A Review of Low-Level Laser Therapy for Spinal Cord Injury: Challenges And Safety
Journal of Lasers in Medical Sciences,
Vol. 11 No. 4 (2020),
3 October 2020
,
Page 363-368
Abstract
Introduction: Damage to the spinal cord is a central nervous system disorder that results in direct damage to neural cells (axons, cell bodies) and glia, followed by autonomic, motor and sensory impairments. Inflammatory response after this injury can contribute to secondary tissue damage that leads to further behavioral and functional disorders. Inflammation is a complex process, which occurs after an injury. If this progressive process is not well controlled can lead to additional damage to the spinal cord which is preventing neural improvement and regeneration and, which ultimately will not provide good clinical consequences. Inflammation in the injured spinal cord is a physiological response that causes the death of glial and neuronal cells. The reduction of the initial inflammatory process after damage to the spinal cord is one of the important therapeutic strategies. It has been proposed that low-level laser (LLL) therapy, as a noninvasive manner, can modulate inflammatory processes, which leads to a significant improvement in neurological symptoms after spinal cord injury (SCI).
Methods: A comprehensive review was performed on SCI, the etiologies, and treatment methods using the keywords spinal cord injury, low-level laser, and inflammation in valid medical databases such as Google Scholar, PubMed, and Elsevier (76 articles). Among the collected papers, articles that were most relevant to the purposes of the study were selected and studied.
Results: LLL therapy was able to reduce inflammation and also attenuate neuronal damage after spinal cord damage.
Conclusion: In conclusion, the present study illustrates that LLL therapy has positive effects on improving functional recovery and regulating the inflammatory function in the SCI.
- Spinal Cord Injury (SCI), Inflammation, Low-level laser therapy
How to Cite
References
References:
Lin L, Lin H, Bai S, Zheng L, Zhang X. Bone marrow mesenchymal stem cells (BMSCs) improved functional recovery of SCI partly by promoting axonal regeneration. Neurochem Int. 2018;115:80-4.
Choi JS, Leem JW, Lee KH, Kim SS, Suh-Kim H, Jung SJ, Kim UJ, Lee BH. Effects of human mesenchymal stem cell transplantation combined with polymer on functional recovery following spinal cord hemisection in rats. The Korean Journal of Physiology & Pharmacology. 2012 1;16(6):405-11.
Abbaszadeh HA, Tiraihi T, Delshad AR, Zadeh MS, Taheri T. Bone marrow stromal cell transdifferentiation into oligodendrocyte-like cells using triiodothyronine as an inducer with the expression of platelet-derived growth factor α as a maturity marker. Iranian biomedical journal. 2013 Apr;17(2):62.
Abrams GM, Ganguly K. Management of chronic spinal cord dysfunction. Continuum (Minneap Minn). 2015;21(1 Spinal Cord Disorders):188-200.
Xu P, Yang X. The efficacy and safety of mesenchymal stem cell transplantation for SCI patients: a meta-analysis and systematic review. Cell transplantation. 2019 Jan;28(1):36-46.
Yu C, Xia K, Gong Z, Ying L, Shu J, Zhang F, Chen Q, Li F, Liang C. The application of neural stem/progenitor cells for regenerative therapy of SCI. Current stem cell research & therapy. 2019 Aug 1;14(6):495-503.
Massetti J, Stein DM. SCI. In: White JL, Sheth KN, editors. Neurocritical care for the advanced practice clinician. Cham, Switzerland: Springer; 2018. p. 269-88. doi:10.1007/978-3-319-48669-7_15.
Fan B, Wei Z, Yao X, Shi G, Cheng X, Zhou X, et al. Microenvironment imbalance of SCI. Cell Transplant. 2018;27(6):853-66. doi: 10.1177/0963689718755778.
Ahuja CS, Wilson JR, Nori S, Kotter MR, Druschel C, Curt A, et al. Traumatic SCI. Nat Rev Dis Primers. 2017;3:17018. doi: 10.1038/nrdp.2017.18.
