Ultrasound modulates pro-inflammatory cytokine release in soft tissue
Ultrasound modulates pro-inflammatory cytokine release in soft tissue
Introduction: ultrasound therapy promotes cytokine release in vitro1 and has been suggested to improve the healing rates of pressure ulcers2. Unfortunately much of the evidence is conflicting, and it is difficult to draw firm conclusions on effectiveness3. Traditionally US is thought to promote the release of proinflammatory cytokines and speed up the inflammatory phase of tissue repair5. Thus the aim of this study was to investigate the effect of US on proinflammatory cytokine release in vivo.
Methods: fifteen healthy volunteers were recruited following ethics approval. Microdialysis fibres were implanted at a depth of 1mm at two separate sites on the volar aspect of the non-dominant forearm. The fibres were perfused with PBS (3µl/min) and each site randomly allocated to receive either non thermal low intensity US at a pulse ratio of 1:4 and an intensity of 0.5 W/cm2 and sham ultrasound (SUS) for 10 minutes. Dialysate was collected for 30 minutes prior to intervention and every 30 minutes following intervention and pro-inflammatory cytokines (IL-1ß, IL-6, IL-8, TNF?) quantified via immunoassay.
Results: the mean (± SEM) baseline concentrations of IL-1ß, IL-6, IL-8 and TNF? were 0.9 (0.2), 3.5 (0.8), 14.3 (4.1) and 0.3 (0.08) pg/ml. There was no significant difference in baseline values between the two sites. A significant (p<0.05) increase in all cytokines from baseline was observed following the application of sham US, with the mean (± SEM) concentrations of IL-1ß, IL-6, IL-8 and rising to 2.8 (0.5), 11.4 (1.6), 31.6 (3.6) and 0.8 (0.2) pg/ml. In contrast the increase seen in all cytokines, except TNF?, following HFUS was significantly (p<0.01) reduced, the mean (± SEM) IL-1ß, IL-6, IL-8 and TNF? concentrations being 0.8 (0.1), 5.6 (0.7), 20.1 (2.3), and 0.4 (0.05) pg/ml (Figure 1).
Discussions: this study demonstrates that US is able to modulate cytokine release in the superficial soft tissue and significantly reduces the release of proinflammatory cytokines compared to sham US.
Clinical relevance: This suggests that current thinking concerning the mechanism of action of therapeutic US may need to be re-evaluated, and further studies are needed to explore the mechanisms involved and the potential benefits to the management of pressure ulcers
Voegeli, David
e6f5d112-55b0-40c1-a6ad-8929a2d84a10
17 September 2015
Voegeli, David
e6f5d112-55b0-40c1-a6ad-8929a2d84a10
Voegeli, David
(2015)
Ultrasound modulates pro-inflammatory cytokine release in soft tissue.
18th Annual Meeting of the European Pressure Ulcer Advisory Panel, Ghent, Belgium.
16 - 18 Sep 2015.
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Conference or Workshop Item
(Paper)
Abstract
Introduction: ultrasound therapy promotes cytokine release in vitro1 and has been suggested to improve the healing rates of pressure ulcers2. Unfortunately much of the evidence is conflicting, and it is difficult to draw firm conclusions on effectiveness3. Traditionally US is thought to promote the release of proinflammatory cytokines and speed up the inflammatory phase of tissue repair5. Thus the aim of this study was to investigate the effect of US on proinflammatory cytokine release in vivo.
Methods: fifteen healthy volunteers were recruited following ethics approval. Microdialysis fibres were implanted at a depth of 1mm at two separate sites on the volar aspect of the non-dominant forearm. The fibres were perfused with PBS (3µl/min) and each site randomly allocated to receive either non thermal low intensity US at a pulse ratio of 1:4 and an intensity of 0.5 W/cm2 and sham ultrasound (SUS) for 10 minutes. Dialysate was collected for 30 minutes prior to intervention and every 30 minutes following intervention and pro-inflammatory cytokines (IL-1ß, IL-6, IL-8, TNF?) quantified via immunoassay.
Results: the mean (± SEM) baseline concentrations of IL-1ß, IL-6, IL-8 and TNF? were 0.9 (0.2), 3.5 (0.8), 14.3 (4.1) and 0.3 (0.08) pg/ml. There was no significant difference in baseline values between the two sites. A significant (p<0.05) increase in all cytokines from baseline was observed following the application of sham US, with the mean (± SEM) concentrations of IL-1ß, IL-6, IL-8 and rising to 2.8 (0.5), 11.4 (1.6), 31.6 (3.6) and 0.8 (0.2) pg/ml. In contrast the increase seen in all cytokines, except TNF?, following HFUS was significantly (p<0.01) reduced, the mean (± SEM) IL-1ß, IL-6, IL-8 and TNF? concentrations being 0.8 (0.1), 5.6 (0.7), 20.1 (2.3), and 0.4 (0.05) pg/ml (Figure 1).
Discussions: this study demonstrates that US is able to modulate cytokine release in the superficial soft tissue and significantly reduces the release of proinflammatory cytokines compared to sham US.
Clinical relevance: This suggests that current thinking concerning the mechanism of action of therapeutic US may need to be re-evaluated, and further studies are needed to explore the mechanisms involved and the potential benefits to the management of pressure ulcers
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Published date: 17 September 2015
Venue - Dates:
18th Annual Meeting of the European Pressure Ulcer Advisory Panel, Ghent, Belgium, 2015-09-16 - 2015-09-18
Organisations:
Faculty of Health Sciences
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Local EPrints ID: 382889
URI: http://eprints.soton.ac.uk/id/eprint/382889
PURE UUID: 53700716-a060-4f84-bfca-eb1e5a1cb3a6
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Date deposited: 06 Nov 2015 09:37
Last modified: 14 Mar 2024 21:34
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Author:
David Voegeli
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