The nuts and bolts of low-level laser (light) therapy

Hoon Chung, Tianhong Dai, Sulbha K Sharma, Ying-Ying Huang, James D Carroll, Michael R Hamblin, Hoon Chung, Tianhong Dai, Sulbha K Sharma, Ying-Ying Huang, James D Carroll, Michael R Hamblin

Abstract

Soon after the discovery of lasers in the 1960s it was realized that laser therapy had the potential to improve wound healing and reduce pain, inflammation and swelling. In recent years the field sometimes known as photobiomodulation has broadened to include light-emitting diodes and other light sources, and the range of wavelengths used now includes many in the red and near infrared. The term "low level laser therapy" or LLLT has become widely recognized and implies the existence of the biphasic dose response or the Arndt-Schulz curve. This review will cover the mechanisms of action of LLLT at a cellular and at a tissular level and will summarize the various light sources and principles of dosimetry that are employed in clinical practice. The range of diseases, injuries, and conditions that can be benefited by LLLT will be summarized with an emphasis on those that have reported randomized controlled clinical trials. Serious life-threatening diseases such as stroke, heart attack, spinal cord injury, and traumatic brain injury may soon be amenable to LLLT therapy.

Conflict of interest statement

CONFLICTS OF INTEREST James D. Carroll is the owner of THOR Photomedicine, a company which sells LLLT devices.

Figures

FIGURE 1
FIGURE 1
Basic physics of LLLT. (a) Light as an electromagnetic wave. (b) Gaussian laser beam profile. (c) Snellius’ law of reflection. (d) Optical window because of minimized absorption and scattering of light by the most important tissue chromophores in the near-infrared spectral region.
FIGURE 2
FIGURE 2
Cellular mechanisms of LLLT. Schematic diagram showing the absorption of red or near infrared (NIR) light by specific cellular chromophores or photoacceptors localized in the mitochondrial. During this process in mitochondria respiration chain ATP production will increase, and reactive oxygen species (ROS) are generated; nitric oxide is released or generated. These cytosolic responses may in turn induce transcriptional changes via activation of transcription factors (e.g., NF-κB and AP1).
FIGURE 3
FIGURE 3
Two possible sources of nitric oxide (NO) release from cytochrome c oxidase (CCO). Path1 shows CCO can act as a nitrite reductase enzyme: Path 2 shows possible photo-dissociation of NO from CCO.
FIGURE 4
FIGURE 4
Biphasic dose response in LLLT. Three dimensional plot illustrating effects of varying irradiation time equivalent to fluence or irradiance on the biological response resulting in stimulation or inhibition.
FIGURE 5
FIGURE 5
Some examples of LLLT devices and applications. (a and b) Intravascular laser therapy (Institute of Biological Laser therapy, Gottingen, Germany). (c and d) Laserneedle acupuncture system (Laserneedle GmbH, Glienicke-Nordbahn, Germany). (e and f) Lasercomb (Lexington Int LLC, Boca Raton, FL) for hair regrowth. (g) Laser cap (Transdermal Cap Inc, Gates Mills, OH) for hair regrowth.

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Source: PubMed

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