Kuang-Shun Chueh et al., 2024: Low-Intensity Extracorporeal Shock Wave Therapy Ameliorates Detrusor Hyperactivity with Impaired Contractility via Transient Potential Vanilloid Channels: A Rat Model for Ovarian Hormone Deficiency
Kuang-Shun Chueh 1 2 3 , Tai-Jui Juan 4 , Jian-He Lu 5 , Bin-Nan Wu 6 , Rong-Jyh Lin 7 8 , Jing-Wen Mao 4 , Hung-Yu Lin 9 10 11 , Shu-Mien Chuang 3 , Chao-Yuan Chang 1 8 12 , Mei-Chen Shen 3 , Ting-Wei Sun 3 , Yung-Shun Juan 1 3
1Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
2Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80661, Taiwan.
3Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan.
4Department of Medicine, National Defense Medical College, Taipei 11490, Taiwan.
5Emerging Compounds Research Center, Department of Environmental Science and Engineering, College of Engineering, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan.
6Department of Pharmacology, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
7Department of Parasitology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
8Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
9School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan.
10Division of Urology, Department of Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan.
11Division of Urology, Department of Surgery, E-Da Hospital, Kaohsiung 824005, Taiwan.
12Department of Anatomy, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
Abstract
This study explores low-intensity extracorporeal shock wave therapy (LiESWT)'s efficacy in alleviating detrusor hyperactivity with impaired contractility (DHIC) induced by ovarian hormone deficiency (OHD) in ovariectomized rats. The rats were categorized into the following four groups: sham group; OVX group, subjected to bilateral ovariectomy (OVX) for 12 months to induce OHD; OVX + SW4 group, underwent OHD for 12 months followed by 4 weeks of weekly LiESWT; and OVX + SW8 group, underwent OHD for 12 months followed by 8 weeks of weekly LiESWT. Cystometrogram studies and voiding behavior tracing were used to identify the symptoms of DHIC. Muscle strip contractility was evaluated through electrical-field, carbachol, ATP, and KCl stimulations. Western blot and immunofluorescence analyses were performed to assess the expressions of various markers related to bladder dysfunction. The OVX rats exhibited significant bladder deterioration and overactivity, alleviated by LiESWT. LiESWT modified transient receptor potential vanilloid (TRPV) channel expression, regulating calcium concentration and enhancing bladder capacity. It also elevated endoplasmic reticulum (ER) stress proteins, influencing ER-related Ca2+ channels and receptors to modulate detrusor muscle contractility. OHD after 12 months led to neuronal degeneration and reduced TRPV1 and TRPV4 channel activation. LiESWT demonstrated potential in enhancing angiogenic remodeling, neurogenesis, and receptor response, ameliorating DHIC via TRPV channels and cellular signaling in the OHD-induced DHIC rat model.
Int J Mol Sci. 2024 Apr 30;25(9):4927. doi: 10.3390/ijms25094927. PMID: 38732143
PMCID: PMC11084446
Comments 1
The article explores the potential of Low-Intensity Extracorporeal Shock Wave Therapy (LiESWT) as a treatment for detrusor hyperactivity with impaired contractility (DHIC) in rats with ovarian hormone deficiency (OHD), which mimics conditions such as overactive bladder (OAB) in humans. The study involved four groups of rats, including those that underwent ovariectomy (OVX) to induce hormone deficiency and received different durations of LiESWT treatment. The LiESWT was performed by a DUOLITH SD1-TOP-focused shock wave system (STORZ MEDICAL, AG, Kreuzlingen, Switzerland). The energy of the LiESWT was set at an intensity of 0.12 mJ/mm2, a frequency of 3 Hz, and to 300 impulse shock waves
This is a very sophisticated animal study. The key findings include:
• Ovariectomized (OVX) rats exhibited significant bladder dysfunction, including overactivity and impaired contractility representing an adequate model for OAB.
• LiESWT was effective in improving bladder function by modulating transient receptor potential vanilloid (TRPV) channels, which regulate calcium concentrations, thus improving bladder capacity.
• The therapy also improved the expression of endoplasmic reticulum (ER) stress proteins and Ca2+ channels involved in muscle contractility.
• OHD led to neuronal degeneration and reduced activation of key TRPV channels (TRPV1 and TRPV4), affecting bladder function.
• LiESWT was able to reverse some of these effects by enhancing neurogenesis, receptor responses, and angiogenic remodeling, ultimately improving DHIC.
The study suggests that LiESWT could be a promising non-invasive treatment for conditions like OAB and DHIC in clinical practice, especially those related to hormone deficiency.
Jens Rassweiler