LLLT / Cold Laser Literature watch for February 2011

28 LLLT papers for you this month, including two systematic reviews: One for osteoarthritis of the hand and the other on dentin hypersensitivity. An intriguing review of the cytochrome c oxidase mechanism for the NO / ROS nerds amongst you. There are four clinical trials: chronic rhinosinusitis (at last a cure for the common cold?), healing after tooth extraction, recovery of muscular strength following muscle fatigue and laser acupuncture on knee osteoarthritis. Two papers from one of the gods of phototherapy Kendric Smith, and several clinical retrospectives from the Japanese journal “Laser Therapy. Over to you now, what do you think? – there is a comments section available for you on the blog so go there and write back to me, I’d love to have your comments.

Effects of rehabilitative interventions on pain, function and physical impairments in people with hand osteoarthritis: a systematic review.

Ye L, Kalichman, L, Spittle, A, Dobson F, Bennell K

ABSTRACT: INTRODUCTION: Hand osteoarthritis (OA) is associated with pain, reduced grip strength, loss of range of motion and joint stiffness leading to impaired hand function and difficulty with daily activities. The effectiveness of different rehabilitation interventions on specific treatment goals has not yet been fully explored. The objective of this systematic review is to provide evidence based knowledge on the treatment effects of different rehabilitation interventions for specific treatment goals for hand OA. METHODS: A computerized literature search of Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ISI Web of Science, the Physiotherapy Evidence Database (PEDro) and SCOPUS was performed. Evidence level 2b or higher studies that compared a rehabilitation intervention with a control group and assessed at least one of the following outcome measures: pain, physical hand function or other measures of hand impairment, were included. The eligibility and methodological quality of trials were systematically assessed by two independent reviewers using the PEDro scale. Treatment effects were calculated using standardized mean difference and 95% confidence intervals. RESULTS: Ten studies were included, of which six were of higher-quality (PEDro score>6). The rehabilitation techniques reviewed included three studies on exercise, two studies each on laser and heat, and one study each on splints, massage and acupuncture. One higher quality trial showed a large positive effect of 12-months use of a night splint on hand pain, function, strength and range of motion. Exercise had no effect on hand pain or function although it may be able to improve hand strength. Low level laser therapy may be useful to improving range of motion. No rehabilitation interventions were found to improve stiffness. CONCLUSIONS: There is emerging high quality evidence to support that rehabilitation interventions can offer significant benefits to individuals with hand OA. A summary of the higher quality evidence is provided to assist with clinical decision making based on current evidence. Further high-quality research is needed concerning the effects of rehabilitation interventions on specific treatment goals for hand OA.

Arthritis Res Ther 2011 Feb 18 13(1) R28

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21332991

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Effectiveness of laser in dentinal hypersensitivity treatment: a systematic review.

Sgolastra F, Petrucci A, Gatto R, Monaco A

Department of Health Science, School of Dentistry, Faculty of Medicine, University of L’Aquila, L’Aquila, Abruzzo, Italy.

INTRODUCTION: The effectiveness of laser treatment in reducing dentinal hypersensitivity (DH) is controversial, with important concerns related to the high efficacy of placebo laser. The purpose of this systematic review was to identify and evaluate literature regarding the effectiveness of laser therapy compared with placebo laser therapy. The secondary aim was to survey the literature regarding laser treatment safety. METHODS: An exhaustive literature search with strict inclusion and exclusion criteria was performed with electronic databases and by hand. The goal was to identify all randomized, placebo-controlled clinical trials that have assessed the effectiveness of DH reduction compared with placebo laser. RESULTS: Only 3 randomized clinical trials were retrieved. These studies supported that laser treatment could reduce DH, but the reduction was not significant compared with placebo laser treatment. No side effects, adverse reactions, or pulp damage were reported at the energy and power settings used. CONCLUSIONS: Laser therapy can reduce DH-related pain, but the evidence for its effectiveness is weak, and the possibility of a placebo effect must be considered.

J Endod 2011 Mar 37(3) 297-303

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21329811

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Phototherapy for chronic rhinosinusitis.

Krespi YP, Kizhner V

St. Luke’s-Roosevelt Hospital, New York, NewYork. krespi@nyhni.org.

OBJECTIVES: Near-infrared laser illumination (NILI), with or without photo-activated (PA) agents, has bactericidal and wound healing promoting effects. NILI may have a potential role managing chronic rhinosinusitis (CRS). METHODS: A prospective randomized study with 23 symptomatic post-surgical CRS patients with positive cultures was conducted. Two groups (GR1 and GR2) were treated with NILI. Objective nasal endoscopic scoring (NES) was elaborated. GR1 was treated with a 940 nm laser, while GR2 was treated with a topical PA agent, indocyanine-green, followed with 810 nm laser. SNOT20 scores, NES, and cultures were obtained prior to illumination. Saccharin test was performed 1 week following treatment. RESULTS: Some cultures remained positive through treatment, with Staph. aureus predominating. Both therapy arms demonstrated clinical efficacy. The SNOT20 score change was 0.9, 0.8 for GR1 and GR2, respectively (P < 0.05). Improvement (P < 0.05) was observed based on NES. No significant difference was observed between two treatment groups. All passed the saccharin test. Therapeutic effect was sustained for a minimum of 2 months. Side effects were minimal. CONCLUSIONS: NILI was objectively and subjectively beneficial in managing CRS, safe, reproducible, sustained and appeared not to interfere with ciliary motility. CRS exacerbation was avoided without using antibiotics or steroids. Lasers Surg. Med. (c) 2011 Wiley-Liss, Inc.

