The impact of photobiomodulation on osteoblast-like cell: a review

Effects of photobiomodulation on different phases of in vitro osteogenesis

The present study aimed to evaluate the effect of photobiomodulation therapy (PBM) on different stages of osteogenesis in vitro. For this, osteoblastic-like cells (Saos-2 cell lineage) were irradiated in two different periods: during the Proliferation phase (PP; from the second to the fourth day) and during the Differentiation phase (DP; from the seventh to the ninth day). The energy density used in the study was 1.5 J/ cm2. The following parameters were evaluated: 1) quantification of collagen type 1 (COL 1), osteopontin (OPN), and bone morphogenetic protein 2 (BMP-2); 2) quantification of alkaline phosphatase (ALP) activity; and 3) quantification of  extracellular matrix (ECM) mineralization. Non-irradiated cultures were used as controls. The data were analyzed using the Student's t-test or one-way ANOVA, considering a significance level of 5%. The results indicated that COL 1 and BMP-2 quantification was higher in Saos-2 irradiated during the DP in relation to the control group at day 10 (p < 0.05). No differences were observed for other comparisons at this time point (p > 0.05). OPN expression was greater in PP compared with the other experimental groups at day 10 (p < 0.05). Irradiation did not affect ALP activity in Saos-2 regardless of the exposure phase and the time point evaluated (p > 0.05). At day 14, ECM mineralization was higher in Saos-2 cultures irradiated during the DP in relation to the PP (p < 0.05). In conclusion, the results suggested that the effects of PBM on osteoblastic cells may be influenced by the stage of cell differentiation.

The role of photobiomodulation in accelerating bone repair

Bone repair is faced with obstacles such as slow repair rates and limited bone regeneration capacity. Delayed healing even nonunion could occur in bone defects, influencing the life quality of patients severely. Photobiomodulation (PBM) utilizes different light sources to derive beneficial therapeutic effects with the advantage of being non-invasive and painless, providing a promising strategy for accelerating bone repair. In this review, we summarize the parameters, mechanisms, and effects of PBM regulating bone repair, and further conclude the current clinical application of PBM devices in bone repair. The wavelength of 635-980 nm, the output power of 40-100 mW, and the energy density of less than 100 J/cm2 are the most commonly used parameters. New technologies, including needle systems and biocompatible and implantable optical fibers, offer references to realize an efficient and safe strategy for bone repair. Further research is required to establish the reliability of outcomes from in vivo and in vitro studies and to standardize clinical trial protocols.

Effect of 980 nm photobiomodulation delivered by a handpiece with Gaussian vs. Flat-Top profiles on proliferation and differentiation of buccal fat pad stem cells

The aim of this study was to compare the effectiveness of the Gaussian and Flat-Top profiles in proliferation and differentiation of mesenchymal stem cell of buccal fat pad. Based on the timing schedule and type of laser handpieces, the cells were assigned to a control group with no radiation, and two irradiation test groups (980 nm) with Flat-Top (F) (power of 1.1 W, beam area of 1 cm2 ) and standard Gaussian (G) (power of 0.7 W, beam area of 0.5 cm2 ) handpieces. Each test group was divided into three subgroups, receiving one time (60 J/cm2 ), two times (120 J/cm2 ), and three times (180 J/cm2 ) irradiation. 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) and Annexin V tests were performed. The Alizarin Red staining and polymerase chain reaction tests were done both at the beginning and the end of the first and second weeks. The degree of mineralization and expression of osteogenic markers, RUNX2, OCN, and OPN were evaluated. Based on the MTT and Annexin V test results, both test groups outperformed the control group in degrees of cell proliferation during the first day of laser irradiation (p < 0.05). After one and two times irradiation, the expression of osteogenic markers in the test groups was significantly higher than the control group. PBM with Flat-Top and Gaussian handpieces can enhance ossification and cell differentiation regardless of the type of handpieces.

Osteoblastic differentiation and changes in the redox state in pulp stem cells by laser treatment

The aim of this study was to determine the effect of low-level laser therapy (LLLT) on cell proliferation, mitochondrial membrane potential changes (∆Ψm), reactive oxygen species (ROS), and osteoblast differentiation of human dental pulp stem cells (hDPSCs). These cells were irradiated with 660- and 940-nm lasers for 5 s, 50 s, and 180 s. Cell proliferation was assessed using the resazurin assay, cell differentiation by RUNX2 and BMP2 expression, and the presence of calcification nodules using alizarin-red S staining. ROS was determined by the dichlorofluorescein-diacetate technique and changes in ∆Ψm by the tetramethylrhodamine-ester assay. Data were analyzed by a Student's t-test and Mann-Whitney U test. The 940-nm wavelength for 5 and 50 s increased proliferation at 4 days postirradiation. After 8 days, a significant decrease in proliferation was observed in all groups. Calcification nodules were evident in all groups, with a greater staining intensity in cells treated with a 940-nm laser for 50 s, an effect that correlated with increased RUNX2 and BMP2 expression. ROS production and Δψm increased independently of irradiation time. In conclusion, photobiomodulation (PBM) with LLLT induced morphological changes and reduced cell proliferation rate, which was associated with osteoblastic differentiation and increased ROS and Δψm, independent of wavelength and time.

