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Hernández-Bule ML, Naharro-Rodríguez J, Bacci S, Fernández-Guarino M. Unlocking the Power of Light on the Skin: A Comprehensive Review on Photobiomodulation. Int J Mol Sci 2024; 25:4483. [PMID: 38674067 PMCID: PMC11049838 DOI: 10.3390/ijms25084483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Photobiomodulation (PBM) is a procedure that uses light to modulate cellular functions and biological processes. Over the past decades, PBM has gained considerable attention for its potential in various medical applications due to its non-invasive nature and minimal side effects. We conducted a narrative review including articles about photobiomodulation, LED light therapy or low-level laser therapy and their applications on dermatology published over the last 6 years, encompassing research studies, clinical trials, and technological developments. This review highlights the mechanisms of action underlying PBM, including the interaction with cellular chromophores and the activation of intracellular signaling pathways. The evidence from clinical trials and experimental studies to evaluate the efficacy of PBM in clinical practice is summarized with a special emphasis on dermatology. Furthermore, advancements in PBM technology, such as novel light sources and treatment protocols, are discussed in the context of optimizing therapeutic outcomes and improving patient care. This narrative review underscores the promising role of PBM as a non-invasive therapeutic approach with broad clinical applicability. Despite the need for further research to develop standard protocols, PBM holds great potential for addressing a wide range of medical conditions and enhancing patient outcomes in modern healthcare practice.
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Affiliation(s)
| | | | - Stefano Bacci
- Research Unit of Histology and Embriology, Department of Biology, University of Florence, 50139 Florence, Italy;
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de Alencar Fernandes Neto J, Simões TMS, de Oliveira TKB, Dos Santos Pereira J, Nonaka CFW, de Vasconcelos Catão MHC. Effects of photobiomodulation with blue Light Emitting Diode (LED) on the healing of skin burns. Lasers Med Sci 2023; 38:275. [PMID: 37993749 DOI: 10.1007/s10103-023-03929-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/30/2023] [Indexed: 11/24/2023]
Abstract
The management of skin burns is still challenging. Among the therapeutic methods used, there are topical treatments with pharmacological and herbal agents, low-intensity therapeutic ultrasound, use of biomaterials, reconstructive techniques and photobiomodulation therapy. The aim of this study was to evaluate the effects of photobiomodulation with blue Light Emitting Diode (LED) on burn healing. Fifty Wistar rats were divided into control (CTRL) (n = 25) and blue LED (LED) (n = 25), with subgroups (n = 5) for each time of euthanasia (7, 14, 21, 28 and 32 days). Treated animals were daily irradiated (470 nm, 1W, 0.44 W/cm2, 50 J/cm2). Clinical evaluations were performed and the Wound Retraction Index (WRI) was determined. Histological sections were submitted to hematoxylin-eosin, toluidine blue and the immunohistochemical technique, with anti-α-SMA and anti-TGF-β1 antibodies. All data were directly collected by previously calibrated evaluators in a blind manner. The values were included in a statistical program. For all statistical tests used, 5% significance level (p < 0.05) was considered. No statistically significant differences in WRI between groups were observed (p > 0.05). Re-epithelialization was higher using LED at 7 and 14 days (p < 0.05) and greater amount of inflammatory cells was observed at 7 days (p = 0.01). With LED at 21 and 32 days, greater number of mast cells were observed (p < 0.05), as well as smaller number of myofibroblasts at 14, 21, 28 and 32 days (p < 0.05) and lower percentage of TGF-β1 positive cells in the conjunctiva at 7, 14 and 21 days (p < 0.05). Negative correlations were observed in LED between the percentage of TGF-β1 in the epithelium and the mean number of inflammatory cells and number of myofibroblasts (p < 0.05). The results suggest that, depending on the period, blue LED can modulate the healing processes of third-degree skin burns, such as re-epithelialization, inflammatory response, mast cell concentration, myofibroblast differentiation and TGF-β1 immunoexpression. Despite these effects, this therapy does not seem to have significant influence on the retraction of these wounds. Future studies, using different protocols, should be carried out to expand the knowledge about the photobiomodulatory mechanisms of this type of light in the healing process.