Lasers Surg Med 2011 Feb 2

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21290392

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Therapeutic photobiomodulation: nitric oxide and a novel function of mitochondrial cytochrome c oxidase

Poyton RO, Ball KA

Department of Molecular, Cellular, and Developmental Biology, University of Colorado, Boulder, Colorado 80309, USA

Currently, light therapies are widely used in both human and veterinarian medicine. The application of light to clinical therapeutics includes: photodynamic therapy, used to kill cancer cells; UVA therapies, used to treat a variety of skin diseases; and photobiomodulation, used to promote cell growth and recovery from injury. Photobiomodu-lation uses light emitting diodes (LEDs) or low energy lasers, which emit light in the visible red to near infrared range. Light in this range penetrates tissue reasonably well, lacks the carcinogenic/mutagenic properties of UV light, and acts on an endogenous photoreceptor which likely acts to initiate light-altered signaling pathways. Although early studies identified mitochondrial cytochrome c oxidase as an endogenous photoreceptor for photobiomodulation, the cellular and molecular mechanisms underlying photobiomodulation have not been clear. Three recent findings provide important new insight. First, nitric oxide has been implicated. Second, cytochrome c oxidase, an enzyme known to reduce oxygen to water at the end of the mitochondrial respiratory chain, has been shown to have a new enzymatic activity – the reduction of nitrite to nitric oxide. This nitrite reductase activity is elevated under hypoxic conditions but also occurs under normoxia. And third, low intensity light enhances nitric oxide synthesis by cytochrome c oxidase without altering its ability to reduce oxygen. From these findings, we propose that cytochrome c oxidase functions in photobiomodulation by producing nitric oxide, a signaling molecule which can then function in both intra- and extracellular signaling pathways. We also propose that the effectiveness of photobiomodulation is under the control of tissue oxygen and nitrite levels.

Discov Med. 2011 Feb;11(57):154-9

http://www.ncbi.nlm.nih.gov/pubmed?term=21356170

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The effect of GaAlAs laser irradiation on the recovery process of muscular strength following muscle fatigue

Yasushi Ishide, Toshio Ohshiro, Fumio Ueda, Mitsuyoshi Murayama, Takafumi Ohshiro, Kiyofumi Takenouchi and Mitsuaki Kohzuma

Keio University Institute of Physical Education Japan Medical Laser Laboratory Ohshiro Clinic

Abstract Low reactive-level laser therapy (LLLT) has been reported to reduce chronic and acute pain. Recently, some studies have shown that LLLT may also delay skeletal muscle fatigue during high-intensity exercise. We have hypothesized that laser irradiation may also attenuate muscle fatigue or pain experienced after sports or exercise. However, only a few reports have described the use of lasers in sports medicine. This study was conducted to determine the effectiveness of LLLT in aiding the recovery from exercise-induced skeletal muscle fatigue. Subjects and Methods: Isometric plantar flexion was repeatedly performed on 9 students until the force output declined to 50% maximal voluntary contraction (MVC). Subjects were assigned to perform 3 experiments under different LLLT conditions: laser irradiation to the neck (NKL), to the muscle (MSL), and no laser irradiation (CON). MVC and muscle hardness, girth, blood oxygen saturation, and heart rate were measured during the pre-exercise, post-exercise, and recovery phases. The neck and muscle were irradiated for 15 s using the Oh-Lase HT 2001 semi-conductor laser (830 nm; 60 mW, continuous wave), immediately after MVC measurement during the post-exercise phase. Results: The total exercise time and mean output forces were analyzed using repeated-measures and one-factor ANOVA with post-hoc tests; no significant differences were observed among the 3 conditions for the pre and post-exercise MVC levels before irradiation (NKL, 68.1% MVC; MSL, 66.4% MVC; CON, 66.1% MVC). However, the MVC at 5 and 10 min after exercise was significantly greater in the NKL and MSL groups than in the CON group (MVC after 5 min: 80.4%, 76.9%, and 69.7% for the NKL, MSL, and CON groups, respectively; MVC after 10 min: 81.8%, 81.2%, and 74.4%). Further, no significant differences were observed in the MVC recorded at 15 and 30 min. Therefore, compared to the CON group, the NKL and MSL groups exhibited early muscle-strength recovery from fatigue caused by repeated contractions. Conclusion: We concluded that LLLT at the parameters used in the present study effectively promoted the recovery of the isometric force output after muscle fatigue induced by repeated contractions, especially in the acute-exhaustion phase.

Laser Therapy. 2010, Vol. 19, No. 1, p.11-22 .

http://www.jstage.jst.go.jp/article/islsm/19/1/19_11/_article

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Laser and led photobiology

Kendric C. Smith

Stanford University School of Medicine

Low Level Light Therapy, or LLLT, is a very important new area of photomedicine. However, there are a number of reasons why LLLT has not been accepted into the main stream of science and medicine, and I will discuss a few of them below. Let me add, however, that I know from personal experience that LLLT works on wound healing, and carpal tunnel syndrome, when done properly. I have been trying for over 40 years to teach photobiology to laser people, and more recently, to LED people as well. At a laser meeting in the 1970s, at the height of the feeling that lasers were magical, I made a slide to demonstrate the biological effect of a laser. It showed a man dropping a big laser on his foot, and yelling OUCH. I said that this is the ONLY type of biological effect that a laser can have on a person. A laser is an expensive flashlight, and it is the light produced BY the laser that has a chance of producing a biological effect, assuming that it is of the correct wavelength and output, etc. Because so many bad papers have been published on LLLT, it has not achieved the universal acceptance that that it deserves. There are two main reasons for bad papers on LLLT; one is the lack of proper scientific training by the authors, and the other is their lack of knowledge of photobiology. I will give you some examples of very bad science.

