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Traumatic and non-traumatic injuries are common complications in the aging adult. Inflammation is related to aging in older individuals and may lead to an increased risk of mortality, reduced muscle strength, and decreased mobility. Unresolved inflammation could be related to the origin of many chronic diseases associated with aging such as autoimmune and neurodegenerative diseases or tumors. With any injury to the body there is initially process of inflammation and wound healing that in large number of cases are related with pain that increases in the following days. On the other hand, chronic inflammation in high percentage of cases are related to chronic pain, very common symptoms in aging. Chronic inflammation is associated with normal and pathological aging. Surgery, orthopedic fixation, pharmaceutical therapies and physiotherapy can be used to the treatment of the pathologies and injured area. Here we review the use of gallium arsenide (GaAs)-based near-infrared lightemitting diodes (LEDs) as a coadjutant therapy to control inflammation and wound healing. GaAs-based near infrared LED therapy can be used alongside surgery, orthopedic fixation and pharmaceutical treatments. Studies have shown it to be an effective therapy for the treatment of inflammation and to speed wound healing. This review of clinical observations highlights the capability of GaAs-based LEDs to accelerate wound healing and avoid inflammation.
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Healthy Aging Research | www.har-journal.com Ibe et al. 2015 | 4:24
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The role of near-infrared light-emitting diodes in aging adults related to
inflammation
Onyekachi Ibe 1,2, Erin Morency 3, Pablo Sosa 4, Lori Burkow-Heikkinen 5*
1 School of Engineering, Wayne State University, MI, USA 2 School of Engineering, DeVry University Southfield, MI, USA 3 School of
Nursing, Oakland University, Human Health Building, Rochester, MI, USA 4 Department of Neuroscience, Clinical and Surgical
Neurology, School of Medicine, National University of Cuyo, Centro Universidad, Mendoza, Argentina 5 American College of Sports
Medicine, Indianapolis, IN, USA
Abstract
Traumatic and non-traumatic injuries are common complications in the aging adult. Inflammation is related to
aging in older individuals and may lead to an increased risk of mortality, reduced muscle strength, and decreased
mobility. Unresolved inflammation could be related to the origin of many chronic diseases associated with aging
such as autoimmune and neurodegenerative diseases or tumors. With any injury to the body there is initially a
process of inflammation and wound healing that in large number of cases are related with pain that increases in
the following days. On the other hand, chronic inflammation in high percentage of cases are related to chronic
pain, very common symptoms in aging. Chronic inflammation is associated with normal and pathological aging.
Surgery, orthopedic fixation, pharmaceutical therapies and physiotherapy can be used to the treatment of the
pathologies and injured area. Here we review the use of gallium arsenide (GaAs)-based near-infrared light-
emitting diodes (LEDs) as a coadjutant therapy to control inflammation and wound healing. GaAs-based near-
infrared LED therapy can be used alongside surgery, orthopedic fixation and pharmaceutical treatments. Studies
have shown it to be an effective therapy for the treatment of inflammation and to speed wound healing. This
review of clinical observations highlights the capability of GaAs-based LEDs to accelerate wound healing and
avoid inflammation.
Citation: Ibe O, Morency E, Sosa P, Burkow-Heikkinen L (2015) The role of near-infrared light-emitting diodes in aging adults related
to inflammation. Healthy Aging Research 4:24. doi:10.12715/har.2015.4.24
Received: December 19, 2014; Accepted: January 28, 2015; Published: April 10, 2015
Copyright: © 2015 Ibe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Competing interests: The authors have declared that no competing interests exist.
* Email: lburkow@comcast.net
Introduction
An LED is an electronic device component that emits
light when electricity passes through it. LEDs are
mostly is monochromatic, occurring at a single
wavelength. The LED light spectrum output can range
from ultra violet to red. The ultraviolet and blue colors
are about 400 nm, while the red color is about 700
nm. LED infrared emission can be greater than 830
nm and these types of LED devices are called Infrared
Emitting Diodes (IRED). LEDs function by
electroluminescence, a visible light production by an
exposed substance to an electrical field with non-
thermal energy generation. Gallium arsenide (GaAs)
is a common semiconductor material used for near-
infrared LEDs, but other semiconductors are also
used. Aluminum gallium indium phosphide (AlGaInP)
and other semiconductor compounds in groups III-V
of the periodic table have also been utilized.
Low-level laser therapy and near-infrared LEDs have
similar effects on inflammation and wound healing.
