Extracorporeal shock wave therapy ameliorates secondary lymphedema by promoting lymphangiogenesis

Kubo, Masayuki; Li, Tao‐Sheng; Kamota, Takahiro; Ohshima, Mako; Shirasawa, Bungo; Hamano, Kimikazu

doi:10.1016/j.jvs.2010.03.017

Cited by 46 publications

(45 citation statements)

References 33 publications

(45 reference statements)

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“…Neurogenesis is also promoted by the FGF-2 (fibroblast growth factor) (Laird, 1995;Mudò, 2009), which is also activated by ESW. The stimulation of the endothelial lymphatic growth factor (ELGF) has a positive effect on lymph angiogenesis (Kubo, 2010;Serizawa, 2011). Following application of ESW to a necrosis of the hip, a systemic increase in the concentration of NO, VEGF …”

Section: Discussionmentioning

confidence: 99%

Focused low-energy extracorporeal shock waves with distally symmetric polyneuropathy (DSPNP): A pilot study

Lohse-Busch

Marlinghaus

Reime

et al. 2014

NRE

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BACKGROUND: Incidental observations led to the question whether ESWT could alleviate the still difficult-to-improve symptoms of DSPNP. METHODS: In a pilot study, out of an original 24 patients with DSPNP, 10 patients with diabetes mellitus were excluded because of their inhomogeneous performances. Of the 14 patients remaining, 6 received one sham treatment at the beginning. All 14 patients were then treated with ESWT to the soles of the feet using the Duolith ® shock wave generator (Storz Medical) 3 times weekly for 2 weeks. The assessments were carried out before and after the sham treatment, the first ESWT (question: before and after the first ESWT or only after?) and after 2, 4 and 8 weeks. RESULTS:The placebo treatment did not influence pain or paraesthesia. After the 2 weeks of ESWT, intensity decreased from 100% to 23.6%, rising again after 8 weeks to 45.7% of the original state (p < 0.01). The placebo treatment did however have a great effect on walking abilities. The results of ESWT did not become significant until the 8th week.Step length improved by 14.6% (p < 0.001), walking speed by 24.8% (p < 0.001) and time of dual support during the stance phase of the gait declined by 12.2% (p < 0.009). CONCLUSIONS: Despite the small number of cases, it appears that ESWT can alleviate some of the symptoms of DSPNP.

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Section: Discussionmentioning

confidence: 99%

Focused low-energy extracorporeal shock waves with distally symmetric polyneuropathy (DSPNP): A pilot study

Lohse-Busch

Marlinghaus

Reime

et al. 2014

NRE

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“…Therefore, ESWT may result in an increase in lymphatic regulators, such as VEGF-C and VEGFR-3, around the damaged lymphatic vessels. This notion was supported by the recent study of Kubo et al [15]. However, this physical reaction has not yet been proven to exist for lymphangiogenesis, the regeneration of lymphatic vessels.…”

Section: Discussionmentioning

confidence: 81%

“…ESWT treatment was then regularly administered under anesthesia every 3 days for 4 weeks. The dose intensity (ESWT energy level and frequency) is well established based on extensive animal use testing [15,17,18]. …”

Section: Methodsmentioning

confidence: 99%

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Extracorporeal Shock Wave Therapy Combined with Vascular Endothelial Growth Factor-C Hydrogel for Lymphangiogenesis

Kim

Lee

et al. 2012

J Vasc Res

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Background/Aims: Lymphedema is a clinically incurable disease that occurs commonly after lymph node dissection and/or irradiation. Several studies have recently demonstrated that extracorporeal shock wave therapy (ESWT) could promote lymphangiogenesis associated with expression of vascular endothelial growth factor (VEGF)-C. This research concerned primarily the synergistic effect of ESWT combined with VEGF-C incorporated hydrogel (VEGF-C hydrogel) combination therapy for promoting lymphangiogenesis and ultimately alleviating lymphedema. Methods: The VEGF-C hydrogel was applied to the injury site in a mouse model of lymphedema and then regularly underwent ESWT (0.05 mJ/mm², 500 shots) every 3 days for 4 weeks. Results: Four weeks after the treatment, mice treated with VEGF-C hydrogel and ESWT showed signs of the greatest decrease in edema/collagenous deposits when compared with the other experimental group. LYVE-1-positive vessels also revealed that the VEGF-C/ESWT group had significantly induced the growth of new lymphatic vessels compared to the other groups. Western blot analysis showed that expression of VEGF-C (1.24-fold) and VEGF receptor-3 (1.41-fold) was significantly increased in the VEGF-C/ESWT group compared to the normal group. Conclusion: These results suggested that VEGF-C and ESWT had a synergistic effect and were very effective in alleviating the symptoms of lymphedema and promoting lymphangiogenesis.

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“…Neurogenesis is also promoted by FGF-2 (fibroblast growth factor) (Laird, 1995;Mudò, 2009), which is also stimulated by ESW. Lymphangiogenesis is positively influenced via the stimulation of endothelial lymph vessel growth factor (eLGF) (Kubo, 2010). Following application of ESW to a hip necrosis, a systemic increase in the concentration of NO, VEGF, and FGF was detectable in serum over a period of four weeks, and is no longer significantly elevated after 3 months (Wang, 2011).…”

Section: Introductionmentioning

confidence: 99%

Symptomatic treatment of unresponsive wakefulness syndrome with transcranially focused extracorporeal shock waves

Lohse-Busch

Reime

Falland

2014

NRE

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OBJECTIVE: Can stimulation of nerve growth factors by focused transcranial extracorporeal shock wave therapy (TESWT) be made effective for persons within unresponsive wakefulness syndrome (apallic syndrome)? DESIGN: Between eight and 18 years after the brain lesion, five patients with unresponsive wakefulness syndrome of differing severity received TESWT with the device Duolith (Storz Medical) during four-week physicomedical complex therapies. In the previous years they had been treated with the same complex therapies without TESWT. The vigilance did not change. RESULTS: After two-four years and an average of 5.2 treatment series, the patients' abilities improved by 135.9% on the German Coma Remission Scale (KRS) and by 43.6% on the Glasgow Coma Scale. In the motor area of the KRS, the patients improved by 64.3%. Three PEG feeding tubes could be removed, nonverbal communication initiated four times. CONCLUSION: In this longitudinal observation study, focused TESWT stimulated vigilance in patients with unresponsive wakefulness syndrome. The precise neurophysiological effects remain to be verified by a study of the clinical results.

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Extracorporeal shock wave therapy ameliorates secondary lymphedema by promoting lymphangiogenesis

Abstract: Extracorporeal shock wave therapy promotes lymphangiogenesis and ameliorates secondary lymphedema, suggesting that extracorporeal shock wave therapy may be a novel, feasible, effective, and noninvasive treatment for lymphedema.

Cited by 46 publications

References 33 publications

Focused low-energy extracorporeal shock waves with distally symmetric polyneuropathy (DSPNP): A pilot study

Focused low-energy extracorporeal shock waves with distally symmetric polyneuropathy (DSPNP): A pilot study

Extracorporeal Shock Wave Therapy Combined with Vascular Endothelial Growth Factor-C Hydrogel for Lymphangiogenesis

Symptomatic treatment of unresponsive wakefulness syndrome with transcranially focused extracorporeal shock waves

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