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Inhibition of Ferroptosis in Prostatitis Model by Low Intensity Extracorporeal Shock Wave Therapy through the
Dongxu Lin1, Kang Li1, Wenbo Kuang1
1Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
The World Journal of Men'S Health
|February 20, 2026
Summary
Low-intensity extracorporeal shock wave therapy (Li-ESWT) alleviates chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) by reducing inflammation and fibrosis. This therapy mitigates ferroptosis, a form of cell death, through the Integrin-β1/NRF2 pathway.
Area of Science:
- Urology
- Biomedical Engineering
- Cellular Biology
Background:
- Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) affects many individuals, with limited understanding of treatment mechanisms.
- Low-intensity extracorporeal shock wave therapy (Li-ESWT) is a clinical option for CP/CPPS, but its underlying molecular pathways are not fully elucidated.
Purpose of the Study:
- To investigate the mechanotransduction signaling pathways activated by Li-ESWT.
- To explore the association between Li-ESWT and ferroptosis in CP/CPPS models.
- To clarify the role of the Integrin-β1/NRF2 pathway in Li-ESWT's therapeutic effects.
Main Methods:
- Experimental autoimmune prostatitis (EAP) rat model induced via prostate antigen immunization.
- Treatment groups included Li-ESWT, ferroptosis inducer (RSL3), and iron chelator (DFO).
- In vitro studies on LPS-stimulated RWPE-1 cells with modulated Integrin-β1/NRF2-xCT/GPX4 axis.
Main Results:
- Li-ESWT significantly alleviated EAP symptoms, reducing inflammation, fibrosis, and hyperalgesia.
- Li-ESWT suppressed oxidative stress and ferroptosis markers, including reduced reactive oxygen species, ferrous iron, and lipid peroxidation.
- Activation of the Integrin-β1/NRF2-xCT/GPX4 pathway was observed, crucial for Li-ESWT's anti-ferroptotic effects.
Conclusions:
- Li-ESWT effectively ameliorates CP/CPPS pathologies in an animal model.
- The therapeutic benefits of Li-ESWT are mediated by the mitigation of ferroptosis via the Integrin-β1/NRF2 signaling pathway.
- This study provides mechanistic insights into Li-ESWT for CP/CPPS treatment.
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