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BioMed Research International Volume 2017 ,2017-10-15
Extracorporeal Shock Wave Rebuilt Subchondral Bone In Vivo and Activated Wnt5a/Ca2+ Signaling In Vitro
Research Article
Lai Yu 1 , 2 Shuitao Liu 3 , 4 Zhe Zhao 4 Lin Xia 2 Haochong Zhang 4 Jing Lou 4 Jun Yang 4 Gengmei Xing 2 Gengyan Xing 4
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DOI:10.1155/2017/1404650
Received 2017-04-02, accepted for publication 2017-08-29, Published 2017-08-29
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摘要

Background. This study aimed to identify the optimal extracorporeal shock wave (ESW) intensity and to investigate its effect on subchondral bone rebuilt in vivo and Wnt5a/Ca2+ signaling in vitro using an osteoarthritis (OA) rat model and bone marrow mesenchymal stem cells (BMMSCs), respectively. Methods. OA rats treated with (OA + ESW group) or without (OA group) ESW (n=12/group) were compared with healthy controls (control group, n=12). Gait patterns and subchondral trabecular bone changes were measured. Western blot and quantitative real-time polymerase chain reaction detected protein expression and gene transcription, respectively. Results. The gait disturbances of OA + ESW group were significantly improved compared with the OA group at 6th and 8th weeks. The micro-CT analysis indicated that the BMD, BSV/BV, BV/TV, Tr.S, and Tr.Th are significantly different between OA group and OA + ESW group. Expression of Wnt5a was increased rapidly after ESW treatment at 0.6 bar and peaked after 30 min. Conclusions. ESW were positive for bone remodeling in joint tibial condyle subchondral bone of OA rat. ESW prevented histological changes in OA and prevented gait disturbance associated with OA progression. Optimal intensity of ESW induced changes in BMMSCs via activation of the Wnt5a/Ca2+ signaling pathway.

授权许可

Copyright © 2017 Lai Yu et al. 2017
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

图表

Longitudinal changes of gait parameters in rats. Imbalance in various indicators according to depth at 0th week (0 w), 2nd week (2 w), 4th week (4 w), 6th week (6 w), and 8th week (8 w) was measured by the gait analysis paradigm in rats after OA models were established successfully. Values presented are mean ± 95% confidence interval of the corresponding numerical. In the OA and OA + ESW group, significant differences were seen compared with the control. (a) The swing speed (mm/s) at 2 w, 6 w, and 8 w (n=12; P∗<0.05 and P∗∗<0.01 compared with the control group). (b) The max contact area (mm2) at 4 w, 6 w, and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (c) The single stance (s) at 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (d) The duty cycle (%) at 6 w and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (e) The stand (s) at 6 w and 8 w (n=12; P∗<0.05 and P∗∗<0.01 compared with the control group). (f) The swing (s) at 6 w and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). No difference was observed within groups but for OA + ESW groups # represents the time point at which significant differences were seen in OA + ESW group compared with the baseline (0 w). The other essential results were attached in supplemental information (Figure S3). Error bar is standard error of mean [SEM].

Longitudinal changes of gait parameters in rats. Imbalance in various indicators according to depth at 0th week (0 w), 2nd week (2 w), 4th week (4 w), 6th week (6 w), and 8th week (8 w) was measured by the gait analysis paradigm in rats after OA models were established successfully. Values presented are mean ± 95% confidence interval of the corresponding numerical. In the OA and OA + ESW group, significant differences were seen compared with the control. (a) The swing speed (mm/s) at 2 w, 6 w, and 8 w (n=12; P∗<0.05 and P∗∗<0.01 compared with the control group). (b) The max contact area (mm2) at 4 w, 6 w, and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (c) The single stance (s) at 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (d) The duty cycle (%) at 6 w and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (e) The stand (s) at 6 w and 8 w (n=12; P∗<0.05 and P∗∗<0.01 compared with the control group). (f) The swing (s) at 6 w and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). No difference was observed within groups but for OA + ESW groups # represents the time point at which significant differences were seen in OA + ESW group compared with the baseline (0 w). The other essential results were attached in supplemental information (Figure S3). Error bar is standard error of mean [SEM].