Wu Q, Li YL, Ning GZ, Feng SQ, Chu TC, Li Y, et al. Epidemiology of traumatic cervical SCI in Tianjin, China. Spinal Cord. 2012;50(10):740-4. doi: 10.1038/sc.2012.42.
Blesch A, Lu P, Tuszynski MH. Neurotrophic factors, gene therapy, and neural stem cells for spinal cord repair. Brain Res Bull. 2002;57(6):833-8. doi: 10.1016/s0361-9230(01)00774-2.
Pineau I, Lacroix S. Proinflammatory cytokine synthesis in the injured mouse spinal cord: multiphasic expression pattern and identification of the cell types involved. J Comp Neurol. 2007;500(2):267-85. doi: 10.1002/cne.21149.
Papa S, Mauri E, Rossi F, Perale G, Veglianese P. Introduction to SCI as clinical pathology. In: Perale G, Rossi F, editors. SCI (SCI) Repair Strategies. Amsterdam: Elsevier; 2019. p. 1-12. doi: 10.1016/B978-0-08-102807-0.00001-6.
Chen CH, Sung CS, Huang SY, Feng CW, Hung HC, Yang SN, et al. The role of the PI3K/Akt/mTOR pathway in glial scar formation following SCI. Exp Neurol. 2016;278:27-41. doi: 10.1016/j.expneurol.2016.01.023.
Anwar MA, Al Shehabi TS, Eid AH. Inflammogenesis of secondary SCI. Front Cell Neurosci. 2016;10:98. doi: 10.3389/fncel.2016.00098.
Mataliotakis GI, Tsirikos AI. Spinal cord trauma: pathophysiology, classification of SCI syndromes, treatment principles and controversies. Orthop Trauma. 2016;30(5):440-9. doi: 10.1016/j.mporth.2016.07.006.
Beattie MS, Farooqui AA, Bresnahan JC. Review of current evidence for apoptosis after SCI. J Neurotrauma. 2000;17(10):915-25. doi: 10.1089/neu.2000.17.915.
Beattie MS. Inflammation and apoptosis: linked therapeutic targets in SCI. Trends Mol Med. 2004;10(12):580-3. doi: 10.1016/j.molmed.2004.10.006.
Rust R, Kaiser J. Insights into the dual role of inflammation after SCI. J Neurosci. 2017;37(18):4658-60. doi: 10.1523/JNEUROSCI.0498-17.2017.
Kwon BK, Tetzlaff W, Grauer JN, Beiner J, Vaccaro AR. Pathophysiology and pharmacologic treatment of acute SCI. Spine J. 2004;4(4):451-64. doi: 10.1016/j.spinee.2003.07.007.
Zhou X, He X, Ren Y. Function of microglia and macrophages in secondary damage after SCI. Neural Regen Res. 2014;9(20):1787-95. doi: 10.4103/1673-5374.143423.
Dasari VR, Veeravalli KK, Dinh DH. Mesenchymal stem cells in the treatment of spinal cord injuries: A review. World J Stem Cells. 2014;6(2):120-33. doi: 10.4252/wjsc.v6.i2.120.
Marques SA, Almeida FM, Fernandes AM, dos Santos Souza C, Cadilhe DV, Rehen SK, et al. Predifferentiated embryonic stem cells promote functional recovery after spinal cord compressive injury. Brain Res. 2010;1349:115-28. doi: 10.1016/j.brainres.2010.06.028.
Schwab JM, Brechtel K, Mueller CA, Failli V, Kaps HP, Tuli SK, et al. Experimental strategies to promote spinal cord regeneration—an integrative perspective. Prog Neurobiol. 2006;78(2):91-116. doi: 10.1016/j.pneurobio.2005.12.004.
Casha S, Yu WR, Fehlings MG. Oligodendroglial apoptosis occurs along degenerating axons and is associated with FAS and p75 expression following SCI in the rat. Neuroscience. 2001;103(1):203-18. doi: 10.1016/s0306-4522(00)00538-8.
