Creating a Practical Tool for Predicting Major Amputation Rate in Patients With Diabetic Hindfoot Ulcers: Focus on Ischemia and Infection

BACKGROUND

Patients with diabetic hindfoot ulcers typically harbor significant concerns regarding their prospects for healing or the potential for major amputation. Nonetheless, a scarcity of data addressing this prevalent and critical query exists. Thus, the aim of this study was to create an initial risk-scoring system to forecast the prognosis of individuals with diabetic hindfoot ulcers, leveraging assessments of ischemia and infection severity, which are recognized as the principal risk factors for amputation.

METHODS

Ischemia severity was categorized as iS0, iS1, or iS2 based on transcutaneous partial oxygen tension values, while infection severity was classified as iN0, iN1, or iN2 according to the results of tissue and bone biopsy cultures. Risk scores were determined by summing the scores for ischemia and infection severity, yielding a range of 0 to 4. Wound healing outcomes were graded as either healed with or without major amputation. Wound healing outcomes were assessed based on the assigned risk scores.

RESULTS

With ascending risk scores, the proportion of patients subjected to major amputation also increased (P value for trend < 0.001). Univariable logistic regression analysis revealed a significant positive correlation between escalating risk scores and major amputation incidence. Patients with a risk score of 4 exhibited a 41-fold higher likelihood of undergoing major amputation compared to those with a risk score of 0.

CONCLUSION

Risk scores can serve as a reliable predictor of the major amputation rate in patients with diabetic hindfoot ulcers.

In Vitro Effects of Low-Level Laser Therapy on the Viability and Secretory Activity of Resting Macrophages

Background/Objectives: Low-level laser therapy (LLLT) covers a wide range of parameters in terms of laser properties and dosage, which is important for its effects. It is important to select safe, optimal irradiation conditions to obtain the desired therapeutic effect of LLLT on cells. This article is focused on the selection of favourable (biostimulating) exposure conditions for LLLT, which are the beam application method (continuous [C] or pulsed [P] laser beam), radiation power and LLLT dose, on the viability and secretory activity regarding resting macrophages of the RAW 264.7 cell line. Methods: RAW 264.7 macrophages were seeded on 24-well tissue culture. ASTAR PhysioGo 400C apparatus with a spot applicator generating electromagnetic radiation in the infrared light range of 808 nm and power of 100 mW and 200 mW was used for laser irradiation of macrophages. Cells were treated with different doses of constant radiation 5 J/cm2/well or 10 J/cm2/well. Results: It was shown that the most beneficial radiation parameters for cells were obtained with a pulsed laser beam of 200 mW power and a dose of 5 J/cm2, which caused an increase in macrophage adhesion and viability, as well as an increase in NO secretion by macrophages and their TOS, with a simultaneous decrease in the secretion of TNF-α, MCP-1 and MMP-9 by cells. Conclusions: The research results presented above indicate that the effect of LLLT on resting macrophages modulates their biological activity, and the intensity of photobiostimulation depends on the irradiation parameters, including wavelength, power, dose and method of laser beam application.

Effects of low-level laser irradiation on canine fibroblasts

Low-level laser (LLL) therapy is a well-known noninvasive treatment that stimulates fibroblasts to improve wound healing. LLL can improve fibroblast proliferation and migration without causing toxicity. The present study aimed to evaluate the effects of two laser wavelengths at different irradiation times on canine fibroblasts. Fibroblasts were isolated from canine oral mucosa. After seeding for 24 hr, the fibroblasts were irradiated using the Erchonia® EVL dual-diode laser at wavelengths of 405 nm (5 mW) and 640 nm (7.5 mW) with irradiation times of 120, 360, and 1,800 sec. The proliferating and viability cells were evaluated 24 hr after laser irradiation. Wound closure rates were calculated at 0, 24, and 48 hr after laser irradiation. Parameters, including proliferation cell, cell viability, and cell migration, tended to be higher in the 360-sec group (405 nm) and 120-sec group (640 nm) than in other groups. Our findings suggest that LLL therapy at wavelengths of 405 and 640 nm with an irradiation time of 120-360 sec (0.26-0.51 J/cm2) can stimulate the proliferation and migration of canine fibroblasts. This finding may contribute to a better understanding of the beneficial role of LLL stimulation in canine wound healing.

