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Effect of extracorporeal shock wave on proliferation and differentiation of equine adipose tissue-derived mesenchymal stem cells in vitro.

Abstract: Mesenchymal stem cells are regarded as common cellular precursors of the musculoskeletal tissue and are responsible for tissue regeneration in the course of musculoskeletal disorders. In equine veterinary medicine extracorporeal shock wave therapy (ESWT) is used to optimize healing processes of bone, tendon and cartilage. Nevertheless, little is known about the effects of the shock waves on cells and tissues. Thus, the aim of this study was to investigate the influence of focused ESWT on the viability, proliferation, and differentiation capacity of adipose tissue-derived mesenchymal stem cells (ASCs) and to explore its effects on gap junctional communication and the activation of signalling cascades associated with cell proliferation and differentiation. ASCs were treated with different pulses of focused ESWT. Treated cells showed increased proliferation and expression of Cx43, as detected by means of qRT-PCR, histological staining, immunocytochemistry and western blot. At the same time, cells responded to ESWT by significant activation (phosphorylation) of Erk1/2, detected in western blots. No significant effects on the differentiation potential of the ASCs were evident. Taken together, the present results show significant effects of shock waves on stem cells in vitro.
Publication Date: 2013-03-08 PubMed ID: 23671817PubMed Central: PMC3636727
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research investigates how extracorporeal shock wave therapy (ESWT) can improve the proliferation and differentiation of adipose tissue-derived mesenchymal stem cells (ASCs) in horses. The study also looked into the effects ESWT has on cellular processes and signalling associated with cell proliferation and differentiation.

Research Methodology

  • The study aimed to understand the effect of ESWT on the viability, proliferation, and differentiation ability of ASCs.
  • Gap junctional communication and activation of signalling cascades related to cell proliferation and differentiation were also looked into.
  • ASCs were exposed to various pulses of focused ESWT. Various protocols such as qRT-PCR, histological staining, immunocytochemistry, and western blot were employed to determine the impact.

Research Findings

  • The research found that following ESWT, the ASCs exhibited increased proliferation and elevated expression of Cx43.
  • The research also documented the significant activation or phosphorylation of Erk1/2 in response to ESWT. This was detected via western blots.
  • However, there were no substantial effects recorded on the differentiation capacity of the ASCs following ESWT treatment.

Conclusion

  • Although ESWT did not significantly affect ASC differentiation, it demonstrated prominent impacts on ASC proliferation.
  • This finding could have considerable implications for veterinary medicine, particularly in improving healing processes in equines’ bones, tendons, and cartilage.
  • The insight from this study, which focuses on ESWT’s effects on stem cells, could potentially inform future research or treatments centered on tissue regeneration.

Cite This Article

APA
Raabe O, Shell K, Goessl A, Crispens C, Delhasse Y, Eva A, Scheiner-Bobis G, Wenisch S, Arnhold S. (2013). Effect of extracorporeal shock wave on proliferation and differentiation of equine adipose tissue-derived mesenchymal stem cells in vitro. Am J Stem Cells, 2(1), 62-73.

Publication

ISSN: 2160-4150
NlmUniqueID: 101578936
Country: United States
Language: English
Volume: 2
Issue: 1
Pages: 62-73

Researcher Affiliations

Raabe, O
  • Institute of Veterinary -Anatomy, -Histology, and -Embryology, Justus-Liebig University of Giessen Germany.
Shell, K
    Goessl, A
      Crispens, C
        Delhasse, Y
          Eva, A
            Scheiner-Bobis, G
              Wenisch, S
                Arnhold, S

