{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:07:50Z","timestamp":1792782470973,"version":"4.5.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Suleyman Demirel University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sepsis-associated liver injury is a major cause of morbidity and mortality, with oxidative stress, inflammation, and apoptotic signaling playing central roles in pathogenesis. Non-invasive physical modalities such as pulsed magnetic fields (PMF) and radiofrequency electromagnetic fields (RF-EMF) have shown organ-protective effects in various experimental settings; however, their combined application in hepatic inflammation has not been previously investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty female Wistar rats were randomized into five groups: Control, LPS, LPS\u2009+\u2009PMF, LPS\u2009+\u2009RF, and LPS\u2009+\u2009PMF+RF. Acute liver injury was induced with intraperitoneal LPS. PMF and RF-EMF were applied individually or in combination. Liver tissues were analyzed by histopathology, immunohistochemistry, and RT-qPCR for oxidative (NRF2, SOD), inflammatory (TNF-\u03b1), mitochondrial apoptotic (BCL2, BAX, Cyt-C, Caspase-9), and ER stress (PERK, Caspase-12, Caspase-3) markers. Serum ALT, AST, and albumin levels were also measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      LPS significantly increased TNF-\u03b1, BAX, Cyt-C, Caspase-9, PERK, Caspase-12, and Caspase-3 expression, while decreasing NRF2, SOD, and BCL2 (all ***\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Both PMF and RF monotherapies partially restored these parameters; however, the combined PMF\u2009+\u2009RF application achieved the most pronounced effects at the molecular and histopathological levels, normalizing oxidative stress markers, reducing pro-inflammatory and apoptotic signaling, and improving histopathological scores (all **\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 to ***\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 vs. LPS). Serum AST and ALT levels were significantly reduced by PMF monotherapy, while RF and combined PMF\u2009+\u2009RF treatments also produced significant decreases compared to the LPS group, albeit to a lesser extent. Serum albumin levels remained unchanged across all groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Concurrent low-frequency PMF and RF-EMF exposure confers synergistic hepatoprotection in endotoxin-induced liver injury by modulating oxidative, inflammatory, and apoptotic pathways. These findings suggest that dual-modality PMF and RF-EMF exposure may represent a promising non-invasive experimental strategy for mitigating endotoxin-driven hepatic injury. Further studies in clinically relevant sepsis and ischemia-reperfusion models, with extended follow-up and mechanistic validation, are warranted before translational inference.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00068-026-03119-2","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T09:22:32Z","timestamp":1771838552000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Synergistic mitigation of endotoxin-induced liver injury by low-frequency PMF and 27.12\u00a0MHz RF-EMF: a multi-biomarker experimental study"],"prefix":"10.1007","volume":"52","author":[{"given":"Bilal","family":"Turan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halil","family":"Asci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orhan","family":"Imeci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammet","family":"Tepebasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arzu","family":"Ulusoy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serdar","family":"Acar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isa","family":"Karaca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orhan","family":"Akp\u0131nar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozlem","family":"Ozmen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"issue":"3","key":"3119_CR1","doi-asserted-by":"publisher","first-page":"381","DOI":"10.33549\/physiolres.935201","volume":"73","author":"Q