Chen SW, Xie YF. Glial implications in transplantation therapy of SCI. Chin J Traumatol. 2009;12(1):55-61.
Niknazar S, Nahavandi A, Peyvandi AA, Peyvandi H, Roozbahany NA, Abbaszadeh HA. Hippocampal NR3C1 DNA methylation can mediate part of preconception paternal stress effects in rat offspring. Behav Brain Res. 2017 May 1;324:71-76. doi: 10.1016/j.bbr.2017.02.014
Gensel JC, Zhang B. Macrophage activation and its role in repair and pathology after SCI. Brain Res. 2015;1619:1-11. doi: 10.1016/j.brainres.2014.12.045.
Prüss H, Kopp MA, Brommer B, Gatzemeier N, Laginha I, Dirnagl U, et al. Non‐resolving aspects of acute inflammation after SCI (SCI): indices and resolution plateau. Brain Pathol. 2011;21(6):652-60. doi: 10.1111/j.1750-3639.2011.00488.x.
Beck KD, Nguyen HX, Galvan MD, Salazar DL, Woodruff TM, Anderson AJ. Quantitative analysis of cellular inflammation after traumatic SCI: evidence for a multiphasic inflammatory response in the acute to chronic environment. Brain. 2010;133(Pt2):433-47. doi: 10.1093/brain/awp322.
Takahashi JL, Giuliani F, Power C, Imai Y, Yong VW. Interleukin‐1β promotes oligodendrocyte death through glutamate excitotoxicity. Ann Neurol. 2003;53(5):588-95. doi: 10.1002/ana.10519.
Darabi S, Tiraihi T, Noori-Zadeh A, Rajaei F, Darabi L, Abbaszadeh HA. Creatine and retinoic acid effects on the induction of autophagy and differentiation of adipose tissue-derived stem cells into GABAergic-like neurons. J Babol Univ Med Sci. 2017;19(8):41-9. doi: 10.22088/jbums.19.8.41.
Plemel JR, Wee Yong V, Stirling DP. Immune modulatory therapies for SCI–past, present and future. Exp Neurol. 2014;258:91-104. doi: 10.1016/j.expneurol.2014.01.025.
Shi Z, Huang H, Feng S. Stem cell-based therapies to treat SCI: a review. J Neurorestoratology. 2017;5(1):125-31. doi: 10.2147/JN.S139677.
Qu J, Zhang H. Roles of mesenchymal stem cells in SCI. Stem Cells Int. 2017;2017:5251313. doi: 10.1155/2017/5251313.
Janzadeh A, Sarveazad A, Yousefifard M, Dameni S, Samani FS, Mokhtarian K, et al. Combine effect of Chondroitinase ABC and low level laser (660 nm) on SCI model in adult male rats. Neuropeptides. 2017;65:90-9. doi: 10.1016/j.npep.2017.06.002.
Hosseini M, Yousefifard M, Baikpour M, Rahimi-Movaghar V, Nasirinezhad F, Younesian S, et al. The efficacy of Schwann cell transplantation on motor function recovery after spinal cord injuries in animal models: a systematic review and meta-analysis. J Chem Neuroanat. 2016;78:102-11. doi: 10.1016/j.jchemneu.2016.09.002.
Hosseini M, Karami Z, Janzadenh A, Jameie SB, Haji Mashhadi Z, Yousefifard M, et al. The effect of intrathecal administration of muscimol on modulation of neuropathic pain symptoms resulting from SCI; an experimental study. Emerg (Tehran). 2014;2(4):151-7.
Mojarad N, Yousefifard M, Janzadeh A, Damani S, Golab F, Nasirinezhad F. Comparison of the antinociceptive effect of intrathecal versus intraperitoneal injection of paracetamol in neuropathic pain condition. J Med Physiol. 2016;1(1):10-6.