                  References

                  This article includes 47 references
                  1. Silver IA, Brown PN, Goodship AE, Lanyon LE, McCullagh KG, Perry GC, Williams IF. A clinical and experimental study of tendon injury, healing and treatment in the horse.. Equine Vet J Suppl 1983 Jul;(1):1-43.
                    pubmed: 9079042
                  2. Marr CM, Love S, Boyd JS, McKellar Q. Factors affecting the clinical outcome of injuries to the superficial digital flexor tendon in National Hunt and point-to-point racehorses.. Vet Rec 1993 May 8;132(19):476-9.
                    pubmed: 8506599doi: 10.1136/vr.132.19.476google scholar: lookup
                  3. Carrade DD, Owens SD, Galuppo LD, Vidal MA, Ferraro GL, Librach F, Buerchler S, Friedman MS, Walker NJ, Borjesson DL. Clinicopathologic findings following intra-articular injection of autologous and allogeneic placentally derived equine mesenchymal stem cells in horses.. Cytotherapy 2011 Apr;13(4):419-30.
                    pubmed: 21105841doi: 10.3109/14653249.2010.536213google scholar: lookup
                  4. Nixon AJ, Begum L, Mohammed HO, Huibregtse B, O'Callaghan MM, Matthews GL. Autologous chondrocyte implantation drives early chondrogenesis and organized repair in extensive full- and partial-thickness cartilage defects in an equine model.. J Orthop Res 2011 Jul;29(7):1121-30.
                    pubmed: 21319216doi: 10.1002/jor.21366google scholar: lookup
                  5. Koch TG, Berg LC, Betts DH. Current and future regenerative medicine - principles, concepts, and therapeutic use of stem cell therapy and tissue engineering in equine medicine.. Can Vet J 2009 Feb;50(2):155-65.
                    pmc: PMC2629419pubmed: 19412395
                  6. Vidal MA, Kilroy GE, Lopez MJ, Johnson JR, Moore RM, Gimble JM. Characterization of equine adipose tissue-derived stromal cells: adipogenic and osteogenic capacity and comparison with bone marrow-derived mesenchymal stromal cells.. Vet Surg 2007 Oct;36(7):613-22.
                  7. Raabe O, Reich C, Wenisch S, Hild A, Burg-Roderfeld M, Siebert HC, Arnhold S. Hydrolyzed fish collagen induced chondrogenic differentiation of equine adipose tissue-derived stromal cells.. Histochem Cell Biol 2010 Dec;134(6):545-54.
                    pubmed: 21076963doi: 10.1007/s00418-010-0760-4google scholar: lookup
                  8. Raabe O, Shell K, Würtz A, Reich CM, Wenisch S, Arnhold S. Further insights into the characterization of equine adipose tissue-derived mesenchymal stem cells.. Vet Res Commun 2011 Aug;35(6):355-65.
                    pubmed: 21614641doi: 10.1007/s11259-011-9480-zgoogle scholar: lookup
                  9. Smith RK, Korda M, Blunn GW, Goodship AE. Isolation and implantation of autologous equine mesenchymal stem cells from bone marrow into the superficial digital flexor tendon as a potential novel treatment.. Equine Vet J 2003 Jan;35(1):99-102.
                    pubmed: 12553472doi: 10.2746/042516403775467388google scholar: lookup
                  10. Wilke MM, Nydam DV, Nixon AJ. Enhanced early chondrogenesis in articular defects following arthroscopic mesenchymal stem cell implantation in an equine model.. J Orthop Res 2007 Jul;25(7):913-25.
                    pubmed: 17405160doi: 10.1002/jor.20382google scholar: lookup