Zhang","year":"2024","unstructured":"Zhang Q, Jiang Y, Qin Y, Liu J, Xie Y, Zhang L, Li K, Wang X, Liu G. Linoleic acid alleviates lipopolysaccharide induced acute liver injury via activation of Nrf2. Physiol Res. 2024;73(3):381\u201391.","journal-title":"Physiol Res"},{"key":"3119_CR2","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.freeradbiomed.2022.08.027","volume":"191","author":"R Cuciniello","year":"2022","unstructured":"Cuciniello R, Luongo D, Ferramosca A, Lunetti P, Rotondi-Aufiero V, Crispi S, Zara V, Maurano F, Filosa S, Bergamo P. Conjugated Linoleic acid downregulates alzheimer\u2019s hallmarks in aluminum mouse model through an Nrf2-mediated adaptive response and increases brain glucose transporter levels. Free Radic Biol Med. 2022;191:48\u201358.","journal-title":"Free Radic Biol Med"},{"key":"3119_CR3","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1146\/annurev.pathmechdis.3.121806.151434","volume":"3","author":"JH Lin","year":"2008","unstructured":"Lin JH, Walter P, Yen TS. Endoplasmic reticulum stress in disease pathogenesis. Annu Rev Pathol. 2008;3:399\u2013425.","journal-title":"Annu Rev Pathol"},{"key":"3119_CR4","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/s12906-025-04792-3","volume":"25","author":"F Liao","year":"2025","unstructured":"Liao F, Li Y, Zhang Z, et al. Pulsed electromagnetic fields modulate energy metabolism during wound healing process: an in vitro model study. BMC Complement Med Ther. 2025;25:50.","journal-title":"BMC Complement Med Ther"},{"issue":"6","key":"3119_CR5","doi-asserted-by":"publisher","first-page":"1465","DOI":"10.7150\/ijms.105479","volume":"22","author":"ES Ozden","year":"2025","unstructured":"Ozden ES, Ozcan MS, Ilhan I, Tepebasi MY, Taner R, Uysal D, Asci H, Comlekci S, Ozmen O. Radiofrequency electromagnetic field \u0131nhibits HIF-1 alpha and activates eNOS signaling to prevent intestinal damage in a model of mesenteric artery ischemia in rats. Int J Med Sci. 2025;22(6):1465\u201376.","journal-title":"Int J Med Sci"},{"issue":"14","key":"3119_CR6","doi-asserted-by":"publisher","first-page":"11239","DOI":"10.3390\/ijms241411239","volume":"24","author":"J Flatscher","year":"2023","unstructured":"Flatscher J, et al. Pulsed electromagnetic fields (PEMF)\u2014Physiological response and its potential in trauma treatment. Int J Mol Sci. 2023;24(14):11239.","journal-title":"Int J Mol Sci"},{"issue":"17\u201318","key":"3119_CR7","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1007\/s00508-015-0732-8","volume":"127","author":"B Li","year":"2015","unstructured":"Li B, Li W, Bi JQ, et al. Effect of long-term pulsed electromagnetic field exposure on hepatic and Immunologic functions of rats. Wiener Klinische Wochenschrift. 2015;127(17\u201318):959\u201362.","journal-title":"Wiener Klinische Wochenschrift"},{"issue":"6","key":"3119_CR8","doi-asserted-by":"publisher","first-page":"539","DOI":"10.4149\/gpb_2023026","volume":"42","author":"F Gevrek","year":"2023","unstructured":"Gevrek F, Yelli S, G\u00fcrg\u00fcl S. The effects of the pulsed magnetic field on sepsis-induced liver tissue injury in rats. Gen Physiol Biophys. 2023;42(6):539\u201349.","journal-title":"Gen Physiol Biophys"},{"issue":"10","key":"3119_CR9","doi-asserted-by":"publisher","first-page":"5661","DOI":"10.3390\/ijms23105661","volume":"23","author":"CG Lee","year":"2022","unstructured":"Lee CG, Park C, Hwang S, Hong JE, Jo M, Eom M, Lee Y, Rhee KJ. Pulsed electromagnetic field (PEMF) treatment reduces Lipopolysaccharide-Induced septic shock in mice. Int J Mol Sci. 2022;23(10):5661.","journal-title":"Int J Mol Sci"},{"issue":"4","key":"3119_CR10","doi-asserted-by":"publisher","first-page":"178","DOI":"10.14744\/hf.2024.2024.0005","volume":"5","author":"Y Gokce","year":"2024","unstructured":"Gokce Y, Seker U, Ozoner MP. Safety analysis of different \u0131ntensities of elf-pemf in terms of apoptotic, inflammatory, and transcription factor NF-\u039ab expression levels in rat liver. Hepatol Forum. 