Abstract:
The etiology and progression of osteoporosis are multifactorial and still not fully understood. With the development of evidence-based medicine and pathophysiology, the treatment for promoting new bone formation and restoring the health of bone has gradually developed into a multidisciplinary and comprehensive treatment. In this project, we proved that the use of ELF-PEMF as a treatment for promoting new bone formation and preventing fracture non-union is effective and feasible. Our data indicated that the daily exposure of specific ELF-PEMF was able to directly increase the cell viability, migration, spreading, and adhesion of SCP-1 cells. The molecular mechanism is that ELF-PEMF activated the TGF-β signaling pathway, and protected the structure and function of the primary cilia of SCP-1 cells. Moreover, we found that the daily intermittent exposure (10 min every 8 h) is even better than the daily continuous exposure (30 min every 24 h) in improving cell viability. Interestingly, we found that piezo1 played an important role in the ELF-PEMF treatment. The gene expression of piezo1 increased after the intermittent exposure, and the function of piezo1 was activated thus leading to calcium influx into SCP-1 cells. In contrast, treating cells with piezo1 inhibitor Dooku1 blocked the function of piezo1 and impaired the mineral deposition. Therefore, ELF-PEMF can directly promote fracture healing. Nevertheless, we also found that ELF-PEMF with specific parameters can modulate the activity of macrophages to indirectly affect the osteogenesis of SCP-1 cells, e.g., field A induced the pro-inflammatory activity of macrophages, and field B induced the anti-inflammatory activity of macrophages, and enhanced the ECM formation of SCP-1 cells on the early stage. Taken together, ELF-PEMF exposure can, directly and indirectly, promote the healing process and might be a useful tool in critical bone healing such as Pseudarthrosis.
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