Can photobiomodulation therapy (PBMT) control blood glucose levels and alter muscle glycogen synthesis?

Dose-response and efficacy of 904 nm photobiomodulation on diabetic foot ulcers healing: a randomized controlled trial

PURPOSE

This study aimed to examine the impact of a 904 nm photobiomodulation (PBM) on diabetic ulcers using varying dosages.

METHODS

The study was a randomized, double-blind, placebo-controlled clinical trial that compared treatments using PBM (GaAs 904 nm 30w) with three different energy densities (4 J/cm2; 8 J/cm2; 10 J/cm2) in the healing process of non-infected diabetic foot ulcers. Eighty volunteers (48.75% female; 58.5 ± 11.1 years) were randomized into three intervention groups treated with PBM and one control group (PBM placebo). Volunteers performed up 20 interventions with PBM, either placebo or actual, in conjunction with conventional therapy, which involved dressing the wound with Helianthus annuus vegetable oil. The primary variable was the ulcer size reduction rate.

RESULTS

GaAs 904 nm PBM yielded a clinically and significant ulcer size rate reduction of diabetic foot ulcers, independently of energy density range (p < 0.05). However, 10 J/cm² had 60% of completely healed ulcers and the highest proportion of patients reaching 50% of ulcer reduction rate after 5 weeks of treatment. In addition, only 10 J/cm² showed a significant difference between control group after a 10-week follow-up (p < 0.05).

CONCLUSION

GaAs 904 nm PBM was effective in treating diabetic foot ulcers in this study and a dosage of 10 J/cm², after a 10-week follow-up, proved to be the most effective compared to the other groups.

CLINICAL TRIAL REGISTRATION NUMBER

NCT04246814.

Can pre-exercise photobiomodulation improve muscle endurance and promote recovery from muscle strength and injuries in people with different activity levels? A meta-analysis of randomized controlled trials

Photobiomodulation therapy (PBMT) was introduced as an ergogenic aid for sport performance in healthy individuals is still controversial. The main aim of this study is to assess the potential enhancements in muscle endurance and recovery from muscle strength and injuries mediated by PBMT among individuals exhibiting diverse activity levels. Randomized controlled trials (RCT) of PBMT interventions for healthy people (both trained and untrained individuals) exercising were searched (up to January 16, 2024) in four electronic databases: Web of Science, PubMed, Scopus and Embase. Primary outcome measures included muscle endurance, muscle strength and creatine kinase (CK) levels; secondary outcome measure included Lactate dehydrogenase (LDH) levels. Subgroup analyses based on physical activity levels were conducted for each outcome measure. Thirty-four RCTs were included based on the article inclusion and exclusion criteria. Statistical results showed that PBMT significantly improved muscle endurance (standardized mean difference [SMD] = 0.31, 95%CI 0.11, 0.51, p < 0.01), indicating a moderate effect size. It also facilitated the recovery of muscle strength (SMD = 0.24, 95%CI 0.10, 0.39, p < 0.01) and CK (mean difference [MD] = -77.56, 95%CI -112.67, -42.44, p < 0.01), indicating moderate and large effect sizes, respectively. Furthermore, pre-application of PBMT significantly improved muscle endurance, recovery of muscle strength and injuries in physically inactive individuals and athletes (p < 0.05), while there was no significant benefit for physically active individuals. Pre-application of PBMT improves muscle endurance and promotes recovery from muscle strength and injury (includes CK and LDH) in athletes and sedentary populations, indicating moderate to large effect sizes, but is ineffective in physically active populations. This may be due to the fact that physically active people engage in more resistance training, which leads to a decrease in the proportion of red muscle fibres, thus affecting photobiomodulation.

BetaBuddy: An automated end-to-end computer vision pipeline for analysis of calcium fluorescence dynamics in β-cells

Insulin secretion from pancreatic β-cells is integral in maintaining the delicate equilibrium of blood glucose levels. Calcium is known to be a key regulator and triggers the release of insulin. This sub-cellular process can be monitored and tracked through live-cell imaging and subsequent cell segmentation, registration, tracking, and analysis of the calcium level in each cell. Current methods of analysis typically require the manual outlining of β-cells, involve multiple software packages, and necessitate multiple researchers-all of which tend to introduce biases. Utilizing deep learning algorithms, we have therefore created a pipeline to automatically segment and track thousands of cells, which greatly reduces the time required to gather and analyze a large number of sub-cellular images and improve accuracy. Tracking cells over a time-series image stack also allows researchers to isolate specific calcium spiking patterns and spatially identify those of interest, creating an efficient and user-friendly analysis tool. Using our automated pipeline, a previous dataset used to evaluate changes in calcium spiking activity in β-cells post-electric field stimulation was reanalyzed. Changes in spiking activity were found to be underestimated previously with manual segmentation. Moreover, the machine learning pipeline provides a powerful and rapid computational approach to examine, for example, how calcium signaling is regulated by intracellular interactions.

