Therapeutic Low-Intensity Ultrasound for Peripheral Nerve Regeneration – A Schwann Cell Perspective

Peripheral nerve injuries are common conditions that can arise from trauma (e.g., compression, severance) and can lead to neuropathic pain as well as motor and sensory deficits. Although much knowledge exists on the mechanisms of injury and nerve regeneration, treatments that ensure functional recovery following peripheral nerve injury are limited. Schwann cells, the supporting glial cells in peripheral nerves, orchestrate the response to nerve injury, by converting to a “repair” phenotype. However, nerve regeneration is often suboptimal in humans as the repair Schwann cells do not sustain their repair phenotype long enough to support the prolonged regeneration times required for successful nerve regrowth. Thus, numerous strategies are currently focused on promoting and extending the Schwann cells repair phenotype. Low-intensity ultrasound (LIU) is a non-destructive therapeutic approach which has been shown to facilitate peripheral nerve regeneration following nerve injury in rodents. Still, clinical trials in humans are scarce and limited to small population sizes. The benefit of LIU on nerve regeneration could possibly be mediated through the repair Schwann cells. In this review, we discuss the known and possible molecular mechanisms activated in response to LIU in repair Schwann cells to draw support and attention to LIU as a compelling regenerative treatment for peripheral nerve injury.

Immunological features of chronic endometritis

Chronic endometritis is a clinical and morphological syndrome with a complex of morphological and functional changes in the endometrium, leading to a violation of the physiological cyclic transformation and receptivity of endometrial tissues. The treatment of chronic endometritis requires special consideration. Despite the progress of pharmacotherapy, there are significant methodological and practical difficulties. Cavitated solutions, low-intensity ultrasound effects, and photochromotherapy increase the effectiveness of the treatment of chronic endometritis and female infertility.

Sonodynamic Effects of a Novel Ether-Group Modified Porphyrin Derivative Combined With Pulsed Low-Intensity Ultrasound on PC-9 Cells

Sonodynamic therapy (SDT) is a developing modality for cancer treatment based on the synergistic effect of ultrasound and chemical compounds which are known as sonosensitizers. The development of more efficient sonosensitizers has become an urgent issue in this field. In this study, a novel porphyrin derivative (BBTPP) mediated SDT was evaluated on PC-9 cells. Pulsed low-intensity ultrasound (PLIU) was used for its little thermal and mechanical damage. The accumulation of drugs in cells was evaluated through porphyrin fluorescence, and the cytotoxicity of BBTPP was evaluated using a cell counting kit-8 assay. The sonodynamic effect was investigated by Hoechst 33342/PI and Annexin V-FITC/PI double staining, which showed an apoptotic rate of 18.87% in the BBTPP-SDT group, as compared with 1.71%, 1.4%, 1.57%, 3.61%, 11.18% in the control, BBTPP, hematoporphyrin monomethyl ether (HMME), ultrasound, and HMME-SDT groups, respectively. The sono-toxic effect of BBTPP was significantly superior to HMME. Our results showed that BBTPP-SDT resulted in much higher intracellular reactive oxygen species (ROS) and lipid peroxidation levels which were evaluated by 2′,7′-dichlorodihydrofluorescein diacetate (H2DCFDA) and Liperfluo assay, respectively. The expressions of Bax, Bcl-2, caspase-9, caspase-8, and cleaved caspase-3 proteins were evaluated to investigate the apoptotic mechanism of BBTPP-SDT. The results of this study showed that the combination of BBTPP and PLIU induced the generation of ROS, resulting in lipid peroxidation, and activated both the extrinsic and intrinsic apoptotic pathways of PC-9 cells. Our results also suggested that the ether group introduced in the side chain of porphyrin could enhance the sono-toxicity of porphyrin-based sensitizers under the sonication of PLIU. These results supported the possibility of BBTPP as a promising sonosensitizer, and an appropriate side chain could enhance the sono-sensitivity of porphyrins.

Study on the effect of a triple cancer treatment of propolis, thermal cycling-hyperthermia, and low-intensity ultrasound on PANC-1 cells

To reduce side effects and enhance treatment efficacy, study on combination therapy for pancreatic cancer, a deadly cancer, has gained much attraction in recent years. In this study, we propose a novel triple treatment combining propolis and two physical stimuli‒thermal cycling-hyperthermia (TC-HT) and low-intensity ultrasound (US). The study found that, after the triple treatment, the cell viability of a human cancer cell line PANC-1 decreased to a level 80% less than the control, without affecting the normal pancreatic cells. Another result was excessive accumulation of reactive oxygen species (ROS) after the triple treatment, leading to the amplification of apoptotic pathway through the MAPK family and mitochondrial dysfunction, while activating autophagy simultaneously. This study, to the best of our knowledge, is the first attempt to combine TC-HT, US, and a natural compound in cancer treatment. The combination of TC-HT and US also promotes the anticancer effect of the heat-sensitive chemotherapy drug cisplatin on PANC-1 cells. It is expected that optimized parameters for different agents and different types of cancer will expand the methodology on oncological therapy in a safe manner.

