Stimulation of bone growth factor synthesis in human osteoblasts and fibroblasts after extracorporeal shock wave application.
BACKGROUND
Nonunion is a common problem in Orthopedic Surgery. In the recent years alternatives to the standard surgical procedures were tested clinically and in vitro. Extracorporeal shock wave therapy (ESWT) showed promising results in both settings. We hypothesized that in target tissue cells from nonunions like fibroblasts and osteoblasts ESWT increases the release of bone growth factors.


METHODS
Fibroblasts and osteoblasts were suspended in 3 ml cryotubes and subjected to 250/500 shock waves at 25 kV using an experimental electrohydraulic lithotripter. After ESWT, cell viability was determined and cells were seeded at 1 × 10(5) cells in 12 well plates. After 24, 48, and 72 h cell number was determined and supernatant was frozen. The levels of growth factors FGF-2 and TGF-β(1) were examined using ELISA. A control group was treated equally without receiving ESWT.


RESULTS
After 24 h there was a significant increase in FGF-2 levels (p < 0.05) with significant correlation to the number of impulses (p < 0.05) observed. TGF-β(1) showed a time-dependent increase with a peak at 48 h which was not significantly different from the control group.


CONCLUSIONS
FGF-2, an important growth factor in new bone formation, was shown to be produced by human fibroblasts and osteoblasts after treatment with ESWT. These findings demonstrate that ESWT is able to cause bone healing through a molecular way by inducing growth factor synthesis.
Hausdorf
Joerg
J
Orthopaedic Department, Campus Großhadern, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany. joerg.hausdorf@med.uni-muenchen.de
Sievers
Birte
B
Schmitt-Sody
Marcus
M
Jansson
Volkmar
V
Maier
Markus
M
Mayer-Wagner
Susanne
S
D000368:Aged; D001846:Bone Development / Q000502:physiology*; D002478:Cells, Cultured; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005346:Fibroblast Growth Factors / Q000096:biosynthesis*; D005347:Fibroblasts / Q000378:metabolism*; D006801:Humans; D066298:In Vitro Techniques; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010006:Osteoblasts / Q000378:metabolism*; D010641:Phenotype; D018709:Statistics, Nonparametric; D016212:Transforming Growth Factor beta / Q000096:biosynthesis*
D016212:Transforming Growth Factor beta; D005346:Fibroblast Growth Factors