The cellular effects of Pulsed Electromagnetic Fields on osteoblasts: A review

2019 · Benefit · Low evidence

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BenefitLow evidencePaper 1842

Study snapshot

Publicationmanual · 2019

Study typereview

Reported directionBenefit

Evidence ratingLow

Abstract

The cellular effects of Pulsed Electromagnetic Fields on osteoblasts: A review Galli C, Pedrazzi G, Guizzardi S. The cellular effects of Pulsed Electromagnetic Fields on osteoblasts: A review. Bioelectromagnetics. 2019 Mar 25. doi: 10.1002/bem.22187. Abstract Electromagnetic fields (EMFs) have long been known to interact with living organisms and their cells and to bear the potential for therapeutic use. Among the most extensively investigated applications, the use of Pulsed EMFs (PEMFs) has proven effective to ameliorate bone healing in several studies, although the evidence is still inconclusive. This is due in part to our still-poor understanding of the mechanisms by which PEMFs act on cells and affect their functions and to an ongoing lack of consensus on the most effective parameters for specific clinical applications. The present review has compared in vitro studies on PEMFs on different osteoblast models, which elucidate potential mechanisms of action for PEMFs, up to the most recent insights into the role of primary cilia, and highlight the critical issues underlying at least some of the inconsistent results in the available literature ncbi.nlm.nih.gov Excerpt Two main stimulation regimes possess the most evidence supporting their biological action: a 75 Hz, 1.5-2.5 mT PEMF stimulation with trapezoidal waves and a 0.3-1.8 mT, 15 Hz PRF PEMF stimulation with carrier frequency of about 4 kHz, which correspond to the most common, commercially available clinical stimulation devices. These choices appear to be rooted in habit or equipment availability rather than a systematic screening, which is still needed in the osteoblast field. Taken together, the literature on in vitro studies on osteoblasts seem to solidly support an effect of PEMFs on osteoblastic differentiation, and several works have reported a modulation of the RANKL/OPG axis [Chang et al., 2005; Borsje et al., 2010; Jansen et al., 2010; He et al., 2018; Wang et al., 2018], which is central to bone homeostasis. Moreover, there is robust and consistent evidence that BMP-2 [Bodamyali et al., 1998; Patterson et al., 2006; Selvamurugan et al., 2007; Yan et al., 2015; Wang et al., 2019], TGF‐β [Lohmann et al., 2000; Patterson et al., 2006; Selvamurugan et al., 2017], and Wnt [Lin et al., 2015; Zhou et al., 2015; Zhai et al., 2016] signaling are modulated in osteoblasts by PEMFs. It has been long known that cell membrane appears at the center of the effects of PEMFs because of their action on ion channels, most noticeably calcium channels, and the release of bioactive factors and membrane trafficking. Most recently, primary cilia have been reported to play a role in transducing PEMF signaling to cells [Yan et al., 2015; Xie et al., 2016; Wang et al., 2018] and could provide a unifying theory to explain differences in cell responsiveness depending on their differentiation stage and the involvement of signaling pathways that could all be regulated at the receptor level by an effect on membrane trafficking. Besides biochemical signaling, therefore, a closer attention to morphology is probably needed in any new study on osteoblasts and PEMFs. Reports of morphological effects of PEMFs on cells are sporadic but consistent [Noriega-Luna et al., 2011; Wang et al., 2018], and they might be central to a more correct interpretation of the latest data to better understand the cellular targets of PEMFs and therefore improve their clinical use.

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AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typereview

Effect directionbenefit

PopulationIn vitro osteoblast models (cell studies)

Sample sizeNot supplied

ExposureELF

Evidence strengthLowConfidence: 74% · Peer reviewed: yes

Main findings

This review compares in vitro studies of pulsed electromagnetic fields (PEMFs) across different osteoblast models and summarizes proposed mechanisms. It reports that in vitro literature generally supports effects of PEMFs on osteoblastic differentiation and consistent modulation of pathways including RANKL/OPG, BMP-2, TGF-β, and Wnt, while noting inconsistent results and lack of consensus on optimal stimulation parameters.

Outcomes measured

osteoblast differentiation
bone healing (therapeutic efficacy; discussed)
RANKL/OPG axis modulation
BMP-2 signaling modulation
TGF-β signaling modulation
Wnt signaling modulation
ion channel activity (notably calcium channels)
release of bioactive factors and membrane trafficking
primary cilia involvement in signal transduction
cell morphology changes

Limitations

Evidence for clinical bone-healing efficacy described as still inconclusive
Poor understanding of mechanisms of action
Ongoing lack of consensus on the most effective PEMF parameters for specific clinical applications
Inconsistent results in the available literature

View raw extracted JSON

{
  "study_type": "review",
  "exposure": {
    "band": "ELF",
    "source": "therapeutic device (PEMF)",
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": null
  },
  "population": "In vitro osteoblast models (cell studies)",
  "sample_size": null,
  "outcomes": [
    "osteoblast differentiation",
    "bone healing (therapeutic efficacy; discussed)",
    "RANKL/OPG axis modulation",
    "BMP-2 signaling modulation",
    "TGF-β signaling modulation",
    "Wnt signaling modulation",
    "ion channel activity (notably calcium channels)",
    "release of bioactive factors and membrane trafficking",
    "primary cilia involvement in signal transduction",
    "cell morphology changes"
  ],
  "main_findings": "This review compares in vitro studies of pulsed electromagnetic fields (PEMFs) across different osteoblast models and summarizes proposed mechanisms. It reports that in vitro literature generally supports effects of PEMFs on osteoblastic differentiation and consistent modulation of pathways including RANKL/OPG, BMP-2, TGF-β, and Wnt, while noting inconsistent results and lack of consensus on optimal stimulation parameters.",
  "effect_direction": "benefit",
  "limitations": [
    "Evidence for clinical bone-healing efficacy described as still inconclusive",
    "Poor understanding of mechanisms of action",
    "Ongoing lack of consensus on the most effective PEMF parameters for specific clinical applications",
    "Inconsistent results in the available literature"
  ],
  "evidence_strength": "low",
  "confidence": 0.74,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "pulsed electromagnetic fields",
    "PEMF",
    "osteoblasts",
    "in vitro",
    "bone healing",
    "osteoblastic differentiation",
    "RANKL",
    "OPG",
    "BMP-2",
    "TGF-β",
    "Wnt signaling",
    "calcium channels",
    "membrane trafficking",
    "primary cilia",
    "morphology"
  ],
  "suggested_hubs": [
    {
      "slug": "in-vitro-studies",
      "weight": 0.78,
      "reason": "Review focuses on in vitro osteoblast models exposed to PEMFs."
    },
    {
      "slug": "therapeutic-emf",
      "weight": 0.72,
      "reason": "Discusses PEMF as a therapeutic modality for bone healing and cellular mechanisms."
    }
  ]
}

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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.1002/bem.22187
PubMed: Not supplied

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