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Affiliation(s)
- José de Alencar Fernandes Neto
- Graduate Program in Dentistry, State University of Paraiba, R. Baraúnas, 531, Bodocongó, Campina Grande, PB, 58429-500, Brazil
| | - Thamyres Maria Silva Simões
- Graduate Program in Dentistry, State University of Paraiba, R. Baraúnas, 531, Bodocongó, Campina Grande, PB, 58429-500, Brazil
| | - Tharcia Kiara Beserra de Oliveira
- Faculty of Medical Sciences, University Center UniFacisa, Av. Sen. Argemiro de Figueiredo, 1901, Itararé, Campina Grande, PB, 58411-020, Brazil
| | - Joabe Dos Santos Pereira
- Department of Pathology, Federal University of Rio Grande do Norte, R. General Gustavo Cordeiro de Faria, s/n, Petrópolis, Natal, RN, 59012-570, Brazil
| | - Cassiano Francisco Weege Nonaka
- Graduate Program in Dentistry, State University of Paraiba, R. Baraúnas, 531, Bodocongó, Campina Grande, PB, 58429-500, Brazil
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Fernández-Guarino M, Hernández-Bule ML, Bacci S. Cellular and Molecular Processes in Wound Healing. Biomedicines 2023; 11:2526. [PMID: 37760967 PMCID: PMC10525842 DOI: 10.3390/biomedicines11092526] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
This review summarizes the recent knowledge of the cellular and molecular processes that occur during wound healing. However, these biological mechanisms have yet to be defined in detail; this is demonstrated by the fact that alterations of events to pathological states, such as keloids, consisting of the excessive formation of scars, have consequences yet to be defined in detail. Attention is also dedicated to new therapies proposed for these kinds of pathologies. Awareness of these scientific problems is important for experts of various disciplines who are confronted with these kinds of presentations daily.
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Affiliation(s)
- Montserrat Fernández-Guarino
- Dermatology Service, Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (Irycis), 28034 Madrid, Spain;
| | - Maria Luisa Hernández-Bule
- Bioelectromagnetic Lab, Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (Irycis), 28034 Madrid, Spain;
| | - Stefano Bacci
- Research Unit of Histology and Embriology, Department of Biology, University of Florence, Viale Pieraccini 6, 50134 Firenze, Italy
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Prado TP, Zanchetta FC, Barbieri B, Aparecido C, Melo Lima MH, Araujo EP. Photobiomodulation with Blue Light on Wound Healing: A Scoping Review. Life (Basel) 2023; 13:life13020575. [PMID: 36836932 PMCID: PMC9959862 DOI: 10.3390/life13020575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Photobiomodulation consists of inducing healing by irradiating light. This scoping review investigates the effect of blue light on the healing process. METHODS The MEDLINE, Web of Science, Scopus, and CINAHL databases were searched. Two reviewers independently examined the search results and extracted data from the included studies. A descriptive analysis was performed. RESULTS Twenty-two articles were included. Studies were categorized as in vitro/mixed, preclinical, and clinical. The power density used was 10-680 mW/cm2 in most of the in vitro/preclinical studies, the irradiation time ranged from 5 s to 10 min, and different wavelengths and energy densities were used. In clinical studies, the wavelength ranged from 405 to 470 nm, and the energy density varied from 1.5 to 30 J/cm2. CONCLUSIONS A low energy density (<20 J/cm2) was able to stimulate the different cell types and proteins involved in healing, while a high energy density, 20.6-50 J/cm2, significantly reduced cell proliferation, migration, and metabolism. There is a great variety of device parameters among studies, and this makes it difficult to conclude what the best technical specifications are. Thus, further studies should be performed in order to define the appropriate parameters of light to be used.
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Affiliation(s)
- Thais P. Prado
- School of Nursing, University of Campinas (Unicamp), Campinas 13083-887, Brazil
- Laboratory of Cell Signaling, Obesity and Comorbidities Research Center, University of Campinas, Campinas 13083-864, Brazil
| | - Flávia Cristina Zanchetta
- School of Nursing, University of Campinas (Unicamp), Campinas 13083-887, Brazil
- Laboratory of Cell Signaling, Obesity and Comorbidities Research Center, University of Campinas, Campinas 13083-864, Brazil
| | - Beatriz Barbieri
- School of Nursing, University of Campinas (Unicamp), Campinas 13083-887, Brazil
- Laboratory of Cell Signaling, Obesity and Comorbidities Research Center, University of Campinas, Campinas 13083-864, Brazil
| | - Caroline Aparecido
- School of Nursing, University of Campinas (Unicamp), Campinas 13083-887, Brazil
- Laboratory of Cell Signaling, Obesity and Comorbidities Research Center, University of Campinas, Campinas 13083-864, Brazil
| | - Maria Helena Melo Lima
- School of Nursing, University of Campinas (Unicamp), Campinas 13083-887, Brazil
- Laboratory of Cell Signaling, Obesity and Comorbidities Research Center, University of Campinas, Campinas 13083-864, Brazil
| | - Eliana P. Araujo
- School of Nursing, University of Campinas (Unicamp), Campinas 13083-887, Brazil
- Laboratory of Cell Signaling, Obesity and Comorbidities Research Center, University of Campinas, Campinas 13083-864, Brazil
- Correspondence:
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Blue-LED-Light Photobiomodulation of Inflammatory Responses and New Tissue Formation in Mouse-Skin Wounds. Life (Basel) 2022; 12:life12101564. [PMID: 36295000 PMCID: PMC9604901 DOI: 10.3390/life12101564] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/21/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Recent studies evidence that blue-LED-light irradiation can modulate cell responses in the wound healing process within 24 h from treatment. This study aims to investigate blue-light (410-430 nm) photobiomodulation used in a murine wound model within six days post-treatment. Methods: A superficial wound was made in 30 CD1 male mice. The injuries were treated with a blue LED light (20.6 J/cm2), and biopsies were collected at 24, 72, and 144 h. Histology, fluorescence analysis, and advanced microscopy techniques were used. Results: We can observe an increase in the cellular infiltrate response, and in mast-cell density and their degranulation index correlated to the expression of the major histocompatibility complex after 24 h. Furthermore, after six days, the vessel density increases with the expression of the platelet-derived growth factor in the mast cells. Finally, collagen deposition and morphology in the treated wounds appear more similar to unwounded skin. Conclusions: Blue-light photobiomodulation stimulates several cellular processes that are finely coordinated by mast cells, leading to more rapid wound healing and a better-recovered skin morphology.
