Low-intensity pulsed ultrasound promotes spinal fusion by regulating macrophage polarization

Zhang, Zicheng; Yang, Yilin; Li, Bo; Hu, Xu-Ce; Xu, Shuai; Wang, Fei; Li, Ming; Zhou, Xin; Wei, Xianzhao

doi:10.1016/j.biopha.2019.109499

Cited by 33 publications

(29 citation statements)

References 23 publications

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“…Thirteen preclinical articles describing 225 total animals were ultimately included in the final review (Figure 1). 14,29,35–45 Of the 12 excluded studies, the reasons for exclusion were full English‐language text unavailability (n = 5) and irrelevant end points (n = 7).…”

Section: Resultsmentioning

confidence: 99%

“…The primary mechanisms by which LIPUS is believed to stimulate osseous formation are summarized in Table 3, 45,47–61 as well as conceptually illustrated in Figure 4. Pressure waves produced by LIPUS in biological tissues are detected by integrins, which translate the biomechanical input to biochemical signaling cascades.…”

Section: Discussionmentioning

confidence: 99%

“…LIPUS has also been shown to promote vascular formation, including via the upregulation of provascular growth factors and activation of the YAP/TAZ pathway that is central to angiogenesis 59,60 . Recent evidence also suggests that LIPUS may mediate macrophage polarization, 45 altering the cytokine milieu to favor bone formation.…”

Section: Discussionmentioning

confidence: 99%

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Low‐Intensity Pulsed Ultrasound as a Potential Adjuvant Therapy to Promote Spinal Fusion

Cottrill

Downey

Pennington

et al. 2020

J of Ultrasound Medicine

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Despite extensive research, nonunion continues to affect a nontrivial proportion of patients undergoing spinal fusion. Recently, preclinical studies have suggested that low‐intensity pulsed ultrasound (LIPUS) may increase rates of spinal fusion. In this study, we summarized the available in vivo literature evaluating the effect of LIPUS on spinal fusion and performed a meta‐analysis of the available data to estimate the degree to which LIPUS may mediate higher fusion rates. Across 13 preclinical studies, LIPUS was associated with a 9‐fold increase in the odds of successful spinal fusion. Future studies are necessary to establish the benefit of LIPUS on spinal fusion in clinical populations.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Low‐Intensity Pulsed Ultrasound as a Potential Adjuvant Therapy to Promote Spinal Fusion

Cottrill

Downey

Pennington

et al. 2020

J of Ultrasound Medicine

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“…The production of exosomes was also reported to possibly mitigate tumor necrosis factor α–induced endothelial inflammation by inhibiting the nuclear factor κB signaling pathway in human umbilical vein endothelial cells 25 . The potential of LIPUS to modulate the phenotype of inflammatory cells, reducing the number of neutrophils and inflammatory macrophages, was also observed in a preclinical model of spinal fusion 26 and muscle injury 19 . Reduced levels of inflammatory cyclooxygenase 2 after LIPUS were observed in animal models of rheumatoid arthritis 27 and tendon, skeletal muscle, ligament, and tendon‐bone junction injuries, 22 although increased production of cyclooxygenase 2 was reported in LIPUS‐treated fractures 28 …”

Section: Figurementioning

confidence: 88%

Can Low‐Intensity Pulsed Ultrasound Treat Discrete Pulmonary Lesions in Patients With COVID‐19?

Prada

Cogliati

et al. 2020

J of Ultrasound Medicine

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“…There are several hurdles that the application of LIPUS in a clinical setting encounters. The first is the definition of a fresh fracture, which discriminates cases older than 1 week Zura et al, 2017). This might prevent some potential candidates from receiving non-invasive treatment strategies such as LIPUS.…”

Section: Lipus and Fresh Fractures: Surgery Vs Castmentioning

confidence: 99%

Pulsed ultrasound for bone regeneration – outcomes and hurdles in the clinical application: a systematic review

Puts

Vico²,

Beilfuss³

et al. 2021

eCM

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Impaired bone-fracture healing is associated with long-term musculoskeletal disability, pain and psychological distress. Low-intensity pulsed ultrasound (LIPUS) is a non-invasive and side-effect-free treatment option for fresh, delayed- and non-union bone fractures, which has been used in patients since the early 1990s. Several clinical studies, however, have questioned the usefulness of the LIPUS treatment for the regeneration of long bones, including those with a compromised healing. This systematic review addresses the hurdles that the clinical application of LIPUS encounters. Low patient compliance might disguise the effects of the LIPUS therapy, as observed in several studies. Furthermore, large discrepancies in results, showing profound LIPUS effects in regeneration of small-animal bones in comparison to the clinical studies, could be caused by the suboptimal parameters of the clinical set-up. This raises the question of whether the so-called “acoustic dose” requires a thorough characterisation to reveal the mechanisms of the therapy. The adequate definition of the acoustic dose is especially important in the elderly population and patients with underlying medical conditions, where distinct biological signatures lead to a delayed regeneration. Non-industry-funded, randomised, double-blind, placebo-controlled clinical trials of the LIPUS application alone and as an adjuvant treatment for bones with complicated healing, where consistent control of patient compliance is ensured, are required.

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Low-intensity pulsed ultrasound promotes spinal fusion by regulating macrophage polarization

Cited by 33 publications

References 23 publications

Low‐Intensity Pulsed Ultrasound as a Potential Adjuvant Therapy to Promote Spinal Fusion

Low‐Intensity Pulsed Ultrasound as a Potential Adjuvant Therapy to Promote Spinal Fusion

Can Low‐Intensity Pulsed Ultrasound Treat Discrete Pulmonary Lesions in Patients With COVID‐19?

Pulsed ultrasound for bone regeneration – outcomes and hurdles in the clinical application: a systematic review

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