Inhibitory modulation of cytochrome c oxidase activity with specific near-infrared light wavelengths attenuates brain ischemia/reperfusion injury.

The interaction of light with biological tissue has been successfully utilized for multiple therapeutic purposes. Previous studies have suggested that near infrared light (NIR) enhances the activity of mitochondria by increasing cytochrome c oxidase (COX) activity, which we confirmed for 810 nm NIR. In contrast, scanning the NIR spectrum between 700 nm and 1000 nm revealed two NIR wavelengths (750 nm and 950 nm) that reduced the activity of isolated COX. COX-inhibitory wavelengths reduced mitochondrial respiration, reduced the mitochondrial membrane potential (ΔΨm), attenuated mitochondrial superoxide production, and attenuated neuronal death following oxygen glucose deprivation, whereas NIR that activates COX provided no benefit. We evaluated COX-inhibitory NIR as a potential therapy for cerebral reperfusion injury using a rat model of global brain ischemia. Untreated animals demonstrated an 86% loss of neurons in the CA1 hippocampus post-reperfusion whereas inhibitory NIR groups were robustly protected, with neuronal loss ranging from 11% to 35%. Moreover, neurologic function, assessed by radial arm maze performance, was preserved at control levels in rats treated with a combination of both COX-inhibitory NIR wavelengths. Taken together, our data suggest that COX-inhibitory NIR may be a viable non-pharmacologic and noninvasive therapy for the treatment of cerebral reperfusion injury.

[Effect of high frequency electrotherapy on caspase-3 and ultra microstructure of hippocampus in rats following cerebral ischemia/reperfusion].

OBJECTIVE: To investigate the effect of high frequency electrotherapy (HFE) on rat hippocampus after cerebral ischemia/reperfusion (I/R).
 Methods: A rat model of cerebral I/R injury was established. The rats were randomly divided into a sham group, an I/R group and an HFE group. The HFE group received thearapy daily for different sessions for 1, 3, 7 d. Neuronal deficit score,neuron ultra microstructure in the hippocampus and caspase-3 protein expression were measured on 1 st, 3 th and 7th d.
 Results: Compared with the I/R group, the HFE group showed the decreased neurological deficit scores, with significant differences between the 2 groups (P<0.05). The injury in HFE group was reduced compared with that in the I/R group based on the electron microscope test, with significant difference. Caspase-3 protein in brain tissue in the HFE group also downregulated compared with that in the I/R group (P<0.05).
 Conclusion: High frequency electrotherapy can improve neural function, suppress caspase-3 expression and apoptosis in nerve cells and improve the ultra microstructure of neurons, displaying a protective effect on cerebral I/R injury in rats.

Evaluation of low-level laser therapy on skeletal muscle ischemia-reperfusion in streptozotocin-induced diabetic rats by assaying biochemical markers and histological changes.

The purpose of the present study was to assess the effects of low-level laser therapy (LLLT) on skeletal muscle ischemia-reperfusion (IR) injuries in streptozotocin-induced diabetic rats. Twenty male Wistar rats were randomly assigned into two experimental groups, as follows: the diabetic IR group (G1, n = 10) and the diabetic IR + LLLT group (G2, n = 10). Ischemia was induced in anesthetized rats from the right femoral artery clipping for 2 h, followed by a reperfusion for 24 h. Then, the laser irradiation (K30 handheld probe, AZOR, Technica, Russia, 650 nm, 30 mW, surface area = 1 cm(2), energy density = 1.8 J/cm(2)) was carried out by irradiating the rats over a unique point on the skin over the middle region of the right gastrocnemius muscle belly three times (every 8 h), starting after initiating the reperfusion for 3 min. At the end of the reperfusion period, rats were anaesthetized and blood samples were collected and used for the estimation of pO2, pCO2, pH, HCO3, serum creatine phosphokinase (CPK), and lactate dehydrogenase (LDH). Subsequently, the right gastrocnemius muscle samples were taken for wet/dry weight ratio assessment and histological/biochemical examination. The pO2, pCO2, HCO3, and pH levels were similar for both groups (P > 0.05). The serum LDH and CPK levels were significantly lower (P < 0.05) for G2 compared to G1. In comparison to G1, tissue malondialdehyde level in G2 was significantly decreased (P < 0.05). In G2, superoxide dismutase activity was significantly increased compared to G1 (P < 0.05). Unlike G2, a significant decrease in the activity of catalase was observed in G1 (P < 0.05). The wet/dry ratio in G1 was significantly higher than that of G2 (P < 0.05). Histological examination confirmed that the extent of muscle changes in G1 was higher than G2 (P < 0.05). Finally, according to this study, LLLT has a beneficial effect on the IR muscle injury treatment in the diabetic rats. Therefore, we suggest that further research needs to be conducted using different laser parameters and examining response over a longer period of tissue recovery.

