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Rajai Firouzabadi S, Mohammadi I, Aarabi A, Sadraei S. Low-Level Laser Therapy for Allergic Rhinitis: A Systematic Review and Meta-Analysis. Int Arch Allergy Immunol 2024; 185:871-883. [PMID: 38663361 PMCID: PMC11370728 DOI: 10.1159/000538049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 02/22/2024] [Indexed: 09/04/2024] Open
Abstract
INTRODUCTION Allergic rhinitis (AR) is a common allergic disorder that impairs social and physical functioning as well as quality of life. It is characterized by sneezing, rhinorrhea, congestion, and itching which respond suboptimally to drug therapy. Low-level laser therapy (LLLT) has anti-inflammatory and immunosuppressive properties that have shown promise in some studies. We aimed to systematically review LLLT's effectiveness in treating AR and meta-analyze our findings. METHODS A systematic search of PubMed, Scopus, and Web of Science was conducted on November 24, 2023. All studies investigating LLLT on AR were included, and a pre-post meta-analysis of nasal symptoms (rhinorrhea, nasal congestion, nasal itching, and sneezing) in the LLLT-treated arm was conducted. Rhinoconjunctivitis quality of life questionnaire (RQLQ) scores before and after LLLT were also meta-analyzed alongside a pairwise meta-analysis of LLLT with placebo, acupuncture, steroids/antihistamines, and ultraviolet lasers. A random-effects model was used with a conservative pre-post correlation of 0.4 and standardized mean difference (SMD) as the effect size. RESULTS Sixteen studies were included in this review, and we found that nasal symptoms are alleviated post-LLLT in people with AR (SMD: -1.4, 95 CI: [-2.07 to -1.13], p value <0.001). RQLQ scores were also reduced after LLLT (SMD = -0.72, 95 CI: [-0.94 to -0.50], p value <0.001), and very few adverse events were reported. This meta-analysis, however, had significant publication bias and heterogeneity. When compared to a placebo, LLLT did not significantly improve nasal symptoms (SMD: -0.69, p value = 0.167), which might mean the post-LLLT nasal symptom alleviation is due to a placebo effect. Comparisons to other treatment modalities were too few to deduce anything meaningful, although it does appear that LLLT is less effective than UV lasers. CONCLUSION LLLT is most likely effective at alleviating nasal symptomology and has a low likelihood of adverse event incidence, yet more high-quality studies with larger sample sizes are needed to compare LLLT to a placebo to ensure its superiority to the placebo effect, as well as non-inferiority clinical trials to compare it to standard treatments.
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Affiliation(s)
| | - Ida Mohammadi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aryan Aarabi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samin Sadraei
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Treatment Effect of Phototherapy with Low-Level Energy in Patients with Allergic Rhinitis: A Single-Arm Observational Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020226. [PMID: 36837427 PMCID: PMC9958624 DOI: 10.3390/medicina59020226] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023]
Abstract
Allergic rhinitis is one of the most common health challenges and has a chronic and repetitive course that requires symptomatic treatment. We aimed to investigate the effect of phototherapy on allergic rhinitis and how long it takes to demonstrate treatment effect. Twenty-one patients who were diagnosed with allergic rhinitis using the skin prick test were enrolled. Red light (660 nm) and infrared light (940 nm) with a low power energy of 5 mW were used three times a day at intervals of at least 5 h. The Rhinoconjuntivitis Quality of Life Questionnaire (RQLQ) and a visual analog scale (VAS) were used to measure the changes in symptoms. The median RQLQ and VAS scores before treatment were 62 (49-81.5) and 3 (2-5) points, respectively. The RQLQ score improved significantly at two and four weeks after treatment (52 [39-62.5]) and 46.0 [30.5-57.0], respectively). The VAS scores also improved significantly at two and four weeks after treatment. Nasal obstruction and rhinorrhea improved significantly at one week after the procedure. Low-power (5 mW) light irradiation (660 nm red light and 940 nm infrared) was effective in improving the symptoms of allergic rhinitis. In addition, symptom improvement became clear approximately a week after use. Further studies are required to reach a definitive conclusion.