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Spinella A, de Pinto M, Galluzzo C, Testoni S, Macripò P, Lumetti F, Parenti L, Magnani L, Sandri G, Bajocchi G, Starnoni M, De Santis G, Salvarani C, Giuggioli D. Photobiomodulation Therapy: A New Light in the Treatment of Systemic Sclerosis Skin Ulcers. Rheumatol Ther 2022; 9:891-905. [PMID: 35334095 PMCID: PMC9127012 DOI: 10.1007/s40744-022-00438-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/01/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Skin ulcers (SU) represent one of the most frequent manifestations of systemic sclerosis (SSc), occurring in almost 50% of scleroderma patients. SSc-SU are often particularly difficult to treat with conventional systemic and local therapies. In this study, a preliminary evaluation of the role and effectiveness of blue light photobiomodulation (PBM) therapy with EmoLED® in the treatment of scleroderma skin ulcers (SSc-SU) was performed. METHODS We retrospectively analyzed 12 consecutive SSc patients with a total of 15 SU on finger hands. All patients were treated with adequate systemic therapy and local treatment for SU; after a standard skin ulcer bed preparation with debridement of all lesions, EmoLED® was performed. All patients were locally treated every week during 2 months of follow-up; SU data were collected after 4 weeks (T4) and 8 weeks (T8). Eight SSc patients with comparable SU were also evaluated as controls. RESULTS The application of EmoLED® in addition to debridement apparently produced faster healing of SU. Complete healing of SU was recorded in 41.6% cases during EmoLED® treatment. Significant improvements in SU area, length, and width, wound bed, and related pain were observed in EmoLED® patients from T0 to T8. Control subjects treated with standard systemic/local therapies merely showed an amelioration of SU area and width at the end of the follow-up. No procedural or post-procedural adverse events were reported. CONCLUSIONS The positive clinical results and the absence of side effects suggest that EmoLED® could be a promising tool in the management of SSc-SU, with an interesting role to play in the healing process in addition to conventional systemic and local treatments.
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Affiliation(s)
- Amelia Spinella
- Scleroderma Unit, Chair and Rheumatology Unit, Medical School, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Policlinico di Modena, Via del Pozzo, 71, 41125, Modena, Italy
| | - Marco de Pinto
- Scleroderma Unit, Chair and Rheumatology Unit, Medical School, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Policlinico di Modena, Via del Pozzo, 71, 41125, Modena, Italy
| | - Claudio Galluzzo
- Scleroderma Unit, Chair and Rheumatology Unit, Medical School, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Policlinico di Modena, Via del Pozzo, 71, 41125, Modena, Italy
| | - Sofia Testoni
- Scleroderma Unit, Chair and Rheumatology Unit, Medical School, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Policlinico di Modena, Via del Pozzo, 71, 41125, Modena, Italy
| | - Pierluca Macripò
- Scleroderma Unit, Chair and Rheumatology Unit, Medical School, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Policlinico di Modena, Via del Pozzo, 71, 41125, Modena, Italy
| | - Federica Lumetti
- Scleroderma Unit, Chair and Rheumatology Unit, Medical School, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Policlinico di Modena, Via del Pozzo, 71, 41125, Modena, Italy
| | - Luca Parenti
- Scleroderma Unit, Chair and Rheumatology Unit, Medical School, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Policlinico di Modena, Via del Pozzo, 71, 41125, Modena, Italy
| | - Luca Magnani
- Unit of Rheumatology, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Gilda Sandri
- Scleroderma Unit, Chair and Rheumatology Unit, Medical School, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Policlinico di Modena, Via del Pozzo, 71, 41125, Modena, Italy
| | | | - Marta Starnoni
- Division of Plastic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Modena, Italy
| | - Giorgio De Santis
- Division of Plastic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Modena, Italy
| | - Carlo Salvarani
- Unit of Rheumatology, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Dilia Giuggioli
- Scleroderma Unit, Chair and Rheumatology Unit, Medical School, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Policlinico di Modena, Via del Pozzo, 71, 41125, Modena, Italy.