The influence of low-level laser irradiation on spinal cord injuries following ischemia-reperfusion in rats.

PURPOSE: To investigate if low level laser therapy (LLLT) can decrease spinal cord injuries after temporary induced spinal cord ischemia-reperfusion in rats because of its anti-inflammatory effects. METHODS: Forty eight rats were randomized into two study groups of 24 rats each. In group I, ischemic-reperfusion (I-R) injury was induced without any treatment. Group II, was irradiated four times about 20 minutes for the following three days. The lesion site directly was irradiated transcutaneously to the spinal direction with 810 nm diode laser with output power of 150 mW. Functional recovery, immunohistochemical and histopathological changes were assessed. RESULTS: The average functional recovery scores of group II were significantly higher than that the score of group I (2.86 ± 0.68, vs 1.38 ± 0.09; p<0.05). Histopathologic evaluations in group II were showed a mild changes in compare with group I, that suggested this group survived from I-R consequences. Moreover, as seen from TUNEL results, LLLT also protected neurons from I-R-induced apoptosis in rats. CONCLUSION: Low level laser therapy was be able to minimize the damage to the rat spinal cord of reperfusion-induced injury.

The influence of low-level laser irradiation on spinal cord injuries following ischemia- reperfusion in rats

PURPOSE:To investigate if low level laser therapy (LLLT) can decrease spinal cord injuries after temporary induced spinal cord ischemia-reperfusion in rats because of its anti-inflammatory effects.METHODS: Forty eight rats were randomized into two study groups of 24 rats each. In group I, ischemic-reperfusion (I-R) injury was induced without any treatment. Group II, was irradiated four times about 20 minutes for the following three days. The lesion site directly was irradiated transcutaneously to the spinal direction with 810 nm diode laser with output power of 150 mW. Functional recovery, immunohistochemical and histopathological changes were assessed.RESULTS:The average functional recovery scores of group II were significantly higher than that the score of group I (2.86 ± 0.68, vs 1.38 ± 0.09; p<0.05). Histopathologic evaluations in group II were showed a mild changes in compare with group I, that suggested this group survived from I-R consequences. Moreover, as seen from TUNEL results, LLLT also protected neurons from I-R-induced apoptosis in rats.CONCLUSION:Low level laser therapy was be able to minimize the damage to the rat spinal cord of reperfusion-induced injury.

Effect of low-level laser therapy on lung injury induced by hindlimb ischemia/reperfusion in rats.

