Cell death and proliferation in Nd-YAG laser, electrocautery, and scalpel wounds on mice skin

Effects of an Ultra-Polished Scalpel on Incisional Wounds in a Diabetic Model

Inflammation after surgical incisions is related to the degree of tissue damage. Healing with low inflammation is desirable, especially in patients with compromised healing potential. This experimental study was conducted to assess the degree of inflammatory reaction and scar formation from incisions made by an ultra-polished scalpel (UPS). Two paravertebral incisions were made with a conventional scalpel (CS) and a UPS in 18 individual rats with diabetes. The fibrotic tissue (scar) area and expression levels of collagen, transforming growth factor, and matrix metalloproteinases were quantified on postoperative days 3, 7, and 30. The scar widths and areas were significantly lower in the UPS group than in the CS group. The scar widths were 64.3 ± 14.7 µm and 86.8 ± 12.1 µm in the UPS and CS groups, respectively ( P = 0.03). The scar areas were 11,398 ± 1595 µm 2 in the UPS group and 17,433 ± 3487 µm 2 in the CS group ( P = 0.014). The UPS group had less inflammation on day 3, less transforming growth factor synthesis on days 3 and 7, lower levels of matrix metalloproteinases, and less collagen synthesis on day 7 than did the CS group. The UPS achieved less local inflammation by reducing the local tissue damage in diabetic rat models, enabling better healing, and resulting in less scar formation. The UPS warrants further clinical study as it may bring beneficial outcomes for patients with impaired healing capability and patients who seek to reduce scarring.

The Impact of Proteomic Investigations on the Development and Improvement of Skin Laser Therapy: A Review Article

Introduction: Different molecular approaches have contributed to finding various responses of skin to external and internal tensions such as laser irradiation and many important mediators of skin disease have been identified through these approaches. However, different essential signals of skin biomarker pathways and proteins are partially detected or completely unknown. In the present study, the impact of proteomics on the evaluation of laser therapy for the treatment of skin diseases is investigated. Methods: The keywords of "Proteomics", "Laser therapy", "Skin", and "Skin disease" were searched in Google Scholar, Scopus and PubMed search engines. After screening, 53 documents were included in the study. Results: The global assessments revealed that different proteins in different signaling pathways of skin metabolism in terms of health or illness after laser therapy are expressed differentially. The results indicated that the application of proteomics is a useful method for promoting the results of laser interventions. Conclusion: This kind of research dealt with the practical proteomics of skin diseases and skin laser therapy.

Photobiomodulation (Laser and LED) on Sternotomy Healing in Hyperglycemic and Normoglycemic Patients Who Underwent Coronary Bypass Surgery with Internal Mammary Artery Grafts: A Randomized, Double-Blind Study with Follow-Up

BACKGROUND AND OBJECTIVE

This study aimed at analyzing the healing effects of low-level laser therapy (LLLT) (λ620 nm, 6 J/cm²) and light-emitting diode (LED) therapy (λ640 nm, 6 J/cm²) on the longitudinal sternotomy incisions of hyperglycemic and normoglycemic patients who underwent coronary artery bypass grafting (CABG).

MATERIALS AND METHODS

120 volunteers were electively submitted to CABG and were randomly allocated into four different groups of equal size (n = 30): control, placebo, laser (λ of 640 nm and spatial average energy fluency [SAEF] of 1.06 J/cm²), and LED (λ of 660 ± 20 nm and SAEF of 0.24 J/cm²). Laser and LED groups were irradiated from the second to eighth day postsurgery, and sternotomy incision was photographically registered. Then, participants were also separated into hyperglycemic and normoglycemic groups, according to their fasting blood glucose test before surgery. Three researchers blindly analyzed the incision photographs to determine hyperemia and wound closure at the first day of hospital discharge (eighth postoperative day).

RESULTS

LLLT and LED groups had similarly less hyperemia and less incision bleeding or dehiscence (p ≤ 0.005) and the outcomes were also analogous between hyperglycemic and normoglycemic patients, which indicates no difference observed in an intragroup analysis (p ≥ 0.05).

CONCLUSIONS

With the present therapy parameters, it may be assumed that both coherent light (laser) and non-coherent light (LED) are effective in promoting sternotomy and healing acceleration, which are evident on the eighth day postsurgery.

Comparative study of the effects of laser photobiomodulation and extract of Brassica oleracea on skin wounds in wistar rats: A histomorphometric study

The objective of this study was to investigate the effect of a photobiomodulation laser and Brassica oleracea on tissue morphology in skin wounds. The parameters analyzed were type I and III collagen fibers, and thickness and surface density of the epithelial tissue, as well as how quickly the wound closed. Five skin wounds 12mm in diameter were made on the backs of the animals, which were randomized into four groups (8 animals each). Saline Group: 0.9% saline solution; Ointment Group (extract of Cabbage, B. oleracea, 10% lanolin); Balsam Group (10% glycolic extract of B. oleracea emulsion oil); L60 Group (laser GaAsAl 60J/cm(2)). The applications were made daily during a 20-day treatment, and every 4 days tissue from different wounds was removed. The reduction in the size of the wounds on the 4th, 8th, 12th and 16th days was significantly greater in the treated groups compared to the control group. At all the time points analyzed, there was a greater proportion of collagen in the Balsam and L60 groups (p<0.05). There was also a greater proliferation of epithelial cells in the L60 and Balsam groups after 20 days of treatment (p<0.05). The healing extract and laser 60j/cm(2) exerted a great effect on collagen proliferation in stimulating scar tissue maturation.