Glucose Improves the Efficacy of Photobiomodulation in Changing ATP and ROS Levels in Mouse Fibroblast Cell Cultures

In this study, we tested the idea that photobiomodulation-the application of red to near infrared light (~λ = 600-1300 nm) to body tissues-is more effective in influencing cell metabolism when glucose is readily available. To this end, we used a mouse fibroblast (L-929) cell culture model and had two sets of conditions: non-stressed (10% FBS (foetal bovine serum)) and stressed (1% FBS), both either with or without glucose. We treated (or not) cells with photobiomodulation using an 810 nm laser at 15 mW/cm2 (~7.2 J/cm2). Our results showed that photobiomodulation was neither cytotoxic nor effective in enhancing measures of cell viability and proliferation, together with protein levels in any of the cell cultures. Photobiomodulation was, however, effective in increasing adenosine triphosphate (ATP) and decreasing reactive oxygen species (ROS) levels and this was-most importantly-only in conditions where glucose was present; corresponding cultures that did not contain glucose did not show these changes. In summary, we found that the benefits of photobiomodulation, in particular in changing ATP and ROS levels, were induced only when there was glucose available. Our findings lay a template for further explorations into the mechanisms of photobiomodulation, together with having considerable experimental and clinical implications.

Dose and time-response effect of photobiomodulation therapy on glycemic control in type 2 diabetic patients combined or not with hypoglycemic medicine: A randomized, crossover, double-blind, sham-controlled trial

Photobiomodulation therapy (PBMt) combined or not with oral hypoglycemic medication has not been investigated in type 2 diabetes (T2DM) patients. All 10 T2DM patients were assessed randomly at 6 different occasions (3 with and 3 without regular oral hypoglycemic medication). Capillary glycemia was assessed after overnight fast (pre-prandial), 1 h postprandially (standardized meal, 338 kcal), and 30 min, 3 h, 6 h, 12 h post-PBMt (830 nm; 25 arrays of LEDs, 80 mW/array). Three doses (0 J-sham, 100 J, 240 J per site) were applied bilaterally on quadriceps femoris muscles, hamstrings, triceps surae, ventral upper arm and forearm; and randomly combined or not with oral hypoglicemic medication, totaling six different therapies applied for all 10 TDM2 patients (PBMt sham, PBMt 100 J, PBMt 240 J, PBMt sham + medication, PBMt 100 J + medication, PBMt 240 J + medication). Cardiac autonomic control was assessed by heart rate variability (HRV) indices. Without medication, there was reduction in glycemia after all PBMt doses, with 100 J as the best dose that persisted until 12 h and presented lower area under the curve (AUC). With medication, glycemia decreased similarly among doses. No differences between 100 J and sham + medication, but AUC was significantly lower after 100 J, suggesting better glycemic control. Low frequency component of HRV increased after sham + medication and 100 J, suggesting higher sympathetic activation. PBMt showed time- and dose-response effect to reduce glycemia in T2DM patients. Effects on HRV were consistent with glycemic control.

Physical therapy in diabetic foot ulcer: Research progress and clinical application

Diabetes foot ulcer (DFU) is one of the most intractable complications of diabetes and is related to a number of risk factors. DFU therapy is difficult and involves long-term interdisciplinary collaboration, causing patients physical and emotional pain and increasing medical costs. With a rising number of diabetes patients, it is vital to figure out the causes and treatment techniques of DFU in a precise and complete manner, which will assist alleviate patients' suffering and decrease excessive medical expenditure. Here, we summarised the characteristics and progress of the physical therapy methods for the DFU, emphasised the important role of appropriate exercise and nutritional supplementation in the treatment of DFU, and discussed the application prospects of non-traditional physical therapy such as electrical stimulation (ES), and photobiomodulation therapy (PBMT) in the treatment of DFU based on clinical experimental records in ClinicalTrials.gov.

Light-emitting diode (LED) photobiomodulation regulates thermogenesis and lipogenesis markers in adipose tissue and improves anthropometric and metabolic parameters in obese mice