Some studies have demonstrated that near-infrared
LED is more efficient at speeding up wound healing
compared to laser therapy [3-7]. Near-infrared (NIR)
LED therapy has been shown to improve
inflammation and accelerate wound healing, as well as
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helping to control pain. NIR-LED devices for light
therapy are affordable, portable and easy to use,
unlike other light therapy sources, such as lasers or
incandescent light. Furthermore, they have improved
dramatically in quality since the late 1990s, when they
had rather unstable power outputs and divergent
wavelengths. Older generation NIR-LEDs were not
able to produce a meaningful clinical reaction to
tissues. A new generation of NIR LEDs, also called
the “NASA LEDs”, developed by Whelan et al., have
a lower divergence and also a more stable power
output [8].
For NIR-LEDs to be most effective it is important that
they have an appropriate wavelength for the target
cell. Recent literature suggests a wavelength of 830
nm for all aspects of wound healing, pain, anti-
inflammatory treatment and skin rejuvenation.
According to Kim et al., if the wavelength is
incorrect, absorption will be suboptimal and,
according to the Grotthus-Draper law of
photobiology, there can be no reaction without
absorption.
Photon intensity, or power density (W/cm2), should
be sufficient for the retention of enough photons to
achieve the desired result. If the intensity is too high,
photon energy will be undesirably transformed into
heat in the targeted tissue.
Finally, Kim et al. the fluency or dosage must be
adequate (J/cm2). According to the Bunsen-Roscoe
law of reciprocity, if the power density is too low,
prolonging irradiation time to achieve an ideal energy
density or dose will most likely not give a good final
result [9].
Traumatic head and body injury, surgical procedure,
and metabolic ulcers are common in the aging
population. Each of these, and a variety of other
conditions prevalent in the elderly, lead to a systemic
response to injury. As aging progresses, the body's
ability to respond to injury decreases. Inflammation in
aging is characterized by increased inflammatory
cytokines, decreased adaptation and defective tissue
repair. Research into coadjutant therapies for
pharmaceutical interventions needs to focus on
enhancing the body's response mechanism and NIR-
LEDs have shown positive results.
NIR-LED therapy has shown tremendous possibilities
in anti-photo aging using non-thermal radiation. The
radiation components in the NIR-LED device help
improve the anti-inflammatory elements of cell
rejuvenation treatments [10]. The mitochondria theory
on aging states that oxidative stress, caused by
mitochondria DNA mutations, is associated with
decreased ATP production leading to cellular
degeneration. An experiment conducted by
Kokkinopoulos and his team show a significant
mitochondrial shift in vitro using a 670nm light
exposure and the result showed that aging related
retinal inflammation can be reduced significantly with
the application of light therapy of 670nm [ 11]. There
are other NIR-LED therapy devices for anti-aging
with the range of 940nm and above but more clinical
research needs to be done on these devices.
Vascularized living tissue responds to injury (caused
by infections, chemicals or physical agents, immune
reactions and other methods) by becoming inflamed.
Inflammation is intended to contain and isolate the
damage, destroy microorganisms and inactivate
toxins, and prepare tissues for repair and wound
healing. Although inflammation is fundamentally a
protective response, it can also be harmful since it can
cause severe hypersensitivity reactions or an
inexorable and progressive organic lesion by chronic
inflammation and subsequent fibrosis. Inflammation
can be modulated by different biological, chemical
and physical agents. The wide variety of drugs used in
the treatment of inflammation are well known, as well
as physical agents, such as cold and light. The latter,
in particular photomodulation through NIR-LEDs, has
been demonstrated to have a positive effect in
reducing inflammation and promoting the acceleration
of wound healing and skin rejuvenation. NIR-LED
therapeutic devices are non-coherent, which means the
light intensity is consistent and can spread, covering
larger areas of the tissue. NIR-LED therapies have
short wavelengths and, based on our studies and
literature cited, the shorter the wavelength the deeper
the penetration of light to the tissues. NIR-LEDs are
affordable, portable, easy to use, and continue to
provide viable applications in medicine, for example,
to reduce edema, the migration of inflammatory cells,
and the production of inflammatory cytokines, as well
as accelerating the regeneration of connective tissues.
There are no known risk factors for addiction with this
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type of treatment. The length of time the radiation
therapy needs to be applied for optimal outcomes has
yet to be determined.
Extensive review of the English and Spanish literature
was performed using PubMed, BioMed, and Google
Scholar scientific databases. The literature search
included articles relating to light emitting diode, low
level laser therapy in aging.
