Low-frequency electromagnetic fields combined with tissue engineering techniques accelerate intervertebral fusion.

Stem cell research & therapy · 2021 · Benefit · Low evidence

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BenefitLow evidencePaper 5705

Study snapshot

PublicationStem cell research & therapy · 2021

Study typeanimal

Reported directionBenefit

Evidence ratingLow

Abstract

BACKGROUND: Intervertebral fusion is the most common surgery to treat lumbar degenerative disease (LDD). And the graft material used in the operation is derived from the iliac crest to promote fusion. However, autografts possess the fatal disadvantage of lack of source. Therefore, economical and practical bone substitutes are urgently needed to be developed. Sinusoidal electromagnetic fields (EMF) combined with tissue engineering techniques may be an appropriate way to promote intervertebral fusion. METHODS: In this research, porous scaffolds made of polycaprolactone (PCL) and nano-hydroxyapatite (nHA) were used as cell carriers. Then, the scaffolds loaded with bone marrow mesenchymal stem cells (BMSCs) were treated with sinusoidal electromagnetic field and the osteogenic capability of BMSCs was tested later. In addition, an intervertebral disc of the tail vertebra of the rat was removed to construct a spinal intervertebral fusion model with a cell-scaffold implanted. The intervertebral fusion was observed and analyzed by X-ray, micro-CT, and histological methods. RESULTS: BMSCs stimulated by EMF possess splendid osteogenic capability under an osteogenic medium (OM) in vitro. And the conditioned medium of BMSCs treated with EMF can further promote osteogenic differentiation of the primitive BMSCs. Mechanistically, EMF regulates BMSCs via BMP/Smad and mitogen-activated protein kinase (MAPK)-associated p38 signaling pathways. In vivo experiments revealed that the scaffold loaded with BMSCs stimulated by EMF accelerated intervertebral fusion successfully. CONCLUSION: In summary, EMF accelerated intervertebral fusion by improving the osteogenic capacity of BMSCs seeded on scaffolds and might boost the paracrine function of BMSCs to promote osteogenic differentiation of the homing BMSCs at the injured site. EMF combined with tissue engineering techniques may become a new clinical treatment for LDD.

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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 typeanimal

Effect directionbenefit

PopulationRat tail vertebra intervertebral fusion model; bone marrow mesenchymal stem cells (BMSCs) in vitro

Sample sizeNot supplied

ExposureELF

Evidence strengthLowConfidence: 74% · Peer reviewed: yes

Main findings

In vitro, BMSCs stimulated by sinusoidal EMF showed increased osteogenic capability under osteogenic medium, and conditioned medium from EMF-treated BMSCs promoted osteogenic differentiation of untreated BMSCs. Mechanistically, EMF was reported to regulate BMSCs via BMP/Smad and MAPK-associated p38 pathways. In a rat tail vertebra fusion model, scaffolds loaded with EMF-stimulated BMSCs accelerated intervertebral fusion based on imaging and histology.

Outcomes measured

Osteogenic capability/differentiation of BMSCs in vitro
Paracrine/conditioned-medium effects on osteogenic differentiation
BMP/Smad signaling pathway activity
MAPK-associated p38 signaling pathway activity
Intervertebral fusion in vivo assessed by X-ray, micro-CT, histology

Limitations

EMF exposure parameters (e.g., field strength, frequency, duration) not reported in the abstract
Sample size not reported in the abstract
Animal model and in vitro findings may not directly translate to humans
Scaffold composition and cell-loading details are limited to brief description in the abstract

View raw extracted JSON

{
  "study_type": "animal",
  "exposure": {
    "band": "ELF",
    "source": "therapeutic/experimental sinusoidal electromagnetic field",
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": null
  },
  "population": "Rat tail vertebra intervertebral fusion model; bone marrow mesenchymal stem cells (BMSCs) in vitro",
  "sample_size": null,
  "outcomes": [
    "Osteogenic capability/differentiation of BMSCs in vitro",
    "Paracrine/conditioned-medium effects on osteogenic differentiation",
    "BMP/Smad signaling pathway activity",
    "MAPK-associated p38 signaling pathway activity",
    "Intervertebral fusion in vivo assessed by X-ray, micro-CT, histology"
  ],
  "main_findings": "In vitro, BMSCs stimulated by sinusoidal EMF showed increased osteogenic capability under osteogenic medium, and conditioned medium from EMF-treated BMSCs promoted osteogenic differentiation of untreated BMSCs. Mechanistically, EMF was reported to regulate BMSCs via BMP/Smad and MAPK-associated p38 pathways. In a rat tail vertebra fusion model, scaffolds loaded with EMF-stimulated BMSCs accelerated intervertebral fusion based on imaging and histology.",
  "effect_direction": "benefit",
  "limitations": [
    "EMF exposure parameters (e.g., field strength, frequency, duration) not reported in the abstract",
    "Sample size not reported in the abstract",
    "Animal model and in vitro findings may not directly translate to humans",
    "Scaffold composition and cell-loading details are limited to brief description in the abstract"
  ],
  "evidence_strength": "low",
  "confidence": 0.74,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "low-frequency electromagnetic fields",
    "sinusoidal electromagnetic field",
    "tissue engineering",
    "polycaprolactone",
    "nano-hydroxyapatite",
    "bone marrow mesenchymal stem cells",
    "osteogenic differentiation",
    "intervertebral fusion",
    "rat model",
    "BMP/Smad",
    "MAPK p38"
  ],
  "suggested_hubs": []
}

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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: 10.1186/s13287-021-02207-x
PubMed: 33597006

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