To evaluate the effects of Light-Emitting Diode (LED) irradiation on the expression of thermogenesis and lipogenesis-associated markers in adipose tissue and metabolic parameters of obese mice. Twenty-four male mice were divided into four groups: i) ST fed standard diet; ii) HCD fed hyperglycemic diet; iii) LED + I fed hyperglycemic diet and irradiated with LED in the interscapular region; iv) LED + A fed hyperglycemic diet and irradiated with LED in the abdominal region. The first phase of the study comprehended the induction of obesity for 12 weeks. Next, the animals were submitted to six irradiation sessions (days 1, 3, 7, 10, 14, and 21) using a 660-nm LED (5.77 J/cm² at 48,1 mW/cm²). Anthropometric, biochemical, and histological parameters and the expression of thermogenesis and lipogenesis-associated markers were assessed in adipose tissue. There was diminished weight gain between the HCD and LED + A groups (ST: 0.37 ± 0.65; HCD: 3.10 ± 0.89; LED + I: -1.26 ± 0.83; LED + A: -2.07 ± 1.27 g; p < 0.018). There was a 33.3% and 23.8% reduction in epidydimal adipose tissue weight and a 25% and 10.7% in the visceral adiposity for the LED + I and LED + A groups, respectively, when compared with HCD. There was a decreased accumulation of fat droplets in adipose tissue in LED + A and LED + I groups. Additionally, LED irradiation was associated with increased mRNA expression of uncoupling protein 1 (UCP1) in the brown adipose tissue (ST: 2.27 ± 0.19; HCD: 1.54 ± 0.12; LED + I: 2.44 ± 0.22; p = 0.014) and decreased fatty acid synthetase (FAS) expression in epidydimal adipose tissue (ST: 0.79 ± 0.13; HCD: 1.59 ± 0.13; LED + A: 0.85 ± 0.04; p = 0.0008). LED treatment improved anthropometric parameters, possibly associated with the histological alterations, thermogenesis and lipogenesis markers in white adipose tissue, and expression modulation in brown adipose tissue.

Duodenal Dual-Wavelength Photobiomodulation Improves Hyperglycemia and Hepatic Parameters with Alteration of Gut Microbiome in Type 2 Diabetes Animal Model

BACKGROUND

Recently, the duodenum has garnered interest for its role in treating metabolic diseases, including type 2 diabetes (T2DM). Multiple sessions of external photobiomodulation (PBM) in previous animal studies suggested it resulted in improved hyperglycemia, glucose intolerance, and insulin resistance with a multifactorial mechanism of action, despite the target organ of PBM not being clearly proven. This study aimed to determine whether a single session of a duodenal light-emitting diode (LED) PBM may impact the T2DM treatment in an animal model.

METHODS

Goto-Kakizaki rats as T2DM models were subjected to PBM through duodenal lumen irradiation, sham procedure, or control in 1-week pilot (630 nm, 850 nm, or 630/850 nm) and 4-week follow-up (630 nm or 630/850 nm) studies. Oral glucose tolerance tests; serum glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic polypeptide, and insulin levels; liver chemistry and histology; and gut microbiome in the PBM, sham control, and control groups were evaluated.

RESULTS

In the 1-week study, duodenal dual-wavelength (D, 630/850 nm) LED PBM showed improved glucose intolerance, alkaline phosphatase and cholesterol levels, and weight gain than other groups. The D-LED PBM group in the 4-week study also showed improved hyperglycemia and liver enzyme levels, with relatively preserved pancreatic islets and increased serum insulin and GLP-1 levels. Five genera (Bacteroides, Escherichia, Parabacteroides, Allobaculum, and Faecalibaculum) were significantly enriched 1 week after the D-LED PBM. Bacteroides acidifaciens significantly increased, while Lachnospiraceae significantly decreased after 1 week.

CONCLUSION

A single session of D-LED PBM improved hyperglycemia and hepatic parameters through the change of serum insulin, insulin resistance, insulin expression in the pancreatic β-cells, and gut microbiome in T2DM animal models.

Dose Response Effect of Photobiomodulation on Hemodynamic Responses and Glucose Levels in Men with Type 2 Diabetes: A Randomized, Crossover, Double-Blind, Sham-Controlled Trial

This study verifies the acute dose response effect of photobiomodulation (PBM) by light emitting diodes (LEDs) on hemodynamic and metabolic responses in individuals with type 2 diabetes mellitus (T2DM). Thirteen participants with T2DM (age 52 ± 7 years) received PBM by a light-emitting diode array (50 GaAIAs LEDs, 850 ± 20 nm, 75 mW per diode) on the rectus and oblique abdomen, quadriceps femoris, triceps surae, and hamstring muscle areas, bilaterally, using different energy treatments (sham, 75, 150, 300, 450, and 600 Joules) in random order with a washout of at least 15 days apart. The PBM by LEDs statistically decreased plasma glucose levels (primary outcome) in 15 min after application of the 75 and 450 J irradiation protocol, reduced blood lactate levels 15 min after application of the 75, 450, and 600 J irradiation protocol, increased cardiac output (Q˙) and cardiac index (CI) in the 1st minute after application of the 75 and 300 J irradiation protocol, and reduced Q˙ and heart rate (HR) in the 15 min after application of the 300 J and 600 J irradiation protocol, respectively. For hemodynamic variables, including Q˙, total peripheral resistance (TPR), and HR, we observed that the ideal therapeutic window ranged between 75 and 300 J, while for metabolic variables, glucose and lactate, the variation was between 450 and 600 J.

