Open Access

Extracorporeal shock wave therapy with low-energy flux density inhibits hypertrophic scar formation in an animal model

  • Authors:
    • Jing-Chun Zhao
    • Bo-Ru Zhang
    • Lei Hong
    • Kai Shi
    • Wei-Wei Wu
    • Jia-Ao Yu
  • View Affiliations

  • Published online on: January 29, 2018     https://doi.org/10.3892/ijmm.2018.3434
  • Pages: 1931-1938
  • Copyright: © Zhao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Hypertrophic scar is characterized by excessive deposits of collagen during skin wound healing, which could become a challenge to clinicians. This study assessed the effects of the extracorporeal shock wave therapy (ESWT) on hypertrophic scar formation and the underlying gene regu­lation. A rabbit ear hypertrophic scar model was generated and randomly divided into three groups: L-ESWT group to receive L-ESWT (energy flux density of 0.1 mJ/mm2), H-ESWT (energy flux density of 0.2 mJ/mm2) and sham ESWT group (S-ESWT). Hypertrophic scar tissues were then collected and stained with hematoxylin and eosin (H&E) and Masson's trichrome staining, respectively, to assess scar elevation index (SEI), fibroblast density and collagen fiber arrangement. Expression of cell proliferation marker proliferating cell nuclear antigen (PCNA) and α-smooth muscle actin (α-SMA) were assessed using RT-PCR and immunohistochemistry in hypertrophic scar tissues. H&E staining sections showed significant reduction of SEI and fibroblast density in both ESWT treatment groups compared to S-ESWT, but there was no dramatic difference between L-ESWT and H-ESWT groups. Masson's trichrome staining showed that collagen fibers were more slender and broader and oriented in parallel to skin surface after administration of ESWT compared to control tissues. At the gene level, PCNA‑positive fibroblasts and α-SMA-positive myofibroblasts were significantly decreased after L-ESWT or H-ESWT compared to the controls. Furthermore, there was no significant difference in expression of PCNA mRNA between L-ESWT or H-ESWT and S-ESWT, whereas expression of α-SMA mRNA significantly decreased in L-ESWT compared to that of H-ESWT and S-ESWT (P=0.002 and P=0.030, respectively). In conclusion, L-ESWT could be effective on suppression of hypertrophic scar formation by inhibition of scar elevation index and fibroblast density as well as α-SMA expression in hypertrophic scar tissues of the rabbit model.
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April-2018
Volume 41 Issue 4

Print ISSN: 1107-3756
Online ISSN:1791-244X

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Spandidos Publications style
Zhao J, Zhang B, Hong L, Shi K, Wu W and Yu J: Extracorporeal shock wave therapy with low-energy flux density inhibits hypertrophic scar formation in an animal model. Int J Mol Med 41: 1931-1938, 2018.
APA
Zhao, J., Zhang, B., Hong, L., Shi, K., Wu, W., & Yu, J. (2018). Extracorporeal shock wave therapy with low-energy flux density inhibits hypertrophic scar formation in an animal model. International Journal of Molecular Medicine, 41, 1931-1938. https://doi.org/10.3892/ijmm.2018.3434
MLA
Zhao, J., Zhang, B., Hong, L., Shi, K., Wu, W., Yu, J."Extracorporeal shock wave therapy with low-energy flux density inhibits hypertrophic scar formation in an animal model". International Journal of Molecular Medicine 41.4 (2018): 1931-1938.
Chicago
Zhao, J., Zhang, B., Hong, L., Shi, K., Wu, W., Yu, J."Extracorporeal shock wave therapy with low-energy flux density inhibits hypertrophic scar formation in an animal model". International Journal of Molecular Medicine 41, no. 4 (2018): 1931-1938. https://doi.org/10.3892/ijmm.2018.3434