Yi-Ran Wang et al., 2024: Safety of low-intensity extracorporeal shock wave therapy in prostate disorders: in vitro and in vivo evidence
Yi-Ran Wang 1, Bin Feng 2, Wen-Bo Qi 3, Yu-Wen Gong 1, Xiang-Bin Kong 1, Hui Cheng 4, Zhi-Long Dong 1, Jun-Qiang Tian 1, Zhi-Ping Wang 1
1Institute of Urology, Gansu Province Clinical Research Center for Urinary System Disease, The Second Hospital and Clinical Medical School, Lanzhou University, Lanzhou 730000, China.
2Department of Urology, Gansu Provincial Hospital, Lanzhou 730000, China.
3Department of Radiotherapy, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China.
4Department of Urology, Gansu Provincial Second People's Hospital, Lanzhou 730000, China.
Abstract
Recent evidence suggests that low-intensity extracorporeal shock wave therapy (Li-ESWT) is a promising treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS); however, its safety in pelvic organs, particularly prostate tissues and cells, remains unclear. The current study evaluates the risks of prostate cell damage or oncogenesis following the administration of Li-ESWT for prostatitis. To this end, a robust in vitro model (Cell Counting Kit-8 [CCK-8] assay, clone formation assay, cell scratch assay, lactate dehydrogenase [LDH] release assay, flow cytometry, and immunoblotting assay) was designed to examine the effects of Li-ESWT on cell proliferation, clonogenicity, migration, membrane integrity, and DNA damage. Exome sequencing of Li-ESWT-treated cells was performed to determine the risk of carcinogenesis. Furthermore, an in vivo rat model ( n = 20) was employed to assess the effects of Li-ESWT on cancer biomarkers (carcinoembryonic antigen [CEA], Ki67, proliferating cell nuclear antigen [PCNA], and gamma-H2A histone family member X, phosphorylation of the H2AX Ser-139 [ γ -H2AX]) in prostate tissue. Based on our findings, Li-ESWT promotes cellular growth and motility without inducing significant cell membrane or DNA damage or alterations. Genetic analyses did not demonstrate an increase in mutations, and no damage to prostate tissue or upregulation of cancer biomarkers was detected in vivo. This comprehensive in vitro and in vivo assessment confirms the safety of Li-ESWT in managing prostate disorders.
Asian J Androl. 2024 Aug 6. doi: 10.4103/aja202448. Online ahead of print. PMID: 39107962
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Comments 1
Introduction: The study assesses the potential risks of low-intensity extracorporeal shock wave therapy (Li-ESWT) in treating prostate disorders, particularly chronic prostatitis and pelvic pain. The research explores whether Li-ESWT could induce cellular damage or oncogenesis in prostate tissues.
Methods: In an in vitro model, the researchers used several assays to evaluate cell proliferation, migration, membrane integrity, and DNA damage. These tests found that Li-ESWT promoted cell growth and mobility but did not cause significant damage to cell membranes or DNA, nor did it lead to mutations that could cause cancer. Similarly, in an in vivo rat model, the therapy did not induce detectable damage to prostate tissue or cause changes in cancer biomarkers.
Results: The study's results suggest that Li-ESWT is a safe treatment option for prostate disorders, showing no evidence of promoting cancer or damaging prostate tissue in both cellular and animal models.
Conclusions: These findings support the continued use of Li-ESWT in clinical settings for managing conditions like chronic prostatitis, with no apparent risk of oncogenesis or tissue damage. Therapeutic interventions that result in cellular damage can induce genetic mutations and initiate abnormal cell proliferation, which may ultimately result in cancer. In the present study, we employed in vitro and in vivo models to delve into the biological impacts of Li-ESWT on cells, revealing that Li-ESWT does not elicit cellular damage. These findings provide robust evidence that validates the safety of Li-ESWT for treating CP/CPPS.
This should be substituted by further clinical results.
Jens Rassweiler