Extracorporeal shock wave markedly alleviates radiation-induced chronic cystitis in rat

Yen-Ta Chen; Kuan-Hung Chen; Pei-Hsun Sung; Chih-Chao Yang; Ben-Chung Cheng; Chih-Hung Chen; Chia-Lo Chang; Jiunn-Jye Sheu; Fan-Yen Lee; Pei-Lin Shao; Cheuk-Kwan Sun; Hon-Kan Yip

Extracorporeal shock wave markedly alleviates radiation-induced chronic cystitis in rat

Am J Transl Res. 2018 Mar 15;10(3):1036-1052. eCollection 2018.

Authors

Yen-Ta Chen^{1

2}, Kuan-Hung Chen^{3

2}, Pei-Hsun Sung^{4

2}, Chih-Chao Yang⁵, Ben-Chung Cheng⁵, Chih-Hung Chen⁶, Chia-Lo Chang⁷, Jiunn-Jye Sheu^{8

2}, Fan-Yen Lee^{8

2

9}, Pei-Lin Shao¹⁰, Cheuk-Kwan Sun¹¹, Hon-Kan Yip^{4

10

12

2

13}

Affiliations

¹ Division of Urology, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung 83301, Taiwan.
² Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial HospitalKaohsiung 83301, Taiwan.
³ Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung 83301, Taiwan.
⁴ Divisions of General Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung 83301, Taiwan.
⁵ Division of Colorectal Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung 83301, Taiwan.
⁶ Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung, 83301, Taiwan.
⁷ Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung 83301, Taiwan.
⁸ Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung 83301, Taiwan.
⁹ Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical CenterTaipei 11490, Taiwan.
¹⁰ Department of Nursing, Asia UniversityTaichung 41354, Taiwan.
¹¹ Department of Emergency Medicine, E-Da Hospital, I-Shou University School of Medicine for International StudentsKaohsiung 82445, Taiwan.
¹² Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial HospitalKaohsiung 83301, Taiwan.
¹³ Department of Medical Research, China Medical University Hospital, China Medical UniversityTaichung 40402, Taiwan.

PMID: 29636892
PMCID: PMC5883143

Abstract

This study tested the hypothesis that extracorporeal shock wave (ECSW) treatment can effectively inhibit radiation-induced chronic cystitis (CC). Adult male Sprague-Dawley (SD) rats (n = 24) were randomly divided into group 1 (normal control), group 2 (CC induced by radiation with 300 cGy twice with a four-hour interval to the urinary bladder), group 3 [CC with ECSW treatment (0.2 mJ/mm²/120 impulses/at days 1, 7, and 14 after radiation)]. Bladder specimens were harvested by day 28 after radiation. By day 28 after radiation, the degree of detrusor contraction impairment was significantly higher in group 2 than that in groups 1 and 3, and significantly higher in group 3 than that in group 1 (P<0.0001). The urine albumin concentration expressed an opposite pattern compared to that of detrusor function among the three groups (P<0.0001). The bladder protein expressions of inflammatory (TLR-2/TLR-4/IL-6/IL-12/MMP-9/TNF-α/NF-κB/RANTES/iNOS) and oxidative-stress (NOX-1/NOX-2/oxidized protein) biomarkers exhibited a pattern identical to that of urine albumin in all groups (all P<0.0001). The cellular expressions of inflammatory (CD14+/CD68+/CD74+/COX-2/MIF+/substance P+) and cytokeratin (CK13+/HMW CK+/CK+17/CK+18/CK+19) biomarkers, and collagen-deposition/fibrotic areas as well as epithelial-damaged score displayed an identical pattern compared to that of urine albumin among the three groups (all P<0.0001). In conclusion, ECSW treatment effectively protected urinary bladder from radiation-induced CC.

Keywords: Chronic cystitis; extracorporeal shock wave; inflammation; oxidative stress; radiotherapy.