Modulation of VEGF and MAPK-related pathway involved in extracorporeal shockwave therapy accelerate diabetic wound healing.
Authors of this article are:
Chen RF, Chang CH, Wang CT, Yang MY, Wang CJ, Kuo YR.
A summary of the article is shown below:
BACKGROUND: Extracorporeal shockwave therapy (ESWT) has a significant positive effect to accelerate chronic wound healing. This study investigated whether the VEGF- related pathway has involved in ESWT enhancement of diabetic wound healing.METHODS: In this study, we used a dorsal skin defect (area, 6×5 cm) in a streptozotocin (STZ)-induced diabetes rodent model. Thirty-two male Wistar rats were divided into 4 groups. Group I consisted of non-diabetic control; group II, diabetic control without treatment; group III, diabetic rats received ESWT, and group IV, rats received Avastin (a VEGF monoclonal antibody) on day 0 (post-wounding immediately) to days 7 and ESWT on days 3 and day 7. The wound healing was assessed clinically. The VEGF, eNOS, and Ki-67, were analyzed with immunohistochemical staining. The mRNA expression of MAPK related genes were measured by real-time quantitative RT-PCR.RESULTS: The wound size was significantly reduced in the ESWT-treated rats as compared to the diabetic control (P< 0.01). The positive effect of ESWT increasing wound healing was significantly suppressed in pre-treatment of Avastin group. Histological findings revealed significant increase in neo-vessels in ESWT group as compared to the control. In immunohistochemical stain, significant increases in VEGF, eNOS, and Ki-67 expressions were noted in the ESWT group as compared to that in controls. However, Avastin suppressed the shockwave effect and down-regulation of VEGF, eNOS, and Ki-67 expressions in Avastin-ESWT group as compared to that in ESWT alone group. Highly mRNA expression of Kras, Raf1, Mek1, Jnkk, Jnk and Jun at early stage in ESW treatment group, as compared to the diabetic control.CONCLUSIONS: Treatment with multiple sessions of ESWT significantly enhanced diabetic wound healing associated with increased neo-vascularization and tissue regeneration. The bio-mechanism of ESWT enhanced wound healing is correlated with VEGF and MAPK mediated pathway. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.
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MAPK;VEGF;diabetic wound;extracorporeal shock-wave therapy;wound healing
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