Biomodulative effects induced by 805 nm laser light irradiation of normal and tumor cells

Possible adverse effects of low-level laser on oral and oropharyngeal cancer cells: A scope review

BACKGROUND

The effects of laser therapy on normal cells are well known and accepted, but the impact of this therapy on malignant cells are not yet fully understood. This review aims to map and outline what the scientific literature addresses on the effects of laser therapy on malignant cells.

METHODS

This review article followed the guidelines of the PRISMA-ScR protocol, being all the search, analysis, and selection of articles based on it.

RESULTS

After all application of the predetermined criteria, five studies were included, dated between the years 2013 and 2021. With the complete reading of the selected studies, 100% of the articles were classified as category III of the Agency for Healthcare as Research and Quality classification. Similar themes among the papers included were investigated and compared. In these five studies, the visible red and near infrared wavelengths were used, and energy densities varied between 1 and 5 J/cm² . It was observed that low-level laser could alter the expression of cell proliferation and migration proteins, such as cyclin D1, E-cadherin, and β-catenin. In addition, changes related to increased cell viability and metabolism were also identified.

CONCLUSION

The low-level laser seems to positively regulate the proliferative, migratory, and viability capacity of neoplastic cells, depending on the protocol used. All these studies included in the review are equivalent to in vitro studies; the cells are not in such a complex environment as is an organized tissue, making it necessary to carry out more complex tests, such as in vivo research.

Low-Level Laser Therapy Induces Melanoma Tumor Growth by Promoting Angiogenesis

The effects of low-level laser therapy (LLLT) on tumor growth are inconsistent. In this study, we investigated the effects of LLLT on melanoma tumor growth and angiogenesis. C57/BL6 mice were challenged with B16F10 melanoma cells and treated with LLLT for 5 consecutive days; untreated mice were used as controls. Tumor weight, angiogenesis, immunohistochemistry, and protein levels were compared between the treated and untreated mice. In an in vitro experiment, B16F10 cells were treated with LLLT. Proteins were extracted and subjected to Western blot analysis for analyzing signaling pathways. Compared with the findings in the untreated mice, tumor weight substantially increased in the treated mice. Both immunohistochemical and Western blot analyses revealed markedly increased levels of CD31, a biomarker of vascular differentiation, in the LLLT group. In B16F10 cells, LLLT considerably induced the phosphorylation of extracellular signal-regulated kinase (ERK), which, in turn, phosphorylated p38 mitogen-activated protein kinase (MAPK). Furthermore, LLLT induced the expression of vascular endothelial growth factor, but not hypoxia-inducible factor-1α, through the ERK/p38 MAKP signaling pathways. Our findings indicate that LLLT induces melanoma tumor growth by promoting angiogenesis. Therefore, it should be avoided in patients with melanoma.

Photobiomodulation therapy in management of cancer therapy-induced side effects: WALT position paper 2022

Disclaimer

This article is based on recommendations from the 12th WALT Congress, Nice, October 3-6, 2018, and a follow-up review of the existing data and the clinical observations of an international multidisciplinary panel of clinicians and researchers with expertise in the area of supportive care in cancer and/or PBM clinical application and dosimetry. This article is informational in nature. As with all clinical materials, this paper should be used with a clear understanding that continued research and practice could result in new insights and recommendations. The review reflects the collective opinion and, as such, does not necessarily represent the opinion of any individual author. In no event shall the authors be liable for any decision made or action taken in reliance on the proposed protocols.

Objective

This position paper reviews the potential prophylactic and therapeutic effects of photobiomodulation (PBM) on side effects of cancer therapy, including chemotherapy (CT), radiation therapy (RT), and hematopoietic stem cell transplantation (HSCT).

Background

There is a considerable body of evidence supporting the efficacy of PBM for preventing oral mucositis (OM) in patients undergoing RT for head and neck cancer (HNC), CT, or HSCT. This could enhance patients’ quality of life, adherence to the prescribed cancer therapy, and treatment outcomes while reducing the cost of cancer care.

Methods

A literature review on PBM effectiveness and dosimetry considerations for managing certain complications of cancer therapy were conducted. A systematic review was conducted when numerous randomized controlled trials were available. Results were presented and discussed at an international consensus meeting at the World Association of photobiomoduLation Therapy (WALT) meeting in 2018 that included world expert oncologists, radiation oncologists, oral oncologists, and oral medicine professionals, physicists, engineers, and oncology researchers. The potential mechanism of action of PBM and evidence of PBM efficacy through reported outcomes for individual indications were assessed.

Results

There is a large body of evidence demonstrating the efficacy of PBM for preventing OM in certain cancer patient populations, as recently outlined by the Multinational Association for Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). Building on these, the WALT group outlines evidence and prescribed PBM treatment parameters for prophylactic and therapeutic use in supportive care for radiodermatitis, dysphagia, xerostomia, dysgeusia, trismus, mucosal and bone necrosis, lymphedema, hand-foot syndrome, alopecia, oral and dermatologic chronic graft-versus-host disease, voice/speech alterations, peripheral neuropathy, and late fibrosis amongst cancer survivors.

Conclusions

There is robust evidence for using PBM to prevent and treat a broad range of complications in cancer care. Specific clinical practice guidelines or evidence-based expert consensus recommendations are provided. These recommendations are aimed at improving the clinical utilization of PBM therapy in supportive cancer care and promoting research in this field. It is anticipated these guidelines will be revised periodically.

