Electromagnetic Fields and Osteoarthritis 2025

Objective To study the effects of electromagnetic field (EMF) exposure on osteoporosis in ovariectomized mice. Methods Sixty 8-week-old female Kunming mice were divided into four groups at random: a sham operation group (group A), an ovariectomized group (group B), an EMF and ovariectomized group (group C) and a nilestriol and ovariectomized group (group D). Bilateral ovariectomies were performed on all mice except those in group A. The mice of group C were exposured to a 15 Hz, 1.0 mT electromagnetic field. The mice of group D were given at nilestriol 1.5 mg/kg/week. The bone mineral density (BMD) of the lumbar vertebrae was measured before the mice were sacrificed at the 12th week. Blood specimens were collected every two weeks to measure the ac-tivity of alkaline phosphatase (ALP) and the concentration of bone gamma-carboxyglutamic-acid-containing proteins (BGP), calcium and estradiol in the serum. Histological sections were taken to examine and analyze the changes in bone trabeculae in the lumbar vertebrae after 6 and 12 weeks. Results EMF at 15 Hz and 1.0 mT intensity signifi-cantly increased the activity of ALP and the concentrations of BGP and calcium in the serum. In addition, the absorp-tion of bone trabeculae in the lumbar vertebrae was significantly restrained. Conclusions EMF at 15 Hz and 1.0 mT can restrain the development of osteoporosis in ovariectomized mice. Key words: Electromagnetic fields; Alkaline phosphatase; Bone gamma-carboxyglutamic-aeid-containing proteins ; Estradiol; Bone trabeculae

In contrast to RF produced plasmas, in the case of microwave plasmas the energy from the electromagnetic (EM) field is communicated only to electrons since ions, being a few thousand times much heavier than electrons, cannot respond to the periodic changes in the direction of the E-field of microwaves (typical frequency range 100 MHz-300 GHz) and therefore cannot gain energy in the EM field. The energy of electrons is essentially transferred to heavy particles either through numerous enough collisions during the E-field period (high enough gas pressures) or through electron-cyclotron resonance (pressures below mTorr) sustaining in this way the gas discharge. This had led to introduce the concept of power absorbed per electron qA and power loss on a per electron basis qL [1]. Under steady-state conditions and when the plasma volume (the volume in which plasma particles recombine and, thus, power is lost) is equal to the volume in which power is absorbed from the MW field, we have the power balance qA = qL, which can be shown to be much informative than the usual global power balance. qA is defined as where n is the electron collision frequency for momentum transfer, w, the wave angular frequency, e/me, the electron charge to mass ratio, and , the mean squared value of the EM E-field. The value of qA (absorbed power) is shown to adjust so as to compensate exactly for qL (power losses), which is thus the dominant power parameter; as a result, the intensity of the maintenance E-field sustaining the discharge comes out as an internal parameter, i.e., it is operator-independent, in contrast to what is generally believed whatever the kind of E-field sustained discharges. Other related features are: i) whenever this can be achieved, the smaller the volume in which power is absorbed with respect to the volume in which it is spent, the higher the intensity of the maintenance E-field: this leads to higher atomic (molecular) excitation rates inside than outside the absorption region (such is the case in micro-discharges); ii) an interesting fact as far as understanding RF and MW discharge properties is concerned is that the value of qL decreases with increasing frequency from the RF domain to that of MWs; iii) similarity laws, initially derived with DC discharges, are generalized to include RF and microwave discharges. For example, qA/p as a function of pR (p is gas pressure and R discharge-tube inner radius) replaces advantageously the widely used E/p vs. pR similarity law since qA is more easily measured than E2 and further it avoids considering the latter as an external parameter, etc.; iv) using the power per electron balance, it can be proved that the EM E-field intensity under electron cyclotron resonance (ECR) condition passes through a minimum, not a maximum, contrary to what is generally claimed; v) the E-field intensity under pulsed regime can be maximized under short enough pulse length and long enough off-time in between.

Nonthermal pulsed electromagnetic fields, from low frequency to pulse-modulated radio frequency, have been successfully employed as adjunctive therapy for the treatment of delayed and non-union fractures, fresh fractures and chronic wounds. Recent increased understanding of the mechanism of action of electromagnetic fields (EMF) has permitted technologic advances allowing the development of EMF devices which are portable and disposable, can be incorporated into dressings, supports and casts, and can be used over clothing. This broadens the use of non-pharmacological, non-invasive EMF therapy to the treatment of postoperative pain and edema to enhance surgical recovery. EMF therapy is rapidly becoming a standard part of surgical care, and new, more significant, clinical applications for osteoarthritis, brain and cardiac ischemia and traumatic brain injury are in the pipeline. This study reviews recent evidence which suggests that calmodulin (CaM)-dependent nitric oxide signaling is involved in cell and tissue response to weak nonthermal EMF signals. There is abundant evidence that EMF signals can be configured a priori to increase the rate of CaM activation, which, in turn, can modulate the biochemical cascades living cells and tissues employ in response to external insult. Successful applications in pilot clinical trials, coupled with evidence at the cellular and animal levels, provide support that EMF is a first messenger that can modulate the response of challenged biological systems.