                  11. Guest DJ, Smith MR, Allen WR. Monitoring the fate of autologous and allogeneic mesenchymal progenitor cells injected into the superficial digital flexor tendon of horses: preliminary study.. Equine Vet J 2008 Mar;40(2):178-81.
                    pubmed: 18267891doi: 10.2746/042516408X276942google scholar: lookup
                  12. Watts AE, Yeager AE, Kopyov OV, Nixon AJ. Fetal derived embryonic-like stem cells improve healing in a large animal flexor tendonitis model.. Stem Cell Res Ther 2011 Jan 27;2(1):4.
                    pmc: PMC3092144pubmed: 21272343doi: 10.1186/scrt45google scholar: lookup
                  13. Godwin EE, Young NJ, Dudhia J, Beamish IC, Smith RK. Implantation of bone marrow-derived mesenchymal stem cells demonstrates improved outcome in horses with overstrain injury of the superficial digital flexor tendon.. Equine Vet J 2012 Jan;44(1):25-32.
                  14. Ogden JA, Tóth-Kischkat A, Schultheiss R. Principles of shock wave therapy.. Clin Orthop Relat Res 2001 Jun;(387):8-17.
                  15. Pettersson B, Tiselius HG. Extracorporeal shock wave lithotripsy of proximal and distal ureteral stones.. Eur Urol 1988;14(3):184-8.
                    pubmed: 3383929doi: 10.1159/000472934google scholar: lookup
                  16. Block G, Adams LG, Widmer WR, Lingeman JE. Use of extracorporeal shock wave lithotripsy for treatment of nephrolithiasis and ureterolithiasis in five dogs.. J Am Vet Med Assoc 1996 Feb 15;208(4):531-6.
                    pubmed: 8603902
                  17. Adams LG, Senior DF. Electrohydraulic and extracorporeal shock-wave lithotripsy.. Vet Clin North Am Small Anim Pract 1999 Jan;29(1):293-302, xv.
                    pubmed: 10028164doi: 10.1016/s0195-5616(99)50017-xgoogle scholar: lookup
                  18. Vetterkind S, Illenberger S, Kubicek J, Boosen M, Appel S, Naim HY, Scheidtmann KH, Preuss U. Binding of Par-4 to the actin cytoskeleton is essential for Par-4/Dlk-mediated apoptosis.. Exp Cell Res 2005 May 1;305(2):392-408.
                    pubmed: 15817164doi: 10.1016/j.yexcr.2005.01.012google scholar: lookup
                  19. Haupt G. Use of extracorporeal shock waves in the treatment of pseudarthrosis, tendinopathy and other orthopedic diseases.. J Urol 1997 Jul;158(1):4-11.
                  20. Bolt DM, Burba DJ, Hubert JD, Pettifer GR, Hosgood GL. Evaluation of cutaneous analgesia after non-focused extracorporeal shock wave application over the 3rd metacarpal bone in horses.. Can J Vet Res 2004 Oct;68(4):288-92.
                    pmc: PMC1111360pubmed: 15581224
                  21. Crowe OM, Dyson SJ, Wright IM, Schramme MC, Smith RK. Treatment of chronic or recurrent proximal suspensory desmitis using radial pressure wave therapy in the horse.. Equine Vet J 2004 May;36(4):313-6.
                    pubmed: 15163037doi: 10.2746/0425164044890562google scholar: lookup
                  22. McClure SR, Van Sickle D, White MR. Effects of extracorporeal shock wave therapy on bone.. Vet Surg 2004 Jan-Feb;33(1):40-8.
                  23. McClure SR, VanSickle D, Evans R, Reinertson EL, Moran L. The effects of extracorporeal shock-wave therapy on the ultrasonographic and histologic appearance of collagenase-induced equine forelimb suspensory ligament desmitis.. Ultrasound Med Biol 2004 Apr;30(4):461-7.