The Synthesis of Europium-Doped Calcium Carbonate by an Eco-Method as Free Radical Generator Under Low-Intensity Ultrasonic Irradiation for Body Sculpture

Body sculpture is a common method to remove excessive fat. The diet and exercise are the first suggestion to keep body shape; however, those are difficult to keep adherence. Ultrasound has been developed for fat ablation; however, it could only serve as the side treatment along with liposuction. In the study, a sonosensitizer of europium-doped calcium carbonate (CaCO3: Eu) would be synthesized by an eco-method and combined with low-intensity ultrasound for lipolysis. The crystal structure of CaCO3: Eu was identified by x-ray diffractometer (XRD). The morphology of CaCO3: Eu was analyzed by scanning electron microscope (SEM). The chemical composition of CaCO3: Eu was evaluated by energy-dispersed spectrophotometer (EDS) and inductively coupled plasma mass spectrometer (ICP-MS). The electronic diffraction pattern was to further check crystal structure of the synthesized individual grain by transmission electron microscope (TEM). The particle size was determined by Zeta-sizer. Water-soluble tetrazolium salt (WST-1) were used to evaluate the cell viability. Chloromethyl-2′,7′-dichlorofluorescein diacetate (CM-H2DCFDA) and live/dead stain were used to evaluate feasibility in vitro. SD-rat was used to evaluate the safety and efficacy in vivo. The results showed that CaCO3: Eu had good biocompatibility and could produce reactive oxygen species (ROS) after treated with low-intensity ultrasound. After 4-weeks, the CaCO3: Eu exposed to ultrasound irradiation on SD rats could significantly decrease body weight, waistline, and subcutaneous adipose tissue. We believe that ROS from sonoluminescence, CO2-bomb and locally increasing Ca2+ level would be three major mechanisms to remove away adipo-tissue and inhibit adipogenesis. We could say that the combination of the CaCO3: Eu and low-intensity ultrasound would be a non-invasive treatment for the body sculpture.

Production Enhancement of Human Adipose-Derived Mesenchymal Stem Cells By Low-Intensity Ultrasound Stimulation

Background: Low-intensity ultrasound (LIUS) has been used to increase the proliferation rate of various stem cells including human adipose-derived mesenchymal stem cells (hAdMSCs). hAdMSCs is now commercially produced for various therapeutic applications. The purpose of this study was to show feasibility of enhancing the productivity of cell culture during 16-day cell culturing and increasing proliferation rate of hAdMSCs by LIUS stimulation with appropriate ultrasound parameters. Methods: Beam patterns of 5 and 10 MHz ultrasound transducers were measured to confirm the area of stimulation. The intensity of sound waves transmitted through a Petri-dish was measured in situ for quantitative evaluation. Bromodeoxyuridine (BrdU) incorporation assay was performed to search for appropriate parameters for LIUS stimulation of hAdMSCs. Cell culture medium supplemented with 8% fetal bovine serum (FBS) in a 35 mm Petri-dish was used for 16 days with subculture from 2 to 6 passage. Results: A frequency of 5 MHz, an intensity of 300 , a duration of 10 minutes per day, and continuous waves with 100% duty cycle were the best parameters according to the BrdU assay of proliferation rate of hAdMSCs. LIUS stimulation group had about 3.25-fold greater number of cells from passage 2 to 6 compared with the control group. Doubling time was decreased to 4.44 hours in average. Cell viability was the same between the control and LIUS stimulation groups.Conclusions: This study of enchanced proliferation rate and cell culture productivity of hAdMSCs by LIUS stimulation may lay the foundation for the application of LIUS stimulation in cell therapeutic industry by reducing the production cost and time required for cell therapy.

The syntheses of poly (diethylene glycol adipate) in low-intensity ultrasound

Poly (diethylene glycol adipate) is an important product of chemical technology. Several grades of polyesters (P-9, P-9A) are produced in the industry, in which poly(diethylene glycol adipate) is the main component. These composites are used in production of binders of mixed rocket solid fuels, as well as consumer goods. Poly(diethylene glycol adipate) is obtained by polycondensation of diethylene glycol and adipic acid. Usually, the polycondensation is carried out using catalysts. The use of catalysts complicates this process: requires further purification process or in solvent free system might slow reaction rate due to the limiting diffusion between reactants and mass transfer limitations. Therefore, it was proposed to use low-intensity ultrasound, which allows to influence the kinetics of the process without complicating the system. In this work, the reaction of polycondensation of diethylene glycol and adipic acid in low-intensity ultrasound was studied. The results of applying low-intensity ultrasound to the preparation of poly(diethylene glycol adipate) showed an increase in the reaction rate of the formation of a high-molecular compound and a change in the thermal regime. Application of low-intensity ultrasound provides synchronization of vibration and rotation of self-organizing dissipative structures, which leads to the decrease in energy consumption for mass transfer, thereby increasing the reaction rate. The low-intensity ultrasound demonstrated to be an effective method to intensify the polycondensation reaction.