808-nm Photobiomodulation Affects the Viability of a Head and Neck Squamous Carcinoma Cellular Model, Acting on Energy Metabolism and Oxidative Stress Production

Photobiomodulation (PBM) is a form of low-dose light therapy that acts through energy delivery from non-ionizing sources. During the recent two decades, there has been tremendous progress with PBM acceptance in medicine. However, PBM effects on potential stimulation of existing malignant or pre-malignant cells remain unknown. Thus, the primary endpoint was to assess the safety of PBM treatment parameters on head and neck squamous cell carcinoma (HNSCC) proliferation or survival. The secondary endpoint was to assess any putative anti-cancer effects of PBM treatments. Cell viability, energy metabolism, oxidative stress, and pro- and anti-apoptotic markers expression were investigated on a Human Head and Neck Squamous Cell Carcinoma cellular model (OHSU-974 FAcorr cell line). PBM therapy was administered through the 810 nm diode laser (GaAlAs) device (Garda Laser, 7024 Negrar, Verona, Italy) at the powers of 0, 0.25, 0.50, 0.75, 1.00, or 1.25 W in continuous wave (CW) mode for an exposure time of 60 s with a spot-size of 1 cm² and with a distance of 1.86 cm from the cells. Results showed that 810-nm PBM affected oxidative phosphorylation in OHSU-971 FAcorr, causing a metabolic switch to anaerobic glycolysis. In addition, PBM reduced the catalase activity, determining an unbalance between oxidative stress production and the antioxidant defenses, which could stimulate the pro-apoptotic cellular pathways. Our data, at the parameters investigated, suggest the safeness of PBM as a supportive cancer therapy. Pre-clinical and clinical studies are necessary to confirm the in vitro evidence.

Effects of 660 nm and 810 nm Low-Power Diode Laser on Proliferation and Invasion of Oral Cancer Cells in Cell Culture Media

In the present study, the effects of 660 and 810 nm diode laser on the proliferation and invasion of cancer cells were investigated. Sixteen plates of oral cancer cells originated from tongue SCC were irradiated with diode laser at 660 nm (40 and 80 mW) and 810 nm (100 and 200 mW) with the energy density of 4 J cm^-2 . One plate received no irradiation (the control). Irradiation was performed at four times (0, 24, 72 and 168 h). Cell proliferation was measured by MTT assay. The Ki67 and vascular endothelial growth factor (VEGF) markers were examined by real-time polymerase chain reaction (RT-PCR). Cyclin D1, E-cadherin, β-catenin and matrix metalloproteinase-9 (MMP-9; flow cytometry) were also evaluated. Proliferation was lower in the irradiated groups. This result was significant for all groups at 24 h. The percentages of cyclin D1 and MMP-9 were higher in 810 nm groups, β-catenin and E-cadherin were higher in 660 nm groups, VEGF marker was significantly lower in 810 nm/200 mW group, and Ki67 marker has no difference between the groups. According to the results of this study, laser irradiation at 0 and 24 h resulted in a significant inhibitory effect on cell proliferation especially in 660 nm/80 mW and 810 nm/200 mW. Further studies are needed in this respect.

Safety and efficacy of photobiomodulation therapy in oncology: A systematic review

We performed a systematic review of the current literature addressing the safety and efficacy of photobiomodulation therapy (PBMT) in cancer patients. In this systematic review, the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were used. In vitro, in vivo, and clinical studies, which investigated the effect of PBMT on cell proliferation/differentiation, tumor growth, recurrence rate, and/or overall survival were included. The Medline/PubMed, EMBASE, and Scopus databases were searched through April 2020. A total of 67 studies met the inclusion criteria with 43 in vitro, 15 in vivo, and 9 clinical studies identified. In vitro studies investigating the effect of PBMT on a diverse range of cancer cell lines demonstrated conflicting results. This could be due to the differences in used parameters and the frequency of PBM applications. In vivo studies and clinical trials with a follow‐up period demonstrated that PBMT is safe with regards to tumor growth and patient advantage in the prevention and treatment of specific cancer therapy‐related complications. Current human studies, supported by most animal studies, show safety with PBMT using currently recommended clinical parameters, including in Head & Neck cancer (HNC) in the area of PBMT exposure. A significant and growing literature indicates that PBMT is safe and effective, and may even offer a benefit in patient overall survival. Nevertheless, continuing research is indicated to improve understanding and provide further elucidation of remaining questions regarding PBM use in oncology.

Physiological mechanisms of the low-intensity laser radiation impact on the highly qualified athletes’ special physical performance

In the context of strengthening the fight against doping and limiting the use of synthetic pharmaceuticals, the effective remedies to increase physical performance and accelerate the recovery of athletes are being sought. One of such remedies is exposure to low-level laser radiation (LLLR, LLLT). The study was aimed to investigate the physiological response of highly qualified female rowers’ functional systems to the LLLR irradiation course. To monitor the body of athletes, we used laser Doppler flowmetry (LDF), mathematical analysis of heart rate, neuroenergy mapping, as well as pedagogical testing using the Concept 2 simulator. After irradiation of the neck in the projection of the carotid arteries with pulsed infrared LLLR, the blood perfusion rate increased by 38% (р < 0.05) and cell oxygen utilization rate increased by 48% (р < 0.05). The decrease in the hemoglobin oxygen saturation by 16% (р < 0.05) was also observed. Due to LLLT, the activity of the autonomous regulation mechanism increased with an increase in the total power of the heart rate variability spectrum (TP) by 41% (р < 0.05), and in high-frequency power (HF) by 73% (р < 0.05). The influence of central mechanism decreased with a decrease in amplitude mode (AMo) by 71% (р < 0.05), and in stress-index (SI) by 175% (р < 0.05). Irradiation by LLLR promoted the efficiency of oxygen delivery to certain cerebral cortex areas with the increase of SPL. Аfter LLLT, the speed of 2000 meters distance "passing" by athletes also increased by 3.32% (p > 0.05). The discovered effects of LLLT allow one to expand the range of physiotherapeutic agents that enhance the special physical performance of athletes and accelerate recovery.

