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Effects of the extracorporeal shock wave therapy on the skin: an experimental study

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Abstract

Extracorporeal shock wave therapy (ESWT) has been extensively studied for its multiple biological properties, and although it is widely applied in esthetical procedures, little is known about its effects on the epidermis and dermis. In this study, a histological and immunohistochemical study of the effects of ESWT was performed on rat skin. Forty-five female rats were treated with one or two sessions of ESWT and sacrificed on days 1, 7, 14, and 21 after treatment. The samples were histologically processed and then morphometric analyses were performed to assess the epidermis, dermis, and subcutaneous fat tissue thickness. Immunohistochemical reactions were also performed against the antibodies: basic fibroblastic growth factor (FGF2), its receptor (FGFR1), and α-smooth muscle actin. Slides were scanned and digitally assessed, to determine the microvessel density (MVD) and digital scoring of the immunohistochemical staining. The results showed that ESWT produced a significantly higher collagen content, MVD, and epidermis and dermis thickness than the control, non-treated group. Both in epidermis and dermis, FGF2 was overexpressed in the ESWT-treated groups, whereas FGFR1 was increased only in the group treated with two ESWT sessions at 21-days post-treatment. The ESWT-treated groups have also shown diminished thickness of subcutaneous fat tissue. In conclusion, ESWT induces neocollagenesis and neoangiogenesis, and upregulates the FGF2 expression, particularly in the groups treated with two sessions. Furthermore, it was demonstrated that overexpression of FGF2 on skins treated with ESWT seems to be a key role on its mechanism of action.

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Funding

This study was funded by the Brazilian National Council of Scientific and Technological Development (CNPq) research fellowship (registered under numbers 145722/2013-9, 101367/2014-7, and 117277/2014-2 to C.D.S.) and by FAPESP (São Paulo Research Foundation) for the Ph.D. fellowship to C.D.S. (#2015/25905-1).

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Author notes

  1. Thayná Melo de Lima Morais and Liliane Santos de Vasconcellos contributed equally to this work.

Authors and Affiliations

  1. Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira 901, Piracicaba, SP, 1314-903, Brazil

    Thayná Melo de Lima Morais & Ciro Dantas Soares

  2. Physiotherapy Department, Potiguar University, Natal, Brazil

    Patrícia Froes Meyer, Liliane Santos de Vasconcellos, Julio Costa e Silva, Ito Ferreira e Andrade, Vinicius Alves Freire de Farias & Igor Candido da Silva

  3. Medicine Department, Potiguar University, Natal, Brazil

    Roberta Marinho Falcão Gondim Araújo & Rodrigo Marcel Valentim da Silva

  4. Physiotherapy Department, Federal University of Rio Grande do Norte, Natal, Brazil

    Esteban Fortuny Pacheco

Authors
  1. Thayná Melo de Lima Morais
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  2. Patrícia Froes Meyer
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  3. Liliane Santos de Vasconcellos
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  8. Roberta Marinho Falcão Gondim Araújo
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  11. Ciro Dantas Soares
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Corresponding author

Correspondence to Ciro Dantas Soares.

Ethics declarations

This experimental protocol followed the guidelines of the Animal Experimentation Code of Ethics and Brazilian College of Animal Experimentation and was duly approved by the Ethics Committee of Potiguar University, Laureate International Universities (protocol number 002/2017).

Conflict of interest

The authors declare that they have no conflicts of interest.

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Not applicable. This article does not contain any studies with human participants.

Electronic supplementary material

Supplementary Figure 1

A: The device utilized for the experiments. B: Image demonstrating the use of the device in one subject. (PNG 4691 kb)

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de Lima Morais, T.M., Meyer, P.F., de Vasconcellos, L.S. et al. Effects of the extracorporeal shock wave therapy on the skin: an experimental study. Lasers Med Sci 34, 389–396 (2019). https://doi.org/10.1007/s10103-018-2612-8

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  • DOI: https://doi.org/10.1007/s10103-018-2612-8

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