Low-Level Laser
Therapy (LLLT) Mediated
Tissue Regeneration
Presented by Collin Keating
The Chronic Pain Problem
100 million people experience chronic pain in the US and 1.5 billion worldwide1
10% of Americans experienced pain everyday in the last 3 months or more 2
27% low back pain / 15% migraines / 15% neck pain / 4% facial pain 3
#1 cause of long-term disability in US3
36 million Americans miss work every year due to chronic pain 3
Chronic pain treatment focuses on symptom suppression, not solving issue
Effect of Chronic Pain on Health
Problems associated with chronic pain include:
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Decreased life satisfaction3
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Insomnia - 20%3
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Depression - 77%3
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Chemical dependency3
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Different than addiction, patients rely on medication to suppress pain
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Anti-opioid sentiments harming chronic pain patients
Suicide - HR 2.15 for extreme pain4
Current Treatments for Musculoskeletal Pain
1.
Physical therapy
2.
Surgery
3.
Laser ablation
4.
Corticosteroid injections
5.
Pain medication
6.
Implantable peripheral nerve stimulation devices
7.
Limited treatments with adult stem cells outside United States
Stem Cells A Promising Treatment
Pros:
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Used by body in injury repair naturally
Able to treat intractable injuries
Cons:
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No FDA approved treatments for injuries
Teratoma formation
Stem cells grow slowly
How Can LLLT Help Repair Injuries?
LLLT can accelerate stem cell growth in vitro5,6,7,8,9 and the healing process in vivo
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Works on a variety of tissue types10
Helps maintain non-differentiation in vitro9
Facilitates induced differentiation in vitro7
Increased angiogenesis in many cases11,12
Decreased inflammation stage in certain tissue types 11
Increased regeneration12,13,14,15,16,17
Can be used in combination with induced pluripotent stem cells (iPSC’s)
LLLT Regeneration Mechanisms
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Credit: Gupta, et al.
Increased cytochrome c
enzyme activity and etransport
Enhanced mitochondrial
respiration
Enhanced ATP production
Increased oxidative redox
potential → Activated
intracellular signalling
pathways
Conclusion
Chronic pain affects large percentages of the population
Photomedicine alone an effective treatment for injury repair
Stem cells most promising treatment for solving underlying issue
Photomedicine enhances stem cell proliferation and viability
Photomedicine and stem cell treatments work synergistically
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“Summary.” Relieving Pain in America: a Blueprint for Transforming Prevention, Care, Education, and Research, National Academies Press, 2011.
“NIH Analysis Shows Americans Are In Pain.” National Center For Complementary and Integrative Health, NCCIH, 11 Aug. 2015,
www.nccih.nih.gov/news/press-releases/nih-analysis-shows-americans-are-in-pain.
National Center for Health Statistics Health, United States, 2006 With Chartbook on Trends in the Health of Americans Hyattsville, MD: 2006
Ilgen MA, Bohnert AS, Ganoczy D, Bair MJ, McCarthy JF, Blow FC. Opioid dose and risk of suicide. Pain. 2016;157(5):1079–1084. doi: 10.1097/j.pain.0000000000000484.
Low-level laser irradiation (LLLI) promotes proliferation of mesenchymal and cardiac stem cells in culture.Tuby H, Maltz L, Oron U. Lasers Surg Med. 2007 Apr; 39(4):373-8
Effect of low-level laser irradiation and epidermal growth factor on adult human adipose-derived stem cells. Mvula B, Moore TJ, Abrahamse H. Lasers Med Sci. 2010 Jan;
25(1):33-9
Hou JF, Zhang H, Yuan X, Li J, Wei YJ, Hu SS. In vitro effects of low-level laser irradiation for bone marrow mesenchymal stem cells: proliferation, growth factors secretion
and myogenic differentiation. Lasers Surg Med. 2008;40:726–33
Kreisler M, Christoffers AB, Willershausen B, d’Hoedt B. Effect of low-level GaAlAs laser irradiation on the proliferation rate of human periodontal ligament fibroblasts: an in
vitro study. J Clin Periodontol. 2003;30:353–8
de Villiers JA, Houreld NN, Abrahamse H. Influence of low intensity laser irradiation on isolated human adipose derived stem cells over 72 hours and their differentiation
potential into smooth muscle cells using retinoic acid. Stem Cell Rev. 2011;7:869–82.
Gupta A, Avci P, Sadasivam M, Chandran R, Parizotto N, Vecchio D. et al. Shining light on nanotechnology to help repair and regeneration. Biotechnol Adv. 2013;31:607–31.
Peplow PV, Chung TY, Baxter GD. Photodynamic modulation of wound healing: a review of human and animal studies. Photomed Laser Surg. 2012;30:118–48.
Nunez SC, Franca CM, Silva DF, Nogueira GE, Prates RA, Ribeiro MS. The influence of red laser irradiation timeline on burn healing in rats. Lasers Med Sci. 2012
Nakano J, Kataoka H, Sakamoto J, Origuchi T, Okita M, Yoshimura T. Low-level laser irradiation promotes the recovery of atrophied gastrocnemius skeletal muscle in rats.
Exp Physiol. 2009;94:1005–15.
Anders JJ, Borke RC, Woolery SK, Van de Merwe WP. Low power laser irradiation alters the rate of regeneration of the rat facial nerve. Lasers Surg Med. 1993;13:72–82
Carrinho PM, Renno AC, Koeke P, Salate AC, Parizotto NA, Vidal BC. Comparative study using 685-nm and 830-nm lasers in the tissue repair of tenotomized tendons in the
mouse. Photomed Laser Surg. 2006;24:754–8.
Oron U, Yaakobi T, Oron A, Mordechovitz D, Shofti R, Hayam G, et al. Low-energy laser irradiation reduces formation of scar tissue after myocardial infarction in rats and
dogs. Circulation. 2001;103:296–301
Dadpay M, Sharifian Z, Bayat M, Dabbagh A. Effects of pulsed infra-red low level-laser irradiation on open skin wound healing of healthy and streptozotocin-induced diabetic
rats by biomechanical evaluation. J Photochem Photobiol B. 2012;111:1–8