Laser Therapy. 2010, Vol. 19, No. 2, p.72-78 .

http://www.jstage.jst.go.jp/article/islsm/19/2/19_72/_article

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Superpulsed laser therapy on healing process after tooth extraction in patients waiting for liver transplantation.

Mozzati M, Martinasso G, Cocero N, Pol R, Maggiora M, Muzio G, Canuto RA

Oral Surgery Unit, Dentistry Section, Department of Biomedical Sciences and Human Oncology, University of Turin, Turin, Italy.

Alveolar healing following tooth extraction is a complex repair process involving different tissues, including epithelium and bone. This research aimed to study the effect of laser therapy on alveolar healing process in patients waiting for liver transplantation, evaluating some inflammation, osteogenesis, and clinical parameters. Twelve patients with hepatic failure waiting for liver transplantation, with indications to bilateral extraction, entered the split-mouth study. One post-extractive defect was treated with laser while the other was left without treatment. Specimens of soft tissues were removed from around the tooth before extraction and after 7 days. Superpulsed laser irradiation prevented IL-1beta increase and induced IL-6, IL-10, and collagen III increase at 7 days in comparison to their level before extraction, whereas the other parameters were unmodified. Moreover, the epithelial regeneration evidenced a positive result of laser therapy, and the patients reported less pain in the site treated with laser. In conclusion, laser therapy appears to be the treatment of choice for patients due to its clinical efficacy, safety, good tolerance, and its ability to prevent inflammation.

Lasers Med Sci 2011 Jan 29

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21279404

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[Clinical observation on acupoint irradiation with combined laser or red light on patients with knee osteoarthritis of yang deficiency and cold coagulation type].

Ren XM, Wang M, Shen XY, Wang LZ, Zhao L

Acupuncture and Tuina College, Shanghai University of TCM, Shanghai 201203, China. snowysh@hotmail.com

OBJECTIVE: To explore the effects of combined laser on patients with knee osteoarthritis (OA) of yang deficiency and cold coagulation type. METHODS: Forty-one cases with knee OA of yang deficiency and cold coagulation type were randomly divided into a combined laser group (n = 22) and a red light group (n = 19), with combined laser and red light irradiation on Dubi (ST 35) and Neixiyan (EX-LE 4), respectively. They were treated for 6 weeks. The scores of Western Ontario and McMaster Universities’ Osteoarthritis Index (WOMAC VA3. 1) were used for assessment of therapeutic effects. RESULTS: After treatment for 2 weeks and 6 weeks, the WOMAC scores significantly decreased in the two groups as compared with those before treatment (P < 0.05, P < 0.01 and P < 0.001). The mean improvement rate of WOMAC scores in the combined laser group was better than those in the red light group. CONCLUSION: Combined laser irradiation can improve the pain, stiffness and functional limitation of patients with knee OA of yang deficiency and cold coagulation type.

Zhongguo Zhen Jiu 2010 Dec 30(12) 977-81

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21290832

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Low reactive level laser therapy in the treatment of post herpetic neuralgia

Katsumi Sasaki, Toshio Ohshiro, Takafumi Ohshiro and Yuki Taniguchi

Keikokai Ohshiro Clinic Japan Medical Laser Laboratory

Post herpetic neuralgia (PHN) can be an extremely painful condition which in many cases proves resistant to all the accepted forms of treatment. It is frequently most severe in the elderly and may persist for years with no predictable course. Since 1980, we have been applying low reactive level laser therapy (LLLT) for patients with PHN. We report herein on the results of a retrospective study concerning those patients in whom LLLT has been applied for pain attenuation of PHN. One hundred and twenty-three patients (73 male, 50 female, mean age: 66.11yr) have received LLLT for various entities of PHN over the past 29 years. In these cases the affected tissue area(s) was as follows: thorax and back (48 cases); head and neck (41 cases); abdomen and lumbar (17 cases); upper limb (9 cases); and lower limb (8 cases). The overall total improvement rate was 60.16%. Patient whose treatment was given within six month of onset obtained the highest improvement rate (mean, 76.34%). LLLT was effective for PHN in the acute and chronic phase, but LLLT was particularly effective for the acute phase patients whose onset before treatment was 6 months or less. The results demonstrate a significant reduction in PHN pain intensity, hypersensitivity and other complaints

Laser Therapy. 2010, Vol. 19, No. 2, p.101-105 .

http://www.jstage.jst.go.jp/article/islsm/19/2/19_101/_article

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Low-Level Laser Irradiation Alters Cardiac Cytokine Expression Following Acute Myocardial Infarction: A Potential Mechanism for Laser Therapy.

Yang, Z, Wu Y, Zhang H, Jin P, Wang W, Hou, J, Wei Y, Hu S

1 Department of Surgery, Cardiovascular Institute and Fu Wai Hospital , Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China .

