Pain Medicine Center, Swiss Paraplegic Center, Guido A. Zäch-Strasse 1, 6207 Nottwil, Switzerland.
Clinica de Dor, R. São João de Brito 610, 4100-455 Porto, Portugal.
Med Sci (Basel). 2023 Sep 10;11(3):58. doi: 10.3390/medsci11030058.
In 2013, it was reported that pulsed radiofrequency (PRF) could be applied to obtain a systemic anti-inflammatory effect. Patients with chronic pain and patients with an inflammatory condition from other disciplines could potentially profit from this finding. At that time, intravenous application was used, but since then, it became clear that it could be applied transcutaneously as well. This procedure was named RedoxPRF. This can be used both for regional and for systemic application. Recently, the basic element of the mode of action has been clarified from the analysis of the effects of PRF on a standard model of muscle injury in rats. The objective of this paper is to present a hypothesis on the mode of action of RedoxPRF now that the basic mechanism has become known. Cell stress causes an increased production of free radicals, disturbing the redox equilibrium, causing oxidative stress (OS) either directly or secondarily by other types of stress. Eventually, OS causes inflammation and an increased sympathetic (nervous) system activity. In the acute form, this leads to immune paralysis; in the chronic form, to immune tolerance and chronic inflammation. It is hypothesized that RedoxPRF causes a reduction of free radicals by a recombination of radical pairs. For systemic application, the target cells are the intravascular immune cells that pass through an activated area as on an assembly line. Hypothesis conclusions: 1. RedoxPRF treatment works selectively on OS. It has the unique position of having a point of engagement at the most upstream level of the train of events. 2. RedoxPRF has the potential of being a useful tool in the treatment of inflammatory diseases and possibly of stage 4 cancer. 3. In the treatment of chronic pain, RedoxPRF is an entirely new method because it is different from ablation as well as from stimulation. We propose the term "functional restoration". 4. Controlled studies must be conducted to develop this promising new field in medicine further.
2013 年有报道称，脉冲射频（PRF）可用于获得全身抗炎作用。患有慢性疼痛的患者和其他学科的炎症患者可能会从这一发现中受益。当时，采用的是静脉内应用，但此后，人们清楚地认识到，它也可以经皮应用。该程序被命名为氧化还原脉冲射频（RedoxPRF）。它既可以用于区域性应用，也可以用于系统性应用。最近，从对大鼠肌肉损伤标准模型中 PRF 作用效果的分析中，已经阐明了其作用机制的基本要素。本文的目的是在基本机制已经明确的情况下，提出关于 RedoxPRF 作用机制的假说。细胞应激会导致自由基产生增加，扰乱氧化还原平衡，导致氧化应激（OS），无论是直接还是间接通过其他类型的应激引起的。最终，OS 会导致炎症和交感神经系统（神经）活性增加。在急性形式下，这会导致免疫麻痹；在慢性形式下，导致免疫耐受和慢性炎症。假设 RedoxPRF 通过自由基对的重组来减少自由基。对于系统性应用，靶细胞是穿过激活区域的血管内免疫细胞，就像在装配线上一样。假说结论：1. RedoxPRF 治疗对 OS 有选择性作用。它在事件链的最上游水平具有独特的作用点。2. RedoxPRF 有可能成为治疗炎症性疾病和可能的 4 期癌症的有用工具。3. 在治疗慢性疼痛时，RedoxPRF 是一种全新的方法，因为它与消融和刺激不同。我们提出了“功能恢复”这一术语。4. 必须进行对照研究，以进一步发展这一有前途的医学新领域。
