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THOR on YouTube33 new LLLT papers for you this month including: a review of 21 papers on muscle performance, fatigue and repair, a controlled multicenter trial on male pattern baldness, another trial on oral mucositis and how about this, 810nm laser ameliorates diabetes!
Low-level laser (light) therapy (LLLT) on muscle tissue: performance, fatigue and repair benefited by the power of light.
Ferraresi C, Hamblin MR, Parizotto NA
Laboratory of Electro-thermo-phototherapy, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo 13565-905, Brazil; and Department of Biotechnology, Federal University of Sao Carlos, Sao Carlos, Sao Paulo 13565-905, Brazil.
The use of low level laser (light) therapy (LLLT) has recently expanded to cover areas of medicine that were not previously thought of as the usual applications such as wound healing and inflammatory orthopedic conditions. One of these novel application areas is LLLT for muscle fatigue and muscle injury. Since it is becoming agreed that mitochondria are the principal photoacceptors present inside cells, and it is known that muscle cells are exceptionally rich in mitochondria, this suggests that LLLT should be highly beneficial in muscle injuries. The ability of LLLT to stimulate stem cells and progenitor cells means that muscle satellite cells may respond well to LLLT and help muscle repair. Furthermore the ability of LLLT to reduce inflammation and lessen oxidative stress is also beneficial in cases of muscle fatigue and injury. This review covers the literature relating to LLLT and muscles in both preclinical animal experiments and human clinical studies. Athletes, people with injured muscles, and patients with Duchenne muscular dystrophy may all benefit.
Photonics Lasers Med 2012 Nov 1 1(4) 267-286
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Low-Level Light Therapy for Androgenetic Alopecia: A 24-Week, Randomized, Double-Blind, Sham Device-Controlled Multicenter Trial.
Kim H, Choi JW, Kim JY, Shin JW, Lee SJ, Huh CH
Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea; Department of Dermatology, Inje University Busan Paik Hospital, Busan, Korea.
BACKGROUND: Androgenetic alopecia (AGA) is a common disorder affecting men and women. Finasteride and minoxidil are well-known, effective treatment methods, but patients who exhibit a poor response to these methods have no additional adequate treatment modalities. OBJECTIVE: To evaluate the efficacy and safety of a low-level light therapy (LLLT) device for the treatment of AGA. METHODS: This study was designed as a 24-week, randomized, double-blind, sham device-controlled trial. Forty subjects with AGA were enrolled and scheduled to receive treatment with a helmet-type, home-use LLLT device emitting wavelengths of 630, 650, and 660 nm or a sham device for 18 minutes daily. Investigator and subject performed phototrichogram assessment (hair density and thickness) and global assessment of hair regrowth for evaluation. RESULTS: After 24 weeks of treatment, the LLLT group showed significantly greater hair density than the sham device group. Mean hair diameter improved statistically significantly more in the LLLT group than in the sham device group. Investigator global assessment showed a significant difference between the two groups, but that of the subject did not. No serious adverse reactions were detected. CONCLUSION: LLLT could be an effective treatment for AGA.
Dermatol Surg 2013 Apr 3
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Cost-effectiveness of the introduction of specialized oral care with laser therapy in hematopoietic stem cell transplantation.
Bezinelli LM, de Paula Eduardo F, da Graca Lopes RM, Biazevic MG, de Paula Eduardo C, Correa L, Hamerschlak N, Michel-Crosato E
Unit of Bone Marrow Transplantation, Hospital Israelita Albert Einstein, Sao Paulo, Brazil; Department of Social Dentistry, Universidade de Sao Paulo, Sao Paulo, Brazil.
Oral mucositis (OM) is one of the side effects of hematopoietic stem cell transplantation (HSCT), resulting in major morbidity. The aim of this study was to determine the cost-effectiveness of the introduction of a specialized oral care program including laser therapy in the care of patients receiving HSCT with regard to morbidity associated with OM. Clinical information was gathered on 167 patients undergoing HSCT and divided according to the presence (n = 91) or absence (n = 76) of laser therapy and oral care. Cost analysis included daily hospital fees, parenteral nutrition (PN) and prescription of opioids. It was observed that the group without laser therapy (group II) showed a higher frequency of severe degrees of OM (relative risk = 16.8, 95% confidence interval -5.8 to 48.9, p < 0.001), with a significant association between this severity and the use of PN (p = 0.001), prescription of opioids (p < 0.001), pain in the oral cavity (p = 0.003) and fever > 37.8 degrees C (p = 0.005). Hospitalization costs in this group were up to 30% higher. The introduction of oral care by a multidisciplinary staff including laser therapy helps reduce morbidity resulting from OM and, consequently, helps minimize hospitalization costs associated with HSCT, even considering therapy costs. Copyright (c) 2013 John Wiley & Sons, Ltd.
Hematol Oncol 2013 Apr 29
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Laser treatment of recurrent herpes labialis: a literature review.
de Paula Eduardo C, Aranha AC, Simoes A, Bello-Silva MS, Ramalho KM, Esteves-Oliveira M, de Freitas PM, Marotti J, Tuner J
Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry of the University of Sao Paulo (USP), Av. Prof. Lineu Prestes, 2227, 05508-000, Sao Paulo, SP, Brazil, cpeduard@usp.br.
Recurrent herpes labialis is a worldwide life-long oral health problem that remains unsolved. It affects approximately one third of the world population and causes frequent pain and discomfort episodes, as well as social restriction due to its compromise of esthetic features. In addition, the available antiviral drugs have not been successful in completely eliminating the virus and its recurrence. Currently, different kinds of laser treatment and different protocols have been proposed for the management of recurrent herpes labialis. Therefore, the aim of the present article was to review the literature regarding the effects of laser irradiation on recurrent herpes labialis and to identify the indications and most successful clinical protocols. The literature was searched with the aim of identifying the effects on healing time, pain relief, duration of viral shedding, viral inactivation, and interval of recurrence. According to the literature, none of the laser treatment modalities is able to completely eliminate the virus and its recurrence. However, laser phototherapy appears to strongly decrease pain and the interval of recurrences without causing any side effects. Photodynamic therapy can be helpful in reducing viral titer in the vesicle phase, and high-power lasers may be useful to drain vesicles. The main advantages of the laser treatment appear to be the absence of side effects and drug interactions, which are especially helpful for older and immunocompromised patients. Although these results indicate a potential beneficial use for lasers in the management of recurrent herpes labialis, they are based on limited published clinical trials and case reports. The literature still lacks double-blind controlled clinical trials verifying these effects and such trials should be the focus of future research.
Lasers Med Sci 2013 Apr 13
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Testing Infrared Laser Phototherapy (810 nm) to Ameliorate Diabetes: Irradiation on Body Parts of Diabetic Mice.
Peplow PV, Baxter GD
Department of Anatomy, University of Otago, Dunedin 9010, New Zealand.
