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A novel implant surface modification mode of Fe3O4-containing TiO2 nanorods with sinusoidal electromagnetic field for osteoblastogenesis and angiogenesis. Mater Today Bio 2023; 19:100590. [PMID: 36910272 PMCID: PMC9996442 DOI: 10.1016/j.mtbio.2023.100590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 02/24/2023] Open
Abstract
Implants made of Ti and its alloys are widely utilized in orthopaedic surgeries. However, insufficient osseointegration of the implants often causes complications such as aseptic loosening. Our previous research discovered that disordered titanium dioxide nanorods (TNrs) had satisfactory antibacterial properties and biocompatibility, but TNrs harmed angiogenic differentiation, which might retarded the osseointegration process of the implants. Magnetic nanomaterials have a certain potential in promoting osseointegration, electromagnetic fields within a specific frequency and intensity range can facilitate angiogenic and osteogenic differentiation. Therefore, this study used Fe3O4 to endow magnetism to TNrs and explored the regulation effects of Ti, TNrs, and Fe3O4-TNrs under 1 mT 15 Hz sinusoidal electromagnetic field (SEMF) on osteoblastogenesis, osseointegration, angiogenesis, and its mechanism. We discovered that after the addition of SEMF treatment to VR-EPCs cultured on Fe3O4-TNrs, the calcineurin/NFAT signaling pathway was activated, which then reversed the inhibitory effect of Fe3O4-TNrs on angiogenesis. Besides, Fe3O4-TNrs with SEMF enhanced osteogenic differentiation and osseointegration. Therefore, the implant modification mode of Fe3O4-TNrs with the addition of SEMF could more comprehensively promote osseointegration and provided a new idea for the modification of implants.
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The Possible Role of Electrical Stimulation in Osteoporosis: A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59010121. [PMID: 36676745 PMCID: PMC9861581 DOI: 10.3390/medicina59010121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023]
Abstract
Osteoporosis is mainly a geriatric disease with a high incidence, and the resulting spinal fractures and hip fractures cause great harm to patients. Anti-osteoporosis drugs are the main treatment for osteoporosis currently, but these drugs have potential clinical limitations and side effects, so the development of new therapies is of great significance to patients with osteoporosis. Electrical stimulation therapy mainly includes pulsed electromagnetic fields (PEMF), direct current (DC), and capacitive coupling (CC). Meanwhile, electrical stimulation therapy is clinically convenient without side effects. In recent years, many researchers have explored the use of electrical stimulation therapy for osteoporosis. Based on this, the role of electrical stimulation therapy in osteoporosis was summarized. In the future, electrical stimulation might become a new treatment for osteoporosis.
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Circadian Rhythm Modulates the Therapeutic Activity of Pulsed Electromagnetic Fields on Intervertebral Disc Degeneration in Rats. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:9067611. [PMID: 35368872 PMCID: PMC8975688 DOI: 10.1155/2022/9067611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/23/2022] [Accepted: 03/10/2022] [Indexed: 11/29/2022]
Abstract
Circadian rhythm (CR) imparts significant benefits in treating multiple diseases, such as heart diseases and arthritis. But the CR effect on intervertebral disc degeneration (IVDD) therapy remains unclear. Recent studies revealed that pulsed electromagnetic fields (PEMF) are capable of alleviating IVDD. In this study, we evaluated the CR-mediated regulation of PEMF therapeutic effect on IVDD induced by rat tail disc needle puncture. Our results demonstrated that the daytime PEMF stimulation (DPEMF) is more effective than the nighttime PEMF (NPEMF) in delaying IVDD. Moreover, the rats treated with DPEMF maintained better disc stability and histology after 8 weeks, relative to NPEMF. CR and PEMF cotherapies were also examined in cellular models, whereby serum shock was used to induce different levels of clock gene expression in the nucleus pulposus (NP), thus imitating CR in vitro. PEMF at ZT8 (higher level of clock gene expression) correlated with a higher extracellular matrix (ECM) component expression, compared to ZT20 (lower level of clock gene expression). Taken together, these data suggest a strong role of CR in regulating the beneficial effect of PEMF on IVDD. Our findings provide a potential clinical significance of CR in optimizing PEMF positive effects on IVDD.
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Huang J, Li Y, Wang L, He C. Combined Effects of Low-Frequency Pulsed Electromagnetic Field and Melatonin on Ovariectomy-Induced Bone Loss in Mice. Bioelectromagnetics 2021; 42:616-628. [PMID: 34516671 DOI: 10.1002/bem.22372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 08/12/2021] [Accepted: 09/01/2021] [Indexed: 02/05/2023]
Abstract
Pulsed electromagnetic field (PEMF) therapy and melatonin (MEL) supplementation are expected to be important strategies for the treatment of osteoporosis. The aim of the current study was to investigate the efficacy of PEMF therapy, MEL supplementation, a combination of PEMF therapy, and MEL supplementation (PEMF + MEL) in mice with bilateral ovariectomy (OVX)-induced osteoporosis. Forty 12-week-old female C57/BL mice were randomly assigned to five groups (n = 8/group): OVX, PEMF, MEL, PEMF + MEL, and sham-operation (sham) groups. All mice in the first four groups were subjected to OVX. The mice in the PEMF and PEMF + MEL groups were exposed to PEMF (75 Hz, 1.6 mT, 1 h/day for 12 weeks), while those in the MEL and PEMF + MEL groups were administered MEL (50 mg/kg, i.p.). Body mass, micro-computed tomography, histology, immunohistochemistry, and real-time polymerase chain reaction were performed. PEMF + MEL treatment enhanced bone volume fraction (BV/TV) 2.2-fold over OVX control (P < 0.001) and increased expression levels of collagen type I (COL1) 1.9-fold and bone morphogenetic protein 2 (BMP2) 2.5-fold. PEMF + MEL also reduced the ratio of bone surface/bone volume (BS/BV) by 40% (P < 0.05) and appeared to reduce the number of osteoclasts in the metaphysis area. Preservation of bone value and bone microarchitecture in the combined therapy group were found to be superior to those in the single treatment groups. However, there were no apparent differences between the PEMF and MEL groups. The use of a combination of PEMF therapy and MEL supplementation may be an effective method to treat osteoporosis. © 2021 Bioelectromagnetics Society.