2024;5(4):178\u201383. PMID: 39524317; PMCID: PMC11440225.","journal-title":"Hepatol Forum"},{"key":"3119_CR11","doi-asserted-by":"publisher","DOI":"10.3390\/medicina61020238","author":"\u00c7 Balci","year":"2025","unstructured":"Balci \u00c7, \u00d6zcan MS, A\u015fci H, Karabacak P, Kuru\u015f\u00e7u O, Taner R, et al. Med (Kaunas). 2025;61(2):238. https:\/\/doi.org\/10.3390\/medicina61020238. PMID: 40005355; PMCID: PMC11857468. Radiofrequency Electromagnetic and Pulsed Magnetic Fields Protected the Kidney Against Lipopolysaccharide-Induced Acute Systemic Inflammation, Oxidative Stress, and Apoptosis by Regulating the IL-6\/HIF1\u03b1\/eNOS and Bcl2\/Bax\/Cas-9 Pathways."},{"issue":"4","key":"3119_CR12","doi-asserted-by":"publisher","first-page":"839","DOI":"10.31362\/patd.1720986","volume":"18","author":"\u015e Topsakal","year":"2025","unstructured":"Topsakal \u015e, Kolay \u00d6, A\u015f\u00e7\u0131 H, \u00d6zmen \u00d6. Dual magnetic field therapy mitigates LPS-induced pancreatic injury by preserving islet structure and endocrine function in rats. Pam T\u0131p Derg Ekim. 2025;18(4):839\u201349. https:\/\/doi.org\/10.31362\/patd.1720986.","journal-title":"Pam T\u0131p Derg Ekim"},{"issue":"2","key":"3119_CR13","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.clinbiochem.2003.10.014","volume":"37","author":"O Erel","year":"2004","unstructured":"Erel O. A novel automated method to measure total antioxidant response against potent free radical reactions. Clin Biochem. 2004;37(2):112\u20139.","journal-title":"Clin Biochem"},{"issue":"12","key":"3119_CR14","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1016\/j.clinbiochem.2005.08.008","volume":"38","author":"O Erel","year":"2005","unstructured":"Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem. 2005;38(12):1103\u201311.","journal-title":"Clin Biochem"},{"issue":"8","key":"3119_CR15","doi-asserted-by":"publisher","first-page":"1491","DOI":"10.3390\/antiox12081491","volume":"12","author":"M Fuertes-Agudo","year":"2023","unstructured":"Fuertes-Agudo M, Luque-T\u00e9var M, Cucarella C, Mart\u00edn-Sanz P, Casado M. Advances in Understanding the role of NRF2 in liver pathophysiology and its relationship with Hepatic-Specific Cyclooxygenase-2 expression. Antioxid (Basel). 2023;12(8):1491.","journal-title":"Antioxid (Basel)"},{"key":"3119_CR16","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.1007\/s00296-010-1488-0","volume":"31","author":"I G\u00f3mez-Ochoa","year":"2011","unstructured":"G\u00f3mez-Ochoa I, G\u00f3mez-Ochoa P, G\u00f3mez-Casal F, et al. Pulsed electromagnetic fields decrease Proinflammatory cytokine secretion (IL-1\u03b2 and TNF-\u03b1) on human fibroblast-like cell culture. Rheumatol Int. 2011;31:1283\u20139.","journal-title":"Rheumatol Int"},{"key":"3119_CR17","doi-asserted-by":"publisher","first-page":"7272","DOI":"10.1038\/s41598-019-43573-0","volume":"9","author":"LH Huang","year":"2019","unstructured":"Huang LH, Cui LH, Kim DH, et al. Regulating response and leukocyte adhesion of human endothelial cell by gradient nanohole substrate. Sci Rep. 2019;9:7272.","journal-title":"Sci Rep"},{"key":"3119_CR18","doi-asserted-by":"publisher","first-page":"131","DOI":"10.3892\/mmr.2016.6012","volume":"15","author":"C Fu","year":"2017","unstructured":"Fu C, Dai X, Yang Y, Lin M, Cai Y, Cai S. Dexmedetomidine attenuates lipopolysaccharide-induced acute lung injury by inhibiting oxidative stress, mitochondrial dysfunction and apoptosis in rats. Mol Med Rep. 2017;15:131\u20138.","journal-title":"Mol Med