Dynamic imaging demonstrates that pulsed electromagnetic fields (PEMF) suppress IL-6 transcription in bovine nucleus pulposus cells

Chronic E. Coli Drug-Resistant Cystitis Treated with a Sequence of Modulated Extremely Low-Frequency Electromagnetic Fields: A Randomized Study of 148 Cases

(1) Background: This study investigated the effects of sequenced electromagnetic fields, modulated at extremely low frequencies and intensities, in the treatment of drug-resistant Escherichia coli (E. coli)-induced chronic bacterial cystitis. (2) Methods: A total of 148 female participants, aged 18 to 80 years diagnosed with chronic bacterial cystitis caused by drug-resistant E. coli, were recruited for this study. Participants were randomly assigned to two groups: an experimental group (n = 74) with osteopathic palpation and assessment treated with a sequence of electromagnetic fields, and a control group (n = 74) receiving a placebo treatment. Both groups were assessed at this study's outset, 4 weeks after eight applications, and at 12 weeks for symptomatic presentation and laboratory parameters. (3) Results: After 4 weeks of treatment, a significant difference was observed between the two groups regarding D-DIMER levels, IL-6 levels, erythrocyte levels, leukocyte levels, and E. coli levels (p < 0.001). By the 12th week, the experimental group continued to exhibit a significant reduction in the examined parameters compared to the control group (p < 0.001). Additionally, the treatment did not induce any side effects in the patients in the experimental group. (4) Conclusions: Treatment with coherently sequenced electromagnetic fields, modulated at an extremely low frequency and intensity, not only appears to provide an effective alternative for the symptoms of chronic bacterial cystitis caused by drug-resistant E. coli but also demonstrates a potent antibacterial effect.

Pulsed Electromagnetic Field Stimulation in Lumbar Spine Fusion for Patients With Risk Factors for Pseudarthrosis

BACKGROUND

Lumbar spinal fusion surgeries are increasing steadily due to an aging and ever-growing population. Patients undergoing lumbar spinal fusion surgery may present with risk factors that contribute to complications, pseudarthrosis, prolonged pain, and reduced quality of life. Pulsed electromagnetic field (PEMF) stimulation represents an adjunct noninvasive treatment intervention that has been shown to improve successful fusion and patient outcomes following spinal surgery.

METHODS

A prospective, multicenter study investigated PEMF as an adjunct therapy to lumbar spinal fusion procedures in patients at risk for pseudarthrosis. Patients with at least 1 of the following risk factors were enrolled: prior failed fusion, multilevel fusion, nicotine use, osteoporosis, or diabetes. Fusion status was determined by radiographic imaging, and patient-reported outcomes were also evaluated.

RESULTS

A total of 142 patients were included in the analysis. Fusion status was assessed at 12 months follow-up where 88.0% (n = 125/142) of patients demonstrated successful fusion. Fusion success for patients with 1, 2+, or 3+ risk factors was 88.5%, 87.5%, and 82.3%, respectively. Significant improvements in patient-reported outcomes using the Short Form 36, EuroQol 5 Dimension (EQ-5D) survey, Oswestry Disability Index, and visual analog scale for back and leg pain were also observed compared with baseline scores (P < 0.001). A favorable safety profile was observed. PEMF treatment showed a positive benefit-risk profile throughout the 6-month required use period.

CONCLUSIONS

The addition of PEMF as an adjunct treatment in patients undergoing lumbar spinal surgery provided a high rate of successful fusion with significant improvements in pain, function, and quality of life, despite having risk factors for pseudarthrosis.

CLINICAL RELEVANCE

PEMF represents a useful tool for adjunct treatment in patients who have undergone lumbar spinal surgery. Treatment with PEMF may result in improved fusion and patient-reported outcomes, regardless of risk factors.

TRIAL REGISTRATION

NCT03176303.

The Effect of Different Frequencies of Pulsed Electromagnetic Fields on Cartilage Repair of Adipose Mesenchymal Stem Cell-Derived Exosomes in Osteoarthritis

BACKGROUND

The intra-articular injection of mesenchymal stem cell (MSC)-derived exosomes has already been proved to reverse osteoarthritic cartilage degeneration. Pulsed electromagnetic field (PEMF) has been found to regulate the biogenic function of MSCs. However, the effect of PEMF on MSC-derived exosomes has not yet been characterized. The aim of this study was to elucidate the regulatory role of different frequencies of PEMF in promoting the osteoarthritic cartilage regeneration of MSC-derived exosomes.

