Shockwave Therapy Modulates the Expression of BMP2 for Prevention of Bone and Cartilage Loss in the Lower Limbs of Postmenopausal Osteoporosis Rat Model

Shan-Ling Hsu,Chieh-Cheng Hsu,Shun-Wun Jhan,Ching-Jen Wang,Jih-Yang Ko,Jai-Hong Cheng,Meng-Shiou Lee,Wen-Yi Chou,Tsai-Chin Hsu

doi:10.3390/biomedicines8120614

Abstract

Osteoporosis (OP) causes bone loss and weakness, increasing the risk of bone fracture. In this study, rats were divided into Sham, OP, SW(F) (0.25 mJ/mm2 with 1600 impulses to the left medial femur), and SW(T) (0.25 mJ/mm2 with 1600 impulses to the left medial tibia). The bone strength results following SW(T) were better than SW(F) in the modulus, extension at peak load, handleability, and strain at break. SW(T) had the best prevention for bone loss in both lower limbs of ovariectomized (OVX) rats. The cartilage cellular matrixes of both knees were improved in SW(T) and SW(F) compared to that of OP. Serum bone morphogenetic protein 2 (BMP2) in rats undergoing SW(T) or SW(F) was significantly improved compared to that in Sham and OP. The expressions of BMP2, BMP4, and SMAD family member 4 (Smad4) in addition to the Wnt family member 3A (Wnt3a) and Cyclin D1 signaling key factors were significantly induced in the cartilage of both knees by shockwave (SW). SW(T) presented the best efficacy to induce serum BMP2 to prevent bone loss from both lower limbs. Here, we display the protective effects of SW therapy to induce BMP2, BMP4, Smad4, Wnt3a, and Cyclin D1 signaling factors for cartilage loss in both knees of OVX rats.

Highlights

Osteoporosis (OP) is a common bone disorder that escalates with age, especially in women after menopause [1]
The results displayed a protective effect in bone strength in the SW(T) and SW(F) groups, and the improvement in bone strength was greater in the SW(T) group than the SW(F) group
The results demonstrated that treatment administered in the SW(T) group had better protective effects than in the SW(F) group in terms of improving bone recovery of both lower limbs in OVX rats

Summary

Introduction

Osteoporosis (OP) is a common bone disorder that escalates with age, especially in women after menopause [1]. OP causes a decrease in bone mineral density (BMD), deterioration of bone quality, and micro-architectural fractures of the bone. Many studies have been performed to assess potential approaches to the prevention or possible regression of postmenopausal bone loss, such as pharmacologic therapy, traditional Chinese medicine, Biomedicines 2020, 8, 614; doi:10.3390/biomedicines8120614 www.mdpi.com/journal/biomedicines. Biomedicines 2020, 8, 614 physical exercise, mechanical stimulation, and electrical stimulation [4,5,6]. Pharmaceutical approaches include antiresorptive and stimulating agents, whereas nonpharmaceutical approaches include exercise programs and biophysical interventions [7,8]. Shockwave (SW) therapy, vibration, magnetic fields, and low-intensity pulsed ultrasound (LIPUS) are biophysical interventions that provide options for local treatment of OP at common fracture sites. The long-range or systemic effects of these methods are unclear and require further assessment

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Conclusion