THOR LLLT research, training and conference news September 2013

26 papers for you this month starting with a phase III trial of LLLT to prevent oral mucositis in 94 head and neck cancer patients receiving chemoradiation therapy, a controlled clinical trial on 64 diabetic leg ulcers with THOR LED cluster, a clinical trial on 60 patients with diabetic polyneuropathy, a muscle fatigue study, a rat study on acute joint inflammation which confirms that low irradiance (power density) is better than high (as usual) and that the target is the synovia (not the joint) and, finally, a pointless study on hearing loss with a 635nm laser. They used a green 532nm and a red 635nm laser each 7.5mW, applied to the ear, head, and neck for a total of 5 mins. I’m not sure why anyone would think that was going to work!

Phase III trial of low-level laser therapy to prevent oral mucositis in head and neck cancer patients treated with concurrent chemoradiation.

Antunes HS, Herchenhorn D, Small IA, Araujo CM, Viegas CM, Cabral E, Rampini MP, Rodrigues PC, Silva TG, Ferreira EM, Dias FL, Ferreira CG

Coordination of Clinical Research, Instituto Nacional de Cancer (INCA), Rio de Janeiro, Brazil. Electronic address: hspindola@inca.gov.br.

BACKGROUND: Oral mucositis (OM) is a complication of chemoradiotherapy treatment of head and neck squamous cell carcinoma (HNSCC) patients with no effective therapy. This study was designed to assess the efficacy of preventive low-level laser therapy (LLLT) in reducing the incidence of grade 3-4 OM. MATERIAL AND METHODS: From June 2007 to December 2010, 94 HNSCC patients entered a prospective, randomized, double-blind, placebo-controlled phase III trial. Chemoradiotherapy consisted of conventional radiotherapy plus concurrent cisplatin every 3weeks. A diode InGaAlP (660nm-100mW-1J-4J/cm2) was used. OM evaluation was performed by WHO and OMAS scales and quality of life by EORTC questionnaires (QLQ). RESULTS: A six-fold decrease in the incidence of grades 3-4 OM was detected in the LLLT group compared to the placebo; (6.4% versus 40.5%). LLLT impacted the incidence of grades 3-4 OM to a relative risk ratio of 0.158 (CI 95% 0.050-0.498). After treatment QLQ-C30 showed, differences favoring LLLT in physical, emotional functioning, fatigue, and pain; while the QLQ-H&N35 showed improvements in LLLT arm for pain, swallowing, and trouble with social eating. CONCLUSION: Preventive LLLT in HNSCC patients receiving chemoradiotherapy is an effective tool for reducing the incidence of grade 3-4 OM. Efficacy data were corroborated by improvements seen in quality of life.

Radiother Oncol 2013 Sep 14

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24044799

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Efficacy of Low Level Laser Therapy on Wound Healing in Patients with Chronic Diabetic Foot Ulcers—A Randomised Control Trial

Basavaraj M. Kajagar Ashok S. Godhi Archit Pandit S. Khatri

Department of Surgery, Jawaharlal Nehru Medical College, Nehru Nagar, Belgaum 590 010 Karnataka, India

Abstract Foot ulcers are serious complications of Diabetes Mellitus (DM) and are known to be resistant to conventional treatment. They may herald severe complications if not treated wisely. Electromagnetic radiations in the form of photons are delivered to the ulcers in laser form to stimulate healing. This study was conducted to evaluate the efficacy of Low Level Laser Therapy (LLLT) in diabetic ulcer healing dynamics. To determine mean percentage reduction of wound area in study and control groups. Settings: KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum. Study Design: Randomized-Control Study. Methods: A total of 68 patients with Type 2 DM having Meggitt-Wagner Grade I foot ulcers of at least more than 4 weeks duration, less than 6×6 cm2 with negative culture were studied. Patients were randomized into two groups of 34 each. Patients in study group received LLLT with conventional therapy and those in control group were treated with conventional therapy alone. Healing or percentage reduction in ulcer area over a period of 15 days after commencement of treatment was recorded. Statistical Analysis: Unpaired Student T Test and Mann Whitney U test. Mean age of the patients was 50.94 years in control group and 54.35 years in study group (p 0 0.065). There was no significant difference between control and study group with respect to mean FBS and HbA1c levels (p > 0.05), suggesting no biochemical differences between two groups. Initial ulcer area was 2608.03 mm2 in study group and 2747.17 mm2 in control group (p 0 0.361). Final ulcer area was 1564.79 mm2 in study group and 2424.75 mm2 in control group (p 0 0.361). Percentage ulcer area reduction was 40.24 ± 6.30 mm2 in study group and 11.87 ± 4.28 mm2 in control group (p < 0.001, Z 0 7.08). Low Level Laser Therapy is beneficial as an adjunct to conventional therapy in the treatment of diabetic foot ulcers (DFU).

Indian J Surg. 2012 Oct;74(5):359-63. doi: 10.1007/s12262-011-0393-4.

http://www.ncbi.nlm.nih.gov/pubmed/?term=24082586

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Lower-level laser therapy improves neurosensory disorders resulting from bilateral mandibular sagittal split osteotomy: A randomized crossover clinical trial.

Gasperini G, de Siqueira IC, Costa LR

Department of Oral and Maxillofacial Surgery (Dr. Giovanni Gasperini, Ms), UFG Hospital, Primeira Avenida, s/n – Setor Universitario, 74605-020 Goiania, Goias, Brazil. Electronic address: gasperinibuco@gmail.com.

