Clinical applications of low-intensity pulsed ultrasound and its potential role in urology

Abstract

Low-intensity pulsed ultrasound (LIPUS) is a form of ultrasound that delivered at a much lower intensity (<3 W/cm2) than traditional ultrasound energy and output in the mode of pulse wave, and it is typically used for therapeutic purpose in rehabilitation medicine. LIPUS has minimal thermal effects due to its low intensity and pulsed output mode, and its non-thermal effects which is normally claimed to induce therapeutic changes in tissues attract most researchers’ attentions. LIPUS have been demonstrated to have a rage of biological effects on tissues, including promoting bone-fracture healing, accelerating soft-tissue regeneration, inhibiting inflammatory responses and so on. Recent studies showed that biological effects of LIPUS in healing morbid body tissues may be mainly associated with the upregulation of cell proliferation through activation of integrin receptors and Rho/ROCK/Src/ERK signaling pathway, and with promoting multilineage differentiation of mesenchyme stem/progenitor cell lines through ROCK-Cot/Tpl2-MEK-ERK signaling pathway. Hopefully, LIPUS may become an effective clinical procedure for the treatment of urological diseases, such as chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), erectile dysfunction (ED), and stress urinary incontinence (SUI) in the field of urology. It still needs an intense effort for basic-science and clinical investigators to explore the biomedical applications of ultrasound.

The Current Status of Stem-Cell Therapy in Erectile Dysfunction: A Review

“…On the horizon for the treatment of ED is low-intensity pulsed ultrasound (LIPUS), a non-invasive method of upregulating endogenous mesenchymal stem cells [71]. Studies have shown that LIPUS stimulates cell proliferation through activation of integrin receptors and the Rho/ROCK/Src/ERK signaling pathway [72], and by promoting the multilineage differentiation of mesenchymal stem/progenitor cell lines through the ROCK-Cot/Tpl2-MEK-ERK signaling pathway [73].…”

Ultrasound-Assisted Magnetic Nanoparticle-Based Gene Delivery

“…LIPUS is a particular type of ultrasounds shown in Fig 1a, which generates at a frequency of 1-3 MHz and repeats at 1 kHz with a duty cycle of 20% to deliver a low-intensity pulsed wave [27]. It has been proven to be very safe for human use for many aspects of the medical applications, such as bone healing [28], inflammation inhibiting [29], soft-tissue regeneration [30], and the induction of cell-membrane porosity. LIPUS has also been proven to help division and proliferation in many types of cells, such as algal cell [39,40], stem/progenitor cell [37] and mammalian cell [38] and can also increase CHO cells growth and antibody production [35], increase cell permeability [39] and enhance gene delivery by using microbubble [36].…”

Inhibitory effects of low-intensity pulsed ultrasound sonication on the proliferation of osteosarcoma cells

“…LIPUS was previously demonstrated to promote bone formation and accelerate bone maturation in cases of bone fracture (6,7), distraction osteogenesis (8) and delayed fracture union (9). LIPUS appears to act by affecting the biological mechanisms of cell proliferation, gene regulation and cell differentiation (10). Osteosarcoma is characterized by the production of malignant osteoid matrix and differentiation of mesenchymal osteoblasts (11).…”