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Denzinger M, Schenk KBM, Krauß S, Held M, Daigeler A, Wolfertstetter PR, Knorr C, Illg C, Eisler W. Immune-modulating properties of blue light do not influence reepithelization in vitro. Lasers Med Sci 2022; 37:2431-2437. [PMID: 35048232 DOI: 10.1007/s10103-022-03502-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/30/2021] [Indexed: 11/29/2022]
Abstract
Phototherapy is gaining more attention in the treatment of various diseases. Especially, blue light seems to be a promising approach for wound healing promotion due to its antimicrobial and immune-modulating properties. Despite this, there is only little research focusing on the immune-modulating properties of blue light and its possible effects on wound healing. Therefore, we investigated the effects of blue light irradiation on peripheral blood mononuclear cells (PBMC) and the influence on reepithelization in vitro. PBMCs were irradiated with DermoDyne® (DermoDyne HealthCare, Berlin, Germany) and effects on cell viability, cytokine expression, and scratch wound closure were evaluated afterwards. Irradiated cells showed a higher Interleukin-γ concentration while irradiation reduced resazurin concentration in a time-dependent manner. No differences in reepithelization were detectable when keratinocytes were treated with the supernatant of these blue light irradiated PBMCs. Blue light-mediated ex vivo stimulation of PBMCs does not cause faster reepithelization in an in vitro setting. Further research is needed to investigate the wound healing effects of phototherapy with blue light.
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Affiliation(s)
- Markus Denzinger
- Department of Pediatric Surgery and Orthopedics, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, Steinmetzstraße 1-3, 93049, Regensburg, Germany.
| | - Katharina B M Schenk
- Department of Medicine, St. John of God Hospital Regensburg, Regensburg, Germany
| | - Sabrina Krauß
- Clinic for Plastic, Reconstructive, Hand and Burn Surgery, BG Trauma Center, Eberhard-Karls-Universität Tübingen, Tübingen, Germany
| | - Manuel Held
- Clinic for Plastic, Reconstructive, Hand and Burn Surgery, BG Trauma Center, Eberhard-Karls-Universität Tübingen, Tübingen, Germany
| | - Adrien Daigeler
- Clinic for Plastic, Reconstructive, Hand and Burn Surgery, BG Trauma Center, Eberhard-Karls-Universität Tübingen, Tübingen, Germany
| | - Patricia Reis Wolfertstetter
- Department of Pediatric Surgery and Orthopedics, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, Steinmetzstraße 1-3, 93049, Regensburg, Germany
| | - Christian Knorr
- Department of Pediatric Surgery and Orthopedics, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, Steinmetzstraße 1-3, 93049, Regensburg, Germany
| | - Claudius Illg
- Clinic for Plastic, Reconstructive, Hand and Burn Surgery, BG Trauma Center, Eberhard-Karls-Universität Tübingen, Tübingen, Germany
| | - Wiebke Eisler
- Clinic for Plastic, Reconstructive, Hand and Burn Surgery, BG Trauma Center, Eberhard-Karls-Universität Tübingen, Tübingen, Germany
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Fraccalvieri M, Amadeo G, Bortolotti P, Ciliberti M, Garrubba A, Mosti G, Bianco S, Mangia A, Massa M, Hartwig V, Salvo P, Ricci EB. Effectiveness of Blue light photobiomodulation therapy in the treatment of chronic wounds. Results of the Blue Light for Ulcer Reduction (B.L.U.R.) Study. Ital J Dermatol Venerol 2021; 157:187-194. [PMID: 34498454 DOI: 10.23736/s2784-8671.21.07067-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Lower limb ulcers not responding to standard treatments after 8 weeks are defined as chronic wounds, and they are a significant medical problem. Blue light (410-430 nm) proved to be effective in treating wounds, but there is a lack of data on chronic wounds in clinical practice. The study's purpose was to determine if Blue Light photobiomodulation with EmoLED medical device in addition to Standard of Care is more effective compared to Standard of care alone in promoting re-epithelialization of chronicwounds of lower limbs in 10 weeks. METHODS 90 patients affected by multiple or large area ulcers were enrolled. To minimize all variabilities, each patient has been used as control of himself. Primary endpoint was the comparison of the re-epithelialization rate expressed as a percentage of the difference between the initial and final area. Secondary endpoints were: treatment safety, pain reduction, wound area reduction trend over time, healing rate. RESULTS At week 10, the wounds treated with EmoLED in addition to Standard Care showed a smaller residual wound area compared to the wounds treated with Standard of Care alone: 42.1% vs 63.4% (p=0.029). The difference is particularly evident in venous leg ulcers, 33.3% vs 60.1% (p=0.007). 17 treated wounds and 12 controls showed complete healing at week 10. Patients showed a significant reduction in pain (p = 2*10-7). CONCLUSIONS Blue Light treatment in addition to Standard of Care accelerates consistently the re-epithelialization rate of chronic wounds, especially venous leg ulcers and increases the chances of total wound healing in 10 weeks.
