DOI: 10.1093/jsxmed/qdae001.243 ISSN: 1743-6095

(254) Extracorporeal Shock Wave Therapy Combined with Cannabidiol Reduces Prostatic Inflammation by Regulating TLR4-NFκB Signaling Pathway

WJ Bae, JJ Piao, S Kim, S Park, SW Kim
  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health



Chronic prostatitis is a refractory male disease that has bothered patients and confused urologists for a long time. Recently, extracorporeal shockwave therapy (ESWT), has evolved as a promising treatment approach in several inflammatory disease. Cannabidiol (CBD) is a minor cannabinoid with reported analgesic and anti-inflammatory properties.


To evaluate the effect of CBD and ESWT in lipopolysaccharide(LPS)-induced prostatic inflammation \


RWPE-1 cells were randomly divided into five groups: (a) RWPE-1 group (normal control), (b) LPS group (LPS-induced inflammation) and (c) CBD group (LPS-induced RWPE-1 treated with 0.1ug/ml of CBD), (d) ESWT group (LPS-induced RWPE-1 treated with ESWT), (e) CBD+ESWT group (LPS-induced RWPE-1 treated with CBD and ESWT). After administration of treatment, cells were collected for immunocytochemistry and Western blot analysis, respectively.


CBD and ESWT improved the inflammation of LPS-induced RWPE-1 cells, with the most significant improvement in the CBD+ESWT group (p <0.01). Compared with the LPS group, CBD, ESWT decreased cyclooxygenase 2 (COX-2) expression by inhibiting the TLR4-NFκB pathway (p<0.01).


CBD and ESWT reduce inflammation by degrading COX-2 in the microenvironment through the TLR4-NFκB inhibition pathway. ESWT combined with CBD improves inflammation significantly, thus suggesting that the combination treatment may be a potential and promising therapeutic approach for prostatitis.



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