{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:20:03Z","timestamp":1790864403007,"version":"4.1.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,10,27]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Paraplegia following spinal cord ischemia represents a devastating complication of both aortic surgery and endovascular aortic repair. Shock wave treatment was shown to induce angiogenesis and regeneration in ischemic tissue by modulation of early inflammatory response via Toll\u2010like receptor (\n              <jats:styled-content style=\"fixed-case\">TLR)<\/jats:styled-content>\n              3 signaling. In preclinical and clinical studies,\n              <jats:styled-content style=\"fixed-case\">shock wave treatment<\/jats:styled-content>\n              had a favorable effect on ischemic myocardium. We hypothesized that\n              <jats:styled-content style=\"fixed-case\">shock wave treatment<\/jats:styled-content>\n              also may have a beneficial effect on spinal cord ischemia.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A spinal cord ischemia model in mice and spinal slice cultures ex\u00a0vivo were performed. Treatment groups received immediate shock wave therapy, which resulted in decreased neuronal degeneration and improved motor function. In spinal slice cultures, the activation of TLR3 could be observed. Shock wave effects were abolished in spinal slice cultures from\n              <jats:styled-content style=\"fixed-case\">TLR<\/jats:styled-content>\n              3\n              <jats:sup>\u2212\/\u2212<\/jats:sup>\n              mice, whereas the effect was still present in\n              <jats:styled-content style=\"fixed-case\">TLR<\/jats:styled-content>\n              4\n              <jats:sup>\u2212\/\u2212<\/jats:sup>\n              mice.\n              <jats:styled-content style=\"fixed-case\">TLR<\/jats:styled-content>\n              4 protein was found to be downregulated parallel to\n              <jats:styled-content style=\"fixed-case\">TLR<\/jats:styled-content>\n              3 signaling. Shock wave\u2013treated animals showed significantly better functional outcome and survival. The protective effect on neurons could be reproduced in human spinal slices.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Shock wave treatment protects from neuronal degeneration via\n              <jats:styled-content style=\"fixed-case\">TLR<\/jats:styled-content>\n              3 signaling and subsequent\n              <jats:styled-content style=\"fixed-case\">TLR<\/jats:styled-content>\n              4 downregulation. Consequently, it represents a promising treatment option for the devastating complication of spinal cord ischemia after aortic repair.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.115.002440","type":"journal-article","created":{"date-parts":[[2015,10,28]],"date-time":"2015-10-28T07:28:11Z","timestamp":1446017291000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["Shock Wave Treatment Protects From Neuronal Degeneration via a Toll\u2010Like Receptor 3 Dependent Mechanism: Implications of a First\u2010Ever Causal Treatment for Ischemic Spinal Cord Injury"],"prefix":"10.1161","volume":"4","author":[{"given":"Daniela","family":"Lobenwein","sequence":"first","affiliation":[{"name":"University Hospital for Cardiac Surgery, Innsbruck Medical University, Innsbruck, 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