Anti-cancer targets and molecular mechanisms of formononetin in treating osteosarcoma based on network pharmacology

Osteosarcoma (OS) is a multifactorial bone malignancy that accounts for most cancers in children and adolescents. Formononetin has been proven to exhibit various pharmacological effects including anti-tumor, anti-obesity, anti-inflammation, and neuroprotective effects. Few studies have examined the pharmacological activities of formononetin in OS treatment, but the mechanism has not yet been completely elucidated. Network pharmacology is a new method based on the theory of system biology for analyzing the network of biological systems and selecting specific signal nodes for multi-target drug molecular design. Here, we used network pharmacology to explore the possible mechanism of formononetin in OS treatment. Human OS cell line MG63 was processed with four concentrations (0, 2, 5, 8 μg/mL) of formononetin. Subsequently, an MTT assay was performed to test cell proliferation and a scratch test was used to evaluate the migration ability of cancer cells. Caspase-3, p53, p21, and bcl-2 expression levels incubated with different concentrations of formononetin in MG63 cells were determined using Western blotting. After treated with formononetin for 48 h, MG63 cells exhibited marked apoptosis. The results revealed that certain concentrations of formononetin significantly exerted inhibitory effects on MG63 cell proliferation. Furthermore, formononetin decreased the bcl-2 level in MG63 cells but increased caspase-3, p21, and p53 levels in a concentration-dependent manner. Additionally, formononetin suppressed the expression of SATB2. Therefore, formononetin could dose-dependently inhibit MG63 cell proliferation and induce apparent cell apoptosis, providing a candidate treatment for OS, whereas SATB2 could be a potential prognostic biomarker for screening OS and therapeutic target of formononetin.

Effects of different physical factors on osteogenic differentiation

Osteoblasts are essential for bone formation and can perceive external mechanical stimuli, which are translated into biochemical responses that ultimately alter cell phenotypes and respond to environmental stimuli, described as mechanical transduction. These cells actively participate in osteogenesis and the formation and mineralisation of the extracellular bone matrix. This review summarises the basic physiological and biological mechanisms of five different physical stimuli, i.e. light, electricity, magnetism, force and sound, to induce osteogenesis; further, it summarises the effects of changing culture conditions on the morphology, structure and function of osteoblasts. These findings may provide a theoretical basis for further studies on bone physiology and pathology at the cytological level and will be useful in the clinical application of bone formation and bone regeneration technology.

Effects of Laser Application on Alveolar Bone Mesenchymal Stem Cells and Osteoblasts: An In Vitro Study

Mesenchymal stem cells isolated from the bone marrow have a great differentiation potential, being able to produce many cell lines, including osteoblasts. Osteoblasts have an important role in bone remodeling by actively participating in the maturation and mineralization of the extracellular matrix. The aim of this study was to determine the effect of laser application on the viability and proliferation of osteoblasts. Methods: Alveolar bone was harvested from 8 patients and placed into a culture medium to induce proliferation of mesenchymal stem cells. These were differentiated into osteoblasts in special conditions. The cells from each patient were split into two groups, one was treated using a 980 nm laser (1W output power, pulsed mode, 20 s, 50 mm distance) (laser “+”) and the other one did not receive laser stimulation (laser “-”). Results: Using the confocal microscope, we determined that the cells from the laser “+” group were more active when compared to the laser “-” group. The number of cells in the laser “+” group was significantly greater compared to the laser “-” group as the ImageJ-NIH software showed (p = 0.0072). Conclusions: Laser application increases the proliferation rate of osteoblasts and intensifies their cellular activity.

Response of osteoblastic cells to low-level laser treatment: a systematic review

Low-level laser therapy (LLLT)-induced photobiomodulation (PBM) stimulates bone tissue regeneration by inducing osteoblast differentiation and mitochondrial activation. However, the role of reactive oxygen species (ROS) in this process remains controversial. The aim of this systematic review was to collect and analyze the available literature on the cellular and molecular effects of LLLT on osteoblasts and the role of ROS in this process. A search was conducted in PubMed, ScienceDirect, Scopus, and Web of Science. Studies published in English over the past 15 years were selected. Fourteen articles were included with moderate (n = 9) and low risk of bias (n = 5). Thirteen studies reported the use of diode lasers with wavelengths (λ) between 635 and 980 nm. One study used an Nd:YAG laser (λ1064 nm). The most commonly used λ values were 808 and 635 nm. The energy densities ranged from 0.378 to 78.75 J/cm², and irradiation times from 1.5 to 300 s. Most studies found increases in proliferation, ATP synthesis, mitochondrial activity, and osteoblastic differentiation related to moderate and dose-dependent increases in intracellular ROS levels. Only two studies reported no significant changes. The data presented heterogeneity owing to the variety of LLLT protocols. Although several studies have shown a positive role of ROS in the induction of proliferation, migration, and differentiation of different cell types, further research is required to determine the specific role of ROS in the osteoblastic cell response and the molecular mechanisms involved in triggering previously reported cellular events.

