Low-intensity laser irradiation stimulates bone nodule formation via insulin-like growth factor-I expression in rat calvarial cells

Low-level controllable blue LEDs irradiation enhances human dental pulp stem cells osteogenic differentiation via transient receptor potential vanilloid 1

Human dental pulp stem cells (hDPSCs) have attracted tremendous attention in tissue regeneration engineering due to their excellent multidirectional differentiation potential. Photobiomodulation (PBM) using low-level light-emitting diodes (LEDs) or lasers has been proved to promote the osteogenesis of mesenchymal stem cells. However, the effect of LEDs on osteogenic differentiation of hDPSCs has little published data. In this work, the effect of blue LEDs with different energy densities of 2, 4, 6, 8, 10 J/cm² on osteogenic differentiation of hDPSCs was examined by using in vitro ALP staining, ALP activity, mineralization, and real-time PCR. The results showed that compared with the control group, osteogenic differentiation was significantly enhanced in blue LEDs treated groups. As the energy density increased, the level of osteogenesis initially increased and then decreased reaching the highest level at 6 J/cm². Transient receptor potential vanilloid 1 (TRPV1), a Ca²⁺ ion channel, was believed to be a potential player in osteogenesis by photobiomodulation. By immunofluorescence assay, calcium influx assay, PCR, and ALP staining, it was shown that blue LEDs irradiation can increase the activity of TRPV1 and intracellular calcium levels similarly to the agonist of TRPV1 capsaicin. Additionally, pretreatment with capsazepine, a selective TRPV1 inhibitor, was able to abrogate the osteogenic effect of blue LEDs. In conclusion, these findings proposed that blue LEDs can promote the osteogenesis of hDPSCs within the appropriate range (4-8 J/cm²) during culture of osteogenic medium, and TRPV1/Ca²⁺ may be an essential signaling pathway involved in blue LEDs-induced osteogenesis, providing new insights for the use of hDPSCs in tissue regeneration engineering.

Changes in Cell Biology under the Influence of Low-Level Laser Therapy

Low-level laser therapy (LLLT) has become an important part of the therapeutic process in various diseases. However, despite the broad use of LLLT in everyday clinical practice, the full impact of LLLT on cell life processes has not been fully understood. This paper presents the current state of knowledge concerning the mechanisms of action of LLLT on cells. A better understanding of the molecular processes occurring within the cell after laser irradiation may result in introducing numerous novel clinical applications of LLLT and potentially increases the safety profile of this therapy.

Effects of different wavelengths of low-level laser therapy on orthodontically induced inflammatory root resorption in rats investigated with micro-computerized tomography

INTRODUCTION

The objective of this research was to investigate the effects of different wavelengths low-level laser therapies on orthodontically induced inflammatory root resorption (OIIRR) during orthodontic tooth movement in rats by micro-computerized tomography.

METHODS

Forty Wistar albino rats were divided into 5 groups: control group (A), 405-nm laser group (B), 532-nm laser group (C), 650-nm laser group (D), and 940-nm laser group (E). The left side of group A was used as a positive control (A-PC), and the right side of group A was used as a negative control (A-NC) group. In all groups, the maxillary left first molars were moved mesially by 50 g of force for 14 days. The lasers were performed for 9 minutes on the maxillary left first molar tooth. At the end of the experimental period, OIIRR measurements were performed at the mesial and the distal sides along the mesial root of the maxillary first molars.

RESULTS

The root resorption volume was significantly lower in group A-NC than in groups A-PC, B, and D. The percentage of root resorption was significantly lower in group A-NC than in all other groups. The root resorption volume and the percentage of root resorption in groups C, D, and E were significantly lower than group A-PC. The depth and the width of the lacuna and even the number of mesial lacunae were similar between groups. The distal and the total lacunae were significantly lower in group A-NC than in all other groups except group C.

CONCLUSIONS

The 532-nm, 650-nm, and 940-nm lasers significantly reduced the volume of OIIRR. In addition, the 532-nm laser reduced the number of lacunae both distally and totally than all the other groups.

In Vitro Cytological Responses against Laser Photobiomodulation for Periodontal Regeneration

Periodontal disease is a chronic inflammatory disease caused by periodontal bacteria. Recently, periodontal phototherapy, treatment using various types of lasers, has attracted attention. Photobiomodulation, the biological effect of low-power laser irradiation, has been widely studied. Although many types of lasers are applied in periodontal phototherapy, molecular biological effects of laser irradiation on cells in periodontal tissues are unclear. Here, we have summarized the molecular biological effects of diode, Nd:YAG, Er:YAG, Er,Cr:YSGG, and CO₂ lasers irradiation on cells in periodontal tissues. Photobiomodulation by laser irradiation enhanced cell proliferation and calcification in osteoblasts with altering gene expression. Positive effects were observed in fibroblasts on the proliferation, migration, and secretion of chemokines/cytokines. Laser irradiation suppressed gene expression related to inflammation in osteoblasts, fibroblasts, human periodontal ligament cells (hPDLCs), and endothelial cells. Furthermore, recent studies have revealed that laser irradiation affects cell differentiation in hPDLCs and stem cells. Additionally, some studies have also investigated the effects of laser irradiation on endothelial cells, cementoblasts, epithelial cells, osteoclasts, and osteocytes. The appropriate irradiation power was different for each laser apparatus and targeted cells. Thus, through this review, we tried to shed light on basic research that would ultimately lead to clinical application of periodontal phototherapy in the future.

Photobiomodulation Therapy in the Proliferation and Differentiation of Human Umbilical Cord Mesenchymal Stem Cells: An In Vitro Study

Introduction: Since photobiomodulation therapy (PBMT) favors in vitro mesenchymal stem cell (MSC) preconditioning before MSC transplantation, increasing the proliferation of these cells without molecular injuries by conserving their characteristics, in the present in vitro study we analyzed the effect of PBMT on the proliferation and osteogenic differentiation of human umbilical cord mesenchymal stem cells (hUCMSCs). Methods: Irradiation with an InGaAIP Laser (660 nm, 10 mW, 2.5 J/cm² , 0.08 cm² spot size, and 10 s) was carried out. The cells were divided into four groups: CONTROL [cells grown in Dulbecco's Modified Eagle Medium (DMEM)], OSTEO (cells grown in an osteogenic medium); PBMT (cells grown in DMEM+PBMT), and OSTEO+PBMT (cells grown in an osteogenic medium plus PBMT). The cell proliferation curve was obtained over periods of 24, 48 and 72 hours using the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. Osteogenic differentiation was analyzed by the formation of calcium nodules over periods of 7, 14 and 21 days. Morphometric analysis was performed to quantify the total area of nodular calcification. Results: The highest cell proliferation and cell differentiation occurred in the OSTEO+PBMT group, followed by the PBMT, OSTEO and CONTROL groups respectively, at the observed times (P <0.05). Conclusion: PBMT enhanced the osteogenic proliferation and the differentiation of hUCMSCs during the periods tested, without causing damage to the cells and preserving their specific characteristics, a fact that may represent an innovative pretreatment in the application of stem cells.

