Cheng Jai-Hong, Chen Cheng-Wei, Chou Wen-Yi, Chen Po-Cheng, Wu Kuan-Ting, Jhan Shun-Wun, Hsu Shan-Ling, Wu Yi-No, Chen Hou-Tsung
Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.
Medical Research, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.
Biomedicines. 2024 Dec 12;12(12):2823. doi: 10.3390/biomedicines12122823.
Osteoporosis (OP) is a chronic inflammatory bone disease characterized by reduced bone structure and strength, leading to increased fracture risk. Effective therapies targeting both bone and cartilage are limited. This study compared the therapeutic effects of extracorporeal shockwave therapy (ESWT), bisphosphonate (Aclasta), and human Wharton jelly-derived mesenchymal stem cells (WJMSCs) in a rat model of OP. Female rats were assigned to four groups: Sham (no surgery or treatment), OP (bilateral ovariectomy, OVX), ESWT (OVX + ESWT on both tibias at 0.25 mJ/mm, 1500 impulses per tibia), Aclasta (OVX + zoledronic acid 0.1 mg/kg via tail vein injection), and WJMSC (OVX + 2 × 10⁶ WJMSCs). Pathological changes, bone microarchitecture (by micro-CT), serum cytokines (by ELISA), and tissue-specific molecular markers (by immunohistochemistry) were evaluated. All treatments improved bone density, preserved cartilage, and modulated cytokines (IL31, IL33, VEGF, and BMP2), with Aclasta showing the greatest improvements in bone parameters and cartilage preservation. ESWT and WJMSC also demonstrated significant effects, with ESWT highlighting non-invasive chondroprotective potential. Aclasta provided the best overall therapeutic response, particularly in bone regeneration. However, ESWT and WJMSC also showed comparable chondroprotective effects. ESWT emerges as a promising non-invasive alternative for OP management when pharmacological or cell-based therapies are not feasible.
骨质疏松症（OP）是一种慢性炎症性骨病，其特征是骨结构和强度降低，导致骨折风险增加。针对骨骼和软骨的有效治疗方法有限。本研究比较了体外冲击波疗法（ESWT）、双膦酸盐（阿仑膦酸钠）和人脐带华通胶间充质干细胞（WJMSCs）在骨质疏松症大鼠模型中的治疗效果。将雌性大鼠分为四组：假手术组（不进行手术或治疗）、骨质疏松症组（双侧卵巢切除术，OVX）、ESWT组（OVX + 双侧胫骨接受0.25 mJ/mm的ESWT，每侧胫骨1500次脉冲）、阿仑膦酸钠组（OVX + 通过尾静脉注射唑来膦酸0.1 mg/kg）和WJMSC组（OVX + 2×10⁶个WJMSCs）。评估了病理变化、骨微结构（通过显微CT）、血清细胞因子（通过酶联免疫吸附测定）和组织特异性分子标志物（通过免疫组织化学）。所有治疗均改善了骨密度、保护了软骨并调节了细胞因子（IL31、IL33、VEGF和BMP2），阿仑膦酸钠在骨参数和软骨保护方面的改善最为显著。ESWT和WJMSC也显示出显著效果，ESWT突出了其非侵入性软骨保护潜力。阿仑膦酸钠提供了最佳的总体治疗反应，特别是在骨再生方面。然而，ESWT和WJMSC也显示出相当的软骨保护作用。当药物治疗或基于细胞的治疗不可行时，ESWT成为一种有前景的非侵入性骨质疏松症治疗替代方法。