BACKGROUND AND OBJECTIVES: Irradiation of left flank of genetic diabetic mice with 660 nm wavelength laser, 100 mW, 20 seconds/day for 7 days did not significantly alter blood plasma glucose compared to nonirradiated controls. Infrared light would provide for a greater amount of photoenergy penetrating the skin and muscle. Genetic diabetic mice were irradiated with 810 nm wavelength laser to test for antidiabetic effect. MATERIALS AND METHODS: Sixty-five diabetic mice were used. Body weight and water intake of mice were measured daily for 7 days prior to start of treatment (Day 0). Mice were irradiated with 810 nm wavelength laser, 50 mW, 40 seconds/day, 7 days on left flank (n = 11), mid-upper abdomen (n = 14), or left inguinal region (n = 14); some mice were not irradiated (control, n = 26). Body weight and water intake of mice were measured to Day 7. On Day 7, mice were fasted for 4 hours, anesthetized with sodium pentobarbitone (s.c.) and blood collected by cardiac puncture into EDTA-treated tubes. Blood plasma was assayed for glucose and fructosamine. Blood was collected and assayed from nonirradiated nondiabetic mice (n = 12). RESULTS: On Day 7 body weight was significantly lower and water intake significantly higher compared to Day 0 for diabetic mice irradiated on left flank (40.7 +/- 0.5 vs. 42.2 +/- 0.4 g, 28.2 +/- 1.5 vs. 23.4 +/- 1.5 g, respectively); there was no significant change for diabetic mice irradiated on mid-upper abdomen or left inguinal region and also for nonirradiated diabetic mice. On Day 7 blood plasma glucose levels for irradiated diabetic mice were not significantly different to nonirradiated diabetic mice. Blood plasma fructosamine level of diabetic mice irradiated on left inguinal region was significantly lower than for nonirradiated diabetic mice (312 +/- 6 vs. 377 +/- 15 micromol/L); for diabetic mice irradiated on left flank or mid-upper abdomen (362 +/- 22, 357 +/- 19 micromol/L) it was not significantly different to nonirradiated diabetic mice. CONCLUSION: Irradiation of left inguinal region in diabetic mice with 810 nm laser has potential to ameliorate diabetes as shown by decreased blood plasma fructosamine. Lasers Surg. Med. 9999:XX-XX, 2013. (c) 2013 Wiley Periodicals, Inc.
Lasers Surg Med 2013 Apr 45(4) 240-5
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Clinical evaluation of the efficiency of low-level laser therapy for oral lichen planus: a prospective case series.
Cafaro A, Arduino PG, Massolini G, Romagnoli E, Broccoletti R
Oral Medicine Section, Department of Surgical Sciences, University of Turin, UNITO LINGOTTO DENTAL INSTITUTE c/o Lingotto, Via Nizza 230, 10126, Turin, Italy.
Oral lichen planus (OLP) is an inflammatory disease that can be painful, mainly in the atrophic and erosive forms. Numerous drugs have been used with dissimilar results, but most treatments are empirical. However, to date, the most commonly employed and useful agents for the treatment of OLP are topical corticosteroids. The study objective was to detail the clinical effectiveness of low-level laser therapy (LLLT) for the management of OLP unresponsive to standard topical therapy. The authors studied a prospective cohort of 30 patients affected by OLP, who received biostimulation with a 980-nm gallium-aluminum-arsenide (GaAIAs) diode laser (DM980, distributed by DMT S.r.l., Via Nobel 33, 20035, Lissone, Italy). Outcome variables, statistically evaluated, were: the size of lesions; visual analogue score of pain and stability of the therapeutic results in the follow-up period. Eighty-two lesions were treated. We reported significant reduction in clinical scores of the treated lesions and in reported pain. No detailed complications or therapy side effects were observed during the study. As previously reported by our group with a preliminary report, this study suggests that LLLT could be a possible treatment choice for patients with unresponsive symptomatic OLP, also reducing the possible invasiveness correlated with other therapies.
Lasers Med Sci 2013 Apr 3
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Efficacy of Low Level Laser Therapy on Scar Tissue.
Freitas CP, Melo C, Alexandrino AM, Noites A
Abstract Background: Physiotherapy has a very important role for the maintenance of the integumentary system integrity. Very few evidence exists in humans. Nevertheless, there are some studies about tissue regeneration using low level laser therapy (LLLT). Aim: To analyse the effectiveness of LLLT on scar tissue. Methods: Seventeen volunteer subjects were stratified by age of their scars, and then randomly assigned to an experimental group (EG) – n= 9 -, and a placebo group (PG) – n= 8. Fifteen sessions were applied to both groups 3 times a week. However in the PG the laser device was switched off. Scars’ thickness, length, width, macroscopic aspect, pain threshold, pain perception and itching were measured. Results: After 5 weeks there were no statistically significant differences in any variable between both groups. Therefore, analysing independently each group, EG showed a significantly improvement in macroscopic aspect (p=0,003) using LLLT. Taking into account scars’ age, LLLT showed in EG a tendency to decrease older scars’ thickness. Conclusion: The intervention with LLLT appears to have a positive effect on the macroscopic scars’ appearance, and on old scars’ thickness, in the studied sample. However, it cannot be said for sure that LLLT has influence on scar tissue.
J Cosmet Laser Ther 2013 Apr 22
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Enhancement of bone consolidation in mandibular distraction osteogenesis: A contemporary review of experimental studies involving adjuvant therapies.
Hong P, Boyd D, Beyea SD, Bezuhly M
IWK Health Centre, Dalhousie Pediatric Craniofacial Group, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada; School of Human Communication Disorders, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: Paul.Hong@iwk.nshealth.ca.
BACKGROUND: One of the major disadvantages of mandibular distraction osteogenesis (MDO) is the prolonged time required for consolidation of the regenerate bone. The objective of the present study is to perform a contemporary review of various adjuvant therapies to enhance bone consolidation in MDO. METHODS: A PubMed search for articles related to MDO, along with the references of those articles, was performed. Inclusion and exclusion criteria were applied to all experimental studies assessing adjuvant therapies to enhance bone consolidation. RESULTS: A total of 1414 titles and abstracts were initially reviewed; 61 studies were included for full review. Many studies involved growth factors, hormones, pharmacological agents, gene therapy, and stem cells. Other adjuvant therapies included mechanical stimulation, laser therapy, and hyperbaric oxygen. Majority of the studies demonstrated positive bone healing effects and thus adjuvant therapies remain a viable strategy to enhance and hasten the consolidation period. CONCLUSION: Although most studies have demonstrated promising results, many questions still remain, such as optimal amount, timing, and delivery methods required to stimulate the most favorable bone regeneration. As well, further studies comparing various adjuvant therapies and documentation of long-term adverse effects are required prior to clinical application.
J Plast Reconstr Aesthet Surg 2013 Apr 17
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Is It Time to Consider Photobiomodulation As a Drug Equivalent?
Karu T
Institute of Laser and Information Technologies of Russian Academy of Sciences , Moscow, Russian Federation.
Photomed Laser Surg 2013 Apr 19
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Is low-level laser therapy in relieving neck pain effective? Systematic review and meta-analysis.
Kadhim-Saleh A, Maganti H, Ghert M, Singh S, Farrokhyar F
Faculty of Medicine, University of Ottawa, Ottawa, Canada.
