RESUMEN
To this day, two methods of phototherapy (PT) have been successfully used in post-surgical immunorehabilitation of patients with breast cancer (BC): intravenous laser irradiation of the patients' blood and reinfusion of lympholeukosuspension of BC patients after single irradiation with HeNe laser. The objective of this pilot experimental study was to verify the effectiveness of the percutaneous use of polychromatic visible light combined with polychromatic infrared (pVIS+pIR) radiation similar to the major components of natural solar spectrum in post-surgical management of BC patients. Patients with BC (adenocarcinoma) of I-II stages, n=19 who had undergone mastectomy, were divided into 2 groups. The control group of patients (n=8) underwent a conventional course of post-surgical rehabilitation and sham irradiation. Patients of the PT group (n=11) additionally received 7days of daily treatment with polychromatic light on the sacral area, D=15cm. The PT course began on the day after mastectomy (Bioptron-2 device; Switzerland, 480-3400nm, 95% polarization, 40mW/cm2, 24J/cm2). Mastectomy produced many changes in cellular and humoral immunity, which was recorded on the 1st and 8th post-surgical days. The PT course resulted in a faster normalization of post-surgical leukocytosis and activation of cytotoxic CD8+ T-lymphocytes (Lym), reduced the elevated concentration in blood of immune complexes and in parallel promoted cytotoxic activity of CD16+/CD56+ NK-cells. The PT up-regulated the number of NK-cells in patients with its decrease on the 1st post-surgical day and prevented the decrease in the amount of monocytes, CD19+ B-Lym, CD3+ T-Lym, CD4+ T-helpers, activated CD3+/HLADR+ T-Lym, and the decrease of the phagocytotic capability of neutrophils. PT blocked the down-regulation of the IgM, IgA concentration and abnormally sharp increase of the proinflammatory cytokine IFN-γ content. Therefore, a 7-day course with polychromatic light prevented the development of immunosupression in the BC patients at the early post-mastectomy period.
Asunto(s)
Neoplasias de la Mama/inmunología , Neoplasias de la Mama/cirugía , Luz Solar , Neoplasias de la Mama/patología , Femenino , HumanosRESUMEN
OBJECTIVE: The aim of this work was to study the effect of phototherapy (PT) with percutaneous exposures to polychromatic visible and IR light (pVIS + pIR) on breast cancer (BC) patients at the early postmastectomy period, on the growth-promoting (GP) properties of their blood serum, by evaluating its capability to support proliferation of normal and tumor human cells in vitro. MATERIAL AND METHODS: After mastectomy, one group of patients was treated daily for 1 week on the sacral area with pVIS + pIR light (480-3400 nm, 40 mW/cm(2), 95% polarization, 24 J/cm(2)). The second group used as a control was sham irradiated. Blood serum samples collected before surgery, and 1 and 8 days after surgery, were added (2.5%) into nutrition media for cells instead of 10% of fetal calf serum. Cell targets were cultures of human fibroblasts (FBs), keratinocytes (KCs), three lines of the human BC cells (BT-474, HBL-100, Hs 578T) and cells of human epidermoid carcinoma (A-431). Cell number was evaluated by staining cell nuclei with crystal violet and a spectrometric assay of the extracted dye. RESULTS: The day after mastectomy there were no significant changes in the GP activity of sera. After a 7-day PT course, an increase of this activity was recorded for normal FBs and KCs by 18% and 24%, respectively, in comparison with presurgical levels. GP activity of the same patients' sera for all tumor cells, BT-474, HBL-100, Hs 578T and A-431, decreased by 32%, 17%, 11%, and 7% respectively. As a result, enhancement of proliferation of KCs and FBs and inhibition of proliferation of tumor cells was seen. CONCLUSIONS: The results suggest an effect at the systemic level where pVIS + pIR light may stimulate growth of human skin cells and simultaneously downregulate the proliferation of tumor cells, including BC cells. This argues in favor of the oncological safety of PT for BC patients postsurgically.