Inflammation and wound healing
The timeline for wound healing depends greatly on
the level of inflammation. During 2009 1.8 million
patients, in the United States, were discharged from
hospitals for wound care and management [12]
following a range of causes of injury including gait
disturbances; decreased muscle mass; metabolic
diseases; heart disease; and traumatic brain injury [13-
29], Table 1 shows conditions that increase risks for
injury in the aging. All of these may be common
events in the aging population. Aging results in
chronic low grade inflammation that is associated
with increased risk for disease, poor physical
functioning, and mortality.
Table 1. Potential causes for injury of the aging adult [13-29]
Exercise and fitness
Physical Abuse
Ataxia
Oncology
Metabolic diseases
Heart disease
Arterial Ischemia
Venous disease
Dementia
Polypharmacy
Traumatic brain
injury
Traumatic spinal
cord injury
Surgical wounds
Tooth extractions
Traffic collisions
Medical prosthesis
rejection
Catastrophic
Events
Warfare
Terrorism
Bone Fracture
Ligament strain
Skin Infection
Orthostatic
changes
Inflammation and tissue response to injury is
characterized by acute and chronic phases. In the
acute phase, changes in vascular caliber and
permeability occur with the consequent migration of
leukocytes, particularly neutrophils. Increased
vascular permeability is induced in various ways, one
of which is via chemical mediators such as histamine,
interleukin (IL)-1, and tumor necrotic factor (TNF), as
well as by the migration of leukocytes, and the release
of reactive oxygen species (ROS) and proteolytic
enzymes.
Both IL-1 and TNF facilitate increased vascular
permeability and migration of lymphocytes, enabling
the phenomena of acute inflammation and increased
interstitial fluid. The application of near-infrared light
on tissue in the acute phase of inflammation causes a
decrease in the levels of both IL-1 and TNF-α [30,31].
During acute inflammation, the release of chemical
mediators modulates vascular and cellular phenomena
such as chemotaxis, leukocyte activation,
phagocytosis and release of leukocyte products. An
early mediator released in the area of injury is
histamine, released primarily from mast cells, which
causes vasodilation. Stimulation via near-infrared
LEDs, or low-level lasers, has the ability to modulate
the number of mast cell degranulations [32-34].
Leukocyte activation facilitates the release of pro-
inflammatory molecules, such as the production of
cytokines and metabolites of arachidonic acid. One of
the key enzymes in the production of arachidonic acid
derivatives, such as prostaglandins and thromboxanes,
is cyclooxygenase-2 (COX-2). The activity of this
enzyme can be decreased in areas of inflammation by
stimulation with near-infrared light. Furthermore, the
participation of neutrophils and macrophages in the
acute stage of inflammation allows both phagocytosis
to be initiated, and the release of products from
phagolysosomes into the interstitial space, which can
damage tissue [35,36].
Key products released primarily by macrophages are
growth factors and ROS, which cause tissue damage
and the inactivation of anti-proteases. Irradiation with
near-infrared lasers has been shown to decrease the
number of neutrophils and macrophages at the site of
inflammation, and reduces ROS levels at both
neutrophils and the damaged tissues [37-40]. Nitric
oxide (NO) is a mediator that has some protective
effects during acute phase inflammation. Some of
these effects are to maintain vascular tone and reduce
leukocyte recruitment. Studies have shown NO levels
can be increased by stimulation with near-infrared
light [41-43]. Finally, if the injurious agent can be
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eliminated, the regulatory mechanisms of the
inflammatory process can occur, leading to tissue
regeneration. If the offending agent is not properly
removed it can lead to chronic inflammation.
Chronic inflammation is a lengthy process of weeks to
months, in which active inflammation, tissue
destruction, and attempts at healing occur in a
simultaneous manner. In contrast to acute
inflammation, chronic inflammation is characterized
by the infiltration of mononuclear inflammatory cells,
tissue destruction, and attempts at healing by fibrosis
and angiogenesis. Macrophages are the dominant and
central cells in chronic inflammation; they are
activated by clinical mediators such as interferon-γ,
produced by T-lymphocytes. The application of near-
infrared light significantly inhibits the expression of
interferon-γ and IL-1β, and decreases inflammation by
changing the expression of genes encoding
inflammatory cytokines [44,45]. Macrophage
activation produces chemical mediators that stimulate
tissue repair; in turn, some of these mediators generate
ROS, NO and proteases, which further cause tissue
injury. The concentration of ROS, as well as
metalloproteases, may be decreased in the damaged
tissue by stimulation with near-infrared light. In
addition, tissue repair mediators such as transforming
growth factor (TGF)-β1 and platelet-derived growth
factor (PDGF), can be modulated by light [40,46-48].
