RESUMEN
Intervertebral disc (IVD) degeneration with chronic low back pain is associated with neo-vascularisation into the deeper IVD regions. During this process, endothelial cells (ECs), which are primarily responsible for angiogenesis, interact with the adjacent annulus fibrosus (AF) cells, which are the first line of defence against the invasion of vascular structures into deeper IVD regions. However, the accumulation of inflammatory and catabolic enzymes that results from this interaction promotes matrix degradation and an inflammatory response. Thus, regulating the production of these mediators and catabolic enzymes could ameliorate IVD degeneration. Photobiomodulation (PBM) therapy is a non-invasive stimulation known to have biologically beneficial effects on wound healing, tissue repair, and inflammation. Here, we examined the effects of PBM, administered at various wavelengths (645, 525, and 465 nm) and doses (16, 32, and 64 J/cm2), on EC-stimulated human AF cells. Our results show that PBM selectively inhibited the EC-mediated production of inflammatory mediators, catabolic enzymes, and neurotrophins by human AF cells in a dose- and wavelength-dependent manner. These results suggest that PBM could be a superior and advanced treatment strategy for IVD degeneration.
Asunto(s)
Anillo Fibroso/citología , Medios de Cultivo Condicionados/química , Células Endoteliales/citología , Matriz Extracelular/metabolismo , Degeneración del Disco Intervertebral/metabolismo , Terapia por Luz de Baja Intensidad/métodos , Neovascularización Patológica/metabolismo , Adulto , Anillo Fibroso/metabolismo , Anillo Fibroso/efectos de la radiación , Células Cultivadas , Relación Dosis-Respuesta en la Radiación , Células Endoteliales/química , Matriz Extracelular/genética , Femenino , Regulación de la Expresión Génica/efectos de la radiación , Humanos , Interleucina-6/genética , Interleucina-6/metabolismo , Interleucina-8/genética , Interleucina-8/metabolismo , Degeneración del Disco Intervertebral/genética , Degeneración del Disco Intervertebral/radioterapia , Masculino , Metaloproteinasas de la Matriz/genética , Metaloproteinasas de la Matriz/metabolismo , Persona de Mediana Edad , Modelos Biológicos , Neovascularización Patológica/radioterapiaRESUMEN
BACKGROUND: Recent studies have reported contrasting results of the effects of laser therapy on post-operative intervertebral disk herniation, with a lack of evidence-based advantages of this modality within a rehabilitation protocol. The aim of this study was to report the clinical effects of photobiomodulation therapy within a post-operative rehabilitation protocol in dogs submitted to surgery for thoracolumbar disk extrusion. Twenty-four dogs were included in the study (12 dogs treated with laser therapy and rehabilitation protocol and 12 dogs treated with same rehabilitation protocol but without laser therapy). RESULTS: All dogs treated with laser therapy showed improved neurological status (Modified Frankel Score more than 3 within 30 days of physiotherapy starting) if deep nociception on admission was maintained (P = 0.04). However, Kaplan-Meier analysis did not show any statistical difference in time to regain ambulatory ability, although there was a tendency for a shorter mean time of 14.2 ± 8.55 days in the laser group versus 24 ± 18.49 days in the no laser group. CONCLUSIONS: The use of laser therapy in the post-operative rehabilitation of dogs affected by intervertebral disc extrusion and submitted to surgery for spinal decompression could help improve their neurological status.
Asunto(s)
Enfermedades de los Perros/radioterapia , Degeneración del Disco Intervertebral/veterinaria , Desplazamiento del Disco Intervertebral/veterinaria , Terapia por Láser/veterinaria , Terapia por Luz de Baja Intensidad/veterinaria , Animales , Descompresión Quirúrgica/veterinaria , Enfermedades de los Perros/cirugía , Perros , Femenino , Degeneración del Disco Intervertebral/radioterapia , Degeneración del Disco Intervertebral/rehabilitación , Degeneración del Disco Intervertebral/cirugía , Desplazamiento del Disco Intervertebral/radioterapia , Desplazamiento del Disco Intervertebral/rehabilitación , Desplazamiento del Disco Intervertebral/cirugía , Vértebras Lumbares , Masculino , Periodo Posoperatorio , Vértebras TorácicasRESUMEN
BACKGROUND: For spinal-cord-injured (SCI) patients, integrative medicine approaches such as photomedicine and acupuncture can renew hope and offer previously unrecognized ways to help regain function and improve quality of life. OBJECTIVE: By understanding the mechanisms of action that these two modalities share, practitioners can better target specific attributes of spinal cord pathophysiology that are limiting recovery. Naturally occurring intervertebral disk disease (IVDD) in dogs affords unparalleled translational opportunities to develop treatment strategies involving photobiomodulation and acupuncture. CONCLUSIONS: Insights derived through clinical trials of dogs with IVDD have the potential to raise the standard of care for both human and canine SCI patients.