[Photobiomodulation with active oxygen and lactoferrin in the treatment of medication-related osteonecrosis of the jaw. A case report]

Medication-related osteonecrosis jaw (MRONJ) affects about 5% of patients treated with bisphosphonates and other similar drugs. This case report describes the management of a case of MRONJ using photobiomodulation therapy (FBM) combined with active oxygen and lactoferrin (Blue®M). This is a 62-year-old patient with hypertension, rheumatoid arthritis and osteoporosis treated with Bonames®. After extraction, she presented exposed bone in the alveolar ridge of quadrant III. Under informed consent, minimally invasive surgery was performed with electrical instruments (Piezotome®). Histopathological analysis revealed necrotic bone tissue with chronic inflammatory infiltrate. The treatment included Blue®M teeth&bone once a day for 30 days, topical application of Blue®M gel every morning for 15 days and FBM with 808nm diode laser (Therapy-DMC®). The laser sessions were daily until day 3, and then twice a week for four weeks. The patient also performed mouthwashes with Blue®M every night for 30 days. Initially, the patient reported pain of 3/10 on the visual analog scale, which decreased to 0/10 at the end of treatment. Clinically, soft tissue healing was observed at 30 days and 60 days and the CT scan showed hyperdense cancellous bone with well-formed cortical and no alterations. Finally, this case suggests that the combination of FBM with topical active oxygen therapy and lactoferrin, along with minimally invasive surgical intervention, holds promise for the management of MRONJ.

Wavelength-dependent photobiomodulation (PBM) for proliferation and angiogenesis of melanoma tumor in vitro and in vivo

Photobiomodulation (PBM) has widely been used to effectively treat complications associated with cancer treatment, including oral mucositis, radiation dermatitis, and surgical wounds. However, the safety of PBM against cancer still needs to be validated as the effects of PBM on cancer cells and their mechanisms are unclear. The current study investigated the wavelength-dependent PBM effects by examining four different laser wavelengths (405, 532, 635, and 808 nm) on B16F10 melanoma tumor cells. In vitro tests showed that PBM with 808 nm promoted both proliferation and migration of B16F10 cells. In vivo results demonstrated that PBM with 808 nm significantly increased the relative tumor volume and promoted angiogenesis with overexpression of VEGF and HIF-1α. In addition, PBM induced the phosphorylation of factors closely related to cancer cell proliferation and tumor growth and upregulated the related gene expression. The current result showed that compared to the other wavelengths, 808 nm yielded a significant tumor-stimulating effect the malignant melanoma cancer. Further studies will investigate the in-depth molecular mechanism of PBM on tumor stimulation in order to warrant the safety of PBM for clinical cancer treatment.

Effect of low-level laser therapy on proliferation and cytotoxicity of mouse fibroblasts and human fibroblasts: An in vitro study

Background

Diode laser is known for its biostimulatory effects on various cell populations such as osteoblasts and fibroblasts. The usage of low-level laser therapy for photobiomodulation depends on its type, emission wavelength, and energy selected. Previously performed in vitro studies have determined its effect on cell proliferation and cytotoxicity; however, the results were inconsistent.

Objectives

The objectives of this study were to evaluate and compare diode laser effect on mouse embryonic fibroblasts (MEFs) and human gingival fibroblasts (HGFs) for proliferation and cytotoxicity.

Materials and Methods

32 samples, 16 wells of MEF cells (Group I) and HGF cells (Group II) each with 8 subgroups containing control (no laser irradiation) and experimental (laser irradiated) groups were cultured after being seeded at 4000 cells/ well with 4cm inter-well distance. Experimental group cell cultures were irradiated with a single dose of 810 nm diode laser (energy 1J/cm2, 12.5 mW, 80 s/well) using continuous wave mode after 1 day of incubation. Spectrophotometric analysis was done after 24 h of laser irradiation for cell proliferation and cell cytotoxicity on the 2nd, 3rd, and 7th days on all groups.

Results

Human and mouse fibroblast groups showed positive results when irradiated with an 810 nm laser. A hundred percent proliferation was seen for MEF in 7 days and HGF in 2 days. Two percent cytotoxicity was seen on the 2nd and 3rd day in MEF. Increased cell proliferation and minimal cytotoxic effects were seen with diode laser usage.

Conclusion

Low-level laser irradiation indicates an increase in cell proliferation with less cytotoxicity on mouse and human fibroblasts.

