Cellular and tissue mechanisms for the action of low-intensity optical radiation on patients with diabetic foot syndrome
Abstract
Introduction. The low-intensity visible and infrared radiation of lasers and LEDs is widely used in medicine
for the treatment of a number of diseases, including in patients with diabetic foot syndrome. However, there is no consistency and certainty in the characteristics of radiation and the duration of exposure to achieve the best effect in a particular patient.
The aim of the work is a systematic analysis of the literature on the influence of low-intensity electromagnetic
radiation of the optical spectrum range on the healing of foot ulcers and the normalization of the condition of patients with diabetes, as well as the mechanisms of therapeutic action.
Materials and methods. An analysis of medical publications based on the MedLine database for the period from 1995 to 2019 was carried out on this topic.
Results. Based on the analysis of published works, the parameters of low intensity optical radiation are established that stimulate the healing of ulcers, the normalization of blood supply and innervation in patients with diabetic foot syndrome. The most probable mechanisms of the therapeutic effect of low intensity optical radiation with diabetic foot syndrome have been identified.
Findings. A systematic analysis of the literature shows that low-intensity optical radiation from both lasers and LEDs causes a reaction at the cellular and tissue levels, which results in pronounced therapeutic effects, including the healing of ulcers in both experimental animals and patients with diabetic syndrome feet. The mechanisms of therapeutic action of low-intensity electromagnetic radiation of the optical spectrum range are biochemical rather than thermal. As a result of photochemical stimulation, the proliferation of cells, in particular fibroblasts, is accelerated, cellular respiration, production of collagen and growth factors are enhanced, macrophage activity and angiogenesis are activated, which leads to the cleansing of wounds and ulcers, the removal of inflammation, the normalization of microcirculation and the development of a new blood vessel system. period from 1995 to 2019 was carried out on this topic.
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Tardivo JP, Adami F, Correa JA, Pinhal MAS, Baptista S. A clinical trial testing the efficacy of PDT in preventing
amputation in diabetic patients. Photodiagn. Photodyn. Ther. 2014;11:342–50.
Marques C, Martins A, Conrado LA. The use of hyperbaric oxygen therapy and LED therapy in diabetic foot.
In: Rechmann P, Fried D, Hennig T, editors. Proc. of SPIE5312, Lasers in Surgery: Advanced Characterization,
Therapeutics, and Systems XIV. Bellingham: SPIE; 2004; p. 47–53.
Minatel DG, Enwemeka CS, Franca SC, Frade MAC. Fototerapia (LEDs 660/890nm) no tratamento de ulceras
de perna em pacientes diabéticos: Estudo de caso. Anais Brasileiros de Dermatologia. 2009;84(3):279–83.
Roelandts R. The history of phototherapy: something new under the sun? J. Am. Acad. Dermatol. 2002;46:926–30.
Kizilova NN, Korobov AM. [Mechanisms of influence of low-intensity optical radiation on the microcirculation
system]. Obzor. Fotobiol. fotomed [Overview. Photobiol. photomed.]. 2016;1:79–93. (in Russian)
Mester E, Szende B Gartner P. The effect of laser beams on the growth of hair in mice. Radiobiol. Radiother. (Berlin). 1968;9: 621–6.
Pereira AN, Eduardo Cde P, Matson E, Marques MM. Effect of low–power laser irradiation on cell growth and
procollagen synthesis of cultured fibroblasts. Lasers Surg. Med. 2002;31:263–7.
Kana JS, Hutschenreiter G, Haina D, Waidelich W. Effect of low–power density laser radiation on healing of open
skin wounds in rats. Arch. Surg. 1981;116: 293–6.
Sommer AP, Pinheiro AL, Mester AR, et al. Biostimulatory windows in low–intensity laser activation: lasers,
scanners, and NASA's light–emitting diode array system. J. Clin. Laser. Med. Surg. 2001;19:29–33.
Carrejo NC, Moore AN, Lopez Silva TL, et al. Multidomain peptide hydrogel accelerates healing of full–thickness
wounds in diabetic mice. ACS Biomater. Sci. Eng. 2018;4(4):1386–96.
