Shock wave as biological therapeutic tool: From mechanical stimulation to recovery and healing, through mechanotransduction.


Author: d'Agostino MC1, Craig K2, Tibalt E3, Respizzi S3

Affiliation: <sup>1</sup>ESWT Center, Rehabilitation Department, Humanitas Research Hospital, Rozzano, Milan, Italy. Electronic address: info@cristinadagostino.it.

<sup>2</sup>Kompass Health Associates, Auckland, New Zealand.

<sup>3</sup>ESWT Center, Rehabilitation Department, Humanitas Research Hospital, Rozzano, Milan, Italy.
Conference/Journal: Int J Surg.
Date published: 2015 Dec
Other:
 Volume ID: 24   ,  Issue ID: Pt B   ,  Pages: 147-53   ,  Special Notes: doi: 10.1016/j.ijsu.2015.11.030. Epub  2015 Nov 28.   ,  Word Count: 253  
    Extracorporeal Shock Wave Therapy (ESWT) is a form of "mechanotherapy", that, from its original applications as urological lithotripsy, gained the field of musculo-skeletal diseases as Orthotripsy (mainly tendinopaties and bone regenerative disorders) and Regenerative Medicine as well. The mechanisms of action of Shock Waves (SW), when applied in non-urological indications, are not related to the direct mechanical effect, but to the different pathways of biological reactions, that derive from that acoustic stimulations, through "mechano-transduction". So, the "mechanical model" of urological lithotripsy has been substituted by a "biological model", also supported by current knowledge in "mechanobiology", the emerging multidisciplinary field of science that investigates how physical forces and changes in cell/tissue mechanics can influence the tissue development, physiology and diseases. Although some details are still under study, it is known that SW are able to relief pain, as well to positively regulate inflammation (probably as immunomodulator), to induce neoangiogenesis and stem cells activities, thus improving tissue regeneration and healing. ESWT can be nowadays considered an effective, safe, versatile, repeatable, noninvasive therapy for the treatment of many musculo-skeletal diseases, and for some pathological conditions where regenerative effects are desirable, especially when some other noninvasive/conservative therapies have failed. Moreover, based on the current knowledge in SW mechanobiology, it seems possible to foresee new interesting and promising applications in the fields of Regenerative Medicine, tissue engineering and cell therapies. 



Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.



KEYWORDS: Inflammation; Macrophages; Mechanotransduction; Remodeling; Shock waves; Tissue; Tissue regeneration



PMID: 26612525  DOI: 10.1016/j.ijsu.2015.11.030