Bumpy structured nanofibrous membrane as a highly efficient air filter with antibacterial and antiviral property

Recently, the pandemic infectious diseases caused by coronavirus have prompted the development of air filter membranes to against infectious agents and protect human health. This research focuses on air filter membrane with antibacterial and antiviral property for high-efficiency particulate matter (PM) removal. Herein, polyamide-6 electrospun nanofibers were anchored with silver nanoparticles through hydrogen-bond. Bumpy nanorough surface and multilevel structure contribute to improve capture capacity, and silver nanoparticles provide a strong ability to inactivate bacteria and virus. In conclusion, this membrane exhibits high PM_2.5 filtration efficiency of 99.99% and low pressure drop of 31 Pa; simultaneous removal of multiple aerosol pollutants, e.g., SO_x, NO_x, methylbenzene, L-Nicotine; superior antibacterial performance against Escherichia coli (Gram negative bacteria) and Staphylococcus aureus (Gram positive bacteria), antiviral property against Porcine Deltacoronavirus and not significant cytotoxicity. Research of air filtration material is important to remove air pollutants and to prevent infection and spread of respiratory infectious diseases.

Photobiomodulation using LLLT and LED of cells involved in osseointegration and peri-implant soft tissue healing

This study evaluated the influence of photobiomodulation (PBM) using low-level laser therapy (PBM/LLLT) or light-emitting diode (PBM/LED) therapy on peri-implant tissue healing. A laboratory model was used to assess the adhesion and metabolism of osteoblasts (SaOs-2), human gingival fibroblasts (HGF), and normal oral keratinocytes (NOK) seeded on a titanium (Ti) surface. After seeding the cells on disks of Ti placed in wells of 24-well plates, three irradiations were performed every 24 h at energy density of 3 J/cm². For PBM/LLLT, a LaserTABLE device was used with a wavelength of 780 nm and 25 mW, while for PBM/LED irradiation, a LEDTABLE device was used at 810 nm, 20 mW, at a density of 3 J/cm². After irradiations, the number of cells (NC) attached and spread on the Ti surface, cell viability (CV), total protein (TP), and collagen (Col) synthesis were assessed. Alkaline phosphate activity (ALP) was evaluated only for SaOs-2. Data were submitted to ANOVA complemented by Turkey statistical tests at a 5% significance level. PBM significantly increased adherence of NOK to the Ti surface, while no significant effect was observed for SaOs-2 and HGF. PBM positively affected CV, as well as Col and TP synthesis, in distinct patterns according to the cell line. Increased ALP activity was observed only in those cells exposed to PBM/LLLT. Considering cell specificity, this investigation reports that photobiomodulation with low-power laser and LED at determined parameters enhances cellular functions related to peri-implant tissue healing in a laboratory model.

Photobiomodulation: An Effective Approach to Enhance Proliferation and Differentiation of Adipose-Derived Stem Cells into Osteoblasts

Osteoporosis is regarded as the most common chronic metabolic bone condition in humans. In osteoporosis, bone mesenchymal stem cells (MSCs) have reduced cellular function. Regenerative medicine using adipose-derived stem cell (ADSC) transplantation can promote the growth and strength of new bones, improve bone stability, and reduce the risk of fractures. Various methods have been attempted to differentiate ADSCs to functioning specialized cells for prospective clinical application. However, commonly used therapies have resulted in damage to the donor site and morbidity, immune reactions, carcinogenic generation, and postoperative difficulties. Photobiomodulation (PBM) improves ADSC differentiation and proliferation along with reducing clinical difficulties such as treatment failures to common drug therapies and late initiation of treatment. PBM is a noninvasive, nonthermal treatment that encourages cells to produce more energy and to undergo self-repair by using visible green and red and invisible near-infrared (NIR) radiation. The use of PBM for ADSC proliferation and differentiation has been widely studied with multiple outcomes observed due to laser fluence and wavelength dependence. In this article, the potential for differentiating ADSCs into osteoblasts and the various methods used, including biological induction, chemical induction, and PBM, will be addressed. Likewise, the optimal laser parameters that could improve the proliferation and differentiation of ADSC, translating into clinical success, will be commented on.