Examining tumor modulating effects of photobiomodulation therapy on head and neck squamous cell carcinomas

The aim of the present systematic review was to analyze studies that investigated the effects of photobiomodulation therapy on head and neck squamous cell carcinoma cells.

Exploring the effects of low-level laser therapy on fibroblasts and tumor cells following gamma radiation exposure

Ionizing radiation (IR) induces DNA damage and low-level laser therapy (LLLT) has been investigated to prevent or repair detrimental outcomes resulting from IR exposure. Few in vitro studies, however, explore the biological mechanisms underlying those LLLT benefits. Thus, in this work, fibroblasts and tumor cells are submitted to IR with doses of 2.5 Gy and 10 Gy. After twenty-four-h, the cells are exposed to LLLT with fluences of 30 J cm^-2 , 90 J cm^-2 , and 150 J cm^-2 . Cellular viability, cell cycle phases, cell proliferation index and senescence are evaluated on days 1 and 4 after LLLT irradiation. For fibroblasts, LLLT promotes - in a fluence-dependent manner - increments in cell viability and proliferation, while a reduction in the senescence was observed. Regarding tumor cells, no influences of LLLT on cell viability are noticed. Whereas LLLT enhances cell populations in S and G₂ /M cell cycle phases for both cellular lines, a decrease in proliferation and increase in senescence was verified only for tumor cells. Putting together, the results suggest that fibroblasts and tumor cells present different responses to LLLT following exposure to gamma-radiation, and these promising results should stimulate further investigations. Senescence of tumor cells and fibroblasts on the 4^th day after ionizing radiation (IR) and low-level laser therapy (LLLT) exposures. The number of senescent cells increased significantly for tumor cells (a) while for fibroblasts no increment was observed (b). The blue collor indicates senescence activity.

Low level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 1: mechanisms of action, dosimetric, and safety considerations

PURPOSE

There is a large body of evidence supporting the efficacy of low level laser therapy (LLLT), more recently termed photobiomodulation (PBM), for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a better understanding of mechanisms involved, may expand the applications for PBM in the management of other complications associated with HNC treatment. This article (part 1) describes PBM mechanisms of action, dosimetry, and safety aspects and, in doing so, provides a basis for a companion paper (part 2) which describes the potential breadth of potential applications of PBM in the management of side-effects of (chemo)radiation therapy in patients being treated for HNC and proposes PBM parameters.

METHODS

This study is a narrative non-systematic review.

RESULTS

We review PBM mechanisms of action and dosimetric considerations. Virtually, all conditions modulated by PBM (e.g., ulceration, inflammation, lymphedema, pain, fibrosis, neurological and muscular injury) are thought to be involved in the pathogenesis of (chemo)radiation therapy-induced complications in patients treated for HNC. The impact of PBM on tumor behavior and tumor response to treatment has been insufficiently studied. In vitro studies assessing the effect of PBM on tumor cells report conflicting results, perhaps attributable to inconsistencies of PBM power and dose. Nonetheless, the biological bases for the broad clinical activities ascribed to PBM have also been noted to be similar to those activities and pathways associated with negative tumor behaviors and impeded response to treatment. While there are no anecdotal descriptions of poor tumor outcomes in patients treated with PBM, confirming its neutrality with respect to cancer responsiveness is a critical priority.

CONCLUSION

Based on its therapeutic effects, PBM may have utility in a broad range of oral, oropharyngeal, facial, and neck complications of HNC treatment. Although evidence suggests that PBM using LLLT is safe in HNC patients, more research is imperative and vigilance remains warranted to detect any potential adverse effects of PBM on cancer treatment outcomes and survival.

Light enhanced bone regeneration in an athymic nude mouse implanted with mesenchymal stem cells embedded in PLGA microspheres

BACKGROUND

Biodegradable microspheres fabricated from poly (Lactic-co-glycolic acid) (PLGA) have attracted considerable attention in the bone tissue regeneration field. In this study, rabbit mesenchymal stem cells (rMSCs) adherent to PLGA microspheres were implanted into athymic nude mice and irradiated with 647 nm red light to promote bone formation. It was found that irradiating rMSCs with high levels of red light (647 nm) from an LED (light-emitting diode) increased levels of bone specific markers in rMSCs embedded on PLGA microspheres.

RESULT

These increased expressions were observed by RT-PCR, real time-QPCR, immunohistochemistry (IHC), and von Kossa and Alizarin red S staining. Microsphere matrices coated with rMSCs were injected into athymic nude mice and irradiated with red light for 60 seconds showed significantly greater bone-specific phenotypes after 4 weeks in vivo.

CONCLUSION

The devised PLGA microsphere matrix containing rMSCs and irradiation with red light at 647 nm process shows promise as a means of coating implantable biomedical devices to improve their biocompatibilities and in vivo performances.

