Biological Effects of a Software-controlled Voltage Pulse Generator (PhyBack PBK-2C) on the Release of Vascular Endothelial Growth Factor (VEGF)

Abstract

Background: Electrical stimulation (ES) may induce vascular permeability and physiological angiogenesis. ES of rat muscles significantly increases the microvessel density and vascular endothelial growth factor (VEGF) protein levels. Thus, a pilot study was designed to analyze the effects of low-voltage electric impulses on VEGF levels in patients with dystrophic ulcers. Materials and Methods: Circulating VEGF levels were analyzed in 9 patients undergoing an ES session with low voltage software-controlled impulses applied through topical transducers (1-9 μs width, 1-420-Hz frequency and 30-120 V strength-100 μA max). Results: The session was accompanied by a peak of circulating VEGF (3-10 min from start) in all 9 patients, which was preceded by a rise of TNF-α (2-min) and was independently associated with soluble E-selectin levels. Nitric oxide generation was significantly improved on the day after treatment. No hemostatic activation or sustained inflammatory reaction were observed. Conclusion: ES may represent a safe method for augmenting VEGF-mediated vascular protection, either directly or by induction of NO.