The Signalling Effects of Photobiomodulation on Osteoblast Proliferation, Maturation and Differentiation: A Review

Proliferation of osteoblasts is essential for maturation and mineralization of bone matrix. Ossification, the natural phase of bone-forming and hardening is a carefully regulated phase where deregulation of this process may result in insufficient or excessive bone mineralization or ectopic calcification. Osteoblasts can also be differentiated into osteocytes, populating short interconnecting passages within the bone matrix. Over the past few decades, we have seen a significant improvement in awareness and techniques using photobiomodulation (PBM) to stimulate cell function. One of the applications of PBM is the promotion of osteoblast proliferation and maturation. PBM research results on osteoblasts showed increased mitochondrial ATP production, increased osteoblast activity and proliferation, increased and pro-osteoblast expression in the presence of red and NIR radiation. Osteocyte differentiation was also accomplished using blue and green light, showing that different light parameters have various signalling effects. The current review addresses osteoblast function and control, a new understanding of PBM on osteoblasts and its therapeutic impact using various parameters to optimize osteoblast function that may be clinically important. Graphical Abstract.

Photobiomodulation with a 645 nm Diode Laser of Saos-2 Cells and Platelet-Rich Plasma: The Potential for a New Mechanism of Action

Objective: The main focus of this in vitro study was to highlight possible differences between outcomes of photobiomodulation performed in the presence or absence of growth factors derived from platelet-rich plasma. Background: Photobiomodulation has garnered increasing attention, thanks to a large number of controlled clinical trials that have proven its efficacy in various oral pathologies. Nevertheless, the mechanism of action is still a matter of debate. Materials and methods: The cell model used was Saos-2ATTC HTB-85, a human osteosarcoma cell line that retains an osteogenic potential matching that of osteoblastic cells. Photobiomodulation was performed with a 645 nm diode laser; we investigated three different fluence values (2, 5, and 10 J/cm²) delivered with 3 different irradiation times (1, 2, and 4 min). The design of the study included a case-control structure. Cell viability was assessed by resazurin reduction assay before laser irradiation. We assessed cell differentiation by Alizarin-red Sigma Aldrich assay 48 h after the last laser irradiation. Results: Results show that the combination of photobiomodulation and platelet-rich plasma can lead to a statistically significant increase in both proliferation and differentiation rates. Conclusions: Only a defined amount of energy, that is, a fluence of 5 J/cm² delivered in 2 min and of 10 J/cm² in 4 min, was proven to be the most effective in the presence of platelet-rich plasma to induce cell proliferation and calcium deposition.

Efficacy of Flat-Top Hand-Piece Using 980 nm Diode Laser Photobiomodulation on Socket Healing after Extraction: Split-Mouth Experimental Model in Dogs

The objective was to evaluate the effect of photobiomodulation (PBM) using 980 nm diode laser therapy (0.60 W, 0.77 W cm^-2 , 36 J, 46 J cm^-2 , 60 s) irradiated in continuous wave mode by flat-top hand-piece on socket healing in the maxilla and mandible. A split-mouth experimental design was performed on 6 dogs. The 3^rd premolar tooth was extracted from the maxilla and mandibles for both sides. The right-sided sockets were irradiated (PBM group), and the left-sided sockets were kept as control. Irradiation was done after extraction and at 48-h interval for 14 days. Both the buccal and lingual sides were irradiated to reach a total irradiation time of 120 s. Bone density was evaluated at 3, 4 and 5 weeks using cone beam computed tomography. We showed that maxillary sockets in the PBM group had higher bone density compared to control one at 3, 4, 5 weeks (P = 0.029, <0.001, <0.001), respectively. Mandibular sockets revealed no significant difference between PBM and control at 3 weeks (P = 0.347), while at 4 and 5 weeks PBM group showed higher bone density (P = 0.004, <0.001). In both groups, there was a significant increase (P < 0.001) in bone density by time which was higher in the PBM group. We concluded that PBM using a flat-top hand-piece of 980-nm improved the bone density of extraction sockets.

Interaction between Laser Light and Osteoblasts: Photobiomodulation as a Trend in the Management of Socket Bone Preservation-A Review

Simple Summary

Dental implants are becoming an accepted tool, and thousands of implants are placed every year by specialists and general practitioners. However, more than 10% of bone surgeries and related procedures can show healing complications as a consequence of infections, tissue damage, or inadequate blood supply. In particular, a deficient blood supply impacts on the optimal healing process because of altered oxygen delivery to cells in the wound and a decrease in their energy supply. Researchers showed how red and infrared light affects key cellular pathways by interacting with specific photoacceptors located within the cell, particularly in mitochondria. Low-level laser therapy or photobiomodulation (PBM), as the recent medical subject heading defines it, is based on a light–cell interaction, which modifies cell metabolism by increasing oxygen consumption and ATP production through mitochondria. Although not all aspects of this interconnection are completely described, many in vitro and in vivo studies showed the benefit of PBM in wound defect management. For instance, treatment of bone with PBM results in a greater amount of new-formed osteoblasts and matrix, an increase in collagen synthesis, and microvascular reestablishment. In our review, we highlight the osteoblast–light interaction, and the in vivo therapeutic tool of PBM for socket preservation is discussed.