Effect of pulsed Nd:YAG laser in the treatment of neuropathic foot ulcers in children with spina bifida: a randomized controlled study

OBJECTIVE

This study assessed the effects of pulsed Nd:YAG laser treatment of neuropathic foot ulcers in children with spina bifida.

BACKGROUND DATA

Children with spina bifida face increased risk for developing neuropathic foot ulcers.

METHODS

In a randomized controlled trial, 39 children and adolescents (ages 6-15 years) with spina bifida and stage III neuropathic foot ulcers were randomly assigned to the laser group or the placebo laser group. The former received pulsed Nd:YAG laser treatments (i.e., total energy of 300-350 J during three sessions/week) plus standard wound care, and the latter received sham laser treatments plus standard wound care. Wound size and wound appearance were assessed for all patients at the beginning of the treatment, after 5 weeks, and after 10 weeks.

RESULTS

The decrease in wound surface area at 5 and 10 weeks post- treatment was significantly greater in the laser group (i.e., 2.44 ± 0.33 and 0.29 ± 0.25 cm(2), respectively) than in the placebo group (i.e., 3.81 ± 0.18 and 3.24 ± 0.44 cm(2), respectively). Also, the decrease in the total score for the Pressure Sore Status Tool (PSST) at 5 and 10 weeks post-treatment was significantly different for the laser group (i.e., 32.76 ± 2.30 and 17.52 ± 1.66, respectively) than for the placebo group (i.e., 46.50 ± 2.12 and 38.11 ± 3.17, respectively).

CONCLUSIONS

Treatment with pulsed neodymium:yttrium aluminum garnet (Nd:YAG) laser combined with standard wound care decreases wound size and improves wound appearance for stage III neuropathic foot ulcers in children with spina bifida.

Use of laser phototherapy on a delayed wound healing of oral mucosa previously submitted to radiotherapy: case report

Radiotherapy produces both acute and delayed effects on mucosal tissues, disturbing their healing. This report shows a successful treatment with laser phototherapy (LPT) on a delayed wound healing in oral mucosa previously submitted to radiotherapy with a follow up of 3 years. A 47-year-old patient treated 6 months earlier for tongue squamous cell carcinoma by surgery and radiotherapy presented with a mass in the operated area. Biopsy showed chronic inflammatory infiltrate around a residual polyglactin suture. After 2 months there was a painful mucosal dehiscence on the biopsy site. LPT was performed using a semiconductor laser with 660-nm wavelength (InGaAlP) and spot size of 0·04 cm(2) . The parameters applied were 40 mW, 4 Jcm(2) /point, 0·16 J/point, 2·4 J/session. The irradiation was performed punctually, through contact mode in 15 points (4 seconds/point), on top of and around the lesion, during ten sessions. The wound healed completely after ten sessions. This treatment proved to be conservative and effective, inducing healing of a chronic wound in a tissue previously submitted to radiotherapy.

Influência do laser arseneto de gálio-alumínio em feridas cutâneas de ratos

OBJETIVO: O presente estudo avaliou o efeito do laser arseneto de gálio-alumínio (GaAsAl) 830nm (30j/cm²) e da pomada Dersani® no processo cicatricial cutâneo de ratos wistar, em relação à proliferação fibroblástica e revascularização. MATERIAIS E MÉTODOS: Foram utilizados 18 ratos wistar adultos jovens, machos, com peso médio de 324 g, provenientes do Biotério do Centro de Ciências Biológicas da Universidade Federal de Viçosa. Foram feitas cinco feridas de 12 mm no dorso dos animais utilizando bisturi. Os animais foram divididos aleatoriamente em três grupos, cada grupo com seis animais: Grupo 1: Controle - os animais tiveram a ferida tratada com salina, Grupo 2: Feridas tratados com laser GaAsAl (830nm) 30J/cm² e Grupo 3: Feridas tratadas com Dersani®. As aplicações foram feitas diariamente durante 20 dias de experimento. O material para análise histológica foi corado com hematoxilina-eosina (HE), fotografados e analisados por meio do programa Image Pro-plus®, por contagem de pontos sob células de interesse. RESULTADOS: Foi observado maior número de fibroblastos nos grupos tratados com o laser GaAsAl e com a pomada Dersani®, quando comparados ao controle no quarto dia do experimento. No entanto, no oitavo dia o grupo tratado com laser apresentou um número significativamente menor de fibroblastos, quando comparado ao controle e ao Dersani®. Em relação à revascularização foi observada diferença significativa entre o laser e o Dersani® no oitavo dia de experimento, em que o Dersani® se mostrou mais efetivo na formação de vasos sanguíneos. CONCLUSÃO: O grupo tratado com o laser GaAsAl no quarto dia aumentou significativamente a quantidade de fibroblastos quando comparado ao controle.

The effects of laser irradiation on osteoblast and osteosarcoma cell proliferation and differentiation in vitro

OBJECTIVE

The aim of this study was to investigate the effects of 670-nm, 780-nm, and 830-nm laser irradiation on cell proliferation of normal primary osteoblast (MC3T3) and malignant osteosarcoma (MG63) cell lines in vitro.

BACKGROUND

Some studies have shown that laser phototherapy is able to stimulate the osteogenesis of bone tissue, increasing osteoblast proliferation and accelerating fracture consolidation. It has been suggested that laser light may have a biostimulatory effect on tumor cells. However, the mechanism by which the laser acts on cells is not fully understood.