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Affiliation(s)
- Marco Fraccalvieri
- AOU Città della Salute e della Scienza di Torino, Sede Ospedale San Lazzaro, Turin, Italy -
| | - Giuseppe Amadeo
- U.O.C. Chirurgia Plastica, A.O.U. Policlinico G. Martino, Messina, Italy
| | - Paolo Bortolotti
- Presidio Ospedaliero di Lucca, Cittadella della Salute Campo di Marte, Lucca, Italy
| | - Marino Ciliberti
- Azienda Sanitaria Locale Napoli 3 Sud, Castellammare di Stabia, Naples, Italy
| | - Angela Garrubba
- Polo Bari Nord (P.O. Corato P.O. San Paolo), ASL/BA, Corato, Bari, Italy
| | | | | | - Antongiulio Mangia
- AOU Città della Salute e della Scienza di Torino, Sede Ospedale San Lazzaro, Turin, Italy
| | - Maurizio Massa
- Presidio Ospedaliero di Lucca, Cittadella della Salute Campo di Marte, Lucca, Italy
| | | | | | - Elia B Ricci
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
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Kim S, Le VH, Kim B, Kim CJ, Im SH, Kim KH. Longitudinal Label-Free Two-Photon Microscopy of Cellular Healing Processes in Non-Ablative Fractional Laser Wounds. Lasers Surg Med 2021; 53:1413-1426. [PMID: 34139024 DOI: 10.1002/lsm.23445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 05/26/2021] [Accepted: 05/31/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES Wound healing is an important biomedical problem with various associated complications. Although cutaneous wound healing has been studied in vivo extensively using various optical imaging methods, early-stage cellular healing processes were difficult to study due to scab formation. The objective of this study is to demonstrate that minimal laser wounds and optical microscopy can access the detailed cellular healing processes of cutaneous wounds from the early stage. STUDY DESIGN/MATERIALS AND METHODS A non-ablative fractional laser (NAFL) and label-free two-photon microscopy (TPM) were used to induce minimal cutaneous wounds and to image the wounds in three-dimension. Sixteen hairless mice and a single human volunteer were used. NAFL wounds were induced in the hindlimb skin of the mice and in the forearm skin of the human subject. The NAFL wounds were longitudinally imaged during the healing period, starting from an hour post wound induction in the earliest and until 21 days. Cells in the wound and surrounding normal skin were visualized based on two-photon excited auto-fluorescence (TPAF), and cellular changes were tracked by analyzing longitudinal TPM images both qualitatively and quantitatively. Damage and recovery in the skin dermis were tracked by using the second harmonic generation (SHG) signal of collagen. Immunofluorescence and hematoxylin and eosin histology analysis were conducted to validate the TPM results of the murine skin. RESULTS Cellular healing processes in NAFL wounds and surroundings could be observed by longitudinal TPM. In the case of murine skin, various healing phases including inflammation, re-epithelization, granulation tissue formation, and late remodeling phase including collagen regeneration were observed in the same wounds owing to minimal or no scab formation. The re-epithelization process was analyzed quantitatively by measuring cell density and thickness of the epithelium in the wound surroundings. In the case of the human skin, the access inside the wound was blocked for a few days post wound induction due to scabs but the cellular changes in the wound surroundings were observed from the early stage. Cellular healing processes in the NAFL wound of the human skin were similar to those in murine skin. CONCLUSIONS The minimal NAFL wound model and label-free TPM demonstrated the cell level assessment of wound healing processes with applicability to human subjects. © 2021 Wiley Periodicals LLC.
