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Shock Wave Therapy Promotes Angiogenesis via Toll-like Receptor 3

Shock Wave Therapy Promotes Angiogenesis via Toll-like Receptor 3

Title of study: Toll-like receptor 3 signalling mediates angiogenic response upon shock wave treatment of ischaemic muscle

Authors: Johannes Holfeld, Can Tepeköylü, Christin Reissig, Daniela Lobenwein, Bertram Scheller, Elke Kirchmair, Radoslaw Kozaryn, Karin Albrecht-Schgoer, Christoph Krapf, Karin Zins, Anja Urbschat, Kai Zacharowski, Michael Grimm, Rudolf Kirchmair, Patrick Paulus

Shock wave therapy (SWT) is a medical treatment used to stimulate blood vessel growth in tissues affected by reduced blood flow, such as those affected by ischemic heart or limb disease. However, the exact way in which SWT works is not fully understood. This study aimed to investigate the mechanism of SWT and its effect on Toll-like receptor 3 (TLR3), a component of the immune system that plays a role in inflammation and angiogenesis (the formation of new blood vessels).

The researchers found that SWT caused the release of cytoplasmic RNA from endothelial cells in a time-dependent manner, which in turn activated TLR3. In experiments using a mouse model of hind limb ischemia, the researchers observed that SWT induced angiogenesis and arteriogenesis (the formation of new arteries) only in mice with a functional TLR3 gene. These effects were accompanied by improved blood flow in the treated limbs.

The study suggests that SWT may cause cellular cavitation without damaging the target cells, which releases cytoplasmic RNA and activates TLR3. This activation of TLR3 leads to the release of molecules that promote inflammation and angiogenesis, ultimately resulting in the formation of new blood vessels and improved blood flow.

The findings of this study provide new insights into the mechanism of action of SWT and suggest that TLR3 plays a central role in mediating the therapeutic effects of SWT. This knowledge could inform the development of more targeted and effective treatments for ischemic heart and limb diseases.

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