Ruppert KA, Nguyen TT, Prabhakara KS, Toledano Furman NE, Srivastava AK, Harting MT, et al. Human mesenchymal stromal cell-derived extracellular vesicles modify microglial response and improve clinical outcomes in experimental SCI. Sci Rep. 2018;8(1):480. doi: 10.1038/s41598-017-18867-w.
Kobiela Ketz A, Byrnes KR, Grunberg NE, Kasper CE, Osborne L, Pryor B, et al. Characterization of macrophage/microglial activation and effect of photobiomodulation in the spared nerve injury model of neuropathic pain. Pain Medicine. 2017 May 1;18(5):932-46.
Song JW, Li K, Liang ZW, Dai C, Shen XF, Gong YZ, et al. Low-level laser facilitates alternatively activated macrophage/microglia polarization and promotes functional recovery after crush SCI in rats. Sci Rep. 2017;7(1):620. doi: 10.1038/s41598-017-00553-6.
Ando T, Sato S, Kobayashi H, Nawashiro H, Ashida H, Hamblin MR, et al. Low-level laser therapy for SCI in rats: effects of polarization. J Biomed Opt. 2013;18(9):098002. doi: 10.1117/1.JBO.18.9.098002.
Anders JJ. The potential of light therapy for central nervous system injury and disease. Photomed Laser Surg. 2009;27(3):379-80. doi: 10.1089/pho.2009.0053.
Mohsenifar Z, Fridoni M, Ghatrehsamani M, Abdollahifar MA, Abbaszadeh H, Mostafavinia A, et al. Evaluation of the effects of pulsed wave LLL on tibial diaphysis in two rat models of experimental osteoporosis, as examined by stereological and real-time PCR gene expression analyses. Lasers Med Sci. 2016;31(4):721-32.
Ekim A, Armagan O, Tascioglu F, Oner C, Colak M . Effect of low level laser therapy in rheumatoid arthritis patients with carpal tunnel syndrome. Swiss Med Wkly. 2007;137(23-24):347-52.
de Carvalho Pde T, Leal-Junior EC, Alves AC, Rambo CS, Sampaio LM, Oliveira CS, et al. Effect of low-level laser therapy on pain, quality of life and sleep in patients with fibromyalgia: study protocol for a double-blinded randomized controlled trial. Trials. 2012;13(1):221. doi: 10.1186/1745-6215-13-221.
Shirani AM, Gutknecht N, Taghizadeh M, Mir M. Low-level laser therapy and myofacial pain dysfunction syndrome: a randomized controlled clinical trial. Lasers Med Sci. 2009;24(5):715-20. doi: 10.1007/s10103-008-0624-5.
Masoumipoor M, Jameie SB, Janzadeh A, Nasirinezhad F, Soleimani M, Kerdary M. Effects of 660-and 980-nm low-level laser therapy on neuropathic pain relief following chronic constriction injury in rat sciatic nerve. Lasers Med Sci. 2014;29(5):1593-8. doi: 10.1007/s10103-014-1552-1.
Rochkind S, Rousso M, Nissan M, Villarreal M, Barr‐Nea L, Rees DG. Systemic effects of low‐power laser irradiation on the peripheral and central nervous system, cutaneous wounds, and burns. Lasers Surg Med. 1989;9(2):174-82. doi: 10.1002/lsm.1900090214.
Aimbire F, Albertini R, Pacheco MT, Castro-Faria-Neto HC, Leonardo PS, Iversen VV, et al. Low-level laser therapy induces dose-dependent reduction of TNFα levels in acute inflammation. Photomed Laser Surg. 2006;24(1):33-7. doi: 10.1089/pho.2006.24.33.
Aimbire F, Ligeiro de Oliveira AP, Albertini R, Corrêa JC, Ladeira de Campos CB, Lyon JP, et al. Low level laser therapy (LLL) decreases pulmonary microvascular leakage, neutrophil influx and IL-1β levels in airway and lung from rat subjected to LPS-induced inflammation. Inflammation. 2008;31(3):189-97. doi: 10.1007/s10753-008-9064-4.