Abstract

Bone defects are the main reason for aesthetic and functional disability, which negatively affect patient’s quality of life. Particularly, after tooth extraction, the bone of the alveolar process resorbs, limiting the optimal prosthetic implant placement. One of the major pathophysiological events in slowly- or non-healing tissues is a blood supply deficiency, followed by a significant decrease in cellular energy amount. The literature shows that photons at the red and infrared wavelengths can interact with specific photoacceptors located within the cell. Through this mechanism, photobiomodulation (PBM) can modify cellular metabolism, by increasing mitochondrial ATP production. Here, we present a review of the literature on the effect of PBM on bone healing, for the management of socket preservation. A search strategy was developed in line with the PRISMA statement. The PubMed and Scholar electronic databases were consulted to search for in vivo studies, with restrictions on the year (<50 years-old), language (English), bone socket preservation, and PBM. Following the search strategy, we identified 269 records, which became 14, after duplicates were removed and titles, abstract and inclusion-, exclusion-criteria were screened. Additional articles identified were 3. Therefore, 17 articles were included in the synthesis. We highlight the osteoblast–light interaction, and the in vivo therapeutic tool of PBM is discussed.

Laser therapy increases the proliferation of preosteoblastic MC3T3-E1 cells cultured on poly(lactic acid) films

This study aimed to verify the efficacy of low-level laser irradiation (LLLI) on the proliferation of MC3T3-E1 preosteoblasts cultured on poly(lactic acid) (PLA) films. The produced films were characterized by contact angle tests, scanning electron microscopy (SEM), atomic force microscopy, differential scanning calorimetry, and X-ray diffraction. The MC3T3-E1 cells were cultured as three different groups: Control-cultured on polystyrene plastic surfaces; PLA-cultured on PLA films; and PLA + Laser-cultured on PLA films and submitted to laser irradiation (660 nm; 30 mW; 4 J/cm² ). Cell proliferation was analyzed by Trypan blue and Alamar blue assays at 24, 48, and 72 h after irradiation. Cell viability was assessed by Live/Dead assay, apoptosis-related events were evaluated by Annexin V/propidium iodide (PI) expression, and cell cycle events were analyzed by flow cytometry. Cell morphology on the surface of films was assessed by SEM. Cell counting and biochemical assay results indicate that the PLA + Laser group exhibited higher proliferation (p < 0.01) when compared with the Control and PLA groups. The Live/Dead and Annexin/PI assays indicate increased cell viability in the PLA + Laser group that also presented a higher percentage of cells in the proliferative cell cycle phases (S and G2/M). These findings were also confirmed by the higher cell density observed in the irradiated group through SEM images. The evidence from this study supports the idea that LLLI increases the proliferation of MC3T3-E1 cells on PLA surfaces, suggesting that it can be potentially applied in bone tissue engineering.

Efficacy of Nonsurgical Mechanical Debridement With and Without Adjunct Low-Level Laser Therapy in the Treatment of Peri-Implantitis: A Randomized Controlled Trial

We hypothesized that in the long term (6-month follow-up), nonsurgical mechanical debridement (NSMD) with adjunct low-level laser therapy (LLLT) is more effective for the treatment of peri-implantitis than NSMD alone. The aim of the present 6-month follow-up convenience-sample cohort study was to assess the efficacy of LLLT as an adjunct to NSMD in the treatment of peri-implantitis. A questionnaire was used to collect demographic information. Patients with peri-implantitis in the test and control groups underwent NSMD with and without adjunct LLLT, respectively. Randomization was done by tossing a coin. In the test group, the laser was applied perpendicular to the periodontal pocket for 20 seconds at a constant distance of 15 mm and with a continuous wavelength (3.41 J/cm2 delivery with a 1.76 cm2 spot and average output of 0.3 W). In both groups, peri-implant probing depth, bleeding upon probing, and crestal bone resorption were assessed at baseline and at the 3-month and 6-month follow-up. Group comparisons were performed, and P < .05 was considered statistically significant. Sixty-seven individuals with peri-implantitis were included. The mean age of participants who underwent NSMD with adjunct LLLT and NSMD alone was 46.5 ± 3.4 and 45.3 ± 1.1 years, respectively. At the 3- and 6-month follow-up, peri-implant (P < .05), bleeding upon probing (P < .05), and probing depth (P < .05) were significantly higher among patients who underwent NSMD alone compared with patients who underwent NSMD with adjunct LLLT. There was no significant difference in crestal bone resorption in all patients up to the 6-month follow-up. In the short term, NSMD with adjunct LLLT was a useful treatment protocol for the treatment of peri-implant soft-tissue inflammation.