Bilateral sagittal split osteotomy (BSSO) is a technique commonly used to correct mandibular disproportion but many patients experience hypoaesthesia of the inferior alveolar nerve (IAN). The purpose of this study was to verify the effectiveness of using a low-level laser therapy protocol after BSSO. The 10 patients in our study, who underwent BSSO with Le Fort I osteotomy and had low-level laser therapy on one side of the jaw, were evaluated over a period of 60 days. The data for the treated and non-treated sides were compared post-operatively. At 15, 30 and 60 days after surgery, when sensitivity was recovered on both sides. On the treated side, recovery was faster and was almost complete at the time of the last evaluation. We suggest that this lower-level laser therapy protocol can improve tissue response and accelerate the recovery of neurosensory disorders following BSSO. (NCT01530100).

J Craniomaxillofac Surg 2013 Sep 3

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24011464

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Evaluation of low level laser therapy in reducing diabetic polyneuropathy related pain and sensorimotor disorders.

Bashiri H

Department of Internal Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran. hbashirimd@yahoo.com.

Over the past three decades physicians have used light level laser therapy (LLLT) for the management and the treatment of diabetic peripheral neuropathy and have obtained results that calls for further investigations. This study aimed to investigate the effectiveness of LLLT in treatment of pain symptoms in patients with diabetic polyneuropathy. In this study 60 patients with diabetic peripheral neuropathy were matched based on their sex, age, BMI, type of diabetes, duration of diabetes, and duration of pain, and randomized to case and control groups based on their established scores on the visual analog scale (VAS) and the Toronto clinical scoring system (TCSS). Cases received laser therapy with wavelength of 78 nm and 2.5 j/cm2 two times a week, each time for 5 min, for one month. During the same period, controls received sham laser therapy. Comparing the differences between the two groups’ VAS and TCSS mean scores before the intervention with that of the 2 weeks and 4 weeks after the intervention we were able to see a statistically significant difference between the two groups (P<0.05). On the other hand, when we compared their VAS and TCSS mean scores 4 weeks and 2 weeks after the intervention we did not find any statistically significant difference between the two groups. We achieved the same results when we examined cases’ and controls’ pre and post VAS and TCSS scores independent from each other; no improvement in the assessment based on their 2 and 4 weeks comparisons tests. Laser therapy resulted in improved neuropathy outcomes in diabetic patients who received it relative to the group that received sham therapy, evaluating before and after LLLT assessments. Further studies are needed to test types of lasers, as well as different dosage and exposure levels required in different phase of neuropathic care, so as to obtain reproducible results.

Acta Med Iran 2013 51(8) 543-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24026991

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The effect of low-level laser therapy on hearing.

Goodman SS, Bentler RA, Dittberner A, Mertes IB

Department of Communication Sciences & Disorders, The University of Iowa, Iowa City, IA 52242, USA.

One purported use of low-level laser therapy (LLLT) is to promote healing in damaged cells. The effects of LLLT on hearing loss and tinnitus have received some study, but results have been equivocal. The purpose of this study was to determine if LLLT improved hearing, speech understanding, and/or cochlear function in adults with hearing loss. Using a randomized, double-blind, placebo-controlled design, subjects were assigned to a treatment, placebo, or control group. The treatment group was given LLLT, which consisted of shining low-level lasers onto the outer ear, head, and neck. Each laser treatment lasted approximately five minutes. Three treatments were applied within the course of one week. A battery of auditory tests was administered immediately before the first treatment and immediately after the third treatment. The battery consisted of pure-tone audiometry, the Connected Speech Test, and transient-evoked otoacoustic emissions. Data were analyzed by comparing pre- and posttest results. No statistically significant differences were found between groups for any of the auditory tests. Additionally, no clinically significant differences were found in any individual subjects. This trial is registered with ClinicalTrials.gov (NCT01820416).

ISRN Otolaryngol 2013 2013 916370

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24024040

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Laser and light-based treatment of Keloids – a review.

Mamalis AD, Lev-Tov H, Nguyen DH, Jagdeo JR

Department of Dermatology, University of California Davis, Sacramento, CA, USA.

BACKGROUND: Keloids are an overgrowth of fibrotic tissue outside the original boundaries of an injury and occur secondary to defective wound healing. Keloids often have a functional, aesthetic, or psychosocial impact on patients as highlighted by quality-of-life studies. OBJECTIVES: Our goal is to provide clinicians and scientists an overview of the data available on laser and light-based therapies for treatment of keloids, and highlight emerging light-based therapeutic technologies and the evidence available to support their use. METHODS: We employed the following search strategy to identify the clinical evidence reported in the biomedical literature: in November 2012, we searched PubMed.gov, Ovid MEDLINE, Embase and Cochrane Reviews (1980-present) for published randomized clinical trials, clinical studies, case series and case reports related to the treatment of keloids. The search terms we utilized were ‘keloid(s)’ AND ‘laser’ OR ‘light-emitting diode’ (LED) OR ‘photodynamic therapy’ (PDT) OR ‘intense pulsed light’ OR ‘low level light’ OR ‘phototherapy.’ RESULTS: Our search yielded 347 unique articles. Of these, 33 articles met our inclusion and exclusion criteria. CONCLUSION: We qualitatively conclude that laser and light-based treatment modalities may achieve favourable patient outcomes. Clinical studies using CO2 laser are more prevalent in current literature and a combination regimen may be an adequate ablative approach. Adding light-based treatments, such as LED phototherapy or PDT, to laser treatment regimens may enhance patient outcomes. Lasers and other light-based technology have introduced new ways to manage keloids that may result in improved aesthetic and symptomatic outcomes and decreased keloid recurrence.