Application of combined photobiomodulation and curcumin-loaded iron oxide nanoparticles considerably enhanced repair in an infected, delayed-repair wound model in diabetic rats compared to either treatment alone

Herein, we attempted to evaluate the therapeutic potential of photobiomodulation (PBM) and curcumin-loaded iron nanoparticles (CUR), alone and in combination, on wound closure rate (WCR), microbial flora by measuring colony-forming units (CFUs), the stereological and biomechanical properties of repairing wounds in the maturation stage of the wound healing course in an ischemic infected delayed healing wound model (IIDHWM) of type I diabetic (TIDM) rats. There were four groups: group 1 was the control, group 2 received CUR, rats in group 3 were exposed to PBM (80 Hz, 890 nm, and 0.2 J/cm2), and rats in group 4 received both PBM and CUR (PBM + CUR). We found CFU was decreased in groups 2, 3, and 4 compared to group 1 (p = 0.000 for all). Groups 2, 3, and 4 showed a considerable escalation in WCR compared to group 1 (p = 0.000 for all). In terms of wound strength parameters, substantial increases in bending stiffness and high-stress load were observed in groups 2, 3, and 4 compared to group 1 (p = 0.000 for all). Stereological examinations revealed decreases in neutrophil and macrophage counts and increases in fibroblast counts in groups 2, 3, and 4compared  to group 1 (p = 0.000 for all). Blood vessel counts were more dominant in the PBM and PBM + CUR groups over group 1 (p = 0.000 for all). CFU and wound strength as well as macrophage, neutrophil, and fibroblast counts were found to be improved in the PBM + CUR and PBM groups compared to the CUR group (ranging from p = 0.000 to p < 0.05). Better results were achieved in the PBM + CUR  treatment  over the PBM therapy. We determined therapy with PBM + CUR, PBM alone, and CUR alone substantially accelerated diabetic wound healing in an IIDHWM of TIDM rats compared to control  group. Concomitantly, the PBM + CUR and PBM groups attained significantly enhanced results for WCR, stereological parameters, and wound strength than the CUR group, with the PBM + CUR results being superior to those of the PBM group.

Photobiomodulation therapy reverses spermatogenesis arrest in hyperthermia-induced azoospermia mouse model

Testicular heat stress leads to impairment of spermatogenesis in mammals. Involved mechanism in this vulnerability to heat-induced injury remains unclear, and research is being conducted to find an approach to reverse spermatogenesis arrest caused by hyperthermia. Recently, different studies have utilized photobiomodulation therapy (PBMT) therapy for the improvement of sperm criteria and fertility. This study aimed at evaluating the effect of PBMT on the improvement of spermatogenesis in mouse models of hyperthermia-induced azoospermia. A total of 32 male NMRI mice were equally divided into four groups consisting of control, hyperthermia, hyperthermia + Laser 0.03 J/cm2, and hyperthermia + Laser 0.2 J/cm2. To induce scrotal hyperthermia, mice were anesthetized and placed in a hot water bath at 43 °C for 20 min for 5 weeks. Then, PBMT was operated for 21 days using 0.03 J/cm2 and 0.2 J/cm2 laser energy densities in the Laser 0.03 and Laser 0.2 groups, respectively. Results revealed that PBMT with lower intensity (0.03 J/cm2) increased succinate dehydrogenase (SDH) activity and glutathione (GSH)/oxidized glutathione (GSSG) ratio in hyperthermia-induced azoospermia mice. At the same time, low-level PBMT reduced reactive oxygen species (ROS), mitochondrial membrane potential, and lipid peroxidation levels in the azoospermia model. These alterations accompanied the restoration of spermatogenesis manifested by the elevated number of testicular cells, increased volume and length of seminiferous tubules, and production of mature spermatozoa. After conducting experiments and analyzing the results, it has been revealed that the use of PBMT at a dosage of 0.03 J/cm2 has shown remarkable healing effects in the heat-induced azoospermia mouse model.