To investigate the effect of low-level laser therapy (LLLT 650 nm) on the lung remote organ injury induced by hindlimb ischemia/reperfusion (I/R). The experiments were performed on 50 healthy mature male Wistar rats weighing mean 230 ± 20 g. The rats were randomly allocated into five equal groups as follows: normal group (animals nonmanipulated), sham group (operated with no ischemia), laser group (animals nonmanipulated and irradiated with laser), I/R group, and I/R + LLLT group. Rats were prepared for sterile surgery, and then, right hindlimbs were subjected to I/R induced by the femoral artery occlusion for duration of 120 min, followed by a 60-min reperfusion. The LLLT (K30 handheld probe, AZOR, Technica, Russia, 650 nm, 30 mW, surface area = 1 cm(2), 60 S/cm(2), energy density = 1.8 J/cm(2)) was carried out by irradiating the rats over a unique point on the skin over the right upper bronchus for 5 and 15 min after initiating reperfusion for 3 min. At the end of the trial, rats were euthanized under deep anesthesia and the right lung tissues were removed. Myeloperoxidase (MPO) and superoxide dismutase (SOD) activities and nitric oxide (NO), malondialdehyde (MDA), and glutathione (GSH) levels were measured in the lung tissues. The tissue samples were further examined histopathologically under light microscopy. It was found that I/R elevated MPO activity, MDA, and NO levels accompanied by a reduction in SOD activities and GSH levels (P < 0.05). LLLT restored MDA and NO levels, MPO and SOD activity, GSH levels, and lung injury scores (P < 0.05). In light of these findings, the LLLT has alleviated the lung tissue injuries after skeletal muscle I/R in this experimental model.

Effects of light-emitting diode (LED) therapy on skeletal muscle ischemia reperfusion in rats.

Low-level laser therapy has been shown to decrease ischemia-reperfusion injuries in the skeletal muscle by induction of synthesis of antioxidants and other cytoprotective proteins. Recently, the light-emitting diode (LED) has been used instead of laser for the treatment of various diseases because of its low operational cost compared to the use of a laser. The objective of this work was to analyze the effects of LED therapy at 904 nm on skeletal muscle ischemia-reperfusion injury in rats. Thirty healthy male Wistar rats were allocated into three groups of ten rats each as follows: normal (N), ischemia-reperfusion (IR), and ischemia-reperfusion + LED (IR + LED) therapy. Ischemia was induced by right femoral artery clipping for 2 h followed by 2 h of reperfusion. The IR + LED group received LED irradiation on the right gastrocnemius muscle (4 J/cm(2)) immediately and 1 h following blood supply occlusion for 10 min. At the end of trial, the animals were euthanized and the right gastrocnemius muscles were submitted to histological and histochemical analysis. The extent of muscle damage in the IR + LED group was significantly lower than that in the IR group (P < 0.05). In comparison with other groups, tissue malondialdehyde (MDA) levels in the IR group were significantly increased (P < 0.05). The muscle tissue glutathione (GSH), superoxide dismutases (SOD), and catalase (CAT) levels in the IR group were significantly lower than those in the subjects in other groups. From the histological and histochemical perspective, the LED therapy has alleviated the metabolic injuries in the skeletal muscle ischemia reperfusion in this experimental model.

The effects of low-intensity laser therapy on hepatic ischemia-reperfusion injury in a rat model.

Ischemia-reperfusion (I/R) is a major mechanism of liver injury following hepatic surgery or transplantation. Despite numerous reports on the role and relics of low-intensity laser therapy (LILT) in many organs, the potential effects of LILT on hepatic ischemia-reperfusion have not been explored. This study was aimed to investigate the impresses of LILT applied to the skin following hepatic ischemia and reperfusion. Thirty-six healthy male Wistar rats were allocated into three groups of twelve animals each as follows: Sham, Ischemia-reperfusion (IR), and Ischemia-reperfusion with laser treatment (IR+LILT). Hepatic ischemia was induced by clamping the arterial and portal venous for 45 min. A laser diode (400 mW, 804 nm) was applied to the skin surface at the anatomical site of the liver at a dose of 3 J/cm(2), and the duration of irradiation was selected 120 s with 15-min interval after beginning the reperfusion. Animals were maintained under anesthesia and sacrificed 6 h subsequent reperfusion. Hepatic samples were evaluated for histological assessment and biochemistry analysis. Serum aminotransferase levels, tumor necrosis factor-alpha (TNF-α) levels, malondialdehyde (MDA), and glutathione (GSH) levels were significantly lower (P < 0.05) in the irradiated group compared to the I/R group during the 6 h after reperfusion. The number of histopathological changes in the hepatic tissues was significantly lower in the treated group (P < 0.05). These observations suggest that LILT applied in transcutaneous manner effectively improves hepatic injuries after ischemia-reperfusion period in rats.

