Laser Photobiomodulation (PBM)-A Possible New Frontier for the Treatment of Oral Cancer: A Review of In Vitro and In Vivo Studies

The Effect of Photobiomodulation on the Conditioned Media of 3T3-L1 Cells in the Treatment of Breast Cancer

Introduction: Breast cancer ranks among the most prevalent malignancies, and its prompt diagnosis significantly amplifies the prospects of successful treatment. Approximately one in seven women will experience a breast cancer diagnosis in their lifetime. Stromal cells and their secreted factors exert various effects on tumor growth, impacting proliferation, invasion, and metastasis. Research has emphasized the significant impact of proteins secreted by adipose tissue on breast cancer proliferation, surpassing the influence of factors released by other cell types. Yet, the specific transcription factors and cofactors involved in adipokine expression in the tumor microenvironment remain enigmatic. Methods: In this study, adipocyte cells were cultured and exposed to 980 nm and 650 nm Photobiomodulation. The MDA-MD-231 cells (triple negative cancer cell line) were cultured with a conditioned medium from laser-treated cells. The real-time assay was employed to analyze the gene expression level changes involved in apoptosis. Results: Results showed that the irradiated conditioned medium at 980 nm and 650 nm caused a reduction in cell viability of cancer cells. Conversely, the conditioned medium from the irradiated cells triggered an increase in the expression of Caspase 3, Caspase 9, and BAX2 genes, alongside a decrease in BCL2 gene expression. Conclusion: The findings highlighted the potential of the laser-treated conditioned medium to induce apoptosis pathways in cancer cells, demonstrating a promising avenue for further research in utilizing low-level laser therapy in breast cancer treatment.

Effects of Photobiomodulation Using Low-Level Laser Therapy on Alveolar Bone Repair

Alveolar bone repair is a complex and extremely important process, so that functions such as the mastication, occlusion and osseointegration of implants can be properly reestablished. Therefore, in order to optimize this process, many procedures have been used, such as grafting with biomaterials and the application of platelet-rich fibrin (PRF). Another method that has been studied is the use of photobiomodulation (PBM) with the use of low-level laser therapy (LLLT), which, through the absorption of photons by the tissue, triggers photochemical mechanisms in the cells so that they start to act in the search for homeostasis of the affected region. Therefore, the objective of this review was to analyze the use of LLLT as a possible auxiliary tool in the alveolar bone repair process. A search was carried out in scientific databases (PubMed/MEDLINE, Web of Science, Scopus and Cochrane) regarding the following descriptors: “low-level laser therapy AND alveolar bone repair” and “photobiomodulation AND alveolar bone repair”. Eighteen studies were selected for detailed analysis, after excluding duplicates and articles that did not meet predetermined inclusion or non-inclusion criteria. According to the studies, it has been seen that LLLT promotes the acceleration of alveolar repair due to the stimulation of ATP production, activation of transcription and growth factors, attenuation of the inflammatory process and induction of angiogenesis. These factors depend on the laser application protocol, and the Gallium Aluminum Arsenide—GaAlAs laser, with a wavelength of 830 nm, was the most used and, when applications of different energy densities were compared, the highest dosages showed themselves to be more efficient. Thus, it was possible to conclude that PBM with LLLT has beneficial effects on the alveolar bone repair process due to its ability to reduce pain, the inflammatory process, induce vascular sprouting and, consequently, accelerate the formation of a new bone matrix, favoring the maintenance or increase in height and/or thickness of the alveolar bone ridge.

Possible adverse effects of low-level laser on oral and oropharyngeal cancer cells: A scope review

BACKGROUND

The effects of laser therapy on normal cells are well known and accepted, but the impact of this therapy on malignant cells are not yet fully understood. This review aims to map and outline what the scientific literature addresses on the effects of laser therapy on malignant cells.

METHODS

This review article followed the guidelines of the PRISMA-ScR protocol, being all the search, analysis, and selection of articles based on it.

RESULTS

After all application of the predetermined criteria, five studies were included, dated between the years 2013 and 2021. With the complete reading of the selected studies, 100% of the articles were classified as category III of the Agency for Healthcare as Research and Quality classification. Similar themes among the papers included were investigated and compared. In these five studies, the visible red and near infrared wavelengths were used, and energy densities varied between 1 and 5 J/cm² . It was observed that low-level laser could alter the expression of cell proliferation and migration proteins, such as cyclin D1, E-cadherin, and β-catenin. In addition, changes related to increased cell viability and metabolism were also identified.