Longitudinal changes of gait parameters in rats. Imbalance in various indicators according to depth at 0th week (0 w), 2nd week (2 w), 4th week (4 w), 6th week (6 w), and 8th week (8 w) was measured by the gait analysis paradigm in rats after OA models were established successfully. Values presented are mean ± 95% confidence interval of the corresponding numerical. In the OA and OA + ESW group, significant differences were seen compared with the control. (a) The swing speed (mm/s) at 2 w, 6 w, and 8 w (n=12; P∗<0.05 and P∗∗<0.01 compared with the control group). (b) The max contact area (mm2) at 4 w, 6 w, and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (c) The single stance (s) at 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (d) The duty cycle (%) at 6 w and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (e) The stand (s) at 6 w and 8 w (n=12; P∗<0.05 and P∗∗<0.01 compared with the control group). (f) The swing (s) at 6 w and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). No difference was observed within groups but for OA + ESW groups # represents the time point at which significant differences were seen in OA + ESW group compared with the baseline (0 w). The other essential results were attached in supplemental information (Figure S3). Error bar is standard error of mean [SEM].

Longitudinal changes of gait parameters in rats. Imbalance in various indicators according to depth at 0th week (0 w), 2nd week (2 w), 4th week (4 w), 6th week (6 w), and 8th week (8 w) was measured by the gait analysis paradigm in rats after OA models were established successfully. Values presented are mean ± 95% confidence interval of the corresponding numerical. In the OA and OA + ESW group, significant differences were seen compared with the control. (a) The swing speed (mm/s) at 2 w, 6 w, and 8 w (n=12; P∗<0.05 and P∗∗<0.01 compared with the control group). (b) The max contact area (mm2) at 4 w, 6 w, and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (c) The single stance (s) at 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (d) The duty cycle (%) at 6 w and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (e) The stand (s) at 6 w and 8 w (n=12; P∗<0.05 and P∗∗<0.01 compared with the control group). (f) The swing (s) at 6 w and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). No difference was observed within groups but for OA + ESW groups # represents the time point at which significant differences were seen in OA + ESW group compared with the baseline (0 w). The other essential results were attached in supplemental information (Figure S3). Error bar is standard error of mean [SEM].

Longitudinal changes of gait parameters in rats. Imbalance in various indicators according to depth at 0th week (0 w), 2nd week (2 w), 4th week (4 w), 6th week (6 w), and 8th week (8 w) was measured by the gait analysis paradigm in rats after OA models were established successfully. Values presented are mean ± 95% confidence interval of the corresponding numerical. In the OA and OA + ESW group, significant differences were seen compared with the control. (a) The swing speed (mm/s) at 2 w, 6 w, and 8 w (n=12; P∗<0.05 and P∗∗<0.01 compared with the control group). (b) The max contact area (mm2) at 4 w, 6 w, and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (c) The single stance (s) at 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (d) The duty cycle (%) at 6 w and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (e) The stand (s) at 6 w and 8 w (n=12; P∗<0.05 and P∗∗<0.01 compared with the control group). (f) The swing (s) at 6 w and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). No difference was observed within groups but for OA + ESW groups # represents the time point at which significant differences were seen in OA + ESW group compared with the baseline (0 w). The other essential results were attached in supplemental information (Figure S3). Error bar is standard error of mean [SEM].

Longitudinal changes of gait parameters in rats. Imbalance in various indicators according to depth at 0th week (0 w), 2nd week (2 w), 4th week (4 w), 6th week (6 w), and 8th week (8 w) was measured by the gait analysis paradigm in rats after OA models were established successfully. Values presented are mean ± 95% confidence interval of the corresponding numerical. In the OA and OA + ESW group, significant differences were seen compared with the control. (a) The swing speed (mm/s) at 2 w, 6 w, and 8 w (n=12; P∗<0.05 and P∗∗<0.01 compared with the control group). (b) The max contact area (mm2) at 4 w, 6 w, and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (c) The single stance (s) at 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (d) The duty cycle (%) at 6 w and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). (e) The stand (s) at 6 w and 8 w (n=12; P∗<0.05 and P∗∗<0.01 compared with the control group). (f) The swing (s) at 6 w and 8 w (n=12, P∗<0.05 and P∗∗<0.01 compared with the control group). No difference was observed within groups but for OA + ESW groups # represents the time point at which significant differences were seen in OA + ESW group compared with the baseline (0 w). The other essential results were attached in supplemental information (Figure S3). Error bar is standard error of mean [SEM].