MATERIALS AND METHODS

Neonatal, murine, calvarial, osteoblastic, and human osteosarcoma cell lines were studied. A single laser irradiation was performed at three different wavelengths, at the energies of 0.5, 1, 5, and 10 J/cm(2). Twenty-four hours after laser irradiation, cell proliferation and alkaline phosphatase assays were assessed.

RESULTS

Osteoblast proliferation increased significantly after 830-nm laser irradiation (at 10 J/cm(2)) but decreased after 780-nm laser irradiation (at 1, 5, and 10 J/cm(2)). Osteosarcoma cell proliferation increased significantly after 670-nm (at 5 J/cm(2)) and 780-nm laser irradiation (at 1, 5, and 10 J/cm(2)), but not after 830-nm laser irradiation. Alkaline phosphatase (ALP) activity in the osteoblast line was increased after 830-nm laser irradiation at 10 J/cm(2), whereas ALP activity in the osteosarcoma line was not altered, regardless of laser wavelength or intensity.

CONCLUSION

Based on the conditions of this study, we conclude that each cell line responds differently to specific wavelength and dose combinations. Further investigations are required to investigate the physiological mechanisms responsible for the contrasting outcomes obtained when using laser irradiation on cultured normal and malignant bone cells.

Effect of low intensity laser interaction with human skin fibroblast cells using fiber-optic nano-probes

Over the past forty years, many efforts have been devoted to study low power laser light interactions with biological systems. Some of the investigations were performed in-vitro, on bulk cell populations. Our present work was undertaken to apply specially engineered fiber-optic based nano-probes for the precise delivery of laser light on to a single cell and to observe production of low power laser light induced reactive oxygen species (ROS). A normal human skin fibroblast (NHF) cell line was utilized in this investigation and the cells were irradiated under two different schemes of exposure: (1) an entire NHF cell population within a Petri dish using a fan beam methodology, and (2) through the precise delivery of laser energy on to a single NHF cell using fiber-optic nano-probe. Photobiostimulative studies were conducted through variation of laser intensity, exposure time, and the energy dose of exposure. Laser irradiation induced enhancement in the rate of cell proliferation was observed to be dependent on laser exposure parameters and the method of laser delivery. The total energy dose (fluence) had a greater influence on the enhancement in the rate of cellular proliferation than compared to laser intensity. The enhancement in the growth rate was observed to have a finite life-time of several days after the initial laser exposure. Fluorescent life-time imaging of ROS was performed during the nano-based single cell exposure method. The kinetics of ROS generation was found to depend strongly on the laser fluence and not on the laser intensity.

Single cell analysis of PKC activation during proliferation and apoptosis induced by laser irradiation

Laser irradiation has been shown to trigger cellular proliferation and apoptosis in various cell types. Studying the signaling pathways involved in the laser irradiation is important for understanding these processes. In present study, to monitor the protein kinase Cs (PKCs) activity in living cells in real time, we transfected and screened human lung adenocarcinoma cells (ASTC-a-1) stably expressing C kinase activity reporter (CKAR) constructed based on fluorescence resonance energy transfer (FRET) technique. The CKAR is a specific, reversible reporter of phosphorylation by PKCs and it can monitor the ongoing balance between PKCs and phosphatases. The increasing dynamics of PKCs activity is monitored during cell proliferation induced by low-power laser irradiation (LPLI) (0.8 J/cm2) in serum-starved ASTC-a-1 cells stably expressing CKAR reporter using FRET imaging on laser scanning confocal microscope and using spectrofluorometric analysis on a luminescence spectrometer, respectively. However, the decreasing dynamics of PKCs activity has been monitored in real time using FRET imaging for the cells treated with high fluence LPLI (60 J/cm2), which was previously found to induce cell apoptosis. Taken together, LPLI induces the ASTC-a-1 cell proliferation by specifically activating PKCs. However, PKCs activity decreases during cell apoptosis induced by high fluence LPLI. Our results indicate that PKCs play an important role in the laser irradiation-induced biological effects.

Low power laser radiation at 685nm stimulates stem-cell proliferation rate in Dugesia tigrina during regeneration

Today's scientific interest in tissue engineering for organ transplantations and regeneration from stem cells, allied with recent observations on biostimulation of tissues and cells by laser radiation, stands as a strong motivation for the present work, in which we examine the effects of the low power laser radiation onto planarians under regenerative process. To investigate those effects, a number of 60 amputated worms were divided in three study groups: a control group and two other groups submitted to daily 1 and 3 min long laser treatment sections at approximately 910 W/m2 power density. A 685 nm diode laser with 35 mW optical power was used. Samples were sent to histological analysis at the 4th, the 7th and the 15th days after amputation. A remarkable increase in stem cells counts for the fourth day of regeneration was observed when the regenerating worms was stimulated by the laser radiation. Our findings encourage further research works on the influence of optical radiation onto stem cells and tissue regeneration.

Effect of 830-nm laser light on the repair of bone defects grafted with inorganic bovine bone and decalcified cortical osseus membrane

OBJECTIVE

The aim of this study was to histologically assess the effect of low-level laser therapy (LLLT) (lambda830 nm) on the repair of standardized bone defects of the femur of Wistar albinus rats grafted with inorganic bovine bone and associated (or not) with decalcified bovine cortical bone membrane.