Low-level laser therapy restores the oxidative stress balance in acute lung injury induced by gut ischemia and reperfusion.

It remains unknown if the oxidative stress can be regulated by low-level laser therapy (LLLT) in lung inflammation induced by intestinal reperfusion (i-I/R). A study was developed in which rats were irradiated (660 nm, 30 mW, 5.4 J) on the skin over the bronchus and euthanized 2 h after the initial of intestinal reperfusion. Lung edema and bronchoalveolar lavage fluid neutrophils were measured by the Evans blue extravasation and myeloperoxidase (MPO) activity respectively. Lung histology was used for analyzing the injury score. Reactive oxygen species (ROS) was measured by fluorescence. Both expression intercellular adhesion molecule 1 (ICAM-1) and peroxisome proliferator-activated receptor-y (PPARy) were measured by RT-PCR. The lung immunohistochemical localization of ICAM-1 was visualized as a brown stain. Both lung HSP70 and glutathione protein were evaluated by ELISA. LLLT reduced neatly the edema, neutrophils influx, MPO activity and ICAM-1 mRNA expression. LLLT also reduced the ROS formation and oppositely increased GSH concentration in lung from i-I/R groups. Both HSP70 and PPARy expression also were elevated after laser irradiation. Results indicate that laser effect in attenuating the acute lung inflammation is driven to restore the balance between the pro- and antioxidants mediators rising of PPARy expression and consequently the HSP70 production.

The effects of low-level laser therapy in a rat model of intestinal ischemia-reperfusion injury.

BACKGROUND AND OBJECTIVE: To investigate the effects of low-level laser therapy applied to the serosal surface of the rat jejunum following ischemia and reperfusion. MATERIALS AND METHODS: Ninety-six male Sprague-Dawley rats were assigned to 15 groups and anesthetized. Small intestinal ischemia was induced by clamping the superior mesenteric artery for 60 minutes. A laser diode (70 mW, 650 nm) was applied to the serosal surface of the jejunum at a dose of 0.5 J/cm(2) either immediately before or following initiation of reperfusion. Animals were maintained under anesthesia and sacrificed at 0, 1, and 6 hours following reperfusion. Intestinal, lung, and liver samples were evaluated histologically. RESULTS: Intestinal injury was significantly worse (P < 0.0001) in animals treated with laser and no ischemia-reperfusion injury (IRI) compared to sham. Intestinal injury was significantly worse in animals that underwent IRI and laser treatment at all time points compared to sham (P < 0.001). In animals that underwent IRI, those treated with laser had significantly worse intestinal injury compared to those that did not have laser treatment at 0 (P = 0.0104) and 1 (P = 0.0015) hour of reperfusion. After 6 hours of reperfusion there was no significant difference in injury between these two groups. Lung injury was significantly decreased following IRI in laser-treatment groups (P < 0.001). CONCLUSIONS: At the dose and parameters used, low-level laser did not protect against intestinal IRI in the acute phase of injury. However, laser did provide protection against distant organ injury. Failure to observe a therapeutic response in the intestine may be due to inappropriate dosing parameters. Furthermore, the model was designed to detect the histologic response within the first 6 hours of injury, whereas the beneficial effects of laser, if they occur, may not be observed until the later phases of healing. The finding of secondary organ protection is important, as lung injury following IRI is a significant source of morbidity and mortality.

Inhibitory effects of prior low-dose x-irradiation on ischemia-reperfusion injury in mouse paw.

