Extracorporeal shock wave therapy ameliorates hindlimb ischemia in rabbits
Extracorporeal shock wave therapy ameliorates hindlimb ischemia in rabbits
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DOI：
10.1620/tjem.214.151
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发表时间：
2008-02-01
影响因子：
2.2
通讯作者：
Shimokawa, Hiroaki
中科院分区：
文献类型：
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作者：
Oi, Keiji;Fukumoto, Yoshihiro;Shimokawa, Hiroaki
我们最近证明，低能量体外心脏冲击波（SW）治疗可以改善猪慢性心肌缺血模型的心肌灌注和心功能，也可以改善严重冠状动脉疾病患者的心肌缺血。本研究旨在探讨我们的SW疗法是否也能有效改善家兔后肢缺血。后肢缺血是通过手术切除整个单侧兔股动脉。术后1周，对缺血区进行SW （n = 9）或假治疗（n = 9），每周3次，连续3周。SW治疗3周后，SW组侧支动脉发育、缺血性/非缺血性髂总动脉流量比、缺血性/非缺血性后肢血压比、缺血性肌肉毛细血管密度均较对照组显著升高，提示SW治疗诱导了治疗性血管生成。重要的是，没有不良反应，如肌肉损伤，出血，或血栓形成，与治疗中注意到。最后，我们研究了内皮一氧化氮合成（eNOS）和血管内皮生长因子（VEGF）在sw诱导的血管生成机制中的作用。与对照组相比，SW组后肢缺血肌肉中eNOS和VEGF蛋白表达水平有升高的趋势。这些结果表明，我们的低能量SW治疗外周动脉疾病也是有效和安全的。
We have recently demonstrated that the low-energy extracorporeal cardiac shock wave (SW) therapy improves myocardial perfusion and cardiac function in a porcine model of chronic myocardial ischemia and also ameliorates myocardial ischemia in patients with severe coronary artery disease. The present study was designed to examine whether our SW therapy also is effective to ameliorate hindlimb ischemia in rabbits. Hindlimb ischemia was made by surgical excision of the entire unilateral rabbit femoral artery. One week after the operation, we performed the SW (n = 9) or sham-therapy (n = 9) to the ischemic region 3 times a week for 3 weeks. Three weeks after the SW therapy, the development of collateral arteries, the flow ratio of the ischemic/non-ischemic common iliac arteries, the blood pressure ratio of the ischemic/non-ischemic hindlimb, and the capillary density in the ischemic muscles were all significantly increased in the SW group compared with the control group, indicating that the SW therapy induced therapeutic angiogenesis. Importantly, no adverse effect, such as muscle damage, hemorrhage, or thrombosis, was noted with the therapy. Finally, we examined the role of endothelial nitric oxide synthesis (eNOS) and vascular endothelial growth factor (VEGF) in the mechanisms of SW-induced angiogenesis on day 28. The expression levels of eNOS and VEGF proteins in ischemic hindlimb muscles tended to be increased in the SW group compared with the control group. These results suggest that our low-energy SW therapy also is effective and safe for the treatment of peripheral artery disease.