J Eur Acad Dermatol Venereol 2013 Aug 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24033440

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Effect of low-level laser therapy (808 nm) on markers of muscle damage: a randomized double-blind placebo-controlled trial.

Felismino AS, Costa EC, Aoki MS, Ferraresi C, de Araujo Moura Lemos TM, de Brito Vieira WH

Department of Physical Therapy, Federal University of Rio Grande do Norte/UFRN, Av. Senador Salgado Filho, 3000, Campus Universitario, Lagoa Nova, Natal, Rio Grande de Norte, 59072-970, Brazil.

The aim of this randomized double-blind placebo-controlled study was to investigate the effect of low-level laser therapy (LLLT) on markers of muscle damage (creatine kinase (CK) and strength performance) in the biceps brachii. Twenty-two physically active men were randomized into two groups: placebo and laser. All volunteers were submitted to an exercise-induced muscle damage protocol for biceps brachii (biceps curl, 10 sets of 10 repetitions with load of 50 % of one-repetition maximum test (1RM)). Active LLLT (808 nm; 100 mW; 35.7 W/cm2, 357.14 J/cm2 per point, energy of 1 J per point applied for 10 s on four points of the biceps brachii belly of each arm) or placebo was applied between the sets of the biceps curl exercise. CK activity and maximum strength performance (1RM) were measured before, immediately after, 24, 48, and 72 h after the exercise-induced muscle damage protocol. There was an increase in CK activity after the muscle damage protocol in both groups; however, this increase was attenuated in the laser group compared to the placebo group at 72 h (placebo = 841 vs. laser = 357 %; p < 0.05). Maximum strength performance was decreased immediately after the muscle damage protocol in both groups (p < 0.05), but at 24, 48, and 72 h, and it returned to the baseline level in both groups. In conclusion, the LLLT attenuated CK activity 72 h after the muscle damage protocol but did not have a positive effect on the recovery of strength performance.

Lasers Med Sci 2013 Sep 5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24005882

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Patterns of traditional chinese medicine diagnosis in thermal laser acupuncture treatment of knee osteoarthritis.

Wang L, Wu F, Zhao L, Zhang H, Shen X, Huang Y, Lao L

Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai 201203, China ; Center for Integrative Medicine, University of Maryland, School of Medicine, 520 West Lombard Street, East Hall, Baltimore, MD 21201, USA.

Knee osteoarthritis (OA) manifests with pain, joint stiffness, and limited function. In traditional Chinese medicine, knee OA is differentiated into three patterns: yang deficiency and cold coagulation, kidney deficiency, and blood stasis. The objective of this study was to determine whether yang deficiency cold coagulation patients respond better to thermal laser acupuncture treatment than do non-yang deficient patients. Fifty-two patients with OA were allocated to group A (yang deficient, n = 26) or B (non-yang deficient, n = 26). All patients received a 20-min thermal laser acupuncture treatment at acupoint Dubi (ST 35) three times a week for two weeks and twice a week for another four weeks. Outcome assessments were performed immediately after the first treatment, and at weeks 2, 6, and 10. Group A function scores were significantly better than those of Group B at weeks 2 (P = 0.049), 6 (P = 0.046), and 10 (P = 0.042), but no significant differences were found between the two groups in pain and stiffness scores at any time point. No significant adverse effect was observed. The combined 10.6 mu m-650 nm laser treatment might be most beneficial to yang deficiency cold coagulation knee OA patients, particularly in improving function.

Evid Based Complement Alternat Med 2013 2013 870305

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24069060

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Can biowarfare agents be defeated with light?

Vatansever F, Ferraresi C, de Sousa MV, Yin R, Rineh A, Sharma SK, Hamblin MR

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

Biological warfare and bioterrorism is an unpleasant fact of 21st century life. Highly infectious and profoundly virulent diseases may be caused in combat personnel or in civilian populations by the appropriate dissemination of viruses, bacteria, spores, fungi or toxins. Dissemination may be airborne, waterborne, or by contamination of food or surfaces. Countermeasures may be directed toward destroying or neutralizing the agents outside the body before infection has taken place, by destroying the agents once they have entered the body before the disease has fully developed, or by immunizing susceptible populations against the effects. A range of light-based technologies may have a role to play in biodefense countermeasures. Germicidal UV (UVC) is exceptionally active in destroying a wide range of viruses and microbial cells, and recent data suggests that UVC has high selectivity over host mammalian cells and tissues. Two UVA mediated approaches may also have roles to play; one where UVA is combined with titanium dioxide nanoparticles in a process called photocatalysis, and a second where UVA is combined with psoralens (PUVA) to produce “killed but metabolically active” microbial cells that may be particularly suitable for vaccines. Many microbial cells are surprisingly sensitive to blue light alone, and blue light can effectively destroy bacteria, fungi, and Bacillus spores and can treat wound infections. The combination of photosensitizing dyes such as porphyrins or phenothiaziniums and red light is called photodynamic therapy (PDT) or photoinactivation, and this approach cannot only kill bacteria, spores, and fungi, but also inactivate viruses and toxins. Many reports have highlighted the ability of PDT to treat infections and stimulate the host immune system. Finally pulsed (femtosecond) high power lasers have been used to inactivate pathogens with some degree of selectivity. We have pointed to some of the ways light-based technology may be used to defeat biological warfare in the future.

