Waugh 2015 | Biological effect
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Waugh CM, Morrissey D, Jones E, Riley GP, Langberg H, Screen HR. In vivo biological response to extracorporeal shockwave therapy in human tendinopathy. Eur Cell Mater. 2015 May 15;29:268-80
In vivo experimental study. 13 healthy individuals and 6 patients with patellar or Achilles tendinopathy received a single session of radial ESWT to the mid-portion of the tendon. Outcomes The study investigated the acute response of inflammatory cytokines associated with mechanical loading, repair processes and tenocyte health and also matrix metalloproteases (MMPs), which are implicated in the homeostasis of tissue regeneration. • Inflammatory cytokines (IL- 1β, IL -2, IL-6 and IL-8) • Matrix metalloproteinase activity Results • IL-6 and IL-8 concentrations were elevated immediately after ESWT and remained significantly elevated for four hours post-ESWT (p < 0.001). • Pro-forms of MMP-2 and -9 also increased after ESWT (p < 0.003) •
Key message The present study demonstrates an immediate and significant increase in some inflammatory and metabolic markers in response to ESWT in both healthy and pathological tendons. This suggest that the mechanical stimulus provided by ESWT might aid the initiation of tendon regeneration in tendinopathy by promoting pro- inflammatory and catabolic processes that are associated with removing damaged matrix constituents.
The biological response to ESWT treatment could be differentiated between possible responders and non- responders
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