LLLT Literature Watch May 2009

This edition finds 41 LLLT research papers on including Post Exercise Muscle Damage, fracture healing, cardicardioprotection and acne.

Comparison Between Single-Diode Low-Level Laser Therapy (LLLT) and LED Multi-Diode (Cluster) Therapy (LEDT) Applications Before High-Intensity Exercise.

Junior EC, Lopes-Martins RA, Baroni BM, De Marchi T, Rossi RP, Grosselli D, Generosi RA, de Godoi V, Basso M, Mancalossi JL, Bjordal JM

1 Laboratory of Human Movement, University of Caxias do Sul , Caxias do Sul, RS, Brazil .

Abstract Background Data and Objective: There is anecdotal evidence that low-level laser therapy (LLLT) may affect the development of muscular fatigue, minor muscle damage, and recovery after heavy exercises. Although manufacturers claim that cluster probes (LEDT) maybe more effective than single-diode lasers in clinical settings, there is a lack of head-to-head comparisons in controlled trials. This study was designed to compare the effect of single-diode LLLT and cluster LEDT before heavy exercise. Materials and Methods: This was a randomized, placebo-controlled, double-blind cross-over study. Young male volleyball players (n = 8) were enrolled and asked to perform three Wingate cycle tests after 4 x 30 sec LLLT or LEDT pretreatment of the rectus femoris muscle with either (1) an active LEDT cluster-probe (660/850 nm, 10/30 mW), (2) a placebo cluster-probe with no output, and (3) a single-diode 810-nm 200-mW laser. Results: The active LEDT group had significantly decreased post-exercise creatine kinase (CK) levels (-18.88 +/- 41.48 U/L), compared to the placebo cluster group (26.88 +/- 15.18 U/L) (p < 0.05) and the active single-diode laser group (43.38 +/- 32.90 U/L) (p < 0.01). None of the pre-exercise LLLT or LEDT protocols enhanced performance on the Wingate tests or reduced post-exercise blood lactate levels. However, a non-significant tendency toward lower post-exercise blood lactate levels in the treated groups should be explored further. Conclusion: In this experimental set-up, only the active LEDT probe decreased post-exercise CK levels after the Wingate cycle test. Neither performance nor blood lactate levels were significantly affected by this protocol of pre-exercise LEDT or LLLT.

Photomed Laser Surg 2009 Mar 20


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Enhancement of nitric oxide release from nitrosyl hemoglobin and nitrosyl myoglobin by red/near infrared radiation: Potential role in cardioprotection.

Lohr NL, Keszler A, Pratt P, Bienengraber M, Warltier DC, Hogg N

Department of Anesthesiology, the Medical College of Wisconsin, MEB 4245, 8701 Watertown Plank Road, Milwaukee, Wisconsin 53226, USA; Department of Internal Medicine, the Medical College of Wisconsin, Milwaukee WI, USA.

Nitric oxide is an important messenger in numerous biological processes, such as angiogenesis, hypoxic vasodilation, and cardioprotection. Although nitric oxide synthases (NOS) produce the bulk of NO, there is increasing interest in NOS independent generation of NO in vivo, particularly during hypoxia or anoxia, where low oxygen tensions limit NOS activity. Interventions that can increase NO bioavailability have significant therapeutic potential. The use of far red and near infrared light (R/NIR) can reduce infarct size, protect neurons from methanol toxicity, and stimulate angiogenesis. How R/NIR modulates these processes in vivo and in vitro is unknown, but it has been suggested that increases in NO levels are involved. In this study we examined if R/NIR light could facilitate the release of NO from nitrosyl heme proteins. In addition, we examined if R/NIR light could enhance the protective effects of nitrite on ischemia and reperfusion injury in the rabbit heart. We show both in purified systems and in myocardium that R/NIR light can decay nitrosyl hemes and release NO, and that this released NO may enhance the cardioprotective effects of nitrite. Thus, the photodissociation to NO and its synergistic effect with sodium nitrite may represent a noninvasive and site-specific means for increasing NO bioavailability.

J Mol Cell Cardiol 2009 Mar 25


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Implantation of low-level laser irradiated mesenchymal stem cells into the infarcted rat heart is associated with reduction in infarct size and enhanced angiogenesis.

Tuby H, Maltz L, Oron U

Department of Zoology, The George S. Wise Faculty of Life Sciences, Tel-Aviv University, Tel-Aviv, Israel.

OBJECTIVE: The aim of the present study was to evaluate the possible beneficial effects of implantation of laser-irradiated mesenchymal stem cells (MSCs) into the infarcted rat heart. BACKGROUND DATA: It was demonstrated that low-level laser therapy (LLLT) upregulates cytoprotective factors in ischemic tissues. MATERIALS AND METHODS: MSCs were isolated from rat bone marrow and grown in culture. The cells were laser irradiated with a Ga-Al-As laser (810 nm wavelength), labeled with 5-bromo-2’deoxyuridine (BrdU), and then implanted into infarcted rat hearts. Non-irradiated cells were similarly labeled and acted as controls. Hearts were excised 3 wk later and cells were stained for BrdU and c-kit immunoreactivity. RESULTS: Infarcted hearts that were implanted with laser-treated cells showed a significant reduction of 53% in infarct size compared to hearts that were implanted with non-laser-treated cells. The hearts implanted with laser-treated cells prior to implantation demonstrated a 5- and 6.3-fold significant increase in cell density that positively immunoreacted to BrdU and c-kit, respectively, as compared to hearts implanted with non-laser-treated cells. A significantly 1.4- and 2-fold higher level of angiogenesis and vascular endothelial growth factor, respectively, were observed in infarcted hearts that were implanted with laser-treated cells compared to non-laser-treated implanted cells. CONCLUSION: The findings of the present study provide the first evidence that LLLT can significantly increase survival and/or proliferation of MSCs post-implantation into the ischemic/infarcted heart, followed by a marked reduction of scarring and enhanced angiogenesis. The mechanisms associated with this phenomenon remain to be elucidated in further studies.

Photomed Laser Surg 2009 Apr 27(2) 227-33


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Phototherapy in peripheral nerve injury for muscle preservation and nerve regeneration.

Rochkind S

Photomed Laser Surg 2009 Apr 27(2) 219-20


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Low infra red laser light irradiation on cultured neural cells: effects on mitochondria and cell viability after oxidative stress.

Giuliani A, Lorenzini L, Gallamini M, Massella A, Giardino L, Calza L

BioPharmaNet-DIMORFIPA, University of Bologna, Via Tolara di Sopra 50, 40064 Ozzano dell’Emilia, Bologna, Italy. a.giuliani@unibo.it

BACKGROUND: Considerable interest has been aroused in recent years by the well-known notion that biological systems are sensitive to visible light. With clinical applications of visible radiation in the far-red to near-infrared region of the spectrum in mind, we explored the effect of coherent red light irradiation with extremely low energy transfer on a neural cell line derived from rat pheochromocytoma. We focused on the effect of pulsed light laser irradiation vis-a-vis two distinct biological effects: neurite elongation under NGF stimulus on laminin-collagen substrate and cell viability during oxidative stress. METHODS: We used a 670 nm laser, with extremely low peak power output (3 mW/cm2) and at an extremely low dose (0.45 mJ/cm2). Neurite elongation was measured over three days in culture. The effect of coherent red light irradiation on cell reaction to oxidative stress was evaluated through live-recording of mitochondria membrane potential (MMP) using JC1 vital dye and laser-confocal microscopy, in the absence (photo bleaching) and in the presence (oxidative stress) of H2O2, and by means of the MTT cell viability assay. RESULTS: We found that laser irradiation stimulates NGF-induced neurite elongation on a laminin-collagen coated substrate and protects PC12 cells against oxidative stress. CONCLUSION: These data suggest that red light radiation protects the viability of cell culture in case of oxidative stress, as indicated by MMP measurement and MTT assay. It also stimulates neurite outgrowth, and this effect could also have positive implications for axonal protection.

BMC Complement Altern Med 2009 9 8


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Effect of low-level laser therapy on the fracture healing process.

Kazem Shakouri S, Soleimanpour J, Salekzamani Y, Oskuie MR

Tabriz University of Medical Sciences, Tabriz, Iran, sk0531ir@yahoo.com.

