Repercussion of inflammatory bowel disease on lung homeostasis: The role of photobiomodulation.

Inflammatory bowel diseases (IBD) are chronic and multifactorial diseases characterized by dysfunction of the intestinal mucosa and impaired immune response. Data show an important relationship between intestine and respiratory tract. The treatments of IBD are limited. Photobiomodulation (PBM) is an effective anti-inflammatory therapy. Our objective was to evaluate the repercussion of IBD as well as its treatment with PBM on pulmonary homeostasis. Male Wistar rats were submitted to IBD induction by acetic acid and treated or not with PBM. Rats were irradiated with red LED on both right and left sides of the ventral surface and beside the external anal region during 3 consecutive days (wavelenght 660 nm, power 100 mw, total energy 15 J and time of irradiation 150 s per point). Our results showed that IBD altered pulmonary homeostasis, since we observed an increase in the histopathological score, in myeloperoxidase activity (MPO), in mast cell degranulation, and in the release and gene expression of cytokines. We also showed that PBM treatment reduced biomarkers of IBD and reverted all augmented parameters in the lung, restoring its homeostasis. Thus, we confirm experimentally the important gut-lung axis and the role of PBM as a promising therapy.

Effects of photobiomodulation in the experimental acetic acid-induced colitis: comparison between male and female.

Ulcerative colitis (UC) is an important chronic and multifactorial disease, which alters the colon mucosal with a significant impact on life quality affecting both men and women. The difference between genders causes changes in the inflammatory processes, modulating the development of several diseases. The available drugs to treat UC exhibit limited outcomes and side effects; thus, new therapies are needed. Photobiomodulation (PBM) emerges as potential treatment by modulating the inflammatory process without side effects and low costs. The aim of this study was to evaluate the effects of PBM in acetic acid-induced UC comparing the responses between male and females. For this purpose, male and female Wistar rats (36) were submitted to induction of UC by rectal administration of 10% acetic acid (colitis group) and treated or not with PBM (colitis-PBM group) (LED, 660 nm, 100 mW, 150 s) in three points: right side and left of the ventral surface and in the external anal region. Non-manipulated rats were used as control (basal group). We investigated the disease activity index (DAI score), myeloperoxidase enzyme activity (MPO) and release of cytokines in the intestine homogenates, and histological analysis. PBM reduces DAI score, MPO activity, and mast cell degranulation while increased mucous production in both females and males. Moreover, PBM reduced histopathological score as well as the levels of IL-6 and IL-4 in the bowel only in males. We also showed reduced levels of IL-1beta and TNF-alpha after PBM in both males and females, while the levels of IL-10 and IFN-gamma were increased. In conclusion, despite our study has shown some differences between males and females, PBM attenuated the biomarkers of UC in both genders constituting a potential combined treatment that is non-invasive and low cost.

Comparison between local abdominal and transcutaneous tail vein photobiomodulation in experimental rat model of ulcerative colitis.

Ulcerative colitis (UC) is a chronic autoimmune disease that impacts the quality of life, but current pharmacological treatments are limited. Photobiomodulation (PBM) is a light-based treatment that can be applied either locally or systemically. Here, we compare the effects of local and vascular PBM (VPBM) in an experimental rat model of UC. Male Wistar rats were induced with UC by rectal instillation of acetic acid and treated with either local abdominal PBM or VPBM to the tail vein using a 660-nm LED. The findings indicated that local PBM but not VPBM reduced intestinal histological scores. Both local and VPBM increased mucus production, decreased mast cell degranulation, and modulated TNF-α and IL-1 ß levels in the intestines. Local PBM also affected the expression of the mRNAs for IL-6, TNF-α, and IFN-γ. In conclusion, we suggest that local PBM appears to be more promising than VPBM for treating UC. However, further research is needed to fully understand the mechanisms and to optimize the parameters of PBM for UC treatment.

Intravascular laser irradiation of blood (ILIB) used to treat lung diseases: a short critical review.

