Non-Pharmacologic Sustained Endothelial Shear Stress: An Evolving Clinical Paradigm

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Background

This Research Topic of Frontiers in Physiology is dedicated to the memory of Professor Marvin A. Sackner, who was a driving force in the concept of using pulsatile shear stress for therapeutics. Dr. Sackner unexpectedly passed away September 29, 2020. He was a pioneer in pulmonary disease, and lifetime contributor to the field of physiology. Dr. Sackner was a graduate of Jefferson Medical School (1957) and served in numerous academic positions including president of the American Thoracic Society. He is well recognized for his contributions in pulmonary physiology and sleep medicine. He was an ardent scholar of physiology, and trained numerous pulmonary physicians all over the world, receiving an Honorary Doctorate Degree for “outstanding work in the entire field of pulmonology and sleep disorders,” from University of Zurich, Switzerland 2007.
Over the years he published more than 40 books and contributions, over 250 peer reviewed journal articles and 37 patents. In the early 1990’s Dr. Sackner and Dr. Adams described and patented a method to produced pulsatile shear stress (Whole Body Periodic Acceleration (WBPA aka pGz)) in humans and animal models. The latter was born from early basic pulmonary research performed in both clinical and laboratory setting. Dr. Sackner was a consummate scholar. He was convinced that “movement is everything” and during the last 10 years, he worked very passionately to patent and create a portable device which would produce pulsatile shear stress. His contributions to science are numerous from the early description of bronchoscopy in the literature to the utility of “chicken soup” for improving mucociliary frequency and clearance, to portable home apnea and sleep monitors, to the most recent passive jogging, all have clinical and practical utility. He was truly a man ahead of his time, in his forward thinking and creativity in both science and art. His illustrious scientific career took him all over the world, where his love for collecting a special kind of art (Concrete and Visual Poetry) was kindled. Along with his late wife Ruth they built one of the world’s largest and most comprehensive collection of this very unique art. The latter resides in the University of Iowa Libraries as The Ruth and Marvin Sackner Archive of Concrete and Visual Poetry. Professor Marvin Sackner truly left a legacy and indelible imprint in the sciences, and art.

Flow mediated dilatation is a standard for acute assessment of endothelial function acting through induced increased blood flow after tourniquet release of an extremity. This creates shear stress to the endothelium which causes release of nitric oxide (NO) and other vasodilator mediators into the circulation with a usual duration of action of 8-10 minutes. In contrast, aerobic exercise promotes sustained shear stress that leads to long-lasting, NO bioavailability and health benefits. However, only about 30% of adults meet aerobic exercise recommended guidelines and are physically inactive. This poses a high risk for premature mortality and major non-communicable diseases and is associated with long periods of reduced shear stress. Noninvasive means and effects of sustained endothelial shear stress that are independent of physical activity will be the focus of this review.

The goal of this Research Topic is to put forth means and effects of producing sustained endothelial shear stress independent of physical activity in healthy humans and diseased patients. The means can be divided into 1) interventions to increase pulsatile shear stress by addition of pulses into circulation 2) interventions to increase laminar shear. We will explore various methods to induce the aforementioned in cells, animal models and human subjects, and signaling pathways which lead to the beneficial effects. The intermediate- and long-term effectiveness of sustained shear stress needs to be rigorously assessed.

Scope and information for Authors
- Preclinical and clinical comparisons between pulsatile and laminar endothelial shear stress.
- Sustained shear stress for management of various cardiovascular conditions including; heart failure, cardiomyopathy, and others.
- Pulsatile shear stress in management of respiratory conditions
- Pulsatile shear stress in management of diabetes
- Sustained shear stress during and after ischemia reperfusion injury
- Sustained shear stress in the management of chronic pain
- Sustained shear stress for hastening recovery from exercise and skeletal muscle injury
- Sustained shear stress in neurological diseases.

Topic Editor Dr. José Antonio Adams is a Co-Inventor of Respiband Plus and of a Computerized Algorithm for the Detection of Valid Pulse Oximeter Waveforms. He and Topic Editor Dr. Marvin A Sackner co-invented Gentle Jogger. Dr. Sackner is a Co-Founder and President of Sackner Wellness Products LLC (Miami, FL, USA). He has a number of patents, both joint and individual. Topic Editor Dr. Alfredo Martínez Ramírez has declared no competing interests with regards to the Research Topic subject.  

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