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Effect of photobiomodulation therapy on inflammatory cytokines in healing dynamics of diabetic wounds: a systematic review of preclinical studies

Karkada G, Maiya GA, Houreld NN, Arany P, Rao Kg M, Adiga S, et al.

Arch Physiol Biochem, 2020 Dec 28.
PMID: 33370535 DOI: 10.1080/13813455.2020.1861025

CONTEXT: Delayed wound healing in diabetes mellitus (DM) is due to the overlapping phases of the healing process. The prolonged inflammation and altered levels of inflammatory cytokines lead to deformed cell proliferation. Photobiomodulation alleviates the expression of inflammatory cytokines and promotes tissue repair, thereby restoring the wound healing process.
OBJECTIVE: To find out the effect of photobiomodulation therapy (PBMT) in the healing dynamics of diabetic wounds with particular emphasis on interleukin-6, interleukin-1β, and tumour necrosis factor-α.
METHODS: Scientific databases searched using keywords of the population: DM, intervention: PBMT, and outcomes: inflammatory cytokines.
RESULTS: We have included five preclinical studies in the present systematic review for qualitative analysis. These studies evaluated the effect of PBMT at different wavelengths, dosage, and time on wound healing in DM.
CONCLUSIONS: The systematic review concludes that PBMT regulates inflammatory cytokines levels, enhances cell proliferation, and migration, thereby improving the wound healing properties.

Matched MeSH terms: Low-Level Light Therapy
Fulltext A Comparative Clinical Study between Concentrated Growth Factor and Low-Level Laser Therapy in the Management of Dry Socket

Kamal A, Salman B, Razak NHA, Samsudin ABR

Eur J Dent, 2020 Oct;14(4):613-620.
PMID: 32777838 DOI: 10.1055/s-0040-1714765

OBJECTIVE: A dry socket is a well-recognized complication of wound healing following tooth extraction. Its etiology is poorly understood and commonly occur among healthy patients. As such, management strategies for dry socket has always been empirical rather than scientific with varying outcome. The aim of this study is to investigate the efficacy of concentrated growth factor (CGF) and low-level laser therapy (LLLT) and compared them to the conventional treatment in the management of dry socket.
MATERIALS AND METHODS: Sixty patients with one dry socket each, at University Dental Hospital Sharjah, were divided into three treatment groups based on their choice. In group I (n = 30), conventional treatment comprising of gentle socket curettage and saline irrigation was done. Group II (n = 15) dry sockets were treated with CGF and group III (n = 15) sockets were lased with LLLT. All dry socket patients were seen at day 0 for treatment and subsequently followed-up at 4, 7, 14, and 21 days. Pain score, perisocket inflammation, perisocket tenderness, and amount of granulation tissue formation were noted.
STATISTICAL ANALYSIS: Data were analyzed as mean values for each treatment group. Comparisons were made for statistical analysis within the group and among the three groups to rank the efficacy of treatment using one-way analysis of variance (ANOVA). Statistically significant difference is kept at p < 0.05.
RESULTS: Conventional treatment group I took more than 7 days to match the healing phase of group II CGF treated socket and group III LLLT irradiated socket (p = 0.001). When healing rate between CGF and LLLT are compared, LLLT group III showed a delay of 4 days compared with CGF in granulation tissue formation and pain control.
CONCLUSION: CGF treated socket was superior to LLLT in its ability to generate 75% granulation tissue and eliminate pain symptom by day 7 (p = 0.001).

Matched MeSH terms: Low-Level Light Therapy
The effectiveness of transmeatal low-power laser stimulation in treating tinnitus

Ngao CF, Tan TS, Narayanan P, Raman R

Eur Arch Otorhinolaryngol, 2014 May;271(5):975-80.
PMID: 23605244 DOI: 10.1007/s00405-013-2491-3