Rep"},{"issue":"4","key":"3119_CR19","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1016\/j.bbamcr.2010.09.013","volume":"1813","author":"KW Kinnally","year":"2011","unstructured":"Kinnally KW, Peixoto PM, Ryu SY, Dejean LM. Is mPTP the gatekeeper for necrosis, apoptosis, or both? Biochim Biophys Acta. 2011;1813(4):616\u201322.","journal-title":"Biochim Biophys Acta"},{"issue":"16","key":"3119_CR20","doi-asserted-by":"publisher","first-page":"3227","DOI":"10.1093\/hmg\/ddr235","volume":"20","author":"W Yu","year":"2011","unstructured":"Yu W, Sun Y, Guo S, Lu B. The PINK1\/Parkin pathway regulates mitochondrial dynamics and function in mammalian hippocampal and dopaminergic neurons. Hum Mol Genet. 2011;20(16):3227\u201340.","journal-title":"Hum Mol Genet"},{"issue":"1","key":"3119_CR21","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1038\/s41392-023-01570-w","volume":"8","author":"X Chen","year":"2023","unstructured":"Chen X, Shi C, He M, Xiong S, Xia X. Endoplasmic reticulum stress: molecular mechanism and therapeutic targets. Signal Transduct Target Ther. 2023;8(1):352.","journal-title":"Signal Transduct Target Ther"},{"issue":"3","key":"3119_CR22","doi-asserted-by":"publisher","first-page":"277","DOI":"10.4196\/kjpp.2018.22.3.277","volume":"22","author":"JH Kim","year":"2018","unstructured":"Kim JH, Sohn UD, Kim HG, Kim HR. Exposure to 835\u00a0MHz RF-EMF decreases the expression of calcium channels, inhibits apoptosis, but induces autophagy in the mouse hippocampus. Korean J Physiol Pharmacol. 2018;22(3):277\u201389.","journal-title":"Korean J Physiol Pharmacol"},{"issue":"11","key":"3119_CR23","doi-asserted-by":"publisher","first-page":"12402","DOI":"10.1002\/cam4.5944","volume":"12","author":"F Capareli","year":"2023","unstructured":"Capareli F, Costa F, Tuszynski JA, Sousa MC, Setogute YC, Lima PD, Carvalho L, Santos E, Gumz BP, Sabbaga J, de Castria TB, Jardim DL, Freitas D, Horvat N, Bezerra ROF, Testagrossa L, Costa T, Zanesco T, Iemma AF, Abou-Alfa GK. Low-energy amplitude-modulated electromagnetic field exposure: feasibility study in patients with hepatocellular carcinoma. Cancer Med. 2023;12(11):12402\u201312.","journal-title":"Cancer Med"},{"issue":"8","key":"3119_CR24","doi-asserted-by":"publisher","first-page":"1020","DOI":"10.3390\/ijerph21081020","volume":"21","author":"R Pinto","year":"2024","unstructured":"Pinto R, Ardoino L, Giardullo P, Villani P, Marino C. A systematic review on the in vivo studies on radiofrequency (100\u00a0kHz-300 GHz) electromagnetic field exposure and Co-Carcinogenesis. Int J Environ Res Public Health. 2024;21(8):1020.","journal-title":"Int J Environ Res Public Health"}],"container-title":["European Journal of Trauma and Emergency Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-026-03119-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00068-026-03119-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-026-03119-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:41:33Z","timestamp":1781635293000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00068-026-03119-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,23]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3119"],"URL":"https:\/\/doi.org\/10.1007\/s00068-026-03119-2","relation":{"references":[{"id-type":"doi","id":"10.3390\/medicina61020238","asserted-by":"subject"}]},"ISSN":["1863-9941"],"issn-type":[{"value":"1863-9941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,23]]},"assertion":[{"value":"4 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. This experimental study was approved by the S\u00fcleyman Demirel University Animal Experiments Local Ethics Committee (SD\u00dc-HADYEK; Approval No: 12.06.2025-06\/528) and was conducted in accordance with institutional and national guidelines for the care and use of laboratory animals, following ARRIVE 2.0 recommendations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"56"}}