Effects of Low-Level Er:YAG Laser Irradiation on Proliferation and Calcification of Primary Osteoblast-Like Cells Isolated From Rat Calvaria

Several reports have shown that the photo-bio-modulation of cells by various lasers has favorable biological effects. However, the effects of low-level Er:YAG laser irradiation on osteoblasts remain unclear. The purpose of this study was to evaluate the effects of low-level Er:YAG laser irradiation on proliferation and osteogenic differentiation of primary osteoblast-like cells isolated from the calvariae of 3-5-day-old Wistar rats. Cells were irradiated by Er:YAG laser at energy fluences of 2.2, 3.3, and 4.3 J/cm2, respectively. After irradiation, cell surface temperatures were measured and cell proliferation was evaluated by flow cytometry and CCK-8. Calcification was evaluated by measuring areas of Alizarin red S staining after 7, 14, and 21 days culture in osteoinductive medium. Gene expression in non-irradiated and laser-irradiated cells was evaluated by qPCR at 3, 6, and 12 h, as well as 1, 3, 7, and 14 days after irradiation. Microarray analysis was performed to comprehensively evaluate the gene expression of non-irradiated and irradiated cells at 3.3 J/cm2 at 6 h after irradiation. No pronounced increase of cell surface temperature was induced by irradiation. Irradiation did not affect osteoblast-like cell proliferation. Osteoblast-like cell calcification was significantly increased 7 days after Er:YAG laser irradiation at 3.3 J/cm2. Bglap expression was significantly increased in cells irradiated at 3.3 J/cm2 6 h post-irradiation. Microarray analysis showed that irradiation at 3.3 J/cm2 caused an upregulation of inflammation-related genes and downregulation of Wisp2. Gene set enrichment analysis also clarified enrichment of inflammation-related and Notch signaling gene sets. In conclusion, low-level Er:YAG laser irradiation at 3.3 J/cm2 enhanced calcification of primary osteoblast-like cells via enhanced Bglap expression and enriched Notch signaling.

Effect of Combined Application of Growth Factors and Diode Laser Bio-Stimulation on the Osseo Integration of Dental Implants

BACKGROUND:

The success of implants is associated first with their osseointegration, and later on with their survival rate. In recent years, many efforts have been exerted to develop implant design, geometry, materials and techniques to enhance the osseointegration process and also to increase the success rate of implant procedures. New techniques, like leukocyte and platelet-rich fibrin (L-PRF) and low-level laser treatment (LLLT), have been developed to enhance the osseointegration around dental implants.

AIM:

This study aims at accelerating bone osseointegration process around dental implant using new techniques to increase the success rate, to allow immediate or early loading of a dental implant, and to make a comparison between the various new techniques in dental implant procedures to figure out which technique will achieve the best results.

METHODS:

The study was conducted on a random sample of 40 male patients. Dental implants were placed in the posterior areas of the lower jaw. Patients were divided randomly into 4 groups; control group, LLLT group, L-PRF group and L-PRF plus LLLT group. They were assessed using cone-beam computed tomography (CBCT).

RESULTS:

The results showed significant differences between all groups over different measured times. All the groups showed improvement in comparison with Normal group, where L-PRF group showed the best result followed by (L-PRF+LLLT) group, while the LLLT group showed the least improvement in comparison with bothL-PRF group and (L-PRF+LLLT) group.

CONCLUSION:

The study demonstrates that L-PRF gives a better performance in the osseointegration around dental implants than LLLT.

Effects of Different Parameters of Diode Laser on Acceleration of Orthodontic Tooth Movement and Its Effect on Relapse: An Experimental Animal Study

AIM

Recent studies have demonstrated that low-level laser therapy (LLLT) can accelerate orthodontic tooth movement. However, there is still controversy about the optimum parameters that can cause acceleration. The present study was designed to examine two different doses of LLLT in the acceleration of orthodontic tooth movement and their effect on relapse.

METHODS

An orthodontic appliance was designed to induce tooth movement on lower incisors of rabbits. The in-al-as diode laser was used to radiate different groups of rabbits according to a specific protocol. The amount of tooth movement was measured for 21 days, and then the orthodontic appliance was removed, and the relapse was measured till day 28.

RESULTS

The amount of tooth movement was significantly greater in the group with irradiation of low dose in comparison with the high dose group and the control group. The relapse was greatest in the group of low dose irradiation and least in the control group.

CONCLUSION

The findings suggest that LLLT with a low dose accelerate the orthodontic tooth movement while LLLT with a high dose was not able to have the same effect. LLLT had a reverse effect on relapse tendency; an increase in the relapse tendency was seen with low dose irradiation.

Effect of Laser Therapy on the Osseointegration of Immediately Loaded Dental Implants in Patients under Vitamin C, Omega-3 and Calcium Therapy

BACKGROUND:

The use of laser therapy in the biostimulation of bone repair has been growing steadily.

AIM:

This study aimed to evaluate the radio-densitometric effect of low-intensity laser therapy on the osseointegration of immediately loaded dental implants in patients under vitamin C, omega-3 and calcium therapy.

PATIENTS AND METHODS:

A single implant was placed in the mandibular first molar region of twenty patients which were equally divided into two groups. In the non-laser group, the healing phase was left to progress spontaneously without any intervention, while in the laser group it was augmented with low-level laser therapy of wavelength 904 nm in contact mode, continuous wave, 20 mW output power and exposure time 30 sec with a dose 4.7 J/cm². Patients in both groups were given vitamin C, calcium and omega-3 starting one month preoperatively. Postoperative digital panoramas were taken immediately after surgery, 1.5 months and 6 months postoperatively. Changes in bone density along the bone-implant interface at the mesial, distal and apical sides were assessed using the Digora software.