Effects of photobiomodulation on glucose homeostasis and morphometric parameters in pancreatic islets of diabetic mice

High-fat diets lead to accumulation of body fat that is associated with the onset of insulin resistance and type II diabetes mellitus. On the other hand, photobiomodulation (PBM) is an electrophysical resource that interacts with cells, stimulating mitochondrial respiration, increasing ATP production, reducing key inflammatory mediators, inhibiting apoptosis, and stimulating angiogenesis. However, little is known about its therapeutic effectiveness on the development of diabetes in diet-induced obese mice. Thus, our aim was to evaluate the effect of PBM applied single point over the pancreas area on glucose homeostasis, insulin expression, and pancreatic morphometric parameters of mice submitted to high-fat diet for 12 weeks. Male mice C57BL6/J were divided into three groups: control group (C), diabetic group (D), and diabetic + PBM (D + PBM). The treatment with PBM started at 9th week and ended in the 12th week, applied 3 × /week. Body mass, fast blood glucose, and glucose and insulin tolerance were evaluated. Immunohistochemistry to detect insulin expression and pancreatic morphometry were also performed. At the end of 12th week, both groups submitted to high-fat diet showed an increase in body mass, adiposity, disturbances on glucose homeostasis, and high insulin expression when compared to the control group. However, mice treated with PBM had more discrete impairments on glucose homeostasis during the glucose tolerance test when compared to untreated D animals. Despite modest, the results were positive and encourage future investigations to explore different doses and duration of PBM to better elucidate its role in obesity-associated type 2 diabetes development.

The bioenergetics of COVID-19 immunopathology and the therapeutic potential of biophysical radiances

In developing an effective clinical tool against COVID-19, we need to consider why SARS-CoV-2 infections develop along remarkably different trajectories: from completely asymptomatic to a severe course of disease. In this paper we hypothesize that the progressive exhaustion and loss of lymphocytes associated with severe stages of COVID-19 result from an intracellular energy deficit in an organism which has already been depleted by preexisting chronic diseases, acute psychological stress and the aging process. A bioenergetics view of COVID-19 immunopathology opens a new biophysical opportunity to enhance impaired immune function via proposed pathways of photomagnetic catalysis of ATP synthesis, regenerative photobiomodulation and the ultrasonic acceleration of cell restructuring. Moreover, we suggest that a coherent application of multiple biophysical radiances (coMra) may synergistically enhance energy-matter-information kinetics of basal self-regeneration of cells and thus improve immune function and accelerate recovery.

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Bioenergetics offers a unifying framework of COVID-19 immunopathology.

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Functional reserve of immune cells depends on the kinetics of basal housekeeping.

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Various biophysical stimuli enhance the kinetics of cellular self-regeneration.

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A coherent application of multiple radiances has potential to treat COVID-19.

Hypoglycemic and hypolipidemic activity of combined milk thistle and fenugreek seeds in alloxan-induced diabetic albino rats

BACKGROUND AND AIM

Despite the availability of antidiabetic drugs, they are not free from associated adverse side effects. This study aimed to evaluate the hypoglycemic and hypolipidemic effects of oral administration of seeds from two medicinal plants: (1) Milk thistle and (2) fenugreek.

MATERIALS AND METHODS

Plant seeds were washed in distilled water and ground with a coffee grinder. Alloxan was used to induce diabetes in 20 male albino rats. Diabetic rats were randomly divided into two groups: (1) Group 1 (n=10), diabetic rats fed with 0.5 g/kg milk thistle and 2 g/kg fenugreek seeds per day and (2) Group 2 (n=10), diabetic rats fed standard rodent food for 4 weeks.

RESULTS

Oral administration of milk thistle and fenugreek seeds for 2 weeks resulted in significant improvement in body weight, blood glucose, glycosylated hemoglobin (HbA1c), cholesterol, and triglyceride levels in alloxan-induced diabetic rats. After 4 weeks, this ameliorative effect was significantly elevated with respect to blood glucose (155.00±9.70 mg/dL vs. 427.50±5.70 mg/dL; p<0.001), HbA1c (5.5±0.19% vs. 13.65±1.77%; p<0.001), cholesterol (281.50±10.95 mg/dL vs. 334.30±6.80 mg/dL; p<0.001), triglyceride (239.60±6.87 mg/dL vs. 284.20±9.95 mg/dL; p<0.01), and body weight (265.30±8.10 g vs. 207.40±11.4 g; p<0.01) as compared with non-treated diabetic rats.

CONCLUSION

Milk thistle and fenugreek seeds possess hypoglycemic and hypolipidemic properties and could be used as natural compounds that are suitable as parent compounds for the development of new antidiabetic drugs.