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Kennedy R. Phototherapy as a Treatment for Dermatological Diseases, Cancer, Aesthetic Dermatologic Conditions and Allergenic Rhinitis in Adult and Paediatric Medicine. LIFE (BASEL, SWITZERLAND) 2023; 13:life13010196. [PMID: 36676145 PMCID: PMC9864074 DOI: 10.3390/life13010196] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/27/2022] [Accepted: 12/29/2022] [Indexed: 01/11/2023]
Abstract
The development of light-emitting diodes (LEDs) has led to an increase in the use of lighting regimes within medicine particularly as a treatment for dermatological conditions. New devices have demonstrated significant results for the treatment of medical conditions, including mild-to-moderate acne vulgaris, wound healing, psoriasis, squamous cell carcinoma in situ (Bowen's disease), basal cell carcinoma, actinic keratosis, and cosmetic applications. The three wavelengths of light that have demonstrated several therapeutic applications are blue (415 nm), red (633 nm), and near-infrared (830 nm). This review shows their potential for treating dermatological conditions. Phototherapy has also been shown to be an effective treatment for allergenic rhinitis in children and adults. In a double-anonymized randomized study it was found that there was 70% improvement of clinical symptoms of allergic rhinitis after intranasal illumination by low-energy narrow-band phototherapy at a wavelength of 660 nm three times a day for 14 consecutive days. Improvement of oedema in many patients with an age range of 7-17 were also observed. These light treatments can now be self-administered by sufferers using devices such as the Allergy Reliever phototherapy device. The device emits visible light (mUV/VIS) and infra-red light (660 nm and 940 nm) wavelengths directly on to the skin in the nasal cavity for a 3 min period. Several phototherapy devices emitting a range of wavelengths have recently become available for use and which give good outcomes for some dermatological conditions.
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Affiliation(s)
- Roy Kennedy
- Warwickshire College University Centre, Warwick New Road, Royal Leamington Spa, Warwickshire CV32 5JE, UK
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Koycu A, Bas C, Musabak UH, Erbek SS, Koca HS, Babakurban ST, Bahcecitapar M. Effects of Combined Visible and Infrared Light Rhinophototherapy in Patients With Allergic Rhinitis. Am J Rhinol Allergy 2022; 37:65-73. [PMID: 36266929 DOI: 10.1177/19458924221133898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Intranasal phototherapy offers an alternative treatment method for patients with allergic rhinitis who cannot benefit from intranasal corticosteroids and oral antihistamines. Different wavelengths have been tried with promising results. OBJECTIVE In this present study, we aimed to investigate the effects of visible light-infrared light phototherapy on clinical improvements together with its cytologic effects in patients with allergic rhinitis. METHODS Patients with confirmed allergic rhinitis were given a 4-week course of intranasal phototherapy treatment. Weekly symptom questionnaires were applied to monitor clinical effects. Nasal lavage specimens were obtained before the start and at the completion of the 4-week therapy. Fluorescence-activated cell sorting analyses of CD16+, CD24+, and CD 45+ cells were performed. Statistical analyses are performed of weekly changes in symptoms and cell counts. RESULTS CD45+CD16highCD24+ neutrophil count in nasal lavages decreased significantly whereas CD45+CD16dim/-CD24+ eosinophil counts significantly increased and CD45+ granulocyte counts remained unchanged. Symptom scores including nasal itching, nasal discharge, nasal obstruction, sneezing, eye itching, throat itching, and ear itching all statistically decreased compared to baseline at the end of 4 weeks. CONCLUSION Four-week course of intranasal phototherapy with visible and infrared light leads to clinical improvement in allergic rhinitis patients.
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Affiliation(s)
- Alper Koycu
- Department of Otolaryngology, Head and Neck Surgery, 37505Baskent University, Ankara, Turkey
| | - Ceren Bas
- Department of Otolaryngology, Head and Neck Surgery, 37505Baskent University, Ankara, Turkey
| | - Ugur H Musabak
- Division of Immunology and Allergic Diseases, 37505Baskent University, Ankara, Turkey
| | - Selim Sermed Erbek
- Department of Otolaryngology, Head and Neck Surgery, 37505Baskent University, Ankara, Turkey
| | - Huseyin Samet Koca
- Department of Otolaryngology, Head and Neck Surgery, 255409Yuksek Ihtisas University, Ankara, Turkey
| | | | - Melike Bahcecitapar
- Department of Statistics, Faculty of Science, Hacettepe University, Ankara, Turkey
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Popov TA, Passalacqua G, González-Díaz SN, Plavec D, Braido F, García-Abujeta JL, Dubuske L, Rouadi P, Morais-Almeida M, Bonini S, Cheng L, Ansotegui IJ. Medical devices in allergy practice. World Allergy Organ J 2020; 13:100466. [PMID: 33024482 PMCID: PMC7529824 DOI: 10.1016/j.waojou.2020.100466] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/22/2020] [Accepted: 09/03/2020] [Indexed: 12/12/2022] Open
Abstract
Medical devices provide people with some health benefits in terms of diagnosis, prevention, treatment, and monitoring of disease processes. Different medical specialties use varieties of medical devices more or less specific for them. Allergology is an interdisciplinary field of medical science and teaches that allergic reactions are of systemic nature but can express themselves at the level of different organs across the life cycle of an individual. Subsequently, medical devices used in allergology could be regarded as: 1) general, servicing the integral diagnostic and management principles and features of allergology, and 2) organ specific, which are shared by organ specific disciplines like pulmonology, otorhinolaryngology, dermatology, and others. The present position paper of the World Allergy Organization (WAO) is meant to be the first integral document providing structured information on medical devices in allergology used in daily routine but also needed for sophisticated diagnostic purposes and modern disease management. It is supposed to contribute to the transformation of the health care system into integrated care pathways for interrelated comorbidities.