Low-level laser therapy (LLLT) is a biophysical form of intervention in the fracture-repair process, which, through several mechanisms, accelerates the healing of fractures and enhances callus formation. The effect of laser on fracture healing is controversial. Some authors affirm that LLLT can accelerate bone formation by increasing osteoblastic activity. The objective of our study was to evaluate the effect of laser therapy on fracture healing. Thirty rabbits were subjected to tibial bone open osteotomies that were stabilized with external fixators. The animals were divided into two study groups: laser group and control group. Callus development and bone mineral density were quantitatively evaluated by CT; the animals were then killed and the fractures were assessed for biomechanical properties. The results demonstrated that the increasing rate of bone mineral density was higher in the laser (L) group than in the control (C) group. CT at 5 weeks revealed a mean callus density of 297 Hounsfield units (HU) for the control group and 691 HU for the L group, which was statistically significant (P = 0.001). In the L group, the mean recorded fracture tension was 190.5 N and 359.3 N for healed and intact bones, respectively, which was statistically significant (P < 0.001). The result of the study showed that the use of laser could enhance callus development in the early stage of the healing process, with doubtful improvement in biomechanical properties of the healing bone; therefore, laser therapy may be recommended as an additional treatment in non-union fractures in humans.

Lasers Med Sci 2009 Apr 28


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Efficacy of Interferential Low-Level Laser Therapy Using Two Independent Sources in the Treatment of Knee Pain.

Montes-Molina R , Madronero-Agreda MA , Romojaro-Rodriguez AB , Gallego-Mendez V , Prados-Cabiedas C , Marques-Lucas C , Perez-Ferreiro M , Martinez-Ruiz F

1 Unit of Physiotherapy, Hospital Ramon y Cajal , Madrid, Spain .

Abstract Objective: The aim of this study was to evaluate the effectiveness of an interferential pattern generated by two identical and independent lasers in the relief of knee pain. Background Data: Low-level laser therapy (LLLT) is generally applied by a single probe. Materials and Methods: A double-blind controlled clinical trial was performed on 152 patients with knee pain who were randomly assigned into two different groups. Group I patients (n = 76) received interferential laser therapy generated by two identical laser probes located opposite each other on the knee joint. Group II patients (n = 76) received one live probe in conventional laser therapy and one dummy probe. The device used in both groups was an GaAlAs laser (wavelength 810 nm, power 100 mW, in continuous mode). Fifteen laser sessions were applied transcutaneously on 5 knee points (6 J/point) per session. In addition, patients in both groups received a quadriceps strength program based on isometric exercises. A visual analogue scale (VAS) was used for pain evaluation in different situations, such as in standing, in knee flexion/extension, and when going up and down stairs. VAS pain scores were evaluated before, in the middle of, and after treatment. Results: ANOVA results showed no significant differences between groups for all VAS scores or in the interaction with the sessions (p > 0.05). The VAS score results showed a statistically significant pain reduction throughout all sessions (p = 0.000). Conclusions: Interferential laser therapy is safe and effective in reducing knee pain. However, the results of the study indicate that it is not superior to the use of a single conventional laser.

Photomed Laser Surg 2009 Apr 30


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Improvement of Postfractional Laser Erythema with Light-Emitting Diode Photomodulation.

Alster TS, Wanitphakdeedecha R

Washington Institute of Dermatologic Laser Surgery, Washington, District of Columbia.

BACKGROUND The most common side effects of fractional laser skin treatment are erythema and edema. Low-level light therapy and light-emitting diode (LED) devices have been used to stimulate fibroblast activity and hasten wound healing. OBJECTIVE To determine whether LED treatment immediately after fractional laser skin resurfacing affects the severity and duration of postoperative eythema. MATERIALS AND METHODS Twenty patients received treatment with a 590-nm wavelength LED array to randomly selected facial halves immediately after undergoing full-face fractional laser skin resurfacing with a 1,550-nm erbium-doped fiber laser. Differences in erythema between LED-treated and untreated facial halves were recorded at 24, 48, and 96 hours post-treatment. RESULTS The LED-treated facial halves were less erythematous in all 20 patients 24 hours postoperatively. The six patients who received the highest mean energy densities during fractional laser treatment continued to exhibit decreased erythema in the LED-treated areas at 48 hours. At 96 hours post-treatment, no discernible differences between facial halves were observed in any patient. CONCLUSIONS Photomodulation with a 590-nm-wavelength LED array can decrease the intensity and duration of postfractional laser treatment erythema. The authors have indicated no significant interest with commercial supporters.

Dermatol Surg 2009 Apr 2


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[Morphometry and electrophoretic mobility of red blood cells from patients with asthma in the intravenous blood laser irradiation]

Sarycheva TG, Tsybzhitova EB, Popova OV, Aleksandrov OV

The morphometry and electrophoretic mobility of red blood cells from patients with infection-dependent asthma were comparatively studied prior to and following treatment. The patients who had underwent intravenous laser irradiation of blood (ILIB) in addition to conventional therapy had better morphofunctional parameters of red blood cells, by restoring their normal forms, decreasing their transitional ones, and increasing their electrophoretic mobility to normal values. Those who received traditional drug therapy showed no considerable morphofunctional changes of erythrocytes. Thus, in asthmatic patients, the changes in the morphology and function of red blood cells may suggest their membranous structural changes for whose correction ILIB should used.

Klin Lab Diagn 2009 Mar (3) 13-4


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The Application of Low-Level Laser Therapy after Cesarean Section Does Not Compromise Blood Prolactin Levels and Lactation Status.

Mokmeli S, Khazemikho N, Niromanesh S, Vatankhah Z

1 Department of Medical Laser, Milad Hospital , Tehran, Iran .

Abstract Objective: This study evaluates the systemic effect of low-level laser therapy (LLLT) on blood prolactin levels and lactation status when it is used to hasten surgical wound healing in women having undergone a cesarean section. Background Data: LLLT has been used in parturient patients for postpartum mastitis and nipple soreness. However, previous studies have revealed hormonal and physiological effects of LLLT on the lactation status. Materials and Methods: Twenty healthy women scheduled for cesarean section were randomly divided into two groups: an LLLT group and a control group. LLLT was delivered as follows: (1) irradiation with 980 nm (100 mW, 3.3 J/cm(2), total energy 60 J), and 650 nm (30 mW, 1.5 J/cm(2), total energy 27 J) to the incision line, and (2) intravenous laser irradiation at 2.5 mW and 650 nm for 15 min on three consecutive postoperative days. Except for LLLT, all the therapeutic conditions in both groups were identical. Blood prolactin levels were measured in the groups on the third postoperative day, and tissue samples were taken from the wound margins for histological evaluation on the 10th postoperative day. Results: Although there was a difference between blood prolactin levels in the two groups, the difference was not statistically significant (p = 0.205). However, there was a statistically significant difference in the mean lymphocyte counts and number of vessel lumina, with higher numbers seen in the LLLT group. Conclusion: LLLT after cesarean section has no serious deleterious effects on lactation, and it helps to modulate metabolic processes and thus promotes wound healing post-surgery.

Photomed Laser Surg 2009 Apr 30


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Dental Enamel Irradiated with Infrared Diode Laser and Photoabsorbing Cream: Part 1-FT-Raman Study.

De Sant’anna GR, Dos Santos EA, Silva Soares LE, Do Espirito Santo AM, Martin AA, Duarte DA, Pacheco-Soares C, Brugnera A

1 Vale do Paraiba University , UNIVAP, Research and Development Institute, IP&D, Laboratory of Biomedical Vibrational Spectroscopy, LEVB and Dental Laser Center, Sao Jose dos Campos, Sao Paulo, and Cruzeiro do Sul University, UNICSUL, Pediatric Dentistry and Pharmacology and Anesthesiology, Sao Paulo, Brazil .