Effect of femtosecond laser interaction with human fibroblasts: a preliminary study

In in vitro methods and cell culture models, femtosecond (fs) laser interaction has been employed to assess its effect on the proliferation and morphology of human skin fibroblasts. We cultured a primary human skin fibroblast cell line on a glass plate, passages 17-23. The cells were irradiated with a 90-fs laser at a wavelength of 800 nm and a repetition rate of 82 MHz. The target received an average power of 320 mW for 5, 20, and 100 s, corresponding to the radiation exposures of 22.6, 90.6, and 452.9 J/cm2, respectively. Using a laser scanning microscopy technique, the photon densities were measured to be 6.4 × 1018, 2.6 × 1019, and 1.3 × 1020 photons/cm2 in a spot area of 0.07 cm2; the recorded spectra were obtained from the laser interaction after 0.00, 1.00, 25.00, and 45.00 h. The cell count and morphological changes showed that the cultured cells were affected by laser irradiation under photon stress; some fibroblasts were killed, while others were injured and survived. We discovered evidence of the formation of several coenzyme compounds, such as flavin (500-600 nm), lipopigments (600-750 nm), and porphyrin (500-700 nm). This study is motivated by the future development of a novel, ultra-short fs laser system and the need to develop a basic in vitro understanding of photon-human cell interaction. The cell proliferation indicated that cells are partly killed or wounded. The exposure of fibroblasts to fs laser fluence up to 450 J/cm2 accelerates cell growth of the viable residual cell.

Use of Photobiomodulation Combined with Fibrin Sealant and Bone Substitute Improving the Bone Repair of Critical Defects

In this preclinical protocol, an adjunct method is used in an attempt to overcome the limitations of conventional therapeutic approaches applied to bone repair of large bone defects filled with scaffolds. Thus, we evaluate the effects of photobiomodulation therapy (PBMT) on the bone repair process on defects filled with demineralized bovine bone (B) and fibrin sealant (T). The groups were BC (blood clot), BT (B + T), BCP (BC + PBMT), and BTP (B + T + PBMT). Microtomographically, BC and BCP presented a hypodense cavity with hyperdense regions adjacent to the border of the wound, with a slight increase at 42 days. BT and BTP presented discrete hyperdensing areas at the border and around the B particles. Quantitatively, BCP and BTP (16.96 ± 4.38; 17.37 ± 4.38) showed higher mean bone density volume in relation to BC and BT (14.42 ± 3.66; 13.44 ± 3.88). Histologically, BC and BCP presented deposition of immature bone at the periphery and at 42 days new bone tissue became lamellar with organized total collagen fibers. BT and BTP showed inflammatory infiltrate along the particles, but at 42 days, it was resolved, mainly in BTP. In the birefringence analysis, BT and BTP, the percentage of red birefringence increased (9.14% to 20.98% and 7.21% to 27.57%, respectively), but green birefringence was similar in relation to 14 days (3.3% to 3.5% and 3.5% to 4.2%, respectively). The number of osteocytes in the neoformed bone matrix proportionally reduced in all evaluated groups. Immunostaining of bone morphogenetic protein (BMP—2/4), osteocalcin (OCN), and vascular endothelial growth factor (VEGF) were higher in BCP and BTP when compared to the BC and BT groups (p < 0.05). An increased number of TRAP positive cells (tartrate resistant acid phosphatase) was observed in BT and BTP. We conclude that PBMT positively influenced the repair of bone defects filled with B and T.

Application of Fibrin Associated with Photobiomodulation as a Promising Strategy to Improve Regeneration in Tissue Engineering: A Systematic Review

Fibrin, derived from proteins involved in blood clotting (fibrinogen and thrombin), is a biopolymer with different applications in the health area since it has hemostasis, biocompatible and three-dimensional physical structure properties, and can be used as scaffolds in tissue regeneration or drug delivery system for cells and/or growth factors. Fibrin alone or together with other biomaterials, has been indicated for use as a biological support to promote the regeneration of stem cells, bone, peripheral nerves, and other injured tissues. In its diversity of forms of application and constitution, there are platelet-rich fibrin (PRF), Leukocyte- and platelet-rich fibrin (L-PRF), fibrin glue or fibrin sealant, and hydrogels. In order to increase fibrin properties, adjuvant therapies can be combined to favor tissue repair, such as photobiomodulation (PBM), by low-level laser therapy (LLLT) or LEDs (Light Emitting Diode). Therefore, this systematic review aimed to evaluate the relationship between PBM and the use of fibrin compounds, referring to the results of previous studies published in PubMed/MEDLINE, Scopus and Web of Science databases. The descriptors "fibrin AND low-level laser therapy" and "fibrin AND photobiomodulation" were used, without restriction on publication time. The bibliographic search found 44 articles in PubMed/MEDLINE, of which 26 were excluded due to duplicity or being outside the eligibility criteria. We also found 40 articles in Web of Science and selected 1 article, 152 articles in Scopus and no article selected, totaling 19 articles for qualitative analysis. The fibrin type most used in combination with PBM was fibrin sealant, mainly heterologous, followed by PRF or L-PRF. In PBM, the gallium-aluminum-arsenide (GaAlAs) laser prevailed, with a wavelength of 830 nm, followed by 810 nm. Among the preclinical studies, the most researched association of fibrin and PBM was the use of fibrin sealants in bone or nerve injuries; in clinical studies, the association of PBM with medication-related treatments osteonecrosis of the jaw (MRONJ). Therefore, there is scientific evidence of the contribution of PBM on fibrin composites, constituting a supporting therapy that acts by stimulating cell activity, angiogenesis, osteoblast activation, axonal growth, anti-inflammatory and anti-edema action, increased collagen synthesis and its maturation, as well as biomolecules.