Abstract Objectives: Low-level laser irradiation (LLLI) has the potential of exerting cardioprotective effect following myocardial infarction (MI). The authors hypothesized that LLLI could influence the expression of cardiac cytokines and contribute to the reversal of ventricular remodeling. Background: LLLI regulates the expression of cytokines after tissue damage. However, little is known concerning the alteration of the cardiac cytokine expression profile after LLLI. Methods: MI was created by coronary ligation. The surviving rats were divided randomly into laser and control groups. 33 rats were exposed to a diode laser (635 nm, 5 mW, CW, laser, beam spot size 0.8 cm(2), 6 mW/cm(2), 150 sec, 0.8 J, 1J/cm(2)) as laser group. Another 33 rats received only coronary ligation and served as control group. 28 rats received a thoracotomy without coronary ligation (sham group). One day after laser irradiation, 5 rats from each group were sacrificed and the heart tissues were analyzed by cytokine antibody arrays. Enzyme-linked immunosorbent assay (ELISA) was performed to confirm its reliability. Two weeks after MI, cardiac function and structure were evaluated by echocardiography and histological study. Results: Cytokine antibody array indicated 4 cytokines were significantly changed after laser therapy. ELISA confirmed that granulocyte-macrophage colony stimulating factor and fractalkine were the cytokines involved in the response to therapeutic laser irradiation. However, there was no difference in cytokine release between various groups at 2 weeks after MI. Although LLLI did not improve the damaged heart function, it did reduce the infarct area expansion. Conclusions: The antibody-based protein array technology was applied for screening the cytokine expression profile following MI, with or without laser irradiation. The expression of multiple cytokines was regulated in the acute phase after LLLI. Our results revealed a potential novel mechanism for applying laser therapy to the treatment of heart disease.

Photomed Laser Surg 2011 Feb 24

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21348574

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Laser Photobiomodulation of Gene Expression and Release of Growth Factors and Cytokines from Cells in Culture: A Review of Human and Animal Studies.

Peplow PV, Chung TY, Ryan B, Baxter GD

1 Department of Anatomy & Structural Biology, University of Otago , Dunedin, New Zealand .

Abstract Aim: The aim of this paper was to review experimental studies of laser irradiation of human and animal cells in culture to assess the photobiomodulatory effects of such irradiation on gene expression and release of growth factors and cytokines. Background: Previous studies have reported that the release of certain growth factors and cytokines by various types of cells can be modulated by laser irradiation. A review of recent studies may provide further insight into the clinical effects brought about by laser irradiation of cells and tissues, including changes in inflammation and cellular proliferation. Methods: A systematic review was completed of original research papers investigating the effects of laser phototherapy on gene expression and release of these mediators from human and animal cells in culture (January 2002 to September 2009). Relevant papers were retrieved primarily from PubMed and Medline databases. The search terms were “growth factors”, “cytokines”, “laser therapy”, “laser irradiation”, “laser phototherapy,” and “phototherapy”. Results: A total of 17 relevant papers were included in the review, comprising studies on a variety of cell types. Considerable variation occurred in research design, methodology, and irradiation parameters employed, limiting comparison of research findings between studies. Results demonstrated that laser irradiation at green, red, or infrared wavelengths at a range of dosage parameters can cause significant changes in the cellular gene expression and release of these mediators, and that such effects depend upon wavelength and radiant exposure. Conclusion: Findings from the reviewed studies clearly demonstrate the ability of laser irradiation to modulate gene expression and the release of growth factors and cytokines from cells in culture. Further work is indicated at the clinical level to elucidate the putative clinical relevance of these cellular-level effects.

Photomed Laser Surg 2011 Feb 10

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21309703

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Role of low-level laser therapy in neurorehabilitation.

Hashmi JT, Huang YY, Osmani BZ, Sharma SK, Naeser MA, Hamblin MR

Wellman Center for Photomedicine, Massachusetts General Hospital, Department of Dermatology, Harvard Medical School, Boston, MA 02114, USA.

This year marks the 50th anniversary of the discovery of the laser. The development of lasers for medical use, which became known as low-level laser therapy (LLLT) or photobiomodulation, followed in 1967. In recent years, LLLT has become an increasingly mainstream modality, especially in the areas of physical medicine and rehabilitation. At first used mainly for wound healing and pain relief, the medical applications of LLLT have broadened to include diseases such as stroke, myocardial infarction, and degenerative or traumatic brain disorders. This review will cover the mechanisms of LLLT that operate both on a cellular and a tissue level. Mitochondria are thought to be the principal photoreceptors, and increased adenosine triphosphate, reactive oxygen species, intracellular calcium, and release of nitric oxide are the initial events. Activation of transcription factors then leads to expression of many protective, anti-apoptotic, anti-oxidant, and pro-proliferation gene products. Animal studies and human clinical trials of LLLT for indications with relevance to neurology, such as stroke, traumatic brain injury, degenerative brain disease, spinal cord injury, and peripheral nerve regeneration, will be covered.

PM R 2010 Dec 2(12 Suppl 2) S292-305

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21172691

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Late radiation lesions of urinary bladder and rectum in patients with prostate cancer after external radiation therapy and phototherapy with low power near infrared laser

G.M. Zharinov, A.A. Zimin, K.A. Samoilova, N.Yu. Neklasova, L.A. Volodina and V.A. Ovsyannikov

Russian Research Center of Radiology and Surgical Technologies of the Rosmedtechnologies Institute of Cytology, Russian Academy of Sciences Ioffe Physico-Technical Institute

The goal of this paper is to study the effect of phototherapy with near infrared laser on incidence of late radiation lesions of urinary bladder and rectum in patients with prostate cancer after external radiation therapy. The study was carried out at Department of New Technologies of Radiation Therapy. 559 patients with prostate cancer were treated with radiotherapy and hormonal therapy from January 2000 to June 2007. In 308 patients a “Lazernoe Solnyshko” laser apparatus was used (NIIEFA, = 890 nm, 45 mW, 10.8 J, duration of pulses 150 ns, frequency of pulses 3000 Hz, 16 radiating elements). The control group included 251 patients. Action of light was performed on the skin areas submitted to radiation therapy beginning from its 12th session during 4 minutes. In the control group the radiation damage of urinary bladder and rectum appeared in 7.6% and 10.7% of patients, while in the main group – in 1.95% and 2.92%, respectively (p < 0.01). Thus, the course of phototherapy with the near infrared low power laser at performance of radiotherapy decreases incidence of radiation damages of urinary bladder and rectum in patients with prostate cancer.