Коrobov АМ, Коrobov VА, Lisna ТO. A.Korobov-V.Korobov. Phototherapeutic devices of “Barva” series. Transl.
from ukr. Kharkiv: V.N.Karazin KhNU; 2018. 188 p.
Korobov AM, Korobov VA, Bojkacheva OM. [Korobov photonic matrices for the treatment and prevention of
diabetic foot syndrome]. Fotobіol. fotomed [Photobiol. photomed.]. 2011;1:128–9. (in Russian)
Zhuravl'ova LV, Fedorov VO, Korobov AM. [Experience in the treatment of chronic complications of diabetes: view of defeat of musculoskeletal system]. Fotobіol. fotomed. [Photobiol. photomed.]. 2014;3(4):19–23. (in Ukrainian)
Hu W–P, Wang J–J, Yu C–L, et al. Helium–neon laser irradiation stimulates cell proliferation through photostimulatory effects in mitochondria. J. Investigative Dermatol. 2007;127(8):2048–57.
Stadler I, Lanzafame RJ, Evans R, et al. 830–nm irradiation increases the wound tensile strength in a diabetic
murine model. Lasers Surg. Med. 2001;28(3):220–6.
Schindl A, Schindl M, Schön H, et al. Low–intensity laser irradiation improves skin circulation in patients with diabetic microangiopathy. Diabetes Care. 1998;21(4):580-4.
Schindl A, Schindl M, Pernerstorfer–Schön H, et al. Diabetic neuropathic foot ulcer: successful treatment by low–
intensity laser therapy. Dermatology. 1999;198(3):314-6.
Schindl A, Schindl M, Schindl L. Successful treatment of a persistent radiation ulcer by low power laser therapy.
J. Am. Acad. Dermatol. 1997;37(4):646–8.
Kawalec JS, Reyes C, Penfield VK, et al. Evaluation of the Ceralas D15 diode laser as an adjunct tool for wound care: a pilot study. Foot. 2001;11(2):68–73.
Kawalec JS, Hetherington VJ, Pfennigwerth TC, et al. Effect of a diode laser on wound healing by using diabetic
and nondiabetic mice. J. Foot&Ankle Surg. 2004;43(4):214–20.
Kawalec JS, Pfennigwerth TC, Hetherington VJ, et al. A review of lasers in healing diabetic ulcers. Foot.
;14(2):68–71.
Nteleki B, Houreld NN. The use of phototherapy in the treatment of diabetic ulcers. J. Endocrin.
;17(3):128–32.
de Almeida Nunes G.A.M., dos Reis M.C., Rosa M.F.F., et al. A system for treatment of diabetic foot ulcers using
LED irradiation and natural latex. Res. Biomed. Eng. 2016; 32(1):3–13.
Rundo AI, Kosinec VA. [The use of combination phototherapy in the complex treatment of patients with complications of diabetic foot syndrome]. Novosti hirurgii [Surgery News]. 2016;24(2):131–7. (in Russian)
Kizilova N, Korobov A. On biomedical engineering techniques for efficient phototherapy. Int. J. Biosen. Bioelectron. 2018;4(6):289–95. DOI: 10.15406/ ijbsbe.2018.04.00142.
Nemeth AJ. Lasers and wound healing. Dermatol. Clinics. 1993;11(4):783–9.
Karu T. Primary and secondary mechanisms of action of visible to near–IR radiation on cells. J. Photochem.
Photobiol., Ser. B. 1999; 49(1):1–17.
Tuner J, Hode L. Laser Therapy. Clinical Practice and Scientific Background. Grängesberg: Prima Books. 2002.
p.
Pinheiro ALB, Nascimento SC, de Barros Vieira AL, et al. Effects of low–level laser therapy on malignant cells: in
vitro study. J. Clin. Laser Med. Surg. 2002;20(1):23–6.
Matic M, Lazetic B, Poljacki M,et al. Low level laser irradiation and its effect on repair processes in the skin.
Medicinski Pregled. 2003;56(3–4):137–41.