The aim of this study is to determine the efficacy of low-level laser therapy (LLLT) in reducing acute and chronic neck pain as measured by the visual analog scale (VAS). A systematic search of nine electronic databases was conducted to identify original articles. For study selection, two reviewers independently assessed titles, abstracts, and full text for eligibility. Methodological quality was assessed using the Detsky scale. Data were analyzed using random-effects model in the presence of heterogeneity and fixed-effect model in its absence. Heterogeneity was assessed using Cochran’s Q statistic and quantifying I 2. Risk ratios (RR) with 95 % confidence intervals (CI) were reported. Eight randomized controlled trials involving 443 patients met the strict inclusion criteria. Inter-rater reliability for study selection was 92.8 % (95 % CIs 80.9-100 %) and for methodological quality assessment was 83.9 % (95 % CIs 19.4-96.8 %). Five trials included patients with cervical myofascial pain syndrome (CMPS), and three trials included different patient populations. A meta-analysis of five CMPS trials revealed a mean improvement of VAS score of 10.54 with LLLT (95 % CI 0.37-20.71; Heterogeneity I 2 = 65 %, P = 0.02). This systematic review provides inconclusive evidence because of significant between-study heterogeneity and potential risk of bias. The benefit seen in the use of LLLT, although statistically significant, does not constitute the threshold of minimally important clinical difference.
Rheumatol Int 2013 Apr 12
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Efficacy of Light-Emitting Diode Photomodulation in Reducing Erythema After Fractional Carbon Dioxide Laser Resurfacing: A Pilot Study.
Oh IY, Kim BJ, Kim MN, Kim CW, Kim SE
Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, South Korea.
BACKGROUND: The most common side effects of fractional carbon dioxide (CO2 ) laser resurfacing are erythema and edema of the treated skin. Light-emitting diode (LED) devices have been shown to stimulate fibroblast activity and hasten wound healing. The current study was designed to evaluate the efficacy of such LED devices in treating post-laser therapy erythema. OBJECTIVES: To evaluate the clinical efficacy of LED photomodulation in reducing erythema resulting from ablative fractional CO2 laser resurfacing. MATERIALS AND METHODS: Randomly selected facial halves of 10 Korean subjects (Fitzpatrick skin type III-IV) were treated using a 635-nm wavelength LED array immediately after full-face fractional laser skin resurfacing. Each participant was subsequently treated with LED daily for the following 7 days. Clinical photographs, subjective physician assessment, and chromometer erythema index were used to track the results, with clinical improvement assessed using a 5-point grading scale. RESULTS: The postlaser erythema resolved faster on the experimental side than the control side, with improvements noted according to physician assessment and chromometer erythema index. Statistically significant improvements between the two sides were first noted on day 4. CONCLUSION: Treatment using a 635-nm-wavelength LED array decreases the intensity and duration of post-fractional CO2 laser treatment erythema.
Dermatol Surg 2013 Apr 3
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Assessment of immediate pain relief with laser treatment in recurrent aphthous stomatitis.
Prasad R S, Pai A
Post Graduate Student, Department of Oral Medicine and Radiology, The Oxford Dental College. Electronic address: drsheshaprasad@gmail.com.
OBJECTIVES: To compare immediate pain relief, healing time between minor recurrent aphthous ulcers treated with a single session of carbon dioxide (CO2) laser and a placebo. STUDY DESIGN: A prospective clinical study was performed on 25 patients with minor recurrent aphthous stomatitis. Pretreatment pain levels were recorded using a numerical rating scale. Ulcers were randomized to either receive treatment or placebo. Pain levels were assessed immediately after treatment and after 24 h. Healing was assessed on days 3 and 4, and once every 2 days thereafter for 2 weeks. RESULTS: Mean pain scores in the laser group were significantly reduced immediately after treatment (0.68 +/- 0.6) compared with pretreatment (8.48 +/- 0.71; P < .001). In contrast, the placebo group showed little difference in pain scores between pretreatment (8.08 +/- 0.70) and immediately after treatment (7.96 +/- 0.84). In the laser group, significant improvements in healing times were observed (4.08 +/- 0.81 vs. 7.84 +/- 0.90 days; P < .001). CONCLUSION: CO2 laser therapy in recurrent aphthous stomatitis (RAS) provides immediate pain relief sustained over 24 h, along with accelerated healing time.
Oral Surg Oral Med Oral Pathol Oral Radiol 2013 Apr 23
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Evaluation of the effect of low level laser on prevention of chemotherapy-induced mucositis.
Arbabi-Kalati F, Arbabi-Kalati F, Moridi T
Brain and Spinal Injury Research Center, Tehran Universityof Medical Sciences, Tehran, Iran. farbabi@razi.tums.ac.ir.
Radiotherapy in the head and neck region and chemotherapy might give rise to oral mucositis which is a severe and painful inflammation. There is no known definite cure for mucositis. A number of studies have attempted to evaluate the effect of low-power laser on radiotherapy- and chemotherapy-induced mucositis. The present study was undertaken to evaluate the effect of low-power laser on the prevention of mucositis, xerostomia and pain as a result of chemotherapy. The subjects in this double-blind randomized controlled study were 24 adult patients who underwent chemotherapy during 2009-2010. The results showed that low-power laser was able to decrease the effect of chemotherapy on oral mucositis, xerostomia and pain in a variety of malignancies (P<0.05). It can be concluded that low-power laser might decrease the intensity of mucositis.
Acta Med Iran 2013 51(3) 157-62
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[Optimization of an acute destructive cholecystitis treatment, using application of mini-laparotomy access, laser irradiation and regional lymphotropic therapy].
Comparative analysis of the treatment results in 120 patients, suffering destructive form of biliary calculous disease (DFBCD) was performed. Depending on operative access and postoperative conservative therapy applied the patients were divided into two groups. In the main group in 58 patients, suffering DFBCD, a minilaparotomy access was applied, using “mini-assistant” apparatus named after M. I. Prudkov and postoperatively–low-intensive laser irradiation and regional lymphotropic therapy. In a comparison group in 62 patients various laparotomic accesses were used, and a standard postoperative therapy was performed. Normalization of clinical, laboratory and immune indices in the main group were observed in twice earlier than in a control one, and economical together with moral-psychological effect was measured in reduction of the medicines quantity used as well as the patients stationary stay.
Klin Khir 2012 Dec (12) 13-5
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The effectiveness of transmeatal low-power laser stimulation in treating tinnitus.
Ngao CF, Tan TS, Narayanan P, Raman R
Department of Otorhinolaryngology, Faculty of Medicine, University Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.
The aim of this study is to examine the effectiveness of transmeatal low-power laser stimulation (TLLS) in treating tinnitus. This is a prospective, double-blinded, randomized, placebo-controlled trial. Patients with persistent subjective tinnitus as their main symptom were recruited into the study from the outpatient clinics. The recruited patients were randomized into the experimental group or TLLS+ group (patients in this group were prescribed to use TLLS at 5 mW at 650 nM wavelength for 20 min daily and oral betahistine 24 mg twice per day for a total of 10 weeks) and the control group or TLLS- group (patients in this group were prescribed with a placebo device to use and oral betahistine 24 mg twice per day for 10 weeks). All patients were required to answer two sets of questionnaires: the Tinnitus handicap inventory (THI) and visual analogue scales (VAS) symptoms rating scales, before starting the treatment and at the end of the 10-week treatment period. The total score of the THI questionnaire was further graded into five grades, grade 1 being mild and grade 5 being catastrophic. Wilcoxon-signed ranks test and Mann-Whitney test were used to compare and analyze the THI and VAS scores before and after treatment for each group. Changes with p value of
Eur Arch Otorhinolaryngol 2013 Apr 19
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940 nm diode laser therapy in management of recurrent apthous ulcer.
