Efficacy of photobiomodulation therapy in mitigating skin radiation damage
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2018
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Lasers in Surgery and Medicine
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Background: The use of sophisticated radiation dose delivery
and fractionation has significantly improved cancer care. One of
these involves localized, sustained ionizing dose delivery termed
brachytherapy. Despite it therapeutic efficacy, specific side
effects of brachytherapy include localized skin damage and
breakdown for which only palliative treatments are currently
available. The use of low dose biophotonics treatments to
promote tissue healing is termed photobiomodulation (PBM)
therapy. The aim of this study was to evaluate efficacy and
molecular pathways of PBM therapy using two common
wavelengths, red and near-infrared (NIR) to treat radiation
wounds in athymic mice subjected to brachytherapy (sustained
ionizing radiation from 125I seeds).
Study Design/Materials and Method: A pilot study was
performed with thirty-six athymic mice were accomplished for
60 days and divided into six groups: Surgical Control Group
(No radiation and no PBM treatments); Radiation Control
Group (125I seed 0.4252 mCi, no PBM); NIR-PBM Control
Group (NIR PBM alone, LED at l¼880 nm); Red-PBM Control
Group (Red PBM alone LED at l¼660 nm); Radiation- NIR
PBM Group; Radiation-Red PBM Group. Following 21 days,
radiation-induced wounds are evident. PBM treatments (both
wavelengths with output power 40mW for 20 s, fluence 20 J/cm2
on top of implantation site) were performed every week up to
60 days. Wounds were evaluated every 7 days digital imaging,
Laser Doppler Flowmetry (LDF) and tissue temperature with a
thermographic camera. We also performed mPET-CT imaging
using radioactive fluorodeoxyglucose (18F-FDG) at 51 and
81 days post-implantation. Animals were sacrifices
progressively at each time point to correlate clinical
observations with imaging and molecular tissue analyses.
Tissues were collected to analyze molecular pathways
correlating with inflammation, immune response, wound
healing and angiogenesis using mRNA (qRT-PCR) and protein
expression (immunostaining).
Results: Both PBM treated groups demonstrated significant
(p<0.05) improvements in skin radiation wound healing as
compared to radiation group. Distinct improvements in clinical
wound size and closure, improved tissue perfusion and
reduced inflammation as evidenced by decreased wound
thermal images. These wounds were also noted to have
significant differences in the cytokine profiles (TGF-b, VEGF
and PDGF) correlating with better healing responses.
Radiation damage reduces brown fat composition that can
potentially contribute to additional radiation-associated
morbidities. The mPET-CT imaging noted significant
preservation of brown fat composition in PBM-treated radiation alone groups. Further validation of these pathways
is ongoing.
Conclusion: Within the parameters of this study, PBM
treatments demonstrated improved healing in radiation wounds
due to ionizing radiation from 125I seeds. Ongoing work is
examining the precise molecular pathways contributing to these
therapeutic benefits. It is hoped this study will enable further
development of this innovative therapy for managing side-
effects from radiation treatments.
Como referenciar
MOSCA, RODRIGO C.; SANTOS, SOFIA N.; NOGUEIRA, GESSE E.C.; PEREIRA, DAISA L.; COSTA, FRANCIELLI C.; ARANY, PRAVEEN; ZEITUNI, CARLOS A. Efficacy of photobiomodulation therapy in mitigating skin radiation damage. Lasers in Surgery and Medicine, v. 50, p. S15-S16, 2018. 29. DOI: 10.1002/lsm.22799. Disponível em: http://repositorio.ipen.br/handle/123456789/29061. Acesso em: 19 Apr 2024.
Esta referência é gerada automaticamente de acordo com as normas do estilo IPEN/SP (ABNT NBR 6023) e recomenda-se uma verificação final e ajustes caso necessário.