Finally, in chronic inflammation, infiltration of
mononuclear cells into the tissues generates tissue
destruction and attempts at healing tissue.
Aging is associated with various changes in the
inflammatory response. As humans age there is an
upregulation in the anti-stress responses, both cellular
and molecular, that has been coined 'inflammaging'.
Over time this leads to tissue damage that may lead to
a decrease in effective function of the inflammatory
response. Factors that may also lead to continuous
low-grade inflammation in the elderly include
smoking, subclinical disorders, and increased fat
tissue [49]. Fat tissue may be linked to increased
levels of macrophages, which are associated with
cytokine production [50] Newer studies have found a
correlation between infectious history and an
increased risk of heart attack, stroke, and cancer [51]
suggest that infections at early ages leave an imprint
in the host and inflammatory mechanisms can become
flawed, and lead to further diseases during later years.
If an individual's body is adept in keeping
inflammatory cytokines low, or anti-inflammatory
cytokines high, they have a greater chance of attaining
higher ages [52-54].
As humans age the functionality of the mitochondria
decreases; both in effectiveness and by the increase of
free radicals. Free radicals are known to increase pro-
inflammatory signals that lead to cell death or
uncontrolled cell growth has identified these
mitochondrial deficiencies as a cause of chronic
inflammation [55].
Diets high in red meat may also lead to an
accumulation of antibodies for the Neu5Gc sugar
molecule found in red meats, and enters human tissue
after consumption. The human immune system sees
this sugar as a foreign invader and creates antibodies.
Over time, the combination of this foreign invader and
the antibodies causes an inflammatory state that may
become chronic [56].
Healing and tissue regeneration is the final process of
tissue injury, and involves a large number of cells and
chemical mediators. In tissue repair, it is known that
various processes are activated to achieve tissue
regeneration or healing, including the proliferation
and migration of parenchymal cells of connective
tissue, angiogenesis, synthesis of extracellular matrix
(ECM) proteins, and tissue remodeling. The main
connective tissue cells involved in tissue regeneration
are fibroblasts. These cells, by stimulation with near-
infrared light, can increase in activity and number.
Their effects are modulated, in part, by increasing
mediators such as TGF-β1 and PDGF [57-60]. It is
also known that stem cells are involved in tissue
regeneration; these can also be stimulated by near-
infrared light, causing an increase in both number and
activity [61,62]. One of the most important factors in
the process of angiogenesis - a critical component of
wound healing - is vascular endothelial growth factor
(VEGF). Both VEGF and angiogenesis can be
stimulated by near-infrared light [63]. Tissue
continuity is rebuilt by fibroblasts and endothelial
cells. Fibroblasts rebuild the matrix, while endothelial
cells are needed for angiogenesis. Collagen,
particularly Types I and III, is needed to ensure
successful wound healing. As the repair progresses,
fibroblasts synthesize and deposit collagen and other
ECM proteins such as decorin. Levels of these
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molecules can be increased by stimulation with light
[64-66]. Collagen deposition and the composition of
the ECM is remolded by metalloproteases. These
enzymes generate a balance between the synthesis and
degradation of molecules to achieve adequate
regeneration and tissue healing. Metalloproteases can
be modulated by near-infrared light [67,68].
Effect of lasers and LEDs on pathological
conditions
In our experience, inflammation caused by tooth
extraction, repetitive micro-injury to the tendons,
shoulder pain caused by playing golf, acute tennis
elbow pain, and chronic pain of the quadriceps tendon
after swimming, all saw an improved range of motion
and decreased pain after treatment with 940 nm NIR
LEDs. Another study looking at patient recovery after
surgical procedures in various locations (Achilles
tendon, shoulder, wrist, etc.) showed that infrared
light increased the rate of wound healing by 25-35%
[69,70].