Misra N, Maiti D, Misra P, Singh AK
Department of Oral Medicine and Radiology, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India.
Recurrent apthous stomatitis (RAS) is one of the most common oral inflammatory diseases characterised by painful recurrent ulcerations of the orofacial region. The ulcers occur in three clinical forms: minor, major and herpetiform. Several therapies have been advocated to manage these lesions such as topical corticosteroids (triamcinolone acetonide, hydrocortisone acetate and clobetasol propionate), chlorhexidine mouth rinses, tetracycline oral rinses, thalidomide, fluocinonide, colchicines and the immune boosting agent levamosile, vitamin therapy and topical interferon alpha-2a. Laser therapy is used as an alternative method in treatment of RAS. In this paper one patient with RAS was treated using a 940 nm diode laser for symptomatic relief of pain and burning sensation and healing of ulcer.
BMJ Case Rep 2013 2013
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Treating balance disorders by ultra-low-level laser stimulation of acupoints.
Gallamini M
International Society for Posture and Gait Research (ISPGR), Genova, Italy. Electronic address: gallamini@rgmd.it.
BACKGROUND: Balance disorders, a widespread problem in the senior population, are very often related to painful musculoskeletal disabilities and/or to degenerative neurologic pathologies. In a previous work, we investigated the beneficial effects of acupuncture such as laser photobiostimulation, regardless of the etiological origin of the balance dysfunction. AIMS: Attention was focused on two individuals showing balance deficits with different etiologies. One healthy control individual was receiving treatment, one healthy control individual did not receive any treatment. Balance performances were measured before and after ultra-low-level laser (ULLL) stimulation as a basis for the design of further investigations. METHODS: Romberg’s parameters were measured on a force platform. Of the four tested individuals, one showed dizziness symptoms, one was affected by a mild form of Parkinson’s disease, and two showed no dysfunction and were used as controls. RESULTS: It was found that a ULLL stimulation of peripheral Traditional Chinese Medicine (TCM) acupuncture points can be effective, regardless of the pathology. DISCUSSION: A specific clinical analysis of the stability of the beneficial result as a function of homogeneous groups of dysfunctional individuals is needed.
J Acupunct Meridian Stud 2013 Apr 6(2) 119-23
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Management of chronic tendon injuries.
Childress MA, Beutler A
Fort Belvoir Community Hospital, Fort Belvoir, VA, USA.
Chronic tendon injuries present unique management challenges. The assumption that these injuries result from ongoing inflammation has caused physicians to rely on treatments demonstrated to be ineffective in the long term. Nonsteroidal anti-inflammatory drugs should be limited in the treatment of these injuries. Corticosteroid injections should be considered for temporizing pain relief only for rotator cuff tendinopathy. For chronic Achilles tendinopathy (symptoms lasting longer than six weeks), an intense eccentric strengthening program of the gastrocnemius/ soleus complex improved pain and function between 60 and 90 percent in randomized trials. Evidence also supports eccentric exercise as a first-line option for chronic patellar tendon injuries. Other modalities such as prolotherapy, topical nitroglycerin, iontophoresis, phonophoresis, therapeutic ultrasound, extracorporeal shock wave therapy, and low-level laser therapy have less evidence of effectiveness but are reasonable second-line alternatives to surgery for patients who have persistent pain despite appropriate rehabilitative exercise.
Am Fam Physician 2013 Apr 1 87(7) 486-90
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[Physical therapy for scars].
Masanovic MG
Centre hospitalier Felix Guyon, Saint-Denis, La Reunion. marguerite.masanovic@chu-reunion.fr
Physical therapy consists notably of hand or mechanical massages, pressure therapy using various fabrics or splints, cryotherapy, laser therapy, etc. It forms part of the range of therapies used to treat pathological scars, including medical and surgical treatment. While the results are often satisfactory for hypertrophic scars, they remain uncertain for major keloids.
Soins 2013 Jan-Feb (772) 41-3
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[Molecular-cellular mechanisms of light radiation and weak magnetic fields on the blood status and microcirculation system (at therapeutic doses) with using modern magnetolaser equipment (review of the literature)].
Fedorov SN, Zalesskii VN
This review covers the molecular-cellular mechanisms of therapeutic action of light and magnetic field on blood components, blood vessels and the microcirculation system. Noted the role of the magnetic field as a trigger of vasodilation/vasoconstriction, depending on the initial vascular tone. Discussed the importance of NO-dependent effects of magnetic field on the microcirculatory response and angiogenesis.
Lik Sprava 2012 Jul-Sep (5) 3-14
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Therapeutic ultrasound for carpal tunnel syndrome.
Page MJ, O’Connor D, Pitt V, Massy-Westropp N
School of Public Health& PreventiveMedicine,Monash University,Melbourne, Australia. matthew.page@monash.edu.
BACKGROUND: Therapeutic ultrasound may be offered to people experiencing mild to moderate symptoms of carpal tunnel syndrome (CTS). The effectiveness and duration of benefit of this non-surgical intervention remain unclear. OBJECTIVES: To review the effects of therapeutic ultrasound compared with no treatment, placebo or another non-surgical intervention in people with CTS. SEARCH METHODS: On 27 November 2012, we searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL (2012, Issue 11 in The Cochrane Library), MEDLINE (January 1966 to November 2012), EMBASE (January 1980 to November 2012), CINAHL Plus (January 1937 to November 2012), and AMED (January 1985 to November 2012). SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing any regimen of therapeutic ultrasound with no treatment, a placebo or another non-surgical intervention in people with CTS. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials for inclusion, extracted data and assessed the risk of bias in the included studies. We calculated risk ratio (RR) and mean difference (MD) with 95% confidence intervals (CIs) for primary and secondary outcomes. We pooled results of clinically homogenous trials in a meta-analysis using a random-effects model, where possible, to provide estimates of the effect. MAIN RESULTS: We included 11 studies including 414 participants in the review. Two trials compared therapeutic ultrasound with placebo, two compared one ultrasound regimen with another, two compared ultrasound with another non-surgical intervention, and six compared ultrasound as part of a multi-component intervention with another non-surgical intervention (for example, exercises and splint). The risk of bias was low in some studies and unclear or high in other studies, with only two reporting that the allocation sequence was concealed and six reporting that participants were blinded. Overall, there is insufficient evidence that one therapeutic ultrasound regimen is more efficacious than another. Only two studies reported the primary outcome of interest, short-term overall improvement (any measure in which patients indicate the intensity of their complaints compared with baseline, for example, global rating of improvement, satisfaction with treatment, within three months post-treatment). One low quality trial with 68 participants found that when compared with placebo, therapeutic ultrasound may increase the chance of experiencing short-term overall improvement at the end of seven weeks treatment (RR 2.36; 95% CI 1.40 to 3.98), although losses to follow-up and failure to adjust for the correlation between wrists in participants with bilateral CTS in this study suggest that this data should be interpreted with caution. Another low quality trial with 60 participants found that at three months post-treatment therapeutic ultrasound plus splint increased the chance of short-term overall improvement (patient satisfaction) when compared with splint alone (RR 3.02; 95% CI 1.36 to 6.72), but decreased the chance of short-term overall improvement when compared with low-level laser therapy plus splint (RR 0.87; 95% CI 0.57 to 1.33), though participants were not blinded to treatment, it was unclear if the random allocation sequence was adequately concealed, and there was a potential unit of analysis error. Differences between groups receiving different frequencies and intensities of ultrasound, and between ultrasound as part of a multi-component intervention versus other non-surgical interventions, were generally small and not statistically significant for symptoms, function, and neurophysiologic parameters. No studies reported any adverse effects of therapeutic ultrasound, but this outcome was only measured in three studies. More adverse effects data are required before any firm conclusions on the safety of therapeutic ultrasound can be made. AUTHORS’ CONCLUSIONS: There is only poor quality evidence from very limited data to suggest that therapeutic ultrasound may be more effective than placebo for either short- or long-term symptom improvement in people with CTS. There is insufficient evidence to support the greater benefit of one type of therapeutic ultrasound regimen over another or to support the use of therapeutic ultrasound as a treatment with greater efficacy compared to other non-surgical interventions for CTS, such as splinting, exercises, and oral drugs. More methodologically rigorous studies are needed to determine the effectiveness and safety of therapeutic ultrasound for CTS.