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Affiliation(s)
- Jinming Huang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Li
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Liqiong Wang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Chengqi He
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
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Abdelatief EEM, Fathy KA. Effect of class IV laser therapy and Pilates exercises on bone density and pain in primary osteoporosis: a randomised controlled trial. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2021.0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/aims Osteoporosis is a systemic disorder characterised by a decrease in bone quality and density. This causes the bones to become weak and unable to withstand mild stresses, and the associated pain is made worse with activities. The aim of this study was to investigate the effect of class IV laser therapy and Pilates exercises on bone mineral density and pain in patients with primary osteoporosis. Methods A total of 60 patients with osteoporosis (40 women and 20 men) participated in this study. Their age ranged between 40 and 60 years. They were allocated randomly to three groups: Group A (n=20) received multiwave locked system laser therapy, group B (n=20) patients received Pilates exercises and group C (n=20) received multiwave locked system laser therapy and Pilates exercises. The treatment programme took place three times a week for 8 weeks. Bone mineral density of the lumbar spine (L1–L4) was measured by dual-energy X-ray absorptiometry and pain intensity during activities was measured by using the Numeric Pain Rating Scale. Evaluation of lumbar bone mineral density and pain intensity were performed before and after 8 weeks. Results The statistical analysis of this study revealed there was a significant increase of T-scores post-treatment compared to pre-treatment within group A (P=0.0001; P<0.05), group B (P=0.0001; P<0.05), and group C (P=0.0001), with improvement percentages of 19.59, 34.69 and 50.66% respectively. There was a decrease of pain intensity during activities post-treatment compared to pre-treatment within group A (P=0.0001; P<0.05), group B (P=0.0001; P<0.05) and group C (P=0.0001), with improvement percentages of 41.28, 54.39 and 70.09% respectively. Conclusions Class IV laser therapy and Pilates exercises are useful therapeutic modalities to increase bone mineral density and decrease pain in patients with osteoporosis, but combining them is more effective than using them separately.
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Affiliation(s)
| | - Karim Ahmed Fathy
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, October 6 University, Cairo, Egypt
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Hu H, Yang W, Zeng Q, Chen W, Zhu Y, Liu W, Wang S, Wang B, Shao Z, Zhang Y. Promising application of Pulsed Electromagnetic Fields (PEMFs) in musculoskeletal disorders. Biomed Pharmacother 2020; 131:110767. [PMID: 33152929 DOI: 10.1016/j.biopha.2020.110767] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/06/2020] [Accepted: 09/17/2020] [Indexed: 12/13/2022] Open
Abstract
Increasing evidence suggests that an exogenous electromagnetic field might be involved in many biologic processes which are of great importance for therapeutic interventions. Pulsed electromagnetic fields (PEMFs) are known to be a noninvasive, safe and effective therapy agent without apparent side effects. Numerous studies have shown that PEMFs possess the potential to become a stand-alone or adjunctive treatment modality for treating musculoskeletal disorders. However, several issues remain unresolved. Prior to their widely clinical application, further researches from well-designed, high-quality studies are still required to standardize the treatment parameters and derive the optimal protocol for health-care decision making. In this review, we aim to provide current evidence on the mechanism of action, clinical applications, and controversies of PEMFs in musculoskeletal disorders.
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Affiliation(s)
- Hongzhi Hu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China.
| | - Wenbo Yang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Qianwen Zeng
- Department of Pediatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Wei Chen
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
| | - YanBin Zhu
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
| | - Weijian Liu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Shangyu Wang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Baichuan Wang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Zengwu Shao
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Yingze Zhang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China.
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Lin CC, Chang YT, Lin RW, Chang CW, Wang GJ, Lai KA. Single pulsed electromagnetic field restores bone mass and microarchitecture in denervation/disuse osteopenic mice. Med Eng Phys 2020; 80:52-59. [DOI: 10.1016/j.medengphy.2019.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 07/09/2019] [Accepted: 10/14/2019] [Indexed: 12/25/2022]
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Topal O, Çina Aksoy M, Ciriş İM, Doğuç DK, Sert S, Çömlekçi S. Assessment of the effect of pulsed electromagnetic field application on the healing of bone defects in rats with heparin-induced osteoporosis. Electromagn Biol Med 2020; 39:206-217. [PMID: 32419512 DOI: 10.1080/15368378.2020.1762636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Osteoporosis is a systemic skeletal disease characterized by an increase in bone fragility and fracture risk due to low bone mass and deterioration of bone tissue. Application of pulsed electromagnetic fields (PEMF), a non-invasive method with a low complication risk, is known to stimulate bone formation. The present study examines the histomorphometric and biochemical effects of PEMF application on the healing of bone defects in rats with heparin-induced secondary osteoporosis. Briefly, 12-month-old male Sprague-Dawley rats were examined in a prospective, randomized, single-blind study. Osteoporosis was induced by administering a daily dose of 2 IU/g heparin for 33 days. Bone defects were created on the right femur on Day 35. PEMF of an average intensity of 0.8 ± 0.2 mT and a frequency of 7.3 Hz, was applied for 1 h/day, for 28 days following surgery. Bone healing was evaluated by histomorphometric and biochemical analyses. The heparin + PEMF group displayed the largest amount of new bone area (P = .002) and the lowest mean CTx on Day 63 (P = .05). This study demonstrates that heparin administration leads to bone loss and osteoporosis, whereas the application of PEMF decreases this effect.