CONCLUSION

The low-level laser seems to positively regulate the proliferative, migratory, and viability capacity of neoplastic cells, depending on the protocol used. All these studies included in the review are equivalent to in vitro studies; the cells are not in such a complex environment as is an organized tissue, making it necessary to carry out more complex tests, such as in vivo research.

The exploration of new biomarkers for oral cancer through the ceRNA network and immune microenvironment analysis

The competitive endogenous RNA (ceRNA) and tumor-penetrating immune cells may be related to the prognosis of oral cancer. However, few studies have focused on the correlation between ceRNAs and immune cells. Thus, we developed a method based on a ceRNA network and tumor-infiltrating immune cells to elucidate the molecular pathways that may predict prognosis in patients with oral cancer. Download RNAseq expression data of oral cancer and control samples from the Cancer Genome Atlas (TCGA), obtain differentially expressed genes and establish a ceRNA network. The cox analysis and lasso regression analysis were used to screen key RNAs to establish a prognostic risk assessment model, and draw a 1.3.5-year forecast nomogram. Then the CIBERSORT algorithm was used to screen important tumor immune infiltrating cells associated with oral cancer. Another prognostic predictive model related to immune cells was established. Finally, co-expression analysis was applied to explore the relationship between key genes in the ceRNA network and important immune cells. Multiple external data sets are used to test the expression of key biomarkers. We constructed prognostic risk models of ceRNA and immune cells, which included 9 differentially expressed mRNAs and 2 types of immune cells. It was discovered from the co-expression analysis that a pair of important biomarkers were associated with the prognosis of oral cancer. T cells regulatory and CGNL1 (R = 0.39, P < .001) showed a significant positive correlation. External data set validation also supports this result. In this study, we found that some crucial ceRNAs (GGCT, TRPS1, CGNL1, HENMT1, LCE3A, S100A8, ZNF347, TMEM144, TMEM192) and immune cells (T cells regulatory and Eosinophils) may be related to the prognosis of oral cancer.

The distinguishing electrical properties of cancer cells

In recent decades, medical research has been primarily focused on the inherited aspect of cancers, despite the reality that only 5-10% of tumours discovered are derived from genetic causes. Cancer is a broad term, and therefore it is inaccurate to address it as a purely genetic disease. Understanding cancer cells' behaviour is the first step in countering them. Behind the scenes, there is a complicated network of environmental factors, DNA errors, metabolic shifts, and electrostatic alterations that build over time and lead to the illness's development. This latter aspect has been analyzed in previous studies, but how the different electrical changes integrate and affect each other is rarely examined. Every cell in the human body possesses electrical properties that are essential for proper behaviour both within and outside of the cell itself. It is not yet clear whether these changes correlate with cell mutation in cancer cells, or only with their subsequent development. Either way, these aspects merit further investigation, especially with regards to their causes and consequences. Trying to block changes at various levels of occurrence or assisting in their prevention could be the key to stopping cells from becoming cancerous. Therefore, a comprehensive understanding of the current knowledge regarding the electrical landscape of cells is much needed. We review four essential electrical characteristics of cells, providing a deep understanding of the electrostatic changes in cancer cells compared to their normal counterparts. In particular, we provide an overview of intracellular and extracellular pH modifications, differences in ionic concentrations in the cytoplasm, transmembrane potential variations, and changes within mitochondria. New therapies targeting or exploiting the electrical properties of cells are developed and tested every year, such as pH-dependent carriers and tumour-treating fields. A brief section regarding the state-of-the-art of these therapies can be found at the end of this review. Finally, we highlight how these alterations integrate and potentially yield indications of cells' malignancy or metastatic index.