Abstract Objective: The aim of this FT-Raman study was to investigate laser-induced compositional changes in enamel after therapy with a low-level infrared diode laser and a photoabsorbing cream, in order to intensify the superficial light absorption before and after cariogenic challenge. Background Data: Dental caries remains the most prevalent disease during childhood and adolescence. Preventive modalities include the use of fluoride, reduction of dietary cariogenic refined carbohydrates, plaque removal and oral hygiene techniques, and antimicrobial prescriptions. A relatively simple and noninvasive caries preventive regimen is treating tooth enamel with laser irradiation, either alone or in combination with topical fluoride treatment, resulting in reduced enamel solubility and dissolution rates. Due to their high cost, high-powered lasers are still not widely employed in private practice in developing countries. Thus, low-power red and near-infrared lasers appear to be an appealing alternative. Materials and Methods: Twenty-four extracted or exfoliated caries-free deciduous molars were divided into six groups: control group (no treatment; n = 8); infrared laser treatment (L; n = 8) (810 nm at 100 mW/cm(2) for 90 sec); infrared diode laser irradiation (810 nm at 100 mW/cm(2) for 90 sec) and photoabsorbing cream (IVL; n = 8); photoabsorbing cream alone (IV; n = 8); infrared diode laser irradiation (810 nm at 100 mW/cm(2) for 90 sec) and fluorinated photoabsorbing agent (IVLF; n = 8); and fluorinated photoabsorbing agent alone (IVF; n = 8). Samples were analyzed using FT-Raman spectroscopy before and after pH cycling cariogenic challenge. Results: There was a significant laser-induced reduction and possible modification of the organic matrix content in enamel treated with the low-level diode laser (the L, IVL, and IVFL groups). Conclusion: The FT-Raman technique may be suitable for detecting compositional and structural changes occurring in mineral phases and organic phases of lased enamel under cariogenic challenge.

Photomed Laser Surg 2009 May 5


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Physiotherapy and cardiac rhythm devices: a review of the current scope of practice.

Digby GC , Daubney ME , Baggs J , Campbell D , Simpson CS , Redfearn DP , Brennan FJ , Abdollah H , Baranchuk A

Cardiac Electrophysiology and Pacing, Arrhythmia Service, Kingston General Hospital K7L 2V7, Queen’s University, Kingston, Ontario, Canada.

Aims Several case reports have demonstrated negative interactions between various physiotherapy modalities and cardiac rhythm devices (CRD). Fear of these potential interactions may lead to suboptimal utilization of physiotherapy treatments in CRD patients. No prior review of available guidelines, or management strategies, on the interaction between physiotherapy modalities and CRD patients has been reported. To review existing guidelines regarding the use of physiotherapy modalities in patients with pacemakers and/or implantable cardioverter-defibrillators (ICDs). To retrospectively analyse CRD patient encounters at a local physiotherapy facility during a period of 2 years. Methods and results A review of the literature regarding the potential interactions between physiotherapy modalities and CRDs was performed. Next, a 2 year retrospective analysis of patient encounters at a physiotherapy facility was conducted. In addition, seven international physiotherapy societies and four CRD manufacturers were surveyed with respect to recommendations regarding physiotherapy treatments in device patients. The local physiotherapy facility treated 25 patients with CRD (22 pacemaker and 3 ICD patients) for a total of 230 visits (9.2 visits/patient). Five patients received transcutaneous electrical nerve stimulation (TENS) and all 25 were administered additional treatment in the form of ultrasound (15), acupuncture (19), Laser (7), traction/manual therapy (12), exercise (8), education (18), taping (5), and/or moist heat (5). No complications occurred. Meanwhile, international societies and device manufacturers offered few specific or consistent recommendations. Conclusion There are no specific international policies regarding the administration of physiotherapy modalities in CRD patients and, thus, there are no specific guidelines to be implemented at the local level. Review of the literature and of recommendations from CRD manufacturers suggests that TENS, Diathermy, and Interferential Electrical Current Therapy are best avoided in patients with CRDs. However, there is no consensus and it may be possible to safely deliver these modalities in a proper setting with device and patient monitoring. Although further research is required in this regard, active collaboration between physiotherapists and CRD clinic physicians should allow for the safe application of most physiotherapy modalities.

Europace 2009 May 2


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A study to determine the effect of combination blue (415nm) and near-infrared (830nm) light-emitting diode (LED) therapy for moderate acne vulgaris.

Sadick N

Weill Cornell Medical College, New York, NY, USA.

Background and objective: Acne vulgaris remains a major problem in dermatological practice. Phototherapy for acne with blue (415nm) and red (633nm) light-emitting diode (LED) arrays has recently attracted attention. This pilot study assessed the efficacy of the combination of 415nm and near-infrared (IR) LED therapy for moderate acne. Methods: Seventeen individuals were recruited: 13 females and four males. Skin types ranged from type II to type VI, and the acne grades at baseline ranged from Burton grade 1 to 5. Patients underwent twice-weekly 20-minute sessions of LED therapy for 4 weeks, alternating between the blue (415nm) and near-IR (830nm) heads. No other treatment was allowed. Results were assessed and compared with the baseline values at 1, 4 and 8 weeks post-treatment. Results: Six individuals failed to complete the study. Eleven individuals showed improvement ranging from 0% to 83.3%. A downward shift in the Burton grade was seen overall. Non-inflammatory lesion counts increased in four patients, but improved in the other seven by an average of 48.8%. No adverse effects were reported. Conclusions: The combination therapy for acne produced results which were less effective in the reduction of inflammatory lesions than those achieved with the previously reported blue/red combination. Further study with a much larger patient population is warranted.

J Cosmet Laser Ther 2009 Apr 24 1-4


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Role of the 585-nm pulsed dye laser in the treatment of acne in comparison with other topical therapeutic modalities.

Leheta TM

Faculty of Medicine, Cairo University, Cairo, Egypt.

Background: Acne vulgaris is a disease of the pilosebaceous unit characterized by the development of inflammatory and/or non-inflammatory lesions that may progress to scars. The increase of bacterial resistance and adverse effects, the teratogenicity of retinoids and lack of response to usual therapies has led to the investigation of new therapeutic alternatives. Objective: To evaluate the role of the pulsed dye laser in the treatment of acne in comparison with other topical therapeutic modalities. Methods: We studied 45 patients with mild to moderate acne. Patients were randomly divided into three groups: group A received treatment with pulsed dye laser therapy every 2 weeks, group B received topical preparations and group C was subjected to chemical peeling using trichloroacetic acid 25%. Results: At 12 weeks of treatment, there was a significant improvement of the lesions within each group with the best results seen in group A; however, no significant difference was detected between the three treatment protocols after the treatment period. Remission in the follow-up period was significantly higher in the first group. Conclusions: Pulse dye laser therapy mainly improves the inflammatory lesions of acne with few adverse effects.

J Cosmet Laser Ther 2009 Apr 24 1-7


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Impact of acupuncture on vasomotor rhinitis: a randomized placebo-controlled pilot study.

Fleckenstein J, Raab C, Gleditsch J, Ostertag P, Rasp G, Stor W, Irnich D

Multidisciplinary Pain Centre, Department of Anaesthesiology, University of Munich, Germany.

OBJECTIVES: Chronic rhinitis without an allergic or infectious etiology (vasomotor rhinitis) is a common disease for which there are only few and not very effective therapeutic treatment options. The current placebo-controlled, partially double-blinded pilot study evaluated the effects of acupuncture on the symptoms of vasomotor rhinitis. DESIGN: A total of 24 patients with confirmed diagnosis of vasomotor rhinitis were randomly allocated to either acupuncture or sham laser acupuncture treatment. The sham laser was a deactivated laser pen beaming normal red light. The main outcome measure was the alteration of the nasal sickness score (NSS; score(max) 27 points). Secondary outcome measures were the evaluation of a subjective symptoms score by patients’ diaries and of their quality of life (SF-12 health survey). A credibility assessment regarding the respective treatment was performed. The study is registered as an International Standard Randomised Controlled Trial, number NCT00682162. RESULTS: NSS of patients treated by acupuncture was significantly reduced from 9.3 +/- 3.89 to 4.1 +/- 3.20 points (p < 0.001), whereas NSS declined from 5.6 +/- 2.74 to 3.7 +/- 2.61 points after sham treatment (p < 0.05). Comparison between the groups revealed a significant change of NSS (Mann-Whitney, p < 0.01), an analysis that also considers the significant difference between the baseline values of both groups (p < 0.05). Secondary outcome measures did not show significant differences between both groups. The credibility assessment was comparable for both treatments. CONCLUSIONS: This pilot study showed significant effects of acupuncture compared to a sham treatment in the NSS on symptoms of vasomotor rhinitis. These results may justify the performance of a large randomized trial to strengthen our understanding of the therapeutic value of acupuncture in the treatment of vasomotor rhinitis.