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Affiliation(s)
- Olgun Topal
- Faculty of Dentistry, Department of Oral Maxillofacial Surgery, Afyonkarahisar Health Sciences University , Afyonkarahisar, Turkey
| | - Müge Çina Aksoy
- Faculty of Dentistry, Department of Oral Maxillofacial Surgery, Süleyman Demirel University , Isparta, Turkey
| | - İbrahim Metin Ciriş
- Faculty of Medicine, Department of Medical Pathology, Süleyman Demirel University , Isparta, Turkey
| | - Duygu Kumbul Doğuç
- Faculty of Medicine, Department of Medical Biochemistry, Süleyman Demirel University , Isparta, Turkey
| | - Seden Sert
- Faculty of Medicine, Department of Medical Biochemistry, Süleyman Demirel University , Isparta, Turkey
| | - Selçuk Çömlekçi
- Faculty of Engineering,Department of Electronics and CommunicationEngineering, Süleyman Demirel University , Isparta, Turkey
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Elshiwi AM, Hamada HA, Mosaad D, Ragab IMA, Koura GM, Alrawaili SM. Effect of pulsed electromagnetic field on nonspecific low back pain patients: a randomized controlled trial. Braz J Phys Ther 2019; 23:244-249. [PMID: 30177406 PMCID: PMC6531640 DOI: 10.1016/j.bjpt.2018.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 07/31/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Further research on pulsed electromagnetic field (PEMF) effects on the different conditions of low back pain was warranted due to lack of studies in this area. OBJECTIVES To investigate the effects of pulsed electromagnetic field therapy with 50Hz frequency, with low intensity of 20Gauss compared to conventional non-invasive treatment modalities in patients with chronic non-specific low back pain. METHODS Design - A prospective, randomized, patient-blinded, controlled trial. Setting - The study was conducted at Outpatient Physiotherapy Clinic in Cairo, Egypt. The study was conducted between May 2015 and September 2016. Participants - Fifty participants with non-specific low back pain enrolled into experimental and control groups. Interventions - The experimental group received the Conventional physical therapy Protocol as well as magnetic field, while the control group received the same Conventional physical therapy and sham electromagnetic field. Both groups received 12 sessions over 4 weeks' period. Outcome measures - Primary outcome measures was pain intensity while the secondary outcome measures were disability and lumbar range of motion - ROM. There were no adverse events occurred during the study. RESULTS Fifty participants with non-specific low back pain (control group n=25; experimental group n=25) were randomized. There were significant between-group differences in pain scores (mean difference - MD 1.52; 95%CI -0.34 to 3.35), function disability (MD 8.14; 95%CI 6.5 to 9.96), Range of Motion (ROM) of lumbar flexion (MD -1.27; 95%CI -1.09 to -1.45), ROM of lumbar extension (MD -1.1; 95%CI -0.97 to -1.23), ROM of lumbar right side bending (MD 8.2; 95%CI 6.56 to 9.84) and ROM of lumbar left side bending (MD 10.4; 95%CI 8.81 to 11.99) in favour of the experimental group. CONCLUSION Adding pulsed electromagnetic field to Conventional physical therapy Protocol yields superior clinical improvement in pain, functional disability, and lumbar ROM in patients with non-specific low back pain than Conventional physical therapy alone.
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Affiliation(s)
- Ahmed Mohamed Elshiwi
- Department of Physical Therapy for Musculoskeletal Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Hamada Ahmed Hamada
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
| | - Dalia Mosaad
- Department of Basic Science, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Ibrahim Mohammed A Ragab
- Department of Physical Therapy for Musculoskeletal Disorders and its Surgery, Faculty of Physical Therapy, Beni-Suef University, Beni-Suef, Egypt
| | - Ghada Mohamed Koura
- Department of Physical Therapy for Musculoskeletal Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt; Department of Medical Rehabilitation, Faculty of Applied Sciences, King Khalid University, Abha, Saudi Arabia
| | - Saud Mashi Alrawaili
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam, Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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Costantini E, Sinjari B, D'Angelo C, Murmura G, Reale M, Caputi S. Human Gingival Fibroblasts Exposed to Extremely Low-Frequency Electromagnetic Fields: In Vitro Model of Wound-Healing Improvement. Int J Mol Sci 2019; 20:ijms20092108. [PMID: 31035654 PMCID: PMC6540598 DOI: 10.3390/ijms20092108] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 03/23/2019] [Accepted: 04/25/2019] [Indexed: 01/24/2023] Open
Abstract
Several clinical studies have suggested the impact of sinusoidal and pulsed electromagnetic fields in quickening wound repair processes and tissue regeneration. The clinical use of extremely low-frequency electromagnetic fields could represent a novel frontier in tissue repair and oral health, with an interesting clinical perspective. The present study aimed to evaluate the effect of an extremely low-frequency sinusoidal electromagnetic field (SEMF) and an extremely low-frequency pulsed electromagnetic field (PEMF) with flux densities of 1 mT on a model of oral healing process using gingival fibroblasts. An in vitro mechanical injury was produced to evaluate wound healing, migration, viability, metabolism, and the expression of selected cytokines and protease genes in fibroblasts exposed to or not exposed to the SEMF and the PEMF. Interleukin 6 (IL-6), transforming growth factor beta 1 (TGF-β), metalloproteinase 2 (MMP-2), monocyte chemoattractant protein 1 (MCP-1), inducible nitric oxide synthase (iNOS), and heme oxygenase 1 (HO-1) are involved in wound healing and tissue regeneration, favoring fibroblast proliferation, chemotaxis, and activation. Our results show that the exposure to each type of electromagnetic field increases the early expression of IL-6, TGF-β, and iNOS, driving a shift from an inflammatory to a proliferative phase of wound repair. Additionally, a later induction of MMP-2, MCP-1, and HO-1 was observed after electromagnetic field exposure, which quickened the wound-healing process. Moreover, electromagnetic field exposure influenced the proliferation, migration, and metabolism of human gingival fibroblasts compared to sham-exposed cells. This study suggests that exposure to SEMF and PEMF could be an interesting new non-invasive treatment option for wound healing. However, additional studies are needed to elucidate the best exposure conditions to provide the desired in vivo treatment efficacy.
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Affiliation(s)
- Erica Costantini
- Department of Medical, Oral and Biotechnological Science, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy.
| | - Bruna Sinjari
- Department of Medical, Oral and Biotechnological Science, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy.
| | - Chiara D'Angelo
- Department of Medical, Oral and Biotechnological Science, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy.
| | - Giovanna Murmura
- Department of Medical, Oral and Biotechnological Science, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy.
| | - Marcella Reale
- Department of Medical, Oral and Biotechnological Science, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy.
| | - Sergio Caputi
- Department of Medical, Oral and Biotechnological Science, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy.