Intravascular laser irradiation of blood (ILIB) was developed to treat cardiovascular diseases due to its rheological effects. In its original form, ILIB was applied by an intravenous optical fiber, restricting its application. However, this technique was modified to non-invasive irradiation through the radial artery, now called vascular photobiomodulation (VPBM). Many studies have used both, ILIB and VPBM, to treat lung diseases. It is well established that lung diseases affect more than 300 million people worldwide with high morbidity and mortality rates. In this short critical review, we discuss the potential benefits of photobiomodulation to treat lung diseases using these two approaches. The search was performed in the electronic database of MEDLINE (Medical Literature Analysis and Retrieval System Online) via PubMed. The data search was carried out from 1991 to 2017. We selected a total of 10 clinical studies using either ILIB or VPBM, in addition to 2 experimental studies in animals. The respiratory diseases treated in these studies included bronchitis, asthma, pneumonia, and tuberculosis. The results showed overall beneficial effects on lung diseases, characterized by a reduction in the inflammatory cascade and antioxidant effects, improvement of hemodynamic parameters, the efficiency of gas exchange, and reduction of hospitalization periods. In conclusion, all studies showed promising effects of ILIB in both animal and human studies. The studies did not discuss any disadvantages or contraindications. However, further studies are needed in order to understand the dosimetry, and the literature is lacking in randomized, controlled clinical trials. Thus, this review highlights the need for additional studies using this approach.

Local (but not systemic) photobiomodulation treatment reduces mast cell degranulation, eicosanoids, and Th2 cytokines in an experimental model of allergic rhinitis.

Allergic rhinitis (AR) is an inflammatory disorder of the nasal mucosa, and is a worldwide health problem with a significant impact on the quality of life. The main goal of AR treatment is to relieve symptoms. However, standard treatments have considerable side effects or are not effective. Photobiomodulation (PBM) therapy has emerged as an alternative treatment. Here, we evaluated the effects of transcutaneous systemic (tail) or local (skin over nostrils) PBM using a 660-nm light-emitting diode (LED) array. Adult rats were assigned into 4 groups: basal, as non-manipulated animals; Sham, as rats sensitized with 7 intradermal injections of ovalbumin (OVA) plus alum followed by intranasal instillation with OVA (2%) daily for 7 days; and the LPBM and SPBM groups, in which the animals were treated with PBM (local or systemic) immediately after the last instillation of OVA (1%) daily for 3 days. Our results showed that local PBM treatment reduced mast cell degranulation in the nasopharynx and nostrils; levels of leukotriene B4, thromboxane A2, and interleukin 4 (IL-4) in the nasopharynx; and gene expression of IL-4. Moreover, we showed higher levels and gene expression of IL-10 after local PBM treatment. Systemic PBM treatment did not change any of the evaluated parameters. In conclusion, our data showed that local (but not systemic) treatment with PBM could improve parameters related to AR in an animal model, and should be tested clinically.

Beneficial effects of infrared light-emitting diode in corticosteroid-resistant asthma.

Corticosteroid-resistant asthma (CRA) is a severe form of disease and clinically important, since patients do not respond to mainstay corticosteroid therapies. Thus, new therapies are needed. However, a big limiting factor in the understanding of CRA is the existence of different immunological and inflammatory phenotypes, a fact that makes it difficult to reproduce experimentally. Photobiomodulation (PBM) emerges as an alternative therapy based on earlier studies. This study aims to evaluate the effect of PBM using infrared light-emitting diode (ILED) on the development of corticosteroid-resistant asthma. Therefore, groups of rats were sensitized and challenged with ovalbumin plus Freund's adjuvant for the induction of CRA, and treated or not with ILED directly in the respiratory tract on the skin (wavelength 810 nm; power 100 mW; density energy 5 J/cm; total energy 15 J; time 150 s). Our experimental model was capable to induce neutrophilic asthma. Besides that, the corticosteroid treatment did not reverse the lung cell migration as well as the levels of leukotriene B4, and interleukins 17 and 6. The treatment with ILED reduced the lung cell migration; myeloperoxidase activity; mast cell degranulation; and the levels of leukotriene B4, thromboxane B2, prostaglandin E2, tumoral necrosis factor alpha, and interleukins 17 and 6. Still, ILED increased the level of interleukin 10. In conclusion, we showed promisor effects of ILED when irradiated directly in the respiratory tract as adjuvant treatment of corticosteroid-resistant asthma.

Transcutaneous systemic photobiomodulation reduced lung inflammation in experimental model of asthma by altering the mast cell degranulation and interleukin 10 level.