BACKGROUND DATA

Bone loss may be a result of pathology, trauma, or surgical procedure. Extensive studies on the process of bone repair have been undertaken, and several techniques for the correction of bone defects have been proposed. Amongst them is the use of several types of grafts, the use of membranes, and the combination of both techniques. There is evidence in the literature of the positive effect of LLLT on the healing of soft tissue wounds. However, its effect on bone healing is not completely understood.

MATERIALS AND METHODS

Five randomized groups were studied: group I (control); group IIA (Gen-ox); group IIB (Gen-ox + LLLT); group IIIA (Gen-ox + Gen-derm); and group IIIB (Gen-ox + Gen-derm + LLLT). Bone defects were created at the femur and were treated according to the group. The animals of irradiated groups were irradiated every 48 h for 15 days; the first irradiation was performed immediately after the procedure. The animals were irradiated transcutaneuosly at four points around the defect. At each point, a dose of 4 J/cm2 was given (phi approximately equal to 0.6 mm, 40 mW), and the total dose per session was 16 J/cm2. The animals were humanely killed at 15, 21, and 30 days after surgery. The specimens were routinely processed to wax, serially cut, stained with H&E and Picrosirius stains, and analyzed under light microscopy.

RESULTS

The results showed more advanced repair of the irradiated groups when compared to the non-irradiated ones. The repair of the irradiated group was characterized by both increased bone formation and on the amount of collagen fibers around the graft within the cavity, as early as the 15th day after surgery, considering the osteoconductive capacity of the Gen-ox and the increment of the cortical repair in specimens with Gen-derm membrane.

CONCLUSION

It is concluded that LLLT had a positive effect on the repair of bone defect by graft associated or not with the use of biological membrane.

Effect of 830-nm Laser Light on the Repair of Bone Defects Grafted with Inorganic Bovine Bone and Decalcified Cortical Osseous Membrane

OBJECTIVE

The aim of this study was to assess histologically the effect of LLLT (lambda830 nm) on the repair of standardized bone defects on the femur of Wistar albinus rats grafted with inorganic bovine bone and associated or not to decalcified bovine cortical bone membrane.

BACKGROUND DATA

Bone loss may be a result of several pathologies, trauma or a consequence of surgical procedures. This led to extensive studies on the process of bone repair and development of techniques for the correction of bone defects, including the use of several types of grafts, membranes and the association of both techniques. There is evidence in the literature of the positive effect of LLLT on the healing of soft tissue wounds. However, its effect on bone is not completely understood.

MATERIALS AND METHODS

Five randomized groups were studied: Group I (Control); Group IIA (Gen-ox); Group IIB (Gen-ox + LLLT); Group IIIA (Gen-ox + Gen-derm) and Group IIIB (Gen-ox + Gen-derm + LLLT). Bone defects were created at the femur of the animals and were treated according to the group. The animals of the irradiated groups were irradiated every 48 h during 15 days; the first irradiation was performed immediately after the surgical procedure. The animals were irradiated transcutaneously in four points around the defect. At each point a dose of 4 J/cm2 was given (phi approximately 0.6 mm, 40 mW) and the total dose per session was 16 J/cm2. The animals were humanely killed 15, 21, and 30 days after surgery. The specimens were routinely processed to wax, serially cut, and stained with H&E and Picrosirius stains and analyzed under light microscopy.

RESULTS

The results showed evidence of a more advanced repair on the irradiated groups when compared to non-irradiated ones. The repair of irradiated groups was characterized by both increased bone formation and amount of collagen fibers around the graft within the cavity since the 15th day after surgery, through analysis of the osteoconductive capacity of the Gen-ox and the increment of the cortical repair in specimens with Gen-derm membrane.

CONCLUSION

It is concluded that LLLT had a positive effect on the repair of bone defect submitted the implantation of graft.

Does LLLT stimulate laryngeal carcinoma cells? An in vitro study

Low level laser therapy (LLLT) has been used successfully in biomedicine and some of the results are thought to be related to cell proliferation. The effects of LLLT on cell proliferation is debatable because studies have found both an increase and a decrease in proliferation of cell cultures. Cell culture is an excellent method to assess both effects and dose of treatment. The aim of this study was to assess the effect of 635nm and 670 nm laser irradiation of H.Ep.2 cells in vitro using MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide). The cells were obtained from squamous cell carcinoma (SCC) of the larynx and were routinely processed from defrost to the experimental condition. Twenty-four hours after transplantation the cells were irradiated with doses ranging from 0.04 to 0.48J/cm2 for seven consecutive days (5 mW diode lasers: 635nm or 670 nm, beam cross-section approximately 1 mm) at local light doses between 0.04 and 0.48 J/cm2. The results showed that 635nm laser light did not significantly stimulate the proliferation of H.Ep.2 cells at doses of 0.04 J/cm2 to 0.48 J/cm2, However, 670nm laser irradiation led to an increased cell proliferation when compared to both control and 635nm irradiated cells. The best cell proliferation was found with 670nm laser irradiated cultures exposed to doses of doses of 0.04 to 0.48 J/cm2. We conclude that both dose and wavelength are factors that may affect cell proliferation of H.Ep.2 cells.