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Wang T, Yang L, Jiang J, Liu Y, Fan Z, Zhong C, He C. Pulsed electromagnetic fields: promising treatment for osteoporosis. Osteoporos Int 2019; 30:267-276. [PMID: 30603841 DOI: 10.1007/s00198-018-04822-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 12/18/2018] [Indexed: 02/05/2023]
Abstract
Osteoporosis (OP) is considered to be a well-defined disease which results in high morbidity and mortality. In patients diagnosed with OP, low bone mass and fragile bone strength have been demonstrated to significantly increase risk of fragility fractures. To date, various anabolic and antiresorptive therapies have been applied to maintain healthy bone mass and strength. Pulsed electromagnetic fields (PEMFs) are employed to treat patients suffering from delayed fracture healing and nonunions. Although PEMFs stimulate osteoblastogenesis, suppress osteoclastogenesis, and influence the activity of bone marrow mesenchymal stem cells (BMSCs) and osteocytes, ultimately leading to retention of bone mass and strength. However, whether PEMFs could be taken into clinical use to treat OP is still unknown. Furthermore, the deeper signaling pathways underlying the way in which PEMFs influence OP remain unclear.
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Affiliation(s)
- T Wang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan, People's Republic of China
- Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - L Yang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan, People's Republic of China
- Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - J Jiang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan, People's Republic of China
- Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Y Liu
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Z Fan
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan, People's Republic of China
- Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - C Zhong
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan, People's Republic of China
- Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - C He
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan, People's Republic of China.
- Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
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12
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Wu G, Zhang J, Chen W, Chen S, Huang Y, Lin R, Huang M, Li Z, Zheng L, Li X. Tougu Xiaotong capsule exerts a therapeutic effect on knee osteoarthritis by regulating subchondral bone remodeling. Mol Med Rep 2018; 19:1858-1866. [PMID: 30592265 DOI: 10.3892/mmr.2018.9778] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 12/12/2018] [Indexed: 01/16/2023] Open
Abstract
Previous studies have shown that Tougu Xiaotong capsule (TGXTC) has therapeutic effects on knee osteoarthritis (OA) through multiple targets. However, the mechanisms of action underlying its regulation of subchondral bone reconstruction remain unclear. In this study, we investigated the effects of TGXTC on subchondral bone remodeling. Eighteen six-month-old New Zealand white rabbits of average sex were randomly divided into the normal, model and TGXTC groups. The rabbit knee OA model was induced by a modified Hulth's method in the model and TGXTC groups, but not the normal group. Five weeks postoperatively, intragastric administration of TGXTC was performed for four weeks. After drug administration, the medial femoral condyle and tibia were prepared for observation of cartilage histology via optical microscopy and micro-computed tomography, the serum was collected for biochemical parameters assay and the subchondral bone isolated from the lateral femoral condyle was collected for detection of IL-1β and TNF-α mRNA and protein by reverse transcription-quantitative polymerase chain reaction and western blot analysis, respectively. The results showed that treatment with TGXTC significantly mitigated cartilage injury and subchondral bone damage, improved the parameter of subchondral trabecular bone, decreased alkaline phosphatase and tartrate-resistant acid phosphatase activity, and significantly reducing the osteoprotegerin/receptor activator of nuclear factor-κB ligand ratio, reduced the expression of IL-1β and TNF-α mRNA and protein. These results suggest that TGXTC could delay the pathological development of OA by regulating subchondral bone remodeling through regulation of bone formation and bone resorption and its relating inflammatory factors, and this may partly explain its clinical efficacy in the treatment of knee OA.
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Affiliation(s)
- Guangwen Wu
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Jiahui Zhang
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Wenlie Chen
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Sainan Chen
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Yunmei Huang
- National Laboratory of Traditional Chinese Medicine Pharmacology (Cell Structure and Function), Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Ruhui Lin
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Meiya Huang
- National Laboratory of Traditional Chinese Medicine Pharmacology (Cell Structure and Function), Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Zuanfang Li
- National Laboratory of Traditional Chinese Medicine Pharmacology (Cell Structure and Function), Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Liangpu Zheng
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Xihai Li
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
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Catalano A, Loddo S, Bellone F, Pecora C, Lasco A, Morabito N. Pulsed electromagnetic fields modulate bone metabolism via RANKL/OPG and Wnt/β-catenin pathways in women with postmenopausal osteoporosis: A pilot study. Bone 2018; 116:42-46. [PMID: 30010081 DOI: 10.1016/j.bone.2018.07.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 07/01/2018] [Accepted: 07/12/2018] [Indexed: 11/21/2022]
Abstract
Pulsed electromagnetic fields (PEMFs) have been proven to enhance in vitro and in vivo osteogenesis with unknown mechanism. Aim of our study was to explore whether RANKL/OPG and Wnt/β-Catenin pathways could be involved in bone response to PEMFs in a setting of postmenopausal osteoporotic women. Forty-three women (mean age 62.8 ± 4.5 yr.) were randomized into two groups. The PEMFs group received PEMFs treatment (50 min treatment session/day, 6 treatment sessions/week, for a total of 25 times), by wearing a specific gilet applied to the trunk and connected to the electromagnetic device (Biosalus, by HSD Srl, Serravalle RSM), while women assigned to control group received sham PEMFs with the same device. BSAP as bone formation and CTX as bone resorption markers, RANKL, OPG, β-Catenin, DKK-1 and sclerostin were obtained at baseline, after 30 and 60 days. In PEMFs group, BSAP levels significantly increased after 30 and 60 days while CTX concentrations decreased at day 60. RANKL levels significantly decreased after 60 days. OPG was not significantly changed, but the RANKL/OPG ratio significantly decreased at day 30. DKK-1 levels decreased, while β-catenin concentrations increased after 30 and 60 days (P < 0.05). No significant changes of calcium, phosphorus, creatinine and sclerostin were detected. In the PEMFs group, at day 30, Δsclerostin was associated with ΔRANKL/OPG ratio (r = -0.5, P = 0.03) and ΔDKK-1 was associated with Δβ-Catenin (r = -0.47, P = 0.02). In women with postmenopausal osteoporosis, our data provide evidence of a PEMFs modulation of RANKL/OPG and Wnt/β-Catenin signaling pathways able to explain the metabolic effects of PEMFs on bone.
