Gene Expression for Extracellular Matrix Proteins in Shockwave-Induced Osteogenesis in Rats

To clarify the mechanisms underlying shockwave-induced osteogenesis, we applied shockwave to rat femoral shafts from the ventral side. We assessed bone mineral content (BMC) and bone mineral density (BMD), and analyzed the spatial and temporal gene expression for pro-α1 (I) collagen (COL1A1), pro-α1 (II) collagen (COL2A1), pro-α1 (X) collagen (COL10A1), osteocalcin (OC) and osteopontin (OPN) using in situ hybridization. On the 21st day post-exposure, BMC and BMD in the exposed femur were elevated by 8.46% and 5.80%, respectively, relative to the unexposed femur. Immediately following exposure, there was evidence of scraping of the cortex and periosteal separation with hemorrhage. On day 4, new periosteal bone formation could be seen on the ventral and dorsal side of the femur. In the newly formed bone, COL1A1, OC and OPN were expressed in osteoblastic cells underlying the periosteum. On day 7, there was progression of periosteal bone and trabeculae formation. COL1A1 and OC were expressed in mature osteoblasts lining the trabeculae, whereas OPN was expressed in immature osteoblastic cells, osteocytes and osteoclasts. On day 14, bone remodeling commenced in the periosteal bone. COL1A1, OC and OPN were still expressed at this stage, however, signals were much weaker. Between 4–7 days, chondrocyte clusters were distributed multi-focally near the exposed site, and there was expression of COL2A1 but not of COL10A1. The results demonstrate that gene expression patterns of shockwave-induced osteogenesis are similar to those of periosteal hard callus formation during fracture healing. Shockwaves can yield dramatic activation of cells in normal long bones, and drive the cells to express genes for osteogenesis.