J Altern Complement Med 2009 Apr 15(4) 391-8


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New insights into the management of acne: an update from the Global Alliance to Improve Outcomes in Acne group.

Thiboutot D, Gollnick H, Bettoli V, Dreno B, Kang S, Leyden JJ, Shalita AR, Lozada VT, Berson D, Finlay A, Goh CL, Herane MI, Kaminsky A, Kubba R, Layton A, Miyachi Y, Perez M, Martin JP, Ramos-E-Silva M, See JA, Shear N, Wolf J Jr

Department of Dermatology, Pennsylvania State University College of Medicine, Hershey, USA. dthiboutot@psu.edu

The Global Alliance to Improve Outcomes in Acne published recommendations for the management of acne as a supplement to the Journal of the American Academy of Dermatology in 2003. The recommendations incorporated evidence-based strategies when possible and the collective clinical experience of the group when evidence was lacking. This update reviews new information about acne pathophysiology and treatment-such as lasers and light therapy-and relevant topics where published data were sparse in 2003 but are now available including combination therapy, revision of acne scarring, and maintenance therapy. The update also includes a new way of looking at acne as a chronic disease, a discussion of the changing role of antibiotics in acne management as a result of concerns about microbial resistance, and factors that affect adherence to acne treatments. Summary statements and recommendations are provided throughout the update along with an indication of the level of evidence that currently supports each finding. As in the original supplement, the authors have based recommendations on published evidence as much as possible.

J Am Acad Dermatol 2009 May 60(5 Suppl) S1-50


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Effect of optically modified polyethylene terephthalate fiber socks on chronic foot pain.

York RM, Gordon IL

ABSTRACT: BACKGROUND: Increasing experimental and clinical evidence suggests that illumination of the skin with relatively low intensity light may lead to therapeutic results such as reduced pain or improved wound healing. The goal of this study was to evaluate prospectively whether socks made from polyethylene terephthalate (PET) incorporating optically active particles (CelliantTM) ameliorates chronic foot pain resulting from diabetic neuropathy or other disorders. Such optically modified fiber is thought to modify the illumination of the skin in the visible and infrared portions of the spectrum, and consequently reduce pain. METHODS: A double-blind, randomized trial with 55 subjects (38 men, 17 women) enrolled (average age 59.7 +/- 11.9 years), 26 with diabetic neuropathy and 29 with other pain etiologies. Subjects twice completed the Visual Analogue Scale (VAS), Brief Pain Inventory (BPI), McGill Pain Questionnaire (MPQ), and SF-36 a week apart (W1+2) before receiving either control or CelliantTM socks. The same questionnaires were answered again one and two weeks (W3+4) later. The questionnaires provided nine scores for analyzing pain reduction: one VAS score, two BPI scores, five MPQ scores, and the bodily pain score on the SF-36. Mean W1+2 and W3+4 scores were compared to measure pain reduction. RESULTS: More pain reduction was reported by CelliantTM subjects for 8 of the 9 pain questions employed, with a significant (p = 0.043) difference between controls and CelliantTM for McGill question III. In neuropathic subjects, CelliantTM caused more pain reduction in 6 of the 9 questions, but not significantly. In non-neuropathic subjects 8 of 9 questions showed more pain reduction with the CelliantTM socks. CONCLUSIONS: Socks with optically modified PET (CelliantTM) appear to have a beneficial impact on chronic foot pain. The mechanism could be related to the effects seen with illumination of tissues with visible and infrared light. Trial Registration: ClinicalTrials.gov NCT00458497.

BMC Complement Altern Med 2009 Apr 22 9(1) 10


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Low-level laser therapy increases transforming growth factor-beta2 expression and induces apoptosis of epithelial cells during the tissue repair process.

Rocha Junior AM, Vieira BJ, de Andrade LC, Aarestrup FM

Universidade Federal de Juiz de Fora-MG, Laboratory of Immunopathology and Experimental Pathology, Juiz de Fora, Minas Gerais, Brazil.

BACKGROUND DATA: Low-level laser therapy (LLLT) has been reported to modulate the healing of wounds by inducing an increase in mitotic activity, fibroblast number, synthesis of collagen, and neovascularization. Objective: In the present study we evaluated the effect of LLLT on expression of TGF-beta(2), an immunosuppressive cytokine, at the site of tissue repair, using an experimental rat model to study cutaneous wound healing. In addition, we also investigated the presence of apoptotic cells in epithelial and connective tissue. MATERIALS AND METHODS: Thirty male Wistar rats were divided into two groups: group 1, which was subjected to surgical skin wounds only (n = 15), and group 2, which was subjected to surgical skin wounds followed by LLLT (n = 15). In group 2, the LLLT was given with these parameters: 15 mW of power, a dose of 3.8 J/cm(2), for 15 sec for three applications. At 10 d post-surgery and laser application the animals were sacrificed with an overdose of anesthetic and tissue samples from the wounds were submitted to immunohistochemistry and in-situ detection of apoptosis. RESULTS: Most of the inflammatory cells and fibroblasts were TGF-beta(2)-positive, and many apoptotic epithelial cells and fibroblasts were seen in the tissue samples from the LLLT-treated animals. However, a few apoptotic epithelial cells and fibroblasts were also seen in the samples obtained from control animals. CONCLUSION: Our results indicate that LLLT may be an important inducer of apoptosis during the process of tissue repair. In addition, we demonstrated that LLTT has an immunomodulatory effect on TGF-beta(2) expression at sites of wound healing.

Photomed Laser Surg 2009 Apr 27(2) 303-7


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HairMax LaserComb(R) Laser Phototherapy Device in the Treatment of Male Androgenetic Alopecia: A Randomized, Double-Blind, Sham Device-Controlled, Multicentre Trial.

Leavitt M, Charles G, Heyman E, Michaels D

Private Dermatology Practice, Maitland, Florida, USA.

The use of low levels of visible or near infrared light for reducing pain, inflammation and oedema, promoting healing of wounds, deeper tissue and nerves, and preventing tissue damage has been known for almost 40 years since the invention of lasers. The HairMax LaserComb(R) is a hand-held Class 3R lower level laser therapy device that contains a single laser module that emulates 9 beams at a wavelength of 655 nm (+/-5%). The device uses a technique of parting the user’s hair by combs that are attached to the device. This improves delivery of distributed laser light to the scalp. The combs are designed so that each of the teeth on the combs aligns with a laser beam. By aligning the teeth with the laser beams, the hair can be parted and the laser energy delivered to the scalp of the user without obstruction by the individual hairs on the scalp. The primary aim of the study was to assess the safety and effectiveness of the HairMax LaserComb(R) laser phototherapy device in the promotion of hair growth and in the cessation of hair loss in males diagnosed with androgenetic alopecia (AGA). This double-blind, sham device-controlled, multicentre, 26-week trial randomized male patients with Norwood-Hamilton classes IIa-V AGA to treatment with the HairMax LaserComb(R) or the sham device (2 : 1). The sham device used in the study was identical to the active device except that the laser light was replaced by a non-active incandescent light source. Of the 110 patients who completed the study, subjects in the HairMax LaserComb(R) treatment group exhibited a significantly greater increase in mean terminal hair density than subjects in the sham device group (p < 0.0001). Consistent with this evidence for primary effectiveness, significant improvements in overall hair regrowth were demonstrated in terms of patients’ subjective assessment (p < 0.015) at 26 weeks over baseline. The HairMax LaserComb(R) was well tolerated with no serious adverse events reported and no statistical difference in adverse effects between the study groups. The results of this study suggest that the HairMax LaserComb(R) is an effective, well tolerated and safe laser phototherapy device for the treatment of AGA in males.