Virulence 2013 Sep 25 4(8)

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24067444

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Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring.

Avci P, Gupta A, Sadasivam M, Vecchio D, Pam Z, Pam N, Hamblin MR

Department of Dermatology, Harvard Medical School, BAR 414 Wellman, Center for Photomedicine, Massachusetts General Hospital, 40 Blossom Street, Boston, MA 02114, USA.

Low-level laser (light) therapy (LLLT) is a fast-growing technology used to treat a multitude of conditions that require stimulation of healing, relief of pain and inflammation, and restoration of function. Although skin is naturally exposed to light more than any other organ, it still responds well to red and near-infrared wavelengths. The photons are absorbed by mitochondrial chromophores in skin cells. Consequently, electron transport, adenosine triphosphate nitric oxide release, blood flow, reactive oxygen species increase, and diverse signaling pathways are activated. Stem cells can be activated, allowing increased tissue repair and healing. In dermatology, LLLT has beneficial effects on wrinkles, acne scars, hypertrophic scars, and healing of burns. LLLT can reduce UV damage both as a treatment and as a prophylactic measure. In pigmentary disorders such as vitiligo, LLLT can increase pigmentation by stimulating melanocyte proliferation and reduce depigmentation by inhibiting autoimmunity. Inflammatory diseases such as psoriasis and acne can also be managed. The noninvasive nature and almost complete absence of side effects encourage further testing in dermatology.

Semin Cutan Med Surg 2013 Mar 32(1) 41-52

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24049929

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Body contouring using 635-nm low level laser therapy.

Nestor MS, Newburger J, Zarraga MB

Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA. nestormd@admcorp.com

Noninvasive body contouring has become one of the fastest-growing areas of esthetic medicine. Many patients appear to prefer nonsurgical less-invasive procedures owing to the benefits of fewer side effects and shorter recovery times. Increasingly, 635-nm low-level laser therapy (LLLT) has been used in the treatment of a variety of medical conditions and has been shown to improve wound healing, reduce edema, and relieve acute pain. Within the past decade, LLLT has also emerged as a new modality for noninvasive body contouring. Research has shown that LLLT is effective in reducing overall body circumference measurements of specifically treated regions, including the hips, waist, thighs, and upper arms, with recent studies demonstrating the long-term effectiveness of results. The treatment is painless, and there appears to be no adverse events associated with LLLT. The mechanism of action of LLLT in body contouring is believed to stem from photoactivation of cytochrome c oxidase within hypertrophic adipocytes, which, in turn, affects intracellular secondary cascades, resulting in the formation of transitory pores within the adipocytes’ membrane. The secondary cascades involved may include, but are not limited to, activation of cytosolic lipase and nitric oxide. Newly formed pores release intracellular lipids, which are further metabolized. Future studies need to fully outline the cellular and systemic effects of LLLT as well as determine optimal treatment protocols.

Semin Cutan Med Surg 2013 Mar 32(1) 35-40

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24049928

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Laser therapy for onychomycosis.

Gupta AK, Simpson FC

Background:Laser therapy is a rapidly expanding new treatment modality for onychomycosis.Objective:To review current and prospective laser systems for the treatment of onychomycosis.Method:We searched the PubMed database, the Food and Drug Administration 510(k) database, ClinicalTrials.gov, and Google Scholar for in vitro studies, peer-reviewed clinical trials, manufacturers’ white papers, and registered clinical trials of laser systems indicated for the treatment of onychomycosis. All published clinical trials were assessed on a 20-point methodological quality scale.Results:We identified three basic science articles, five peer-reviewed articles, three white papers, and four pending clinical trials, as well as numerous gray literature documents. The overall methodological score for the clinical trials was 9.1 +/- 1.1, with peer-reviewed studies showing a higher score (9.8 +/- 1.5) than white papers (7.5 +/- 0.7). We also identified 11 commercial laser device systems of varying global availability.Conclusion:Laser therapy has been tested and approved as a cosmetic treatment only for onychomycosis. It cannot be recommended as a therapeutic intervention to eradicate fungal infection at this time as more rigorous randomized, controlled trials are required to determine if laser therapy is efficacious on par with oral and topical interventions.

J Cutan Med Surg 2013 Oct 1 17(5) 301-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24067848

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Effect of low-level laser irradiation on oxygen free radicals and ventricular remodeling in the infarcted rat heart.

Yang J, Huang Z, Zhou Y, Sai S, Zhu F, Lv R, Fa X

1 Department of Cardiovascular Surgery, the Second Affiliated Hospital of Zhengzhou University , Zhengzhou, People’s Republic of China .

