HOW PHOTOBIOMODULATION WORKS
Although we have long known that there are many light-tissue interactions, we have only just begun to realise the potential of light as a treatment and therapy to manage various health conditions that plague us today. Light can interact with biological tissue through many different mechanisms; photobiomodulation, photochemical interactions, thermal interactions (e.g., coagulation and vaporization), photoablation, plasma-induced ablation, and photodisruption.
Eukaryotic animal cells are light-sensitive due to light receptors, chromophores, porphyrins, cytochrome C oxidase and light-sensitive ion channels. Photobiomodulation is the effect of photons (high-level energy packages) on cells; When the photon reaches the light-receptor it causes a reaction in the cell.
Fast Tissue Regeneration
The effect of chromophore cytochrome c oxidase (CCO) is visualized in figure 1. CCO is located in the mitochondria (energy-producing organelle in eukaryotic cells) as the 4th complex of the respiratory electron transport chain. When CCO is activated it produces more nitric oxide (NO), a signalling molecule and adenine triphosphate (ATP), the fuel for the cell. Enhancing cell metabolism, respiration, speeds-up cell proliferation and indirectly by inducing the production of growth factors as a result of the NO, figure 2. Stem cells proliferate and differentiate faster into different cells-type specific for each tissue essential for adequate tissue regeneration. Most diseases have dysfunctional mitochondria within the pathology.
Anti-inflammatory
Additionally, PBM has strong anti-inflammatory properties by reducing DNA damage in the cell caused by high levels of reactive oxygen species (ROS) and inflammatory cytokines in damaged tissues. The restoration of the cell-metabolism reduces cell-stress so the production of pro-inflammatory substances: COX, ROS, RNS, cAMP en de inflammatory cytokines: TNF-alfa, IL-1beta, IL-6, ICAM-1 and MIP-2 declines. And the production of anti-inflammatory cytokines, like IL-10, see figure 3 is enhanced.
Treatment Variables
Therapeutic depth of light penetration
Dieks Medical is specialized in high power laser technology, 30-60 W, for deep therapeutic tissue penetration of light. The high power and multiple NIR (near-infrared) wavelengths of the emitted light are responsible for the deep therapeutic tissue penetration.
Power and wavelength explained
The power of the laser is expressed in watts (joules per second) and the wavelength in nanometer (nm). The higher the power the more photons the emitted light contains and the higher the wavelength in nm, the more straight forward the photon moves resulting in less contact with the atoms of superficial layers. For every wavelength, there is a percentage of photons that are lost within the layers covering the tissue at the injury site. So the more photons are emitted per second, the higher the power, the more photons are delivered at the injury site.
The combination of NIR-wavelengths and the high power creates the possibility to treat muscles and organs lying deep within the body, like the musculus psoas and the lungs.
Treatment time
Another benefit of the high power of the emitted light is the short treatment duration needed for optimal effect. Within minutes, an enormous amount of photons are emitted on the treatment site, which means that effective treatment can take only a few minutes. Mainly the treatment time depends on the personal characteristic of the patients’ body and the treated area. Dieks Medical has the experience and scientific knowhow to help you learn building personalized treatment protocols.
Therapeutic dosage and side-effects
High power NIR-light Irradiation of body tissues has a wide therapeutic window possibly ranging from 0.5 – 1 J/cm2 on an open wound, 1-10 J/cm2 for superficial targets to 10-50 J/cm2 for deeper-seated targets. The needed therapeutic dosage depends on the depth of the target tissue and its mitochondrial density, next to this the condition that is treated is an important factor as well. For example, the treatment with the highly inflamed or infected wound or body part should be started with low dosages because the photo-thermal effect will kick-in before any possible photobiomodulation (PBM) effect. The heat production in this type of conditions is extremely high due to the extensive tissue damage caused by the infection/inflammation. An effective parameter is the patients’ heat sensation, caution is needed with nerve damage at the injury site.
Deeper lying tissues can be nicely reached by the higher wavelength reducing the power of the lower wavelengths manually to reduces surface tissue heat. This is only necessary of the layers overlying the injured target tissue are injured as well and prevent the injured tissue to be treated with the power that is needed for the PBM-effect.
So high power laser therapy, when applied adequately, has no side-effects.
Eye damage
The eye is a very light-sensitive organ, therefore special glasses should be worn during the application of high power laser therapy. Special attention is needed for treatments above the level of the neck, where black eye covers are inevitable. Therefore Dieks Medical will provide you with the right equipment.