Chronic inflammation in aging is characterized by
increased inflammatory cytokines, decreased
adaptation, and defective tissue repair in response to
injury. Many pathologies are related with aging
process are mediated by the inflammatory process
and, of these, osteoarthritis is among those affecting
the highest number of patients. Oshima et al. observed
that the application of NIR-LEDs to an osteoarthritis
animal model increased Type II collagen expression
and decreased TNF-α expression. This therapy can
decrease levels of inflammation in the osteoarthritic
joints [71]. A reduction in the number of
polymorphonuclear cells and signs of inflammation
was also observed in the treatment of joint
inflammation using near-infrared light therapy [72].
Rheumatoid arthritis is another important illness that
causes significant disability. Monocyte chemotaxis
protein (MCP)-1 is a key chemokine in the
inflammatory status of this disease. Kuboyama el al.
demonstrated that NIR-LED irradiation significantly
reduced MCP-1 gene expression in a rheumatoid
arthritis rat model, thus reducing inflammation [73].
TNF-α and IL-6 are also important mediators in
rheumatoid arthritis; studies in animal arthritis models
have shown that stimulation with near-infrared light
can reduce the levels of both [73,74].
Near-infrared light therapy may have potential
applications as a noninvasive treatment. It has been
suggested that low-level lasers and NIR-LED
irradiation can modulate inflammatory processes,
inhibiting edema formation, vascular permeability and
hyperalgesia, and suppress inflammation in the
synovial membrane [75,76]. In a recent study in an
experimental tendinitis rat model, treatment with near-
infrared LEDs once per day in the same location on
the tendon, showed an increase in the amount of
collagen Types I and III between days seven and 14.
Increased collagen implies increased fiber
organization and wound healing [77]. In a study of
soccer players with second-degree ankle sprains,
results showed that treatment with an 820 nm
aluminum gallium indium phosphide (GaAlAs) diode
laser, alongside conventional RICE (rest, ice,
compression, and elevation), decreased edema after 24
and 48 hours with no recurrence. When range of
motion in patients with tendinopathy was studied,
patients treated with light therapy showed an average
improvement of 32% compared to controls [78].
Xavier et al. studied the effects of NIR-LED therapy
on Achilles tendinitis induced by collagenase in a rat
model. The group treated with an 880 nm near-
infrared LED showed fewer inflammatory cells
arriving at the injury site, and reduced mRNA
expression of IL-1β, IL-6, TNF-α, and COX-2 [79].
NIR-LED therapy may therefore have therapeutic
benefits in reducing signs of inflammation in
tendinitis. Near-infrared light therapy has also been
shown to reduce the pain and increase the diminished
range of joint motion typically seen in tennis elbow
and epicondylitis, with no bony structure involvement
[80]. The application of near-infrared light also
accelerates healing following tenotomy of the tendon
[81].
Some studies have shown that near-infrared light
therapy can reduce inflammation in injuries of the
nervous tissue. Moreira et al. (2009) studied the effect
of near-infrared light in animal models with brain
injury. They observed that, during the first few hours
following brain injury, low-level laser phototherapy
can modulate brain levels of TNF-α, IL-1β and IL-6.
Along with other studies, this shows that stimulation
with near-infrared light decreases inflammation in
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injured brains while also stimulating reconnection of
the injured areas [82,83].
In spinal cord lesions, it has been observed that the
use of 810 nm light treatment in animal models can
increase axonal numbers and decrease the activation
of immune cells and cytokines [84]. Using an animal
model to study a nerve lesion, NIR-LED phototherapy
reduced edema, the number of mononuclear cells
present in the inflammatory infiltration, and increased
nerve regeneration [85]. Albarracin et al. found that
near-infrared photobiomodulation in albino rats
resulted in decreased retinal degeneration, presumably
from reduced cell death, inflammation, and decreased
microglia [86]. The sciatic nerve crush model was
performed on mice while under anesthesia. Seven
days after the operation, NIR-LED irradiation therapy
(950 nm, 80 mW/cm2, 2.5 J/cm2) began - applied to
the skin at the site of injury - and continued for 15
days. In both the spinal cord and sciatic nerve TNF-α
levels decreased, but IL-1β and IL-10 levels did not
change compared to the control [87]. Khalil et al.
studied the role of free radicals and NO in delayed
recovery in aged rats with nerve injury. The results
suggest that ROS and neuronal NO contribute to
delayed recovery of injured nerves in old rats. The
results also raise the notion that possible interaction of
free radicals with NO to form peroxynitrite might be
responsible for such delayed recovery. In previous
paragraphs we describe that ROS may be decreased in
the damaged tissue by stimulation with near-infrared
light and could be an interesting coadjuvant therapy in
these types of lesions [88].