                  24. Pauwels FE, McClure SR, Amin V, Van Sickle D, Evans RB. Effects of extracorporeal shock wave therapy and radial pressure wave therapy on elasticity and microstructure of equine cortical bone.. Am J Vet Res 2004 Feb;65(2):207-12.
                    pubmed: 14974578doi: 10.2460/ajvr.2004.65.207google scholar: lookup
                  25. Revenaugh MS. Extracorporeal shock wave therapy for treatment of osteoarthritis in the horse: clinical applications.. Vet Clin North Am Equine Pract 2005 Dec;21(3):609-25, vi.
                    pubmed: 16297724doi: 10.1016/j.cveq.2005.09.001google scholar: lookup
                  26. Benson BM, Byron CR, Pondenis H, Stewart AA. The effects of radial shock waves on the metabolism of equine cartilage explants in vitro.. N Z Vet J 2007 Feb;55(1):40-4.
                    pubmed: 17339915doi: 10.1080/00480169.2007.36733google scholar: lookup
                  27. Wang CJ, Wang FS, Yang KD, Weng LH, Hsu CC, Huang CS, Yang LC. Shock wave therapy induces neovascularization at the tendon-bone junction. A study in rabbits.. J Orthop Res 2003 Nov;21(6):984-9.
                    pubmed: 14554209doi: 10.1016/S0736-0266(03)00104-9google scholar: lookup
                  28. Wang FS, Yang KD, Chen RF, Wang CJ, Sheen-Chen SM. Extracorporeal shock wave promotes growth and differentiation of bone-marrow stromal cells towards osteoprogenitors associated with induction of TGF-beta1.. J Bone Joint Surg Br 2002 Apr;84(3):457-61.
                    pubmed: 12002511doi: 10.1302/0301-620x.84b3.11609google scholar: lookup
                  29. Byron CR, Benson BM, Stewart AA, Stewart MC. Effects of radial shock waves on membrane permeability and viability of chondrocytes and structure of articular cartilage in equine cartilage explants.. Am J Vet Res 2005 Oct;66(10):1757-63.
                    pubmed: 16273907doi: 10.2460/ajvr.2005.66.1757google scholar: lookup
                  30. Tarbell JM, Weinbaum S, Kamm RD. Cellular fluid mechanics and mechanotransduction.. Ann Biomed Eng 2005 Dec;33(12):1719-23.
                    pubmed: 16389519doi: 10.1007/s10439-005-8775-zgoogle scholar: lookup
                  31. Lischer CJ, Ringer SK, Schnewlin M, Imboden I, Fürst A, Stöckli M, Auer J. Treatment of chronic proximal suspensory desmitis in horses using focused electrohydraulic shockwave therapy.. Schweiz Arch Tierheilkd 2006 Oct;148(10):561-8.
                    pubmed: 17076464doi: 10.1024/0036-7281.148.10.561google scholar: lookup
                  32. Waguespack RW, Burba DJ, Hubert JD, Vidal MA, Lomax LG, Chirgwin SR, Lopez MJ. Effects of extracorporeal shock wave therapy on desmitis of the accessory ligament of the deep digital flexor tendon in the horse.. Vet Surg 2011 Jun;40(4):450-6.
                  33. Smith FL, Carper SW, Hall JS, Gilligan BJ, Madsen EL, Storm FK. Cellular effects of piezoelectric versus electrohydraulic high energy shock waves.. J Urol 1992 Feb;147(2):486-90.
                    pubmed: 1732629doi: 10.1016/s0022-5347(17)37285-3google scholar: lookup
                  34. Martini L, Giavaresi G, Fini M, Borsari V, Torricelli P, Giardino R. Early effects of extracorporeal shock wave treatment on osteoblast-like cells: a comparative study between electromagnetic and electrohydraulic devices.. J Trauma 2006 Nov;61(5):1198-206.
                  35. Lohrer H, Nauck T, Dorn-Lange NV, Schöll J, Vester JC. Comparison of radial versus focused extracorporeal shock waves in plantar fasciitis using functional measures.. Foot Ankle Int 2010 Jan;31(1):1-9.