Laser Therapy. 2010, Vol. 19, No. 2, p.89-95 .

http://www.jstage.jst.go.jp/article/islsm/19/2/19_89/_article

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Molecular targets for low level light therapy

Kendric C. Smith

Stanford University School of Medicine

There are many molecular targets for Low Level Light Therapy (LLLT). The chief target appears to be cytochrome C oxidase in mitochondria, which then initiates a cascade of molecular events that signal the cell to perform various functions. Although visible light can produce photochemistry, infrared radiation only produces molecular rotations and vibrations. A probable explanation of how 633 nm radiation can produce the same biological effect as 904 nm radiation will be presented. The light activation of enzymes by multiple mechanisms will be discussed. To further enhance the scientific basis of LLLT, I propose that gene array experiments be performed at the wavelengths that have been shown to be most effective for different therapies with LLLT. Then we will know what genes are activated by the different wavelengths, and therapy can then be designed with greater confidence for success. It will also help us to determine if the use of more than one wavelength in a therapy might be advantageous. Think of the different wavelengths of light as different drugs, therefore it is important to determine which drug is best, and also the optimum dose.

Laser Therapy. 2010, Vol. 19, No. 3, p.135-142 .

http://www.jstage.jst.go.jp/article/islsm/19/3/19_135/_article

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Effects of HeNe laser on stored blood

Dan Georgel Siposan and Stefan Bobe

Military Technical Academy Center of Transfusion Hematology of the Army

Background: The purpose of the current study was to investigate the possibility of rejuvenating red blood cells (RBC) and prolonging their life using low-level laser radiation (LLLR). The possibility that blood could easily be collected and preserved for 21-42 days determined the authors’ attempt to answer such questions as: the minimum LLLR dose capable of influencing blood qualities without damaging effects, the optimum characteristics of the irradiating source and protocol of irradiation. Because of its complex composition, the physical and chemical properties of blood have not yet been entirely elucidated. Blood irradiation additionally involves a special physical agent, as well as mechanisms of action that are not clearly understood. Material and Methods: We irradiated blood stored in MacoPharma bags, from seven healthy adult donors. A HeNe laser (6 mW, continuous wave) was used as the source of irradiation. Twenty-four to 48 hours after irradiation blood samples underwent rheological and biochemical analyses in order to establish the morpho-functional status of the red blood cells. Results: Marked effects occurred in the case of effectively received doses of 0.4 and 1.2 J·cm-3, suggesting a beneficial action of LLLR on the morphologically functional erythrocytes. Conclusion: This study demonstrated that blood rejuvenation by the physical method of laser irradiation could be an efficient, simple and economic procedure, and that it needs to be tested on patients who require urgent transfusion. Because the irradiated blood demonstrated a better capacity than the non-irradiated blood, we concluded that LLLR had a revitalizing effect on preserved blood.

Laser Therapy. 2010, Vol. 19, No. 4, p.245-255

http://www.jstage.jst.go.jp/article/islsm/19/4/19_245/_article

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Analysis of the curative effect of GaAlAs diode laser therapy in female infertility

Yuki Taniguchi, Toshio Ohshiro, Takafumi Ohshiro and Katsumi Sasaki

Ohshiro Clinic Japan Medical Laser Laboratory

Abstract Background and Aims: During the lifespan of the female, biochemical changes occur in the ovarian environment. These changes are brought about by numerous endogenous and exogenous factors, and can have a profound effect on ovarian oocyte quality. Oocytes of poor quality may be the cause of female infertility and are a major obstacle in successful assisted reproductive technologies (ART). We have previously reported on the efficacy of low reactive laser therapy (LLLT) using a GaAlAs diode laser device which emits laser light of 830 nm at an output of 60 mW to improve the poor quality of oocytes as an adjunctive treatment of refractory female infertility. The aim of this study is to assess the LLLT curative effect. Subjects and Method: Eight hundred and fourteen female patients who presented at the Ohshiro clinic for treatment of infertility from July 1st, 2000 till December, 2009 were enrolled in the analysis. We analyzed the therapeutic frequency and the therapeutic period (the number of menstrual cycles) between pregnant women and non-pregnant women. Results were expressed as means ± standard error of mean. The statistical difference was determined with the two-sided Student’s t-test and the Mann-Whitney’s U test. Differences with P ‹ 0.05 were considered significant. Result: The mean therapeutic frequency and mean therapeutic period in the subjects who gave birth was 3.3 ±2.6 times a month and 5.2 ±6.1 months, respectively, which correspond to the whole oogenesis period. Conclusion: We concluded that laser therapy once per week and a period of 5-6 menstrual cycles might be necessary to gain a good curative effect as the laser effect could last 1 week and the competence of oocytes depends on numerous processes taking place during the whole oogenesis period.

Laser Therapy. 2010, Vol. 19, No. 4, p.257-261

http://www.jstage.jst.go.jp/article/islsm/19/4/19_257/_article

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Differential responses of fibroblasts, non-neoplastic epithelial cells, and oral carcinoma cells to low-level laser therapy.

Schartinger VH, Galvan, O, Riechelmann, H, Dudas, J

Department of Otorhinolaryngology, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria, volker.schartinger@i-med.ac.at.