Anti-inflammatory effect of green photobiomodulation in human adipose-derived mesenchymal stem cells

Photo biomodulation (PBM) as a non-invasive and safe treatment has been demonstrated the anti-inflammatory potential in a variety of cell types, including stem cells. However, further investigations using different laser parameters combined with more accurate methods such as quantitative measurement of inflammatory gene expression at the mRNA level are still necessary. The aim of this study was to evaluate the effect of 532 nm green laser on cell proliferation as well as expression of inflammatory genes in human adipose-derived mesenchymal stem cells (hADMSCs) using RNA sequencing (RNA-seq) technique and confirmatory RT-PCR. hADMSCs were cultured in DMEM low glocuse medium with 10% fetal bovine serum until the fourth passage. Cultured cells were divided in two groups: control group (no laser irradiation) and laser group, irradiated with 532 nm laser at 44 m J/cm² with an output power of 50 mW and a density of 6 mW/cm², every other day, 7 s each time. The cell viability was assessed using MTT assay 24 h after each irradiation on days 3, 5, and 7 after cell seeding, followed by performing RNA-seq and RT-PCR. The MTT assay showed that PBM increased cell proliferation on day 5 after irradiation compared to day 3 and decreased on day 7 compared to day 5. In addition, gene expression analysis in hADMSCs using RNA-seq revealed down-regulation of inflammatory genes including CSF2, CXCL2, 3, 5, 6, 8, and CCL2, 7. These results indicate that 532 nm PBM with the parameters used in this study has a time-dependent effect on hADMSCs proliferation as well as anti-inflammatory potential.

[Low-level laser therapy in oncology - what's new? Analysis of 2018-2021 publications]

Low-level laser therapy (LLLT) is included in the Federal project «Fight against oncological diseases», which provides for equipping all specialized medical institutions in Russia with the appropriate devices until 2026.

PURPOSE OF THE STUDY

Publications analysis on the use of LLLT in oncology.

MATERIAL AND METHODS

To search for publications, databases and libraries were used: PubMed, Scopus, ResearchGate, Google Scholar, J-STAGE, eLibrary.ru for the period 2018-2021. For analysis, publications were selected that are of interest from the point of view of improving the methodology of LLLT, the prospects for the development of this method in the prevention, treatment and rehabilitation of patients. A total of 223 publications were found, including 39 reviews and meta-analyses, mostly in English (165) and Portuguese (41).

RESULTS AND DISCUSSION

The inclusion of LLLT in the ISOO/MASCC/ASCO recommendations for the treatment of complications such as mucositis, salivary gland hypofunction and xerostomia caused by non-surgical methods of treating cancer patients should be considered as a promising trend. An extremely low level of quality of LLLT techniques was noted, most often the replacement with meaningless «doses», «fluences» instead of the necessary parameters: wavelength, operating mode, power, frequency, exposure, etc. The use of only local illumination instead of systemic methods of LLLT does not allow obtaining the best results of treatment and prevention. Eliminating the shortcomings of treatment protocols with a focus on Russian experience, when laser blood illumination (intravenously or externally) and laser acupuncture are also necessarily carried out with local illumination of the lesion, will bring the effectiveness of LLLT to a qualitatively new, higher level.

808-nm Photobiomodulation Affects the Viability of a Head and Neck Squamous Carcinoma Cellular Model, Acting on Energy Metabolism and Oxidative Stress Production

Photobiomodulation (PBM) is a form of low-dose light therapy that acts through energy delivery from non-ionizing sources. During the recent two decades, there has been tremendous progress with PBM acceptance in medicine. However, PBM effects on potential stimulation of existing malignant or pre-malignant cells remain unknown. Thus, the primary endpoint was to assess the safety of PBM treatment parameters on head and neck squamous cell carcinoma (HNSCC) proliferation or survival. The secondary endpoint was to assess any putative anti-cancer effects of PBM treatments. Cell viability, energy metabolism, oxidative stress, and pro- and anti-apoptotic markers expression were investigated on a Human Head and Neck Squamous Cell Carcinoma cellular model (OHSU-974 FAcorr cell line). PBM therapy was administered through the 810 nm diode laser (GaAlAs) device (Garda Laser, 7024 Negrar, Verona, Italy) at the powers of 0, 0.25, 0.50, 0.75, 1.00, or 1.25 W in continuous wave (CW) mode for an exposure time of 60 s with a spot-size of 1 cm² and with a distance of 1.86 cm from the cells. Results showed that 810-nm PBM affected oxidative phosphorylation in OHSU-971 FAcorr, causing a metabolic switch to anaerobic glycolysis. In addition, PBM reduced the catalase activity, determining an unbalance between oxidative stress production and the antioxidant defenses, which could stimulate the pro-apoptotic cellular pathways. Our data, at the parameters investigated, suggest the safeness of PBM as a supportive cancer therapy. Pre-clinical and clinical studies are necessary to confirm the in vitro evidence.