Cochrane Database Syst Rev 2013 3 CD009601
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In regard to de Lima et al.
Olson RA
To the Editor: The Brazilian investigators should be applauded for pursuing a randomized, double-blind controlled trial, seeking to determine whether low-level laser (LLL) therapy can effectively reduce oral mucositis in head-and-neck cancer patients under- going concurrent chemoradiation therapy (1). This is certainly an important topic that affects many patients. To date, there have been limited gains in effective preventive treatments for oral mucositis (2, 3). However, several limitations in the study meth- odology severely hinder the ability to assess whether the inter- vention is effective or not. First, the study by de Lima et al (1) was only powered to detect a 30% difference in oral mucositis risk, which left the study unable to detect a more modest yet still clinically meaningful difference. Second, the method used to analyze the primary outcomes reduced the power to detect a significant difference; by performing comparisons of oral mucositis rates at multiple time points, the investigators had to adjust for the multiple pairwise comparisons performed and thereby reduced the likelihood of identifying a significant difference in oral mucositis rates. The investigators would have had a higher chance of finding a signifi- cant difference by comparing oral mucositis rates aggregated across the multiple time points in a single analysis. Third, the heterogeneous study population, including patients who did not receive oral cavity radiation therapy, potentially diluted any benefit from LLL in preventing oral mucositis from oral cavity radiation therapy. If the investigators had powered the study to detect a more conservative difference in oral mucositis and only accrued patients who had their oral cavity in the high-dose radiation therapy volume, then potentially a meaningful difference in the primary outcome would have been detected. Alternatively, a negative study under these conditions would have better allowed readers to conclude that LLL is unlikely to be of benefit to patients, directing the clinical and research community to turn to other potential strategies. Unfortunately, this current study assessing whether LLL can prevent oral mucositis in head-and-neck cancer patients receiving concurrent chemoradiotherapy does not adequately allow us to accept or reject the null hypothesis.
Int J Radiat Oncol Biol Phys 2013 Mar 15 85(4) 895
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In reply to Olson.
de Castro G Jr, Snitcovsky IM
To the Editor: We thank Dr Olson for the interest in our publication (1, 2). As mentioned, the effect of measures to prevent chemoradiation-induced oral mucositis (OM) is limited. When designing the study, we estimated a 30% decrease in the incidence of grade 3 to 4 OM (80%inthecontrolarm vs 50%in the experimental arm), judged as clinically meaningful, considering that the real impact of low-level laser (LLL) therapy in this scenario was unknown. Another important aspect is related to the time points at which grades 3 to 4 OM are diagnosed during radiation therapy, leading to more frequent treatment interruptions as early as they appear, which is the reason why we decided to perform comparisons of OM rates at different time points in our study. Respectfully, we partially agree with the possibility of diluting LLL therapy benefits due to the inclusion of patients with primary tumors located neither in the oral cavity nor the oropharynx in our study. In daily practice, OM is also detected when delivering concurrent chemoradiation in patients whose disease is diagnosed with primary tumors located in larynx or nasopharynx, as examples. Finally, because we did observe significantly fewer unplanned treatment breaks in those patients treated with LLL, a marginal benefit could not be excluded in terms of reduced rates of grades 3 to 4 OM. Recently reported studies by Gautam et al (3) and Antunes et al (4) were positive in terms of reducing severe OM and associated pain in patients undergoing chemoradiation, receiving LLL prophylaxis with higher energy density (3.5-4.0 J/cm2). Standardization of LLL parameters (wavelength and power) is necessary.
Int J Radiat Oncol Biol Phys 2013 Mar 15 85(4) 895-6
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Healing of normal and osteopenic bone with titanium implant and low-level laser therapy (GaAlAs): a histomorphometric study in rats.
de Vasconcellos LM, Barbara MA, Deco CP, Junqueira JC, do Prado RF, Anbinder AL, de Vasconcellos LG, Cairo CA, Carvalho YR
Department of Bioscience and Oral Diagnosis, Sao Jose dos Campos School of Dentistry, State University of Sao Paulo (UNESP), Av. Engenheiro Francisco Jose Longo, 777, Sao Jose dos Campos, 12245-000, Sao Paulo, Brazil.
The study investigates the influence of low-level laser therapy (LLLT) on bone healing in the femur of osteopenic and normal rats with titanium implants. Ovariectomy and control group were randomly submitted to LLLT, which was applied by gallium-aluminum-arsenium (GaAlAs) laser at the surgical site before and after placing the implant, for seven times. Histomorphometric and statistical analysis were performed. Most irradiated groups showed higher values than the nonirradiated groups. The GaAlAs infrared diode laser may improve the osseointegration process in osteopenic and normal bone, particularly based on its effects in the initial phase of bone formation.
Lasers Med Sci 2013 Apr 28
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Effect of red and near-infrared wavelengths on low-level laser (light) therapy-induced healing of partial-thickness dermal abrasion in mice.
Gupta A, Dai T, Hamblin MR
BAR414, Wellman Center for Photomedicine, Massachusetts General Hospital, 40 Blossom Street, Boston, MA, 02114, USA.
