Histotripsy for collagenous tissues: a novel therapeutic approach to tendon injury
胶原组织的组织解剖学:一种治疗肌腱损伤的新方法
基本信息
- 批准号:10113612
- 负责人:
- 金额:$ 21.52万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-05-09 至 2022-10-31
- 项目状态:已结题
- 来源:
- 关键词:AccountingAddressAdoptionAdultAftercareAnimal ModelAnimalsBiological MarkersBlood capillariesBlood specimenClinicalClinical TreatmentCollagenContralateralDevelopmentElastic TissueElementsExposure toFailureFocused Ultrasound TherapyFrequenciesFutureGelGoalsHeartHeatingHistologicHumanImmune responseInflammationInjuryInterventionJoint structure of shoulder regionLengthLimb structureLiverMechanicsMedicalMethodsModalityModelingMuscleMusculoskeletal PainNeedlesOperative Surgical ProceduresOrganOutcomePatientsPhysiologic pulsePrevalencePropertyProtocols documentationPuncture procedureRattusRelaxationResistanceRoleRotator CuffSamplingShockShoulder PainSourceStressTechniquesTendon InjuriesTendon structureTestingTherapeuticTherapeutic InterventionTimeTissuesTreatment CostTreatment ProtocolsUltrasonographyUpper ExtremityWorkclinical developmentclinical translationcohortcommon treatmentexperiencehealinghuman modelimprovedin vivoinjuredinnovationjoint mobilizationmechanical loadmechanical propertiesmillisecondmusculoskeletal injurynovelnovel therapeutic interventionpressurerepairedresponserotator cuff tearsuccesssupraspinatus muscletechnique developmenttissue injurytooltreatment site
项目摘要
PROJECT SUMMARY/ABSTRACT
High intensity focused ultrasound (HIFU) modalities, such as histotripsy, have been used successfully to
emulsify soft organs, like the heart and liver, but highly collagenous tissues, like tendons, have proven resistant
to mechanical emulsification with histotripsy. Recently, histotripsy was shown to initiate an immune response
and release biomarkers. If histotripsy can successfully emulsify collagenous tissues, it has the potential to
initiate a healing response by inducing inflammation and subsequently release healing factors. With the high
clinical prevalence of tendon injuries, establishing whether histotripsy can create microdamage in collagenous
tendons to promote healing has the potential for long-term impact.
Rotator cuff tear is a highly prevalent cause of shoulder pain, which is why patients seek medical treatment.
Surgical repair is a common treatment for rotator cuff tear, but fails up to 90% of the time, likely from the high
mechanical loading the rotator cuff experiences in its dual roles with joint mobility and stability. Others have
used dry needling (DN), which involves repeated puncturing of the tendon with a fine-gauge needle to induce
microdamage and release healing factors, but adoption of this approach is not wide-spread. Development of
techniques that can noninvasively promote healing while maintaining mechanical integrity of the muscle-tendon
units are desperately needed. Demonstration of histotripsy therapy for collagenous tissue emulsification would
provide a clinically transferrable tool to immediately supplement current treatment options of a contemporary
clinical problem.
Here, we propose to establish non-invasive histotripsy protocols that produce better indicators of tendon
healing compared to DN, while simultaneously maintaining tendon's mechanical properties. These goals will be
accomplished by: 1) testing novel histotripsy protocols to induce microdamage in collagen gels and ex vivo rat
tendons; 2) evaluating the mechanical properties of tendon following histotripsy and DN, and develop a finite
element model to evaluate parameters and perform predictive analyses; and 3) determining whether histotripsy
enhances collagenous tissue healing in vivo in a pilot survival study in rats. This innovative work seeks to
demonstrate that histotripsy can successfully emulsify collagenous tissues, and enhance the release of healing
factors. Once feasibility has been demonstrated, the methods and models developed in this project will be
scaled to examine histotripsy in larger animal models and humans. Long term, outcomes will lead to histotripsy
emulsification of other collagenous tissues as well as clinical translation of tendon healing protocols, which has
the potential to revolutionize treatment for rotator cuff tear and other collagenous tissue injuries.
项目摘要/摘要
高强度聚焦超声(HIFU)方式,如组织检查,已成功地用于
乳化软组织,如心脏和肝脏,但高度胶原性组织,如肌腱,已被证明具有抵抗力
组织学机械乳化术。最近,组织学被证明可以启动一种免疫反应
并释放生物标记物。如果组织尿道学能够成功地乳化胶原组织,它就有可能
通过诱导炎症来启动愈合反应,然后释放愈合因子。伴随着高潮
肌腱损伤的临床发生率,确定组织碎石术是否可以造成胶原的微小损伤
肌腱促进愈合有可能产生长期影响。
肩袖撕裂是导致肩痛的一个非常普遍的原因,这就是为什么患者会寻求治疗。
手术修复肩袖撕裂是一种常见的治疗方法,但失败的几率高达90%,很可能是从高位。
机械负荷肩袖在关节活动度和稳定性方面具有双重作用。其他人则有
使用干针刺法,即用细针反复刺穿肌腱以诱导
微损伤和释放愈合因素,但采用这种方法并不广泛。发展中的
在保持肌腱机械完整性的同时非侵入性地促进愈合的技术
单位是非常需要的。组织学疗法在胶原组织乳化术中的应用
提供临床上可转移的工具,立即补充当代患者的当前治疗选择
临床问题。
在这里,我们建议建立非侵入性组织摩擦检查方案,以产生更好的肌腱指标。
与糖尿病肾病相比,愈合,同时保持肌腱的力学性能。这些目标将是
通过:1)测试新的组织摩擦学方案在胶原凝胶和体外大鼠中诱导微损伤
肌腱;2)通过组织学检查和糖尿病肾病评估肌腱的力学性能,并建立有限的
用于评估参数和执行预测分析的元素模型;以及3)确定组织摩擦学
在大鼠的一项先导性生存研究中促进体内胶原组织的愈合。这项创新的工作旨在
证明组织摩擦能成功地乳化胶原组织,促进愈合的释放
各种因素。一旦可行性被证明,在这个项目中开发的方法和模型将是
在较大的动物模型和人类中进行了组织试验。从长远来看,结果将导致组织旅行
其他胶原组织的乳化以及肌腱愈合方案的临床翻译,它具有
有可能对肩袖撕裂和其他胶原组织损伤的治疗产生革命性的影响。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Julianna Simon其他文献
Julianna Simon的其他文献
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{{ truncateString('Julianna Simon', 18)}}的其他基金
Focused ultrasound-induced cavitation in elastic, anisotropic tissues: a treatment for tendinopathies
弹性各向异性组织中聚焦超声诱导空化:肌腱病的治疗方法
- 批准号:
10708190 - 财政年份:2022
- 资助金额:
$ 21.52万 - 项目类别:
Focused ultrasound-induced cavitation in elastic, anisotropic tissues: a treatment for tendinopathies
弹性各向异性组织中聚焦超声诱导空化:肌腱病的治疗方法
- 批准号:
10586628 - 财政年份:2022
- 资助金额:
$ 21.52万 - 项目类别:
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