The effect of shock wave therapy on gene expression in human osteoblasts isolated from hypertrophic fracture non-unions

摘要

Shock wave therapy has been increasingly evaluated as a non-invasive alternative for the treatment of delayed fracture healing and non-unions. Although several clinical studies showed a beneficial effect especially for the hypertrophic type of non-union, little is known about the biological mechanism of its osteogenic effect. To identify the molecular background for the positive effect of shock waves on healing of fracture non-unions, we have analyzed the changes of the global gene expression in human osteoblasts after exposure to shock waves of different energy flux densities. Human osteoblasts were isolated from five patients at non-union sites, treated with 500 impulses of energy flux densities of 0.06 and , and cultured for 96 h. HG-U133A microarrays were used for the analysis of the shock wave-regulated mRNA-transcripts. Differential gene expression was verified by reverse transcriptase polymerase chain reactions. We identified 47 transcripts that showed differential expression after and 45 transcripts after energy treatment. Most intriguing was the up-regulation of neprilysin, calmegin, osteoglycin, asporin, and interleukin-13 receptor-. Eighteen identified genes were previously described to fulfill an important function in bone growth and metabolism. Our study provides the first molecular profile of shock wave-induced gene expression changes in human osteoblasts from patients with hypertrophic fracture non-unions, and it offers a possible molecular explanation for the positive effects of shock waves in patients ridden with this disease .