Low-level laser therapy (LLLT) is used in the treatment of chemoradiotherapy- or radiotherapy-induced oropharyngeal mucositis (ORM). In head and neck cancer, tumor cells may lie in the LLLT irradiation field, and LLLT might promote tumor progression. We therefore investigated the effect of LLLT on proliferation, cell cycle distribution, and apoptosis in a human oral carcinoma cell line (SCC-25), non-malignant epithelial cells (BEAS-2B), and fibroblasts in vitro. The cell lines were subjected to LLLT on three consecutive days for 15 min. Cell proliferation was assessed using the MTT assay, cell cycle distribution by flow cytometry and propidium-iodide DNA staining, and apoptosis using an Annexin V-FITC assay. Controls were sham-treated, but not exposed to the laser treatment. LLLT treatment resulted in increased fibroblast proliferation (p < 0.001), whereas decreased cell proliferation was observed after LLLT treatment of BEAS-2B (p = 0.003) and SCC-25 cells (p < 0.001). In SCC-25 cells, an increased percentage of S-phase cells and decreased percentage of G1-phase cells were observed (p < 0.001). Moreover, a proapoptotic effect of LLLT was observed in SCC-25 cells (p = 0.02). LLLT did not exhibit a tumor-promoting effect in this in vitro study.

Support Care Cancer 2011 Feb 22

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21340656

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Irradiation at 636 nm Positively Affects Diabetic Wounded and Hypoxic Cells in Vitro.

Sekhejane PR, Houreld NN, Abrahamse H

Laser Research Centre, Faculty of Health Sciences, University of Johannesburg , Doornfontein, South Africa .

Abstract Objective: This study investigated the effect of low-intensity laser irradiation (LILI) on pro-inflammatory cytokines involved in wound healing processes in diabetes and hypoxia. Background data: Diabetes is associated with impaired wound healing and a prolonged inflammatory phase. Pro-inflammatory cytokines such as interleukin (IL)-1beta, tumor necrosis factor (TNF)-alpha and IL-6 are elevated in diabetes. LILI has been reported to accelerate wound healing and decrease inflammatory cytokines. Methods: A human skin fibroblast cell line (WS1) was used in vitro. Cells were exposed to various insults, namely, wounding, and a diabetic or hypoxic environment. Experimental cells were exposed to an energy density of 5 J/cm(2) using a continuous wave 636-nm diode laser at an average power of 95 mW, an illuminated area of 9.05 cm(2), and an irradiance of 11 mW/cm(2) (irradiation time, 476 sec). The effect of laser irradiation on cytokine expression was examined at 1 or 24 h post-irradiation. Cellular morphology, viability, proliferation, and cytokine expression (IL-1beta, IL-6, and TNF-alpha) were investigated. Translocation of nuclear factor – kappa B (NF-kappaB) was also determined. Results: There was a higher rate of migration in irradiated wounded cultures, and irradiated hypoxic cells showed an improvement in cellular morphology. All cell models showed an increase in proliferation. Normal wounded cells showed a decrease in apoptosis, TNF-alpha, and IL-1beta. Diabetic wounded cells showed an increase in viability and a decrease in apoptosis and IL-1beta, whereas hypoxic cells showed an increase in viability and IL-6, and a decrease in apoptosis and TNF-alpha. NF-kappaB was translocated into the nucleus post-irradiation. Conclusions: Phototherapy resulted in hastened wound closure, increased proliferation, and normalization of cellular function. The decrease in the different pro-inflammatory cytokines and NF-kappaB translocation was model and time dependent. Overall, laser irradiation resulted in a reduction in inflammatory cytokines and directed cells into the cell survival pathway.

Photomed Laser Surg 2011 Feb 19

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21332376

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Low-Level Laser Therapy Induces Differential Expression of Osteogenic Genes During Bone Repair in Rats.

Favaro-Pipi E, Ribeiro DA, Ribeiro JU, Bossini P, Oliveira P, Parizotto NA, Tim C, de Araujo HS, Renno AC

1 Department of Physiotherapy, Federal University of Sao Carlos , Sao Carlos, SP-Brazil .

Abstract Objectives: The aim of this study was to measure the temporal pattern of the expression of osteogenic genes after low-level laser therapy during the process of bone healing. We used quantitative real-time polymerase chain reaction (qPCR) along with histology to assess gene expression following laser irradiation on created bone defects in tibias of rats. Material and Methods: The animals were randomly distributed into two groups: control or laser-irradiated group. Noncritical size bone defects were surgically created at the upper third of the tibia. Laser irradiation started 24 h post-surgery and was performed for 3, 6, and 12 sessions, with an interval of 48 h. A 830 nm laser, 50 J/cm(2), 30 mW, was used. On days 7, 13, and 25 post-injury, rats were sacrificed individually by carbon dioxide asphyxia. The tibias were removed for analysis. Results: The histological results revealed intense new bone formation surrounded by highly vascularized connective tissue presenting slight osteogenic activity, with primary bone deposition in the group exposed to laser in the intermediary (13 days) and late stages of repair (25 days). The quantitative real-time PCR showed that laser irradiation produced an upregulation of BMP-4 at day 13 post-surgery and an upregulation of BMP4, ALP, and Runx 2 at day 25 after surgery. Conclusion: Our results indicate that laser therapy improves bone repair in rats as depicted by differential histopathological and osteogenic genes expression, mainly at the late stages of recovery.

Photomed Laser Surg 2011 Feb 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21306231

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Application of Low-Level Laser Irradiation (LLLI) and rhBMP-2 in Critical Bone Defect of Ovariectomized Rats: Histomorphometric Evaluation.