Bioactive structural basis of proteoglycans from Sarcandra glabra based on spectrum-effect relationship

ETHNOPHARMACOLOGICAL RELEVANCE

Proteoglycans are one of the active ingredients of great importance in Sarcandra glabra. The biological activities of proteoglycans extracted from Sarcandra glabra including suppressing tumor growth and antioxidant activity were studied. However, raw materials from different regions may cause differences in the activity of natural extracts, especially for bioactive biomacromolecules. Conventional identification of S.glabra cannot accurately reflect the distinguishing relationship between internal components and the pharmacological activity. The identification of biologically active structures was obtained by constructing multiple fingerprint and spectrum-effect relationship.

AIM OF THE STUDY

To evaluate the bioactive structural basis of proteoglycans from S.glabra based on spectrum-effect relationship and chemometric methods.

MATERIALS AND METHODS

Multiple fingerprinting including HPSEC, PMP-HPLC, and FT-IR of proteoglycans was established from 18 batches of samples based on the structural characteristics. Both antitumor activity and antioxidant activity were determined. Mathematical analysis was used to analyze the spectrum-effect relationship.

RESULTS

PCA results showed monosaccharides including Xly, Rha, and GlcA, carboxyl group in acidic sugars, peptide bond in proteins, and methylene groups could be used as markers for distinguishing the samples from different sources. The results of the spectrum-effect relationship analysis indicated that the bioactive markers of inhibitory activity on MG63 and U2OS cells by PLS-DA were related to GlcA, Xyl, Fuc, β-glycosidic bonds, peptide linkage, and methylene groups. Markers composing monosaccharide for antioxidant activity were Xyl, GlcA, and GlcN. Meanwhile, the group markers were pyranose ring, carboxyl group, peptide linkage, and methylene structure.

CONCLUSIONS

The material basis that affects the pharmacological efficacy could be found according to the spectrum-effect relationship analysis. This study could lay a foundation for further exploring the relationship between structural characteristics and pharmacodynamics of macromolecular glycoconjugates in Traditional Chinese Medicine.

Laser and LED photobiomodulation effects in osteogenic or regular medium on rat calvaria osteoblasts obtained by newly forming bone technique

The purposes of this study are to evaluate the effects of photobiomodulation (PBM) with laser and LED on rat calvaria osteoblasts (rGO lineage), cultured in osteogenic (OST) or regular (REG) medium, after induction of a quiescent state and to test if PBM is capable of osteogenic induction and if there is a sum of effects when combining OST medium with PBM. Before irradiation, the cells were put in a quiescent state (1% FBS) 24 h, when red (AlGaInP-660 nm) and infrared laser (GaAlAs-808 nm) and LED (637 ± 15 nm) were applied. The groups were as follows: red laser (RL3-5 J/cm², 3 s and RL5-8.3 J/cm², 5 s, 1.66 W/cm²); infrared laser (IrL3-5 J/cm², 3 s and IrL5-8.3 J/cm², 5 s); LED (LED3-3 s and LED5-5 s, 0.02 J/cm², 0.885 W/cm²); positive (C+, 10% FBS) and negative control (C-, 1% FBS). For alkaline phosphatase (ALP) and mineralization assays, the cells were cultured in REG (DMEM 10% FBS) and OST medium (DMEM 10% FBS, 50 μg/mL ascorbic acid, 10 mM β-glycerophosphate). Statistical analysis was performed using ANOVA and Tukey's tests (p < 0.05). RL5 and LED5 increased proliferation, in vitro wound closure, ALP, and mineralization in rGO cells (p < 0.05). PBM with red laser and LED induced mineralization by itself, without osteogenic medium, not observed for infrared laser (p < 0.05). A sum of effects was observed in osteogenic medium and PBM by infrared, red laser, and LED (5 s). Red laser and LED increased proliferation, migration, and secretory phases in rGO cells in a dose-dependent manner. PBM with red laser and LED promotes osteogenic induction by itself. PBM with infrared laser and osteogenic medium potentializes mineralization.

Evidence from systematic reviews on photobiomodulation of human bone and stromal cells: Where do we stand?

This study summarizes the available evidence from systematic reviews on the in vitro effects of photobiomodulation on the proliferation and differentiation of human bone and stromal cells by appraising their methodological quality. Improvements for future studies are also highlighted, with particular emphasis on in vitro protocols and cell-related characteristics. Six reviews using explicit eligibility criteria and methods selected in order to minimize bias were included. There was no compelling evidence on the cellular mechanisms of action or treatment parameters of photobiomodulation; compliance with quality assessment was poor. A rigorous description of laser parameters (wavelength, power, beam spot size, power density, energy density, repetition rate, pulse duration or duty cycle, exposure duration, frequency of treatments, and total radiant energy), exposure conditions (methods to ensure a uniform irradiation and to avoid cross-irradiation, laser-cell culture surface distance, lid presence during irradiation) and cell-related characteristics (cell type or line, isolation and culture conditions, donor-related factors where applicable, tissue source, cell phenotype, cell density, number of cell passages in culture) should be included among eligibility criteria for study inclusion. These methodological improvements will maximize the contribution of in vitro studies on the effects of photobiomodulation on human bone and stromal cells to evidence-based translational research.

