[Low level laser therapy in inflammatory and infectious oral diseases]. / Photothérapie par diode électroluminescente des pathologies inflammatoires et infectieuses de la cavité orale.

PURPOSE: Low Level Laser Therapy (LLLT) is an increasingly studied technique. The authors of a meta-analysis published in 2012 had already confirmed the effectiveness of LLLT for radio-induced mucitis. Our purpose was to check its indication for similar pathologies. MATERIAL AND METHODS: The articles were selected with the PubMed engine. The selected terms were "Low Level Laser Therapy", "oral surgery", "oral infection", "oral inflammation", "oral mucosal lesions", "oral mucosal disease", "stomatitis", "aphtous", "Herpes", "oral lichen planus", and "oral ulceration". The analysis was made on the following criteria: assessment criteria, methodological quality, and bias. We estimated the level of proof according to Sackett's modified score. RESULTS: Six articles were selected. Two focused on the effectiveness of LLLT for Herpes simplex virus 1 oral symptoms. Two focused on the effectiveness of LLLT for oral lichen planus. One focused on the effectiveness of LLLT for recurrent aphthous stomatitis. The last one focused on the usefulness of LLLT to control stomatitis pain in the hand-foot-and-mouth disease. CONCLUSION: All the selected studies were assessed with a Sackett's score of IV. No study presented the required quality standards to recommend the treatment of LLLT for the selected indications.

A radiation-induced adaptive response prolongs the survival of prion-infected mice.

Previously, it has been demonstrated that an "adaptive response" that includes the prevention, repair, and removal of oxidative damage can be evoked by radiation at dose rates substantially lower than those at which risks have been observed. The exact pathogenic mechanism of prion diseases is unknown, but circumstantial evidence suggests that oxidative stress plays a central role. Exposure of prion-infected mice to four 500 mGy/fraction doses of (60)Co γ-radiation administered every other day at a low dose rate (0.5 mGy/min) starting at 2 days before infection, 7 days postinfection (dpi), or 50 dpi significantly prolonged the survival of infected mice. The 500-mGy radiation treatments started at 50 dpi also significantly prolonged the symptom-free period of the disease and caused a significant delay in the rise of the 8-hydroxydeoxyguanosine concentration observed in the urine of nonirradiated infected mice at 98 dpi. The duration of the reduction in oxidative stress achieved by the radiation treatments was similar in length to the prolonged survival of the irradiated mice. This suggests that the adaptive response induced by low-dose whole-body radiation treatments prolongs the survival of prion-infected mice by reducing oxidative stress.

Radiolabelling of peptides for diagnosis and therapy of non-oncological diseases.

Radiolabelled peptides have significant potential as radiopharmaceuticals for the diagnosis and therapy of receptor-expressing diseases. Methods have been developed for labelling peptides with a variety of radionuclides having a broad range of chemical and physical properties. These methods include both direct (where the radionuclide is bound directly to one or more atoms of the peptide structure) and indirect techniques in which bifunctional coupling agents are employed. Although most commonly applied to date in the field of oncology, a significant number of applications in non-oncological diseases have also been proposed and these can be expected to expand as the technology progresses. An overview is presented of some peptide-receptor systems in radiopharmaceutical development and the techniques which have been employed to radiolabel these peptides with isotopes of iodine, yttrium, indium, gallium, copper and technetium. While many of the examples employed are derived from cancer related indications, identical radiopharmaceutical chemistry can also be applied to peptides with applications in the fields of immunology, infection and other inflammatory conditions.

Peptide radiopharmaceuticals for diagnosis and therapy.