Clin Drug Investig 2009 29(5) 283-92


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Abstracts of Laser Helsinki 2008 13th International Congress of EMLA (European Medical Laser Association) in conjunction with EMLA Finland and MAL (Medical Acupuncture and Laser) in cooperation with ASLMS (American Society for Laser Medicine and Surgery). Helsinki, Finland. August 23-24, 2008.

Photodiagnosis Photodyn Ther 2008 Aug 5 Suppl 1 S1-46


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Low level light effects on inflammatory cytokine production by rheumatoid arthritis synoviocytes.

Yamaura M, Yao M, Yaroslavsky I, Cohen R, Smotrich M, Kochevar IE

Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.

BACKGROUND AND OBJECTIVE: Low level light therapy (LLLT) is being evaluated for treating chronic and acute pain associated with rheumatoid arthritis (RA) and other inflammatory diseases. The mechanisms underlying the effectiveness of LLLT for pain relief in RA are not clear. The objectives of this study were to determine whether LLLT decreased production of pro-inflammatory cytokines by cells from RA joints, and, if so, to identify cellular mechanisms. STUDY DESIGN/MATERIALS AND METHODS: Synoviocytes from RA patients were treated with 810 nm radiation before or after addition of tumor necrosis factor-alpha (TNF-alpha). mRNA for TNF-alpha, interleukin (IL)-1beta, IL-6, and IL-8 was measured after 30, 60, and 180 minutes using RT-PCR. Intracellular and extracellular protein levels for 12 cytokines/chemokines were measured at 4, 8, and 24 hours using multiplexed ELISA. NF-kappaB activation was detected using Western blotting to follow degradation of IkappaBalpha and nuclear localization of the p65 subunit of NF-kappaB. RESULTS: Radiation at 810 nm (5 J/cm(2)) given before or after TNF-alpha decreases the mRNA level of TNF-alpha and IL-1beta in RA synoviocytes. This treatment using 25 J/cm(2) also decreases the intracellular levels of TNF-alpha, IL-1beta, and IL-8 protein but did not affect the levels of seven other cytokines/chemokines. TNF-alpha-induced activation of NF-kappaB is not altered by 810 nm radiation using 25 J/cm(2). CONCLUSIONS: The mechanism for relieving joint pain in RA by LLLT may involve reducing the level of pro-inflammatory cytokines/chemokines produced by synoviocytes. This mechanism may be more general and underlie the beneficial effects of LLLT on other inflammatory conditions.

Lasers Surg Med 2009 Apr 41(4) 282-90


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Superpulsed laser irradiation increases osteoblast activity via modulation of bone morphogenetic factors.

Saracino S, Mozzati M, Martinasso G, Pol R, Canuto RA, Muzio G

Department of Experimental Medicine and Oncology, University of Turin, Corso Raffaello 30, 10125 Turin, Italy.

BACKGROUND AND OBJECTIVE: Laser therapy is a new approach applicable in different medical fields when bone loss occurs, including orthopedics and dentistry. It has also been used to induce soft-tissue healing, for pain relief, bone, and nerve regeneration. With regard to bone synthesis, laser exposure has been shown to increase osteoblast activity and decrease osteoclast number, by inducing alkaline phosphatase (ALP), osteopontin, and bone sialoprotein expression. Studies have investigated the effects of continuous or pulsed laser irradiation, but no data are yet available on the properties of superpulsed laser irradiation. This study thus aimed to investigate the effect of superpulsed laser irradiation on osteogenic activity of human osteoblast-like cells, paying particular attention to investigating the molecular mechanisms underlying the effects of this type of laser radiation. STUDY DESIGN/MATERIALS AND METHODS: Human osteoblast-like MG-63 cells were exposed to 3, 7, or 10 superpulsed laser irradiation (pulse width 200 nanoseconds, minimum peak power 45 W, frequency 30 kHz, total energy 60 J, exposure time 5 minutes). The following parameters were evaluated: cell growth and viability (light microscopy, lactate dehydrogenase release), calcium deposits (Alizarin Red S staining), expression of bone morphogenetic factors (real-time PCR). RESULTS: Superpulsed laser irradiation decreases cell growth, induces expression of TGF-beta2, BMP-4, and BMP-7, type I collagen, ALP, and osteocalcin, and increases the size and the number of calcium deposits. The stimulatory effect is maximum on day 10, that is, after seven applications. CONCLUSIONS: Reported results show that superpulsed laser irradiation, like the continuous and pulsed counterparts, possesses osteogenic properties, inducing the expression of molecules known to be important mediators of bone formation and, as a consequence, increasing calcium deposits in human MG-63 cells. Moreover, the data suggest a new potential role for PPARgamma as a regulator of osteoblast proliferation.

Lasers Surg Med 2009 Apr 41(4) 298-304


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Effects of low-level laser therapy on proliferation and differentiation of murine bone marrow cells into osteoblasts and osteoclasts.

Bouvet-Gerbettaz S, Merigo E, Rocca JP, Carle GF, Rochet N

Laboratory of Genetics, Physiopathology and Bone Tissue Engineering (GePITOs), University of Nice-Sophia Antipolis, Centre National de la Recherche Scientifique (CNRS), UFR of Medicine, 28 Valombrose Avenue, 06107 Nice, France.

BACKGROUND AND OBJECTIVE: Low-Level Laser Therapy (LLLT) has been suggested to improve bone tissue healing. The cellular and molecular mechanisms involved in this effect are still unclear but bone cell proliferation and differentiation alteration have been proposed. The aim of the present study was to investigate, in vitro, the effect of LLLT on bone cell proliferation, osteoblastic and osteoclastic differentiation, both involved in bone remodeling and regeneration. STUDY DESIGN/MATERIALS AND METHODS: Murine bone marrow cells, which contain both osteoblast and osteoclast progenitors, were cultured and induced to differentiate in the absence or in the presence of LLLT. Laser exposition parameters were determined using a powermeter and consisted in an 808 nm infrared wavelength laser light in continuous mode, with an energy density of 4 J/cm(2) administered three times a week. Cell proliferation and differentiation were assessed after specific staining and microscopic analysis of the cultures after various times, as well as by quantitative RT-PCR analysis of a panel of osteoblast and osteoclast markers after nucleic acid extraction. RESULTS: The use of a powermeter revealed that the power emitted by the optical fiber of the laser device was markedly reduced compared to the displayed power. This allowed to adjust the LLLT parameters to a final energy density exposure of 4 J/cm(2). In these conditions, proliferation of bone marrow mesenchymal stem cells as well as osteoclast or osteoblast differentiation of the corresponding progenitors were found similar in control and LLLT conditions. CONCLUSION: Using the present experimental protocol, we concluded that an 808 nm wavelength infrared LLLT does not alter murine bone progenitor cell proliferation and differentiation. Moreover our results confirm the necessary use of a powermeter to fix LLLT protocol parameters.

Lasers Surg Med 2009 Apr 41(4) 291-7


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Laser phototherapy as topical prophylaxis against head and neck cancer radiotherapy-induced oral mucositis: comparison between low and high/low power lasers.

Simoes A, Eduardo FP, Luiz AC, Campos L, Sa PH, Cristofaro M, Marques MM, Eduardo CP

Centro de Pesquisa em Biologia Oral, Departamento de Materiais Dentarios, Faculdade de Odontologia, Universidade de Sao Paulo (FOUSP), Sao Paulo 05508-900, Brazil. lysimoes@usp.br

BACKGROUND AND OBJECTIVE: Oral mucositis is a dose-limiting and painful side effect of radiotherapy (RT) and/or chemotherapy in cancer patients. The purpose of the present study was to analyze the effect of different protocols of laser phototherapy (LPT) on the grade of mucositis and degree of pain in patients under RT. PATIENTS AND METHODS: Thirty-nine patients were divided into three groups: G1, where the irradiations were done three times a week using low power laser; G2, where combined high and low power lasers were used three time a week; and G3, where patients received low power laser irradiation once a week. The low power LPT was done using an InGaAlP laser (660 nm/40 mW/6 J cm(-2)/0.24 J per point). In the combined protocol, the high power LPT was done using a GaAlAs laser (808 nm, 1 W/cm(2)). Oral mucositis was assessed at each LPT session in accordance to the oral-mucositis scale of the National Institute of the Cancer-Common Toxicity criteria (NIC-CTC). The patient self-assessed pain was measured by means of the visual analogue scale. RESULTS: All protocols of LPT led to the maintenance of oral mucositis scores in the same levels until the last RT session. Moreover, LPT three times a week also maintained the pain levels. However, the patients submitted to the once a week LPT had significant pain increase; and the association of low/high LPT led to increased healing time. CONCLUSIONS: These findings are desired when dealing with oncologic patients under RT avoiding unplanned radiation treatment breaks and additional hospital costs.

