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ARTICLE | BODY CONTOURING | effect of PEMF therapy on skin microvascular blood


flow, where a 30% increase in blood flow was reported in both healthy3


and diabetic subjects4 . . Mayrovitz et al5 also


found a four-fold increase in blood flow in post-mastectomy patients5


Mode of action of PEMF therapy The biophysical mechanism of PEMF on biologic tissue has been studied extensively6


, and over the years a


number of mechanisms have been proposed to explain the vast range of reported clinical effects on different tissues. In the 1990s, studies began to focus on the effect of PEMF on intracellular Ca2+


and the binding of Ca2+ . to


calmodulin (CaM; calcium-modulated protein), based on previous findings that CaM-dependent cascades are involved in tissue repair response7


The most recent studies of the PEMF mechanism of


action have focused on the Ca/CaM-dependent nitric oxide (NO) cascades. Nitric oxide is synthesised via nitric oxide synthase (NOS), an enzyme with a number of isoforms8


. The endothelial and


neuronal isoforms of NOS, which are up-regulated by the binding of Ca2+


to CaM, produce short bursts


of NO that in turn cause immediate relaxation of blood and lymph vessels9, 10


. In addition, these short


bursts also trigger the production of cyclic guanosine monophosphate (cGMP) that results in growth factor production8


completely. Another well-designed study demonstrated an increase in DNA synthesis in articular chondrocytes via PEMF-induced nitric oxide production12


. In this study,


when CaM, NOS and cGMP inhibitors were used, the PEMF effect on DNA synthesis was completely eliminated. To summarise, the most recent proposed mechanism


of action suggests that PEMF signals increase the rate of CA2+


binding to CaM, and catalyse specific isoforms of


NOS (endothelial NOS; eNOS). Within minutes, eNOS produces NO, which can orchestrate an anti-inflammatory response by increasing blood and lymph flow. NO also triggers cGMP production, which results in the release of growth factors dependent on the stage of healing. PEMF has been used in medicine for many years


for a variety of applications, such as bone fusion, chronic ulcer healing, and pain management. Although there is sufficient scientific evidence to support its positive effect on dermal components, it was only in 2009 when this technology was first introduced into the aesthetic market, as part of the (MP)¨ technology. PEMF has been proven to stimulate the


production of collagen fibres and the proliferation of fibroblasts in the dermis, which promote a


. This proposed


mechanism is supported by a range of studies. In one study, application of PEMF on a


culture of human umbilical vein endothelial cells significantly increased tubule formation mediated by the production of FGF-211


. When FGF-2 was inhibited, the effect diminished


healthier, younger-looking skin, and also trigger angiogenesis ® a process vitally important for the sufficient supply of nutrients and oxygen to ageing skin, as it is well


established that ageing brings about a substantial loss in dermal micro-vascularity.


RF tissue


tightening exerts a thermal effect in the dermis without wounding the cutaneous layer. The passage of RF through the tissue produces resistance which transforms into thermal energy.


30 ❚ June 2012 | prime-journal.com


The role of radiofrequency in (MP)2 RF tissue tightening exerts a thermal effect in the dermis without wounding the cutaneous layer. The passage of RF through the tissue produces resistance which transforms into thermal energy. It has been proposed that the generation of heat in the tissue would cause collagen injury and c on t r a c t ion 1 3 , 14 Subsequently, this thermal injury could result in the triggering of a wound-healing response15 which begins in the synthesis of collagen type III that is later


. ,


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