Characterization of OA-induced subchondral bone changes in rats. (a) TBSB = three-dimensional reconstruction of trabecular bone of the subchondral bone. Micro-CT images of the joint tibial condyle subchondral bone at 8 weeks were different in the control versus ESW stimulation groups. Structural integrity of the subchondral bone was enhanced in the OA + ESW group compared with the OA group. (b) Micro-CT analysis of subchondral bone to evaluate knee joint function after ESW treatment in the MIA-induced OA rat model. BMD, BSA/BV, BV/TV, Tr.N, Tr.S, and Tr.Th data for all groups. P∗<0.05 and P∗∗<0.01 compared with control (error bar is SEM).

Characterization of OA-induced subchondral bone changes in rats. (a) TBSB = three-dimensional reconstruction of trabecular bone of the subchondral bone. Micro-CT images of the joint tibial condyle subchondral bone at 8 weeks were different in the control versus ESW stimulation groups. Structural integrity of the subchondral bone was enhanced in the OA + ESW group compared with the OA group. (b) Micro-CT analysis of subchondral bone to evaluate knee joint function after ESW treatment in the MIA-induced OA rat model. BMD, BSA/BV, BV/TV, Tr.N, Tr.S, and Tr.Th data for all groups. P∗<0.05 and P∗∗<0.01 compared with control (error bar is SEM).

Histopathologic assessment of cartilage and subchondral bone. (a) Hematoxylin-eosin (HE) staining of cartilage and subchondral bone at the 8th week after OA models were established successfully. (b) Wnt5a immunohistochemical (IHC) staining of subchondral bone of knee joint tibial condyle from 8-week control or experimental groups. The red arrows represent staining positive cells. (c) The OA group showed significant increases in Mankin score that was comparable to that of control. The ESW appeared effective in OA + ESW group compared with OA group (P∗∗<0.05; error bar is SEM). (d) The number of Wnt5a-positive cells within the selected area was counted. Significant decreases in Wnt5a in the OA group compared with the control. The OA + ESW group showed significant increases in Wnt5a that were comparable to the OA (P∗∗<0.05, error bar is SEM).

Histopathologic assessment of cartilage and subchondral bone. (a) Hematoxylin-eosin (HE) staining of cartilage and subchondral bone at the 8th week after OA models were established successfully. (b) Wnt5a immunohistochemical (IHC) staining of subchondral bone of knee joint tibial condyle from 8-week control or experimental groups. The red arrows represent staining positive cells. (c) The OA group showed significant increases in Mankin score that was comparable to that of control. The ESW appeared effective in OA + ESW group compared with OA group (P∗∗<0.05; error bar is SEM). (d) The number of Wnt5a-positive cells within the selected area was counted. Significant decreases in Wnt5a in the OA group compared with the control. The OA + ESW group showed significant increases in Wnt5a that were comparable to the OA (P∗∗<0.05, error bar is SEM).

Histopathologic assessment of cartilage and subchondral bone. (a) Hematoxylin-eosin (HE) staining of cartilage and subchondral bone at the 8th week after OA models were established successfully. (b) Wnt5a immunohistochemical (IHC) staining of subchondral bone of knee joint tibial condyle from 8-week control or experimental groups. The red arrows represent staining positive cells. (c) The OA group showed significant increases in Mankin score that was comparable to that of control. The ESW appeared effective in OA + ESW group compared with OA group (P∗∗<0.05; error bar is SEM). (d) The number of Wnt5a-positive cells within the selected area was counted. Significant decreases in Wnt5a in the OA group compared with the control. The OA + ESW group showed significant increases in Wnt5a that were comparable to the OA (P∗∗<0.05, error bar is SEM).

Histopathologic assessment of cartilage and subchondral bone. (a) Hematoxylin-eosin (HE) staining of cartilage and subchondral bone at the 8th week after OA models were established successfully. (b) Wnt5a immunohistochemical (IHC) staining of subchondral bone of knee joint tibial condyle from 8-week control or experimental groups. The red arrows represent staining positive cells. (c) The OA group showed significant increases in Mankin score that was comparable to that of control. The ESW appeared effective in OA + ESW group compared with OA group (P∗∗<0.05; error bar is SEM). (d) The number of Wnt5a-positive cells within the selected area was counted. Significant decreases in Wnt5a in the OA group compared with the control. The OA + ESW group showed significant increases in Wnt5a that were comparable to the OA (P∗∗<0.05, error bar is SEM).