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Affiliation(s)
- Antonino Catalano
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy.
| | - Saverio Loddo
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Federica Bellone
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Carmelo Pecora
- Vertebral Surgery Section, Carmona Clinic, Messina, Italy
| | - Antonino Lasco
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Nunziata Morabito
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
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Shanb AA, Youssef EF, Muaidi QI, Alothman AA. Whole body vibration versus magnetic therapy on bone mineral density in elderly osteoporotic individuals. J Back Musculoskelet Rehabil 2017; 30:903-912. [PMID: 28453453 DOI: 10.3233/bmr-160607] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Osteoporosis usually develops gradually and progresses without significant signs and symptoms. It is one of the most common musculoskeletal conditions associated with aging. OBJECTIVES To evaluate the effects of whole body vibration (WBV) or magnetic therapy in addition to standard pharmacological treatment on bone mineral density (BMD) in elderly individuals being treated for osteoporosis. METHODS Eighty-five participants, 60-75 years of age, were randomly divided into three groups. All three groups received the same standard pharmacological treatment comprised of vitamin D, calcium, and alendronate sodium. In Group I, thirty participants were also exposed to WBV for 25 minutes in each session with two sessions per week for 4 months. In Group II, thirty participants were exposed to magnetic therapy for 50 minutes in each session with two sessions per week for 4 months. In Group III, twenty-five participants received only pharmacological treatment. Dual-energy X-ray absorptiometry was used to measure BMD of the lumbar spine and femoral heads before and after interventions. Venus blood sample was drawn for analysis of calcium and vitamin D. RESULTS An ANOVA test detected significant (p< 0.05) differences in BMD after treatment among the three groups with no significant difference was detected between patients receiving WBV and magnetic therapy. Statistical t-tests detected significant (p< 0.05) increases in BMD after application of WBV or magnetic therapy in combination with pharmacological treatment, but no significant increase after pharmacological treatment alone. CONCLUSIONS Addition of either WBV or magnetic therapy to standard pharmacological treatment for osteoporosis significantly increased BMD in elderly subjects. No significant difference in effectiveness was detected between these two alternative therapy modalities. Consequently, either WBV or magnetic therapy could be effectively applied in conjunction with pharmacological treatment to increase BMD in elderly osteoporotic patients.
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Affiliation(s)
- Alsayed Abdelhameed Shanb
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Alkhobar, Dammam City, KSA
| | - Enas Fawzy Youssef
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Alkhobar, Dammam City, KSA
| | - Qassim Ibrahim Muaidi
- Chairman of Physical Therapy Department, Imam Abdulrahman Bin Faisal University, Alkhobar, Dammam City, KSA
| | - Abdullah Ahmed Alothman
- King Fahd Teaching Hospital, Imam Abdulrahman Bin Faisal University, Alkhobar, Dammam City, KSA
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15
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Zhu S, He H, Zhang C, Wang H, Gao C, Yu X, He C. Effects of pulsed electromagnetic fields on postmenopausal osteoporosis. Bioelectromagnetics 2017; 38:406-424. [PMID: 28665487 DOI: 10.1002/bem.22065] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 06/05/2017] [Indexed: 02/05/2023]
Abstract
Postmenopausal osteoporosis (PMOP) is considered to be a well-defined subject that has caused high morbidity and mortality. In elderly women diagnosed with PMOP, low bone mass and fragile bone strength have been proven to significantly increase risk of fragility fractures. Currently, various anabolic and anti-resorptive therapies have been employed in an attempt to retain healthy bone mass and strength. Pulsed electromagnetic fields (PEMFs), first applied in treating patients with delayed fracture healing and nonunions, may turn out to be another potential and effective therapy for PMOP. PEMFs can enhance osteoblastogenesis and inhibit osteoclastogenesis, thus contributing to an increase in bone mass and strength. However, accurate mechanisms of the positive effects of PEMFs on PMOP remain to be further elucidated. This review attempts to summarize recent advances of PEMFs in treating PMOP based on clinical trials, and animal and cellular studies. Possible mechanisms are also introduced, and the future possibility of application of PEMFs on PMOP are further explored and discussed. Bioelectromagnetics. 38:406-424, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Siyi Zhu
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
- Laboratory of Endocrinology and Metabolism, Department of Endocrinology, National Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Hongchen He
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Chi Zhang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Haiming Wang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Chengfei Gao
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Xijie Yu
- Laboratory of Endocrinology and Metabolism, Department of Endocrinology, National Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Chengqi He
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
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16
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Liu C, Zhang Y, Fu T, Liu Y, Wei S, Yang Y, Zhao D, Zhao W, Song M, Tang X, Wu H. Effects of electromagnetic fields on bone loss in hyperthyroidism rat model. Bioelectromagnetics 2016; 38:137-150. [PMID: 27973686 DOI: 10.1002/bem.22022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 10/22/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Chaoxu Liu
- Department of Orthopaedics; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Yingchi Zhang
- Department of Orthopaedics; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Tao Fu
- Department of Orthopaedics; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Yang Liu
- Department of Orthopaedics; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Sheng Wei
- Department of Orthopaedics; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Yong Yang
- Department of Orthopaedics; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Dongming Zhao
- Department of Orthopaedics; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | | | - Mingyu Song
- Department of Gynaecology and Obstetrics; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Xiangyu Tang
- Department of Radiology; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Hua Wu
- Department of Orthopaedics; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
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17
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Andrade R, Duarte H, Pereira R, Lopes I, Pereira H, Rocha R, Espregueira-Mendes J. Pulsed electromagnetic field therapy effectiveness in low back pain: A systematic review of randomized controlled trials. Porto Biomed J 2016; 1:156-163. [PMID: 32258569 DOI: 10.1016/j.pbj.2016.09.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 09/23/2016] [Indexed: 12/13/2022] Open
Abstract
Background Low back pain is a worldwide prevalent musculoskeletal condition in the general population. In this sense, the pulsed electromagnetic fields (PEMF) therapy has shown significant clinical benefits in several musculoskeletal conditions. Objective To assess the effectiveness of the PEMF therapy in reducing pain and clinical symptomatology in patients with low back pathological conditions. Methods It was performed a comprehensive database search using Pubmed, Scopus, Cochrane Library and PEDro databases to assess the effectiveness of the PEMF therapy in reducing pain and clinical symptomatology in patients with low back pathological conditions. The search was performed from January 2005 to August 2015 and conducted by two independent investigators, which scrutinize the reference list of most relevant studies. The methodological quality was assessed by the PEDro scale and the level of evidence was set according Oxford Center for Evidence-Based Medicine scale. Results Six studies were eligible inclusion on the qualitative analysis and five into the quantitative analysis, scoring an overall 6.8 points according the PEDro scale. The studies showed heterogeneity concerning the intervention protocols. Nevertheless, the effect sizes' indicated a clear tendency to reduction of the pain intensity favoring the PEMF groups, reaching a minimal clinically important difference. Conclusion PEMF therapy seems to be able to relieve the pain intensity and improve functionality in individuals with low back pain conditions. Further research is needed regarding PEMF effects on the different conditions of low back pain, with standardized protocols, larger samples and adjustment for low back pain confounders in order to achieve stronger conclusions.