RESULTS:

Independent student t-test was used to compare means of variables between the laser and the non-laser group while repeated measures ANOVA was used to compare bone densities at different times for the same group. Significant increased differences were observed at the mesial, distal and apical sides surrounding the implants of both groups per time. However, the rate of increase was significantly higher in the laser group. The mean difference at the mesial side after 6 months was 21.99 ± 5.48 in the laser group and 14.21 ± 4.95 in the non-laser group, while it read 21.74 ± 3.56 in the laser group and 10.78 ± 3.90 in non-laser group at the distal side and was 18.90 ± 5.91 in the laser group and 10.39 ± 3.49 in non-laser group at the apical side. Significance was recorded at P = 0.004, P = 0.0001, and 0.001 at the mesial, distal and apical sides respectively.

CONCLUSION:

The low-intensity laser irradiation significantly promoted bone healing and speeded up the osseointegration process emphasising the laser’s biostimulatory effect.

Effects of 915 nm laser irradiation on human osteoblasts: a preliminary in vitro study

Photobiomodulation (PBM) is a non-invasive treatment that uses laser or led devices making its effects a response to light and not to heat. The possibility of accelerating dental implant osteointegration and orthodontic movements and the need to treat refractory bone lesions, such as bisphosphonate related osteonecrosis of the jaws, has led researchers to consider the effects of PBM on bone for dentistry purposes. The aim of our study was to investigate the effects of 915 nm light supplied with a GaAs diode laser on human osteoblasts in vitro. Osteoblasts were isolated from mandibular cortical bone of a young healthy donor. The irradiation parameters were as follows: doses = 5, 15 and 45 J/cm²; power densities = 0.12 and 1.25 W/cm²; and irradiation times = 41.7, 125 and 375 s. We performed one irradiation per day for 3 and 6 days to study proliferation and differentiation, respectively. Microscopic analysis showed a greater amount of bone nodules in samples treated with 5 J/cm² and 0.12 W/cm² compared to controls (56.00 ± 10.44 vs 19.67 ± 7.64, P = 0.0075). Cell growth and quantification of calcium deposition did not show any differences when comparing irradiated and non-irradiated samples. Photobiomodulation, with the parameters investigated in the present study, positively modulated the mineralization process in human osteoblasts, inducing the formation of a greater amount of bone nodules, but did not increase cell proliferation.

Low-level ultrahigh-frequency and ultrashort-pulse blue laser irradiation enhances osteoblast extracellular calcification by upregulating proliferation and differentiation via transient receptor potential vanilloid 1

BACKGROUND AND OBJECTIVE

Low-level laser irradiation (LLLI) exerts various biostimulative effects, including promotion of wound healing and bone formation; however, few studies have examined biostimulation using blue lasers. The purpose of this study was to investigate the effects of low-level ultrahigh-frequency (UHF) and ultrashort-pulse (USP) blue laser irradiation on osteoblasts.

STUDY DESIGN/ MATERIALS AND METHODS

The MC3T3-E1 osteoblast cell line was used in this study. Following LLLI with a 405 nm newly developed UHF-USP blue laser (80 MHz, 100 fs), osteoblast proliferation, and alkaline phosphatase (ALP) activity were assessed. In addition, mRNA levels of the osteoblast differentiation markers, runt-related transcription factor 2 (Runx2), osterix (Osx), alkaline phosphatase (Alp), and osteopontin (Opn) was evaluated, and extracellular calcification was quantified. To clarify the involvement of transient receptor potential (TRP) channels in LLLI-induced biostimulation, cells were treated prior to LLLI with capsazepine (CPZ), a selective inhibitor of TRP vanilloid 1 (TRPV1), and subsequent proliferation and ALP activity were measured.

RESULTS

LLLI with the 405 nm UHF-USP blue laser significantly enhanced cell proliferation and ALP activity, compared with the non-irradiated control and LLLI using continuous-wave mode, without significant temperature elevation. LLLI promoted osteoblast proliferation in a dose-dependent manner up to 9.4 J/cm² and significantly accelerated cell proliferation in in vitro wound healing assay. ALP activity was significantly enhanced at doses up to 5.6 J/cm² , and expression of Osx and Alp mRNAs was significantly increased compared to that of the control on days 3 and 7 following LLLI at 5.6 J/cm² . The extent of extracellular calcification was also significantly higher as a result of LLLI 3 weeks after the treatment. Measurement of TRPV1 protein expression on 0, 3, and 7 days post-irradiation revealed no differences between the LLLI and control groups; however, promotion of cell proliferation and ALP activity by LLLI was significantly inhibited by CPZ.

CONCLUSION

LLLI with a 405 nm UHF-USP blue laser enhances extracellular calcification of osteoblasts by upregulating proliferation and differentiation via TRPV1. Lasers Surg. Med. 50:340-352, 2018. © 2017 Wiley Periodicals, Inc.

Comparison of the in vitro effects of low-level laser therapy and low-intensity pulsed ultrasound therapy on bony cells and stem cells

To compare the in vitro effectiveness of Low-Level Laser Therapy (LLLT) and Low Intensity Pulsed Ultrasound (LIPUS) on bony cells and related stem cells. In this study, we aim to systematically review the published scientific literature which explores the use of LLLT and LIPUS to biostimulate the activity or the proliferation of bony cells or stem cells in vitro. We searched the database PubMed for LLLT or LIPUS, with/without bone, osteoblast, osteocyte, stem cells, the human osteosarcoma cell line (MG63), bone-forming cells, and cell culture (or in vitro). These studies were subdivided into categories exploring the effect of LLLT or LIPUS on bony cells, stem cells, and other related cells. 75 articles were found between 1987 and 2016; these included: 50 full paper articles on LLLT and 25 full papers on LIPUS. These articles met the eligibility criteria and were included in our review. A detailed and concise description of the LLLT and the LIPUS protocols and their individual effects on bony cells or stem cells and their results are presented in five tables. Based on the main results and the conclusions of the reviewed articles in the current work, both, LLLT and LIPUS, apply a biostimulatory effect on osteoblasts, osteocytes, and enhance osteoblast proliferation and differentiation on different bony cell lines used in in vitro studies, and therefore, these may be useful tools for bone regeneration therapy. Moreover, in consideration of future cell therapy protocols, both, LLLT and LIPUS (especially LLLT), enhnce a significant increase in the initial number of SCs before differentiation, thus increasing the number of differentiated cells for tissue engineering, regenerative medicine, and healing. Further studies are necessary to determine the LLLT or the LIPUS parameters, which are optimal for biostimsulating bony cells and SCs for bone healing and regenerative medicine.