Siessere S, Sousa LG, Issa JP, Iyomasa MM, Pitol DL, Barbosa AP, Semprini M, Sebald W, Bentley MV, Regalo SC

1 Facultie of Dentistry, University of Sao Paulo , Ribeirao Preto, Sao Paulo, Brazil .

Abstract Objectives: The aim of this study was to evaluate the osteogenic potential of recombinant human bone morphogenetic protein-2 (rhBMP-2) and low-level laser irradiation (LLLI), isolated or combined in critical bone defects (5 mm) in parietal bone using ovariectomized female rats as an experimental animal model. Materials and Methods: Forty-nine female Wistar rats, bilaterally ovariectomized (OVX), were divided into seven treatment groups of seven animals each: (I) laser in a single application, (II) 7 mug of pure rhBMP-2, (III) laser and 7 mug of pure rhBMP-2, (IV) 7 mug of rhBMP-2/monoolein gel, (V) laser and 7 mug of rhBMP-2/monoolein gel, (VI) laser and pure monoolein gel, and (VII) critical bone defect controls. The low-level laser source used was a gallium aluminum arsenide semiconductor diode laser device (lambda = 780 nm, D = 120 J/cm(2)). Results: Groups II and III presented higher levels of newly formed bone than all other groups with levels of 40.57% and 40.39%, respectively (p < 0.05). The levels of newly formed bone of groups I, IV, V, and VI were similar with levels of 29.67%, 25.75%, 27.75%, and 30.64%, respectively (p > 0.05). The area of new bone formation in group VII was 20.96%, which is significantly lower than groups I, II, III, and VI. Conclusions: It was concluded that pure rhBMP-2 and a single dose of laser application stimulated new bone formation, but the new bone formation area was significantly increased when only rhBMP-2 was used. Additionally, the laser application in combination with other treatments did not influence the bone formation area.

Photomed Laser Surg 2011 Feb 8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21303263

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Effect of CO2 Laser Irradiation on Hormesis Induction in Cultured Oral Cells.

Iwasaka K, Tomita K, Ozawa Y, Katayama T, Sakagami H

Division of Operative Dentistry, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Saitama 350-0283, Japan. iwasaka@dent.meikai.ac.jp/sakagami@dent.meikai.ac.jp.

BACKGROUND: Many drugs (including toxicants) and radiation therapy have been reported to exert bi-phasic hormetic effects on cultured cells, but only when both the concentration and treatment time were optimal. Most previous studies have been carried out with multiple laser modalities other than CO(2) laser, and there has been no comparison of the hormetic response between normal and tumor cells. We investigated here whether CO(2) laser treatment induces hormesis in human gingival fibroblast (HGF) and oral squamous cell carcinoma (HSC-2) cells. MATERIALS AND METHODS: Cells were cultured for 24, 48 or 72 hours after exposure to various irradiation powers, and the viable cell number was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) method. RESULTS: CO(2) laser irradiation stimulated cell growth at low and inhibited it at high irradiation power. Among three dispatch modes, super pulse (SP)2 most effectively induced growth stimulation in HGF, at an irradiation dose slightly lower than that which induced cytotoxicity. Higher irradiation doses were comparably cytotoxic against both normal (HGF) and tumor (HSC-2) cells, reaching a plateau of cytotoxicity within 24 hours. CONCLUSION: Since both the range and magnitude of hormetic response in HGF cells were very narrow and small, it is crucial to establish the optimal conditions for hormesis induction for clinical application in dentistry.

In Vivo 2011 Jan-Feb 25(1) 93-8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21282740

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Low level laser therapy (LLLT) for elderly residents in facilities of health care services

Yasuo Ito, Ikuko Ohkuni, Nobuyuki Ushigome, Takashi Harada, Hiroshi Tsuruoka, Go Endo and Kane Suzuki

Yamakita Clinic Department of Physical Medicine and Rehabilitation, Toho University Institute of Sosei Social Welfare Work

The present study examines the usefulness of low level laser therapy (LLLT) given to residents in nursing homes for the elderly. In many cases the elderly have complications brought about by disuse. The disuse syndrome is a general term describing unhealthy symptoms caused by a considerable decrease in activity. The main symptoms include chronic pain, decubitus ulcers, cognitive disorders, deterioration in respiratory and circulatory functions, pneumonia, constipation, urinary tract infections, muscular dystrophy, bone atrophy, and so on. From these symptoms, we confirmed LLLT is effective for decubitus ulcers and improves the patients’ quality of life (QOL). However, only 10% of the patients, 2 of the 20 patients we treated, could return to their homes.

Laser Therapy. 2010, Vol. 19, No. 2, p.97-100 .

http://www.jstage.jst.go.jp/article/islsm/19/2/19_97/_article

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Application of low-level laser therapy to orthopedic diseases and evaluation of its optical characteristics

Yoshimi Asagai, Kengo Yamamoto and Toshio Ohshiro

Shinano Handicapped Children’s Hospital Department of Orthopaedic Surgery, Tokyo Medical University Japan Medical Laser Laboratory

This paper reports the findings obtained in our recent clinical study of the characteristics of low-level laser therapy (LLLT) and discusses the possibility of applying these findings to the treatment of previously unreported orthopedic diseases. Histological study of muscles: Following long-term (3-week or longer) irradiation, there was an increase in nerve activity, suggesting the possibility that irradiation have the potential to alter the distribution of the myofiber types. Application to a patient with osteoarthritis of the hip: The narrowing of the joint space and the range of motion of hip joint alleviated or improved and the pain lessened markedly. Application to patients with congenital clubfoot: The application of LLLT and corrective massage before the correction of deformities with a cast facilitated the correction, enabling further improvement in congenital clubfoot. The possibility of the application of LLLT in patients with osteoporosis: LLLT tended to stimulate ossification and suppress bone resorption temporarily, suggesting the feasibility of applying LLLT as a means of treating osteoporosis. The possibility of the use of LLLT applied to the neck for the improving the cerebral blood flow was evaluated in patients with spastic cerebral palsy, using single photon emission computed tomography. Better knowledge of the characteristics of light may expand the scope of application of phototherapy for other diseases.