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Affiliation(s)
- Renato Andrade
- Faculty of Sports, University of Porto, Porto, Portugal.,Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal
| | - Hugo Duarte
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Rogério Pereira
- Faculty of Health Sciences, University of Fernando Pessoa, Porto, Portugal.,Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal
| | - Isabel Lopes
- Physical Medicine and Rehabilitation Department, Centro Hospitalar São João EPE, Porto, Portugal.,Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal
| | - Hélder Pereira
- Orthopaedic Department, Centro Hospitalar Póvoa de Varzim, Vila do Conde, Portugal.,3B's Research Group - Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, Guimarães, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Ripoll y De Prado Sports Clinic FIFA Medical Centre of Excellence, Murcia-Madrid, Spain.,Dom Henrique Research Centre, Porto, Portugal
| | - Rui Rocha
- Orthopaedic Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal.,Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,3B's Research Group - Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, Guimarães, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Orthopaedics Department of Minho University, Minho, Portugal
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18
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Wang R, Wu H, Yang Y, Song M. Effects of electromagnetic fields on osteoporosis: A systematic literature review. Electromagn Biol Med 2016; 35:384-90. [PMID: 27356174 DOI: 10.3109/15368378.2015.1107840] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Electromagnetic fields (EMFs) as a safe, effective and noninvasive treatment have been researched and used for many years in orthopedics, and the common use clinically is to promote fracture healing. The effects of EMFs on osteoporosis have not been well concerned. The balance between osteoblast and osteoclast activity as well as the balance between osteogenic differentiation and adipogenic differentiation of bone marrow mesenchymal stem cells plays an important role in the process of osteoporosis. A number of recent reports suggest that EMFs have a positive impact on the balances. In this review, we discuss the recent advances of EMFs in the treatment of osteoporosis from basic research to clinical study and introduce the possible mechanism. In addition, we presented future perspectives of application of EMFs for osteoporosis.
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Affiliation(s)
- Rong Wang
- a Department of Gastroenterology , General Hospital of the Yangtse River Shipping , Hubei , P. R. China
| | - Hua Wu
- b Department of Orthopedics , Tongji Hospital, Huazhong University of Science and Technology , Hubei , P. R. China
| | - Yong Yang
- b Department of Orthopedics , Tongji Hospital, Huazhong University of Science and Technology , Hubei , P. R. China
| | - Mingyu Song
- c Department of Obstetrics and Gynecology , Tongji Hospital, Huazhong University of Science and Technology , Hubei , P. R. China
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19
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Single-pulsed electromagnetic field therapy increases osteogenic differentiation through Wnt signaling pathway and sclerostin downregulation. Bioelectromagnetics 2015; 36:494-505. [DOI: 10.1002/bem.21933] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 07/15/2015] [Indexed: 01/20/2023]
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20
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Ledda M, D'Emilia E, Giuliani L, Marchese R, Foletti A, Grimaldi S, Lisi A. Nonpulsed Sinusoidal Electromagnetic Fields as a Noninvasive Strategy in Bone Repair: The Effect on Human Mesenchymal Stem Cell Osteogenic Differentiation. Tissue Eng Part C Methods 2015; 21:207-17. [DOI: 10.1089/ten.tec.2014.0216] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Mario Ledda
- Institute of Translational Pharmacology, National Research Council, Rome, Italy
| | - Enrico D'Emilia
- Dipartimento Insediamenti produttivi ed Interazione con l'Ambiente (INAIL-DIPIA), Rome, Italy
| | - Livio Giuliani
- Dipartimento Insediamenti produttivi ed Interazione con l'Ambiente (INAIL-DIPIA), Rome, Italy
- INAIL Florence, Rome, Italy
| | | | - Alberto Foletti
- Institute of Translational Pharmacology, National Research Council, Rome, Italy
| | - Settimio Grimaldi
- Institute of Translational Pharmacology, National Research Council, Rome, Italy
| | - Antonella Lisi
- Institute of Translational Pharmacology, National Research Council, Rome, Italy
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21
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Zhou J, Ma XN, Gao YH, Yan JL, Shi WG, Xian CJ, Chen KM. Sinusoidal electromagnetic fields promote bone formation and inhibit bone resorption in rat femoral tissuesin vitro. Electromagn Biol Med 2014; 35:75-83. [DOI: 10.3109/15368378.2014.971958] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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22
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van der Jagt OP, van der Linden JC, Waarsing JH, Verhaar JAN, Weinans H. Electromagnetic fields do not affect bone micro-architecture in osteoporotic rats. Bone Joint Res 2014; 3:230-5. [PMID: 25015993 PMCID: PMC4112789 DOI: 10.1302/2046-3758.37.2000221] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objectives Electromagnetic fields (EMF) are widely used in musculoskeletal
disorders. There are indications that EMF might also be effective
in the treatment of osteoporosis. To justify clinical follow-up
experiments, we examined the effects of EMF on bone micro-architectural
changes in osteoporotic and healthy rats. Moreover, we tested the
effects of EMF on fracture healing. Methods EMF (20 Gauss) was examined in rats (aged 20 weeks), which underwent
an ovariectomy (OVX; n = 8) or sham-ovariectomy (sham-OVX; n = 8).
As a putative positive control, all rats received bilateral fibular
osteotomies to examine the effects on fracture healing. Treatment
was applied to one proximal lower leg (three hours a day, five days
a week); the lower leg was not treated and served as a control.