Wnt5a expression following the intervention with various ESW energy levels. (a, b) BMMSCs were exposed to ESW (0.2 bar, 0.4 bar, and 0.6 bar, 6 Hz, and 1000 shots) and detected at various time points as indicated. The expression of Wnt5a was analyzed by western blots. (c) BMMSCs were exposed to ESW (0.2 bar, 0.4 bar, and 0.6 bar, 6 Hz, and 1000 shots) and detected at various time points as indicated. The mRNA was extracted from the cell lysates, and Q-RT-PCR with the primers of Wnt5a and GAPDH (internal control) was performed as described in Methods. The quantitative data were shown as 2-ΔΔct (n=4). (d) Immunofluorescence of Wnt5a in BMMSCs. BMMSCs were treated with or without ESW (0.6 bar, 6 Hz, and 1000 s). Scale bar = 100 µm. Thirty minutes after ESW intervention, cells were prepared for immunofluorescence and pictures were taken under a fluorescence microscope using a ×40 objective.

Wnt5a expression following the intervention with various ESW energy levels. (a, b) BMMSCs were exposed to ESW (0.2 bar, 0.4 bar, and 0.6 bar, 6 Hz, and 1000 shots) and detected at various time points as indicated. The expression of Wnt5a was analyzed by western blots. (c) BMMSCs were exposed to ESW (0.2 bar, 0.4 bar, and 0.6 bar, 6 Hz, and 1000 shots) and detected at various time points as indicated. The mRNA was extracted from the cell lysates, and Q-RT-PCR with the primers of Wnt5a and GAPDH (internal control) was performed as described in Methods. The quantitative data were shown as 2-ΔΔct (n=4). (d) Immunofluorescence of Wnt5a in BMMSCs. BMMSCs were treated with or without ESW (0.6 bar, 6 Hz, and 1000 s). Scale bar = 100 µm. Thirty minutes after ESW intervention, cells were prepared for immunofluorescence and pictures were taken under a fluorescence microscope using a ×40 objective.

Wnt5a expression following the intervention with various ESW energy levels. (a, b) BMMSCs were exposed to ESW (0.2 bar, 0.4 bar, and 0.6 bar, 6 Hz, and 1000 shots) and detected at various time points as indicated. The expression of Wnt5a was analyzed by western blots. (c) BMMSCs were exposed to ESW (0.2 bar, 0.4 bar, and 0.6 bar, 6 Hz, and 1000 shots) and detected at various time points as indicated. The mRNA was extracted from the cell lysates, and Q-RT-PCR with the primers of Wnt5a and GAPDH (internal control) was performed as described in Methods. The quantitative data were shown as 2-ΔΔct (n=4). (d) Immunofluorescence of Wnt5a in BMMSCs. BMMSCs were treated with or without ESW (0.6 bar, 6 Hz, and 1000 s). Scale bar = 100 µm. Thirty minutes after ESW intervention, cells were prepared for immunofluorescence and pictures were taken under a fluorescence microscope using a ×40 objective.

Wnt5a expression following the intervention with various ESW energy levels. (a, b) BMMSCs were exposed to ESW (0.2 bar, 0.4 bar, and 0.6 bar, 6 Hz, and 1000 shots) and detected at various time points as indicated. The expression of Wnt5a was analyzed by western blots. (c) BMMSCs were exposed to ESW (0.2 bar, 0.4 bar, and 0.6 bar, 6 Hz, and 1000 shots) and detected at various time points as indicated. The mRNA was extracted from the cell lysates, and Q-RT-PCR with the primers of Wnt5a and GAPDH (internal control) was performed as described in Methods. The quantitative data were shown as 2-ΔΔct (n=4). (d) Immunofluorescence of Wnt5a in BMMSCs. BMMSCs were treated with or without ESW (0.6 bar, 6 Hz, and 1000 s). Scale bar = 100 µm. Thirty minutes after ESW intervention, cells were prepared for immunofluorescence and pictures were taken under a fluorescence microscope using a ×40 objective.

