The Science behind PEMF Therapy

Pulsed electromagnetic field (PEMF) is emerging as innovative treatment for regulation of inflammation, which could have significant effects on tissue regeneration. PEMF modulates inflammatory processes through the regulation of pro- and anti-inflammatory cytokine secretion during different stages of inflammatory response. Consistent outcomes in studies involving animal and human tissue have shown promise for the use of PEMF as an alternative or complementary treatment to pharmaceutical therapies. Thus, PEMF treatment could provide a novel nonpharmaceutical means of modulating inflammation in injured tissues resulting in enhanced functional recovery. This review examines the effect of PEMF on immunomodulatory cells (e.g., mesenchymal stem/stromal cells [MSCs] and macrophages [MΦ]) to better understand the potential for PEMF therapy to modulate inflammatory signaling pathways and improve tissue regeneration. This review cites published data that support the use of PEMF to improve tissue regeneration. Our studies included herein confirm anti-inflammatory effects of PEMF on MSCs.

The immune system plays an essential role in tissue regeneration following tissue damage as well as during cell signaling homeostasis. The immune response to tissue injury is crucial in determining the efficacy and rate of the healing process, including the extent of scarring and the restoration of organ function.1 To integrate the immune system into regenerative strategies, one of the first challenges is to modulate the precise functions of the different immune components during the tissue healing process. The regulatory interactions of the immune system with tissue regeneration are not unidirectional, and stem cells, as key players in regeneration, can modulate the immune system in several ways to facilitate regeneration

However, the immune system does not always perform a complementary role in regeneration, and several reports have suggested that increased inflammation can inhibit the regeneration process. An argument can be made that there are immune-mediated mechanisms of regeneration and repair that can be modulated by pulsed electromagnetic field (PEMF) therapy to improve the ability of tissue to regenerate. Until recently, allopathic medicine rejected the possibility that an electromagnetic field (EMF) could affect biochemical mechanisms with weak electrical fields. Biochemistry, however, is based on an understanding of the flow of energy that drives chemical reactions.

Currently approved for use on animals only.

Physical properties of molecules can be combined to express internal energy and thermodynamic potentials, which are necessary for equilibrium and homeostasis in spontaneous processes.4 New models of biophysics emphasize cooperative electrical activity of highly ordered elements at all levels of physiology: cells, tissues, organs, organ systems, as well as the entire human organism. Research has shown that effects caused by low-frequency or weak EMF therapies can induce changes in cell proliferation, alterations in membrane structure and function, changes in nucleic acids, protein phosphorylation and adenosine triphosphate (ATP) synthesis, as well as entrainment of brain rhythms and conditioned brain response in vitro and in vivo.5–7 Parameters of these EMFs include frequency, intensity (field strength), waveform, and time of exposure. Recognition of physiological sensitivities to exogenous EMF came from the observation of endogenous internal electrical processes.4 For example, the piezoelectric properties of bone use electromechanical control to determine either osteoblastic or osteoclastic phenotype of cells.8 However, biophysical properties of cell function have mostly been ignored when choosing treatments for inflammation/immune modulation and regenerative medicine therapies.

Using PEMF to regulate cell signaling mechanisms involved in the inflammatory/immune response pathways of different cell types has become an innovative alternative treatment in the pursuit of regenerative therapies.9,10 Several studies have reported that PEMF can modulate both cell surface receptor expression/activation and downstream signal transduction pathways, thereby restoring homeostatic cell functions such as viability, proliferation, differentiation, communication with neighboring cells, and interaction with components of the extracellular matrix (ECM).11–18 PEMF can activate multiple intracellular pathways, including numerous processes and biochemical mechanisms within both the immune system and tissue regenerative processes, such as the musculoskeletal system7,19,20 and the nervous system.21–23 PEMFs are physical stimuli that affect biological systems through the production of coherent or interfering fields that modify fundamental electromagnetic frequencies generated by living organisms.7,24 These endogenous frequencies are ubiquitous in tissue, for instance, frequencies from 5 to 30 Hz have been found during postural muscle activity (quiet standing) and 10 Hz during walking.25 Successful regeneration requires a balanced immune cell response, with the recruitment of accurately polarized immune cells in an appropriate quantity.2 Here is where PEMF could have an influential role in the inflammatory process and thereby support tissue regeneration.