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Affiliation(s)
- Seonghan Kim
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
| | - Viet-Hoan Le
- Department of Life Sciences & Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, 37673, Republic of Korea
| | - Bumju Kim
- Department of Life Sciences & Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, 37673, Republic of Korea
| | - Chan Johng Kim
- Department of Life Sciences & Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, 37673, Republic of Korea
| | - Sin-Hyeog Im
- Department of Life Sciences & Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, 37673, Republic of Korea.,ImmunoBiome Inc. Bio Open Innovation Center, 47 Jigok-ro, Nam-gu, Pohang, Gyeongbukdo, 37673, Republic of Korea
| | - Ki Hean Kim
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
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Rossi F, Magni G, Tatini F, Banchelli M, Cherchi F, Rossi M, Coppi E, Pugliese AM, Rossi degl’Innocenti D, Alfieri D, Pavone FS, Pini R, Matteini P. Photobiomodulation of Human Fibroblasts and Keratinocytes with Blue Light: Implications in Wound Healing. Biomedicines 2021; 9:biomedicines9010041. [PMID: 33466557 PMCID: PMC7824830 DOI: 10.3390/biomedicines9010041] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/18/2020] [Accepted: 12/29/2020] [Indexed: 12/15/2022] Open
Abstract
In recent years, photobiomodulation (PBM) has been recognized as a physical therapy in wound management. Despite several published research papers, the mechanism underlying photobiomodulation is still not completely understood. The investigation about application of blue light to improve wound healing is a relatively new research area. Tests in selected patients evidenced a stimulation of the healing process in superficial and chronic wounds treated with a blue LED light emitting at 420 nm; a study in animal model pointed out a faster healing process in superficial wound, with an important role of fibroblasts and myofibroblasts. Here, we present a study aiming at evidencing the effects of blue light on the proliferation and metabolism in fibroblasts from healthy skin and keratinocytes. Different light doses (3.43, 6.87, 13.7, 20.6, 30.9 and 41.2 J/cm2) were used to treat the cells, evidencing inhibitory and stimulatory effects following a biphasic dose behavior. Electrophysiology was used to investigate the effects on membrane currents: healthy fibroblasts and keratinocytes showed no significant differences between treated and not treated cells. Raman spectroscopy revealed the mitochondrial Cytochrome C (Cyt C) oxidase dependence on blue light irradiation: a significant decrease in peak intensity of healthy fibroblast was evidenced, while it is less pronounced in keratinocytes. In conclusion, we observed that the blue LED light can be used to modulate metabolism and proliferation of human fibroblasts, and the effects in wound healing are particularly evident when studying the fibroblasts and keratinocytes co-cultures.
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Affiliation(s)
- Francesca Rossi
- Istituto di Fisica Applicata “Nello Carrara”, Consiglio Nazionale delle Ricerche (CNR-IFAC), 50019 Florence, Italy; (F.R.); (F.T.); (M.R.); (R.P.); (P.M.)
| | - Giada Magni
- Istituto di Fisica Applicata “Nello Carrara”, Consiglio Nazionale delle Ricerche (CNR-IFAC), 50019 Florence, Italy; (F.R.); (F.T.); (M.R.); (R.P.); (P.M.)
- Correspondence: (G.M.); (M.B.); (A.M.P.)
| | - Francesca Tatini
- Istituto di Fisica Applicata “Nello Carrara”, Consiglio Nazionale delle Ricerche (CNR-IFAC), 50019 Florence, Italy; (F.R.); (F.T.); (M.R.); (R.P.); (P.M.)
| | - Martina Banchelli
- Istituto di Fisica Applicata “Nello Carrara”, Consiglio Nazionale delle Ricerche (CNR-IFAC), 50019 Florence, Italy; (F.R.); (F.T.); (M.R.); (R.P.); (P.M.)
- Correspondence: (G.M.); (M.B.); (A.M.P.)
| | - Federica Cherchi
- Department of Neuroscience, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, 50139 Florence, Italy; (F.C.); (E.C.)
| | - Michele Rossi
- Istituto di Fisica Applicata “Nello Carrara”, Consiglio Nazionale delle Ricerche (CNR-IFAC), 50019 Florence, Italy; (F.R.); (F.T.); (M.R.); (R.P.); (P.M.)
| | - Elisabetta Coppi
- Department of Neuroscience, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, 50139 Florence, Italy; (F.C.); (E.C.)
| | - Anna Maria Pugliese
- Department of Neuroscience, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, 50139 Florence, Italy; (F.C.); (E.C.)