Photobiomodulation Therapy in Burn Wound Healing: Systematic Review and Meta-Analysis of Preclinical Studies

Background and objective: To determine the effectiveness of photobiomodulation therapy (PBMT) in the burn wound healing compared with the control or with the use of antibiotics, in animal models. Materials and methods: A systematic search was conducted in EMBASE, MEDLINE, and LILACS databases. Preclinical studies were included that analyzed the effectiveness of PBMT in the burn wound healing, which assessed wound contraction, angiogenesis, proliferation of fibroblasts, and collagen deposition. SYRCLE risk of bias tool was used. Random effects models were used to estimate the pooled effect. Results: Thirty-eight studies were included. PBMT favored wound contraction (mean difference = -11.47, 95% confidence interval -19.87 to -3.08, I² = 0%; moderate certainty of evidence). PBMT also favored angiogenesis at doses between 11 and 20 J/cm², and increased the collagenization rate. Conclusions: In animal models, PBMT favored wound contraction, angiogenesis, and collagen deposition in second- and third-degree burn wounds.

Low-level red plus near infrared lights combination induces expressions of collagen and elastin in human skin in vitro

OBJECTIVE

Light therapy has attracted medical interests as a safe, alternative treatment for photo-ageing and photo-damaged skin. Recent research suggested the therapeutic activity of red and infrared (IR) lights may be effective at much lower energy levels than those used clinically. This study was to evaluate the efficacy of low-level red plus near IR light emitting diode (LED) combination on collagen and elastin and ATP production.

METHODS

Human dermal fibroblasts or skin tissues were irradiated daily by red (640 nm) plus near IR (830 nm) LED lights combination at 0.5 mW/cm² for 10 minutes (0.3 J/cm² ). qPCR, ELISAs or histology were used to determine the gene and protein expressions. Fluorescent measurement was used to assess crosslinks of collagen and elastic fibres. ATP production was evaluated by ATP assay.

RESULTS

Treatment of human fibroblast cell cultures with low-level red plus near IR lights combination was found to significantly increase LOXL1, ELN and COL1A1 and COL3A1 gene expressions as well as the synthesis of the procollagen type I and elastin proteins. Treating human skin explants with low-level red plus near IR lights combination similarly induced significant increases in the same gene expressions, type III collagen and elastic fibre formation and crosslinks. ATP production was increased in human dermal fibroblasts after red plus near IR lights combination treatment.

CONCLUSION

Low-level red plus near IR lights combination stimulated the production of collagen and elastin production associated with anti-ageing benefits. These findings suggest that low-level red plus near IR LED light combination may provide an effective treatment opportunity for people with photo-aged skin.

Combination treatment of dendrosomal nanocurcumin and low-level laser therapy develops proliferation and migration of mouse embryonic fibroblasts and alter TGF-β, VEGF, TNF-α and IL-6 expressions involved in wound healing process

INTRODUCTION

Pressure ulcer (PU) is known as the third most costly disorder usually caused by prolonged pressure and stagnation in various parts of the body. Although several therapeutic approaches are employing, obstacles in appropriate healing for skin lesions still exist which necessitates new practical alternative or adjunctive treatments. Low level laser therapy (LLLT) as one of the mentioned new strategies have gained attention. Besides, curcumin is an herbal medicine extracted from turmeric with anti-inflammatory and antioxidative properties with promising beneficial therapeutic effects in wound healing. Employing dendrosomal nanoparticles, we overcome the hydrophobicity of curcumin in the present study. We hypothesized that combination treatment of DNC+LLLT (450 nm) simultaneously may promote the wound healing process.