We have reported that low-dose, unlike high-dose, irradiation enhanced antioxidation function and reduced oxidative damage. On the other hand, ischemia-reperfusion injury is induced by reactive oxygen species. In this study, we examined the inhibitory effects of prior low-dose X-irradiation on ischemia-reperfusion injury in mouse paw. BALB/c mice were irradiated by sham or 0.5 Gy of X-ray. At 4 hrs after irradiation, the left hind leg was bound 10 times with a rubber ring for 0.5, 1, or 2 hrs and the paw thickness was measured. Results show that the paw swelling thickness by ischemia for 0.5 hr was lower than that for 2 hrs. At 1 hr after reperfusion from ischemia for 1 hr, superoxide dismutase activity in serum was increased in those mice which received 0.5 Gy irradiation and in the case of the ischemia for 0.5 or 1 hr, the paw swelling thicknesses were inhibited by 0.5 Gy irradiation. In addition, interstitial edema in those mice which received 0.5 Gy irradiation was less than that in the mice which underwent by sham irradiation. These findings suggest that the ischemia-reperfusion injury is inhibited by the enhancement of antioxidation function by 0.5 Gy irradiation.

The effect of ischemic preconditioning prior to intraoperative radiotherapy on ischemic and on reperfused rat liver.

BACKGROUND: The purpose of this study was to increase the tolerance of the liver to radiation injury with the proven effect of ischemic precondition (IP) in decreasing oxygen-derived free radicals, and to compare the effect of intraoperative radiotherapy (IORT) during ischemia and during reperfusion on rat liver. MATERIALS AND METHODS: Two hundred fifty to 280 g male Wistar rats underwent 45 min of normothermic, segmental liver ischemia with or without IP/5 min ischemia and 10 min reperfusion, in two cycles. During ischemia or reperfusion, IORT doses of 0, 25, or 50 Gy were applied to the ischemic liver lobe. Hepatic microcirculation was monitored by laser Doppler flowmeter. Short- and long-term histological, alkaline phosphatase, bilirubin and tumor necrosis factor-alpha levels, liver tissue, and serum antioxidant alterations were measured. RESULTS: Histological, laboratory, as well as flowmetry alterations caused by 25 Gy were reversible after 6 mo. Three mo following IORT, histological examination revealed parenchymal fibrosis, bridging, liver cell atrophy, and bile duct proliferation in the group that was irradiated with 50 Gy during reperfusion, without IP. In this group, the changes were present 6 mo following IORT, and also the levels of tumor necrosis factor-alpha and oxygen-derived free radicals after reperfusion were increased. All these changes were significantly milder in groups with IP, especially those that were irradiated during ischemia. CONCLUSIONS: IORT to the liver, up to 25 Gy, can be applied without short- or long-term treatment morbidity. Doses of up to 50 Gy are tolerated with IP, which has never been described before. Irradiation during ischemia is less toxic for the liver tissue.

Photoengineering of tissue repair in skeletal and cardiac muscles.

This review discusses the application of He-Ne laser irradiation to injured muscles at optimal power densities and optimal timing, which was found to significantly enhance (twofold) muscle regeneration in rats and, even more, in the cold-blooded toads. Multiple and frequent (daily) application of the laser in the toad model was found to be less effective than irradiation on alternate days. It was found that in the ischemia/reperfusion type of injury in the skeletal leg muscles (3 h of ischemia), infrared Ga-Al-As laser irradiation reduced muscle degeneration, increased the cytoprotective heat shock proteins (HSP-70i) content, and produced a twofold increase in total antioxidants. In vitro studies on myogenic satellite cells (SC) revealed that phototherapy restored their proliferation. Phototherapy induced mitogen-activated protein kinase/extracellular signal-regulated protein kinase (MAPK/ERK) phosphorylation in these cells, probably by specific receptor phosphorylation. Cell cycle entry and the accumulation of satellite cells around isolated single myofibers cultured in vitro was also stimulated by phototherapy. Phototherapy also had beneficial effects on mouse, rat, dog and pig ischemic heart models. In these models, it was found that phototherapy markedly and significantly reduced (50-70%) the scar tissue formed after induction of myocardial infarction (MI). The phototherapeutic effect was associated with reduction of ventricular dilatation, preservation of mitochondria and elevation of HSP- 70i and ATP in the infarcted zone. It is concluded that phototherapy using the correct parameters and timing has a markedly beneficial effect on repair processes after injury or ischemia in skeletal and heart muscles. This phenomenon may have clinical applications.

