title: Effects of low energy shock wave therapy on inflammatory moleculars, bladder pain, and bladder function in a rat cystitis model.
abstract: OBJECTIVE
  Low energy shock wave (LESW) is known to facilitate tissue regeneration with analgesic and anti-inflammatory effects. We examined the effects of LESW on the expression of inflammatory molecules, pain behavior, and bladder function in a rat cystitis model.
  
  
  METHODS
  Control and experimental animals were injected with saline or cyclophosphamide (CYP; 75 mg/kg intraperitoneally) on day 1 and 4. After lower midline incision, the bladders were exposed to LESW (300 pulses, 0.12 mJ/mm2) or sham operation on day 2. In study 1 (N = 12, 4 for each group), the nociceptive effects of CYP were evaluated for 30 min by behavioral assessment on day 4 one hour after CYP injection. In study 2 (N = 21, 7 for each group), continuous cystometry (CMG) was performed on day 8. The bladder was harvested after behavioral assessment or CMG for histology and Western blotting.
  
  
  RESULTS
  CYP-induced upregulation of COX2 and IL6 expression, caused pain behavior (eye closing and hypolocomotion), and bladder inflammation was noted on days 4 and 8 along with bladder hyperactivity. LESW treatment reduced pain behavior and downregulated the NGF expression (33.3%, P < 0.05) on day 4 and IL6 (40.9%, P < 0.05). LESW treatment suppressed bladder overactivity (intercontraction interval 77.8% increase, P < 0.05) by decreasing inflammation and COX2 (38.6%, P < 0.05) expression and NGF expression (25.2%, P = 0.0812).
  
  
  CONCLUSIONS
  CYP-induced bladder pain, inflammation, and overactivity involves activation of IL6, NGF, and COX2 expression. These changes are suppressed by LESW, indicating it as a potential candidate for relieving bladder inflammatory conditions and overactivity.
authors.affiliation: Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.|The Center of Excellence in Shockwave Medicine and Tissue Regeneration, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Hung-Jen
authors.initials: HJ
authors.lastname: Wang
authors.affiliation: Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Wei-Chia
authors.initials: WC
authors.lastname: Lee
authors.affiliation: Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Tyagi
authors.affiliation: Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Chao-Cheng
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.|The Center of Excellence in Shockwave Medicine and Tissue Regeneration, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.|Chung Shan Medical University, Institute of Medicine, Taichung, Taiwan.
authors.forename: Yao-Chi
authors.initials: YC
authors.lastname: Chuang
mesh_terms: D000818:Animals; D051546:Cyclooxygenase 2 / Q000378:metabolism; D003520:Cyclophosphamide; D003556:Cystitis / Q000139:chemically induced / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D004195:Disease Models, Animal; D000074059:Extracorporeal Shockwave Therapy; D005260:Female; D007249:Inflammation / Q000139:chemically induced / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D015850:Interleukin-6 / Q000378:metabolism; D020932:Nerve Growth Factor / Q000378:metabolism; D010146:Pain / Q000139:chemically induced / Q000378:metabolism / Q000503:physiopathology*; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D051381:Rats; D017207:Rats, Sprague-Dawley; D001743:Urinary Bladder / Q000378:metabolism / Q000503:physiopathology; D053201:Urinary Bladder, Overactive / Q000139:chemically induced / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*
chemical_list: D015850:Interleukin-6; D003520:Cyclophosphamide; D020932:Nerve Growth Factor; D051546:Cyclooxygenase 2; C489691:Ptgs2 protein, rat
keywords: COX2; cyclophosphamide; cystitis; shock wave; urinary bladder