Cavitation-generated free radicals during shock wave exposure: investigations with cell-free solutions and suspended cells.

Extracorporeally generated shock waves as used in lithotripsy of urinary and biliary stones exhibit side effects in vivo. Furthermore, these shock waves destroy eukaryotic cells during in vitro treatment in suspension. A possible cause of these damaging effects might be cavitation, the growth and collapse of bubbles in liquids exposed to tensile stresses. During the collapse, temperature inside these cavitation bubbles rises up to several thousand K, leading to the formation of free radicals. We demonstrated the occurrence of cavitation-generated free radicals by direct reaction with fluorescent dyes in solution after shock wave treatment and investigated the resulting cell killing by variation of the cellular antioxidative defense status. We present evidence for the generation of intracellular free radicals during shock wave treatment of suspended cells.