Abstract Objective: The purpose of this study was to assess the effects of low-level laser irradiation (LLLI) on the expression of oxygen free radicals (OFR) and ventricular remodeling (VR) in the model of rat myocardial infarction (RMMI). Background data: LLLI reduces the infarct size and formation of scar tissue in the rat heart after myocardial infarction (MI). However, the exact mechanism has not been demonstrated so far. Methods: RMMI was induced by ligating the left anterior descending coronary artery (LAD). After 3 weeks, LLLI (635 nm, 6 mW laser, 7.64 mW/cm(2), 125 sec, 0.96 J/cm(2)) was applied to the surface of heart directly. Four to six rats were euthanized at 1 h, 24 h, 48 h, 72 h, and 1 week after LLLI, and the infarcted myocardia were excised for the measurement of the activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA). At the end of 4 weeks after MI, the hearts were harvested for histological analysis. Results: Myocardial SOD activity with LLLI was lower compared with control (p<0.05), and myocardial MDA content with LLLI was higher compared with control (p<0.05), at all the time points. In all rats, the activity of SOD was down to the minimum and the content of MDA was up to the peak at 48 h after laser irradiation. The infarct size was reduced (35+/-10% vs. 18+/-9%, p<0.05), the left ventricular wall thickness was increased (0.31+/-0.03 vs. 0.84+/-0.02 mm, p<0.05) and the percentage of collagen fibers in the infarcted area was attenuated (64.34+/-2.20% vs. 30.97+/-2.60%) by LLLI. Conclusions: LLLI could cause OFR accumulation, reduce infarct size, increase ventricular wall thickness, and attenuate the formation of collagen fibers, suggesting the beneficial effects of LLLI on improvement of VR after MI.

Photomed Laser Surg 2013 Sep 31(9) 447-52

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24047222

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Low-level laser therapy for spinal cord injury in rats: effects of polarization.

Ando T, Sato S, Kobayashi H, Nawashiro H, Ashida H, Hamblin MR, Obara M

Keio University, Department of Electronics and Electrical Engineering, 3-14-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa 223-8522, Japan.

ABSTRACT. The effects of laser polarization on the efficacy of near-infrared low-level laser therapy for spinal cord injury (SCI) are presented. Rat spinal cords were injured with a weight-drop device, and the lesion sites were directly irradiated with a linearly polarized 808-nm diode laser positioned either perpendicular or parallel to the spine immediately after the injury and daily for five consecutive days. Functional recovery was assessed daily by an open-field test. Regardless of the polarization direction, functional scores of SCI rats that were treated with the 808-nm laser irradiation were significantly higher than those of SCI alone group (Group 1) from day 5 after injury. The locomotive function of SCI rats irradiated parallel to the spinal column (Group 3) was significantly improved from day 10 after injury, compared to SCI rats treated with the linear polarization perpendicular to the spinal column (Group 2). There were no significant differences in ATP contents in the injured tissue among the three groups. We speculate that the higher efficacy with parallel irradiation is attributable to the deeper light penetration into tissue with anisotropic scattering.

J Biomed Opt 2013 Sep 1 18(9) 98002

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24030687

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Effect of Low Level Laser Therapy on the expression of inflammatory mediators and on neutrophils and macrophages in acute joint inflammation.

Alves AC, Vieira RP, Leal-Junior EC, Dos Santos SA, Ligeiro AP, Albertini R, Junior JA, de Carvalho PD

INTRODUCTION: Inflammation of the synovial membrane plays an important role in the pathophysiology of osteoarthritis (OA). The synovial tissue of patients with initial OA is characterized by infiltration of mononuclear cells and production of pro-inflammatory cytokines and other mediators of joint injury. Our objective was to evaluate the effect of low level laser therapy (LLLT) operating at 50 mW and 100 mW on joint inflammation in rats induced by papain, through histopathological analysis, differential counts of inflammatory cells (macrophages and neutrophils), as well as gene expression of IL-1SZ and IL-6, and protein expression of Tumor necrosis factor alpha (TNF-alpha). Materials and Methods Male Wistar rats (60) were randomly divided into 4 groups of 15 animals, namely, a negative control group; an inflammation injury positive control group; a 50 mW LLLT group, subjected to injury and treated with 50 mW LLLT; and a 100 mW LLLT group, subjected to injury and treated with 100 mW LLLT. The animals were subject to joint inflammation (papain solution, 4%) and then treated with LLLT. On the day of euthanasia, articular lavage was collected and immediately centrifuged; the supernatant was saved for analysis of expression of TNF-alpha protein by ELISA and expression of IL-1SZ and IL-6 mRNA by RT-PCR. A histologic examination of joint tissue was also performed. For the statistical analysis, analysis of variance (ANOVA) with Tukey’s post hoc test was used for comparisons between each group. All data are expressed as mean values and standard deviation, with p < 0.05. RESULTS: Both laser treatment modalities were efficient in reducing cellular inflammation, and both decreased the expression of IL-1SZ and IL-6. However, the 100 mW treatment led to a higher reduction of TNF-alpha compared to the 50 mW treatment. CONCLUSION: LLLT at 50 mW was more efficient in modulating inflammatory mediators (IL-1beta, IL-6) and inflammatory cells (macrophages and neutrophils), which correlated with the histology that showed a reduction in the inflammatory process.

Arthritis Res Ther 2013 Sep 12 15(5) R116

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24028507

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The impact of near-infrared light on dopaminergic cell survival in a transgenic mouse model of parkinsonism.

Purushothuman S, Nandasena C, Johnstone DM, Stone J, Mitrofanis J

Discipline of Physiology, University of Sydney, Australia; Bosch Institute, University of Sydney, Australia.

