Jie ZHANG, Baiwei ZHANG, Chunjing HE
Turkish Journal of Physical Medicine and Rehabilitation - 2026;72(2):216-225
Objectives: This study aimed to investigate the effects of extracorporeal shock wave therapy (ESWT) on the microcirculation of lower extremity skeletal muscle in rats with diabetic vasculopathy (DV) and to elucidate the potential underlying mechanism. Materials and methods: The experimental animal study was conducted between August 2023 and February 2024. Forty healthy adult male Sprague-Dawley rats (mean weight: 226 +/- 21 g; range, 205 to 247 g) were randomly assigned to five groups (n=8 per group): Control group (Group A), DV group (Group B), DV + ESWT group (Group C), DV + LY2157299 group (Group D), and DV + ESWT + LY2157299 group (Group E). The blood flow velocity and femoral artery diameter (FAD) on the right lower limb were measured using a high-resolution ultrasound system in all groups. Protein and messenger ribonucleic acid (mRNA) expression of phosphoinositide 3-kinase (PI3K), serine/threonine-protein kinase (AKT), and transforming growth factor-beta1 (TGF-beta1) in the femoral artery were analyzed using Western blotting and real-time polymerase chain reaction. The expression of CD31 in the gastrocnemius was measured using immunofluorescence. Results: Protein expression of PI3K, AKT, and TGF-beta1 was significantly lower in Groups C, D, and E than in Group B (p < 0.001, p < 0.001, and p < 0.001, respectively). The mRNA expression of AKT and TGF-beta1 in Groups C, D, and E was significantly lower than that in Group B (p < 0.001, p < 0.001, and p < 0.001, respectively). The expression of CD31 in the gastrocnemius, FAD, and blood flow was significantly higher in Groups C, D, and E than in Group B (p < 0.05), with the highest expression in Group E compared with Groups C and D (p < 0.05). Conclusion: Extracorporeal shock wave therapy can downregulate TGF-beta1 expression, inhibit the PI3K/AKT pathway, increase gastrocnemius CD31 expression and lower limb blood flow, and improve blood microcirculation of lower limb skeletal muscle.