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Key Words
- AAP, Asthma Action Plan
- ATS, American Thoracic Society
- Airway inflammation
- Allergic rhinitis
- Allergology
- Allergy
- Allergy diagnosis
- Asthma
- CE mark, Conformité Européenne mark
- CO, Carbon monoxide
- DPIs, Dry Powder Inhalers
- EAI/AAI, Epinephrine/Adrenaline Auto-Injector
- EBC, Exhaled Breath Condensate
- EBT, Exhaled Breath Temperature
- EDS, Exhalation Delivery Systems
- EMA, European Medicines Agency
- ERS, European Respiratory Society
- ERV, Expiratory Reserve Volume
- FDA, Food and Drug Administration
- FEF, Forced Expiratory Flows
- FEV1, Forced Expiratory Volume in 1 second
- FOT, Forced Oscillation Technique
- FRC, Functional Residual Capacity
- FVC, Forced Vital Capacity
- FeNO, Fractional Exhaled Nitric Oxide
- GLI, Global Lung Function Initiative
- IOS, Impulse Oscillometry
- IRV, Inspiratory Reserve Volume
- Lung function tests
- MDPS, Metered-Dose Pump Sprays
- Medical devices
- NDDD, Nasal Drug Delivery Device
- NO, Nitric oxide
- PDMI, Pressurized Metered Dose Inhaler
- PEF, Peak Expiratory Flow
- PNIF, Peak Nasal Inspiratory Flow
- PT, Patch Tests
- PhPT, Photopatch tests
- Ppb, part per billion
- RV, Residual Volume
- SPT, Skin Prick Test
- Skin tests
- TLC, Total Lung Capacity
- UV, Ultra Violet
- VC, Vital Capacity
- VT, Tidal Volume
- WAO, World Allergy Organization
- WHO, World Health Organization
- m-health
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Affiliation(s)
| | | | | | | | | | | | - Lawrence Dubuske
- The George Washington University School of Medicine, Washington DC, USA
| | | | | | - Sergio Bonini
- Institute of Translational Pharmacology, Italian National Research Council, Rome, Italy
| | - Lei Cheng
- Nanjing Medical University, First Affiliated Hospital, Nanjing, China
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Moustafa Y, El Nady HG, Saber MM, Dabbous OA, Kamel TB, Abel-Wahhab KG, Sallam SF, Zaki DA. Assessment of Allergic Rhinitis among Children after Low-Level Laser Therapy. Open Access Maced J Med Sci 2019; 7:1968-1973. [PMID: 31406538 PMCID: PMC6684433 DOI: 10.3889/oamjms.2019.477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Allergic rhinitis (AR) represents one of the most common global health problems with seriously increasing incidence over the last decades. The goal of the treatment of rhinitis is to prevent or reduce the symptoms caused by the inflammation of affected tissues. Intranasal steroids and oral antihistamines are recommended as first lines of treatment. Acupuncture had reported a significant improvement in daily symptoms and an increase of symptom-free days in many studies enrolling adults' patients. AIM This study aimed to evaluate the laser acupuncture effect on the treatment of children AR in comparison to the effect of the medication and to assess the anti-inflammatory effect of laser acupuncture through measurement of serum inflammatory marker (hs-CRP). METHODS Sixty patients with allergic rhinitis their age group ranged from 4 to 18 years were divided randomly into two groups. Group 1 enrolled 30 patient that received AR in the form of intranasal steroids, antihistaminic, leukotriene antagonists while group2 thirty patients received 12 laser acupuncture sessions (2 sessions a \ week) on specific traditional Chinese acupuncture points. RESULTS There was a significant improvement in the severity score symptoms in both groups through and by the end of the study. High Significant improvement in the levels of the inflammatory marker in both groups, especially in the group which receive laser acupuncture sessions. CONCLUSION Laser acupuncture is a reliable, painless and non-invasive successful technique, which may be used as a complementary treatment for pediatric allergic rhinitis.