Cerebrovascular disease is the third leading cause of
death and the leading cause of serious long-term
disability in the Western hemisphere [89]. Endothelial
dysfunction is characterized by a chronic alteration of
inflammatory function and markers of inflammation
and the innate immune response, including C-reactive
protein, IL-6 and TNF-α are linked to the occurrence
of myocardial infarction and stroke in healthy elderly
populations [90]. Near-infrared light therapy is an
emerging technology that could be used in
combination with other therapies to treat
cerebrovascular disease [91]. Moreira et al. (2011)
observed the effects of phototherapy on wound
healing following cerebral ischemia by cryogenic
injury. They showed that the irradiated lesions lost
less tissue than the control, had a significantly higher
number of viable neurons, and the lesions of irradiated
animals had fewer leukocytes and lymphocytes. They
concluded that laser phototherapy was able to control
brain damage, thus leading to wound healing
following cryogenic injury [92]. Another study by
Shen et al. investigated the effects of irradiation from
a low-level laser applied to rat models with stroke.
They observed the proliferation and differentiation of
adipose tissue-derived stem cells in neuronal cells.
The results of Western blot analysis indicated a
significant increase in nestin and oligo-2,
demonstrating that low-level laser irradiation exerts a
positive effect on the differentiation of stem cells and
can be employed to treat ischemic stroke to regain
motor functions [93].
The inflammatory process plays an important role in
some skin diseases. For some skin conditions NIR-
LED therapy has shown bactericidal and anti-
inflammatory effects [94-96]. As for other
inflammatory skin diseases, a study performed in
patients with psoriasis found anti-inflammatory
effects when using 830 nm and 633 nm NIR-LED
therapy [97]. In animal models of serositis it was
observed that the application of near-infrared light
therapy reduced inflammation in peritonitis and
pleurisy by reducing inflammatory cell migration
[98,99].
Near-infrared light therapy may accelerate cutaneous
wound healing in different pathological conditions
such as diabetes, and burned or injured skin. This
accelerated process was observed in association with a
photobiomodulation-related increase of healing
mediators such as integrins, laminin, kinesin, TGF-β1
and matrix metalloproteinase-2. Photobiomodulation
stimulated healing, relieved pain and inflammation,
restored function of tissue, and helped to control
secondary infection [100-106]. The wounds of
patients treated with a 670 nm, 720 nm, and 880 nm
near-infrared LED unit healed twice as quickly as
their counterparts not treated with near-infrared.
Following tissue injury, adequate inflammatory
vascular responses are essential for subsequent tissue
repair. Khodr et al. studied the role of ROS and age in
modulating the inflammatory response in acute and
chronic injury conditions and the implications of this
modulation for tissue repair. The results showed that
antioxidant treatment had no effect on the response
during early and late phases of acute inflammation in
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young rats. However in old rats, the vascular response
was significantly attenuated (60%) or significantly
increased (40%) during the early and late phases of
acute inflammation, respectively. The results suggest
that ROS have a paradoxical role exerting either a
positive or negative effect on the inflammatory
response with age. Related with this observation, the
ROS can be modulated by NIR-LED as we observe
previously in the text [107]. The potential for fracture
and bone injury in the aging adult is high due to gait
disturbances, daily activities, age more than 75, living
alone, chronic pain, metabolic diseases, and
nutrition/vitamin deficits. Bone healing has also been
shown to benefit from light therapy [108,109].
Pinheiro et al. demonstrated that bone irradiated with
near-infrared light showed increased osteoblastic
proliferation, collagen deposition, and bone
neoformation [110]. Rats given a ligature injury at the
first mandibular molar were treated with NIR-LED
irradiation, and histomorphological analysis revealed
decreased bone resorption, lower neutrophil
migration, and lower TNF levels [111].
Pharmacological therapy is widely used to modulate
inflammation and wound healing, but NIR-LED GaAs
therapy is emerging as a promising non-
pharmacological coadjutant treatment for these
conditions. Some studies have compared the effect of
light therapy with that of the most commonly used
drugs for inflammation and wound healing. De
Almeida et al. compared the effects of the topical
application of sodium diclofenac with low-laser
therapy on morphological aspects and the gene
expression of biochemical inflammatory markers.