Huang YY, Gupta A, Vecchio D, de Arce VJ, Huang SF, Xuan W, et al. Transcranial low level laser (light) therapy for traumatic brain injury. J Biophotonics. 2012;5(11‐12):827-37. doi: 10.1002/jbio.201200077.
Chung H, Dai T, Sharma SK, Huang YY, Carroll JD, Hamblin MR. The nuts and bolts of low-level laser (light) therapy. Ann Biomed Eng. 2012;40(2):516-33. doi: 10.1007/s10439-011-0454-7.
Chen YJ, Wang YH, Wang CZ, Ho ML, Kuo PL, Huang MH, et al. Effect of low level laser therapy on chronic compression of the dorsal root ganglion. PloS One. 2014;9(3):e89894. doi: 10.1371/journal.pone.0089894.
Detaboada L, Ilic S, Leichliter‐Martha S, Oron U, Oron A, Streeter J. Transcranial application of low‐energy laser irradiation improves neurological deficits in rats following acute stroke. Lasers Surg Med. 2006;38(1):70-3. doi: 10.1002/lsm.20256.
Mester E, Mester AF, Mester A. The biomedical effects of laser application. Lasers Surg Med. 1985;5(1):31-9. doi: 10.1002/lsm.1900050105.
Ojaghi R, Sohanaki H, Ghasemi T, Keshavarz F, Yousefifard M, Sadeghipour HR. Role of low-intensity laser therapy on naloxone-precipitated morphine withdrawal signs in mice: is nitric oxide a possible candidate mediator? Lasers Med Sci. 2014;29(5):1655-9. doi: 10.1007/s10103-014-1530-7.
Campana VR, Moya M, Gavotto A, Soriano F, Juri HO, Spitale LS, et al. The relative effects of He-Ne laser and meloxicam on experimentally induced inflammation. Laser Ther. 1999;11(1):36-42. doi: 10.5978/islsm.11.36.
Albertini R, Aimbire FS, Correa FI, Ribeiro W, Cogo JC, Antunes E, et al. Effects of different protocol doses of low power gallium–aluminum–arsenate (Ga–Al–As) laser radiation (650 nm) on carrageenan induced rat paw ooedema. J Photochem Photobiol B. 2004;74(2-3):101-7. doi: 10.1016/j.jphotobiol.2004.03.002.
Rizzi CF, Mauriz JL, Freitas Corrêa DS, Moreira AJ, Zettler CG, Filippin LI, et al. Effects of low‐level laser therapy (LLL) on the nuclear factor (NF)‐κB signaling pathway in traumatized muscle. Lasers Surg Med. 2006;38(7):704-13. doi: 10.1002/lsm.20371.
Albertini R, Villaverde AB, Aimbire F, Salgado MA, Bjordal JM, Alves LP, et al. Anti-inflammatory effects of low-level laser therapy (LLL) with two different red wavelengths (660 nm and 684 nm) in carrageenan-induced rat paw edema. J Photochem Photobiol B. 2007;89(1):50-5. doi: 10.1016/j.jphotobiol.2007.08.005.
Svobodova B, Kloudova A, Ruzicka J, Kajtmanova L, Navratil L, Sedlacek R, et al. The effect of 808 nm and 905 nm wavelength light on recovery after spinal cord injury. Scientific reports. 2019;9(1):1-14. doi: 10.1038/s41598-019-44141-2
Kim J, Kim E-H, Lee K, Kim B, Kim Y, Na SH, et al. Low-level laser irradiation improves motor recovery after contusive spinal cord injury in rats. J Tissue Eng Regen Med. 2017;14(1):57-64. doi: 10.1007/s13770-016-0003-4
Veronez S, Assis L, Del Campo P, de Oliveira F, de Castro G, Renno ACM, et al. Effects of different fluences of low-level laser therapy in an experimental model of SCI in rats. Lasers Med Sci. 2017;32(2):343-9. doi: 10.1007/s10103-016-2120-7.