Lasers Surg Med 2009 Apr 41(4) 264-70


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Increase of neuronal sprouting and migration using 780 nm laser phototherapy as procedure for cell therapy.

Rochkind S, El-Ani D, Nevo Z, Shahar A

Division of Peripheral Nerve Reconstruction, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv 64239, Israel. rochkind@zahav.net.il

BACKGROUND AND OBJECTIVES: The present study focuses on the effect of 780 nm laser irradiation on the growth of embryonic rat brain cultures embedded in NVR-Gel (cross-linked hyaluronic acid with adhesive molecule laminin and several growth factors). Dissociated neuronal cells were first grown in suspension attached to cylindrical microcarriers (MCs). The formed floating cell-MC aggregates were subsequently transferred into stationary cultures in gel and then laser treated. The response of neuronal growth following laser irradiation was investigated. MATERIALS AND METHODS: Whole brains were dissected from 16 days Sprague-Dawley rat embryos. Cells were mechanically dissociated, using narrow pipettes, and seeded on positively charged cylindrical MCs. After 4-14 days in suspension, the formed floating cell-MC aggregates were seeded as stationary cultures in NVR-Gel. Single cell-MC aggregates were either irradiated with near-infrared 780 nm laser beam for 1, 4, or 7 minutes, or cultured without irradiation. Laser powers were 10, 30, 50, 110, 160, 200, and 250 mW. RESULTS: 780 nm laser irradiation accelerated fiber sprouting and neuronal cell migration from the aggregates. Furthermore, unlike control cultures, the irradiated cultures (mainly after 1 minute irradiation of 50 mW) were already established after a short time of cultivation. They contained a much higher number of large size neurons (P<0.01), which formed dense branched interconnected networks of thick neuronal fibers. CONCLUSIONS: 780 nm laser phototherapy of embryonic rat brain cultures embedded in hyaluronic acid-laminin gel and attached to positively charged cylindrical MCs, stimulated migration and fiber sprouting of neuronal cells aggregates, developed large size neurons with dense branched interconnected network of neuronal fibers and, therefore, can be considered as potential procedure for cell therapy of neuronal injury or disease.

Lasers Surg Med 2009 Apr 41(4) 277-81


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Effect of low level laser therapy (830 nm) with different therapy regimes on the process of tissue repair in partial lesion calcaneous tendon.

Oliveira FS, Pinfildi CE, Parizoto NA, Liebano RE, Bossini PS, Garcia EB, Ferreira LM

Department of Plastic Surgery, Sao Paulo Federal University-UNIFESP, Sao Paulo, SP 04024-900, Brazil.

BACKGROUND AND OBJECTIVE: Calcaneous tendon is one of the most damaged tendons, and its healing may last from weeks to months to be completed. In the search after speeding tendon repair, low intensity laser therapy has shown favorable effect. To assess the effect of low intensity laser therapy on the process of tissue repair in calcaneous tendon after undergoing a partial lesion. STUDY DESIGN/MATERIALS AND METHODS: Experimentally controlled randomized single blind study. Sixty male rats were used randomly and were assigned to five groups containing 12 animals each one; 42 out of 60 underwent lesion caused by dropping a 186 g weight over their Achilles tendon from a 20 cm height. In Group 1 (standard control), animals did not suffer the lesion nor underwent laser therapy; in Group 2 (control), animals suffered the lesion but did not undergo laser therapy; in Groups 3, 4, and 5, animals suffered lesion and underwent laser therapy for 3, 5, and 7 days, respectively. Animals which suffered lesion were sacrificed on the 8th day after the lesion and assessed by polarization microscopy to analyze the degree of collagen fibers organization. RESULTS: Both experimental and standard control Groups presented significant values when compared with the control Groups, and there was no significant difference when Groups 1 and 4 were compared; the same occurred between Groups 3 and 5. CONCLUSION: Low intensity laser therapy was effective in the improvement of collagen fibers organization of the calcaneous tendon after undergoing a partial lesion.

Lasers Surg Med 2009 Apr 41(4) 271-6


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The effect of low-intensity laser therapy on bone healing around titanium implants: a histometric study in rabbits.

Pereira CL, Sallum EA, Nociti FH Jr, Moreira RW

Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, Campinas State University, Piracicaba, Sao Paulo, Brazil.

PURPOSE: This study aimed to histometrically evaluate the influence of low-intensity laser treatment on bone healing around titanium implants placed in rabbit tibiae. MATERIALS AND METHODS: Each tibia of 12 adult rabbits received a 3.3 x 6-mm titanium implant. The implants placed in the right tibiae were irradiated with a gallium-aluminum-arsenide diode low-intensity laser every 48 hours for 14 days postoperatively, and the left tibiae were not irradiated. After 3 or 6 weeks, the animals were sacrificed (six animals per period), and nondecalcified sections were obtained and analyzed for bone-to-implant contact (BIC) and bone area within the implant threads. Data were subjected to statistical analysis using analysis of variance (ANOVA) and the Tukey test. RESULTS: BIC was significantly increased in the laser-treated group at both 3 weeks and 6 weeks. BIC did not increase significantly with time (3 weeks versus 6 weeks). Conversely, bone area within the threads was significantly increased with time (3 weeks versus 6 weeks), regardless of whether the laser was used. Considering bone area within the threads, no significant difference was found for treatment, eg, with or without laser. CONCLUSION: Low-intensity laser therapy did not affect the area of bone formed within the threads, but it may improve BIC in rabbit tibiae.

Int J Oral Maxillofac Implants 2009 Jan-Feb 24(1) 47-51


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Cancer growth and its inhibition in terms of coherence.

Popp FA

International Institute of Biophysics, Neuss, Germany. iib@lifescientists.de

It is shown that a molecular origin for growth inhibition is rather unlikely because the cross-sectional area of inhibitory forces in a cell population cannot exceed more than about 10(-8) Dalton. A model of the time dependence of cell number N(t), where t is the time, is based on biophotons and explains without any contradiction to known experimental results growth regulation in terms of the factor a = 1/T, which stimulates the cell division rate dN/dt and the factor b = dT/dN(1/T(2)), which inhibits cell division. It accounts for the total cell division rate dN/dt = aN(t) – bN(2)(t). For adults, T is the coherence time of about 10(6) s, corresponding to the longest lifetime of cell organelles in men, while dT/dN = 10(-7) s corresponds to the resolution time of the cell population which is always the average time interval between two cell loss events. Our model follows a stringently holistic approach to describing a cell population as an entity, regulated by a fully coherent (biophoton) field.

Electromagn Biol Med 2009 28(1) 53-60


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The cybrid model of sporadic Parkinson’s disease.

Trimmer PA, Bennett JP Jr

Morris K. Udall Parkinson’s Disease Research Center of Excellence, Department of Neurology, University of Virginia, Charlottesville, VA 22908, USA.

Parkinson’s disease (PD) is the eponym attached to the most prevalent neurodegenerative movement disorder of adults, derived from observations of an early nineteenth century physician and paleontologist, James Parkinson, and is now recognized to encompass much more than a movement disorder clinically or dopamine neuron death pathologically. Most PD ( approximately 90%) is sporadic (sPD), is associated with mitochondrial deficiencies and has been studied in cell and animal models arising from the use of mitochondrial toxins that unfortunately have not predicted clinical efficacy to slow disease progression in humans. We have extensively studied the cytoplasmic hybrid (“cybrid”) model of sPD in which donor mtDNAs are introduced into and expressed in neural tumor cells with identical nuclear genetic and environmental backgrounds. sPD cybrids demonstrate many abnormalities in which increased oxidative stress drives downstream antioxidant response and cell death activating signaling pathways. sPD cybrids regulate mitochondrial ETC genes and gene ontology families like sPD brain. sPD cybrids spontaneously form Lewy bodies and Lewy neurites, linking mtDNA expression to neuropathology, and demonstrate impaired organelle transport in processes and reduced mitochondrial respiration. Our recent studies show that near-infrared laser light therapy normalizes mitochondrial movement and can stimulate respiration in sPD cybrid neurons, and mitochondrial gene therapy can restore respiration and stimulate mitochondrial ETC gene and protein expression. sPD cybrids have provided multiple lines of circumstantial evidence linking mtDNA to sPD pathogenesis and can serve as platforms for therapy development. sPD cybrid models can be improved by the use of non-tumor human stem cell-derived neural precursor cells and by an introduction of postmortem brain mtDNA to test its causality directly.