Laser Therapy. 2010, Vol. 19, No. 2, p.79-88 .

http://www.jstage.jst.go.jp/article/islsm/19/2/19_79/_article

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Pulsed dye laser treatment for recalcitrant viral warts: auto-simultaneous laser treatment

Yuki Taniguchi, Toshio Ohshiro, Takafumi Ohshiro and Katsumi Sasaki

Ohshiro Clinic Japan Medical Laser Laboratory

Verruca vulgaris is a benign proliferative lesion of the skin caused by the human papillomavirus (HPV). It is commonly seen in dermatologic and/or plastic surgery clinics. The diagnosis is straightforward, but the treatment of the lesion may be difficult and lengthy. Several treatment methods have been reported but no specific therapy of choice has been developed. It has been suggested that pulsed dye laser treatment is highly effective in the treatment of viral warts which have not responded to other treatments. Pulsed dye laser treatment is a safe method with low side effects and is mostly well-tolerated by patients. Several authors have recently reported the efficiency of pulsed dye laser treatment for warts, but no report has paid attention to the influence of low levels of laser irradiation about the periphery of the treated lesion which may induce immune activation and pain alleviation. We believe these effects are mainly due to the athermal and atraumatic simultaneous Low reactive Level Laser Therapy effect on photobiomodulated cells at the periphery of the treated lesion. We call this coincident duality of thermal damage and athermal stimulation ‘auto-simultaneous laser treatment’. We report herein on pulse dye laser treatment for a recalcitrant huge viral wart and consider the vital response.

Laser Therapy. 2010, Vol. 19, No. 1, p.31-36 .

http://www.jstage.jst.go.jp/article/islsm/19/1/19_31/_article

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Low reactive level laser therapy (lllt) in patients with atopic dermatitis – oral steroid therapy and degree of tenderness on tender spots

Akinobu Shoji

Department of Dermatology, Ikeda Kaisei Hospital

Aims and background: We investigated what could hinder the effect of treatment with near-infrared laser therapy (830nm) around the stellate ganglion (SGL) in the treatment of atopic dermatitis (AD), the relationship between the skin symptoms score (SS) and the tenderness score (TS) and potential influence of oral steroid therapy on SS and/or TS. Subjects and methods: Study subjects comprised patients with serious and moderate AD treated with or without oral steroids: males 164, females 194, total 358. All patients were treated with ordinary medications together with an SGL treatment to improve the patients’ lifestyle. The SS was evaluated by the patients themselves using a scale of 0 to 10. A digital pressure of approximately 5kg was applied to the tender point sites to calculate the tenderness score (TS), which was calculated as follows: TS=LE+Ax+MSC+SM. For the 2 test, data of SS and TS were first divided into 10 categories by the number of SG-L treatments and then two groups by its effect. Results: In the steroid group, no categories out of ten categories classified by the number of the SGL days showed any significant difference in either the TS or SS, but in the non-steroid group, one category in the male, eight in the female, and nine in the total groups showed a simultaneous statistically significant difference in both the TS and SS. Conclusions: These results show that the patients with atopic dermatitis should not be treated with long term use of oral steroid except for unavoidable cases.

LASER THERAPY. 2010, Vol. 19, No. 3, p.149-158 .

http://www.jstage.jst.go.jp/article/islsm/19/3/19_149/_article

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Efficacy of laser treatment for lingual frenectomy

Kenji Yoshida

Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University

ABSTRACT NOT AVAILABLE

Laser Therapy. 2010, Vol. 19, No. 3, p.170-172 .

http://www.jstage.jst.go.jp/article/islsm/19/3/19_170/_article

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[Biostimulation effects of low-power laser in the repair process.]

Lins RD, Dantas EM, Lucena KC, Catao MH, Granville-Garcia AF, Carvalho Neto LG

Universidade Estadual da Paraiba, Campina Grande, PB, Brasil.

The wound healing process has always been an excellent subject for researchers. The use of low-power laser on wounds during the postoperative phase has increased the speed of the healing process. It has been implied that low power radiation affects cellular metabolic processes and promotes beneficial biological effects (analgesic, anti-inflammatory, and healing). Laser biostimulation appears to influence the behavior of the repair process. This paper aims at reviewing the most interesting aspects of the use of low-power laser in the tissue-repair process.

An Bras Dermatol 2010 Dec 85(6) 849-855

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21308309

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LLLT for facial palsy

Kenji Yoshida

Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University

ABSTRACT NOT AVAILABLE

Laser Therapy. 2010, Vol. 19, No. 3, p.167-169 .

http://www.jstage.jst.go.jp/article/islsm/19/3/19_167/_article

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About James Carroll

Founder and CEO at THOR Photomedicine Ltd. About THOR
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3 Responses to LLLT / Cold Laser Literature watch for February 2011

  1. Mike Patterson says:

    Thanks for the update James. Much more convenient than having to do the pubmed search myself. Seems like Kendrick is now part of the push which should be a boon.

  2. Shari Cheves says:

    Great compilation of articles – the field of laser therapy requires true diligence like this. It all leaves me with hundreds of questions and a despairing case of tendonosis, longing for that perfect list of wavelengths/dosages/conditions. Keep up the good work!

  3. Brian Bennett says:

    James,
    The sound information you provide on this site continues to educate those of us who use this therapy. It gives credence to our daily work and provides a source of inspiration. Those who are unfamiliar with the therpy cannot fail to notice the increasing number of positive trials and recommendations. This excellent site I feel sure will have the Johnny Appleseed effect. Keep up the good work.
    Brian

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