Compared to subjects given diclofenac, those
receiving light therapy showed decreased expression
of COX-2 and TNF-α, and improved morphological
aspects of the tissue [112]. A similar study by de
Paiva Carvalho et al. observed that, compared with
the topical and intramuscular application of
diclofenac, near-infrared light therapy more
effectively decreased the levels of prostaglandin E2
during the treatment of acute muscle strain injury
[113]. Viegas et al. observed that low-level laser
therapy showed a higher degree of collagen fiber
organization and maturation, and a better healing
pattern than that seen with the use of meloxicam, but
meloxicam more effectively decreased the intensity of
polymorphonuclear infiltration and edema in rat
wounds [114]. Finally, some studies have compared
the effects of near-infrared light therapy with those of
corticosteroids. These have observed that, compared
to corticoids, light therapy increases collagen content,
allows a better arrangement of the ECM, an increase
in number of fibroblasts, and accelerated levels of
epithelialization. Near-infrared light accelerates tissue
repair even in the presence of dexamethasone [115-
117]. Other physical therapy use on the treatment of
wound healing is ultrasound. A study by Demir et al.
compared the effects of laser, ultrasound, and
combined laser and ultrasound treatments in
experimental tendon healing. They concluded that
both treatments increased tendon healing biochemical
and biomechanical more than the control groups. No
statistically significant difference was found between
ultrasound and laser therapy and these therapies can
be used successfully in the treatment of tendon
healing [118].
Many diseases of the elderly, such as Alzheimer's
disease, could benefit from NIR-LED therapy studies.
The injury to the brain during the progression of
Alzheimer's disease is also compounded by
inflammation and studies should be completed to
understand the effects of NIR-LED therapy on
Alzheimer's inflammation [49].
Finally, aging and many pathologies related to aging,
are closely associated to inflammatory processes and
are the target of many therapeutic options, often with
undesirable side effects. NIR-LED is emerging as an
adjunctive treatment option without adverse effects,
which makes it an interesting option in adult patient
who frequently consume too many drugs which could
help decrease, or not potentiate, adverse effects. NIR-
LED can exert therapeutic effects at different stages of
the inflammatory process and tissue repair. This
makes it a therapeutic option of great interest for
clinical application and research for its promising
modulatory effects at the molecular level.
Conclusions
GaAs-based NIR-LEDs represent a novel, non-
invasive, and effective coadjutant therapeutic
intervention for the treatment of numerous diseases
linked to inflammation and wound healing. The
equipment is easy to obtain, economically more sound
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than other methods of NIR radiation, can be used
several times during the day, simple to use with little
training, and versatile for use in many fields and
locations.
Acknowledgements
The authors acknowledge the help of Jeffrey Dikin.
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... The near-infrared LED represents a novel, noninvasive, and effective coadjutant therapeutic modality that enhances the natural wound healing process and reduce the risk of infection by promoting biological effects such as decrease of inflammatory cells, increase of fibroblast proliferation, stimulation of angiogenesis, and increase synthesis of collagen depending on irradiation parameters; wavelength and dose. 14,15 The statistical analysis of our study results showed that the mean and SD of LED therapy group pretreatment were 161.14 ± 11.66 mm 2 . There was a significant decrease in the wound surface area after 8 weeks at the end of treatment to 79.54 ± 5.33 mm 2 . ...
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... 19 On the other hand, leukocyte activation can also promote the production of arachidonic acid. 41 It is found that NIR LED light at 880 nm can suppress the activity of a key enzyme in the production of arachidonic acid derivatives in the area of inflammation, i.e., cyclooxygenase-2 (COX-2), and can therefore reduce inflammation. 96 An LED therapy has been reported to be effective for treating inflammation, erythema and edema using 630-660 nm LEDs, with E e ! ...
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... Patient care also includes keeping skin contact with urine or feces to a minimum, changing briefs as needed. New coadjuvant techniques to the prevention techniques mentioned include near infrared Light Emitting Diode treatment and medical Manuka honey to accelerate wound healing [36][37][38][39][40][41]. More research on both of these therapies should be done in the various age groups that benefit from home care. ...
