Discrimination between the effects of pulsed electrical stimulation and electrochemically conditioned medium on human osteoblasts

BACKGROUND

Electrical stimulation is used for enhanced bone fracture healing. Electrochemical processes occur during the electrical stimulation at the electrodes and influence cellular reactions. Our approach aimed to distinguish between electrochemical and electric field effects on osteoblast-like MG-63 cells. We applied 20 Hz biphasic pulses via platinum electrodes for 2 h. The electrical stimulation of the cell culture medium and subsequent application to cells was compared to directly stimulated cells. The electric field distribution was predicted using a digital twin.

RESULTS

Cyclic voltammetry and electrochemical impedance spectroscopy revealed partial electrolysis at the electrodes, which was confirmed by increased concentrations of hydrogen peroxide in the medium. While both direct stimulation and AC-conditioned medium decreased cell adhesion and spreading, only the direct stimulation enhanced the intracellular calcium ions and reactive oxygen species.

CONCLUSION

The electrochemical by-product hydrogen peroxide is not the main contributor to the cellular effects of electrical stimulation. However, undesired effects like decreased adhesion are mediated through electrochemical products in stimulated medium. Detailed characterisation and monitoring of the stimulation set up and electrochemical reactions are necessary to find safe electrical stimulation protocols.

Experimental and numerical methods to ensure comprehensible and replicable alternating current electrical stimulation experiments

Electrical stimulation has received increasing attention for decades for its application in regenerative medicine. Applications range from bone growth stimulation over cartilage regeneration to deep brain stimulation. Despite all research efforts, translation into clinical use has not yet been achieved in all fields. Recent critical assessments have identified limited documentation and monitoring of preclinical in vitro and in vivo experiments as possible reasons hampering clinical translation. In this work, we present experimental and numerical methods to determine the crucial quantities of electrical stimulation such as the electric field or current density. Knowing the stimulation quantities contributes to comprehending the biological response to electrical stimulation and to finally developing a reliable dose-response curve. To demonstrate the methods, we consider a direct contact electrical stimulation experiment that stands representative for a broad class of stimulation experiments. Electrochemical effects are addressed and methods to integrate them into numerical simulations are evaluated. A focus is laid on affordable lab equipment and reproducible open-source software solutions. Finally, clear guidelines to ensure replicability of electrical stimulation experiments are formulated.

Using a Digital Twin of an Electrical Stimulation Device to Monitor and Control the Electrical Stimulation of Cells in vitro

Electrical stimulation for application in tissue engineering and regenerative medicine has received increasing attention in recent years. A variety of stimulation methods, waveforms and amplitudes have been studied. However, a clear choice of optimal stimulation parameters is still not available and is complicated by ambiguous reporting standards. In order to understand underlying cellular mechanisms affected by the electrical stimulation, the knowledge of the actual prevailing field strength or current density is required. Here, we present a comprehensive digital representation, a digital twin, of a basic electrical stimulation device for the electrical stimulation of cells in vitro. The effect of electrochemical processes at the electrode surface was experimentally characterised and integrated into a numerical model of the electrical stimulation. Uncertainty quantification techniques were used to identify the influence of model uncertainties on relevant observables. Different stimulation protocols were compared and it was assessed if the information contained in the monitored stimulation pulses could be related to the stimulation model. We found that our approach permits to model and simulate the recorded rectangular waveforms such that local electric field strengths become accessible. Moreover, we could predict stimulation voltages and currents reliably. This enabled us to define a controlled stimulation setting and to identify significant temperature changes of the cell culture in the monitored voltage data. Eventually, we give an outlook on how the presented methods can be applied in more complex situations such as the stimulation of hydrogels or tissue in vivo.