The effect of focused extracorporeal shock wave therapy on collagen matrix and gene expression in normal tendons and ligaments.
Abstract: Extracorporeal shock wave therapy (ESWT) is frequently used in equine practice, but little is known about its biological action. Objective: To study the effects of ESWT on matrix structure and gene expression levels in normal, physiologically loaded tendinous structures in ponies. Methods: Six Shetland ponies, free of lameness and with ultrasonographically normal flexor and extensor tendons and suspensory ligaments (SL), were used. ESWT was applied at the origin of the suspensory ligament and the mid-metacarpal region of the superficial digital flexor tendon (SDFT) 6 weeks prior to sample taking, and at the mid-metacarpal region (ET) and the insertion on the extensor process of the distal phalanx (EP) of the common digital extensor tendon 3 h prior to tendon sampling. In all animals one forelimb was treated and the other limb was used as control. After euthanasia, tendon tissue was harvested for real-time PCR to determine gene expression levels and additional samples were taken for histological evaluation and biochemical analyses Results: Histologically a disorganisation of the normal collagen structure was observed 3 h after ESWT, remnants of which were still visible after 6 weeks. While degraded collagen levels showed an increase at 3 h post treatment (P= 0.012) they were reduced at 6 weeks post ESWT (P = 0.039). Gene expression for both COL1 (P = 0.004) and MMP14 (P = 0.020) was upregulated at 6 weeks after treatment. Conclusions: Exposure of normal tendinous tissue to ESWT is not uneventful; it leads to a disorganisation of matrix structure and changes in degraded collagen levels. The upregulation of COL1 expression 6 weeks after ESWT may be indicative for repair. Conclusions: The observed disorganisation of the collagen network warrants caution when using ESWT. Exposing noninjured tissue to ESWT should be avoided and it may be advisable to restrict exercise in recently treated patients. However, the induced tissue disorganisation might also be a trigger for repair in chronic tendinopathies.
Publication Date: 2009-07-01 PubMed ID: 19562893DOI: 10.2746/042516409x370766Google Scholar: Lookup
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Summary
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The research study investigates the impact of extracorporeal shock wave therapy (ESWT) on the structure and genetic expressions in the tendons and ligaments of ponies. The results reveal that exposure to ESWT could lead to a disorganization of the collagen structure, changes in degraded collagen levels, and potential repair, which necessity caution while using ESWT.
Objective and Methods
- The objective of the research was to study the effects of Extracorporeal Shock Wave Therapy (ESWT) on the matrix structure and gene expression levels in normal, physiologically loaded tendinous structures in ponies.
- Six healthy Shetland ponies were used for the study. ESWT was applied at different locations on the tendons and ligaments of the ponies’ forelimbs.
- One of the forelimbs was treated while the other was used as a control. Tendon tissue was harvested for real-time PCR testing to determine gene expression levels.
- Histological evaluation and biochemical analyses were also conducted using tissue samples.
Results
- There was a visible disorganization of the collagen structure three hours after ESWT was applied, and traces of this disorganization were still evident six weeks post-treatment.
- The levels of degraded collagen in the tendon increased at three hours post-treatment and were reduced at six weeks after ESWT was applied.
- The gene expression for both COL1 and MMP14 was upregulated six weeks after ESWT treatment.
Conclusions
- The study concluded that the exposure of normal tendinous tissue to ESWT has significant effects, leading to disorganisation of the collagen matrix structure and changes in degraded collagen levels.
- The observed upregulation of COL1 gene expression suggested that ESWT could also trigger a repair process in the affected tendinous tissues.
- The disorganisation of the collagen network in the tendon warrants caution when using ESWT treatment. Thus, exposing non-injured tissue to ESWT should be avoided and exercise should be limited in recently treated patients.
- However, this induced tissue disorganisation may also serve as a possible trigger for repair in chronic tendinopathies.
Cite This Article
APA
Bosch G, de Mos M, van Binsbergen R, van Schie HT, van de Lest CH, van Weeren PR.
(2009).
The effect of focused extracorporeal shock wave therapy on collagen matrix and gene expression in normal tendons and ligaments.
Equine Vet J, 41(4), 335-341.
https://doi.org/10.2746/042516409x370766 Publication
Researcher Affiliations
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 12, 3584 CM Utrecht, The Netherlands.
MeSH Terms
- Animals
- Collagen / metabolism
- Gene Expression Profiling / veterinary
- Gene Expression Regulation / physiology
- High-Energy Shock Waves
- Horses / physiology
- Ligaments / physiology
- Male
- Tendons / physiology
Citations
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