Low-energy extracorporeal shockwave therapy improves locomotor functions, tissue regeneration, and modulating the inflammation induced FGF1 and FGF2 signaling to protect damaged tissue in spinal cord injury of rat model: an experimental animal study

Int J Surg. 2024 Dec 1;110(12):7563-7572. doi: 10.1097/JS9.0000000000002128.

Abstract

Background: Spinal cord injury (SCI) is a debilitating condition that results in severe motor function impairments. Current therapeutic options remain limited, underscoring the need for novel treatments. Extracorporeal shockwave therapy (ESWT) has emerged as a promising noninvasive approach for treating musculoskeletal disorders and nerve regeneration.

Methods: This study explored the effects of low-energy ESWT on locomotor function, tissue regeneration, inflammation, and mitochondrial function in a rat SCI model. Experiments were performed using locomotor function assays, CatWalk gait analysis, histopathological examination, immunohistochemical, and immunofluorescence staining.

Results: The findings demonstrated that low-energy ESWT had a dose-dependent effect, with three treatment sessions (ESWT3) showing superior outcomes compared to a single session. ESWT3 significantly improved motor functions [run patterns, run average speed, and maximum variation, as well as the Basso, Beattie, and Bresnahan score] and promoted tissue regeneration while reducing inflammation. ESWT3 significantly decreased levels of IL-1β, IL6, and macrophages (CD68) while increasing leukocyte (CD45) infiltration. Additionally, ESWT3 upregulated NueN and mitofusin 2 (MFN2), suggesting enhanced neuronal health and mitochondrial function. Moreover, ESWT3 modulated the expression of fibroblast growth factor 1 (FGF1), FGF2, their receptor FGFR1 and phosphorylation of ERK, aiding tissue repair, and regeneration in SCI.

Conclusions: This study highlights the potential of low-energy ESWT as an effective noninvasive treatment for SCI, demonstrating significant improvements in motor recovery, tissue regeneration, anti-inflammatory effects, and mitochondrial protection. These findings provide valuable insights into the mechanisms of ESWT and its therapeutic application for SCI recovery.

MeSH terms

  • Animals
  • Disease Models, Animal*
  • Extracorporeal Shockwave Therapy* / methods
  • Fibroblast Growth Factor 1* / metabolism
  • Fibroblast Growth Factor 2* / metabolism
  • Inflammation* / metabolism
  • Inflammation* / therapy
  • Locomotion / physiology
  • Male
  • Rats
  • Rats, Sprague-Dawley
  • Recovery of Function / physiology
  • Signal Transduction
  • Spinal Cord Injuries* / metabolism
  • Spinal Cord Injuries* / physiopathology
  • Spinal Cord Injuries* / therapy

Substances

  • Fibroblast Growth Factor 2
  • Fibroblast Growth Factor 1