Article

Low-level laser therapy as a non-invasive approach for body contouring: A randomized, controlled study

Authors:
  • OSF Saint Anthony Medical Center
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Abstract

Transmission electron microscopic images have demonstrated the formation of transitory pores in adipocyte cell membranes followed by the collapse of adipose cells subsequent to laser irradiation of 635 nm. The objective is to evaluate the application of a 635 nm and 17.5 mW exit power per multiple diode laser for the application of non-invasive body contouring of the waist, hips, and thighs. Double-blind, randomized, placebo-controlled trial of a 2-week non-invasive laser treatment conducted from May 2007 to June 2008 across multiple-private practice sites in the United States of America. Sixty-seven volunteers between the ages of 18-65 with a body mass index (BMI) between 25 and 30 kg/m(2) and who satisfied the set inclusion criteria participated. Eight of the 67 subjects did not have circumference measurements recorded at the 2-week post-procedure measurement point. Participants were randomly assigned to receive low-level laser treatments or a matching sham treatment three times per week for 2 weeks. Reduction in the total combined inches of circumference measurements of the waist, hip and bilateral thighs from baseline to the completion of the 2-week procedure administration phase was assessed. Participants in the treatment group demonstrated an overall reduction in total circumference across all three sites of -3.51 in. (P < 0.001) compared with control subjects who revealed a -0.684 reduction (P < 0.071745). Test group participants demonstrated a reduction of -0.98 in. (P < 0.0001) across the waist, -1.05 in. (P < 0.01) across the hip, and -0.85 in. (P < 0.01) and -0.65 in. (P < 0.01) across the right and left thighs from baseline to 2 weeks (end of treatment). At 2 weeks post-procedure, test group subjects demonstrated a gain of 0.31 total inches collectively across all three sites. These data suggest that low-level laser therapy can reduce overall circumference measurements of specifically treated regions.

