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首页> 外文期刊>European Cells & Materials >In vivo biological response to extracorporeal shockwave therapy in human tendinopathy
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In vivo biological response to extracorporeal shockwave therapy in human tendinopathy

机译：人体肌腱病对体外冲击波疗法的体内生物学反应

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Extracorporeal shock wave therapy (ESWT) is a non-invasive treatment for chronic tendinopathies, however little is known about the in-vivo biological mechanisms of ESWT. Using microdialysis, we examined the real-time biological response of healthy and pathological tendons to ESWT. A single session of ESWT was administered to the mid-portion of the Achilles tendon in thirteen healthy individuals (aged 25.7 ± 7.0 years) and patellar or Achilles tendon of six patients with tendinopathies (aged 39.0 ± 14.9 years). Dialysate samples from the surrounding peri-tendon were collected before and immediately after ESWT. Interleukins (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-17A, vascular endothelial growth factor and interferon-γ were quantified using a cytometric bead array while gelatinase activity (MMP-2 and -9) was examined using zymography. There were no statistical differences between the biological tissue response to ESWT in healthy and pathological tendons. IL-1β, IL-2, IL-6 and IL-8 were the cytokines predominantly detected in the tendon dialysate. IL-1β and IL-2 did not change significantly with ESWT. IL-6 and IL-8 concentrations were elevated immediately after ESWT and remained significantly elevated for four hours post-ESWT (p  0.001). Pro-forms of MMP-2 and -9 also increased after ESWT (p  0.003), whereas there were no significant changes in active MMP forms. In addition, the biological response to ESWT treatment could be differentiated between possible responders and non-responders based on a minimum 5-fold increase in any inflammatory marker or MMP from pre- to post-ESWT. Our findings provide novel evidence of the biological mechanisms underpinning ESWT in humans in vivo. They suggest that the mechanical stimulus provided by ESWT might aid tendon remodelling in tendinopathy by promoting the inflammatory and catabolic processes that are associated with removing damaged matrix constituents. The non-response of some individuals may help to explain why ESWT does not improve symptoms in all patients and provides a potential focus for future research.
机译：体外冲击波疗法（ESWT）是一种用于慢性肌腱病的非侵入性治疗方法，但是对ESWT的体内生物学机制了解甚少。使用微透析，我们检查了健康和病理肌腱对ESWT的实时生物学反应。在13名健康个体（年龄25.7±7.0岁）和6例肌腱病患者（39.0±14.9岁）的or骨或跟腱中对ESCL进行了单次治疗。在ESWT之前和之后立即收集来自周围肌腱的透析液样品。使用细胞计数珠阵列对白介素（IL）-1β，IL-2，IL-4，IL-6，IL-8，IL-10，IL-12p70，IL-17A，血管内皮生长因子和干扰素-γ进行定量而明胶酶活性（MMP-2和-9）用酶谱法检查。在健康和病理肌腱中，对ESWT的生物组织反应之间没有统计学差异。 IL-1β，IL-2，IL-6和IL-8是在肌腱透析液中主要检测到的细胞因子。 ESWT的IL-1β和IL-2没有明显变化。 ESWT后立即升高IL-6和IL-8浓度，ESWT后四小时内仍显着升高（p <0.001）。 ESWT后MMP-2和-9的前体形式也增加（p <0.003），而活性MMP形式没有明显变化。此外，基于从ESWT之前到之后的任何炎症标记物或MMP的最小增加5倍，可以区分可能的反应者和非反应者对ESWT治疗的生物学反应。我们的发现为人类体内ESWT的生物学机制提供了新的证据。他们认为，ESWT提供的机械刺激可能会通过促进与清除受损基质成分有关的炎症和分解代谢过程而有助于肌腱病中的肌腱重塑。有些人的无反应可能有助于解释为什么ESWT不能改善所有患者的症状，并为将来的研究提供了潜在的关注点。

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