MATERIAL AND METHODS

MTT assay, PI staining followed by flowcytometry, scratch assay and intracellular ROS measurement were used to investigate the effects caused by DNC and LLLT (450 nm) alone and in combination, on proliferation, cell cycle, migration and oxidative stress mouse embryonic fibroblast cells, respectively. The levels of growth factors and pro-inflammatory cytokines were evaluated by qRT-PCR and ELISA.

RESULTS

Our results indicated that combination exposure with DNC and LLLT leads to increased proliferation and migration of MEFs as well as being more efficient in significantly upregulating growth factors (TGF-β, VEGF) and decline in inflammatory cytokines (TNF-α, IL-6). Moreover, findings of this research provide persuasive support for the notion that DNC could reduce the LLLT-induced enhancement in intracellular ROS in mouse embryonic fibroblasts.

CONCLUSION

Concurrent exposure to anti-oxidant concentrations of DNC and LLLT enriched S phase entry and therefor increased proliferation as well as migration on MEFs through regulating the expression levels growth factors and shortening the inflammatory phase by modulating of cytokines. It should be noted that DNC were able to reduce the laser-induced oxidative stress, during wound healing, representing an informative accompaniment with LLLT.

EGFR-conjugated hydrogel accelerates wound healing on ulcer-induced burn wounds by targeting collagen and inflammatory cells using photoimmunomodulatory inhibition

In the present study, we fabricated an epidermal growth factor receptor (EGFR)-conjugated hydrogel to promote wound healing in cold restraint-induced gastric ulceration on burn wounds targeting collagen and inflammatory cells for the treatment of burns and gastric ulcers. Cytotoxicity and cell proliferation assays demonstrated good biocompatibility of hydrogel as a suitable extracellular matrix for targeted cells and support for regenerative cell growth. These findings were confirmed by staining methods. In vitro wound healing was confirmed cell migration in the targeted cells. The effect of the EGFR-H was investigated in cold restraint-induced gastric ulcers in rats, where the treatment was started immediately after ulcer induction. In the in vivo experiment, the EGFR-H demonstrated enhanced ulcer healing ability and less scarring compared to the hydrogel alone and controls. Thus, EGFR-H promotes healing of cold restraint-induced gastric ulcer via EGFR conjugated with a hydrogel. The present study demonstrates a novel pathway to fabricate hydrogels as suitable wound dressing biomaterials to improve deep partial thickness burn wound healing and prevent scar formation when aided by laser therapy.

Textile-integrated polymer optical fibers for healthcare and medical applications

With ever growing interest in far-reaching solutions for pervasive healthcare and medicine, polymer optical fibers have been rendered into textile forms. Having both fiber-optic functionalities and traditional fabric-like comfort, textile-integrated polymer optical fibers have been advocated to remove the technical barriers for long-term uninterrupted health monitoring and treatment. In this context, this paper spotlights and reviews the recently developed textile-integrated polymer optical fibers in conjunction with fabrication techniques, applications in long-term continuous health monitoring and treatment, and future perspectives in the vision of mobile health (mHealth), as well as the introductory basics of polymer optical fibers. It is designed to serve as a topical guidepost for scientists and engineers on this highly interdisciplinary and rapidly growing topic.

Infrared-A Irradiation-induced Inhibition of Human Keratinocyte Proliferation and Potential Mechanisms

Infrared-A (IRA), which can penetrate deeply into the human skin, is a major component of solar radiation and is recognized to promote photoaging of human dermis. To our knowledge, however, the cellular and molecular consequences of human epidermis exposure to IRA have not been clarified. Thus, we investigated whether IRA inhibits the proliferation of normal human epidermal keratinocytes (NHEKs). IRA irradiation ed in cell cycle arrest at G1 and a dose-dependent reduction in the proliferation of NHEKs. We found that mechanistic target of rapamycin complex 1 (mTORC1) was initially inactivated during IRA irradiation due to the formation of stress granules (SGs), and this inactivation was maintained for at least 6 h after irradiation due to Akt dephosphorylation. Furthermore, repeated exposure of human skin equivalents to IRA led to marked thinning of the epidermal cell layer. In conclusion, IRA irradiation inhibits mTORC1 activity possibly through two molecular mechanisms involving SG formation in the early-phase and subsequent Akt dephosphorylation. This sequential mechanism seems to cause G1 cell cycle arrest and a reduction in cell proliferation, supporting the hypothesis that the decreased proliferation of basal keratinocytes that occurs during skin aging might be partly attributable to IRA radiation.