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 <0.05 were considered as statistically significant. Chi square test was used to analyze the change of parameters in categorical forms (to compare between TLLS+ and TLLS-). Changes with p value of <0.05 were considered as statistically significant. Forty-three patients successfully and diligently completed their treatment. It was noted that using any condition of the device, TLLS+ or TLLS-, patient's tinnitus symptoms improved in terms of THI scores (TLLS+, p value = 0.038; TLLS-, p value = 0.001) or VAS scores with a change of at least one grade (TLLS+, p value = 0.007; TLLS-, p value = 0.002) at p value <0.05 significant level. In contrast when TLLS+ group was compared with TLLS- group, no statistically significant result was obtained. In term of VAS scores, there seems to be no statistically significant improvement in patients' annoyance, sleep disruption, depression, concentration and tinnitus loudness and pitch heard between the two groups. Transmeatal low-power laser stimulation did not demonstrate significant efficacy as a therapeutic measure in treating tinnitus.
Study site: Otorhinolaryngology clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Low-Level Light Therapy/instrumentation*
Photobiomodulation After Neurotization (Oberlin Procedure) in Brachial Plexus Injury: A Randomized Control Trial

Foo YH, Tunku Ahmad Yahaya TS, Chung TY, Silvanathan JP

Photobiomodul Photomed Laser Surg, 2020 Apr;38(4):215-221.
PMID: 32301668 DOI: 10.1089/photob.2019.4757

Objective:
To investigate effect of photobiomodulation (PBM) on nerve regeneration after neurotization with the Oberlin Procedure (ulnar fascicle to motor branch to biceps) to restore elbow flexion in patients with brachial plexus injury.
Materials and methods:
This prospective randomized controlled trial was conducted with 14 patients with high brachial plexus injury who underwent neurotization with the Oberlin Procedure to restore elbow flexion. The patients were randomly allocated to two groups of equal numbers: control group and PBM group. In this study, the PBM used has a wavelength of 808 nm, 50 mW power, continuous mode emission, 4 J/cm2 dosimetry, administered daily for 10 consecutive days, with an interval of 2 days (weekends). The outcome of surgery was assessed after 1, 2, 3, and 6 months. The nonparametric Mann-Whitney U-test and chi-square test were utilized to compare the results between both groups.
Results:
After 3 months postoperatively, more patients in the PBM group had demonstrated signs of reinnervation and the mean muscle power was significantly higher in the PBM group. No adverse effects resulted from the administration of PBM.
Conclusions:
PBM is a treatment modality that can improve nerve regeneration after neurotization with the Oberlin Procedure.

Matched MeSH terms: Low-Level Light Therapy*
Influence of gold nanoparticles on wound healing treatment in rat model: Photobiomodulation therapy

Lau P, Bidin N, Islam S, Shukri WNBWM, Zakaria N, Musa N, et al.

Lasers Surg Med, 2017 04;49(4):380-386.
PMID: 27859389 DOI: 10.1002/lsm.22614

BACKGROUND AND OBJECTIVE: The aim of this study is to investigate the effect of gold nanoparticles (AuNPs) in photobiomodulation therapy (PBMT) on wound healing process.
MATERIALS AND METHODS: AuNPs are synthesized by Q-switched Nd:YAG laser ablation technique. Cutaneous wound are induced on 45 Sprague Dawley rats on its dorsal part and then randomly divided into three groups. One group serves as non-treatment group (GC) and another two groups are subjected to AuNPs with and without PBMT. About 808 nm diode laser with output power of 100 mW is used as a light source for PBMT. The treatment was carried out daily with exposure duration of 50 seconds and total fluence of 5 J/cm2 . Wound area is monitored for 9 consecutive days using a digital camera, and histological examination is performed at 3rd, 6th, and 9th day through hematoxylin and eosin stain as well as Masson's trichrome stain.
RESULTS: The group of rats subjected to AuNPs with PBMT shows significantly accelerated wound closure compared to other groups. Histological results indicate that AuNPs and PBMT group is more effective in stimulating angiogenesis and triggers inflammatory response at early stage.
CONCLUSION: The application of AuNPs in PBMT has potential to accelerate wound healing due to enhanced epithelialization, collagen deposition and fast vascularization. Lasers Surg. Med. 49:380-386, 2017. © 2016 Wiley Periodicals, Inc.

Matched MeSH terms: Low-Level Light Therapy/methods*
Effect of a single dose of low-level laser therapy on spontaneous and chewing pain caused by elastomeric separators

Qamruddin I, Alam MK, Fida M, Khan AG

Am J Orthod Dentofacial Orthop, 2016 Jan;149(1):62-6.
PMID: 26718379 DOI: 10.1016/j.ajodo.2015.06.024

The aim of this study was to see the effect of a single dose of low-level laser therapy on spontaneous and chewing pain after the placement of elastomeric separators.