Asunto(s)
Neoplasias de la Mama/terapia , Proliferación Celular/efectos de la radiación , Fototerapia/métodos , Cuidados Posoperatorios/métodos , Neoplasias de la Mama/sangre , Neoplasias de la Mama/patología , Neoplasias de la Mama/cirugía , Carcinoma de Células Escamosas/terapia , Células Cultivadas , Femenino , Humanos , Mastectomía , Persona de Mediana EdadRESUMEN
OBJECTIVE: This study aimed to reveal the effects of polychromatic visible (pVIS) or pVIS + near IR (nIR) light similar to some components of solar light on skin microcirculation and microvascular response to the vasodilatators acetylcholine (ACh) and nitroglycerine (NG), in the extremities of patients with diabetic microangiopathy. BACKGROUND DATA: The mechanisms behind light-induced increases in microcirculation as well as extracellular effects of terrestrial pVIS and pVIS + nIR light remain unknown. MATERIALS AND METHODS: In 24 subjects with type 2 diabetes mellitus local microcirculation was measured in the skin of the foot before and after exposure to both types of light. In another 26 patients systemic microcirculation was studied in the back of the hand before and after exposure of the lumbar-sacral area to light energy. Two different types of light therapy were performed by using two devises: Q-light, which delivers pVIP (385-750 nm) and pVIS nIR light (385-1700 nm) with a power density of 40 mW/cm2, which is similar to summer sunlight at noon in Central Europe. RESULTS: At 2 min after irradiation (12 J/cm2) of the forefoot with pVIS or pVIS + nIR light, a rise in local blood flow volume (Qas) was observed, on average by 39% and 31%, respectively. The maximal effect (+41-47%) had developed in all patients at 30 min, and it then decreased and disappeared completely 24 h post-irradiation. We obtained similar results after irradiation of the sacral area in Qas of the skin of the hand. Both types of microcirculation also increased following a second exposure to the light sources. Enhancement of microcirculation was accompanied by a decrease in the microvascular response to ACh and NG solutions administered intracutaneously by iontophoresis. CONCLUSION: Both types of irradiation stimulated microcirculation at the local and systemic levels through a mechanism of enhancement of endothelium-dependent and endothelium-independent vasodilation, in which nitric oxide plays a major role.
Asunto(s)
Angiopatías Diabéticas/radioterapia , Microcirculación/efectos de la radiación , Óxido Nítrico/fisiología , Fototerapia/métodos , Piel/irrigación sanguínea , Vasodilatación/efectos de la radiación , Adulto , Anciano , Anciano de 80 o más Años , Angiopatías Diabéticas/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: The aim of this study is to evaluate the skin microcirculation increase seen in healthy volunteers after a single exposure to polychromatic visible (pVIS) light, and to prove the role of nitric oxide (NO) in the development of this effect. BACKGROUND DATA: Improvement of microcirculation is one of the most important effects of laser and pVIS light therapy; however, its mechanism of action remains unknown. A main role in the regulation of vascular tone is known to be played by NO. It is produced by NO-synthase (NOS) located in membranes of many cells, including endothelial and blood cells. NOS, a biopteroflavohemoprotein, absorbs pVIS light, resulting in its activation. MATERIALS AND METHODS: The central area of the dorsal side of the right hand (24 cm2) of 42 volunteers was irradiated for 5 min with pVIS light from a Q-light (385-750 nm, 95% polarization, 40 mW/cm2, 12 J/cm2). Then for 90 min, the blood flow rate (Qas) was measured eight times, both in the area of the irradiation (local effect) and in the non-irradiated left hand (systemic effect) by using a high-frequency ultrasound Doppler device, recording Qas in human skin to a depth up to 5 mm. In the central area of the right hand of 14 volunteers an NOS inhibitor, N-monomethyl-L-arginine (L-NMMA, 0.1% solution), was iontophoretically administered prior to exposure, whereas in 10 other subjects it was administered to the left hand with subsequent exposure of the right hand. RESULTS: As soon as 2 min after exposure, Qas in the irradiated area rose on average by 32%, and in 20 min by 45%; it then decreased and in 90 min returned to the initial level. A statistically significant Qas increase in the non-irradiated hand was recorded in 5 min (+9%), and in 20 min it reached a maximum level (+39%), and 90 min later it decreased to the initial values. The presence of L-NMMA in the light-exposed area completely blocked the photoinduced rise of microcirculation, both in the irradiated and in non-irradiated hand; however, its administration to the non-irradiated hand did not prevent these effects. CONCLUSION: The increase in skin microcirculation produced by pVIS light at the local and systemic levels is due to activation of NO synthesis in the irradiated area.