We have examined whether near-infrared light (NIr) treatment mitigates oxidative stress and increased expression of hyperphosphorylated tau in a tau transgenic mouse strain (K3) that has a progressive degeneration of dopaminergic cells in the substantia nigra pars compacta (SNc). The brains of wild-type (WT), untreated K3 and NIr-treated K3 mice, aged five months (thus after the onset of parkinsonian signs and neuropathology), were labelled immunohistochemically for the oxidative stress markers 4-hydroxynonenal (4-HNE) and 8-hydroxy-2′-deoxyguanosine (8-OHDG), hyperphosphorylated tau (using the AT8 antibody) and tyrosine hydroxylase (TH). The average intensity and area of 4-HNE, 8-OHDG and AT8 immunoreactivity were measured using the MetaMorph software and TH+ cell number was estimated using stereology. Our results showed immunoreactivity for 4-HNE, 8-OHDG and AT8 within the SNc was increased in K3 mice compared to WT, and that this increase was mitigated by NIr. Results further showed that TH+ cell number was lower in K3 mice than in WT, and that this loss was mitigated by NIr. In summary, NIr treatment reduced the oxidative stress caused by the tau transgene in the SNc of K3 mice and saved SNc cells from degeneration. Our results, when taken together with those in other models, strengthen the notion that NIr treatment saves dopaminergic cells in the parkinsonian condition.

Brain Res 2013 Oct 16 1535C 61-70

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23998985

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Effects of a low-level semiconductor gallium arsenide laser on local pathological alterations induced by Bothrops moojeni snake venom.

Aranha de Sousa E, Bittencourt JA, Seabra de Oliveira NK, Correia Henriques SV, Dos Santos Picanco LC, Lobato CP, Ribeiro JR, Pereira WL, Carvalho JC, Oliveira da Silva J

Toxicology Laboratory, Pharmaceutical Science Course, Federal University of Amapa, Macapa, AP, Brazil. jocivania@unifap.br elziliam@ibest.com.br adolfo_bittencourt@yahoo.com.br nayanaseabra@yahoo.com.br shayanne_henriques@hotmail.com leide-caroline@hotmail.com camilalobato2011@hotmail.com jocivania@unifap.br.

Antivenom therapy has been ineffective in neutralizing the tissue damage caused by snakebites. Among therapeutic strategies to minimize effects after envenoming, it was hypothesized that a low level laser would reduce complications and reduce the severity of local snake venom effects. In the current study, the effect of a low-level semiconductor gallium arsenide (GaAs) laser on the local pathological alterations induced by B. moojeni snake venom was investigated. The experimental groups consisted of five male mice, each administered either B. moojeni venom (VB), B. moojeni venom + antivenom (VAV), B. moojeni venom + laser (VL), B. moojeni venom + antivenom + laser (VAVL), or sterile saline solution (SSS) alone. Paw oedema was induced by intradermal administration of 0.05 mg kg(-1) of B. moojeni venom and was expressed in mm of directly induced oedema. Mice received by subcutaneous route 0.20 mg kg(-1) of venom for evaluating nociceptive activity and the time (in seconds) spent in licking and biting the injected paw was taken as an indicator of pain response. Inflammatory infiltration was determined by counting the number of leukocytes present in the gastrocnemius muscle after venom injection (0.10 mg kg(-1)). For histological examination of myonecrosis, venom (0.10 mg kg(-1)) was administered intramuscularly. The site of venom injection was irradiated by the GaAs laser and some animals received antivenom intraperitoneally. The results indicated that GaAs laser irradiation can help in reducing some local effects produced by the B. moojeni venom in mice, stimulating phagocytosis, proliferation of myoblasts and the regeneration of muscle fibers.

Photochem Photobiol Sci 2013 Oct 23 12(10) 1895-902

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23995306

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Cancer Phototherapy via Selective Photoinactivation of Respiratory Chain Oxidase to Trigger a Fatal Superoxide Anion Burst.

Wu S, Zhou F, Wei Y, Chen WR, Chen Q, Xing D

South China Normal University, Guang Zhou, China, 510631, MOE Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, guangzhou, China, , China ; wushn@scnu.edu.cn.

Aims: Here we develop a novel cancer treatment modality using mitochondria-targeting, high fluence low-power laser irradiation (HF-LPLI) in mouse tumor models and explore the mechanism of mitochondrial injury by HF-LPLI. Results: We demonstrated that the initial reaction after photon absorption was photosensitization of cytochrome c oxidase (COX), to inhibit enzymatic activity of COX in situ and cause respiratory chain superoxide anion (O2-*) burst. We also found that HF-LPLI exerted its main tumor killing effect through mitochondrial O2-* burst via electron transport chain (ETC). These phenomena were completely absent in the respiration-deficient cells and COX knockdown cells. With a carefully selected irradiation protocol, HF-LPLI could efficaciously destroy tumors. The inhibition of enzymatic activity of COX and generation of O2-* by HF-LPLI in vivo were also detected. Innovation: It is the first time that the mechanism involved in the interaction between light and its photoacceptor under HF-LPLI treatment is clarified. Our results clearly indicate that HF-LPLI initiates its effects via targeted COX photoinactivation and that the tumor-killing efficacy is dependent of the subsequent mitochondrial O2-* burst via ETC. Conclusion: Based on both in vitro and in vivo results, we conclude that HF-LPLI can selectively photoinactivate respiratory chain oxidase to trigger a fatal mitochondrial O2-* burst, producing oxidative damage on cancer cells. This study opens up the possibilities of applications of HF-LPLI as a mitochondria-targeting cancer phototherapy.