This study sought to evaluate the inhibitory effect of pulsed electromagnetic field (PEMF) therapy on bone resorption in a mouse model of lipopolysaccharide (LPS)-induced osteoporosis. A total of 40 mice were divided into four groups: control, LPS, LPS + alendronate, and LPS + PEMF. Blood and spleen samples were analyzed using RT-PCR and ELISA, while calvaria and femurs were assessed by micro-computed tomography (CT) and histological analysis. Serum analysis revealed that, compared with the control group, calcium levels in the PEMF group showed no significant difference, but alkaline phosphatase (ALP) levels were significantly increased, whereas tartrate-resistant acid phosphatase (TRAP) levels were significantly decreased. Moreover, blood cytokine analysis showed reduced expression of TNF-α and IL-1β and increased expression of BMP-2 in the PEMF group. Spleen tissue analysis further demonstrated significant upregulation of IFN-γ and IL-10 expression in the PEMF group. Micro-CT confirmed that PEMF inhibited femoral bone loss and promoted bone regeneration in calvarial defects. Histological evaluation with hematoxylin and eosin and Masson–Goldner trichrome staining confirmed enhanced bone formation in both the femur and calvaria. In conclusion, PEMF effectively alleviates bone loss and promotes bone regeneration in LPS-induced osteoporosis. Furthermore, PEMF exhibits anti-osteoclastogenic activity by reducing inflammatory cytokines and enhancing IFN-γ and IL-10 expression in the spleen.

Obesity is a state of relative growth hormone (GH) deficiency, and GH has been identified as a candidate disease-modifying target in nonalcoholic fatty liver disease (NAFLD) because of its lipolytic and anti-inflammatory properties. However, the GH/IGF-1 axis has not been well characterized in NAFLD. We aimed to investigate serum GH and IGF-1 levels in relation to intrahepatic lipid content (IHL) and markers of hepatocellular damage and fibrosis in NAFLD. This cross-sectional study included 102 adults (43% women; age 19-67; BMI ≥ 25 kg/m2) without type 2 diabetes. IHL was measured by magnetic resonance spectroscopy; NAFLD was defined by ≥ 5% IHL. Peak-stimulated GH in response to GH releasing hormone and arginine was assessed as was serum IGF-1 (LC/MS). There was no difference in mean age, BMI, or sex distribution in NAFLD vs controls. Mean (± SD) IHL was higher in NAFLD vs controls (21.8 ± 13.3% vs 2.9 ± 1.1%, P < 0.0001). Mean peak-stimulated GH was lower in NAFLD vs controls (9.0 ± 6.3 vs 15.4 ± 11.2 ng/mL, P = 0.003), including after controlling for age, sex, visceral adipose tissue, and fasting glucose. In a stepwise model, peak-stimulated GH predicted 14.6% of the variability in IHL (P = 0.004). Higher peak-stimulated GH was also associated with lower ALT. Higher serum IGF-1 levels were associated with lower risk of liver fibrosis by Fibrosis-4 scores. Individuals with NAFLD have lower peak-stimulated GH levels but similar IGF-1 levels as compared to controls. Higher peak-stimulated GH levels are associated with lower IHL and less hepatocellular damage. Higher IGF-1 levels are associated with more favorable fibrosis risk scores. These data implicate GH and IGF-1 as potential disease modifiers in the development and progression of NAFLD.

