title: Substance P and prostaglandin E2 release after shock wave application to the rabbit femur.
abstract: The biologic action of extracorporeal shock wave application on the musculoskeletal system is poorly understood. To prove the hypothesis that alterations of tissue concentrations of substance P and prostaglandin E(2) are involved in the biologic action of shock waves, extracorporeal shock waves with energy flux density of 0.9 mJ/mm2 (1500 pulses at 1/second) were applied in vivo to the distal femur of rabbits. The concentrations of substance P and prostaglandin E(2) eluted from the periosteum of the femur were measured. Compared with the untreated contralateral hindlimbs, substance P release from the periosteum from the femur was increased 6 hours and 24 hours after extracorporeal shock wave application, but was decreased 6 weeks after extracorporeal shock wave application. By contrast, extracorporeal shock wave application did not result in altered prostaglandin E(2) release from the periosteum from the femur. Remarkably, there was a close relationship between the time course of substance P release found here, and the well-known clinical time course of initial pain occurrence and subsequent pain relief after extracorporeal shock wave application to tendon diseases. Accordingly, substance P might be involved in the biologic action of extracorporeal shock wave application on tissue of the musculoskeletal system. This is the first study providing insights into the molecular mechanisms of extracorporeal shock wave application to the musculoskeletal system.
authors.affiliation: Department of Orthopaedic Surgery, Ludwig-Maximilians University, Klinikum Grosshadern, Marchioninistrasse 15, 81366 Munich, Germany. markus.maier@ort.med.uni.muenchen.de
authors.forename: Markus
authors.initials: M
authors.lastname: Maier
authors.forename: Beate
authors.initials: B
authors.lastname: Averbeck
authors.forename: Stefan
authors.initials: S
authors.lastname: Milz
authors.forename: Hans Jürgen
authors.initials: HJ
authors.lastname: Refior
authors.forename: Christoph
authors.initials: C
authors.lastname: Schmitz
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D015232:Dinoprostone / Q000378:metabolism*; D005260:Female; D005269:Femur / Q000378:metabolism*; D008096:Lithotripsy; D011817:Rabbits; D013373:Substance P / Q000378:metabolism*
chemical_list: D013373:Substance P; D015232:Dinoprostone