PhotoBioModulation And Wound Healing
PhotoBioModulation And Wound Healing
PhotoBioModulation
Systems For Hospitals
PBM And Wound Healing For Skin
Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring
★ Key Take-Aways
⮕ Fast-growing technology used to treat a multitude of conditions
⮕ Treats conditions that require stimulation of healing, relief of pain and inflammation, and restoration of function
Pinar Avci, MD, Asheesh Gupta, PhD, Magesh Sadasivam, MTech, Daniela Vecchio, PhD, Zeev Pam, MD, Nadav Pam, MD, and Michael R Hamblin, PhD
Low-level laser (light) therapy (LLLT) is a fast-growing technology used to treat a multitude of conditions that require stimulation of healing, relief of pain and inflammation, and restoration of function. Although the skin is the organ that is naturally exposed to light more than any other organ, it still responds well to red and near-infrared wavelengths. The photons are absorbed by mitochondrial chromophores in skin cells. Consequently electron transport, adenosine triphosphate (ATP) nitric oxide release, blood flow, reactive oxygen species increase and diverse signaling pathways get activated. Stem cells can be activated allowing increased tissue repair and healing. In dermatology, LLLT has beneficial effects on wrinkles, acne scars, hypertrophic scars, and healing of burns. LLLT can reduce UV damage both as a treatment and as a prophylaxis. In pigmentary disorders such as vitiligo, LLLT can increase pigmentation by stimulating melanocyte proliferation and reduce depigmentation by inhibiting autoimmunity.
Inflammatory diseases such as psoriasis and acne can also benefit. The non-invasive nature and almost complete absence of side-effects encourages further testing in dermatology.
Increasingly, non-invasive therapies for skin disease and skin rejuvenation are used, especially in Western countries where relatively high disposable incomes are combined with the desire for an ideal appearance fostered by societal pressures. Although the skin is the organ that is naturally most exposed to light, it still responds well to red and near-infrared wavelengths delivered at the correct parameters with therapeutic intent. Low-level laser therapy (LLLT) was discovered in the late 1960s, but only in recent times has it been widely applied in dermatology.
The introduction of light emitting diode (LED) devices has reduced many of the concerns formerly associated with lasers, such as expense, safety concerns and the need for trained personnel to operate them. In fact, many LED devices are designed for home use and are widely sold on the internet. This review will cover the use of LLLT as possibly the ultimate non-invasive approach to treating the skin.
Low-Level Laser (Light) Therapy and Its Mechanism of Action
LLLT, phototherapy or photobiomodulation refers to the use of photons at a non-thermal irradiance to alter biological activity. LLLT uses either coherent light sources (lasers) or non-coherent light sources consisting of filtered lamps or light-emitting diodes (LED) or, on occasion, a combination of both. The main medical applications of LLLT are reducing pain and inflammation, augmenting tissue repair and promoting regeneration of different tissues and nerves, and preventing tissue damage in situations where it is likely to occur.1,2 In the last few decades, non-ablative laser therapies have been used increasingly for the aesthetic treatment of fine wrinkles, photoaged skin and scars, a process known as photorejuvenation (Table 1).
PMS PubMed Central | PMCID: PMC4126803 NIHMSID: NIHMS430657 PMID: 24049929
PBM For Post Chemo | Radiation Patients
Wound Healing in Post Chemo And Radiation Cancer Patients
★ Key Take-Aways ⮕
⮕ There is robust evidence for using PBM to prevent and treat a broad range of complications in cancer care
⮕ This could enhance patients' quality of life, adherence to the prescribed cancer therapy, and treatment outcomes while reducing the cost of cancer care
Jolien Robijns, Raj G. Nair, Joy Lodewijckx, Praveen Arany, Andrei Barasch, Jan M. Bjordal, Paolo Bossi, Anne Chilles, Patricia M. Corby, Joel B. Epstein, Sharon Elad, Reza Fekrazad, Eduardo Rodrigues Fregnani, Marie-Thérèse Genot, Ana M. C. Ibarra, Michael R. Hamblin, Vladimir Heiskanen, Ken Hu, Jean Klastersky, Rajesh Lalla, Sofia Latifian, Arun Maiya, Jeroen Mebis, Cesar A. Migliorati, Dan M. J. Milstein, Barbara Murphy, Judith E. Raber-Durlacher, Hendrik J. Roseboom, Stephen Sonis, Nathaniel Treister, Yehuda Zadik, and René-Jean Bensadoun
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 profession‐ als, 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 can‐ cer 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.
World Association of PhotoBioModulation Therapy (WALT) | PMID: 36110957 PMCID: PMC9468822 DOI: 10.3389/fonc.2022.927685 | 2018
PBM And Burn Wound Healing
Accelerated burn wound healing with photobiomodulation
therapy involves activation of endogenous latent TGF-β1
★ Key Take-Aways ⮕
⮕ PBM treated burn wounds had significantly improved burn wound healing compared to controls (p < 0.05) (Fig. 1f, g).
⮕ These observations indicate that a non-invasive, low-dose biophotonics treatment could be effectively used in burn wound management.
Imran Khan, Saeed Ur Rahman, Elieza Tang, Karl Engel, Bradford Hall, Ashok B. Kulkarni & Praveen R. Arany
The severity of tissue injury in burn wounds from associated inflammatory and
immune sequelae presents a significant clinical management challenge. Among
various biophysical wound management approaches, low dose biophotonics
treatments, termed Photobiomodulation (PBM) therapy, has gained recent attention.
One of the PBM molecular mechanisms of PBM treatments involves photoactivation of latent TGF-β1 that is capable of promoting tissue healing and regeneration.
This work examined the efficacy of PBM treatments in a full-thickness burn wound healing
in C57BL/6 mice. We first optimized the PBM protocol by monitoring tissue surface
temperature and histology. We noted this dynamic irradiance surface temperature monitored PBM protocol improved burn wound healing in mice with elevated TGF-β
signaling (phospho-Smad2) and reduced inflammation-associated gene expression.
Next, we investigated the roles of individual cell types involved in burn wound healing
following PBM treatments and noted discrete effects on epithelieum, fibroblasts, and
macrophage functions. These responses appear to be mediated via both TGF-β dependent and independent signaling pathways.
Finally, to investigate specific contributions of TGF-β1 signaling in these PBM-burn wound healing, we utilized a chimeric TGF-β1/β3 knock-in (TGF-β1 ) mice. PBM treatments failed to activate the chimeric TGF-β1 complex and failed to improve burn wound healing in these mice.
These results suggest activation of endogenous latent TGF-β1 following PBM treatments plays a key role in burn wound healing.
These mechanistic insights can improve the safety and efficacy of clinical translation of PBM treatments for tissue healing and regeneration.
PubMed | PMID: 34183697 PMCID: PMC8238984 DOI: 10.1038/s41598-021-92650-w