Low level laser therapy modulates viability, alkaline phosphatase and matrix metalloproteinase-2 activities of osteoblasts

Low level laser therapy (LLLT) has been shown to stimulate bone cell metabolism but their impact on the matrix metalloproteinase (MMP) expression and activity is little explored. This study evaluated the influence of LLLT at two different wavelengths, red and infrared, on MC3T3-E1 preosteoblast viability, alkaline phosphatase (ALP) and MMP-2 and -9 activities. To accomplish this, MC3T3-E1 cells were irradiated with a punctual application of either red (660nm; InGaAIP active medium) or infrared (780nm; GaAlAs active medium) lasers both at a potency of 20mW, energy dose of 0.08 or 0.16J, and energy density of 1.9J/cm² or 3.8J/cm², respectively. The control group received no irradiation. Cellular viability, ALP and MMP-2 and -9 activities were assessed by MTT assay, enzymatic activity and zymography, respectively, at 24, 48 and 72h. The treatment of cells with both red and infrared lasers significantly increased the cellular viability compared to the non-irradiated control group at 24 and 48h. The ALP activity was also up modulated in infrared groups at 24 and 72h, depending on the energy densities. In addition, the irradiation with red laser at the energy density of 1.9J/cm² promoted an enhancement of MMP-2 activity at 48 and 72h. However, no differences were observed for the MMP-9 activity. In conclusion, when used at these specific parameters, LLL modulates both preosteoblast viability and differentiation highlighted by the increased ALP and MMP-2 activities induced by irradiation.

A novel combination treatment to stimulate bone healing and regeneration under hypoxic conditions: photobiomodulation and melatonin

Melatonin has anabolic effects on the bone, even under hypoxia, and laser irradiation has been shown to improve osteoblastic differentiation. The aim of this study was to investigate whether laser irradiation and melatonin would have synergistic effects on osteoblastic differentiation and mineralization under hypoxic conditions. MC3T3-E1 cells were exposed to 1% oxygen tension for the hypoxia condition. The cells were divided into four groups: G1-osteoblast differentiation medium only (as the hypoxic condition), G2-treatment with 50 μM melatonin only, G3-laser irradiation (808 nm, 80 mW, GaAlAs diode) only, and G4-treatment with 50 μM melatonin and laser irradiation (808 nm, 80 mW, GaAlAs diode). Immunoblotting showed that osterix expression was markedly increased in the melatonin-treated and laser-irradiated cells at 48 and 72 h. In addition, alkaline phosphatase activity significantly increased and continued to rise throughout the experiment. Alizarin Red staining showed markedly increased mineralized nodules as compared with only melatonin-treated or laser-irradiated cells at day 7, which significantly increased by day 14. Moreover, when melatonin-treated cells were laser-irradiated, the differentiation and mineralization of cells were found to involve p38 MAPK and PRKD1 signaling mechanisms. However, the enhanced effects of laser irradiation with melatonin were markedly inhibited when the cells were treated with luzindole, a selective melatonin receptor antagonist. Therefore, we concluded that laser irradiation could promote the effect of melatonin on the differentiation and mineralization of MC3T3-E1 cells under hypoxic conditions, and that this process is mediated through melatonin 1/2 receptors and PKRD/p38 signaling pathways.

Periodontal and peri-implant wound healing following laser therapy

Laser irradiation has numerous favorable characteristics, such as ablation or vaporization, hemostasis, biostimulation (photobiomodulation) and microbial inhibition and destruction, which induce various beneficial therapeutic effects and biological responses. Therefore, the use of lasers is considered effective and suitable for treating a variety of inflammatory and infectious oral conditions. The CO2 , neodymium-doped yttrium-aluminium-garnet (Nd:YAG) and diode lasers have mainly been used for periodontal soft-tissue management. With development of the erbium-doped yttrium-aluminium-garnet (Er:YAG) and erbium, chromium-doped yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, which can be applied not only on soft tissues but also on dental hard tissues, the application of lasers dramatically expanded from periodontal soft-tissue management to hard-tissue treatment. Currently, various periodontal tissues (such as gingiva, tooth roots and bone tissue), as well as titanium implant surfaces, can be treated with lasers, and a variety of dental laser systems are being employed for the management of periodontal and peri-implant diseases. In periodontics, mechanical therapy has conventionally been the mainstream of treatment; however, complete bacterial eradication and/or optimal wound healing may not be necessarily achieved with conventional mechanical therapy alone. Consequently, in addition to chemotherapy consisting of antibiotics and anti-inflammatory agents, phototherapy using lasers and light-emitting diodes has been gradually integrated with mechanical therapy to enhance subsequent wound healing by achieving thorough debridement, decontamination and tissue stimulation. With increasing evidence of benefits, therapies with low- and high-level lasers play an important role in wound healing/tissue regeneration in the treatment of periodontal and peri-implant diseases. This article discusses the outcomes of laser therapy in soft-tissue management, periodontal nonsurgical and surgical treatment, osseous surgery and peri-implant treatment, focusing on postoperative wound healing of periodontal and peri-implant tissues, based on scientific evidence from currently available basic and clinical studies, as well as on case reports.

Effects of light-emitting diode irradiation on the osteogenesis of human umbilical cord mesenchymal stem cells in vitro

The aim of this study was to examine the effects of light-emitting diode (LED) photobiomodulation therapy on the proliferation and differentiation of human umbilical cord mesenchymal stem cells (hUMSCs) cultured in osteogenic differentiation medium. HUMSCs were irradiated with an LED light at 620 nm and 2 J/cm2 and monitored for cell proliferation and osteogenic differentiation activity. The experiment involved four groups of cells: the control group; the osteogenic group (osteo group); the LED group; the osteogenic + LED group (LED + osteo group). HUMSC proliferation was detected by performing a3-(4,5-dimethylthiazol-2yl)-2,5 diphenyltetrazolium bromide(MTT) assay. Osteogenic activity was evaluated by performing alkaline phosphatase (ALP) and Von Kossa staining, and osteopontin (OPN) gene mRNA expression was evaluated byreverse transcription polymerase chain reaction (RT-PCR). The hUMSCs in the LED + osteo group exhibited a significantly higher proliferation rate than the other subgroups. Additionally, there were greater numbers of ALP-positive cells and Von Kossa nodules in the LED + osteo group. OPN mRNA expression in the LED + osteo group was higher than other subgroups. In conclusion, low levels of LED light at a wavelength of 620 nm enhance the proliferation and osteogenic differentiation of hUMSCs during a long culture period.

