Low-Intensity Extracorporeal Shock Wave Therapy Promotes Bladder Regeneration and Improves Overactive Bladder Induced by Ovarian Hormone Deficiency from Rat Animal Model to Human Clinical Trial

Lin, Kun-Ling; Lu, Jian-He; Chueh, Kuang-Shun; Juan, Tai-Jui; Wu, Bin-Nan; Chuang, Shu-Mien; Lee, Yung-Chin; Shen, Mei-Chen; Long, Cheng-Yu; Juan, Yung-Shun

doi:10.3390/ijms22179296

Open AccessArticle

Low-Intensity Extracorporeal Shock Wave Therapy Promotes Bladder Regeneration and Improves Overactive Bladder Induced by Ovarian Hormone Deficiency from Rat Animal Model to Human Clinical Trial

by

Kun-Ling Lin

^1,2,3,

Jian-He Lu

⁴

,

Kuang-Shun Chueh

^1,5,6,

Tai-Jui Juan

⁷,

Bin-Nan Wu

⁸

,

Shu-Mien Chuang

⁹,

Yung-Chin Lee

¹⁰,

Mei-Chen Shen

⁹,

Cheng-Yu Long

^1,3,*,† and

Yung-Shun Juan

^{1,5,6,9,*,†}

¹

Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan

²

Department of Obstetrics and Gynecology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80661, Taiwan

³

Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan

⁴

Emerging Compounds Research Center, Department of Environmental Science and Engineering, College of Engineering, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan

⁵

Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80661, Taiwan

⁶

Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan

⁷

Department of Medicine, National Defense Medical College, Taipei 11490, Taiwan

⁸

Department of Pharmacology, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan

⁹

Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan

¹⁰

Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 81267, Taiwan

^*

Authors to whom correspondence should be addressed.

^†

These two authors contributed equally to this work.

Int. J. Mol. Sci. 2021, 22(17), 9296; https://doi.org/10.3390/ijms22179296

Submission received: 22 June 2021 / Revised: 8 August 2021 / Accepted: 24 August 2021 / Published: 27 August 2021

(This article belongs to the Special Issue The Role of Oxidative Stress Biomarkers in Translational Clinical Research: From the Bench to Bedside)

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Abstract

Postmenopausal women with ovary hormone deficiency (OHD) are subject to overactive bladder (OAB) symptoms. The present study attempted to elucidate whether low-intensity extracorporeal shock wave therapy (LiESWT) alters bladder angiogenesis, decreases inflammatory response, and ameliorates bladder hyperactivity to influence bladder function in OHD-induced OAB in human clinical trial and rat model. The ovariectomized (OVX) for 12 months Sprague–Dawley rat model mimicking the physiological condition of menopause was utilized to induce OAB and assess the potential therapeutic mechanism of LiESWT (0.12 mJ/mm², 300 pulses, and 3 pulses/second). The randomized, single-blinded clinical trial was enrolled 58 participants to investigate the therapeutic efficacy of LiESWT (0.25 mJ/mm², 3000 pulses, 3 pulses/second) on postmenopausal women with OAB. The results revealed that 8 weeks’ LiESWT inhibited interstitial fibrosis, promoted cell proliferation, enhanced angiogenesis protein expression, and elevated the protein phosphorylation of ErK1/2, P38, and Akt, leading to decreased urinary frequency, nocturia, urgency, urgency incontinence, and post-voided residual urine volume, but increased voided urine volume and the maximal flow rate of postmenopausal participants. In conclusion, LiESWT attenuated inflammatory responses, increased angiogenesis, and promoted proliferation and differentiation, thereby improved OAB symptoms, thereafter promoting social activity and the quality of life of postmenopausal participants.

Keywords: low-intensity extracorporeal shock wave therapy; ovarian hormone deficiency; overactive bladder; bladder angiogenesis

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MDPI and ACS Style

Lin, K.-L.; Lu, J.-H.; Chueh, K.-S.; Juan, T.-J.; Wu, B.-N.; Chuang, S.-M.; Lee, Y.-C.; Shen, M.-C.; Long, C.-Y.; Juan, Y.-S. Low-Intensity Extracorporeal Shock Wave Therapy Promotes Bladder Regeneration and Improves Overactive Bladder Induced by Ovarian Hormone Deficiency from Rat Animal Model to Human Clinical Trial. Int. J. Mol. Sci. 2021, 22, 9296. https://doi.org/10.3390/ijms22179296

AMA Style

Lin K-L, Lu J-H, Chueh K-S, Juan T-J, Wu B-N, Chuang S-M, Lee Y-C, Shen M-C, Long C-Y, Juan Y-S. Low-Intensity Extracorporeal Shock Wave Therapy Promotes Bladder Regeneration and Improves Overactive Bladder Induced by Ovarian Hormone Deficiency from Rat Animal Model to Human Clinical Trial. International Journal of Molecular Sciences. 2021; 22(17):9296. https://doi.org/10.3390/ijms22179296

Chicago/Turabian Style

Lin, Kun-Ling, Jian-He Lu, Kuang-Shun Chueh, Tai-Jui Juan, Bin-Nan Wu, Shu-Mien Chuang, Yung-Chin Lee, Mei-Chen Shen, Cheng-Yu Long, and Yung-Shun Juan. 2021. "Low-Intensity Extracorporeal Shock Wave Therapy Promotes Bladder Regeneration and Improves Overactive Bladder Induced by Ovarian Hormone Deficiency from Rat Animal Model to Human Clinical Trial" International Journal of Molecular Sciences 22, no. 17: 9296. https://doi.org/10.3390/ijms22179296

APA Style

Lin, K.-L., Lu, J.-H., Chueh, K.-S., Juan, T.-J., Wu, B.-N., Chuang, S.-M., Lee, Y.-C., Shen, M.-C., Long, C.-Y., & Juan, Y.-S. (2021). Low-Intensity Extracorporeal Shock Wave Therapy Promotes Bladder Regeneration and Improves Overactive Bladder Induced by Ovarian Hormone Deficiency from Rat Animal Model to Human Clinical Trial. International Journal of Molecular Sciences, 22(17), 9296. https://doi.org/10.3390/ijms22179296

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Low-Intensity Extracorporeal Shock Wave Therapy Promotes Bladder Regeneration and Improves Overactive Bladder Induced by Ovarian Hormone Deficiency from Rat Animal Model to Human Clinical Trial

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