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Background and objective: Low level laser therapy (LLLT) has been used for the last few years to treat sports injuries. The purpose of this study was to compare three therapeutic protocols in treating edema in second degree ankle sprains, that did not require immobilization with a splint, under placebo-controlled conditions. Study design/Material and Methods: Forty-seven soccer players with second degree ankle sprains, selected at random, were divided into the following groups: The first group (n=16) was treated with the conventional initial treatment (RICE- Rest, Ice, Compression, Elevation-), the second group (n=16) was treated with the RICE method plus placebo laser, and the third group (n=15) was treated with the RICE method plus an 820nm GaA1As diode laser with a radiant power output of 40 mW at 16 Hz. Before the treatment, and 24, 48 and 72 hours later, the volume of the edema was measured. Results: A three by three repeated measures ANOVA with a follow up post hoc test revealed that the group treated with the RICE and an 820nm GaA1As diode laser, statistically presented a significant reduction in the volume of the edema after 24 hours (40. 3 ± 2. 4 ml , p<0. 01), 48 hours (56. 4 ± 3.1 ml, p<0. 002) and 72 hours (65.1 ± 4. 4 ml, p<0.001). Conclusions: LLLT combined with RICE can reduce edema in second-degree ankle sprains.
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Background: The epidemiology of chronic pain with advancing age remains poorly established. Although most studies have examined somatic (musculoskeletal and joint) pain, visceral pain (such as headache and abdominal pain) has warranted less attention. We present longitudinal data from age 70 to 90 years concerning chronic musculoskeletal/joint pain, abdominal pain, and headache. Methods: Data was collected by the Jerusalem Longitudinal Study, which is a prospective study of a representative sample from the 1920-1921 birth-cohort living in West Jerusalem. Participants underwent comprehensive assessment at home in 1990, 1998, 2005, and 2010, at ages 70 (n = 460), 78 (n = 763), 85 (n = 1149), and 90 years (n = 394), respectively, and were directly questioned concerning the presence and location of pain. Results: The overall prevalence of pain of any kind at ages 70, 78, 85, and 90 years was 73% (n = 336/460), 81.1% (n = 619/763), 56.3% (n = 647/1149), and 31.2% (n = 123/394), respectively. Pain at younger ages only was associated with female gender, lower educational status, functional dependence, physical inactivity, increased body mass index, loneliness, depression, and poor self-rated health. At ages 70, 78, 85, and 90 years, chronic neck/back pain was present among 41.5%, 58.9%, 30.1%, and 14.6% of participants, respectively; chronic joint pain was present among 43.0%, 60.6%, 45.2%, and 25.2%, respectively. In contrast abdominal pain was less common and disappeared among the oldest old: 14.7%, 13.9%, 1.7%, and 1.5%, respectively, with a similar pattern for headache: 43.3%, 33.5%, 2.1%, and 1.3%. While pain was reported at ≥2 sites by 42.3% and 54.6% at ages 70 and 78 years, respectively, by ages 85 and 90 years, pain was most frequently reported at only 1 site. Conclusions: Visceral pain (headache and abdominal pain) completely disappeared among the oldest old, in contrast to a far smaller decline in somatic (musculoskeletal and joint) pain.
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To explore clinical effects of suturing-assisted locking plate in treating elderly proximal humeral fractures. From January 2005 to January 2013, 55 elderly patients with three- and four-part fractures of proximal humeral fractures were divided into treatment group and control group. In treatment group, there were 31 patients including 12 males, and 19 females aged from 65 to 85 with an average of (74.00±5.42) years old, and treated with suturing-assisted locking plates; 19 patients were Neer 3-part fractures, and 12 patients were Neer 4-part fractures of proximal humerus; 23 patients were suffered from low-energy injuries and 8 patients were caused by high-energy injuries. In control group, there were 24 patients including 7 males, and 17 females aged from 65 to 85 with an average of (72.79±5.34) years old, and treated with locking plates; 16 patients were Neer 3-part fractures, and 8 patients were Neer 4-part fractures of proximal humerus; 17 patients were suffered from low-energy injuries and 7 patients were caused by high-energy injuries. Operative time, blood loss during operation, and bone healing time between two groups were observed and compared. Postoperative Neer scoring were used to evaluate recovery of shoulder joint function. All patients were followed up from 6 to 24 months with an average of 16.1 months. In treatment group, blood loss was (495.806±143.150) ml, function of Neer scoring was 22.645±2.443, range of action was 18.194±2.613, anatomy was 7.935±1.504 and total score of Neer scoring was 77.161±8.335; while in control group, blood loss was (641.667±169.851) ml, function of Neer scoring was 13.958±1.989, range of action was 13.083±2.165, anatomy was 5.500±1.978 and total score of Neer scoring was 58.792±7.313. There were sigificant difference between two groups in these indexes. Suturing-assisted locking plate for the treatment of proximal humerus fractures in elderly, has advantages of less blood loss, simple fracture reduction and rapid recovery of shoulder joint, and is a effective method.