Review on the Cellular Mechanisms of Low-Level Laser Therapy Use in Oncology

Photobiomodulation (PBM) using low-level laser therapy (LLLT) is a treatment that is increasingly used in oncology. Studies reported enhancement of wound healing with reduction in pain, tissue swelling and inflammatory conditions such as radiation dermatitis, oral mucositis, and lymphedema. However, factors such as wavelength, energy density and irradiation frequency influence the cellular mechanisms of LLLT. Moreover, the effects of LLLT vary according to cell types. Thus, controversy arose as a result of poor clinical response reported in some studies that may have used inadequately planned treatment protocols. Since LLLT may enhance tumor cell proliferation, these will also need to be considered before clinical use. This review aims to summarize the current knowledge of the cellular mechanisms of LLLT by considering its effects on cell proliferation, metabolism, angiogenesis, apoptosis and inflammation. With a better understanding of the cellular mechanisms, bridging findings from laboratory studies to clinical application can be improved.

Photobiomodulation therapy improves the growth factor and cytokine secretory profile in human type 2 diabetic fibroblasts

Impaired wound healing is a common complication of diabetes mellitus (DM) and the underlying mechanism of this impairment is still unclear. Fibroblast, as the main reconstructing cell, secretes some critical growth factors and cytokine contributing to wound healing. It is well known that DM alters the behavior of these cells and photobiomodulation therapy (PBMT) compensates some impairments in diabetic fibroblasts. Therefore, the aim of the present study was to demonstrate the impact of diabetes and the role of PBMT through low level laser irradiation on secretory profile of human diabetic fibroblasts. Primary human dermal fibroblasts from normal (HDFs) and diabetic (DHDFs) donors were harvested. For PBMT, the DHDFs were irradiated with a Helium-Neon laser at 632.8 nm wavelength and energy density of 0.5 J/cm², as laser treated group (LT-DHDFs). Next, some cellular behaviors and secretory profiling array for 60 growth factors/cytokines were investigated in LT-DHDFs and then compared with those of controls. The data showed that the PBMT could compensate such impairments occurred in DHDFs in terms of viability, proliferation, and migration. Furthermore, considering our novel findings, out of those 20 growth factors/cytokines involved in cell proliferation, immune system regulation, and cell-cell communication pathways, which significantly decreased in DHDF as compared with HDFs, the PBMT could compensate seven in LT-DHDFs as compared with DHDFs. The seven growth factor/cytokines, which are mainly involved in cell-cell communication, positive regulation of cell proliferation, and chemokine mediated pathway included BDNF, Eotaxin-3, FGF6, FGF7, Fractalkine, fit-3ligand, and GCP-2. Therefore, it is suggested that scrutinizing these differentially secreted molecules and the impaired pathways in DHDFs, in combination with those compensated in LT-DHDFs, could raise our knowledge to manage diabetic ulcer through a feasible and cost effective intervention, specifically PBMT.

Effect of photobiomodulation on cellular migration and survival in diabetic and hypoxic diabetic wounded fibroblast cells

A disrupted wound repair process often leads to the development of chronic wounds, and pose a major physical, social and economic inconvenience on patients and the public health sector. Chronic wounds are a common complication seen in diabetes mellitus (DM), and often the severity necessitates amputation of the lower limbs. Recently, there has been increasing evidence that photobiomodulation (PBM) initiates wound healing, including increased protein transcription for cell proliferation, viability, migration and tissue reepithelialisation. Here, the hypothesis that PBM at a wavelength of 660 nm and energy density of 5 J/cm² regulates wound repair in diabetic wounded and hypoxic diabetic wounded fibroblasts by enhancing cell migration and survival was investigated. PBM increased migration and survival in diabetic wounded and hypoxic diabetic wounded fibroblasts. Our findings suggest that PBM enhances migration and survival in diabetic wounded and hypoxic diabetic wounded fibroblasts, indicating that this therapeutic method may be beneficial against chronic wounds in diabetic patients.

[Short-term results of radiotherapy of cancer of the tongue and mouth floor mucosa using 60Co and 252Cf]

The authors presented the immediate and 3-year results of interstitial and combined therapy of 90 patients with cancer of the tongue and oral fundus mucosa. 60Co- and 252Cf-sources were employed in interstitial radiotherapy. There were no significant differences in therapeutic efficacy using different radiation sources. Some methodological aspects of administration of interstitial radiotherapy, radiation reactions and complications were covered.