Effects of photobiomodulation on interleukin-10 and nitrites in individuals with relapsing-remitting multiple sclerosis - Randomized clinical trial

Tamiris Silva, Yara Dadalti Fragoso, Maria Fernanda Setúbal Destro Rodrigues, Andréa Oliver Gomes, Fernanda Cordeiro da Silva, Lucas Andreo, Ariane Viana, Daniela de Fátima Teixeira da Silva, Maria Cristina Chavantes, Anna Carolina Ratto Tempestini Horliana, Kátia De Angelis, Alessandro Melo Deana, Luciana Prats Branco, Kristianne Porta Santos Fernandes, Lara Jansiski Motta, Raquel Agnelli Mesquita-Ferrari, Sandra Kalil Bussadori, Tamiris Silva, Yara Dadalti Fragoso, Maria Fernanda Setúbal Destro Rodrigues, Andréa Oliver Gomes, Fernanda Cordeiro da Silva, Lucas Andreo, Ariane Viana, Daniela de Fátima Teixeira da Silva, Maria Cristina Chavantes, Anna Carolina Ratto Tempestini Horliana, Kátia De Angelis, Alessandro Melo Deana, Luciana Prats Branco, Kristianne Porta Santos Fernandes, Lara Jansiski Motta, Raquel Agnelli Mesquita-Ferrari, Sandra Kalil Bussadori

Abstract

Objective: Investigate the effects of photobiomodulation (PBM) on the expression of IL-10 and nitrites in individuals with Relapsing-Remitting multiple sclerosis (MS), as these biomarkers play a fundamental role in the physiopathology of the disease. The modulation of IL-10 and nitrites through treatment with PBM may be a novel treatment modality for MS.

Methods: A randomized, uncontrolled, clinical trial was conducted involving 14 individuals with a diagnosis of Relapsing-Remitting MS and a score of up to 6.0 on the Expanded Disability Status Scale (EDSS).

The participants were randomized to two groups: Group 1 -PBM in the sublingual region; Group 2 -PBM over the radial artery. Irradiation was administered with a wavelength of 808 nm and output power of 100 mW for 360 seconds twice a week, totaling 24 sessions. Peripheral blood was analyzed for the determination of serum levels of IL-10 and nitrites.

Results: After treatment with PBM, the expression of IL-10 increased in both the sublingual group (pre-treatment: 2.8 ± 1.4 pg/ml; post-treatment: 8.3 ± 2.4 pg/ml) and the radial artery group (pre-treatment: 2.7 pg/ml ± 1.4; post-treatment: 11.7 ± 3.8 pg/ml). In contrast, nitrite levels were not modulated in the sublingual group (pre-treatment: 65 ± 50 nmol/mg protein; post-treatment: 51 ± 42 nmol/mg protein) or the radial artery group (pre-treatment: 51 ± 16 nmol/mg protein; post-treatment: 42 ± 7 nmol/mg protein).

Conclusion: Treatment with PBM positively modulated the expression of IL-10 but had no effect on nitrite levels. Further studies should be conducted with a larger sample and a control group, as PBM may be a promising complementary treatment for the management of MS. This trial is registered at ClinicalTrials.gov. Identifier: NCT03360487.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Flowchart CONSORT 2010.
Fig 1. Flowchart CONSORT 2010.
Fig 2. Positioning for irradiation.
Fig 2. Positioning for irradiation.
A. Opening of mouth for positioning of laser tip in sublingual region. B. Patient with closed mouth to enable irradiation of sublingual region. C. After palpation of radial artery, laser tip positioned for irradiation.
Fig 3. Physical therapy.
Fig 3. Physical therapy.
1) Feet together for 30 seconds with eyes open and 30 seconds with eyes closed on carpets with different textures; 2) Tandem position for 30 seconds with eyes closed and 30 seconds performing a dual task; 3) Squatting to pick up a ball from a cone, standing up, taking a step and placing the ball on another cone (three repetitions); 4) Sitting on chair with balancing disk and performing dual task of picking up objects from the sides (three times on each side); 5) Walking three meters while answering questions posed by therapist or transporting objects; 6) Two minutes of rest.
Fig 4. Expression of interleukin-10.
Fig 4. Expression of interleukin-10.
Values in both groups before (pre) and after (post) treatment with PBM (p = 0.008, two-way ANOVA).
Fig 5. Nitrite levels.
Fig 5. Nitrite levels.
Values in both groups before (pre) and after (post) treatment with PBM (p = 0.543, two-way repeated-measures ANOVA).
Fig 6. Nitrite levels.
Fig 6. Nitrite levels.
Correlation between EDSS score and nitrite levels. (r = 0.52, p = 0,0542).

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