                    pubmed: 20067715doi: 10.3113/FAI.2010.0001google scholar: lookup
                  36. Bräuner T, Brümmer F, Hülsĕr DF. Histopathology of shock wave treated tumor cell suspensions and multicell tumor spheroids.. Ultrasound Med Biol 1989;15(5):451-60.
                    pubmed: 2781678doi: 10.1016/0301-5629(89)90098-7google scholar: lookup
                  37. Brümmer F, Brenner J, Bräuner T, Hülser DF. Effect of shock waves on suspended and immobilized L1210 cells.. Ultrasound Med Biol 1989;15(3):229-39.
                    pubmed: 2741251doi: 10.1016/0301-5629(89)90067-7google scholar: lookup
                  38. Haake M, Wessel C, Wilke A. [Effects of extracorporeal shock waves (ESW) on human bone marrow cell cultures].. Biomed Tech (Berl) 1999 Oct;44(10):278-82.
                    pubmed: 10584402doi: 10.1515/bmte.1999.44.10.278google scholar: lookup
                  39. Dorotka R, Kubista B, Schatz KD, Trieb K. Effects of extracorporeal shock waves on human articular chondrocytes and ovine bone marrow stromal cells in vitro.. Arch Orthop Trauma Surg 2003 Sep;123(7):345-8.
                    pubmed: 12845449doi: 10.1007/s00402-003-0551-7google scholar: lookup
                  40. Leone L, Vetrano M, Ranieri D, Raffa S, Vulpiani MC, Ferretti A, Torrisi MR, Visco V. Extracorporeal Shock Wave Treatment (ESWT) improves in vitro functional activities of ruptured human tendon-derived tenocytes.. PLoS One 2012;7(11):e49759.
                  41. Mills JC, Stone NL, Pittman RN. Extranuclear apoptosis. The role of the cytoplasm in the execution phase.. J Cell Biol 1999 Aug 23;146(4):703-8.
                    pmc: PMC2156138pubmed: 10459006doi: 10.1083/jcb.146.4.703google scholar: lookup
                  42. Stenderup K, Justesen J, Clausen C, Kassem M. Aging is associated with decreased maximal life span and accelerated senescence of bone marrow stromal cells.. Bone 2003 Dec;33(6):919-26.
                    pubmed: 14678851doi: 10.1016/j.bone.2003.07.005google scholar: lookup
                  43. Risbud MV, Albert TJ, Guttapalli A, Vresilovic EJ, Hillibrand AS, Vaccaro AR, Shapiro IM. Differentiation of mesenchymal stem cells towards a nucleus pulposus-like phenotype in vitro: implications for cell-based transplantation therapy.. Spine (Phila Pa 1976) 2004 Dec 1;29(23):2627-32.
                  44. Longobardi L, O'Rear L, Aakula S, Johnstone B, Shimer K, Chytil A, Horton WA, Moses HL, Spagnoli A. Effect of IGF-I in the chondrogenesis of bone marrow mesenchymal stem cells in the presence or absence of TGF-beta signaling.. J Bone Miner Res 2006 Apr;21(4):626-36.
                    pubmed: 16598383doi: 10.1359/jbmr.051213google scholar: lookup
                  45. Laird DW. Life cycle of connexins in health and disease.. Biochem J 2006 Mar 15;394(Pt 3):527-43.
                    pmc: PMC1383703pubmed: 16492141doi: 10.1042/BJ20051922google scholar: lookup
                  46. Bruzzone R, White TW, Paul DL. Connections with connexins: the molecular basis of direct intercellular signaling.. Eur J Biochem 1996 May 15;238(1):1-27.
                  47. Krutovskikh V, Yamasaki H. The role of gap junctional intercellular communication (GJIC) disorders in experimental and human carcinogenesis.. Histol Histopathol 1997 Jul;12(3):761-8.
                    pubmed: 9225159

