Document Detail

Shockwaves enhance the osteogenetic gene expression in marrow stromal cells from hips with osteonecrosis.
MedLine Citation:
PMID:  21880191     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: This in vitro study investigated the angiogenesis and osteogenesis effects of shockwaves on bone marrow stromal cells (BMSCs) from hips with osteonecrosis.
METHODS: BMSCs were harvested from the bone marrow cavity of the proximal femur in six patients with osteonecrosis of the femoral head. The specimens were divided into four groups, the control, shockwave, shockwave plus nω-nitro- L-arginine methyl ester (L-NAME) and a nitric oxide (NO) donor (NOC18) groups. The control group received no shockwaves and was used as the baseline. The shockwave group received 250 shockwave impulses at 14 Kv (equivalent to 0.18 mJ/mm2 energy flux density). The shockwave plus LNAME group was pre-treated with L-NAME before receiving shockwaves. The NOC18 group received NOC18 after cell culture for 48 hours. The evaluations included cell proliferation (MTT) assay, alkaline phosphatase, real time reverse transcriptase-polymerase chain reaction analysis of vessel endothelial growth factor (VEGF), bone morphogenic protein (BMP)-2, RUNX2 and osteocalcin mRNA expression and von Kossa stain for mineralized nodules.
RESULTS: The shockwave group showed significant increases in MTT, VEGF, alkaline phosphatase, BMP2, RUNX2 and osteocalcin mRNA expression and more mature mineralized nodules compared with the control. Pre-treatment with L-NAME significantly reduced the angiogenic and osteogenic effects of extracorporeal shockwave therapy (ESWT) and the results were comparable with the control. Administration of NOC18 significantly enhanced the angiogenesis and osteogenesis effects compared with the control and the results were comparable with the shockwave group.
CONCLUSION: ESWT significantly enhanced the angiogenic and osteogenic effects of BMSCs mediated through the NO pathway in hips with osteonecrosis. These innovative findings, at least in part, explain some of the mechanism of shockwaves in osteonecrosis of the hip.
Tsung-Cheng Yin; Ching-Jen Wang; Kunder D Yang; Feng-Sheng Wang; Yi-Chih Sun
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chang Gung medical journal     Volume:  34     ISSN:  2309-835X     ISO Abbreviation:  Chang Gung Med J     Publication Date:    2011 Jul-Aug
Date Detail:
Created Date:  2011-09-01     Completed Date:  2012-01-09     Revised Date:  2013-10-22    
Medline Journal Info:
Nlm Unique ID:  101088034     Medline TA:  Chang Gung Med J     Country:  China (Republic : 1949- )    
Other Details:
Languages:  eng     Pagination:  367-74     Citation Subset:  IM    
Department of Orthopedic Surgery, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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MeSH Terms
Bone Marrow Cells / metabolism*
Bone Morphogenetic Protein 2 / genetics
Core Binding Factor Alpha 1 Subunit / genetics
Femur Head Necrosis / metabolism,  therapy*
High-Energy Shock Waves / therapeutic use*
NG-Nitroarginine Methyl Ester / pharmacology
Nitroso Compounds / pharmacology
Osteocalcin / genetics
RNA, Messenger / analysis
Stromal Cells / metabolism
Tetrazolium Salts
Vascular Endothelial Growth Factor A / genetics
Reg. No./Substance:
0/BMP2 protein, human; 0/Bone Morphogenetic Protein 2; 0/Core Binding Factor Alpha 1 Subunit; 0/NOC 18; 0/Nitroso Compounds; 0/RNA, Messenger; 0/RUNX2 protein, human; 0/Tetrazolium Salts; 0/Thiazoles; 0/Vascular Endothelial Growth Factor A; 104982-03-8/Osteocalcin; 298-93-1/thiazolyl blue; 50903-99-6/NG-Nitroarginine Methyl Ester

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