Evaluation of angiogenic and anti-inflammatory effects of extracorporeal shockwave therapy in animal model of ischemic skin flaps

Beograd : [V. N. Antonić]

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Biologija - Neuroimunobiologija / Biology - Neuroimmunobiology

Skoro 30 godina terapija zvučnim udarnim talasima (engl. Extracorporeal Shock Wave Therapy, ESWT) je u upotrebi u kliničkoj praksi kao efikasan tretman za razbijanje kamena u urinarnom traktu. Ova tehnologija je kasnije razvijena i kao efikasan neinvazivan tretman za različite indikacije u ortopediji i traumatologiji uključujući i komplikovane rane koje ne zarastaju. Udarni zvučni talasi su tranzijentni, kratkotrajni akustički pulsevi sa visokim pikom pritiska, koji se dostiže u veoma kratkom vremenu, mereno nanosekunadama (jedan bilioniti deo sekunde). Udarni zvučni talasi koji se koriste u medicini se generišu putem tri tipa generatora i fizičkih rešenja: elektrohidraulički, piezoelektrični i elektromagnetni čiji je krajnji cilj da prenese fizičku energiju do ciljnog tkiva. Odloženo zarastanje, ili rane koje ne zarastaju predstavljaju veliki teret za svakog pacijenta, značajno umanjujući njegov kvalitet života. Velika briga o pacijentu i rani je neophodna u ovim slučajevima i ovo je veliki problem za društvo u smislu smanjene produktivnosti ljudi kao i smislu velikih finansijskih izdataka za zdravstvo. Sa druge strane, teške povrede kao one koje se viđaju u oružanim sukobima i saobraćajnim nesrećama predstavljaju glavni uzrok smrti u mlađoj adultnoj populaciji. Tehnološki napredak, i napredak u dostupnim terapeuticima, koji dovodi do inicijalnog povećanja preživljavanja pacijenata nije praćen razvojem lekova koji su usmereni protiv moguće prateće sistemske inflamacije, koja često progresira do sindroma sistemskog inflamatornog odgovora i sindroma propadanja organskih sistema koji mogu dovesti i do smrtnog ishoda. Zbog svega prethodno pomenutog, finansijski pristupačni, neinvazivni i efikasni tretmani su neophodni da bi se postiglo ubrzavanje i potpuno zarastanje problematičnih rana kao i redukovala cena lečenja. Zbog toga je neophodno utvrditi potencijalnu primenljivost ESWT u relevantnim animalnim modelima i kod pacijenata, i ispitati i razjasniti biološke mehanizme ove terapije. Nekoliko eksperimentalnih i kliničkih studija je pokazalo efikasnost ESWT za ubrzavanje opopravka ostećenog tkiva i regeneraciju različitih rana. Međutim, biološki mehanizmi kojima se ovi procesi ubrzavaju su ostali neobjašnjeni...

For almost 30 years, extracorporeal shock wave therapy (ESWT) has been implemented clinically and has proven to be an effective treatment for urinary stones. This technology has also emerged as an efficacious non - invasive treatment modality for several orthopedic and traumatic indications including problematic soft tissue wounds. Shock waves are produced as transient short - term acoustic pulses with high peak pressure and a very rapid rise to peak pressure on the order of magnitude of nanoseconds (one billionth of a second). Sho ck waves for use in medicine can be generated using different physical principles - electro - hydraulic, piezoelectric and electromagnetic – with the goal of delivering physical energy to target tissue of interest in order to create a desired biological effect. Delayed/non - healing or chronic wounds constitute a burden for each patient affected, significantly impairing quality of life (QOL). Intensive multi - modality wound care is required, and this places an enormous burden on society in terms of lost producti vity and healthcare costs. Severe traumatic wounds seen in civilian and combat related injuries are a major cause of death amongst the younger population. Technological and therapeutic advances that lead to improved initial survival of patients with life - t hreatening injuries were unparalleled in therapeutics development to fight concomitant systemic inflammation that accompanies these injuries. This systemic inflammatory response to wounding often leads to development of a well - known syndrome - systemic inf lammatory response syndrome (SIRS) - and can progress to multiple organ dysfunction syndrome (MODS) and death. Because of all of the aforementioned, cost - effective, non - invasive, and efficacious treatments are imperative to achieve both (accelerated and co mplete) healing of problematic wounds and reduce treatment - related costs to the human and the healthcare system. Therefore, the potential of therapeutic shock wave application in relevant animal models and patients has to be determined in addition to the e lucidation of the biological mechanisms involved. 5 Several experimental and clinical studies have demonstrated efficacy of extracorporeal shock wave therapy in terms of accelerating tissue repair and regenerating various types of wounds. However, the bio logical mechanism(s) by which this treatment modality exerts its therapeutic effects remains unclear...

Extracorporeal shockwave Therapy, ESWT, anti-inflamatorni efekti, kožni režnjevi, angiogeneza, inflamacija, sistemska inflamacija, gastrointestinalni dismotilitet, postoperativni ileus

Extracorporeal Shockwave Therapy, ESWT, anti-inflammatory effects, skin flap, angiogenesis, inflammation, systemic inflammation, gastrointestinal dismotility, postoperative ileus

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