Electromagnetic fields promote severe and unique vascular calcification in an animal model of ectopic calcification

Promising application of Pulsed Electromagnetic Fields (PEMFs) in musculoskeletal disorders

Increasing evidence suggests that an exogenous electromagnetic field might be involved in many biologic processes which are of great importance for therapeutic interventions. Pulsed electromagnetic fields (PEMFs) are known to be a noninvasive, safe and effective therapy agent without apparent side effects. Numerous studies have shown that PEMFs possess the potential to become a stand-alone or adjunctive treatment modality for treating musculoskeletal disorders. However, several issues remain unresolved. Prior to their widely clinical application, further researches from well-designed, high-quality studies are still required to standardize the treatment parameters and derive the optimal protocol for health-care decision making. In this review, we aim to provide current evidence on the mechanism of action, clinical applications, and controversies of PEMFs in musculoskeletal disorders.

Research Models for Studying Vascular Calcification

Calcification of the vessel wall contributes to high cardiovascular morbidity and mortality. Vascular calcification (VC) is a systemic disease with multifaceted contributing and inhibiting factors in an actively regulated process. The exact underlying mechanisms are not fully elucidated and reliable treatment options are lacking. Due to the complex pathophysiology, various research models exist evaluating different aspects of VC. This review aims to give an overview of the cell and animal models used so far to study the molecular processes of VC. Here, in vitro cell culture models of different origins, ex vivo settings using aortic tissue and various in vivo disease-induced animal models are summarized. They reflect different aspects and depict the (patho)physiologic mechanisms within the VC process.

Systematic review on the biological effects of electric, magnetic and electromagnetic fields in the intermediate frequency range (300 Hz to 1 MHz)

BACKGROUND

Many novel technologies, including induction cookers or wireless power transfer, produce electric fields (EF), magnetic fields (MF) or electromagnetic fields (EMF) in the intermediate frequency (IF) range. The effects of such fields on biological systems, however, have been poorly investigated. The aim of this systematic review was to provide an update of the state of research and to evaluate the potential for adverse effects of EF, MF and EMF in the IF range (300 Hz to 1 MHz) on biological systems.

METHODS

The review was prepared in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Methodical limitations in individual studies were assessed using the Office of Health Assessment and Translation (OHAT) Risk of Bias Rating Tool for Human and Animal Studies.

RESULTS

Fifty-six studies exposing humans, animals or in vitro systems were eligible for this review. In these studies, many different endpoints were examined and most of the findings were obtained in studies with exposure to MF. For most endpoints, however, the reviewed studies yielded inconsistent results, with some studies indicating no effect and some linking IF exposure with adverse effects. In the majority of the included studies, the applied field strengths were above the International Commission on Non-Ionizing Radiation Protection (ICNIRP) reference levels for the general public and the applied frequencies were mainly below 100 kHz. Furthermore, many of the reviewed studies suffered from methodical limitations which lowered the credibility of the reported results.

CONCLUSION

Due to the large heterogeneity in study designs, endpoints and exposed systems, as well as the inconsistent results and methodical limitations in many studies, the quality of evidence for adverse effects remains inadequate for drawing a conclusion on investigated biological effects of IF fields for most endpoints. We recommend that in future studies, effects of EF, MF and EMF in the IF range should be investigated more systematically, i.e., studies should consider various frequencies to identify potential frequency-dependent effects and apply different field strengths, especially if threshold-dependent effects are expected. Priority should be given to the investigation of acute effects, like induction of phosphenes, perception, excitation of nerves or muscles and thermal effects. This would be an important step towards the validation of the reference levels recommended by ICNIRP. Furthermore, we recommend that any new studies aim at implementing high quality dosimetry and minimizing sources of risk of bias.