Asthma is a chronic inflammatory disease characterized by recurrent and reversible episodes of wheezing, dyspnea, chest stiffness, and cough. Its treatment includes several drugs, high cost, and considerable side effects. Photobiomodulation (PBM) emerges as an alternative treatment, showing good results, and it can be applied locally or systemically. Here, we aim to evaluate the effect of transcutaneous systemic photobiomodulation (TSPBM) by red diode light. Therefore, adult rats were sensitized and challenged with ovalbumin (OVA) plus alum for induction of asthma and irradiated or not with TSPBM in the caudal vein (wavelength 660 ± 10 nm; total radiant emission 15 J; area 2.8 cm2; energy density 5.35 J/cm2; irradiance 33.3 mW/cm2; exposure time 150 s). Our investigations prioritized the cell migration into the alveolar space and lung, tracheal responsiveness, release and gene expression of cytokines, mast cell degranulation, and anaphylactic antibodies. Our results showed that TSPBM reduced the cell migration and mast cell degranulation without altering the tracheal responsiveness and ovalbumin antibody titers. Indeed, TSPBM increased the levels of interleukin 10 (IL-10) in the BAL fluid without altering the gene expression of cytokines in the lung tissue. Thus, this study showed that transcutaneous systemic irradiation reduced lung inflammation by altering mast cells degranulation and IL-10 level. Considering that this study is a pioneer in the used of light by the systemic route to treat asthma, the data are interesting and instigate future investigations, mainly in relation to the mechanisms involved and in dosimetry.

Beneficial effects of ascorbic acid to treat lung fibrosis induced by paraquat.

Paraquat (PQ) is one of the most widely employed herbicides that is used worldwide and it causes severe toxic effects in humans and animals. A PQ exposition can lead to pulmonary fibrosis (PF) and the mechanisms seem to be linked to oxidative stress, although other pathways have been suggested. Antioxidants can be useful as a therapy, although interventions with this kind of system are still controversial. Hence, this study has investigated the role of ascorbic acid (vitamin C) post-treatment on PQ-induced PF in male C57/BL6 mice. Pulmonary fibrosis was induced by a single PQ injection (10mg/kg; i.p.). The control group received a PQ vehicle. Seven days after the PQ or vehicle injections, the mice received vitamin C (150 mg/kg, ip, once a day) or the vehicle, over the following 7 days. Twenty-four hours after the last dose of vitamin C or the vehicle, the mice were euthanized and their bronchoalveolar lavage fluid (BALF) and their lungs were collected. The data obtained showed that vitamin C reduced the cellular recruitment, the secretion of IL-17 -a cytokine involved in neutrophils migration, TGF-ß-a pro-fibrotic mediator and the collagen deposition. Moreover, vitamin C elevated the superoxide dismutase (SOD) and catalase levels, both antioxidant enzymes, but it did not alter the tracheal contractile response that was evoked by methacholine. Therefore, the researchers have highlighted the mechanisms of vitamin C as being non-invasive and have suggested it as a promising tool to treat lung fibrosis when it is induced by a PQ intoxication.

Vitamin D treatment abrogates the inflammatory response in paraquat-induced lung fibrosis.

A high incidence of intentional or accidental paraquat (PQ) ingestion is related to irreversible lung fibrosis and no effective therapy is currently available. Vitamin D has emerged with promising results as an immunomodulatory molecule when abrogating the inflammatory responses of lung diseases. Therefore, we have investigated the role of vitamin D treatments on PQ-induced lung fibrosis in male C57/BL6 mice. Lung fibrosis was induced by a single injection of PQ (10 mg/kg; i.p.). The control group received PQ vehicle. Seven days later, after the PQ injection or the vehicle injection, the mice received vitamin D (5 µg/kg, i.p., once a day) or vehicle, for a further 7 days. Twenty-four hours after the last dose of vitamin D or the vehicle, the analysis were performed. The vitamin D treatments reduced the number of leukocytes in their BALF and they decreased the IL-6, IL-17, TGF-beta and MMP-9 levels and the abrogated collagenase deposits in their lung tissues. Conversely, the vitamin D treatments increased the resolvin D levels in their BALF. Moreover, their tracheal contractility was also significantly reduced by the vitamin D treatments. Altogether, the data that was obtained showed a promising use of vitamin D, in treating the lung fibrosis that had been induced by the PQ intoxications. This may improve its prognostic use for a non-invasive and low cost therapy.