Systematic evaluations of skin damage irradiated by an erbium:YAG laser: histopathologic analysis, proteomic profiles, and cellular response

BACKGROUND

The erbium:yttrium-aluminum-garnet (Er:YAG) laser is used for surgical resurfacing. It has ablative properties with water as its main chromophore.

OBJECTIVE

This study attempted to establish the cutaneous effect and cellular response to Er:YAG laser irradiation using different fluences (7.5 and 15 J/cm(2)).

METHODS

Female nude mouse was used as the animal model in the study. Physiological parameters were examined and histology was evaluated at 4, 24 and 96 h after laser exposure. A proteomic analysis and immunoblotting were also used to determine the mechanisms of the laser's effect on the skin.

RESULTS

Both fluences were associated with a significant increase in transepidermal water loss (TEWL), erythema (a*), and the skin pH at 4 and 24h. In contrast, at 96 h, the levels of these parameters had generally decreased to the baseline. The histology examined by light microscopy and transmission electron microscopy (TEM) showed vacuolization, hydropic degeneration and epidermal necrosis of laser-irradiated skin. The higher fluence (15 J/cm(2)) exhibited more-severe disruption of the skin. Bulous and scarring were observed in skin treated with the higher fluence during the recovery period. p53 and p21 proteins were significantly activated in skin following exposure to the laser. However, proliferating cell nuclear antigen and cytokeratin expressions were downregulated by the low fluence (7.5 J/cm(2)).

CONCLUSION

Both proliferation and apoptosis occurred when the laser-irradiated the skin.

Expression patterns of proliferating cell nuclear antigen in trichloroacetic acid peeled skin

This study was designed to investigate whether trichloroacetic acid (TCA) peeling induces cellular proliferation in human skin using an immunohistochemical method. A 40% TCA peel resulted in a greater number of proliferating cell nuclear antigen (PCNA)-immunopositive cells in the whole epidermis as compared with 60% TCA or phenol peels. This finding suggests that long-term and frequent TCA peelings of low concentration would require special attention for unexpected cutaneous lesions such as skin tumors.

Keratinocyte growth factor 1 inhibits wound edge epithelial cell apoptosis in vitro

The ability of keratinocyte growth factor 1 to modulate apoptosis in the absence of proliferation was studied in vitro. A HaCaT scrape wound model was developed in which dense monolayers prior to wounding were cultured to quiescence in defined media with hydroxyurea at concentrations that blocked proliferation without loss of cell viability. Scrape wounding was then found to induce apoptosis, originating at the wound edge, but subsequently radiating away over a 24 h period to encompass areas not originally damaged. Keratinocyte growth factor 1 inhibited this radial progression of apoptosis in a concentration-dependent manner up to 20 ng per mL with induced migration present at the wound edge. The extent of this rescue was modulated by the concentration of Ca2+ prior to wounding. In control wound cultures apoptotic bodies were found in cells adjacent to the wound interface but were greatly reduced in keratinocyte-growth-factor-1-treated groups. Keratinocyte growth factor 1 receptor expression was significantly induced within two to three cell widths of the scraped wound edge, at levels far exceeding those found at the leading edge of a nonwounded epithelial sheet. Tumor necrosis factor alpha (1-5 ng per mL) or Escherichia coli lipopolysaccharide (10-50 ng per mL) exacerbated scrape-induced early apoptosis (1-4 h), but was largely ameliorated by coculture with keratinocyte growth factor 1. Keratinocyte growth factor 1 protection was associated with a reduction in both caspase-3 activation and cytokeratin-19 loss. Protected wound edges were also associated with the maintenance of e-cadherin expression and induction of beta1 integrin and actin stress fiber organization. These results suggest that keratinocyte growth factor 1 may play a role in limiting mechanically induced apoptotic processes at the epithelial wound edge in a manner that is distinct from its proliferative function.

Possible involvement of keratinocyte growth factor and its receptor in enhanced epithelial-cell proliferation and acquired recurrence of middle-ear cholesteatoma

Middle-ear cholesteatoma is characterized by enhanced proliferation of epithelial cells and granular tissue formation. However, the molecular mechanism underlying these pathological changes is largely unknown. Keratinocyte growth factor (KGF) is a mesenchymal cell-derived paracrine growth factor that specifically stimulates epithelial cell proliferation. In the present study, we investigated the possible involvement of KGF and its receptor, KGFR, in the pathogenesis of cholesteatoma using in situ hybridization and immunohistochemistry, respectively. We examined 56 cholesteatoma specimens, and 8 normal skin areas as control. KGF and KGFR expression was examined by immunohistochemistry using rabbit anti-human KGF and anti-human KGFR polyclonal antisera raised in our laboratories against synthetic peptides corresponding to parts of human KGF and KGFR, respectively. KGF protein and mRNA were detected exclusively in stromal fibroblasts and infiltrating T lymphocytes in 80% of cholesteatoma cases, whereas KGFR protein and mRNA were localized in the epithelium in 72% of cases. Assessment of the proliferative activity of cholesteatoma using the labeling index for Ki-67 showed a significantly higher Ki-67 labeling index (66%) in KGF+/KGFR+ cases than other cases. There was a significant correlation between KGF+/KGFR+ expression and recurrence. Our results indicate the possible involvement of both KGF and KGFR in enhanced epithelial cell proliferative activity and recurrence of cholesteatoma.