The heat shock protein (HSP) 70 is considered the main hallmark in preclinical studies to stain the peri-infarct region defined area penumbra in preclinical models of brain ischemia. This protein is also considered as a potential disease modifier, which may improve the outcome of ischemic damage. In fact, the molecule HSP70 acts as a chaperonine being able to impact at several level the homeostasis of neurons. Despite being used routinely to stain area penumbra in light microscopy, the subcellular placement of this protein within area penumbra neurons, to our knowledge, remains undefined. This is key mostly when considering studies aimed at deciphering the functional role of this protein as a determinant of neuronal survival. The general subcellular placement of HSP70 was grossly reported in studies using confocal microscopy, although no direct visualization of this molecule at electron microscopy was carried out. The present study aims to provide a direct evidence of HSP70 within various subcellular compartments. In detail, by using ultrastructural morphometry to quantify HSP70 stoichiometrically detected by immuno-gold within specific organelles we could compare the compartmentalization of the molecule within area penumbra compared with control brain areas. The study indicates that two cell compartments in control conditions own a high density of HSP70, cytosolic vacuoles and mitochondria. In these organelles, HSP70 is present in amount exceeding several-fold the presence in the cytosol. Remarkably, within area penumbra a loss of such a specific polarization is documented. This leads to the depletion of HSP70 from mitochondria and mostly cell vacuoles. Such an effect is expected to lead to significant variations in the ability of HSP70 to exert its physiological roles. The present findings, beyond defining the neuronal compartmentalization of HSP70 within area penumbra may lead to a better comprehension of its beneficial/detrimental role in promoting neuronal survival.

Recent data has implicated Staphylococcus aureus (SA) superantigen as a potential disease modifier in patients with chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP). The objective of this work was to compare total serum immunoglobulin E (IgE) and serum eosinophils in patients with CRSwNP and CRS without nasal polyps (CRSsNP) based on culture results of the 3 most commonly isolated bacteria. Retrospective review at a tertiary rhinology referral center of patients with CRS over a 4-year period. Bacterial cultures and immunologic data were obtained from 62 patients with CRSwNP and 34 patients with CRSsNP. SA was the most prevalent bacteria in the CRSwNP group, isolated in 19 patients (31%). Patients with elevated total serum IgE (>114 IU/mL) were more likely to have SA on culture (p = 0.04) in this population. The percent serum eosinophil levels in the SA+ group compared with the SA- group was not significant (6.0 vs 5.1, p = 0.17). Lund-Mackay computed tomography (CT) scores, but not Sino-Nasal Outcome Test 20 (SNOT-20) scores were significantly higher in the SA+ vs SA- group (p = 0.03) in patients with CRSwNP. The CRSsNP group demonstrated no difference in IgE or serum eosinophils between different bacterial groups. Our findings suggest that there is an association between SA sinonasal presence and elevated total serum IgE in patients with CRSwNP. In addition, SA+ patients had higher Lund-Mackay CT scores, indicating a higher objective burden of disease in this group of patients.

OP0005 Electronic Patient Reported Outcome Measures (E-PROMS) for Early Arthritis in Standard Clinical Practice: A Pilot Study

Cytokines and Disability in Interferon-β-1b Treated and Untreated Women with Multiple Sclerosis

One of the therapeutic methods used in stroke rehabilitation is magnetotherapy using extremely low frequency and variable pulse shape electromagnetic field (ELF-EMF). The aim of our study was to investigate the effect of magnetotherapy on the condition of postacute stroke patients, as measured by plasma oxidative stress markers and clinical parameters which show the progress of rehabilitation. The selected 57 post-stroke patients were divided into 2 groups, those with ELFEMF therapy and those without. The level of oxidative stress in the plasma was estimated by typical markers: thiobarbituric acid reactive substances (TBARS), thiol groups, and carbonyl groups. The effect of ELF-EMF on the course of the patients' rehabilitation following ischemic stroke was evaluated with the use of scales of physical activity and mental state: Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS). Our comparative analysis showed that all parameters of oxidative stress are significantly reduced during rehabilitation using ELF-EMF, compared to the control group rehabilitated only by kinesiotherapy. We also recorded much higher therapeutic benefits using magnetotherapy, which revealed a significant improvement of clinimetric parameters. The ELF-EMF therapy meaningfully improves the overall condition of patients through a decrease of oxidative stress markers and it significantly affects the psychophysical abilities of patients after stroke. The change in carbonyl group level correlates with the change in the degree of physical and mental disability; therefore, it could be a marker for the effectiveness of rehabilitation.

The working hypothesis started from the premise of the benefits of the electromagnetic field therapy (EMFT) benefits in order to densify the periodontal bone tissues. The objective of this study was to quantify the results of using this therapy with the Electronic Doctor Stem Generator (EDSG) in the densification of affected alveolar bone tissues by clinical and radiological examinations. The study was performed on 30 patients, who benefited from adjuvant therapy in the electromagnetic field (EMF) with the EDSG device after performing the specific dental treatments. We applied these very low-frequency EMF bioactivation treatment delivered by EDSG device, 30 daily exposures for a 2-hour interval. The results proved the appreciable reduction of teeth mobility, the reduction of periodontal pockets depth and the bone regeneration in the regions exposed to the EMF produced by EDSG device. EMF adjuvant therapy with EDSG device is an innovative, atraumatic and non-invasive therapy.