Evaluation of the effects of pulsed wave LLLT on tibial diaphysis in two rat models of experimental osteoporosis, as examined by stereological and real-time PCR gene expression analyses

Osteoporosis (OP) and osteoporotic fracture are major public health issues for society; the burden for the affected individual is also high. Previous studies have shown that pulsed wave low-level laser therapy (PW LLLT) has osteogenic effects. This study intended to evaluate the impacts of PW LLLT on the cortical bone of osteoporotic rats' tibias in two experimental models, ovariectomized and dexamethasone-treated. We divided the rats into four ovariectomized induced OP (OVX-d) and four dexamethasone-treated (glucocorticoid-induced OP, GIOP) groups. A healthy (H) group of rats was considered for baseline evaluations. At 14 weeks following ovariectomy, we subdivided the OVX-d rats into the following groups: (i) control which had OP, (ii) OVX-d rats treated with alendronate (1 mg/kg), (iii) OVX-d rats treated with LLLT, and (iv) OVX-d rats treated with alendronate and PW LLLT. The remaining rats received dexamethasone over a 5-week period and were also subdivided into four groups: (i) control rats treated with intramuscular (i.m.) injections of distilled water (vehicle), (ii) rats treated with subcutaneous alendronate injections (1 mg/kg), (iii) laser-treated rats, and (iv) rats simultaneously treated with laser and alendronate. The rats received alendronate for 30 days and underwent PW LLLT (890 nm, 80 Hz, 0.972 J/cm(2)) three times per week during 8 weeks. Then, the right tibias were extracted and underwent a stereological analysis of histological parameters and real-time polymerase chain reaction (RT-PCR). A significant increase in cortical bone volume (mm(3)) existed in all study groups compared to the healthy rats. There were significant decreases in trabecular bone volume (mm(3)) in all study groups compared to the group of healthy rats. The control rats with OP and rats from the vehicle group showed significantly increased osteoclast numbers compared to most other groups. Alendronate significantly decreased osteoclast numbers in osteoporotic rats. Concurrent treatments (compounded by PW LLLT and alendronate) produce the same effect on osteoporotic bone.

Effect of Pulsed Wave Low-Level Laser Therapy on Tibial Complete Osteotomy Model of Fracture Healing With an Intramedullary Fixation

Background:

Fractures pose a major worldwide challenge to public health, causing tremendous disability for the society and families. According to recent studies, many in vivo and in vitro experiments have shown the positive effects of PW LLLT on osseous tissue.

Objectives:

The aim of this study was to evaluate the outcome of infrared pulsed wave low-level laser therapy (PW LLLT) on the fracture healing process in a complete tibial osteotomy in a rat model, which was stabilized by an intramedullary pin.

Materials and Methods:

This experimental study was conducted at Shahid Beheshti University of Medical Sciences in Tehran, Iran. We performed complete tibial osteotomies in the right tibias for the population of 15 female rats. The rats were divided randomly into three different groups: I) Control rats with untreated bone defects; II) Rats irradiated by a 0.972 J/cm² PW LLLT; and III) Rats irradiated by a 1.5 J/cm² PW LLLT. The right tibias were collected six weeks following the surgery and a three-point bending test was performed to gather results. Immediately after biomechanical examination, the fractured bones were prepared for histological examinations. Slides were examined using stereological method.

Results:

PW LLLT significantly caused an increase in maximum force (N) of biomechanical repair properties for osteotomized tibias in the first and second laser groups (30.0 ± 15.9 and 32.4 ± 13.8 respectively) compared to the control group (8.6 ± 4.5) LSD test, P = 0.019, P = 0.011 respectively). There was a significant increase in the osteoblast count of the first and second laser groups (0.53 ± 0.06, 0.41 ± 0.06 respectively) compared to control group (0.31 ± 0.04) (LSD test, P = 0001, P = 0.007 respectively).

Conclusions:

This study confirmed the efficacy of PW LLLT on biomechanical strength, trabecular bone volume, callus volume, and osteoblast number of repairing callus in a complete tibial osteotomy animal model at a relatively late stage of the bone healing process.

Low Reactive Level Laser Therapy for Mesenchymal Stromal Cells Therapies

Low reactive level laser therapy (LLLT) is mainly focused on the activation of intracellular or extracellular chromophore and the initiation of cellular signaling by using low power lasers. Over the past forty years, it was realized that the laser therapy had the potential to improve wound healing and reduce pain and inflammation. In recent years, the term LLLT has become widely recognized in the field of regenerative medicine. In this review, we will describe the mechanisms of action of LLLT at a cellular level and introduce the application to mesenchymal stem cells and mesenchymal stromal cells (MSCs) therapies. Finally, our recent research results that LLLT enhanced the MSCs differentiation to osteoblast will also be described.

[The application of stem cells, visible and infrared light in regenerative medicine. Part 1]

OBJECTIVE

The present article was designed to overview the experimental studies of visible and infrared light irradiation of human and animal stem cells (SC) in vitro and in vivo for the evaluation of its photobiomodulatory effects. The results will be used to elaborate substantiation for the choice of the parameters of SC light irradiation and to develop recommendations for the application of this method in regenerative medicine (RM).

BACKGROUND

The clinical application of light irradiation is a matter of contrsy, in the first place due to the difficulties encountered in the rational choice of irradiation parameters. The theoretical substantiation of such choice remains a stumbling block too despite the long history of photoghromotherapy. There is thus far no reliable theoretical basis for the adequate choice of such irradiation parameters as power density, radiation dose, and exposure time. The experiences with the light application for the purpose of regenerative medicine have never been summarized.

RESULTS

The present review encompasses 78 articles selected for the basic analysis that report the studies with the use of a variety of SC types. The analysis has demonstrated that clinical investigations into the influence of light on the stem cells are still in their infancy. It was shown that the irradiation parameters need to be chosen taking into consideration the type of the stem cells. Different authors report the achievement of the maximum SC proliferation and differentiation rates at energy densities as high as 50 mW/sq.cm, small radiation doses (around 1 J/sq.cm) and exposure time (on the order of seconds).

CONCLUSION

The general conclusion for Parts 1 and II of this communication will be presented in the next issue of this journal (number 2, 2015).

Photomodulation of proliferation and differentiation of stem cells by the visible and infrared light

OBJECTIVE

The aim of this article is to review experimental studies of visible and infrared light irradiation of human and animal stem cells (SCs) in vitro and in vivo to assess photobiomodulation effects on their proliferation and differentiation.

BACKGROUND DATA

The clinical application of light irradiation remains controversial, primarily because of the complexity of the rational choice of irradiation parameters. In laboratories, the theoretical justification underlying the choice of irradiation parameters also remains a challenge.