- Correspondence: (G.M.); (M.B.); (A.M.P.)
| | | | - Domenico Alfieri
- EmoLED s.r.l., Sesto Fiorentino, 50019 Florence, Italy; (D.R.d.); (D.A.)
| | - Francesco S. Pavone
- Department of Physics, University of Florence, 50019 Florence, Italy;
- European Laboratory for Non-Linear Spectroscopy (LENS), 50019 Florence, Italy
- Istituto Nazionale di Ottica, Consiglio Nazionale delle Ricerche (CNR-INO), 50125 Florence, Italy
| | - Roberto Pini
- Istituto di Fisica Applicata “Nello Carrara”, Consiglio Nazionale delle Ricerche (CNR-IFAC), 50019 Florence, Italy; (F.R.); (F.T.); (M.R.); (R.P.); (P.M.)
| | - Paolo Matteini
- Istituto di Fisica Applicata “Nello Carrara”, Consiglio Nazionale delle Ricerche (CNR-IFAC), 50019 Florence, Italy; (F.R.); (F.T.); (M.R.); (R.P.); (P.M.)
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Dini V, Romanelli M, Oranges T, Davini G, Janowska A. Blue light emission in the management of hard-to-heal wounds. Ital J Dermatol Venerol 2020; 156:709-713. [PMID: 32720788 DOI: 10.23736/s2784-8671.20.06691-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Blue light (400 and 450 nm) contributes to bringing the inflammatory phase under control, increases angiogenesis, stimulates the metabolism of all cellular processes, reduces scar formation, increases collagen production, and decreases the bacterial burden. METHODS The aim of this study was to promote the healing process in 20 hard-to-heal wounds using a portable light-emitting diodes device that emits blue light (Emoled™). The primary endpoint of the study was to calculate in the three etiologic groups the reduction in wound size by the average delta area in square centimeters and as a percentage, and by the average healing rate (mm/days). The secondary endpoint was to assess the Wound Bed Score (WBS) and to assess patients' pain (Numerical Rating Scale, NRS). RESULTS At week 4 the average healing rate was 0.098 mm/days for venous leg ulcers, 0.353 mm/days for traumatic ulcers, and 0.09 mm/days for vasculitis. Overall, 16 patients had a reduction in wound size, two patients were completely healed, and there was no improvement in two patients. At week 4, the average wound bed score had increased to 12.8 and average pain had decreased to 2.35. Almost all patients (N.=19) showed pain reduction, and all the patients increased wound bed score. CONCLUSIONS The blue LED device is promising in terms of promoting wound healing, improving WBS and reducing pain in patients affected by long-term wounds that do not respond to standard treatment.
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Affiliation(s)
- Valentina Dini
- Department of Dermatology, University of Pisa, Pisa, Italy
| | | | - Teresa Oranges
- Department of Dermatology, University of Pisa, Pisa, Italy.,Department of Health Sciences, Anna Meyer Children's University Hospital, University of Florence, Florence, Italy
| | - Giulia Davini
- Department of Dermatology, University of Pisa, Pisa, Italy
| | - Agata Janowska
- Department of Dermatology, University of Pisa, Pisa, Italy -
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Magni G, Tatini F, Bacci S, Paroli G, De Siena G, Cicchi R, Pavone FS, Pini R, Rossi F. Blue LED light modulates inflammatory infiltrate and improves the healing of superficial wounds. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019; 36:166-168. [PMID: 31769893 DOI: 10.1111/phpp.12527] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/30/2019] [Accepted: 11/22/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Giada Magni
- Institute of Applied Physics, National Research Council (IFAC-CNR), Sesto Fiorentino, Italy
| | - Francesca Tatini
- Institute of Applied Physics, National Research Council (IFAC-CNR), Sesto Fiorentino, Italy
| | - Stefano Bacci
- Department of Biology, University of Florence, Florence, Italy
| | - Gaia Paroli
- Department of Biology, University of Florence, Florence, Italy
| | - Gaetano De Siena
- Institute of Applied Physics, National Research Council (IFAC-CNR), Sesto Fiorentino, Italy
| | - Riccardo Cicchi
- National Institute of Optics, National Research Council (INO-CNR), Florence, Italy.,European Laboratory for Non-Linear Spectroscopy (LENS), University of Florence, Sesto Fiorentino, Italy
| | - Francesco S Pavone
- National Institute of Optics, National Research Council (INO-CNR), Florence, Italy.,European Laboratory for Non-Linear Spectroscopy (LENS), University of Florence, Sesto Fiorentino, Italy.,Department of Physics, University of Florence, Sesto Fiorentino, Italy
| | - Roberto Pini
- Institute of Applied Physics, National Research Council (IFAC-CNR), Sesto Fiorentino, Italy
| | - Francesca Rossi
- Institute of Applied Physics, National Research Council (IFAC-CNR), Sesto Fiorentino, Italy
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Abstract
The abstract book contains the abstracts of keynote lectures, focus sessions, symposia, workshops, AIUC annual meeting, AISLEC annual meeting, EPUAP annual meeting, ETRS special session, sponsor symposia, oral presentations, poster presentations and the subject index.