Low-level laser (light) therapy (LLLT) promotes wound healing, reduces pain and inflammation, and prevents tissue death. Studies have explored the effects of various radiant exposures on the effect of LLLT; however, studies of wavelength dependency in in vivo models are less common. In the present study, the healing effects of LLLT mediated by different wavelengths of light in the red and near-infrared (NIR) wavelength regions (635, 730, 810, and 980 nm) delivered at constant fluence (4 J/cm2) and fluence rate (10 mW/cm2) were evaluated in a mouse model of partial-thickness dermal abrasion. Wavelengths of 635 and 810 nm were found to be effective in promoting the healing of dermal abrasions. However, treatment using 730- and 980-nm wavelengths showed no sign of stimulated healing. Healing was maximally augmented in mice treated with an 810-nm wavelength, as evidenced by significant wound area reduction (p < 0.05), enhanced collagen accumulation, and complete re-epithelialization as compared to other wavelengths and non-illuminated controls. Significant acceleration of re-epithelialization and cellular proliferation revealed by immunofluorescence staining for cytokeratin-14 and proliferating cell nuclear antigen (p < 0.05) was evident in the 810-nm wavelength compared with other groups. Photobiomodulation mediated by red (635 nm) and NIR (810 nm) light suggests that the biological response of the wound tissue depends on the wavelength employed. The effectiveness of 810-nm wavelength agrees with previous publications and, together with the partial effectiveness of 635 nm and the ineffectiveness of 730 and 980 nm wavelengths, can be explained by the absorption spectrum of cytochrome c oxidase, the candidate mitochondrial chromophore in LLLT.
Lasers Med Sci 2013 Apr 26
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Trans-canal laser irradiation reduces tinnitus perception of salicylate treated rat.
Park YM, Na WS, Park IY, Suh MW, Rhee CK, Chung PS, Jung JY
Department of ORL-HNS, College of Medicine, Dankook University, Cheonan, Republic of Korea.
The aim of this study was to find out the effect of low-level laser therapy (LLLT) on salicylate-induced tinnitus in the rat model. Fourteen Sprague-Dawley rats (8 weeks; 240-280gm) were divided into 2 groups (study group, control group). Rats of both groups were treated with 400mg/kg/day of sodium salicylate for 8 consecutive days. Tinnitus was monitored using GPIAS (Gap Prepulse Inhibition of Acoustic Startle) 2h after first salicylate treatment, and every 24h during 9 days of treatment. Rats in laser group were irradiated to each ear with wavelength of 830nm diode laser (165mW/cm2) for 30min daily for 8 days. During salicylate treatment, rats of study group irradiated with low level laser showed significantly higher GPIAS values throughout the experiment. Therapeutic effect of LLLT is demonstrated in animal tinnitus model by means of GPIAS. Further experimental studies are needed to find possible mechanisms and better methods to improve LLLT efficacy.
Neurosci Lett 2013 Apr 11
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Low-intensity far-red light inhibits early lesions that contribute to diabetic retinopathy: in vivo and in vitro.
Tang J, Du Y, Lee CA, Talahalli R, Eells JT, Kern TS
Case Western Reserve University, Cleveland, OH, United States.
Purpose. Treatment with light in the far-red to near-infrared region of the spectrum (photobiomodulation [PBM]) has beneficial effects in tissue injury. We investigated the therapeutic efficacy of 670 nm PBM in rodent and cultured cell models of diabetic retinopathy. Methods. Studies were conducted in streptozotocin-induced diabetic rats and in cultured retinal cells. Diabetes-induced retinal degeneration was assessed functionally, biochemically and histologically in vivo and in vitro. Results. We observed beneficial effects of PBM on the neural and vascular elements of retina. Daily 670 nm PBM treatment (6 J/cm2) resulted in significant inhibition in the diabetes-induced death of retinal ganglion cells, as well as, a 50% improvement of the ERG amplitude (photopic b wave responses) (both p<0.01). To explore the mechanism for these beneficial effects, we examined physiologic and molecular changes related cell survival, oxidative stress and inflammation. PBM did not alter cytochrome oxidase activity in the retina or in cultured retinal cells. PBM inhibited diabetes-induced superoxide production and preserved MnSOD expression in vivo. Diabetes significantly increased both leukostasis and expression of ICAM-1, and PBM essentially prevented both of these abnormalities. In cultured retinal cells, 30mM glucose exposure increased superoxide production, inflammatory biomarker expression and cell death. PBM inhibited all of these abnormalities. Conclusions. PBM ameliorated diabetic retinopathy in vivo and reduced oxidative stress and cell death in vitro. PBM has been documented to have minimal risk. PBM is noninvasive, inexpensive, and easy to administer. We conclude that PBM is a simple adjunct therapy to attenuate the development of diabetic retinopathy.
Invest Ophthalmol Vis Sci 2013 Apr 4
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Low-level laser therapy can produce increased aggressiveness of dysplastic and oral cancer cell lines by modulation of Akt/mTOR signaling pathway.
Sperandio FF, Giudice FS, Correa L, Pinto DS Jr, Hamblin MR, de Sousa SC
Department of Oral Pathology, School of Dentistry, University of Sao Paulo, 2227 Prof. Lineu Prestes Av., Cidade Universitaria, S approximately ao Paulo, SP Brazil 05508-000, Brazil; The Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA; Department of Dermatology, Harvard Medical School, Boston, MA, USA. sperandio@usp.br.
Low-level laser therapy (LLLT) is a non-thermal phototherapy used in several medical applications, including wound healing, reduction of pain and amelioration of oral mucositis. Nevertheless, the effects of LLLT upon cancer or dysplastic cells have been so far poorly studied. Head and neck cancer patients receiving LLLT for oral mucositis, for example, might have remaining tumor cells that could be stimulated by LLLT. This study demonstrated that LLLT (GaAlAs – 660 nm or 780 nm, 40 mW, 2.05, 3.07 or 6.15 J/cm2 ) can modify oral dysplastic cells (DOK) and oral cancer cells (SCC9 and SCC25) growth by modulating the Akt/mTOR/CyclinD1 signaling pathway; LLLT significantly modified the expression of proteins related to progression and invasion in all the cell lines, and could aggravate oral cancer cellular behavior, increasing the expression of pAkt, pS6 and Cyclin D1 proteins and producing an aggressive Hsp90 isoform. Apoptosis was detected for SCC25 and was related to pAkt levels. ((c) 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim).
J Biophotonics 2013 Apr 2
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808 nm Wavelength Light Induces a Dose-Dependent Alteration in Microglial Polarization and Resultant Microglial Induced Neurite Growth.
von Leden RE, Cooney SJ, Ferrara TM, Zhao Y, Dalgard CL, Anders JJ, Byrnes KR
Department of Anatomy, Physiology and Genetics, Uniformed Services University of the Health Sciences, Jones Bridge Road, Bethesda, Maryland, 20814.
