Faculty Member Islamic Azad University- Tabriz Branch Tabriz, Azarbayjan-e Sharqi, Iran
Background: Cardiac shock wave therapy is a potential an effective remedy to promote revascularization in the ischemic myocardium of patients with refractory coronary heart disease. Although gene therapy holds great promise as a treatment for coronary heart disease, current clinical application is hampered by the development of safe and efficient systems for local gene delivery to a specific tissue or organ.
Aims: In this study, along with the administration of angiopoietin-1 (Ang-1)- loaded microbubbles, we developed an experimental combined shock wave therapy and photobiomodulation therapy system and examined its efficacy on myocardial angiogenesis in the hypercholesterolemic rabbit.
Methods: Briefly, New Zealand white rabbits underwent 2% cholesterol rich diet injury for sixteen weeks. Histopathology results showed the formation of thin- cap atheromatous plaques with sever stenosis in all of the rabbits' coronary arteries. The animals treated by extracorporeal electrohydraulic pulsed- focused shock waves (20Kv, 2Hz, 100 pulses) accompanied by Ang-1- loaded PESDA (Perfluorocarbon Exposed Sonicated Dextrose Albumin) microbubbles (100 ml/kg, 2-5×105 bubbles/ml) administration.
Results: The mean value for the myocardial microvessels density increased significantly in the treatment group when compared to the control group, according to histopathology results (p < 0.05).
Conclusion(s): The angiogenesis effect of electrohydraulic shock wave therapy plus enhanced sonoporation effect of shock wave therapy- induced by collapsed microbubbles, accompanied by angiogenesis effect of photobiomodulation therapy, can increase the angiogenesis effect of angiopoietin-1, which can cause VEGF, interleukin-8 (IL8), stromal cell-derived factor 1 (SDF1), and matrix metalloproteinase 9 (MMP9) secretion in hypercholesterolemic rabbits. This can also cause the proliferation, differentiation, and recruitment of endothelial progenitor cells (EPCs), resulting in revascularization in the ischemic myocardium and improvement cardiac function.