METHODS

The adipose tissue-derived MSCs (AMSCs) were extracted from the epididymal fat of healthy rats and further exposed to the PEMF at 1 mT amplitude and a frequency of 15, 45, and 75 Hz, respectively, in an incubator. The chondrocytes were treated with interlukin-1β (IL-1β) and the regenerative effect of co-culturing with PEMF-exposed AMSC-derived exosomes was assessed via Western blot, quantitative polymerase chain reaction, and ELISA assays. A rat model of osteoarthritis was established by anterior cruciate ligament transection (ACLT) surgery and received 4 times intra-articular injection of PEMF-exposed AMSC-derived exosomes once a week. After 8 weeks, the knee joint specimens of rats were collected for micro-computed tomography and histologic analyses.

RESULTS

PEMF-exposed AMSC-derived exosomes could be endocytosed with IL-1β-induced chondrocytes. Compared with the AMSC-derived exosomes alone, the PEMF-exposed AMSC-derived exosomes substantially suppressed the inflammation and extracellular matrix degeneration of IL-1β-induced chondrocytes as shown by higher expression of transcripts and proteins of COL2A1, SOX9, and ACAN and lower expression of MMP13 and caspase-1. Of these, the 75-Hz PEMF presented a more significant inhibitive effect than the 15-Hz and 45-Hz PEMFs. Furthermore, the intra-articular injection of 75-Hz PEMF-exposed exosomes could obviously increase the number of tibial epiphyseal trabeculae, lead to a remarkable decrease in Osteoarthritis Research Society International score, and upregulate the COL2A1 and ACAN protein level of the degenerated cartilage.

CONCLUSION

The present study demonstrated that PEMF stimulation could effectively promote the regeneration effects of AMSC-derived exosomes on osteoarthritic cartilage. Compared with other frequency parameters, the PEMF at a frequency of 75 Hz showed a superior positive effect on AMSC-derived exosomes in suppressing the IL-1β-induced chondrocyte inflammation and extracellular matrix catabolism, as well as the osteoarthritic cartilage degeneration.

Targeting Mesenchymal Stromal Cells/Pericytes (MSCs) With Pulsed Electromagnetic Field (PEMF) Has the Potential to Treat Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation of synovium (synovitis), with inflammatory/immune cells and resident fibroblast-like synoviocytes (FLS) acting as major players in the pathogenesis of this disease. The resulting inflammatory response poses considerable risks as loss of bone and cartilage progresses, destroying the joint surface, causing joint damage, joint failure, articular dysfunction, and pre-mature death if left untreated. At the cellular level, early changes in RA synovium include inflammatory cell infiltration, synovial hyperplasia, and stimulation of angiogenesis to the site of injury. Different angiogenic factors promote this disease, making the role of anti-angiogenic therapy a focus of RA treatment. To control angiogenesis, mesenchymal stromal cells/pericytes (MSCs) in synovial tissue play a vital role in tissue repair. While recent evidence reports that MSCs found in joint tissues can differentiate to repair damaged tissue, this repair function can be repressed by the inflammatory milieu. Extremely-low frequency pulsed electromagnetic field (PEMF), a biophysical form of stimulation, has an anti-inflammatory effect by causing differentiation of MSCs. PEMF has also been reported to increase the functional activity of MSCs to improve differentiation to chondrocytes and osteocytes. Moreover, PEMF has been demonstrated to accelerate cell differentiation, increase deposition of collagen, and potentially return vascular dysfunction back to homeostasis. The aim of this report is to review the effects of PEMF on MSC modulation of cytokines, growth factors, and angiogenesis, and describe its effect on MSC regeneration of synovial tissue to further understand its potential role in the treatment of RA.

Coupling of pulsed electromagnetic fields (PEMF) therapy to molecular grounds of the cell

In this review we compile results cited in reliable journals that show a ratio for the use of pulsed electromagnetic fields (PEMF) in therapy, indeed. This is true especially for chronically inflamed joints. Furthermore, we try to link this therapeutic approach to the molecular background of chronic inflammation and arthritis. At first we start with the clinical outcome of PEMF therapy. Then, we look for possible triggers and an electromagnetic counterpart that is endogenously inherent in cell biology and in the tissues of interest. Finally, we want to investigate causal molecular and cellular mechanisms of possible PEMF actions. It shows that there are endogenous mechanisms, indeed, which can act as triggers for PEMF like the resting membrane potential as well as resonance mechanisms in charged moieties like membrane transporters. Especially voltage-gated calcium channels can be triggered. These may lead into specific signaling pathways and also may elicit nitric oxide as well as moderate radical reactions, which can ultimately lead to e.g. NFκB-like reactions. Concerted in the right way, these reactions can cause a kind of cell protection and ultimately lead to a dampening of inflammatory signals like interleukins.