Photobiomodulation of human osteoblast-like cells in vitro by low-intensity-pulsed LED light

Visible light irradiation is an emerging area in regenerative medicine research. We hypothesized that low‐intensity‐pulsed LED light irradiance may exert photobiomodulatory effects on cultured osteoblast‐like cells. To test this hypothesis, we investigated cell proliferation and markers of cell maturation and metabolic activity following pulsed LED irradiance. Monolayer explant cultures of human osteoblast‐like cells were exposed four times in 24‐h intervals to 2 min of pulsed white LED irradiance of 2.4–2.5 mW·cm⁻² and its different spectra of 0.2–0.5 mW·cm⁻² (frequency range of 10–40 Hz). Cell proliferation was estimated from microscopic cell counting and cell death by lactate dehydrogenase activity in culture media (measured by a colorimetric method). The early markers of osteoblast maturation and metabolic activity, that is, cellular alkaline phosphatase activity and osteocalcin content, were measured using a colorimetric method and ELISA, respectively. Irradiance of 40 Hz caused the highest increase in cell number (P < 0.01). Osteocalcin content in cells decreased following 40 Hz and 10 Hz irradiance (P < 0.05). The 40 Hz blue range irradiance (diffuse transmittance 420–580 nm, maximal cell irradiance 0.5 mW·cm⁻²) caused a decrease in alkaline phosphatase cellular activity (P < 0.001) and an increase in media osteocalcin content (P < 0.05). The 40 Hz green range (diffuse transmittance 560–650 nm, maximal cell irradiance 0.4 mW·cm⁻²) irradiance caused an increase in the number of cells and in cell death. In summary, pulsed (40 Hz) white light irradiance has photomodulatory effects, with its green range spectrum affecting cell proliferation and cell death, and its blue range spectrum affecting cellular maturation and metabolism. The results indicate a low‐intensity threshold of photobiomodulation of osteoblast‐like cells in vitro.

Effects of photobiomodulation in the treatment of fractures: a systematic review and meta-analysis of randomized clinical trials

Several therapeutic strategies have been proposed to optimize the conventional treatment of fractures. Photobiomodulation (PBM) appears to help reduce pain and control inflammation, and it also accelerates bone repair. This systematic review aimed to evaluate the effectiveness and safety of PBM with low-level laser therapy (LLLT) in the bone fracture healing process. We included randomized controlled trials (RCTs) comparing the effects of PBM with those of any other intervention in adults with lower or upper limb bone fractures. The primary outcomes investigated were pain reduction, radiographic healing, and adverse events. The searches were conducted in October 2018. Two RCTs were included that compared PBM to the placebo. A meta-analysis showed significant difference in favor of PBM for pain reduction (MD 1.19, 95% CI [0.61 to 1.77], 106 participants, two RCTs), but this difference was not clinically significant. One RCT (50 participants) showed a clinical and statistical improvement in physical function (MD - 14.60, 95% CI [- 21.39 to - 7.81]) and no difference in radiographic healing, regarding absence of fracture line (RR 1.00, 95% CI [0.93 to 1.08]) and visible bone callus (RR 0.33, 95% CI [0.01 to 7.81]). The certainty of evidence was classified as low to very low. Based on the evidence of low to very low certainty, PBM seems to be associated with the improvement of pain and function. Therefore, new RCTs are required that meet the recommendations of CONSORT to prove the effectiveness and safety of this intervention and support its recommendation in clinical practice.

Photobiomodulation effects on osteogenic differentiation of adipose-derived stem cells

Increasing interest has been observed in the use of photobiomodulation (PBM) to enhance the proliferation of stem cells and induce their differentiation. The effects of PBM at two different wavelengths (635 and 809 nm) with three different energy densities (0.5, 1 and 2 J/cm²) on the osteogenic differentiation of adipose-derived stem cells (ADSC) were investigated. Cell viability and proliferation were evaluated by MTT and Alamar Blue assays. Osteoblast differentiation were assessed by alkaline phosphatase (ALP) activity, Alizarin red staining and reverse-transcription polymerase chain reaction (RT-PCR) for the expression of collagen type I (COL1A), ALP and osteocalcin. 635 nm and 809 nm laser irradiation had no effect on the cell viability on days 7 and 14, except for 0.5 J/cm² group at 14th day after 635 nm irradiation (p < 0.05). Cell proliferation was not changed significantly. Mineralization was increased significantly in 809 nm laser groups but no enhancement was detected in the osteogenic differentiation by ALP activity and gene expression results. In 0.5 and 1 J/cm² groups, ALP and COL1A expressions were down regulated at day 7 after 809 nm laser exposure. These results suggest that PBM may alter osteogenic differentiation of ADSC and increase mineralization but further investigation is needed to define adequate parameters.