BACKGROUND AND OBJECTIVE: Despite the success of using photobiomodulation (PBM), also known as low level light therapy, in promoting recovery after central nervous system (CNS) injury, the effect of PBM on microglia, the primary mediators of immune and inflammatory response in the CNS, remains unclear. Microglia exhibit a spectrum of responses to injury, with partial or full polarization into pro- and anti-inflammatory phenotypes. Pro-inflammatory (M1 or classically activated) microglia contribute to chronic inflammation and neuronal toxicity, while anti-inflammatory (M2 or alternatively activated) microglia play a role in wound healing and tissue repair; microglia can fall anywhere along this spectrum in response to stimulation. MATERIALS AND METHODS: The effect of PBM on microglial polarization therefore was investigated using colorimetric assays, immunocytochemistry, proteomic profiling and RT-PCR in vitro after exposure of primary microglia or BV2 microglial cell line to PBM of differing energy densities (0.2, 4, 10, and 30 J/cm(2) , 808 nm wavelength, 50 mW output power). RESULTS: PBM has a dose-dependent effect on the spectrum of microglial M1 and M2 polarization. Specifically, PBM with energy densities between 4 and 30 J/cm(2) induced expression of M1 markers in microglia. Markers of the M2 phenotype, including CD206 and TIMP1, were observed at lower energy densities of 0.2-10 J/cm(2) . In addition, co-culture of PBM or control-treated microglia with primary neuronal cultures demonstrated a dose-dependent effect of PBM on microglial-induced neuronal growth and neurite extension. CONCLUSION: These data suggest that the Arndt-Schulz law as applied to PBM for a specific bioassay does not hold true in cells with a spectrum of responses, and that PBM can alter microglial phenotype across this spectrum in a dose-dependent manner. These data are therefore of important relevance to not only therapies in the CNS but also to understanding of PBM effects and mechanisms. Lasers Surg. Med. (c) 2013 Wiley Periodicals, Inc.
Lasers Surg Med 2013 Apr 45(4) 253-63
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Potential anti-inflammatory effect of low-level laser therapy on the experimental reflux laryngitis: a preliminary study.
Marinho RR, Matos RM, Santos JS, Ribeiro MA, Ribeiro RA, Lima RC Jr, Albuquerque RL Jr, Thomazzi SM
Departamento de Fisiologia, Universidade Federal de Sergipe (UFS), 49100-000, Sao Cristovao, Sergipe, Brazil.
The most common cause of laryngitis is the laryngopharyngeal reflux disease. The symptoms of laryngitis can be hoarseness, globus, chronic cough, voice fatigue, throat pain, and dysphagia. Low-level laser therapy (LLLT) is beneficial to reduce the pain and inflammatory response without side effects. Therefore, LLLT may be a useful tool for the treatment of laryngitis. This study proposes to analyze the effect of laser therapy in a model of reflux-induced laryngitis. The animals were randomly put into three groups: control-non-intubated; nasogastric intubation-intubated; and nasogastric intubation with laser therapy-intubated treated with 105-J/cm2 laser irradiation. For the induction of laryngitis, the animals were anesthetized and a nasogastric tube was inserted through the nasopharynx until it reached the stomach, for 1 week. Thereafter, measurement of myeloperoxidase activity and the histopathological procedures were performed. In conclusion, we observed in this study that 105-J/cm2 infrared laser reduced the influx of neutrophils in rats, and it improved the reparative collagenization of the laryngeal tissues.
Lasers Med Sci 2013 Apr 24
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Histomorphometrical and radiological comparison of low-level laser therapy effects on distraction osteogenesis: experimental study.
Kan B, Tasar F, Korkusuz P, Ersoy O, Cetinkaya A, Gur CZ, Celik H, Meral G
Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Kocaeli University, Yuvacik Campus P.C, 41900, Basiskele, Kocaeli, Turkey, bahadirkan@gmail.com.
Distraction osteogenesis (DO) is the application of traction to the callus formed between bone segments and stimulation of bone formation by creating stress on the callus with this traction. Shorten the duration of DO and increasing the capacity of bone formation is important to prevent the possible complications of DO. For this reason, it was considered that low-level laser therapy (LLLT) may affect positively DO and it can decrease the complication range by shortening the period. Unilateral mandibular distractors were applied on 16 female white New Zealand rabbit to prove this hypothesis with micro CT, plain radiograph and histomorphometric analyses. Eight rabbits were applied LLLT with GaAlAs laser on the distraction area during the distraction period. On the post-distraction 28th day, four rabbits from study group and four rabbits from control groups were sacrificed. The rest of the rabbits were sacrificed on post-distraction 56th day. As a result of this study, significant positive effects of LLLT on post-distraction 28th day were revealed with all analyses. In histomorphometrical analyses, new bone formation was significantly higher in short-term laser applied group comparing to that of short-term control group (p = 0.029). In both microCT and plain radiograph, the highest radioopacity values were observed in short-term laser group when compared with that of the controls (p = 0.043 and p = 0.025, respectively). Even though LLLT increased the healing capacity on short-term, it was not sufficient on long-term (post-distraction 56th day) healing. LLLT application on distraction period, activate healing on bone so it may decrease DO period. The result of this study should be supported with clinical studies and the most effective laser source, dose and application time should be revealed with experimental and clinical studies.
Lasers Med Sci 2013 Apr 19
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Inhibition of Fibroblast Proliferation In Vitro Using Red Light-Emitting Diodes.
Lev-Tov H, Mamalis A, Brody N, Siegel D, Jagdeo J
Dermatology Service, Sacramento Veteran Affairs Medical Center, Mather, California; Department of Dermatology, University of California Davis, Sacramento, California.
BACKGROUND: Red light is part of the visible light spectrum. The effects of light-emitting diode (LED)-generated red light on human skin are not well-characterized. OBJECTIVE: To study the effect of red LED-generated low-level light therapy (LLLT) on fibroblast proliferation and viability in vitro. METHODS AND MATERIALS: Irradiation of normal human skin fibroblasts using red LED panels was performed in vitro, and modulation of proliferation and viability was quantified using trypan blue dye exclusion assay. RESULTS: Statistically significant decreases in cell proliferation were noted at the following fluences (time): 160 J/cm2 (30 minutes, 34 seconds), 320 J/cm2 (61 minutes, 07 seconds) and 640 J/cm2 (122 minutes, 14 seconds) (Figure 1). Irradiation at the 160- (98.5 +/- 1.2%) and 320-J/cm2 (98.0 +/- 3.1%) doses did not significantly alter viability. CONCLUSION: At certain fluences, red LLLT can effectively inhibit fibroblast proliferation in vitro without altering viability and holds promise for the treatment of scars and other proliferative skin diseases.
Dermatol Surg 2013 Apr 16
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Influence of Low-power Laser Illumination on Pro-inflammatory Response in Human Endothelial Cells Stimulated with Interleukin-1a.
Protasiewicz M, Kuliczkowski W, Woznicka AK, Szymkiewicz P, Derkacz A, Andrzej M, Dziegiel P
Cardiology Department, Medical University of Wroclaw, Wroclaw ul.Borowska 213, 50-556 Wroclaw, Poland. mprot@poczta.onet.pl.