Hu D, Zhu S, Potas JR. Red LED photobiomodulation reduces pain hypersensitivity and improves sensorimotor function following mild T10 hemicontusion SCI. J Neuroinflammation. 2016;13(1):200. doi: 10.1186/s12974-016-0679-3
Paula AA, Nicolau RA, Lima MdO, Salgado MAC, Cogo JC. “Low-intensity laser therapy effect on the recovery of traumatic spinal cord injury”. Lasers Med Sci. 2014;29(6):1849-59. doi: 10.1007/s10103-014-1586-4
Wu X, Dmitriev AE, Cardoso MJ, Viers‐Costello AG, Borke RC, Streeter J, et al. 810 nm wavelength light: an effective therapy for transected or contused rat spinal cord. Lasers Surg Med. 2009;41(1):36-41. doi: 10.1002/lsm.20729.
Byrnes KR, Waynant RW, Ilev IK, Wu X, Barna L, Smith K, et al. Light promotes regeneration and functional recovery and alters the immune response after SCI. Lasers Surg Med. 2005;36(3):171-85. doi: 10.1002/lsm.20143.
Gupta A, Keshri GK, Yadav A, Gola S, Chauhan S, Salhan AK, et al. Superpulsed (Ga‐As, 904 nm) low‐level laser therapy (LLL) attenuates inflammatory response and enhances healing of burn wounds. J Biophotonics. 2015;8(6):489-501. doi: 10.1002/jbio.201400058.
Hamblin MR. Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS biophys. 2017;4(3):337-61. doi: 10.3934/biophy.2017.3.337.
Lapchak PA, Wei J, Zivin JA. Transcranial infrared laser therapy improves clinical rating scores after embolic strokes in rabbits. Stroke. 2004;35(8):1985-8. doi: 10.1161/01.STR.0000131808.69640.b7.
Oron A, Oron U, Chen J, Eilam A, Zhang C, Sadeh M, et al. Low-level laser therapy applied transcranially to rats after induction of stroke significantly reduces long-term neurological deficits. Stroke. 2006;37(10):2620-4. doi: 10.1161/01.STR.0000242775.14642.b8
Naveh N, Bar‐Ilan A, Rosner M, Schwartz M, Weissman C, Belkin M. Low‐energy laser irradiation—a new measure for suppression of arachidonic acid metabolism in the optic nerve. J Neurosci Res. 1990;26(3):386-9. doi: 10.1002/jnr.490260316.
Rochkind S, Barrnea L, Razon N, Bartal A, Schwartz M. Stimulatory effect of He-Ne low dose laser on injured sciatic nerves of rats. Neurosurgery. 1987;20(6):843-7. doi: 10.1227/00006123-198706000-00004.
Gonçalves ED, Souza PS, Lieberknecht V, Fidelis GS, Barbosa RI, Silveira PC, et al. Low-level laser therapy ameliorates disease progression in a mouse model of multiple sclerosis. Autoimmunity. 2016;49(2):132-42. doi: 10.3109/08916934.2015.1124425.
Oron A, Oron U, Streeter J, de Taboada L, Alexandrovich A, Trembovler V, et al. Low-level laser therapy applied transcranially to mice following traumatic brain injury significantly reduces long-term neurological deficits. J Neurotrauma. 2007;24(4):651-6. doi: 10.1089/neu.2006.0198
Sotoudeh A, Jahanshahi A, Zareiy S, Darvishi M, Roodbari N, Bazzazan A. The influence of low-level laser irradiation on spinal cord injuries following ischemia-reperfusion in rats. Acta Cir Bras. 2015;30(9):611-6.
Rochkind S, Shahar A, Alon M, Nevo Z. Transplantation of embryonal spinal cord nerve cells cultured on biodegradable microcarriers followed by low power laser irradiation for the treatment of traumatic paraplegia in rats. Neurol Res. 2002;24(4):355-60.
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