Houreld 2014
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Houreld NN. Shedding light on a new treatment for diabetic wound healing: a review on phototherapy. ScientificWorldJournal. 2014 Jan 6;2014:398412.
• Impaired diabetic wound healing has been associated with impaired cellular function, and decreases in cellular migration, proliferation, nitric oxide (NO) synthesis, growth factors, and collagen synthesis. • There is also an increase in proteinases that degrade the extracellular matrix and collagen (MMPs) and cells appear to be stuck in the inflammatory phase of wound healing. • Photobiomodulation (laser therapy) involves the application of light (often laser light of a specific wavelength or a light emitting diode, LED) to stimulate cellular processes. • Laser irradiation in vitro (dish/test tube) has shown that these cells respond in a favourable fashion, even irradiation of diabetic cells. • There is an increase in factors associated with wound healing : cellular migration, proliferation, viability, collagen production, ATP, mitochondria concentration, cytochrome c oxidase activity, NO, growth factors, and gene regulation. • There is also a decrease in MMPs, apoptosis and proinflammatory cytokines . • The effects of laser irradiation are highly dependent on the laser parameters such as wavelength, power density, and fluence. • Higher fluencies can have a negative effect on cells, while too low fluences have no effect.
Key message By studying the effects of laser irradiation in vitro, the underlying mechanisms are being identified. Phototherapy can be an important tool in speeding up the healing process as well as alleviating pain and inflammation in diabetic wounds.
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