BACKGROUND: Regarding recent findings on the proven influence of laser light on healing and endothelial regeneration processes, this study was conducted in order to examine the influence of low-power laser illumination on the endothelial inflammatory response. MATERIALS AND METHODS: Human umbilical vein endothelial cells (HUVECs) isolated from umbilical cord, cultured in standard conditions, were harvested and passaged in 24-well plates. Laser influence on HUVEC inflammatory response was measured by stimulating them with Interleukin-1beta (IL-1beta) followed by laser light illumination. A 808-nm wave length laser diode and light energy doses of 1.5 and 4.5 J/cm(2) were used (50 mW for 90 and 270 s respectively). The response was measured by assessing Cluster of differentiation 54 (CD54), Cluster of differentiation 62E (CD62E), Monocyte chemotactic protein-1 (MCP-1) expression and von Willebrand factor (vWF) release, at 6 and 24 h after stimulation. The MCP-1 and vWF activity in cell supernatants was measured with an enzyme-linked immunosorbent assay (ELISA) kit. Cytofluorometry was used to assess CD54 and CD62E expression. RESULTS: MCP-1 concentration in supernatants from HUVECs was significantly lower 6 h after 4.5 J/cm(2) stimulation compared to IL-1beta-stimulated cells. No changes in MCP-1 levels after IL-1beta stimulation plus 1.5 J/cm(2) illumination, compared to IL-1beta stimulated HUVECs were noted. IL-1beta stimulation significantly enhanced the concentration of vWF and the expression of CD54 and CD62E. Both energies of laser light illumination inhibited the IL-1beta-induced increase of CD54 and CD62E concentration. vWF activity after illumination was comparable to that of unstimulated cells. There were no significant differences in the viable cell count between the groups tested. CONCLUSION: Low-power laser illumination diminishes the pro-inflammatory and pro-coagulant activity of IL-1beta-stimulated HUVECs.
In Vivo 2013 May-Jun 27(3) 313-9
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Digital photogrammetry and histomorphometric assessment of the effect of non-coherent light (light-emitting diode) therapy (lambda640 +/- 20 nm) on the repair of third-degree burns in rats.
Neves SM, Nicolau RA, Filho AL, Mendes LM, Veloso AM
Faculdade Integral Diferencial-FACID, Rua Veterinario Bugyja Brito, 1354-Bairro Horto Florestal, 64052-410, Teresina, Piaui, Brazil, silvanafisio7@yahoo.com.br.
Recent studies have demonstrated the efficacy of coherent light therapy from the red region of the electromagnetic spectrum on the tissue-healing process. This study analysed the effect of non-coherent light therapy (light-emitting diode-LED) with or without silver sulfadiazine (sulpha) on the healing process of third-degree burns. In this study, 72 rats with third-degree burns were randomly divided into six groups (n = 12): Gr1 (control), Gr2 (non-contact LED), Gr3 (contact LED), Gr4 (sulfadiazine), Gr5 (sulfadiazine + non-contact LED) and Gr6 (sulfadiazine + contact LED). The groups treated with LED therapy received treatment every 48 h (lambda = 640 +/- 20 nm, 110 mW, 16 J/cm2; 41 s with contact and 680 s without contact). The digital photometric and histomorphometric analyses were conducted after the burn occurred. The combination of sulpha and LED (contact or non-contact) improved the healing of burn wounds. These results demonstrate that the combination of silver sulfadiazine with LED therapy (lambda = 640 +/- 20 nm, 4 J/cm2, without contact) improves healing of third-degree burn wounds, significantly reduces the lesion area and increases the granulation tissue, increases the number of fibroblasts, promotes collagen synthesis and prevents burn infections by accelerating recovery.
Lasers Med Sci 2013 Apr 13
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Effect of Low-Level Laser Therapy (LLLT) on Acute Neural Recovery and Inflammation-Related Gene Expression After Crush Injury in Rat Sciatic Nerve.
Alcantara CC, Gigo-Benato D, Salvini TF, Oliveira AL, Anders JJ, Russo TL
Laboratory of Neurological Physiotherapy Research, Physical Therapy, Department, Federal University of Sao Carlos (UFSCar), Sao Carlos, 13565-905, SP, Brazil.
BACKGROUND AND OBJECTIVES: Peripheral nerve function can be debilitated by different kinds of injury. Low-level laser therapy (LLLT) has been used successfully during rehabilitation to stimulate recovery. The aim of this study was to evaluate the effects of LLLT (660 nm, 60 J/cm(2) , 40 mW/cm(2) ) on acute sciatic nerve injury. MATERIALS AND METHODS: Thirty Wistar male rats were divided into three groups: (1) Normal, intact nerves; (2) I3d, crushed nerves evaluated on Day-3 post-injury; (3) I + L3d, crushed nerves submitted to two sessions of LLLT and investigated at 3 days post-injury. Sciatic nerves were removed and processed for gene expression analysis (real-time PCR) of the pro-inflammatory factors TWEAK, Fn14 and TNF-alpha and extracellular matrix remodeling and axonal growth markers, such as TIMP-1, MMP-2, and MMP-9. Zymography was used to determine levels of MMP-2 and MMP-9 activity and Western blotting was used to evaluate TNF-alpha protein content. Shapiro-Wilk and Levene’s tests were applied to evaluate data normality and homogeneity, respectively. One-way ANOVA followed by Tukey test was used for statistical analysis with a significance level set at 5%. RESULTS: An increase in TNF-alpha protein level was found in I + L3 compared to Normal and I3d (P < 0.05). Zymography showed an increase in proMMP-9 activity, in both I3d and I + L3d groups (P < 0.05). The increase was more evident in I + L3d (P = 0.02 compared to I3d). Active-MMP-9 isoform activity was increased in I + L3d compared to Normal and I3d groups (P < 0.05). Furthermore, the activity of active-MMP-2 isoform was increased in I3d and I + L3 (P < 0.05). An increase in TIMP-1 expression was observed in both I3d and I + L3d groups (P < 0.05). CONCLUSIONS: The current study showed that LLLT increased MMPs activity, mainly MMP-9, and TNF-alpha protein level during the acute phase of nerve injury, modulating inflammation. Based on these results, it is recommended that LLLT should be started as soon as possible after peripheral nerve injury. Lasers Surg. Med. 9999:XX-XX, 2013. (c) 2013 Wiley Periodicals, Inc.
Lasers Surg Med 2013 Apr 45(4) 246-52
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Effect and Clinical Implications of the Low-Energy Diode Laser on Bone Cell Proliferation.
Huertas RM, Luna-Bertos ED, Ramos-Torrecillas J, Leyva FM, Ruiz C, Garcia-Martinez O
Biomedical Group (BIO277), Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain.
Laser is a simple, noninvasive technique that has proven useful for treating damaged tissue. However, its effects on bone regeneration and the mechanisms involved are poorly understood. The objective of this study was to evaluate the effects on MG-63 cell proliferation of application of a pulsed diode laser (Ezlase) of 940 nm at low energy levels. After 24 hr of culture, osteoblasts underwent pulsed laser radiation at 0.5, 1, 1.5, and 2 W and fluences of 1-5 J. A control group was not irradiated. After the treatment, cells were incubated for 24 hr, and cell proliferation was analyzed using a spectrophotometric measure of cell respiration (MTT assay). Results were expressed as percentage proliferation versus controls. At 24-hr culture, cell proliferation was increased in laser-treated cells at intensities of 0.5, 1, and 1.5 W/cm2 versus controls; the energy density was positively correlated with cell growth, which reached a peak at 3 J and decreased at higher fluences. The use of pulsed low-level laser with low-energy density range thus appears to exert a biostimulatory effect on bone tissue. Although the data on cell proliferation are robust, in-depth investigation is required into the effect of these irradiation doses on other cell parameters. The present findings demonstrate that laser therapy could be highly useful in tissue regeneration in different clinical settings, including nursing, physical therapy, dentistry, and traumatology.
Biol Res Nurs 2013 Apr 4
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