Pain and Functional Scores in Patients Affected by Knee OA after Treatment with Pulsed Electromagnetic and Magnetic Fields: A Meta-Analysis.

1-11 CARTILAGE BIOLOGY IN OSTEOARTHRITIS: ACTIVATION OF MATRIX DEGRADING ENZYMES

ABSTRACTIntroduction: Inflammatory arthritis is characterized by chronic inflammation in the synovium, associated with degradation of cartilage and erosion of juxta-articular bone. The bone loss and joint destruction mediated by aberrant immunological responses resulting in proinflammatory cytokine release and various immune cell activation are known as osteoimmunology.Areas covered: A structured literature search including Medline and PubMed, Cochrane meta-analyses and abstracts of international congresses was performed to review joint damage in inflammatory arthritis in terms of pathogenesis, novel imaging assessment, and prevention.Expert commentary: Deeper understanding of the integration of the skeletal and immune as well as inflammatory system is paving the way to prevent bone loss and bone destruction in inflammatory arthritis. With the availability of various imaging modalities such as ultrasound, magnetic resonance imaging (MRI) and high-resolution peripheral quantitative computed tomography (HR-pQCT), we are now able to detect early joint damage, early diagnosis of inflammatory arthritis, monitor the progression or even ascertain whether the inflammatory process is effectively suppressed to allow repair of joint damage by novel therapeutic agents.

This is an update of a Cochrane review first published in 2002. Osteoarthritis is a disease that affects the synovial joints, causing degeneration and destruction of hyaline cartilage and subchondral bone. Electromagnetic field therapy is currently used by physiotherapists and may promote growth and repair of bone and cartilage. It is based on principles of physics which include Wolff's law, the piezoelectric effect and the concept of streaming potentials. To assess the benefits and harms of electromagnetic fields for the treatment of osteoarthritis as compared to placebo or sham. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 9), PreMEDLINE for trials published before 1966, MEDLINE from 1966 to October 2013, CINAHL and PEDro up to and including October 2013. Electronic searches were complemented by handsearches. Randomised controlled trials of electromagnetic fields in osteoarthritis, with four or more weeks treatment duration. We included papers in any language. Two review authors independently assessed studies for inclusion in the review and resolved differences by consensus with a third review author. We extracted data using pre-developed data extraction forms. The same review authors assessed the risk of bias of the trials independently using the Cochrane 'Risk of bias' tool. We extracted outcomes for osteoarthritis from the publications according to Outcome Measures in Rheumatology Clinical Trials (OMERACT) guidelines. We expressed results for continuous outcome measures as mean difference (MD) or standardised mean difference (SMD) with 95% confidence interval (CI). We pooled dichotomous outcome measures using risk ratio (RR) and calculated the number needed to treat (NNT). Nine studies with a total of 636 participants with osteoarthritis were included, six of which were added in this update of the review. Selective outcome reporting was unclear in all nine included studies due to inadequate reporting of study design and conduct, and there was high risk of bias for incomplete outcome data in three studies. The overall risk of bias across the nine studies was low for the other domains.Participants who were randomised to electromagnetic field treatment rated their pain relief 15.10 points more on a scale of 0 to 100 (MD 15.10, 95% CI 9.08 to 21.13; absolute improvement 15%) after 4 to 26 weeks' treatment compared with placebo. Electromagnetic field treatment had no statistically significant effect on physical function (MD 4.55, 95% CI -2.23 to 11.32; absolute improvement 4.55%) based on the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scale from 0 to 100 after 12 to 26 weeks' treatment. We also found no statistically significant difference in quality of life on a scale from 0 to 100 (SMD 0.09, 95% CI -0.36 to 0.54; absolute improvement 0.09%) after four to six weeks' treatment, based on the SF-36. No data were available for analysis of radiographic changes. Safety was evaluated in four trials including up to 288 participants: there was no difference in the experience of any adverse event after 4 to 12 weeks of treatment compared with placebo (RR 1.17, 95% CI 0.72 to 1.92). There was no difference in participants who withdrew because of adverse events (measured in one trial) after four weeks of treatment (RR 0.90, 95% CI 0.06 to 13.92). No participants experienced any serious adverse events. Current evidence suggests that electromagnetic field treatment may provide moderate benefit for osteoarthritis sufferers in terms of pain relief. Further studies are required to confirm whether this treatment confers clinically important benefits in terms of physical function and quality of life. Our conclusions are unchanged from the previous review conducted in 2002.