Antioxid Redox Signal 2013 Sep 2

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23992126

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Platelet-rich Plasma, Low-level Laser Therapy or Their Combination Promote Periodontal Regeneration in Fenestration Defects. A Preliminary in Vivo Study.

Nagata MJ, de Campos N, Messora MR, Pola NM, Santinoni CS, Bomfim SR, Fucini SE, Ervolino E, de Almeida JM, Theodoro LH, Garcia VG

Department of Surgery and Integrated Clinic, Dental School of Aracatuba, UNESP – Sao Paulo State University, Aracatuba, Sao Paulo, Brazil.

Background: This study histomorphometrically analyzed the influence of platelet-rich plasma (PRP), low-level laser therapy (LLLT) or their combination on the healing of periodontal fenestration defects (PFD) in rats. Methods: PFD were surgically created in the mandible of 80 rats. The animals were randomly divided into 4 groups: C and PRP – defects were filled with blood clot or PRP, respectively; LLLT and PRP/LLLT – defects received laser irradiation, were filled with blood clot or PRP, respectively, and then irradiated again. Animals were euthanized at either 10 or 30 days post-operative. Percentage of new bone (NB), density of newly formed bone (DNB), new cementum (NC) and extension of remaining defect (ERD) were histomorphometrically evaluated. Data were statistically analyzed (ANOVA; Tukey, P < 0.05). Results: At 10 days, Group PRP presented ERD significantly lower than Group C. At 30 days, Group PRP presented NB and DNB significantly greater than Group C. Groups LLLT, PRP and PRP/LLLT showed significant NC formation at 30 days, with collagen fibers inserted obliquely or perpendicularly to the root surface. NC formation was not observed in any Group C specimen. Conclusion: LLLT, PRP or their combination all promoted NC formation with a functional periodontal ligament. The combination PRP/LLLT did not show additional positive effects when compared to the use of either therapy alone.

J Periodontol 2013 Sep 3

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24001046

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Assessment of the effect of diode laser therapy on incisional wound healing and expression of iNOS and eNOS on rat oral tissue.

Ghalayani P, Jahanshahi G, Birang R, Bazazzadeh M

Dental Materials Research Center and Department of Oral Medicine, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.

BACKGROUND: The aim of this study was to compare the effects of diode laser irradiation on wound healing in oral rat mucosa and also to measure the amount of inducible nitric oxide synthase (iNOS) and endothelial NOS (eNOS) on oral wound healing. Healing was assessed by histology and the amounts of eNOS and iNOS were measured by real-time polymerase chain reaction (PCR). MATERIALS AND METHODS: Twenty-four standardized incisions were carried out on the buccal mucosa of 12 male Wistar rats; each rat received two incisions on the opposite sides of the buccal mucosa by using a steel scalpel. On the right side (test side), a diode laser (660 nm) was employed on the incision for 10 seconds on days 1-4 and 6-9. The left side (control side) did not receive any laser. Histological and real-time PCR analysis were done on tissue samples after 2, 7, 14, and 21 days. RESULTS: Histological analysis showed that the tissue healing after seven days on the laser irradiated side was better than the control side, but there was no significant difference between the two sides on days 2, 14, and 21 after surgery. Paired t-test analysis showed that there was no significant difference in the amount of eNOS between the groups. The difference in the amounts of iNOS between the groups was significant; it was more in the laser-irradiated side than the control side. CONCLUSION: Histological findings showed that diode laser needs several repeated irradiations for the acceleration of wound healing. The iNOS amount showed that increases are associated with better healing.

Dent Res J (Isfahan) 2013 May 10(3) 348-52

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24019803

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Effects of Low-Level Laser Therapy, 660 nm, in Experimental Septic Arthritis.

Araujo BF, Silva LI, Meireles A, Rosa CT, Gioppo NM, Jorge AS, Kunz RI, Ribeiro Lde F, Brancalhao RM, Bertolini GR

Laboratory of Injuries Study and Physical Therapy Resources of the State University of Western Parana (UNIOESTE), Universitaria Street, 2069 Jd. Universitario, P.O. Box 711, 85819-110 Cascavel, PR, Brazil.

The effectiveness of low-level laser therapy (LLLT) in the presence of an infectious process has not been well elucidated. The aim of the study was to evaluate the effects of LLLT in an experimental model of septic arthritis. Methods. Twenty-one Wistar rats were divided as follows: control group, no bacteria; placebo group, bacteria were inoculated; Treated group, bacteria were injected and treatment with LLLTwas performed. To assess nociception, a von Frey digital analgesimeter was applied. Synovial fluid was streaked to analyze bacterial growth. The standard strain of S. aureus was inoculated in the right knee. LLLT was performed with 660 nm, 2 J/cm(2), over 10 days. After treatment, the knees were fixed and processed for morphological analysis by light microscopy. Results. It was found that nociception increases in the right knee. There was a lack of results for the seeding of the synovial fluid. The morphological analysis showed slight recovery areas in the articular cartilage and synovia; however, there was the maintenance of the inflammatory infiltrate. Conclusion. The parameters used were not effective in the nociception reduction, even with the slight tissue recovery due to the maintenance of inflammatory infiltrate, but produced no change in the natural history of resolution of the infectious process.

ISRN Rheumatol 2013 2013 341832

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23997964

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Effect of low-level laser therapy irradiation and Bio-Oss graft material on the osteogenesis process in rabbit calvarium defects: a double blind experimental study.