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Li Y, Zhang J, Xu Y, Han Y, Jiang B, Huang L, Zhu H, Xu Y, Yang W, Qin C. The Histopathological Investigation of Red and Blue Light Emitting Diode on Treating Skin Wounds in Japanese Big-Ear White Rabbit. PLoS One 2016; 11:e0157898. [PMID: 27347879 PMCID: PMC4922561 DOI: 10.1371/journal.pone.0157898] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 06/07/2016] [Indexed: 11/18/2022] Open
Abstract
The biological effects of different wavelengths of light emitting diode (LED) light tend to vary from each other. Research into use of photobiomodulation for treatment of skin wounds and the underlying mechanisms has been largely lacking. We explored the histopathological basis of the therapeutic effect of photobiomodulation and the relation between duration of exposure and photobiomodulation effect of different wavelengths of LED in a Japanese big-ear white rabbit skin-wound model. Skin wound model was established in 16 rabbits (three wounds per rabbit: one served as control, the other two wounds were irradiated by red and blue LED lights, respectively). Rabbits were then divided into 2 equal groups based on the duration of exposure to LED lights (15 and 30 min/exposure). The number of wounds that showed healing and the percentage of healed wound area were recorded. Histopathological examination and skin expression levels of fibroblast growth factor (FGF), epidermal growth factor (EGF), endothelial marker (CD31), proliferating cell nuclear antigen (Ki67) and macrophagocyte (CD68) infiltration, and the proliferation of skin collagen fibers was assessed. On days 16 and 17 of irradiation, the healing rates in red (15 min and 30 min) and blue (15 min and 30 min) groups were 50%, 37.5%, 25% and 37.5%, respectively, while the healing rate in the control group was 12.5%. The percentage healed area in the red light groups was significantly higher than those in other groups. Collagen fiber and skin thickness were significantly increased in both red light groups; expression of EGF, FGF, CD31 and Ki67 in the red light groups was significantly higher than those in other groups; the expression of FGF in red (30 min) group was not significantly different from that in the blue light and control groups. The effect of blue light on wound healing was poorer than that of red light. Red light appeared to hasten wound healing by promoting fibrous tissue, epidermal and endothelial cell proliferation. An increase in the exposure time to 30 min did not confer any additional benefit in both red and blue light groups. This study provides a theoretical basis for the potential therapeutic application of LED light in clinical settings.
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Affiliation(s)
- Yanhong Li
- Key Laboratory of Human Diseases Comparative Medicine, Ministry of Health, Institute of Medical Laboratory Animal Science, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Human Diseases Animal Models, State Administration of Traditional Chinese Medicine, Peking Union Medicine College, Beijing, China
| | - Jigang Zhang
- The General Hospital of the PLA Rocket Force, Department of Dermatology, Beijing, China
| | - Yanfeng Xu
- Key Laboratory of Human Diseases Comparative Medicine, Ministry of Health, Institute of Medical Laboratory Animal Science, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Human Diseases Animal Models, State Administration of Traditional Chinese Medicine, Peking Union Medicine College, Beijing, China
| | - Yunlin Han
- Key Laboratory of Human Diseases Comparative Medicine, Ministry of Health, Institute of Medical Laboratory Animal Science, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Human Diseases Animal Models, State Administration of Traditional Chinese Medicine, Peking Union Medicine College, Beijing, China
| | - Binbin Jiang
- The General Hospital of the PLA Rocket Force, Department of Dermatology, Beijing, China
| | - Lan Huang
- Key Laboratory of Human Diseases Comparative Medicine, Ministry of Health, Institute of Medical Laboratory Animal Science, Chinese Academy of Medical Sciences, Beijing, China
| | - Hua Zhu
- Key Laboratory of Human Diseases Comparative Medicine, Ministry of Health, Institute of Medical Laboratory Animal Science, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Human Diseases Animal Models, State Administration of Traditional Chinese Medicine, Peking Union Medicine College, Beijing, China
| | - Yuhuan Xu
- Key Laboratory of Human Diseases Comparative Medicine, Ministry of Health, Institute of Medical Laboratory Animal Science, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Human Diseases Animal Models, State Administration of Traditional Chinese Medicine, Peking Union Medicine College, Beijing, China
| | - Weiling Yang
- The General Hospital of the PLA Rocket Force, Department of Dermatology, Beijing, China
- * E-mail: (CQ); (WLY)
| | - Chuan Qin
- Key Laboratory of Human Diseases Comparative Medicine, Ministry of Health, Institute of Medical Laboratory Animal Science, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Human Diseases Animal Models, State Administration of Traditional Chinese Medicine, Peking Union Medicine College, Beijing, China
- * E-mail: (CQ); (WLY)
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