Short-time non-enzymatic nitric oxide synthesis from L-arginine and hydrogen peroxide induced by shock waves treatment

AbstractThe evidence that nitric oxide (NO) production is possible by a non-enzymatic pathway has already been shown under restrictive experimental conditions. Here we show that NO can non-enzymatically be formed with short-time kinetics (min), by ‘bombing’ with shock waves a solution containing 1 mM hydrogen peroxide and 10 mM L-arginine. This procedure is widening its medical application with surprisingly positive effects in tissue regeneration and our finding could be one of the first steps for the understanding of the biochemical responsible for these therapeutical effects

Shorttime non-enzymatic nitric oxide synthesis from L-arginine and hydrogen peroxide induced by shock waves treatment. FEBS Lett 2002;520:153–5

Abstract The evidence that nitric oxide (NO) production is possible by a non-enzymatic pathway has already been shown under restrictive experimental conditions. Here we show that NO can non-enzymatically be formed with short-time kinetics (min), by 'bombing' with shock waves a solution containing 1 mM hydrogen peroxide and 10 mM L-arginine. This procedure is widening its medical application with surprisingly positive effects in tissue regeneration and our finding could be one of the first steps for the understanding of the biochemical responsible for these therapeutical effects. ß 2002 Published by Elsevier Science B.V. on behalf of the Federation of European Biochemical Societies

Extracorporeal shock wave therapy in inflammatory diseases: molecular mechanism that triggers anti-inflammatory action.

Abstract: Shock waves (SW), defined as a sequence of single sonic pulses characterised by high peak pressure (100MPa), a fast rise in pressure (< 10 ns) and a short lifecycle (10 s), are conveyed by an appropriate generator to a specifictarget area at an energy density ranging from 0.03 to 0.11 mJ/mm2. Extracorporeal SW (ESW) therapy was first used onpatients in 1980 to break up kidney stones. During the last ten years, this technique has been successfully employed in orthopaedicdiseases such as pseudoarthosis, tendinitis, calcarea of the shoulder, epicondylitis, plantar fasciitis and severalinflammatory tendon diseases. In particular, treatment of the tendon and muscle tissues was found to induce a long-timetissue regeneration effect in addition to having a more immediate anthalgic and anti-inflammatory outcome. In keepingwith this, an increase in neoangiogenesis in the tendons of dogs was observed after 4-8 weeks of ESW treatment. Furthermore,clinical observations indicate an immediate increase in blood flow around the treated area. Nevertheless, thebiochemical mechanisms underlying these effects have yet to be fully elucidated.In the present review, we briefly detail the physical properties of ESW and clinical cases treated with this therapy. Wethen go on to describe the possible molecular mechanism that triggers the anti-inflammatory action of ESW, focusing onthe possibility that ESW may modulate endogenous nitric oxide (NO) production either under normal or inflammatoryconditions. Data on the rapid enhancement of endothelial NO synthase (eNOS) activity in ESW-treated cells suggest thatincreased NO levels and the subsequent suppression of NF-B activation may account, at least in part, for the clinicallybeneficial action on tissue inflammation

SHOCK WAVES IN THE TREATMENT OF STRESS FRACTURES

In soccer players, lower extremity stress fractures are common injuries and are the result of repetitive use damage that exceeds the intrinsic ability of the bone to repair itself. They may be treated conservatively but this may cause long-term complications, such as delayed union, muscle atrophy and chronic pain. Stress fractures that fail to respond to this management require surgical treatment, which is also not without risks and complications. Extracorporeal shock wave therapy (ESWT) has been used successfully on fracture complications, such as delayed union and nonunion. As such, we want to examine ESWT in the management of stress fractures. In this article, we present a retrospective study of 10 athletes affected by chronic stress fractures of the fifth metatarsus and tibia that received three to four sessions of low-middle energy ESWT. At the follow-up (8 wk on average), the clinical and radiography results were excellent and enabled all players to gradually return to sports activities. These reports show that ESWT is a noninvasive and effective treatment for resistant stress fractures in soccer players

Nitric oxide mediates anti-inflammatory action of extracorporeal shock waves

Here, we show that extracorporeal shock waves (ESW), at a low energy density value, quickly increase neuronal nitric oxide synthase (nNOS) activity and basal nitric oxide (NO) production in the rat glioma cell line C6. In addition, the treatment of C6 cells with ESW reverts the decrease of nNOS activity and NO production induced by a mixture of lipopolysaccharides (LPS), interferon-γ (IFN-γ) plus tumour necrosis factor-α (TNF-α). Finally, ESW treatment efficiently downregulates NF-κB activation and NF-κB-dependent gene expression, including inducible NOS and TNF-α. The present report suggests a possible molecular mechanism of the anti-inflammatory action of ESW treatment