Exp Neurol 2009 Mar 26


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[Laser needle acupuncture in women with dysmenorrhoea: a randomised controlled double blind pilot trial]

Kempf D, Berger D, Ausfeld-Hafter B

Kollegiale Instanz fur Komplementarmedizin KIKOM, Universitat Bern, Imhoof-Pavillon, Inselspital, Bern, Switzerland.

BACKGROUND: Dysmenorrhoea is a common gynaecological disorder.It is treated symptomatically if it is not caused by any underlying disease. Acupuncture is successfully used for menstrual disorders but is associated with certain side effects such as pain. Laser needle acupuncture is a new, non-invasive procedure that might mimic the effects of acupuncture. OBJECTIVE: The aim of this study is to investigate whether the effect of active laser needle acupuncture is superior to the effect of placebo laser needle acupuncture in women with dysmenorrhoea. PATIENTS AND METHODS: Women aged 18-50 years and with a minimum menstrual pain of 4 out of 10 points on a visual analogue scale (VAS) were included in this randomised double blind trial and treated with laser needle acupuncture (Laserneedle Computer-System). Every woman was treated with the same 8 acupuncture points (SP6, LV3 and LI4 bilateral; CV3 and ST36 on the right) in 8 sessions of 20 min each, over a period of 3 menstrual cycles. The primary endpoint was successful pain reduction, defined as a 50% reduction of the mean menstrual pain between baseline and end of the study (calculated from those 2 menstrual days with the worst pain levels on the VAS). We compared real laser acupuncture with placebo laser acupuncture (no laser activity). RESULTS: 48 women, mean age 29.6 +/- 7.5 years, were included in the study (30 women in the placebo group, 18 in the verum group). In the real acupuncture group, the success rate was 16.7% (3/18), in the placebo group 20% (6/30). CONCLUSIONS: We could not find a significant advantage of laser needle acupuncture compared to placebo laser needle acupuncture treatment. Further investigations are recommended because laser needle treatment is non-invasive and allows double blind acupuncture studies.

Forsch Komplementmed 2009 Feb 16(1) 6-12


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Effects of near-infrared laser exposure in a cellular model of wound healing.

Skopin MD, Molitor SC

Department of Bioengineering, University of Toledo, Toledo, OH 43606-3390, USA.

BACKGROUND: Clinical studies have demonstrated beneficial outcomes for low-level laser therapy (LLLT) using near-infrared (NIR) wavelengths. It has been hypothesized that the benefits of NIR LLLT are due in part to the thermal effects of NIR exposure. However, it is not clear whether photochemical interactions between NIR light and superficial tissues contribute to beneficial outcomes. To investigate the photochemical effects of NIR exposure, the efficacy of 980 nm NIR LLLT on human fibroblast growth rates is investigated using an in vitro model of wound healing. METHODS: A small pipette is used to induce a wound in fibroblast cell cultures, which are imaged at specific time intervals over 48 h and exposed to a range of laser doses (1.5-66 J/cm(2)) selected to encompass the range of doses used during other in vivo and in vitro studies. For each image acquired, wound sizes were quantified using a novel application of existing image processing algorithms. RESULTS: Cell growth rates were compared across different laser exposure intensities with the same exposure duration, and across different laser exposure durations with the same exposure intensity. Exposure to low- and medium-intensity laser light accelerates cell growth, whereas high-intensity light negated the beneficial effects of laser exposure. Cell growth was accelerated over a wide range of exposure durations using medium-intensity laser light, with no significant inhibition of cell growth at the longest exposure durations used in this study. CONCLUSION: Low-level exposure to 980 nm laser light can accelerate wound healing in vitro without measurable temperature increases. However, these results also demonstrate the need for appropriate supervision of laser therapy sessions to prevent overexposure to NIR laser light that may inhibit cell growth rates observed in response to lower intensity laser exposure.

Photodermatol Photoimmunol Photomed 2009 Apr 25(2) 75-80


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The effect of phototherapy on neutrophils.

Morgan MC, Rashid RM

School of Medicine, University of Texas Health Science Center, Houston, TX, United States.

Background: The role of phototherapy on neutrophils has not been reviewed previously. This novel and non-invasive therapeutic approach is of particular interest for potential use in the treatment of pathologic processes in dermatology and infectious diseases in which neutrophils are the primary culprit. OBJECTIVES: The primary aim of this study was to systematically review the role of phototherapy on neutrophils. METHOD: Original publications were identified through searches in PubMed, Medline, Ovid, and the Cochrane Library. Search terms used included “phototherapy and neutrophils,” “light therapy and neutrophils,” and “laser and neutrophils.” Studies were selected based on the level of evidence-based research. RESULTS: The literature search revealed a total of 22 controlled laboratory studies that evaluated the role of phototherapy on neutrophils. Among the effects of phototherapy noted were increases in: the respiratory burst of neutrophils, apoptosis of polymorphonuclear cells, and plasma NO and iNOS mRNA. Other notable findings include decreased: number of neutrophils in areas of inflammation, ROS production, neutrophil anti-apoptotic factors, and IL-1beta concentration. Studies on PDT demonstrated neutrophilia and resultant decreased tumor growth. CONCLUSION: Evidence indicates that phototherapy has a significant impact on neutrophils, the effect of which varies according to the specific type of phototherapy. These findings have a variety of potential clinical applications including the treatment of various autoimmune conditions, inflammatory diseases, and cancers.

Int Immunopharmacol 2009 Apr 9(4) 383-8


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Low-energy laser irradiation promotes synovial fibroblast proliferation by modulating p15 subcellular localization.

Taniguchi D, Dai P, Hojo T, Yamaoka Y, Kubo T, Takamatsu T

Department of Pathology and Cell Regulation, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.

BACKGROUND AND OBJECTIVE: Low-energy laser irradiation (low-level laser therapy) (LELI/LLLT/photobiomodulation) has been found to modulate various biological effects, especially those involved in promoting cell proliferation. Synovial fibroblasts are important in maintaining the homeostasis of articular joints and have strong chondrogenetic capacity. Here, we investigated the effect and molecular basis of LELI on synovial fibroblast proliferation. STUDY DESIGN/MATERIALS AND METHODS: HIG-82 rabbit synovial fibroblasts were cultured, and laser irradiation (660 nm) was applied at the power density of 40 mW/cm(2) for 2 minutes, corresponding to laser fluence of 4.8 J/cm(2). The effect of LELI on cell proliferation, cell cycle progression, and expression of cyclin-dependent kinase inhibitors (CKIs) were investigated. We also examined whether the effects of LELI on HIG-82 cell proliferation were affected by cAMP content, which is known to influence the cell cycle via inducing CKIs. RESULTS: LELI promoted HIG-82 synovial fibroblast proliferation and induced cytoplasmic localization of cyclin-dependent kinase inhibitor p15 (INK4B/CDKN2B). Moreover, the proliferation of HIG-82 synovial fibroblasts was reduced by cAMP, while cAMP inhibitor, SQ22536, induced p15 cytoplasmic localization and as a result, elevated synovial fibroblast proliferation was observed. In addition, the promotive effect of LELI-induced HIG-82 synovial fibroblast proliferation was abolished by cAMP treatment. Our findings suggest that cAMP may be involved in the effect of LELI on synovial fibroblast proliferation. CONCLUSION: We revealed the effect and molecular link involved in synovial fibroblast proliferation induced by 660-nm LELI. Our study provides new insights into the mechanisms by which LELI has biological effects on synovial fibroblast proliferation. These insights may contribute to further investigation on biological effects and application of LELI in regenerative medicine.

