Mechanism of nonthermal induction of apoptosis by high‐intensity focused electromagnetic procedure: Biochemical investigation in a porcine model

BACKGROUND: Multiple studies have reported adipose tissue reduction after the application of the High‐Intensity Focused Electromagnetic (HIFEM) field technology, yet cellular level evidence of the mechanisms has remained scarce. OBJECTIVES: This study aims to verify or refute previous single‐study histological evidence and further investigates the proposed mechanism of apoptotic induction. METHODS: The thigh of two Large White pigs was treated with HIFEM for 30 minutes. Fat punch biopsies were collected from the application area before, immediately after, and 8 hours post‐treatment. Control samples were taken from the abdomen immediately after and 8 hours post‐treatment. Samples were analyzed for pro‐apoptotic DNA markers (BAX, BCL‐2, TXNIP, MMP9, TNF‐α), the levels of free fatty acids (FFA), and the pH levels of the adipose tissue. RESULTS: The levels of FFA in the treated adipose tissue increased on average by 127.1% immediately post‐treatment and by 134.1% 8 hours post‐treatment, indicating a rapid breakdown of lipids. The average recorded adipose pH changed from 7.30 ± 0.12 at baseline to 6.60 ± 0.07 immediately post‐treatment (P = .001) and to 7.19 ± 0.12 8 hours post‐treatment. The levels of BAX, TXNIP, MMP9, and TNF‐α increased post‐treatment while BCL‐2 decreased. Control samples showed constant levels of pH and pro‐apoptotic markers. The FFAs in the control samples were increased by 41.6%‐51.4%. CONCLUSION: The changes in the levels of the pro‐apoptotic markers conformed to the previously reported elevated fat apoptosis post‐HIFEM treatments. These effects were accompanied by an increase in FFA levels, and by reduced pH levels, due to the increased acidity in the adipose tissue. Further research is required to explore the potential of nonthermal induction of apoptosis.