(2) and shock number ranging from 200-300 impulses. Meanwhile, a minimal value of the ratio of Bax/Bcl-2 was observed.
There is a dose-effect relationship in ESWT. The shock intensity ranging from 0.10-0.13 mJ/mm(2) and shock number ranging from 200-300 impulses were the optimal parameters for ESWT to treat cells in vitro.
体外冲击波疗法（ESWT）已被证明对缺血组织具有血管生成作用。我们假设 ESWT 通过能量密度依赖模式对靶细胞发挥促血管生成作用。
通过培养骨髓源性单核细胞获得大鼠内皮祖细胞（EPCs）。EPCs 分为五组不同的能量密度，每组进一步分为四组不同的冲击次数。因此，共有 20 个子组。经 ESWT 治疗后，检测血管生成因子、凋亡因子、炎症介质和趋化因子的表达，并测量增殖活性。
当 EPCs 接受低能量（0.04-0.13 mJ/mm²）冲击波治疗时，内皮型一氧化氮合酶、血管生成素 1（Ang1）、Ang2 和 B 细胞淋巴瘤 2 的表达增加，白细胞介素 6、成纤维细胞生长因子 2、C-X-C 趋化因子受体 4、血管内皮生长因子 a、Bcl-2 相关 X 蛋白和半胱天冬酶 3 的表达减少，基质细胞衍生因子 1 无统计学意义变化。当细胞接受高能量（0.16 mJ/mm²）冲击波治疗时，除凋亡因子和成纤维细胞生长因子 2 外，大多数细胞因子的表达下降，细胞发生凋亡。当细胞接受强度为 0.10-0.13 mJ/mm²、冲击次数为 200-300 次的 ESWT 治疗时，增殖活性和 Ang1/Ang2 比值达到峰值，同时观察到 Bax/Bcl-2 比值的最小值。
ESWT 存在剂量效应关系。强度为 0.10-0.13 mJ/mm²、冲击次数为 200-300 次的冲击波是 ESWT 治疗细胞的最佳参数。