Radiolabelled peptides are an emerging class of radiopharmaceuticals that share chemical and biological properties. From the chemical point of view they have a poly-amino acid structure varying from 3 to more that 200 amino acids, and they are labelled with different isotopes directly or by a linker. Biologically, they bind to specific cell membrane receptors, thus providing in vivo histopathological information for diagnostic purposes, therapy follow-up or targeted radiotherapy. This paper reviews most of the radiolabelled peptides that have been tested in animals and humans in the fields of oncology, neurology, cardiology, inflammation/infection, atherosclerosis and thrombosis. A new classification is also proposed for peptides targeting tumour cells based on the biological function of target receptors. These tailored radiopharmaceuticals are the basis of the new era of "molecular nuclear medicine".

Radiation therapy for benign diseases: patterns of care study in Germany.

BACKGROUND: Radiotherapy of benign diseases is controversial and rarely applied in Anglo-American countries, whereas in other parts of the world it is commonly practiced for several benign disorders. Similar to a European survey, a patterns of care study was conducted in Germany. METHOD: Using a mailed questionnaire, radiation equipment, treatment indication, number of patients, and treatment concepts were assessed in 1994, 1995, and 1996 in 134 of 152 German institutions (88%): 22 in East and 112 in West Germany; 30 in university hospitals and 104 in community hospitals. Average numbers of each institution and of all institutions were analyzed for frequencies and ratios between regions and among institutions. Radiation treatment concepts were analyzed. RESULTS: A mean of 2 (range 1-7) megavoltage and 1.4 (range 0-4) orthovoltage units were available per institution; 32 institutions (24%) had no orthovoltage equipment. A mean of 20,082 patients were treated annually: 456 (2%) for inflammatory diseases (221 hidradenitis, 78 local infection, 23 parotitis; 134 not specified) 12,600 (63%) for degenerative diseases (2711 peritendinitis humeroscapularis, 1555 epicondylitis humeri; 1382 plantar/dorsal heel spur; 2434 degenerative osteoarthritis; 4518 not specified); 927 (5%) for hyperproliferative diseases (146 Dupuytren's contracture, 382 keloids; 155 Peyronie's disease; 244 not specified); 1210 (6%) for functional disorders (853 Graves' orbitopathy; 357 not specified); and 4889 (24%) for other disorders (e.g., 3680 heterotopic ossification prophylaxis). In univariate analysis, there were geographic (West vs. East Germany) differences in using radiation therapy (RT) for inflammatory and degenerative disorders, and institutional differences (university versus community hospitals) in using RT for hyperproliferative and functional disorders (p < 0.05). The prescribed dose concepts were mostly in the low dose range, <10 Gy but varied widely and inconsistently within geographic regions and institutions. CONCLUSION: Radiation therapy is a well-accepted and frequently practiced treatment for several benign diseases in Germany; however, there are significant geographic and institutional differences. As the number of orthovoltage units decreases, an increasing patient load will demand more megavoltage units, which may compromise the cost-effectiveness of this treatment. Only 4% of all clinical institutions have been involved in controlled clinical trials. To maintain a high level of RT service to other disciplines, RT treatment guidelines, quality control, and continuing medical education are required.

Roentgen therapy for infections: an historical review.

Radiation was used extensively for the treatment of all types of infections before the advent of antibiotics. Although this mode of therapy is now in disrepute, radiation therapists of that era were firm believers in the ability of radiation to cure infections. A review of the literature suggests, but certainly does not prove, that low-dose local radiation, in the range of 75 to 300 roentgens, is an effective treatment modality for a wide variety of infections. Two then-prevailing rationales held that the effect was due either to radiation damage to the immune cells, causing stimulation of the immune response, or to the increase in local inflammation with resultant increased blood flow. Modern research has been limited but provides support for both arguments. Although there are no present indications for using radiation as therapy for infectious disease, a reasonable argument can be made from the available data that radiation is effective for the treatment of localized infections. The mechanisms of low-dose radiation as a treatment for infections remain unclear. The known and probable long-term sequelae of low-dose local irradiation preclude its common use for this condition. Nevertheless, it is hoped that this review will stimulate investigations into this relatively unexplored area of radiobiology.