Human fibroblast alterations induced by low power laser irradiation at the single cell level using confocal microscopy

Low power laser irradiation is regarded to have a significant role in triggering cellular proliferation and in treating diseases of diverse etiologies. The present work contributes to the understanding of the mechanisms of action by studying low power laser effects in human fibroblasts. Confocal laser scanning microscopy is used for irradiation and observation of the same area of interest allowing the imaging of laser effects at the single cell level and in real time. Coverslip cultures were placed in a small incubation chamber for in vivo microscopic observation. Laser stimulation of the cells was performed using the 647 nm line of the confocal laser through the objective lens of the microscope. Mitochondrial membrane potential (delta psi(m)), intracellular pH, calcium alterations and generation of reactive oxygen species (ROS) were monitored using specific fluorescent vital probes. The induced effects were quantified using digital image processing techniques. After laser irradiation, a gradual alkalinization of the cytosolic pH and an increase in mitochondrial membrane potential were observed. Recurrent spikes of intracellular calcium concentration were also triggered by laser. Reactive oxygen species were generated as a result of biostimulation. No such effects were monitored in microscopic fields other than the irradiated ones.

Effects of low-level laser therapy on malignant cells: in vitro study

The aim of this study was to assess the effect of 635- and 670-nm laser irradiation on H.Ep.2 cells in vitro using MTT. In addition to our previous report on the effects of LLLT on the proliferation of laryngeal carcinoma cells in which it was found that irradiaton H.Ep.2 cells with 670-nm laser results in increased cell proliferation, it was decided to evaluate the effect of increased doses of laser light on these cells. The cells, obtained from SCC of the larynx, were routinely processed from defrost to the experimental condition. The cultures were kept either at 5% or 10% of FBS. Twenty-four hours after transplantation, the cells were irradiated with laser light (5-mW diode lasers; 635 and 670-nm; beam cross section approximately 1 mm) at local light doses between 0.04 and 4.8.10(4) Jm(-2). For 670 nm, significant differences in the proliferation were observed between the two concentrations of FBS (p = 0.002) and between irradiated cultures and controls (p = 0.000). Although the results were not significant, 635-nm irradiated cells also proliferated more than nonirradiated ones. This occurred under both conditions of nutrition. It is concluded, that irradiation with 670-nm laser light applied at doses between 0.04 and 4.810(4) Jm(-2) could significantly increase proliferation of laryngeal cancer cells.

Lightdosimetric quantitative analysis of the human petrous bone: experimental study for laser irradiation of the cochlea

BACKGROUND AND OBJECTIVE

Application of laser irradiation targeting the inner ear has to be investigated for therapeutic effectiveness in cochlear injury and dysfunction. In vitro data demonstrate low-level laser-induced photochemical and photobiologic cell response, depending on cell type and irradiation parameters such as light dose. The aim of the presented study was to determine the light dose received by the cochlear hair cells by using different irradiation modalities for the human petrous bone.

STUDY DESIGN/MATERIALS AND METHODS

Lightdosimetric assessment was performed in human cadaver temporal bones (n = 13) after removing the cochlear membranous labyrinth. The external auditory meatus, the tympanic membrane (quadrants), and the mastoid bone were illuminated by a helium-neon laser (lambda = 593 nm) and diode lasers of different wavelengths (lambda = 635, 690, 780, and 830 nm). The spatial distribution of transmitted light in the cochlear windings was measured by means of a retrocochlearly positioned endoscopic CCD camera for image processing and was assigned to acoustic frequencies according to the tonotopic organization of the cochlea. For an estimation of the corresponding space irradiance in an intact cochlea, correction factors have been calculated by a Monte Carlo procedure on the basis of experimentally determined optical properties of skull bone.

RESULTS

The transmission of light across the tympanic cavity and the promontory depends strongly on wave-length of the laser and the position of the radiator. Transtympanal irradiation results in spatial intensity variations of a factor 4 to 10 within the cochlear windings. The space irradiance in an intact cochlea is 10 to 20 times the measured irradiance. For an irradiation of the mastoid, the light transmission within the cochlea is 10(3) to 10(5) times smaller compared with an irradiation of the tympanic membrane and is extremely variable for different specimens.

CONCLUSION

The strong dependence of the cochlear light distribution on various irradiation parameters demonstrates the impact of preclinical lightdosimetric investigations for effective individual laser irradiation of the human cochlea. Because of the observed spatial intensity variations, the optimal external light dose has to be chosen with regard to the tonotopy of the human cochlea. The obtained results are enabling us to apply defined laser light doses to different cochlear winding areas. Mastoidal irradiation leads to therapeutically insufficient light doses within reasonable treatment times, whereas transmeatal irradiation is recommendable. Further studies are mandatory for development of clinical devices for transmeatal irradiation of the cochlea.

Magnetic resonance imaging (MRI) controlled outcome of side effects caused by ionizing radiation, treated with 780 nm-diode laser -- preliminary results

BACKGROUND AND OBJECTIVE

Ionizing radiation therapy by way of various beams such as electron, photon and neutron is an established method in tumor treatment. The side effects caused by this treatment such as ulcer, painful mastitis and delay of wound healing are well known, too. Biomodulation by low level laser therapy (LLLT) has become popular as a therapeutic modality for the acceleration of wound healing and the treatment of inflammation. Evidence for this kind of application, however, is not fully understood yet. This study intends to demonstrate the response of biomodulative laser treatment on the side effects caused by ionizing radiation by means of magnetic resonance imaging (MRI).

STUDY DESIGN/PATIENTS AND METHODS

Six female patients suffering from painful mastitis after breast ionizing irradiation and one man suffering from radiogenic ulcer were treated with lambda=780 nm diode laser irradiation at a fluence rate of 5 J/cm2. LLLT was performed for a period of 4-6 weeks (mean sessions: 25 per patient, range 19-35). The tissue response was determined by means of MRI after laser treatment in comparison to MRI prior to the beginning of the LLLT.