Protection of skeletal muscles from ischemic injury: low-level laser therapy increases antioxidant activity.

OBJECTIVE: The aim of this study was to investigate the effect of low-level laser therapy (LLLT) on ischemic-reperfusion (I-R) injury in the gastrocnemius muscle of the rat. BACKGROUND DATA: Ischemic injury in skeletal muscle is initiated during hypoxia and is aggravated by reoxygenation during blood reperfusion and accumulation of cytotoxic reactive oxygen superoxides. LLLT has been found to biostimulate various biological processes, such as attenuation of ischemic injury in the heart. MATERIALS AND METHODS: The injury was induced in the gastrocnemius muscles of 106 rats by complete occlusion of the blood supply for 3 h, followed by reperfusion. Another group of intact rats served to investigate the effect of LLLT on intact nonischemic muscles. Creatine phosphokinase, acid phosphatase, and heat shock protein were determined 7 days after I-R injury and antioxidant levels 2 h after reperfusion. RESULTS: Laser irradiation (Ga-As, 810 nm) was applied to the muscles immediately and 1 h following blood supply occlusion. It was found that laser irradiation markedly protects skeletal muscles from degeneration following acute I-R injury. This was evident by significantly (p < 0.05) higher content of creatine phosphokinase activity and lower (p < 0.05) activity of acid phosphatase in the LLLT-treated muscles relative to the injured non-irradiated ones. The content of antioxidants and heat shock proteins was also higher (p < 0.05) in the LLLT-treated muscles relative to that of injured non-irradiated muscles. CONCLUSION: The present study describes for the first time the ability of LLLT to significantly prevent degeneration following ischemia/reperfusion injury in skeletal muscles, probably by induction of synthesis of antioxidants and other cytoprotective proteins, such as hsp-70i. The elevation of antioxidants was also evident in intact muscle following LLLT. The above phenomenon may also be of clinical relevance in scheduled surgery or microsurgery requiring extended tourniquet applications to skeletal muscle followed by reperfusion.

Treatment of experimentally induced transient cerebral ischemia with low energy laser inhibits nitric oxide synthase activity and up-regulates the expression of transforming growth factor-beta 1.

BACKGROUND AND OBJECTIVES: Nitric oxide (NO) has been shown to be neurotoxic while transforming growth factor-beta 1 (TGF-beta1) is neuroprotective in the stroke model. The present study investigates the effects of low energy laser on nitric oxide synthase (NOS) and TGF-beta1 activities after cerebral ischemia and reperfusion injury. STUDY DESIGN/MATERIALS AND METHODS: Cerebral ischemia was induced for 1 hour in male adult Sprague-Dawley (S.D.) rats with unilateral occlusion of middle cerebral artery (MCAO). Low energy laser irradiation was then applied to the cerebrum at different durations (1, 5, or 10 minutes). The activity of NOS and the expression of TGF-beta1 were evaluated in groups with different durations of laser irradiation. RESULTS: After ischemia, the activity of NOS was gradually increased from day 3, became significantly higher from day 4 to 6 (P < 0.001), but returned to the normal level after day 7. The activity and expression of the three isoforms of NOS were significantly suppressed (P < 0.001) to different extents after laser irradiation. In addition, laser irradiation was shown to trigger the expression of TGF-beta1 (P < 0.001). CONCLUSIONS: Low energy laser could suppress the activity of NOS and up-regulate the expression of TGF-beta1 after stroke in rats.