PHOTOBIOMODULATION (PBM) THERAPY A proven way to impact tissue at the cellular level Photobiomodulation therapy (PBMT) is a form of light therapy based on the photochemical process called photobiomodulation (PBM). In photobiomodulation therapy, a light source is placed near or in contact with the skin, the light energy penetrates the skin reaching the mitochondria of damaged or diseased tissue leading to photobiomodulation. This process can result in beneficial therapeutic outcomes such as the alleviation of pain, increased blood flow, muscle relaxation, and relief from joint stiffness. 25-27 PBM mechanisms of action The application of a therapeutic dose of light to impaired or dysfunctional tissue leads to a cellular response mediated by mitochondrial mechanisms involved in pain relief and tissue repair processes . 26 The primary target (chromophore) for the process is the cytochrome c complex which is found in the inner membrane of the cell mitochondria. Cytochrome c is a vital component of the electron transport chain that drives cellular metabolism. As light is absorbed, cytochrome c is stimulated, leading to increased production of adenosine triphosphate (ATP), the molecule that facilitates energy transfer within the cell. 26-28 In addition to ATP, laser stimulation also produces free nitric oxide and reactive oxygen species. Nitric oxide is a powerful vasodilator and an important cellular signaling molecule involved in many physiological processes. Reactive oxygen species have been shown to affect many important physiological signaling pathways including the inflammatory response. In concert, these molecules have been shown to increase growth factor production and promote extracellular matrix deposition. The resultant increase in cell proliferation and motility leads to pro-survival pathways for the cell . 26-28
Physiological effects • A nalgesic • Increased tissue oxygenation and nutrition • Increased synthesis of ATP • Impacts the biochemical pathways involved in tissue repair • Increased microcirculation
Jun/Fos
AP-1
Mitochondria
ATP
Gene Transcription
lkB
NO ROS-
NF-kB
HIF-1 α
NF-kB
CA 2+ /NA + Antiporter NA + /H + Antiporter NA + , K + -ATPase CA 2+ Pump ∆CA 2+ , K + ∆cAMP, ∆pH
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