                  Citations

                  This article has been cited 27 times.
                  1. Chung DY, Ryu JK, Yin GN. Regenerative therapies as a potential treatment of erectile dysfunction.. Investig Clin Urol 2023 Jul;64(4):312-324.
                    doi: 10.4111/icu.20230104pubmed: 37417556google scholar: lookup
                  2. Fu S, Lan Y, Wang G, Bao D, Qin B, Zheng Q, Liu H, Wong VKW. External stimulation: A potential therapeutic strategy for tendon-bone healing.. Front Bioeng Biotechnol 2023;11:1150290.
                    doi: 10.3389/fbioe.2023.1150290pubmed: 37064229google scholar: lookup
                  3. Tan Y, Reed-Maldonado AB, Wang G, Banie L, Peng D, Zhou F, Chen Y, Wang Z, Lin G, Lue TF. Microenergy acoustic pulse therapy restores urethral wall integrity and continence in a rat model of female stress incontinence.. Neurourol Urodyn 2022 Aug;41(6):1323-1335.
                    doi: 10.1002/nau.24939pubmed: 35451520google scholar: lookup
                  4. Moretti L, Bizzoca D, Giancaspro GA, Cassano GD, Moretti F, Setti S, Moretti B. Biophysical Stimulation in Athletes' Joint Degeneration: A Narrative Review.. Medicina (Kaunas) 2021 Nov 4;57(11).
                    doi: 10.3390/medicina57111206pubmed: 34833424google scholar: lookup
                  5. Zhao Z, Wang Y, Wang Q, Liang J, Hu W, Zhao S, Li P, Zhu H, Li Z. Radial extracorporeal shockwave promotes subchondral bone stem/progenitor cell self-renewal by activating YAP/TAZ and facilitates cartilage repair in vivo.. Stem Cell Res Ther 2021 Jan 7;12(1):19.
                    doi: 10.1186/s13287-020-02076-wpubmed: 33413606google scholar: lookup
                  6. Salcedo-Jiménez R, Koenig JB, Lee OJ, Gibson TWG, Madan P, Koch TG. Extracorporeal Shock Wave Therapy Enhances the In Vitro Metabolic Activity and Differentiation of Equine Umbilical Cord Blood Mesenchymal Stromal Cells.. Front Vet Sci 2020;7:554306.
                    doi: 10.3389/fvets.2020.554306pubmed: 33344521google scholar: lookup
                  7. Kimura K, Tanaka Y. Facial Tightening Effects, Following Focused and Radial Acoustic Wave Therapy Assessment, Using a Three-Dimensional Digital Imaging.. Lasers Surg Med 2021 Jul;53(5):630-639.
                    doi: 10.1002/lsm.23353pubmed: 33211338google scholar: lookup
                  8. Bukowska J, Szóstek-Mioduchowska AZ, Kopcewicz M, Walendzik K, Machcińska S, Gawrońska-Kozak B. Adipose-Derived Stromal/Stem Cells from Large Animal Models: from Basic to Applied Science.. Stem Cell Rev Rep 2021 Jun;17(3):719-738.
                    doi: 10.1007/s12015-020-10049-ypubmed: 33025392google scholar: lookup
                  9. Liu DD, Ullah M, Concepcion W, Dahl JJ, Thakor AS. The role of ultrasound in enhancing mesenchymal stromal cell-based therapies.. Stem Cells Transl Med 2020 Aug;9(8):850-866.
                    doi: 10.1002/sctm.19-0391pubmed: 32157802google scholar: lookup
                  10. Cheng JH, Wang CJ, Chou WY, Hsu SL, Chen JH, Hsu TC. Comparison efficacy of ESWT and Wharton's jelly mesenchymal stem cell in early osteoarthritis of rat knee.. Am J Transl Res 2019;11(2):586-598.
                    pubmed: 30899364
                  11. Ayala-Cuellar AP, Kang JH, Jeung EB, Choi KC. Roles of Mesenchymal Stem Cells in Tissue Regeneration and Immunomodulation.. Biomol Ther (Seoul) 2019 Jan 1;27(1):25-33.
                    doi: 10.4062/biomolther.2017.260pubmed: 29902862google scholar: lookup
                  12. Zhang H, Li ZL, Yang F, Zhang Q, Su XZ, Li J, Zhang N, Liu CH, Mao N, Zhu H. Radial shockwave treatment promotes human mesenchymal stem cell self-renewal and enhances cartilage healing.. Stem Cell Res Ther 2018 Mar 9;9(1):54.
                    doi: 10.1186/s13287-018-0805-5pubmed: 29523197google scholar: lookup
                  13. Pöschke A, Krähling B, Failing K, Staszyk C. Molecular Characteristics of the Equine Periodontal Ligament.. Front Vet Sci 2017;4:235.
                    doi: 10.3389/fvets.2017.00235pubmed: 29376061google scholar: lookup
                  14. Seabaugh KA, Thoresen M, Giguère S. Extracorporeal Shockwave Therapy Increases Growth Factor Release from Equine Platelet-Rich Plasma In Vitro.. Front Vet Sci 2017;4:205.
