摘要
背景:现有研究发现,体外冲击波可有效抑制组织纤维化形成,但有关体外冲击波抗纤维化的实验研究结果与总结较少,且未对相关信号通路进行归纳整理。目的:综述目前临床或临床前原始研究,对体外冲击波在纤维化组织中的应用及相关分子机制进行归纳总结,为临床治疗纤维化疾病提供新思路。方法:使用计算机检索PubMed、Web of Science以及中国知网、万方、维普数据库中的相关原创性研究,检索时限为2014年1月至2024年9月,英文检索词为“extracorporeal shockwave therapy,shock wave therapy,shock wave,fibrosis,fibroses”等,中文检索词为“冲击波,体外冲击波疗法,纤维化,抗纤维化”,采用主题词和自由词结合的方式进行检索。依据纳入排除标准对检索结果进行筛选、排除,最终纳入67篇文献进行综述分析。结果与结论:①体外冲击波对多种组织纤维化相关疾病有益,可有效降低组织纤维化程度,改善患者临床症状;②体外冲击波主要通过转化生长因子β1、丝裂原活化蛋白激酶、血管生长因子以及炎症信号转导通路,影响纤维化相关细胞因子表达及细胞外基质组成,从而抑制纤维化过度形成;③目前纳入的临床研究数量较少,缺少临床数据支持;另外由于各研究的干预对象及体外冲击波干预方案差异大,实验结果单一,可能对体外冲击波抗纤维化的具体量效机制及总体分子作用体系产生影响;④研究结果表明,体外冲击波未来或可作为一种有效治疗手段参与到纤维化相关疾病的临床治疗中。
BACKGROUND:Existing studies have shown that extracorporeal shock wave intervention can effectively inhibit the formation of tissue fibrosis.However,there are limited experimental studies and summaries regarding the anti-fibrotic effects of extracorporeal shock wave,and no comprehensive review of the associated signaling pathways has been conducted.OBJECTIVE:To review current clinical or preclinical primary studies and summarize the applications of extracorporeal shock wave in fibrotic tissues and the relevant molecular mechanisms,thereby providing novel insights for the clinical treatment of fibrotic diseases.METHODS:The relevant literatures in PubMed,Web of Science,CNKI,WanFang and VIP databases were searched.The search time was from January 2014 to September 2024,and the search terms were“extracorporeal shockwave therapy,shock wave therapy,shock wave,fibrosis,fibroses”in English and“shock wave,extracorporeal shockwave therapy,fibrosis,anti-fibrosis”in Chinese.A combination of subject headings and free terms was used for the search.After screening and excluding studies based on predefined inclusion and exclusion criteria,a total of 67 articles were ultimately included for review and analysis.RESULTS AND CONCLUSION:(1)Extracorporeal shock wave intervention is beneficial for various fibrosis-related diseases,including scars,musculoskeletal disorders,and organ diseases.It can effectively reduce the degree of tissue fibrosis and improve clinical symptoms in patients.(2)Extracorporeal shock wave mainly influences the expression of fibrosis-related cytokines and extracellular matrix composition by modulating signaling pathways such as transforming growth factor-β1,mitogen-activated protein kinases,vascular endothelial growth factor,and inflammatory signaling pathways,thereby inhibiting excessive fibrosis formation.(3)The current review identifies a limited number of clinical studies with insufficient data to support robust conclusions.Additionally,due to the singularity of experimental results and significant differences in intervention subjects and extracorporeal shock wave intervention protocols across studies,there may be an impact on the clarification of the specific dose-response mechanisms and the overall molecular action system of extracorporeal shock wave in anti-fibrosis.To conclude,extracorporeal shock wave may serve as an effective therapeutic approach for the clinical treatment of fibrosis-related diseases in the future.
作者
黄思璟
崔瑞
耿珑玉
高蓓瑶
葛瑞东
江山
Huang Sijing;Cui Rui;Geng Longyu;Gao Beiyao;Ge Ruidong;Jiang Shan(School of Sports Medicine and Rehabilitation,Beijing Sport University,Beijing 100084,China;Department of Rehabilitation Medicine,China-Japan Friendship Hospital,Beijing 100029,China)
出处
《中国组织工程研究》
北大核心
2026年第17期4417-4429,共13页
Chinese Journal of Tissue Engineering Research
基金
中央高水平医院临床科研业务费资助课题(2023-NHLHCRF-YYPPLC-TJ-19),项目负责人:葛瑞东
中央高水平医院临床科研业务费资助课题(2023-NHLHCRF-YSPY-01),项目负责人:江山
国家重点研发计划项目(2022YFC2009700,2022YFC2009706),子课题负责人:江山。
关键词
体外冲击波
冲击波
体外冲击波疗法
抗纤维化
纤维化
分子机制
康复治疗
综述
extracorporeal shock wave
shock wave
extracorporeal shock wave therapy
anti-fibrosis
fibrosis
molecular mechanisms
rehabilitation therapy
review