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Affiliation(s)
- Yousry Moustafa
- Department of Medical Applications of Laser, National Institute of Laser Enhanced Sciences (NILES), Cairo University, Cairo, Egypt
| | - Hala G. El Nady
- Child Health Department, National Research Centre, Cairo, Egypt
| | - Maha M. Saber
- Complementary Medicine Department, National Research Centre, Cairo, Egypt
| | - Ola A. Dabbous
- Department of Medical Applications of Laser, National Institute of Laser Enhanced Sciences (NILES), Cairo University, Cairo, Egypt
| | | | | | - Sara F. Sallam
- Child Health Department, National Research Centre, Cairo, Egypt
| | - Dina A. Zaki
- Child Health Department, National Research Centre, Cairo, Egypt
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Cho HK, Jeong YM, Lee HS, Lee YJ, Hwang SH. Efficacy of endonasal phototherapy for relieving the symptoms of allergic rhinitis: Meta-analysis. Am J Rhinol Allergy 2016; 29:283-91. [PMID: 26163248 DOI: 10.2500/ajra.2015.29.4190] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Endonasal phototherapy can relieve the symptoms of allergic rhinitis (AR) for the patient. However, there is no consensus on whether or not endonasal phototherapy is effective in reducing the symptoms of AR. OBJECTIVE The goal of this meta-analysis was to perform a systematic review of the available literature on the effects of endonasal phototherapy on symptoms of AR. METHODS Two authors independently searched medical literature databases from their inception of article collection to July 2014. Studies that scored the nasal symptoms of AR and quality of life related to AR before and after endonasal phototherapy, and that compared the effects of phototherapy (treatment groups) with sham treatment (sham group) or antihistamine administration (antihistamine group) were included in the analysis. The outcomes of interest were total nasal symptom scores, disease-specific quality of life questionnaire assessments, and endoscopic findings (discharge and turbinate hypertrophy). Overall, a total of 13 trials met the inclusion criteria of this study, with a total sample size of 679 patients. RESULTS Phototherapy significantly reduced nasal symptoms compared with pretreatment values and improved quality of life. The endoscopic findings also significantly improved after phototherapy. In addition, the symptom score and disease-specific quality of life after treatment were significantly lower in the treatment group versus the sham group, and were similar to those in the antihistamine group. CONCLUSIONS Phototherapy could provide nasal symptom relief and improve quality of life related to AR. However, when considering the insufficient evaluation of the efficacy of phototherapy according to the treatment methods and the high heterogeneity apparent in some parameters, further clinical trials with robust research methodologies should be conducted to confirm the results of this study.
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Affiliation(s)
- Hye Kyung Cho
- Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea
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Lee DH, Kim NK, Song JM. Reviewing Research on the Application of Intranasal Phototherapy in Allergic Rhinitis. ACTA ACUST UNITED AC 2014. [DOI: 10.6114/jkood.2014.27.1.099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Moustafa Y, Kassab AN, El Sharnoubi J, Yehia H. Comparative study in the management of allergic rhinitis in children using LED phototherapy and laser acupuncture. Int J Pediatr Otorhinolaryngol 2013; 77:658-65. [PMID: 23394792 DOI: 10.1016/j.ijporl.2013.01.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 01/05/2013] [Accepted: 01/09/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective of this study was to compare the outcomes of LED phototherapy and laser acupuncture treatment on allergic rhinitis in children. METHODS 40 patients with perennial allergic rhinitis were divided randomly into two groups. Patient's ages ranged from 7 to 18 years. One group was subjected to LED phototherapy and the other group was managed by laser acupuncture .The patients were followed-up for 1 year. RESULTS There was a significant improvement in the severity score symptoms in both groups through and by the end of the follow up period. CONCLUSION This led to the conclusion that both techniques are equally safe, reliable, non invasive and successful.
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Affiliation(s)
- Yousry Moustafa
- Otorhinolaryngology Unit, Department of Medical Laser Applications, National Institute of Laser Enhanced Sciences, Cairo University, Egypt
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White S, Leong SC. Re: Endonasal phototherapy for the treatment of allergic rhinitis/hay fever. Clin Otolaryngol 2012; 37:163-4. [PMID: 22515718 DOI: 10.1111/j.1749-4486.2012.02456.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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