Bone architectural changes of the proximal tibia and bone formation
around the osteotomy were evaluated using in vivo microCT
scans at start of treatment and after three and six weeks. Results In both OVX and sham-OVX groups, EMF did not result in cancellous
or cortical bone changes during follow-up. Moreover, EMF did not
affect the amount of mineralised callus volume around the fibular
osteotomy. Conclusions In this study we were unable to reproduce the strong beneficial
findings reported by others. This might indicate that EMF treatment
is very sensitive to the specific set-up, which would be a serious
hindrance for clinical use. No evidence was found that EMF treatment
can influence bone mass for the benefit of osteoporotic patients. Cite this article: Bone Joint Res 2014;3:230–5.
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Affiliation(s)
- O P van der Jagt
- University Medical Centre Rotterdam, Department of Orthopaedics, Erasmus MC, PO Box 2040, 3000CA Rotterdam, the Netherlands
| | - J C van der Linden
- University Medical Centre Rotterdam, Department of Orthopaedics, Erasmus MC, PO Box 2040, 3000CA Rotterdam, the Netherlands
| | - J H Waarsing
- University Medical Centre Rotterdam, Department of Orthopaedics, Erasmus MC, PO Box 2040, 3000CA Rotterdam, the Netherlands
| | - J A N Verhaar
- University Medical Centre Rotterdam, Department of Orthopaedics, Erasmus MC, PO Box 2040, 3000CA Rotterdam, the Netherlands
| | - H Weinans
- UMC Utrecht, Department of Orthopedics and Department of Rheumatology, PO Box 85500, 3508 Utrecht, the Netherlands
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Parhampour B, Torkaman G, Hoorfar H, Hedayati M, Ravanbod R. Effects of short-term resistance training and pulsed electromagnetic fields on bone metabolism and joint function in severe haemophilia A patients with osteoporosis: a randomized controlled trial. Clin Rehabil 2013; 28:440-50. [PMID: 24249841 DOI: 10.1177/0269215513505299] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To assess the effects of short-term resistance training and pulsed electromagnetic fields on bone metabolism and joint function in patients with haemophilia with osteoporosis. DESIGN A randomized, controlled, patient and blood sample assessor-blinded, six-week trial, three times weekly. SETTING Hospital outpatients with severe haemophilia A and osteoporosis. SUBJECTS Forty-eight patients were randomly assigned to resistance training (RT, n = 13), combined resistance training with pulsed electromagnetic fields (RTPEMF, n = 12), pulsed electromagnetic fields (PEMF, n = 11) and control (n = 12) groups. INTERVENTION The RT group received 30-40 minutes of resistance exercises and placebo pulsed electromagnetic fields. The RTPEMF group received the same exercises with lower repetition and 30 minutes of pulsed electromagnetic fields. The PEMF group was exposed to 60 minutes of pulsed electromagnetic fields (30 Hz and 40 Gauss). MAIN MEASURES Bone-specific alkaline phosphatase, N-terminal telopeptide of type 1 collagen, and joint function, using the modified Colorado Questionnaire, were measured before and after the programme. RESULTS The absolute change of bone-specific alkaline phosphatase was significant in the RT and RTPEMF groups compared with the control group (25.41 ± 14.40, 15.09 ± 5.51, and -4.73 ± 2.93 U/L, respectively). The absolute changes in the total score for joint function were significant for knees, ankles, and elbows in the RT group (9.2 ± 1.38, 5.1 ± 0.5, and 3.2 ± 0.8, respectively) and the RTPEMF group (7.7 ± 1.0, 3.3 ± 0.6, and 2.5 ± 0.7, respectively) compared to the PEMF and control groups. This value was significant for knee joints in the PEMF group compared to the control group (3.4 ± 0.5 and 0.66 ± 0.4, respectively). CONCLUSIONS Resistance training is effective for improving bone formation and joint function in severe haemophilia A patients with osteoporosis.
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Ceccarelli G, Bloise N, Mantelli M, Gastaldi G, Fassina L, De Angelis MGC, Ferrari D, Imbriani M, Visai L. A comparative analysis of the in vitro effects of pulsed electromagnetic field treatment on osteogenic differentiation of two different mesenchymal cell lineages. Biores Open Access 2013; 2:283-94. [PMID: 23914335 PMCID: PMC3731679 DOI: 10.1089/biores.2013.0016] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Human mesenchymal stem cells (MSCs) are a promising candidate cell type for regenerative medicine and tissue engineering applications. Exposure of MSCs to physical stimuli favors early and rapid activation of the tissue repair process. In this study we investigated the in vitro effects of pulsed electromagnetic field (PEMF) treatment on the proliferation and osteogenic differentiation of bone marrow MSCs (BM-MSCs) and adipose-tissue MSCs (ASCs), to assess if both types of MSCs could be indifferently used in combination with PEMF exposure for bone tissue healing. We compared the cell viability, cell matrix distribution, and calcified matrix production in unstimulated and PEMF-stimulated (magnetic field: 2 mT, amplitude: 5 mV) mesenchymal cell lineages. After PEMF exposure, in comparison with ASCs, BM-MSCs showed an increase in cell proliferation (p<0.05) and an enhanced deposition of extracellular matrix components such as decorin, fibronectin, osteocalcin, osteonectin, osteopontin, and type-I and -III collagens (p<0.05). Calcium deposition was 1.5-fold greater in BM-MSC-derived osteoblasts (p<0.05). The immunofluorescence related to the deposition of bone matrix proteins and calcium showed their colocalization to the cell-rich areas for both types of MSC-derived osteoblast. Alkaline phosphatase activity increased nearly 2-fold (p<0.001) and its protein content was 1.2-fold higher in osteoblasts derived from BM-MSCs. The quantitative reverse-transcription polymerase chain reaction (qRT-PCR) analysis revealed up-regulated transcription specific for bone sialoprotein, osteopontin, osteonectin, and Runx2, but at a higher level for cells differentiated from BM-MSCs. All together these results suggest that PEMF promotion of bone extracellular matrix deposition is more efficient in osteoblasts differentiated from BM-MSCs.