Matched MeSH terms: Low-Level Light Therapy/methods*
The 808 nm and 980 nm infrared laser irradiation affects spore germination and stored calcium homeostasis: A comparative study using delivery hand-pieces with standard (Gaussian) or flat-top profile

Ferrando S, Agas D, Mirata S, Signore A, De Angelis N, Ravera S, et al.

J. Photochem. Photobiol. B, Biol., 2019 Oct;199:111627.
PMID: 31536925 DOI: 10.1016/j.jphotobiol.2019.111627

Photobiomodulation relies on the transfer of energy from incident photons to a cell photoacceptor. For many years the concept of photobiomodulation and its outcome has been based upon a belief that the sole receptor within the cell was the mitochondrion. Recently, it has become apparent that there are other photoacceptors operating in different regions of the electromagnetic spectrum. Alternative photoacceptors would appear to be water and mechanisms regulating calcium homeostasis, despite a direct effect of laser photonic energy on intracellular calcium concentration outwith mitochondrial activity or influence, have not been clearly demonstrated. Therefore, to increase the knowledge of intracellular‑calcium and laser photon interaction, as well as to demonstrate differences in irradiation profiles with modern hand-pieces, we tested and compared the photobiomodulatory effect of 808 nm and 980 nm diode laser light by low- and higher-energy (60s, 100 mW/cm2, 100 mW/cm2, 500 mW/cm2, 1000 mW/cm2, 1500 mW/cm2, 2000 mW/cm2) irradiated with a "standard" (Gaussian fluence distribution) hand-piece or with a "flat-top" (uniform fluence) hand-piece. For this purpose, we used the eukaryote unicellular-model Dictyostelium discoideum. The 808 nm and 980 nm infrared laser light, at the energy tested directly affect the stored Ca2+ homeostasis, independent of the mitochondrial respiratory chain activities. From an organism perspective, the effect on Ca2+-dependent signal transduction as the regulator of spore germination in Dictyostelium, demonstrates how a cell can respond quickly to the correct laser photonic stimulus through a different cellular pathway than the known light-chromophore(mitochondria) interaction. Additionally, both hand-piece designs tested were able to photobiomodulate the D. discoideum cell; however, the hand-piece with a flat-top profile, through uniform fluence levels allows more effective and reproducible effects.

Matched MeSH terms: Low-Level Light Therapy
1064 nm Nd:YAG laser light affects transmembrane mitochondria respiratory chain complexes

Ravera S, Ferrando S, Agas D, De Angelis N, Raffetto M, Sabbieti MG, et al.

J Biophotonics, 2019 09;12(9):e201900101.
PMID: 31033186 DOI: 10.1002/jbio.201900101

Photobiomodulation (PBM) is a non-plant-cell manipulation through a transfer of energy by means of light sources at the non-ablative or thermal intensity. Authors showed that cytochrome-c-oxidase (complex IV) is the specific chromophore's target of PBM at the red (600-700 nm) and NIR (760-900 nm) wavelength regions. Recently, it was suggested that the infrared region of the spectrum could influence other chromospheres, despite the interaction by wavelengths higher than 900 nm with mitochondrial chromophores was not clearly demonstrated. We characterized the interaction between mitochondria respiratory chain, malate dehydrogenase, a key enzyme of Krebs cycle, and 3-hydroxyacyl-CoA dehydrogenase, an enzyme involved in the β-oxidation (two mitochondrial matrix enzymes) with the 1064 nm Nd:YAG (100mps and 10 Hz frequency mode) irradiated at the average power density of 0.50, 0.75, 1.00, 1.25 and 1.50 W/cm2 to generate the respective fluences of 30, 45, 60, 75 and 90 J/cm2 . Our results show the effect of laser light on the transmembrane mitochondrial complexes I, III, IV and V (adenosine triphosphate synthase) (window effects), but not on the extrinsic mitochondrial membrane complex II and mitochondria matrix enzymes. The effect is not due to macroscopical thermal change. An interaction of this wavelength with the Fe-S proteins and Cu-centers of respiratory complexes and with the water molecules could be supposed.

Matched MeSH terms: Low-Level Light Therapy