The Effects of Photobiomodulation on MC3T3-E1 Cells via 630 nm and 810 nm Light-Emitting Diode

BACKGROUND Photobiomodulation (PBM) has been explored as a promising therapeutic strategy to regulate bone cell growth; however, the effects of PBM on osteoblast cell lines remains poorly understood. In addition, as a light source of PBM, the light uniformity of light-emitting diode (LED) devices has not been given enough attention. MATERIAL AND METHODS Here, we sought to investigate the effects of PBM on MC3T3-E1 cells via 630 nm and 810 nm light from a newly designed LED with high uniformity of light. Cell proliferation, flow cytometric analysis, alkaline phosphatase (ALP) staining, ALP activity, Alizarin Red S staining, and quantitative real-time polymerase chain reaction (qRT-PCR) were carried out to assess treatment response. MC3T3-E1 cells were irradiated with LED devices (630±5 nm and 810±10 nm, continuous wave) for 200 seconds at a power density of 5 mW/cm² once daily. RESULTS Increases in cell proliferation and decreases in cell apoptosis were evident following irradiation. ALP staining intensity and activity were also significantly increased following irradiation. Level of mineralization was obviously enhanced in irradiated groups compared with non-irradiated controls. qRT-PCR also showed significant increases in mRNA expression of osteocalcin (OCN) and osteoprotegerin (OPG) in the irradiated groups. CONCLUSIONS Our results showed that LED PBM could promote the proliferation, ALP staining intensity and activity, level of mineralization, gene expression of OCN and OPG of MC3T3-E1 cells, with no significant difference between the 630 nm- and 810 nm-irradiated groups.

A Comparative Study Between the Effectiveness of 980 nm Photobiomodulation Delivered by Hand-Piece With Gaussian vs. Flat-Top Profiles on Osteoblasts Maturation

Photobiomodulation (PBM) is a clinically accepted tool in regenerative medicine and dentistry to improve tissue healing and repair and to restore the functional disability. The current in vitro study aimed to investigate the photobiomodulatory effects of 980 nm wavelength (the real energy at the target: ~0.9 W, ~0.9 W/cm2, 60 s, ~55 J/cm2 and a single energy ~55 J in CW) on MC3T3-E1 pre-osteoblast, delivered with flattop profile in comparison to the standard profile. The laser groupings and their associated energies were: Group 1 - once per week (total energy 110 J); Group 2 - three times per week (alternate day) (total energy 330 J); Group 3 - five times per week (total energy 550 J). The metabolic activity and the osteoblasts maturation were analyzed by alkaline phosphatase assay, alizarin red S histological staining, immunoblot and/or double immunolabeling analysis for Bcl2, Bax, Runx-2, Osx, Dlx5, osteocalcin, and collagen Type 1. Our data, for the first time, prove that laser irradiation of 980 nm wavelength with flat-top beam profile delivery system, compared to standard-Gaussian profile, has improved photobiomodulatory efficacy on pre-osteoblastic cells differentiation. Mechanistically, the irradiation enhances the pre-osteoblast differentiation through activation of Wnt signaling and activation of Smads 2/3-βcatenin pathway.

Red (635 nm), Near-Infrared (808 nm) and Violet-Blue (405 nm) Photobiomodulation Potentiality on Human Osteoblasts and Mesenchymal Stromal Cells: A Morphological and Molecular In Vitro Study

Photobiomodulation (PBM) has been used for bone regenerative purposes in different fields of medicine and dentistry, but contradictory results demand a skeptical look for its potential benefits. This in vitro study compared PBM potentiality by red (635 ± 5 nm) or near-infrared (NIR, 808 ± 10 nm) diode lasers and violet-blue (405 ± 5 nm) light-emitting diode operating in a continuous wave with a 0.4 J/cm² energy density, on human osteoblast and mesenchymal stromal cell (hMSC) viability, proliferation, adhesion and osteogenic differentiation. PBM treatments did not alter viability (PI/Syto16 and MTS assays). Confocal immunofluorescence and RT-PCR analyses indicated that red PBM (i) on both cell types increased vinculin-rich clusters, osteogenic markers expression (Runx-2, alkaline phosphatase, osteopontin) and mineralized bone-like nodule structure deposition and (ii) on hMSCs induced stress fiber formation and upregulated the expression of proliferation marker Ki67. Interestingly, osteoblast responses to red light were mediated by Akt signaling activation, which seems to positively modulate reactive oxygen species levels. Violet-blue light-irradiated cells behaved essentially as untreated ones and NIR irradiated ones displayed modifications of cytoskeleton assembly, Runx-2 expression and mineralization pattern. Although within the limitations of an in vitro experimentation, this study may suggest PBM with 635 nm laser as potential effective option for promoting/improving bone regeneration.