Abstract
Extracorporeal shock wave therapy (ESWT) has been shown to induce different biological effects on a variety of cells, including regulation and stimulation of their function and metabolism. ESWT can promote different biological responses such as proliferation, migration, and regenerations of cells. Recent studies have shown that mesenchymal stromal cells (MSCs) secrete factors that enhance the regeneration of tissues, stimulate proliferation and differentiation of cells, and decrease inflammatory and immune reactions. Clinically, the combination of these two therapies has been used as a treatment for tendon and ligament lesions in horses; however, there is no scientific evidence supporting this combination of therapies in vivo. Therefore, the objectives of the study were to evaluate the effects of ESWT on equine umbilical cord blood mesenchymal stromal cells (CB-MSCs) proliferative, metabolic, migrative, differentiation, and immunomodulatory properties in vitro. Three equine CB-MSC cultures from independent donors were treated using an electrohydraulic shock wave generator attached to a water bath. All experiments were performed as triplicates. Proliferation, viability, migration and immunomodulatory properties of the cells were evaluated. Equine CB-MSCs were induced to evaluate their trilineage differentiation potential. ESWT treated cells had increased metabolic activity, showed positive adipogenic, osteogenic, and chondrogenic differentiation, and showed higher potential for differentiation toward the adipogenic and osteogenic cell fates. ESWT treated cells showed similar immunomodulatory properties to none-ESWT treated cells. Equine CB-MSCs are responsive to ESWT treatment and showed increased metabolic, adipogenic and osteogenic activity, but unaltered immunosuppressive properties. In vivo studies are warranted to determine if synergistic effects occur in the treatment of musculoskeletal injuries if ESWT and equine CB-MSC therapies are combined.
Highlights
Extracorporeal shock wave therapy (ESWT) is one of the leading treatments of certain orthopedic diseases in humans such as plantar fasciitis and lateral epicondylitis; more recently, it has been used to treat Achilles and patellar tendinopathies [1, 2]
We demonstrated that equine CB-mesenchymal stromal cells (MSCs) respond to ESWT stimulation
The proliferation of these cells was not adversely influenced by shockwave treatment, but the metabolic activity of the treated cells was increased. This increased metabolic activity observed in equine cord blood mesenchymal stromal cells (CB-MSCs) after ESWT is in agreement with other studies that reported increased proliferation, migration, and metabolic activity of human and rat adipose-derived stromal cells (ASCs) [8, 10]
Summary
Extracorporeal shock wave therapy (ESWT) is one of the leading treatments of certain orthopedic diseases in humans such as plantar fasciitis and lateral epicondylitis; more recently, it has been used to treat Achilles and patellar tendinopathies [1, 2]. ESWT is a common treatment for tendon and ligament injuries in the horse suspensory ligament desmitis [3] At present, it is used as adjunct therapy for the management of osteoarthritis in horses [4]. The shape of the generated acoustic wave is characterized by an initial positive rapid phase, of high amplitude, followed by a sudden phase of mild negative pressure, and returns to the ambient values. Their peak pressure is high—up to 100 mpa (500 bar) with a rapid rise (
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