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Affiliation(s)
- Gabriele Ceccarelli
- Department of Public Health, Neuroscience, and Experimental & Forensic Medicine, University of Pavia , Pavia, Italy . ; Center for Tissue Engineering (C.I.T.), University of Pavia , Pavia, Italy
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25
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Pall ML. Electromagnetic fields act via activation of voltage-gated calcium channels to produce beneficial or adverse effects. J Cell Mol Med 2013; 17:958-65. [PMID: 23802593 PMCID: PMC3780531 DOI: 10.1111/jcmm.12088] [Citation(s) in RCA: 245] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 05/20/2013] [Indexed: 12/27/2022] Open
Abstract
The direct targets of extremely low and microwave frequency range electromagnetic fields (EMFs) in producing non-thermal effects have not been clearly established. However, studies in the literature, reviewed here, provide substantial support for such direct targets. Twenty-three studies have shown that voltage-gated calcium channels (VGCCs) produce these and other EMF effects, such that the L-type or other VGCC blockers block or greatly lower diverse EMF effects. Furthermore, the voltage-gated properties of these channels may provide biophysically plausible mechanisms for EMF biological effects. Downstream responses of such EMF exposures may be mediated through Ca2+/calmodulin stimulation of nitric oxide synthesis. Potentially, physiological/therapeutic responses may be largely as a result of nitric oxide-cGMP-protein kinase G pathway stimulation. A well-studied example of such an apparent therapeutic response, EMF stimulation of bone growth, appears to work along this pathway. However, pathophysiological responses to EMFs may be as a result of nitric oxide-peroxynitrite-oxidative stress pathway of action. A single such well-documented example, EMF induction of DNA single-strand breaks in cells, as measured by alkaline comet assays, is reviewed here. Such single-strand breaks are known to be produced through the action of this pathway. Data on the mechanism of EMF induction of such breaks are limited; what data are available support this proposed mechanism. Other Ca2+-mediated regulatory changes, independent of nitric oxide, may also have roles. This article reviews, then, a substantially supported set of targets, VGCCs, whose stimulation produces non-thermal EMF responses by humans/higher animals with downstream effects involving Ca2+/calmodulin-dependent nitric oxide increases, which may explain therapeutic and pathophysiological effects.
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Affiliation(s)
- Martin L Pall
- Professor Emeritus of Biochemistry and Basic Medical Sciences, Washington State University, Portland, OR, USA.
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Zhou J, Wang JQ, Ge BF, Ma XN, Ma HP, Xian CJ, Chen KM. Different electromagnetic field waveforms have different effects on proliferation, differentiation and mineralization of osteoblasts in vitro. Bioelectromagnetics 2013; 35:30-8. [PMID: 23775573 DOI: 10.1002/bem.21794] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Accepted: 04/04/2013] [Indexed: 11/09/2022]
Abstract
Noninvasive electromagnetic fields (EMFs) have been known to be able to improve bone health; however, their optimal application parameters and action mechanisms remain unclear. This study compared the effects of different forms of EMFs (sinusoidal, triangular, square, and serrated, all set at 50 Hz frequency and 1.8 mT intensity) on proliferation, differentiation and mineralization of rat calvarial osteoblasts. Square EMFs stimulated osteoblast proliferation but sinusoidal EMFs inhibited it. Sinusoidal and triangular EMFs produced significantly greater alkaline phosphatase (ALP) activity, ALP staining areas, calcium deposition, mineralized nodule areas, and mRNA expression of Runx-2, osteoprotegerin and insulin-like growth factor-I than square and serrated EMFs (P < 0.01). Triangular EMFs had a greater effect than sinusoidal EMFs on every indices except for Runx-2 mRNA expression (P < 0.05). These results indicated that while square EMFs promoted proliferation and had no effect on the differentiation of osteoblasts, sinusoidal EMFs inhibited proliferation but enhanced osteogenic differentiation. Triangular EMFs did not affect cell proliferation but induced the strongest osteogenic activity among the four waveforms of EMFs. Thus, the effects of EMFs on proliferation and differentiation of osteoblasts in vitro were dependent on their waveforms.
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Affiliation(s)
- Jian Zhou
- Institute of Orthopaedics, Lanzhou General Hospital, Lanzhou Command of People's Liberation Army, Lanzhou, P.R., China
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Zhou J, Ming LG, Ge BF, Wang JQ, Zhu RQ, Wei Z, Ma HP, Xian CJ, Chen KM. Effects of 50 Hz sinusoidal electromagnetic fields of different intensities on proliferation, differentiation and mineralization potentials of rat osteoblasts. Bone 2011; 49:753-61. [PMID: 21726678 DOI: 10.1016/j.bone.2011.06.026] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Revised: 06/17/2011] [Accepted: 06/18/2011] [Indexed: 11/25/2022]
Abstract
Electromagnetic fields (EMFs) have been used clinically to slow down osteoporosis and promote fracture healing for many years. However, the underlying action mechanisms and optimal parameters of the EMF applications are unclear. In this study, we investigated the effects of treatment for different durations with 50 Hz sinusoidal electromagnetic fields (SEMFs) at different intensities on proliferation, differentiation and mineralization potentials of rat osteoblasts. Osteoblasts isolated from neonatal rats were treated with SEMFs (50 Hz at 0.9 mT-4.8 mT, 0.3 mT interval, 30 min/day up to 15 days). Compared to untreated control, SEMFs inhibited osteoblast proliferation (after 3 days' treatment) but increased alkaline phosphatase (ALP) activity (after treatment for 9 days) from 0.9 mT to 1.8 mT, declined from 1.8 mT until 3.0 mT, and then increased again from 3.0 mT to 3.6 mT and decreased once again from 3.6 mT to 4.8 mT. Numbers of colonies stained positive for ALP after 8 days and mineralized nodules stained by Alizarin red after 10 days showed the same bimodal tendency as with the ALP activity, with two peaks at 1.8 mT and 3.6 mT. SEMFs also bimodally increased Runx-2, Col1α2 and Bmp-2 mRNA expression levels in osteoblasts at 12, 24 and 96 h after exposure. The results indicated that while exposure to 50 Hz SEMFs inhibits the osteoblast proliferation, it significantly promotes differentiation and mineralization potentials of osteoblasts in an intensity-dependent manner with peak activity at 1.8 mT and 3.6 mT.
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Affiliation(s)
- Jian Zhou
- Institute of Orthopaedics, Lanzhou General Hospital, [corrected] Lanzhou Command of CPLA, Lanzhou 730050, People's Republic of China.
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