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Global Translational Medicine Electrical stimulation in therapy and biology

Table 1. Summary of the biological effects of electrical stimulation
Biological Mechanism Signaling Ion channels/ Cellular outcomes Applications Advancements Optimization References
effect pathway proteins
Signaling Voltage-gated MAPK/ERK, Voltage-gated Reduces reactive Tissue repair, Improved Calcium 30,31
pathway ion channels PI3K/Akt calcium ion oxygen species chronic oxidative stress ion channel
activation increase calcium channels and increases wound management activation,
ion influx. antioxidants. healing, antioxidative
ischemia effects
Adhesion and Upregulates Not specified Integrins, focal Improves cell Tissue Enhanced Extracellular 32,33
migration integrins and adhesion kinase anchorage, regeneration, galvanotaxis matrix
focal adhesion migration, and immune stimulation
kinaseproteins. extracellular matrix responses
deposition.
Growth and Promotes Biochemical Osteoblast Improves neural Neural repair, Bone/cartilage Neural and 34,35,36
differentiation stem cell signals proteins regeneration, orthopedic scaffolding tissue matrix
differentiation (e.g., bone osteogenesis, and medicine optimization
morphogenetic cartilage formation.
protein )
Parameter Biphasic Not specified Capacitive Safe, sustained Chronic Reduced Focused 39,41,42
optimization waveforms coupling stimulation, minimal stimulation, electrode fouling waveforms
minimize electrodes side effects. tissue
oxidative stress. engineering
Emerging Real-time Multimodal Nano-scaffolds Enhanced accuracy, Spinal injury Integration of Adaptive 44,45,46
techniques adaptive pathways biocompatibility, and repair, nano-approaches methods for
systems for regeneration. soft tissue real-time
precise control. engineering control
Abbreviations: MAPK/ERK: Mitogen-activated protein kinase/extracellular signal-regulated kinase; PI3K/Akt: Phosphatidylinositol 3-kinase/protein
kinase B.
Recent research has focused on optimizing the duration and novel therapies, such as BMT, that may be useful in
and mechanical forces applied during ES to better mimic treating lymphedema. These areas demonstrate how ES
the physiological environment and enhance tissue could enhance treatments for various illnesses, offering
regeneration efficacy. For example, applying mechanical patient-friendly alternatives for managing multiple
loading in combination with electrical fields can encourage pathophysiologic states. ES has recently garnered
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stem cells to differentiate into mature bone- forming cells significant attention for its application in wound healing.
called osteoblasts. Similarly, photo-biomodulation therapy Non-healing ulcers, caused by diabetes or pressure injuries,
leverages cellular responses to light, and when combined often do not respond to conventional treatments and may
with ES, can simultaneously promote the reparative and benefit from adjuvant therapies, such as ES. Sarco-ES may
regenerative processes. These multimodal strategies hold contribute to enhanced cellular functions such as cellular
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significant promise for tissue engineering, especially in migration, proliferation, and deposition of collagen
tissues that require complex cellular behavior to regain filaments, which are essential in wound healing. Scientific
their functionality. The superposition of electrical fields, evidence also shows that ES can activate fibroblasts and
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mechanical stimuli, and light signals presents a powerful keratinocytes, two cells crucial for healing. Moreover, it
approach for localized therapy. It may improve severe has been shown that ES induces the expression of growth
conditions, such as spinal cord trauma, articular cartilage factors, including transforming growth factor- beta and
pathology, and chronic non-healing ulcers. vascular endothelial growth factor, which are essential in
tissue remodeling and neoangiogenesis. ES also promotes
4. Applications of ES in biomedical research the release of anti-inflammatory cytokines, contributing to
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Recently, ES has emerged as an effective technique in a more favorable healing environment at the wound site.
biomedical studies due to its role in modulating cellular These discoveries have led to the recognition of ES as a
responses and functions. It has been used experimentally to possible modality for chronic, non-healing wounds as an
investigate various treatment options by applying specific additional treatment modality.
electrical currents to cells and tissues. These applications Recent advancements in ES have exhibited significant
extend to various fields, such as wound healing and tissue results for targeting drugs, DNA, or RNA in tissues.
engineering, drug and gene delivery, cancer treatment, This is mainly achieved through electroporation, where

Volume 4 Issue 3 (2025) 28 doi: 10.36922/gtm.7774