CaMKII, PKC, and PLC expression following the intervention with various ESW energy levels. ESW increases the mRNA levels of CaMKII and PLC and decreases the mRNA levels of PKC at different time point in BMMSCs. (a) Western blot assay of CaMKII, PKC, and PLC receptor protein expression. GAPDH served as loading control. BMMSCs were exposed to ESW (0.2 bar, 0.4 bar, and 0.6 bar, 6 Hz, and 1000 shots) and detected at various time points as indicated. (b, c, d) BMMSCs were exposed to ESW (0.2 bar, 0.4 bar, and 0.6 bar, 6 Hz, and 1000 shots) and detected at various time points as indicated. The mRNA was extracted from the cell lysates, and Q-RT-PCR with the primers of CaMKII, PKC, PLC, and GAPDH (internal control) was performed as described in Methods. The quantitative data were shown as 2-ΔΔct (n=4).

CaMKII, PKC, and PLC expression following the intervention with various ESW energy levels. ESW increases the mRNA levels of CaMKII and PLC and decreases the mRNA levels of PKC at different time point in BMMSCs. (a) Western blot assay of CaMKII, PKC, and PLC receptor protein expression. GAPDH served as loading control. BMMSCs were exposed to ESW (0.2 bar, 0.4 bar, and 0.6 bar, 6 Hz, and 1000 shots) and detected at various time points as indicated. (b, c, d) BMMSCs were exposed to ESW (0.2 bar, 0.4 bar, and 0.6 bar, 6 Hz, and 1000 shots) and detected at various time points as indicated. The mRNA was extracted from the cell lysates, and Q-RT-PCR with the primers of CaMKII, PKC, PLC, and GAPDH (internal control) was performed as described in Methods. The quantitative data were shown as 2-ΔΔct (n=4).

CaMKII, PKC, and PLC expression following the intervention with various ESW energy levels. ESW increases the mRNA levels of CaMKII and PLC and decreases the mRNA levels of PKC at different time point in BMMSCs. (a) Western blot assay of CaMKII, PKC, and PLC receptor protein expression. GAPDH served as loading control. BMMSCs were exposed to ESW (0.2 bar, 0.4 bar, and 0.6 bar, 6 Hz, and 1000 shots) and detected at various time points as indicated. (b, c, d) BMMSCs were exposed to ESW (0.2 bar, 0.4 bar, and 0.6 bar, 6 Hz, and 1000 shots) and detected at various time points as indicated. The mRNA was extracted from the cell lysates, and Q-RT-PCR with the primers of CaMKII, PKC, PLC, and GAPDH (internal control) was performed as described in Methods. The quantitative data were shown as 2-ΔΔct (n=4).

CaMKII, PKC, and PLC expression following the intervention with various ESW energy levels. ESW increases the mRNA levels of CaMKII and PLC and decreases the mRNA levels of PKC at different time point in BMMSCs. (a) Western blot assay of CaMKII, PKC, and PLC receptor protein expression. GAPDH served as loading control. BMMSCs were exposed to ESW (0.2 bar, 0.4 bar, and 0.6 bar, 6 Hz, and 1000 shots) and detected at various time points as indicated. (b, c, d) BMMSCs were exposed to ESW (0.2 bar, 0.4 bar, and 0.6 bar, 6 Hz, and 1000 shots) and detected at various time points as indicated. The mRNA was extracted from the cell lysates, and Q-RT-PCR with the primers of CaMKII, PKC, PLC, and GAPDH (internal control) was performed as described in Methods. The quantitative data were shown as 2-ΔΔct (n=4).

通讯作者

Gengyan Xing.General Hospital of Chinese People’s Army Police Force, Beijing, China.xgy1350138@163.com

推荐引用方式

Lai Yu,Shuitao Liu,Zhe Zhao,Lin Xia,Haochong Zhang,Jing Lou,Jun Yang,Gengmei Xing,Gengyan Xing. Extracorporeal Shock Wave Rebuilt Subchondral Bone In Vivo and Activated Wnt5a/Ca2+ Signaling In Vitro. BioMed Research International ,Vol.2017(2017)

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