Takac S, Stojanovic S. Diagnostic and biostimulating lasers. Medicinski Pregled. 1998;51(5–6):245–9.
Karu TI, editor. Primary and secondary mechanisms of the action of monochromatic visible and near infrared
radiation on cells. The science of low–power laser therapy. Amsterdam: Gordon and Breach Science; 1998; p. 53–83.
Lubart R, Friedmann H, Peled I, Grossman N. Light effect on fibroblast proliferaton. Laser Therapy. 1993;5(2):55-7.
Silveira PCL, Silva LAD, Fraga DB, et al. Evaluation of mitochondrial respiratory chain activity in muscle healing
by low–level laser therapy. J. Photochem. Photobiol., Ser. B. 2009;95(2):89–92.
Nieuwdorp M, Mooij H, Kroon J, et al. Endothelial glycocalyx damage coincides with microalbuminuria in type 1
diabetes. Diabetes. 2006;55(4):1127–32.
Jensen J, Feldt–Rasmussen B, Borch–Johnsen K, et al. Increased transvascular lipoprotein transport in diabetes:
Association with albuminuria and systolic hypertension. J. Clin. Endocrinol. Metabol. 2005;90(8):4441–5.
Evans DH, Abrahamse H. A review of laboratory–based methods to investigate second messengers in low–level
laser therapy. Medical Laser Appl. 2009;24(3):201–15.
Karu T.I. Multiple roles of cytochrome c oxidase in mammalian cells under action of red and IR–A radiation.
IUBMB Life. 2010;62(8):607–10.
Lubart R, Eichler M, Lavi R, Friedman H, Shainberg A. Low–energy laser irradiation promotes cellular redox
activity. Photomed. Laser Surg. 2005;23:3–9.
Karu TI, Pyatibrat LV, Kolyakov SF, Afanasyeva NI. Absorption measurements of cell monolayers relevant
to mechanisms of laser phototherapy: reduction or oxidation of cytochrome c oxidase under laser radiation at
8 nm. Photomed. Laser Surg. 2008;26(6):593–9.
Silveira PCL, Streck EL, Pinho RA. Evaluation of mitochondrial respiratory chain activity in wound healing by
low–level laser therapy. J. Photochem. Photobiol., Ser. B. 2007;86(3):279–82.
Houreld NN, Masha RT, Abrahamse H. Low–intensity laser irradiation at 660 nm stimulates cytochrome c oxidase
in stressed fibroblast cells. Lasers in Surger.&Med. 2012;44:429–34.
Masha RT, Houreld NN, Abrahamse H. Low–intensity laser irradiation at 660 nm stimulates transcription of
genes involved in the electron transport chain. Photomed.& Laser Surg. 2013;31(2):47–53.
Karu TI, Pyatibrat LV, Afanasyeva NI. Cellular effects of low power laser therapy can be mediated by nitric oxide.
Lasers in Surger.&Med. 2005;36(4):307–14.
Buerk DG. Can we model nitric oxide biotransport? A survey of mathematical models for a simple diatomic
molecule with surprisingly complex biological activities. Annu. Rev. Biomed. Eng. 2001;3:109–43.
Loscalzo J, Vita J, editors. Nitric Oxide and the Cardiovascular System. Contemporary Cardiology. Vol. 4. 2000.
p.
Houreld NN. Shedding Light on a New Treatment for Diabetic Wound Healing: A Review on Phototherapy. Sci. World J. 2014;2014:398–412. DOI:10.1155/2014/398412.
Starwynn D. Laser and LED Treatments: Which is Better? Acupunct. Today. 2004;5(6):1–6.
Mason MG, Nicholls P, Wilson MT, Cooper CE. Nitric oxide inhibition of respiration involves both competitive
(heme) and noncompetitive (coPer) binding to cytochrome c oxidase. Proc. Nat. Acad. Sci. of the USA. 2006;103(3):708–13.
Rubinov AN, Afanas’ev AA. Nonresonance mechanisms of biological effects of coherent and incoherent light. Optics Spectrosc. 2005;98(6):943–8.