O uso terapêutico do LASER de Baixa Intensidade (LBI) em algumas patologias e sua relação com a atuação na Fonoaudiologia / The therapeutic use of low intensity laser (LLLT) in some diseases and its relation to the performance in speech therapy / El uso terapéutico de LÁSER de Baja Intensidad (LBI) en algunas patologías y su relación con la actuación en Fonoaudiología

O uso da luz LASER Terapêutico de Baixa Intensidade (LBI) ou Low Level Laser Therapy (LLLT), é multidisciplinar, sendo este utilizado por vários profissionais: médicos, dentistas, fisioterapeutas, enfermeiros, físicos, biólogos, engenheiros, etc. A Fonoaudiologia começa a despertar o interesse em integrar esse grupo de profissionais, sendo um recurso totalmente terapêutico, não invasivo, sem efeitos tóxicos e colaterais que agrega no trabalho terapêutico e estabelece um prognóstico excelente de reabilitação. Por esse motivo, objetivou-se coletar alguns artigos científicos que abordam os fundamentos físicos e bioquímicos da interação da luz do LASER com o tecido biológico vivo e sua aplicabilidade terapêutica nas especialidades da saúde onde encontramos também a atuação da Fonoaudiologia. Para isso foram selecionadas algumas patologias relacionando-as ao uso do LBI: disfunção temporomandibular (DTM), paralisia facial, disfagias por disfunção motora, cicatrização tecidual incluindo as fissuras mamilares, principal responsável pelo abandono do aleitamento materno. No escopo das patologias, será descrita a ação do LASER e seu efeito biomodulador nos processos: inflamatórios, álgicos, cicatriciais, edematosos, de reparação nervosa e muscular. Conclui-se que o LBI é um avanço tecnológico e uma importante ferramenta terapêutica em campos distintos, significando uma grande evolução em toda a área da saúde, inclusive na Fonoaudiologia. É fundamental destacar que os artigos apresentam falta de padronização na dosimetria e sugere-se que próximos estudos sejam elaborados com a padronização dos documentos da World Association for Laser Therapy (WALT).

The use of Laser Therapy of Low Intensity (LBI) or Low Level Laser Therapy (LLLT), is multidisciplinary, and is used by many professionals: doctors, dentists, physiotherapists, nurses, physicists, biologists, engineers, etc. The Speech Therapy begins to awaken the interest in joining this group of professionals, with a totally therapeutic use, non-invasive, no toxic side effects that adds to the therapeutic work and establishes an excellent rehabilitation prognosis. Therefore, we aimed to collect some research papers that address the physical and biochemical fundamentals of laser light interaction with the living biological tissue and its therapeutic applicability in health specialties where we also find the work of Speech Therapy. For this, we selected some pathology relating the use of LLLT: temporomandibular disorders (TMD), facial palsy, dysphagia by motor dysfunction, tissue healing including the mammillary fissures responsible for abandonment of breastfeeding. In the scope of the conditions, the action of the LASER will be described and its effect on biomodulator processes: inflammatory, nociceptive, scarring, edematous, nerve and muscle repair. We conclude that LLLT is a technological breakthrough and an important tool in different fields, meaning a major evolution in health procedures, even in speech therapy. It is essential to note that the articles present lack of standardization in dosimetry and we suggest that further studies are developed with the standardization of the documents World Association for Laser Therapy (WALT).

El uso de la luz LÁSER Terapéutico de Baja Intensidad (LBI) o Low Level Laser Therapy (LLLT), es multidisciplinar, utilizado por varios profesionales: médicos, dentistas, fisioterapeutas, enfermeros, biólogos, físicos, ingenieros, etc. En la Fonoaudiología también se empieza a tener interés en formar parte de este grupo de profesionales, para el uso de ese recurso terapéutico, sin efectos secundarios, tóxicos y colaterales que se suma al trabajo terapêutico con excelente pronóstico de rehabilitación. Por ese motivo se recogieron articulos científicos que abordan los fundamentos físicos y bioquímicos de la interacción de la luz láser con el tejido biológico vivo y su aplicabilidad terapéutica en especialidades de la salud, donde se encuentra también la actuación Fonoaudiológica. Para tanto se seleccionaron algunas patologias relacionadas al uso de LBI: disfunción temporomandibular (DTM), parálisis facial, disfagia por disfunción motora, cicatrización del tejido incluyendo fisuras mamilares, principal responsable del abandono de la lactancia materna. En el ámbito de las patologias, se describió la acción del LASER y su efecto biomodulador el los procesos: inflamatorios, nociceptivos, cicatrización, edematosos, de reparación nerviosa y muscular. Se concluyó que el LBI es un avance tecnológico y una importante herramienta terapéutica en diferentes campos, significado una evolución importante en toda la salud incluso en la Fonoadiología. Es importante tener en cuenta que los artículos presentes falta de estandarización en la dosimetría y se sugiere que más estudios se realizen con la estandarización de los documentos de la World Association for Laser Therapy (WALT).