                    doi: 10.3389/fvets.2017.00205pubmed: 29270410google scholar: lookup
                  15. Zhang J, Kang N, Yu X, Ma Y, Pang X. Radial Extracorporeal Shock Wave Therapy Enhances the Proliferation and Differentiation of Neural Stem Cells by Notch, PI3K/AKT, and Wnt/β-catenin Signaling.. Sci Rep 2017 Nov 10;7(1):15321.
                    doi: 10.1038/s41598-017-15662-5pubmed: 29127399google scholar: lookup
                  16. Chang MH, Lin SY. Development of an Omnidirectional-Capable Electromagnetic Shock Wave Generator for Lipolysis.. J Healthc Eng 2017;2017:9258512.
                    doi: 10.1155/2017/9258512pubmed: 29065664google scholar: lookup
                  17. Hsu YC, Wu WT, Chang KV, Han DS, Chou LW. Healing of Achilles tendon partial tear following focused shockwave: a case report and literature review.. J Pain Res 2017;10:1201-1206.
                    doi: 10.2147/JPR.S132951pubmed: 28579818google scholar: lookup
                  18. Jin Y, Xu L, Zhao Y, Wang M, Jin X, Zhang H. Endogenous Stem Cells Were Recruited by Defocused Low-Energy Shock Wave in Treating Diabetic Bladder Dysfunction.. Stem Cell Rev Rep 2017 Apr;13(2):287-298.
                    doi: 10.1007/s12015-016-9705-1pubmed: 27921202google scholar: lookup
                  19. Hochstrasser T, Frank HG, Schmitz C. Dose-dependent and cell type-specific cell death and proliferation following in vitro exposure to radial extracorporeal shock waves.. Sci Rep 2016 Aug 1;6:30637.
                    doi: 10.1038/srep30637pubmed: 27477873google scholar: lookup
                  20. Shan HT, Zhang HB, Chen WT, Chen FZ, Wang T, Luo JT, Yue M, Lin JH, Wei AY. Combination of low-energy shock-wave therapy and bone marrow mesenchymal stem cell transplantation to improve the erectile function of diabetic rats.. Asian J Androl 2017 Jan-Feb;19(1):26-33.
                    doi: 10.4103/1008-682X.184271pubmed: 27427555google scholar: lookup
                  21. Hu J, Liao H, Ma Z, Chen H, Huang Z, Zhang Y, Yu M, Chen Y, Xu J. Focal Adhesion Kinase Signaling Mediated the Enhancement of Osteogenesis of Human Mesenchymal Stem Cells Induced by Extracorporeal Shockwave.. Sci Rep 2016 Feb 11;6:20875.
                    doi: 10.1038/srep20875pubmed: 26863924google scholar: lookup
                  22. Leone L, Raffa S, Vetrano M, Ranieri D, Malisan F, Scrofani C, Vulpiani MC, Ferretti A, Torrisi MR, Visco V. Extracorporeal Shock Wave Treatment (ESWT) enhances the in vitro-induced differentiation of human tendon-derived stem/progenitor cells (hTSPCs).. Oncotarget 2016 Feb 9;7(6):6410-23.
                    doi: 10.18632/oncotarget.7064pubmed: 26843618google scholar: lookup
                  23. Arnhold S, Wenisch S. Adipose tissue derived mesenchymal stem cells for musculoskeletal repair in veterinary medicine.. Am J Stem Cells 2015;4(1):1-12.
                    pubmed: 25973326
                  24. Visco V, Vulpiani MC, Torrisi MR, Ferretti A, Pavan A, Vetrano M. Experimental studies on the biological effects of extracorporeal shock wave therapy on tendon models. A review of the literature.. Muscles Ligaments Tendons J 2014 Jul;4(3):357-61.
                    pubmed: 25489555
                  25. Lewallen EA, Riester SM, Bonin CA, Kremers HM, Dudakovic A, Kakar S, Cohen RC, Westendorf JJ, Lewallen DG, van Wijnen AJ. Biological strategies for improved osseointegration and osteoinduction of porous metal orthopedic implants.. Tissue Eng Part B Rev 2015 Apr;21(2):218-30.
                    doi: 10.1089/ten.TEB.2014.0333pubmed: 25348836google scholar: lookup
                  26. Weihs AM, Fuchs C, Teuschl AH, Hartinger J, Slezak P, Mittermayr R, Redl H, Junger WG, Sitte HH, Rünzler D. Shock wave treatment enhances cell proliferation and improves wound healing by ATP release-coupled extracellular signal-regulated kinase (ERK) activation.. J Biol Chem 2014 Sep 26;289(39):27090-27104.
                    doi: 10.1074/jbc.M114.580936pubmed: 25118288google scholar: lookup
                  27. Knobloch K, Joest B, Krämer R, Vogt PM. Cellulite and focused extracorporeal shockwave therapy for non-invasive body contouring: a randomized trial.. Dermatol Ther (Heidelb) 2013 Dec;3(2):143-55.
                    doi: 10.1007/s13555-013-0039-5pubmed: 24297647google scholar: lookup