METHODS

A systematic review was completed of original research articles that investigated the effects of light irradiation on human and animal SCs in vitro and in vivo (to June 2014). Relevant articles were sourced from PubMed and MEDLINE(®). The search terms were laser (light) therapy (irradiation), stem cells, and phototherapy, stem cells.

RESULTS

The analysis revealed the importance of cell type when choosing the cell irradiation parameters. The influence of wavelength on the SC proliferation rate seemed to be nonsignificant. The high values of increased proliferation or differentiation were obtained using high power density, low energy density, and short exposure time. SC exposure to light without inducers did not lead to their differentiation. The maximum differentiation was achieved using irradiation parameters different from the ones needed to achieve the maximum proliferation of the same cells.

CONCLUSIONS

Increased power density and reduced energy density were needed to increase the SC response. Based on the analysis, we have presented a graph of the cell response to generalized photostimulus, and introduced the concepts of "photostress" and "photoshock" to describe the stages of this response.

Evaluation of the effects of LLLT on biomechanical properties of tibial diaphysis in two rat models of experimental osteoporosis by a three point bending test

Osteoporosis (OP) is a disease which causes bone loss and fractures, leading to severe pain and deformity. This study has aimed to assess the effects of pulsed wave low-level laser therapy (PW LLLT) on cortical bone in two experimental models of OP in rats. There were four ovariectomized (OVX-d) groups and four dexamethasone-treated groups. The healthy group were considered for baseline evaluations. At 14 weeks following ovariectomy, the OVX-d rats were further subdivided into the following: control rats with OP, OVX-d rats that received alendronate (1 mg/kg), OVX-d rats treated with LLLT, and OVX-d rats treated with alendronate and LLLT. The remaining rats received dexamethasone for 5 weeks and were divided into four groups: control, alendronate-treated rats (1 mg/kg), laser-treated rats, and laser-treated rats with concomitant administration of alendronate. The rats received alendronate for 30 days. LLLT (890 nm, 80 Hz, 0.972 J/cm(2)) was performed on the tibias three times per week for 8 weeks. After 8 weeks, tibias were extracted and submitted to a three-point bending test. PW LLLT did not increase the biomechanical parameters of osteoporotic bones compared to controls and healthy rats. PW LLLT associated with alendronate treatment significantly increased stress high load in OVX-d rats compared to the healthy group. PW LLLT at the current study parameters failed to cause beneficial biomechanical effects in the examined osteoporotic cortical bones. PW LLLT associated with alendronate treatment produced a more remarkable effect on bone strength in the ovariectomized induced OP rat model.

Five-day, low-level laser therapy for sports-related lower extremity periostitis in adult men: a randomized, controlled trial

Periostitis in the lower leg caused by overexercise is a universal problem in athletes and runners. The purpose of this study was to observe the functional improvement of the lower limbs upon rehabilitation low-level laser therapy (LLLT). All medical data were gathered from enrolled adults with sports-related lower leg pain. A total of 54 patients underwent triple-phase bone scans using skeletal nuclear scintigraphy, which confirmed periostitis in their lower limbs. The patients were then randomly divided into two groups: one group received laser therapy (N = 29) and the other group (N = 25) received an equivalent placebo treatment (a drug or physical therapy). Treatment protocol commenced with rehabilitation intervention and LLLT was performed three times daily for 5 days at a dosage of 1.4 J/cm(2). A Likert-type pain scale was used to evaluate the severity of pain. Balance function, including postural stability testing (PST) and limits of stability (LOS), was also performed to evaluate the function outcome. Patients experienced a significant improvement in pain by day 2 or day 5 after starting LLLT, but here was no significant difference in pain scale between the measurements before (baseline) and after LLLT. Comparing the PST, the group differences of dynamic vs. static testings ranged from -18.54 to -50.22 (compared 12, 8, 4, 3, 2, 1 to 0, all p < 0.0001), and the PST after LLLT were 3.73 units (p = 0.0258) lower than those of before LLLT. Comparing the LOS, the group differences of dynamic vs. static testing were similar to those in PST, and the relationship between LOS and groups only varied with the direction control during dynamic testing in direction at backward/right vs. right (p < 0.0001). LLLT had a positive effect on proprioception in patients with lower limb periostitis. Larger, better controlled studies are needed to determine what specific effects LLLT has on the function of proprioception.

Photobiomodulation of aqueous interfaces as selective rechargeable bio-batteries in complex diseases: personal view

OBJECTIVE

In this personal view, we propose that the modulation of the structure and function of water by light may come to embody a new mechanistic approach for the treatment of complex diseases.

BACKGROUND DATA

Long considered an innocuous medium, water has increasingly been found to be a key player in numerous mechanisms, including first-contact events in which cells decide between survival and apoptosis. Consequently, externally applied electromagnetic energy (light) may selectively target the organization of water to steer biological function.

METHODS

We survey light-water research with particular emphasis on the quasi-crystalline exclusion zone (EZ), part of the cell's aqueous interface that is just now beginning to be decoded. The current state of research, the technical challenges involved in obtaining evidence in biological systems, and some potential uses and implications of EZ water in medicine are presented.

RESULTS

Though existing data have not yet proven the role of EZ water in photobiomodulation, research shows that EZ water can store charge and can later return it in the form of current flow, with as much as 70% of the input charge being readily obtainable. Macroscopic separation of charges can be stable for days to weeks and has unusual electric potential. Water is, thus, an unexpectedly effective charge separation and storage medium.

CONCLUSIONS

We propose that the EZ may be selectively targeted in photobiomodulation as an efficient energy reservoir, which cells can use expeditiously to fuel cellular work, triggering signaling pathways and gene expression in the presence of injury-induced redox potentials.

Low-level laser therapy enhances the stability of orthodontic mini-implants via bone formation related to BMP-2 expression in a rat model

OBJECTIVE

The aim of this study was to investigate the stimulatory effects of low-level laser therapy (LLLT) on the stability of mini-implants in rat tibiae.

BACKGROUND DATA

In adolescent patients, loosening is a notable complication of mini-implants used to provide anchorage in orthodontic treatments. Previously, the stimulatory effects of LLLT on bone formation were reported; here, it was examined whether LLLT enhanced the stability of mini-implants via peri-implant bone formation.