RESULTS

All patients showed complete clinical remission. The time-dependent contrast enhancement curve obtained by the evaluation of MR images demonstrated a significant decrease of enhancement features typical for inflammation in the affected area.

CONCLUSION

Biomodulation by LLLT seems to be a promising treatment modality for side effects induced by ionizing radiation.

Light-induced apoptosis involves a defined sequence of cytoplasmic and nuclear calcium release in AlPcS4-photosensitized rat bladder RR 1022 epithelial cells

Oxidative stress induced by light activation of photosensitizers is regarded to have a role in triggering cell death pathways during photodynamic therapy (PDT). Reactive oxygen species have been proposed to act as signal transduction molecules activating downstream reactions that lead to apoptosis. Mainly debated is the cooperating role of other signaling systems like calcium or pH. The present work contributes to this discussion by studying PDT effects in cell cultures of rat bladder epithelial cells for the hydrophilic tetrasulfonated aluminum phthalocyanine (AlPcS4). Cells were coincubated with the photosensitizer and the calcium-sensitive probe Fluo-3. The light-induced reactions were analyzed with a confocal laser scanning microscope. The dynamics of the process during light activation was observed with subcellular resolution. A transient calcium elevation during the irradiation process was detected, especially in the cell's nuclei, followed by a more sustained increase. The evaluation of the energy-dose-dependent phototoxicity after an incubation time with the photosensitizer of 1 and 24 h, showed enhanced phototoxicity when the drug was present for 24 h. Surprisingly, stimulation of cell proliferation was observed at very low light doses (at 0.2 J/cm2) when the drug was incubated for 24 h (cell viability 160%). Induction of apoptosis could be observed after irradiation with fluences between 1 and 3 J/cm2. Apoptotic cells were identified with fluorescein isothiocyanate-labeled Annexin V, which binds to phosphatidylserine after its translocation to the outer plasma membrane. In the presence of the antioxidant pyrrolidinedithiocarbamate the transient calcium elevation was totally inhibited, as was the subsequent translocation of PS. In contrast, N-acetyl-L-cysteine did not suppress the transient calcium increase. Our data might be consistent with calcium regulated processes during AlPcS4-PDT and the involvement of oxygen radicals.

780 nm low power diode laser irradiation stimulates proliferation of keratinocyte cultures: involvement of reactive oxygen species

BACKGROUND AND OBJECTIVE

The purpose of this study was to determine irradiation parameters of a 780 nm low power CW diode laser (6.5 mW) leading to enhanced proliferation of cultured normal human keratinocytes (NHK). The possible role of reactive oxygen species (ROS) in this response was evaluated.

STUDY DESIGN/MATERIALS AND METHODS

NHK were exposed to a single dose of 0 to 3.6 J/cm2 (0-180 sec) of irradiation. Proliferation parameters studied were: incorporation of 3H-thymidine during 6-24 hr following irradiation; percentage of dividing cells and number of cells, 24 hr and 48 hr following irradiation, respectively.

RESULTS

Proliferation of NHK exposed to 0.45-0.95 J/cm2 was significantly enhanced by 1.3-1.9-folds relative to sham-irradiated controls, as inferred from parameters studied. Exposure to other energy densities was considerably less effective in enhancing proliferation parameters. Added enzymatic antioxidants, superoxide dismutase or catalase, scavenging superoxide anions and H2O2, suppressed this enhanced proliferation. Added scavengers (alpha-tocopherol acetate, scavenging lipid peroxidation, or sodium azide, histidine, mannitol, scavenging singlet oxygen, superoxide anions, and hydroxyl radicals, respectively), or N-acetyl cysteine, the thiol-reducing agent, suppressed the response, but to different extents.

CONCLUSIONS

The results indicate that 780 nm low power diode laser irradiation enhanced keratinocytes proliferation in vitro, with an apparent involvement of ROS in this response, and comparably, might be used to promote their proliferation in vivo to enhance wound healing.

Effects of 780 nm diode laser irradiation on blood microcirculation: preliminary findings on time-dependent T1-weighted contrast-enhanced magnetic resonance imaging (MRI)

Laser therapy by low light doses shows promising results in the modulation of some cell functions. Various clinical studies indicate that laser therapy is a valuable method for pain treatment and the acceleration of wound healing. However, the mechanism behind it is still not completely understood. To explore the effect of a low-power diode laser (lambda = 780 nm) on normal skin tissue, time-dependent contrast enhancement has been determined by magnetic resonance imaging (MRI). In the examinations, six healthy volunteers (four male and two female) have been irradiated on their right planta pedis (sole of foot) with 5 J/cm2 at a fluence rate of 100 mW/cm2. T1-weighted magnetic resonance imaging is used to quantify the time-dependent local accumulation of Gadolinium-DPTA, its actual content in the local current blood volume as well as its distribution to the extracellular space. Images are obtained before and after the application of laser light. When laser light is applied the signal to noise ratio increases by more than 0.35 +/- 0.15 (range 0.23-0.63) after irradiation according to contrast-enhanced MRI. It can be observed that, after biomodulation with light of low energy and low power, wound healing improves and pain is reduced. This effect might be explained by an increased blood flow in this area. Therefore, the use of this kind of laser treatment might improve the outcome of other therapeutic modalities such as tumour ionizing radiation therapy and local chemotherapy.