Lasers Surg Med 2009 Mar 41(3) 232-9


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In vivo effects of low level laser therapy on inducible nitric oxide synthase.

Moriyama Y, Nguyen J, Akens M, Moriyama EH, Lilge L

Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Ontario, Canada M5G 2M9.

BACKGROUND AND OBJECTIVE: Low level laser therapy (LLLT) has been demonstrated to modulate inflammatory processes with evidence suggesting that treatment protocol, such as wavelength, total energy, and number of treatments determine the clinical efficacy. In this study, the effects of LLLT mediated by different wavelengths and continuous versus pulsed delivery mode were quantified in a transgenic murine model with the luciferase gene under control of the inducible nitric oxide synthase (iNOS) expression. STUDY DESIGN/MATERIALS AND METHODS: LLLT modulated iNOS gene expressed in the acute Zymosan-induced inflammation model is quantified using transgenic mice (FVB/N-Tg(iNOS-luc)). Here an energy density of 5 J cm(-2) at either 635, 660, 690, and 905 nm in continuous wave mode and at 905 nm for short pulse delivery were evaluated. Age of the animals was determined as additional modulating the inflammatory response and the LLLT efficacy for some treatment protocols. RESULTS: Animals younger than 15 weeks showed mostly reduction of iNOS expression, while older animals showed increased iNOS expression for some LLLT protocols. Intensity and time course of inducible nitric oxide expression was found to not only depend on wavelength, but also on the mode of delivery, continuous, or pulsed irradiation. CONCLUSION: LLLT exhibit different effects in induced inflammatory process according to different wavelengths and wave mode. Upregulation of iNOS gene following 905 nm pulsed wave suggests a different mechanism in activating the inflammatory pathway response when compared to the continuous wave.

Lasers Surg Med 2009 Mar 41(3) 227-31


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Pulsing influences photoradiation outcomes in cell culture.

Brondon P, Stadler I, Lanzafame RJ

Rochester General Hospital Laser Center, Rochester, New York, USA.

BACKGROUND AND OBJECTIVES: Skin pigmentation can adversely affect phototherapy outcomes. Delivering pulsed light has been suggested as a means of enhancing efficacy. Suitable pulse frequencies remain indeterminate, often being selected empirically. This study was undertaken to determine whether pulsed light delivery mitigates the filtering effect of melanin pigment on photomodulation in vitro. STUDY DESIGN AND METHODS: Human HEP-2 cells were cultured in complete DMEM media. Photoradiation was delivered through 0.025% melanin filters at 670 nm (5.0 J/cm(2)/treatment/24 hours) for 72 hours at different pulse rates. Group A received no light treatment. Group B received treatments without pulsing. Groups C, D, E, F, and G received treatments at 6, 18, 36, 100, and 600 Hz. Cell proliferation was assessed by MTT assay and oxidative burst was measured using the 2.7 dichloro-fluorescein-diacetate assay. RESULTS: Cell proliferation was maximally stimulated at 100 Hz at 48 and 72 hours (n = 4, P< or =0.05). Oxidative burst was maximally stimulated at 600 Hz (n = 4, P< or =0.05). All frequencies were stimulatory at 48 and 72 hours (n = 4, P< or =0.05). CONCLUSION: This investigation suggests that light pulsing may improve outcomes by mitigating the filtration effects of cutaneous melanin. Further studies to further define these effects are warranted.

Lasers Surg Med 2009 Mar 41(3) 222-6


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[Laserotherapy and mesodiencephalic modulation after hemihepatoectomy in the early postoperative period]

Goidenko VS, Seraia EV, Chzao AV, Lapshin VP, Zhuravel’ SV, Chugunov AO, Andreitseva OI, Riumin AO

Vopr Kurortol Fizioter Lech Fiz Kult 2009 Jan-Feb (1) 39-40


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[The use of laseropuncture in patients with bronchial asthma and concomitant chronic rhinosinusitis]

Esaulenko IE, Nikitin AV, Shatalova OL

Vopr Kurortol Fizioter Lech Fiz Kult 2009 Jan-Feb (1) 37-9


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[Impact of low-intensity laser on the suppression of infections caused by Herpes simplex viruses 1 and 2: in vitro study]

Ferreira Dde C, Martins FO, Romanos MT

Setor de Doencas Sexualmente Transmissiveis, Departamento de Microbiologia, Universidade Federal Fluminense, Niteroi, RJ.

The use of low-level laser to suppress infections caused by Herpes simplex viruses 1 and 2 was evaluated after one to five applications. A gradual reduction in replication of Herpes simplex viruses 1 and 2 was observed, with 68.4% and 57.3% inhibition, respectively, after five applications, thus favoring its clinical use.

Rev Soc Bras Med Trop 2009 Jan-Feb 42(1) 82-5


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Laser therapy of painful shoulder and shoulder-hand syndrome in treatment of patients after the stroke.

Karabegovic A, Kapidzic-Durakovic S, Ljuca F

Clinic for Physical Medicine and Rehabilitation, University Clinical Centre, Faculty of Medicine, University of Tuzla, Trnovac b.b., 75 000 Tuzla, Bosnia and Herzegovina.

The common complication after stroke is pain and dysfunction of shoulder of paralyzed arm, as well as the swelling of the hand. The aim of this study was to determine the effects of LASER therapy and to correlate with electrotherapy (TENS, stabile galvanization) in subjects after stroke. We analyzed 70 subjects after stroke with pain in shoulder and oedema of paralyzed hand. The examinees were divided in two groups of 35, and they were treated in the Clinic for Physical Medicine and Rehabilitation in Tuzla during 2006 and 2007. Experimental group (EG) had a treatment with LASER, while the control group (CG) was treated with electrotherapy. Both groups had kinesis therapy and ice massage. All patients were examined on the admission and discharge by using the VAS, DASH, Barthel index and FIM. The pain intensity in shoulder was significantly reduced in EG (p<0,0001), swelling is lowered in EG (p=0,01). Barthel index in both groups was significant higher (p<0,01). DASH was significantly improved after LASER therapy in EG (p<0,01). EG had higher level of independency (p<0,01). LASER therapy used on EG shows significantly better results in reducing pain, swelling, disability and improvement of independency.

Bosn J Basic Med Sci 2009 Feb 9(1) 59-65


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[Application of low-intensity laser radiation and endotoxin-binding preparations to the treatment of female infertility]

Enukidze GG

A total of 38 women of reproductive age (from 20 to 45 years) with chronic inflammatory gynecological diseases including 7 with primary and 9 with secondary infertility were examined by standard clinical, instrumental, and laboratory methods. In addition, variations of such important characteristics as serum endotoxin level and activity of antiendotoxin immunity were measured. The study has demonstrated participation of chronic aggression of endotoxins (of intestinal origin) in pathogenesis of the disorders of interest. Inclusion of the “antiendotoxic component” in the combined therapy allowed the efficacy of the treatment of chronic inflammation and female infertility to be greatly enhanced. It suggests the important (if not decisive) role of bacterial lipopolysacchardides in the pathogenetic mechanism underlying the problems considered in this study.

Vopr Kurortol Fizioter Lech Fiz Kult 2009 Jan-Feb (1) 25-8


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[Parameters of lipid peroxidation and antioxidative protection in patients with chronic pancreatitis treated by low-intensity laser therapy]

Burduli NM, Gutnova SK

The objective of this study was to evaluate the influence of low-intensity laser therapy (LILT) on the processes of lipid peroxidation (LPO) and antioxidative protection (AOP) in patients with chronic pancreatitis. A total of 78 patients aged from 36 to 77 years were treated with LILT in addition to conventional therapy; the patients of the control group (n = 40) received only medicamentous therapy. Examination of the patients in the exacerbation phase of chronic pancreatitis revealed activation of LPO processes and differently-directed shifts of AOP components. These changes are supposed to reflect variations in the activity of the inflammatory processes in the pancreas and oxidative stress on this organ.

Vopr Kurortol Fizioter Lech Fiz Kult 2009 Jan-Feb (1) 17-9


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About James Carroll

Founder and CEO at THOR Photomedicine Ltd. About THOR
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