MATERIALS AND METHODS

Seventy-eight titanium mini-implants were placed into both tibiae of 6-week-old male rats. The mini-implants in the right tibia were subjected to LLLT of gallium-aluminium-arsenide laser (830 nm) once a day during 7 days, and the mini-implants in the left tibia served as nonirradiated controls. At 7 and 35 days after implantation, the stability of the mini-implants was investigated using the diagnostic tool (Periotest). New bone volume around the mini-implants was measured on days 3, 5, and 7 by in vivo microfocus CT. The gene expression of bone morphogenetic protein (BMP)-2 in bone around the mini-implants was also analyzed using real-time reverse-transcription polymerase chain reaction assays. The data were statistically analyzed using Student's t test.

RESULTS

Periotest values were significantly lower (0.79- to 0.65-fold) and the volume of newly formed bone was significantly higher (1.53-fold) in the LLLT group. LLLT also stimulated significant BMP-2 gene expression in peri-implant bone (1.92-fold).

CONCLUSIONS

LLLT enhanced the stability of mini-implants placed in rat tibiae and accelerated peri-implant bone formation by increasing the gene expression of BMP-2 in surrounding cells.

Low-level laser irradiation affects the release of basic fibroblast growth factor (bFGF), insulin-like growth factor-I (IGF-I), and receptor of IGF-I (IGFBP3) from osteoblasts

OBJECTIVE

It was the aim of the present study to evaluate whether the laser irradiation of osteoblasts could enhance the release of growth factors including basic fibroblast growth factor (bFGF), insulin-like growth factor-I (IGF-I), and receptor of IGF-I (IGFBP3).

BACKGROUND DATA

Low-level laser therapy (LLLT) has been shown to have biostimulatory effects on various cell types by enhancing production of some cytokines and growth factors.

MATERIALS AND METHODS

Human mesenchymal stem cells (MSCs) were seeded in osteogenic medium and differentiated into osteoblasts. Three groups were formed: in the first group (single dose group), osteoblasts were irradiated with laser (685 nm, 25 mW, 14.3 mW/cm(2), 140 sec, 2 J/cm(2)) for one time; and in the second group, energy at the same dose was applied for 2 consecutive days (double dose group). The third group was not irradiated with laser and served as the control group. Proliferation, viability, bFGF, IGF-I, and IGFBP3 levels were compared between groups.

RESULTS

Both of the irradiated groups revealed higher proliferation, viability, bFGF, IGF-I, and IGFBP3 expressions than did the nonirradiated control group. There was increase in bFGF and IGF-I expressions and decrease in IGFBP3 in the double dose group compared to single dose group.

CONCLUSIONS

The results of the present study indicate that LLLT increases the proliferation of osteoblast cells and stimulates the release of bFGF, IGF-I, and IGFBP3 from these cells. The biostimulatory effect of LLLT may be related to the enhanced production of the growth factors.

High power-pulsed Nd:YAG laser as a new stimulus to induce BMP-2 expression in MC3T3-E1 osteoblasts

BACKGROUND AND OBJECTIVE

High-power laser has recently become a physical stimulus for bone regeneration. Little is known about how high-power laser irradiation affects osteoblast differentiation. This study investigated osteoblast responses to high-power laser and combined irradiation with BMP-2 treatment.

STUDY DESIGN/MATERIALS AND METHODS

MC3T3-E1 pre-osteoblasts were exposed to laser irradiation, 100 ng/ml BMP-2 or both. Cells were irradiated with a Q-switched, pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, with a 1,064 nm wavelength and 0.75 W output power under 1.5, 3, or 5 J/cm(2) energy densities. Cell proliferation was evaluated using tetrazolium salt, WST-8. To determine the effect of these treatments on in vitro osteogenesis, we examined alkaline phosphatase (ALP) activity, mineral deposition, and expression of genes associated with osteogenesis. Quantitative real time PCR or ELISA was used to examine cytokine expression. In each experiment, either non-irradiated or BMP-2 (100 ng/ml)-treated cells were used as controls.

RESULTS

High-power, low-level, Nd:YAG laser irradiation significantly increased ALP activity, when combined with BMP-2 or not. Cell proliferation declined in the irradiation and combined irradiation/BMP-2 groups. Interestingly, Nd:YAG laser stimulation resulted in significant induction of endogenous BMP-2 protein and gene expression. The increased expression of upstream regulators cbfa1 by Nd:YAG laser alone was comparable to exogenous BMP-2 treatment (100 ng/ml). Combined laser/BMP-2 treatment was synergistic in the expression of some genes (IGF-1, cbfa1) and ALP activity, compared to both BMP-2 treatment and laser irradiation alone. In vitro matrix mineralization was significantly accelerated by laser stimulation compared to that of the control, more so than with the combined laser/BMP-2 treatment.

CONCLUSIONS

The present in vitro findings demonstrate that high-power, low-level Nd:YAG laser increased osteoblast activity, very efficiently accelerating mineral deposition. Osteoinductive effect of laser is likely mediated by activation of BMP-2-related signaling pathway.

Low-intensity laser irradiation stimulates mineralization via increased BMPs in MC3T3-E1 cells

BACKGROUND

Previously, we reported that low-intensity laser irradiation accelerated bone formation, and that this mechanism deeply involved insulin-like growth factor I expression. However, as bone formation is supported by many local factors, the mechanism involved in laser irradiation remains incompletely understood. Therefore, the purpose of this study was to determine the effects of laser irradiation on the osteogenic response in vitro.

METHODS

Mouse osteoblast-like cells, MC3T3-E1, were cultured and were irradiated for 5-20 minutes (0.96-3.82 J/cm(2)) at the subconfluent stage using a low-intensity Ga-Al-As diode laser apparatus. After laser irradiation, expression of bone morphogenetic proteins (BMPs), transcription factors (Runx2, Osterix, Dlx5, Msx2), and phosphorylation of Smad1 were determined, and calcium content of cell cultures was also determined.

RESULTS

Irradiation at 1.91 J/cm(2) significantly increased the expression of BMPs and Runx2, Osterix, Dlx5, Msx2, and the phosphorylation of Smad1. Noggin, a BMP receptor blocker, inhibited the laser-induced Runx2 expression and phosphorylation of Smad1. Moreover, laser irradiation significantly increased the calcium content of cell cultures, and noggin inhibited this increase.

CONCLUSION

These results suggest that low-intensity laser irradiation stimulates in vitro mineralization via increased expression of BMPs and transcription factors associated with osteoblast differentiation.

Laser 904 nm action on bone repair in rats with osteoporosis

SUMMARY

The aim of the present study was to determine the action of AsGA laser irradiation on bone repair in the tibia of osteopenic rats. The animals were randomly divided into eight experimental groups according to the presence of ovarian hormone (sham group) or the absence of the hormone (OVX group), as well as being irradiated or non-irradiated. Low-level 904-nm laser (50 mJ/cm(2)) accelerated the repair process of osteopenic fractures, especially in the initial phase of bone regeneration.