Rasouli Ghahroudi AA, Rokn AR, Kalhori KA, Khorsand A, Pournabi A, Pinheiro AL, Fekrazad R

Periodontology Department, Tehran University of Medical Sciences, Tehran, Iran, amirali_rasouli@yahoo.com.

This study aims to assess the effect of low-level laser therapy (LLLT) irradiation and Bio-Oss graft material on the osteogenesis process in the rabbit calvarium defects. Twelve white male New Zealand rabbits were included in this study. Four 8-mm diameter identical defects were prepared on each rabbit’s calvarium. One site was left as an untreated control (C), the second site was filled with Bio-Oss (B), the third site was treated with laser irradiation (L), and the fourth site treated with Bio-Oss and laser irradiation (B + L). In the laser group, a diode laser (wavelength 810 nm, output power 300 mW, irradiation mode CW, energy density 4 J/cm2) was applied immediately after surgery and then one other day for the next 20 days. After 4 and 8 weeks, the animals were sacrificed and histological and histomorphometric examinations were performed and the data were subjected to Friedman and repeated measurements ANOVA tests. Significant differences were not found regarding inflammation severity, foreign body reactions, and vitality of newly formed bone on 4th and 8th week after operation. The mean amount of new bone was 15.83 and 18.5 % in the controls on the 4th and 8th week; 27.66 and 25.16 % in the laser-irradiated group; 35.0 and 41.83 % in Bio-Oss and 41.83 and 47.0 % in the laser + Bio-Oss treated specimens with significant statistical differences (p <0.05). Application of LLLT in combination with Bio-Oss(R) can promote bone healing. Therefore, LLLT may be clinically beneficial in promoting bone formation in skeletal defects.

Lasers Med Sci 2013 Aug 31

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23996072

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Effect of low-level laser irradiation on osteoblast-like cells cultured on porous hydroxyapatite scaffolds.

Incerti Parenti S, Panseri S, Gracco A, Sandri M, Tampieri A, Alessandri Bonetti G

Reparto di Ortognatodonzia, Dipartimento di Scienze Biomediche e Neuromotorie (DIBINEM), Universita di Bologna, Bologna, Italy. E-mail: serena.incerti2@unibo.it.

Objective. To determine the effect of laser irradiation at a low dose on human osteoblastlike cells. Materials and methods. 32 porous hydroxyapatite scaffolds currently used for bone tissue engineering were seeded with MG63 cells and irradiated or not with a GaAlAs diode laser (wavelength 915 nm, dose 2 J/cm2) using different power density and exposure duration. Results. After 72-h incubation, cells showed well spread morphology and good adhesion on both laser-treated and untreated scaffolds. Laser irradiation did not interfere in cell viability and proliferation as compared with the non-irradiated controls. Conclusion. This study suggests that there is no effect of 915 nm laser irradiation at a dose of 2 J/cm2 on the proliferation rate of MG63 cells. Future investigations are needed to compare different dose and wavelength regimens in order to determine the optimal set of laser parameters for maximum cell yield and safe clinical application.

Ann Ist Super Sanita 2013 49(3) 255-60

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24071604

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Effects of laser therapy on the proliferation of human periodontal ligament stem cells.

Soares DM, Ginani F, Henriques AG, Barboza CA

Federal University of Rio Grande do Norte, Natal, RN, Brazil.

Low-level laser irradiation (LLLI) stimulates the proliferation of a variety of cell types. However, very little is known about the effect of laser therapy on dental stem cells. The aim of the present study was to evaluate the effect of LLLI (660 nm, 30 mW) on the proliferation rate of human periodontal ligament stem cells (hPDLSC), obtained from two healthy permanent third molars extracted due to surgical indication. Culture cells were either irradiated or not (control) with an InGaAIP diode laser at 0 and 48 h, using two different energy densities (0.5 J/cm(2), 16 s and 1.0 J/cm(2), 33 s). Cell proliferation was evaluated by the Trypan blue exclusion method and by measuring mitochondrial activity using the MTT-based cytotoxicity assay at intervals of 0, 24, 48, and 72 h after the first laser application. An energy density of 1.0 J/cm(2) improved the cell proliferation in comparison to the other groups (control and laser 0.5 J/cm(2)) at 48 and 72 h. The group irradiated with 1.0 J/cm(2) presented significantly higher MTT activity at 48 and 72 h when compared to the energy density of 0.5 J/cm(2). It can be concluded that LLLI using infrared light and an energy density of 1.0 J/cm(2) has a positive stimulatory effect on the proliferation of hPDLSC.

Lasers Med Sci 2013 Sep 7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24013624

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Photobiomodulation of aqueous interfaces: finding evidence to support the exclusion zone in experimental and clinical studies.

Santana-Blank L, Rodriguez-Santana E, Santana-Rodriguez KE

Fundalas, Foundation for Interdisciplinary Research and Development , Caracas, Venezuela .

Photomed Laser Surg 2013 Sep 31(9) 461-2

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24047224

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Laser acupuncture in the treatment of burning mouth syndrome: a pilot study.

Brailo V, Bosnjak A, Vucicevic Boras V, Kvesic Jurisic A, Pelivan I, Kraljevic-Simunkovic S

Department of Oral Medicine, School of Dental Medicine, University of Zagreb, , Zagreb, Croatia.

Acupunct Med 2013 Sep 7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24014212

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About James Carroll

Founder and CEO at THOR Photomedicine Ltd. About THOR
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