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PEMF antioxidative defense mechanisms

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Received: 17 July 2017 Accepted: 13 October 2017 Published: xx xx xxxx
Extremely low frequency pulsed
electromagnetic fields cause
antioxidative defense mechanisms in human osteoblasts via induction
of •O2− and H2O2
Sabrina Ehnert1, Anne-Kristin Fentz2, Anna Schreiner1, Johannes Birk1, Benjamin Wilbrand1,
Patrick Ziegler1, Marie K. Reumann1, Hongbo Wang3, Karsten Falldorf2 & Andreas K. Nussler1
Recently, we identified a specific extremely low-frequency pulsed electromagnetic field (ELF-PEMF) that supports human osteoblast (hOBs) function in an ERK1/2-dependent manner, suggesting reactive oxygen species (ROS) being key regulators in this process. Thus, this study aimed at investigating how ELF-PEMF exposure can modulate hOBs function via ROS. Our results show that single exposure to ELF- PEMF induced ROS production in hOBs, without reducing intracellular glutathione. Repetitive exposure (>3) to ELF-PEMF however reduced ROS-levels, suggesting alterations in the cells antioxidative stress response. The main ROS induced by ELF-PEMF were •O2− and H2O2, therefore expression/activity of antioxidative enzymes related to these ROS were further investigated. ELF-PEMF exposure induced expression of GPX3, SOD2, CAT and GSR on mRNA, protein and enzyme activity level. Scavenging
•O2− and H2O2 diminished the ELF-PEMF effect on hOBs function (AP activity and mineralization). Challenging the hOBs with low amounts of H2O2 on the other hand improved hOBs function. In summary, our data show that ELF-PEMF treatment favors differentiation of hOBs by producing non- toxic amounts of ROS, which induces antioxidative defense mechanisms in these cells. Thus, ELF-PEMF treatment might represent an interesting adjunct to conventional therapy supporting bone formation under oxidative stress conditions, e.g. during fracture healing.
In 2000 osteoporosis caused approx. 9 million fractures worldwide1. Due to the anticipated demographic changes, this number is expected to be doubled by 20402,3. Despite great surgical advances, osteoporotic fractures remain a major public health concern. Fracture healing is delayed and often accompanied by postoperative complications, which in turn negatively affects the general outcome2,4.
For almost 50 years various forms of electric and electromagnetic fields (EMFs) have been used to promote bone formation after fractures as well as for the treatment of osteoporosis5. Despite the overall positive effects of EMFs on osteotomies, spine fusions, as well as delayed and non-union fractures6,7, this technology remained a niche application, probably, because the modes of action are not sufficiently understood8. In human bone EMFs are assumed to induce mechanisms similar to mechanical load, when a strain gradient develops. Compensation of the resulting pressure gradients in the interstitial fluid causes flow-related shear stress and electrical potentials9. However, the underlying molecular mechanisms are not explained as easily. A variety of physical models and the- ories try to elucidate the influence of EMFs on molecules as well as on biological and chemical processes. These include, among others, alterations in ion flux and membrane potential, re-organization of the cytoskeleton, action of voltage-sensitive enzymes, regulation of gene expression via EMF-responsive sequences, and modifications in the cells oxidative state8,10,11.
1Siegfried Weller Institute for Trauma Research, Eberhard-Karls-Universität Tübingen, Schnarrenbergstr. 95, D- 72076, Tübingen, Germany. 2Sachtleben GmbH, Hamburg, Spectrum UKE, Martinistraße 64, D-20251, Hamburg, Germany. 3Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Dadao 1277#, 430022, Wuhan, China. Correspondence and requests for materials should be addressed to S.E. (email:
Scientific REPORtS | 7: 14544 | DOI:10.1038/s41598-017-14983-9 1

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