INTRODUCTION

The development of new techniques to speed the process of bone repair has provided significant advances in the treatment of fractures. Some attention recently focused on the effects of biostimulation on bone.

METHODS

Forty-eight adult rats were randomly divided into eight experimental groups (six animals in each group) according to the presence of ovarian hormone (sham group) or absence of the hormone (ovariectomized (OVX) group) as well as being irradiated or non-irradiated. For the application of low-level laser therapy, the animals were anesthetized with one third of the dose sufficient to immobilize the animal and irradiated with AsGa laser (904 nm, 50 mJ/cm(2) for 2 s, point form and in contact). The control animals received the same type of manipulation as the irradiated animals, but with the laser turned off. Half of the animals were killed 7 days following the confection of the bone defect, and the other half were killed 21 days after the surgery. After complete demineralization, the tibias were cut cross-sectionally in the central region of the bone defect and embedded in paraffin blocks. The blocks were then cut in semi-seriated slices and stained with hematoxylin and eosin.

RESULTS

There was new bone formation in the animals in the OVX group with laser treatment killed after 7 days (p < 0.001). The lowest percentage of bone formation was observed in the OVX without laser killed after 7 days (p > 0.05). All animals killed after 21 days exhibited linear closure of the lesion.

CONCLUSION

Low-level 904-nm laser (50 mJ/cm(2)) accelerated the repair process of osteopenic fractures, especially in the initial phase of bone regeneration.

Comparison of the effects of electrical field stimulation and low-level laser therapy on bone loss in spinal cord-injured rats

OBJECTIVE

This study investigated the effects of low-level laser therapy (LLLT) and electrical stimulation (ES) on bone loss in spinal cord-injured rats.

MATERIALS AND METHODS

Thirty-seven male Wistar rats were divided into four groups: standard control group (CG); spinal cord-injured control (SC); spinal cord-injured treated with laser (SCL; GaAlAs, 830 nm, CW, 30 mW/cm, 250 J/cm(2)); and spinal cord-injured treated with electrical field stimulation (SCE; 1.5 MHz, 1:4 duty cycles, 30 mW, 20 min). Biomechanical, densitometric, and morphometric analyses were performed.

RESULTS

SC rats showed a significant decrease in bone mass, biomechanical properties, and morphometric parameters (versus CG). SCE rats showed significantly higher values of inner diameter and internal and external areas of tibia diaphyses; and the SCL group showed a trend toward the same result (versus SC). No increase was found in either mechanical or densitometric parameters.

CONCLUSION

We conclude that the mentioned treatments were able to initiate a positive bone-tissue response, maybe through stimulation of osteoblasts, which was able to determine the observed morphometric modifications. However, the evoked tissue response could not determine either biomechanical or densitometric modifications.

Lasers, stem cells, and COPD

The medical use of low level laser (LLL) irradiation has been occurring for decades, primarily in the area of tissue healing and inflammatory conditions. Despite little mechanistic knowledge, the concept of a non-invasive, non-thermal intervention that has the potential to modulate regenerative processes is worthy of attention when searching for novel methods of augmenting stem cell-based therapies. Here we discuss the use of LLL irradiation as a "photoceutical" for enhancing production of stem cell growth/chemoattractant factors, stimulation of angiogenesis, and directly augmenting proliferation of stem cells. The combination of LLL together with allogeneic and autologous stem cells, as well as post-mobilization directing of stem cells will be discussed.

Effects of low-level laser therapy on proliferation and differentiation of murine bone marrow cells into osteoblasts and osteoclasts

BACKGROUND AND OBJECTIVE

Low-Level Laser Therapy (LLLT) has been suggested to improve bone tissue healing. The cellular and molecular mechanisms involved in this effect are still unclear but bone cell proliferation and differentiation alteration have been proposed. The aim of the present study was to investigate, in vitro, the effect of LLLT on bone cell proliferation, osteoblastic and osteoclastic differentiation, both involved in bone remodeling and regeneration.

STUDY DESIGN/MATERIALS AND METHODS

Murine bone marrow cells, which contain both osteoblast and osteoclast progenitors, were cultured and induced to differentiate in the absence or in the presence of LLLT. Laser exposition parameters were determined using a powermeter and consisted in an 808 nm infrared wavelength laser light in continuous mode, with an energy density of 4 J/cm(2) administered three times a week. Cell proliferation and differentiation were assessed after specific staining and microscopic analysis of the cultures after various times, as well as by quantitative RT-PCR analysis of a panel of osteoblast and osteoclast markers after nucleic acid extraction.

RESULTS

The use of a powermeter revealed that the power emitted by the optical fiber of the laser device was markedly reduced compared to the displayed power. This allowed to adjust the LLLT parameters to a final energy density exposure of 4 J/cm(2). In these conditions, proliferation of bone marrow mesenchymal stem cells as well as osteoclast or osteoblast differentiation of the corresponding progenitors were found similar in control and LLLT conditions.

CONCLUSION

Using the present experimental protocol, we concluded that an 808 nm wavelength infrared LLLT does not alter murine bone progenitor cell proliferation and differentiation. Moreover our results confirm the necessary use of a powermeter to fix LLLT protocol parameters.

Molecular mechanisms of cell proliferation induced by low power laser irradiation

Low power laser irradiation (LPLI) promotes proliferation of multiple cells, which (especially red and near infrared light) is mainly through the activation of mitochondrial respiratory chain and the initiation of cellular signaling. Recently, the signaling proteins involved in LPLI-induced proliferation merit special attention, some of which are regulated by mitochondrial signaling. Hepatocyte growth factor receptor (c-Met), a member of tyrosine protein kinase receptors (TPKR), is phosphorylated during LPLI-induced proliferation, but tumor necrosis factor alpha (TNF-alpha) receptor has not been affected. Activated TPKR could activate its downstream signaling elements, like Ras/Raf/MEK/ERK, PI3K/Akt/eIF4E, PI3K/Akt/eNOS and PLC-gamma/PKC pathways. Other two pathways, DeltaPsim/ATP/cAMP/JNK/AP-1 and ROS/Src, are also involved in LPLI-induced proliferation. LPLI-induced cell cycle progression can be regulated by the activation or elevated expressions of cell cycle-specific proteins. Furthermore, LPLI induces the synthesis or release of many molecules, like growth factors, interleukins, inflammatory cytokines and others, which are related to promotive effects of LPLI.