Photobiomodulation is one of the most exciting areas of medicine that is being explored. The application of soft lasers (under 500mW) allows us to influence the body without causing harm to the tissue.
There are many different brands that offer laser therapies, each with a unique set of strengths.
Until recently, practitioners have found benefit in topical laser therapy, but because of the way that laser is absorbed in the skin, it has been impossible to treat the body systemically, or to get different wavelengths of laser into the body. The exception being red to infrared lasers. These two lasers, alongside yellow laser (550-600nm), are especially effective in transcranial laser therapy, although that would be a whole discussion on its own.
In recent years, however, advances have been made in getting laser INTO the body. This has opened up a host of possibilities, with information from Germany promising to offer many options for patients.
In general, there are specific cellular structures that are able to absorb specific wavelengths (colours) of light (known as photoreceptors). The light stimulus gives a cellular signal affecting the chemical behaviour, metabolism, movement, and gene expression. All associated enzymes and/or proteins are now affected. This cascade event can ripple across an entire cell
Instead of light, which scatters, one is injecting billions of photons at different wavelengths into the body. Other than looking pretty, what does this mean and what effect does it have on the patient?
Rainbow of healing
Each of the different wavelengths has a different effect on the body:
- Positive influence on rheological properties of the blood
- Diminishing tendency of aggregation of thrombocytes and improved deformability of erythrocytes
- Activation of phagocytic activity of macrophages
- Activation of platelets
- Positive effect on the proliferation of lymphocytes and B-and T-cell subpopulations
- Stimulation of immune response with increase of the immunoglobulins IgG, IgM and IgA
- Stimulation of interferons, interleukins, and TNF-alpha
- Hypoxia of the tissue is improved, and fibrinolysis is activated
- Development of so-called “giant mitochondria” with activation of various metabolic pathways, increased production of ATP and normalization of cell membrane potential
- Analgetic, spasmolytic and sedative effects
- Improves microcirculation in central nervous structures with stimulation of the functional activity of the hypothalamus and limbic system, leading to an activation of hormonal, metabolic, immunological and vegetative processes with mobilization of adaptive reserves
- Green binds to haemoglobin
- Improves the function, behaviour and cell elasticity of red blood cells [17, 20, 38, 61]
- Increases Oxygen Delivery – improved oxygen affinity
- increased attraction of oxygen to haemoglobin
- Improved ability to carry more oxygen
- Decreases in lactic acid
- Reduces blood viscosity and improves blood flow
- Activates reparative and stabilizing pathways
- Platelet activation with gradual loss of natural platelet reactivity and ability to respond to activating agents
- Positive effect on Sodium/Potassium Pump, which helps to regulate intra-and extra-cellular cation homeostasis f oxygen to haemoglobin
- Improved ability to carry more oxygen
Activity of Na+/K+-ATPase of red blood cells irradiated with Nd:YAG laser of various fluences. Results are presented as mean ±S.E.M. of the concentration of inorganic phosphate (n=8). Equation of the trend line and coefficient of determination (R2 ) are shown.
Kassak et al. (2005): Green laserlight increases the production of ATP in the irradiated mitochondria for more than 30%
- Blue light releases nitric oxide (NO) in monocytes with vasodilatation and improvement of endothelial dysfunction
- NO is known to be a growth, immune, and neuromodulator, as well as a stimulator of stem cell proliferation and it has a critical roles in analgesia, vasodilation and angiogenesis through c-GMP pathway
- Increased production of NO is activating the telomerase and thus stopping shortening of telomeres anti-aging
- Increased NO is lowering blood pressure
- Blue laser is known to act anti-inflammatory by reducing pro-inflammatory cytokines and contributory factors for a variety of conditions (NF-kB, CRP, IL2, IL6, TNF alpha, Leptin, chemokines etc.)
- Blue light is effective for treating infections by production of ROS (especially in combination with photosensitive substances like Curcumin or Riboflavin)
- Improvement of the antioxidant enzymatic system with detoxifying effect
- Strong anti-depressive effects (especially in combination with Hypericin from St. John’s Wort Plant) and positive influence on the general mood
- Positive effects on pain relief in chronic pain patients
- Improves Serotonin and Vitamin-D production
- Positive effects on the hormone system
Ultraviolet blood irradiation can strengthen the immune system and improve overall health. It has shown to have the following benefits:
- Increases oxygen absorption into body tissues
- Destroys fungal, viral, and bacterial growth
- Improves circulation and decreases platelet aggregation
- Improves circulation by dilating blood vessels
- Improves the body’s ability to detoxify and inactivate or remove toxins
- Activates cortisone-like molecules, sterols, into vitamin D
- Restores normal size and movement of fat elements
Three main areas that are being used in daily clinical practice include:
- Interstitial laser therapy
- Intraarticular laser therapy
- Intravenous laser therapy
Interstitial and intraarticular laser therapy
These two areas focus mainly on regenerative principles. An 18G needle is placed close to the affected area and a piece of sterile fibre optic cable is then threaded through. The different wavelengths of laser would then be injected, much like one would inject a steroid into the area.
In combination with platelet rich plasma, one finds boosting of regeneration, as well as the lowering of pain and inflammation.
The intravenous application of laser therapy allows for the systemic treatment of a person. A piece of fiber optic cable is threaded through a canula inserted intravenously.
One example for the absorption of different colours within cells is the process in the mitochondrial respiratory chain
- Complex 1 (NADH dehydrogenase) absorbs blue and ultraviolet light
- Complex 3 (cytochrome c reductase) absorbs green and yellow light
- Complex 4 (cytochrome c oxidase) absorbs red and infrared light
Thus, by using intravenous laser, one can improve mitochondrial function.
Emerging cancer treatments
It is important to point out that there are contraindications to keep in mind. Cancer is one of the main contraindications when one considers photobiomodulation.
If one introduces photosensitisers, one can effectively target cancer cells, as well as circulating tumor cells.
One of the most-used photosensitisers is intravenous curcumin. Over and above the benefits of curcumin that is 100% absorbed, it also acts as a beacon for the laser by entering circulating tumor cells. When a blue photon hits a yellow cell, it changes the oxygen in the cell into singlet oxygen. This effectively kills only the targeted cell.
The future is bright
I believe that photobiomodulation is but in its infancy. In the coming years, we should see many more advancements made, especially with the combination of frequencies to the wavelengths.
There is a thing to be said about Star Trek medical bay technology finally coming true.