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... Resultados de diferentes estudos relatam a eficácia da LLLT na diminuição de medidas corporais, 3,[5][6][7][8] o que dá suporte à utilização dessa tecnologia como uma alternativa não invasiva para remodelamento corporal e redução do tecido subcutâneo. Entretanto, até hoje poucos estudos utilizaram métodos objetivos para determinação da espessura do tecido subcutâneo antes e depois do tratamento com LLLT. ...
... Redução nas medidas de circunferência corporal já foram descritas por outros investigadores. 3,[5][6][7][8]13 A maioria dos autores relatou a utilização desse tratamento na região abdominal, 3,5,6,8 com efeitos significativos até duas semanas após sua finalização. Em nosso estudo, observamos a manutenção dos resultados por período consideravelmente mais extenso para a região abdominal e semelhante aos descritos para a região do quadril. ...
... Redução nas medidas de circunferência corporal já foram descritas por outros investigadores. 3,[5][6][7][8]13 A maioria dos autores relatou a utilização desse tratamento na região abdominal, 3,5,6,8 com efeitos significativos até duas semanas após sua finalização. Em nosso estudo, observamos a manutenção dos resultados por período consideravelmente mais extenso para a região abdominal e semelhante aos descritos para a região do quadril. ...
Article
Introduction: Low level laser therapy has been considered a non-invasive treatment alternative to body remodeling and fat tissue reduction. Objective: To evaluate the efficacy of low level laser therapy in reducing body circumference measures and subcutaneous adipose tissue of the abdomen and hips areas. Methods: An open, prospective, monocentric study was performed including 25 women with localized fat on the hips and abdomen. Nine sessions of low level laser therapy were performed over 3 weeks. The participants were assessed at baseline and at 1, 4 and 12 weeks after treatment. Assessment of weight and body circumferences, lipid profile tests and MRI were performed. Results: The abdominal circumference measurements showed a significant reduction up to 12 weeks after the treatment. Participants showed a more marked reduction in the hips region one week after the last session. Also one week after the completion of the treatment, 80% of the participants considered that the treatment improved their body contour. There was absence of reports of adverse events related to the treatment. Conclusion: Low level laser therapy is safe and effective in reducing the circumference measurements, particularly in the abdominal region.
... cm in the abdomen. 11,12,15,17 RF studies showed reductions of 4.93 cm, 23 3.58 cm, 26 2.7 cm 24 and 1.4 cm. 25 Three HIFU studies showed reductions of 4.1-4.7 cm 9,31,33 and four showed reductions of 2.1-2.5 cm. [28][29][30]32 The only study to use both HIFU and RF therapies showed a 3.91 cm reduction. ...
... cm. 12,13,15,17 The only other study to measure efficacy in the hips was with LPG Endermologie, which reported 1.85 cm and 3.19 cm reduction after 7 and 14 treatments respectively. 36 Fat reduction in the thighs Cryolipolysis and shockwave combined showed a 5.78 cm circumferential reduction in both thighs combined. ...
... cm. 12,13,15,17 Of the two LLLT studies which only treated one thigh to maintain the other as an internal control, one achieved only a 0.64 cm mean reduction 16 and the other found no significant reduction. 18 One HIFU study showed a 1.6 cm reduction 33 and one RF study reported a 1.2 cm reduction in the thighs. ...
Article
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The risks, financial costs and lengthy downtime associated with surgical procedures for fat reduction have led to the development of a number of non-invasive techniques. Non-invasive body contouring now represents the fastest growing area of aesthetic medicine. There are currently four leading non-invasive techniques for reducing localized subcutaneous adipose tissue: low-level laser therapy (LLLT), cryolipolysis, radio frequency (RF) and high-intensity focused ultrasound (HIFU). To review and compare leading techniques and clinical outcomes of non-invasive subcutaneous fat reduction. The terms 'non-invasive', 'low-level laser', 'cryolipolysis', 'ultrasound' and 'radio frequency' were combined with 'lipolysis', 'fat reduction' or 'body contour' during separate searches in the PubMed database. We identified 31 studies (27 prospective clinical studies and four retrospective chart reviews) with a total of 2937 patients that had been treated with LLLT (n = 1114), cryolipolysis (n = 706), HIFU (n = 843) or RF (n = 116) or other techniques (n = 158) for fat reduction or body contouring. A majority of these patients experienced significant and satisfying results without any serious adverse effects. The studies investigating these devices have all varied in treatment regimen, body locations, follow-up times or outcome operationalization. Each technique differs in offered advantages and severity of adverse effects. However, multiple non-invasive devices are safe and effective for circumferential reduction in local fat tissue by 2 cm or more across the abdomen, hips and thighs. Results are consistent and reproducible for each device and none are associated with any serious or permanent adverse effects. © 2015 European Academy of Dermatology and Venereology.
... A multicenter, double-blind, randomized, placebocontrolled trial was performed on 67 patients. 52 Patients were randomized to active treatment using LLLT (35 patients) or inactive sham treatment (32 patients). Treatment in both groups was performed over 2 weeks, with 3 sessions that 2 days apart per week. ...
... The active treatment group also saw reductions in thigh circumference, whereas the placebo group did not. 52 Jackson et al 53 further reported a series of 689 patients who had undergone LLLT for body contouring. These patients underwent a 2-week regimen of 6 total sessions, as described in the previous study. ...
... These patients underwent a 2-week regimen of 6 total sessions, as described in the previous study. 52 The authors had complete data for 660 participants, and the mean overall reduction in waist, hip, and thigh circumference was 3.27 inches. This change was statistically significant. ...
Article
The demand for body contouring is rapidly increasing, and interest in noninvasive approaches has also grown. The author reviewed the evidence base behind the currently available devices and methods for nonsurgical body contouring. There is little high-level evidence in the present literature to support the effectiveness of any of these devices. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.
... L ow level laser therapy (LLLT) has become established as an effective method for reducing waist, hip, thigh, and upper arm circumference of overweight, but non-obese individuals (body mass index [BMI] <30kg/m 2 ). [1][2][3][4] Because it is a completely noninvasive procedure, the use of LLLT for body contouring is not associated with adverse effects, such as pain or infection and no adverse changes in serum lipids. 5 LLLT has no adverse effects on the skin or underlying musculofascial system and may improve the appearance of cellulite. ...
... Clinical studies demonstrating the effectiveness of LLLT have used red diodes emitting light at a wavelength of 635nm applied for 40 minutes (20 minutes to front and back) three times weekly for two weeks [1][2][3] or green diodes emitting light at a wavelength of 532nm for 30 minutes (15 minutes to front and back) three times weekly for two weeks. 4 A similar treatment protocol has demonstrated the effectiveness of the 635nm wavelength for reducing upper arm circumference. ...
... The results of this study confirm the results of previous studies demonstrating the effectiveness of LLLT for reducing circumference measurements of the bilateral thighs, hips, and waist circumference. [1][2][3][4] In addition, it has extended these results to include significant reductions in upper abdomen circumference. The mean combined baseline circumference measurements decreased from 166.9 inches (423.9cm) to 161.4 inches (410.0cm) ...
Article
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Objective: The efficacy of low-level laser therapy for noninvasive body contouring has been previously demonstrated in clinical trials leading to its market clearance. Subjects achieved these beneficial effects following three weekly low-level laser therapy treatments for two weeks. The objective of this study was to determine if the same aesthetic benefit can be achieved following one weekly low-level laser therapy treatment for six weeks. Setting: Two private dermatology practices. Participants: Healthy adults with a body mass index of 25 to 40kg/m(2) (N=54). Measurements: Subjects underwent one weekly low-level laser therapy procedure for six consecutive weeks using a device consisting of six 17mW, 635nm red diodes. Waist, hip, thigh, and upper abdomen circumference were measured weekly. Study success criteria was a 4.5-inch mean decrease in combined body circumference. Results: The mean decrease in combined circumference reduction at six weeks was 5.4 inches (p<0.001), and most subjects (72.2%) achieved a ≥4.5-inch decrease. Most subjects (81.0%) were Satisfied (27%) or Very Satisfied (54%) with the aesthetic results they achieved. There were no adverse events. Conclusion: One weekly low-level laser therapy treatment for six weeks is clinically effective for reducing waist, hip, thigh, and upper abdomen circumference and may be more effective than the previous two-week treatment protocol. ClinicalTrials.gov Identifier: NCT02109107.
... There is still much to elucidate about the mechanisms underlying LLLT and how it acts on cells and tissues, but there is evidence that the response usually exhibit a biphasic dose-response profile [11]. In the adipose tissues, some authors have attempted to modify their metabolism using LLLT, and some clinical studies [12,13] tried to explain how there could be the reduction of body contours promoted by the LLLT, including the transitory induction of pores in the membranes of the adipocytes and consequently liberation of intracellular constituents (fat) and its removal and metabolism; however, the mechanisms still remain unclear. ...
... However, the effect of LLLT on the metabolic activity is not yet established. Jackson et al. [12] performed a noncontrolled and nonrandomized pilot clinical study that investigated the effects of the LLLT (635 nm) on lipid parameters. The individuals were able to maintain a regular diet and exercise regimen during the study. ...
... According to one narrative, by forming temporary pores in the adipocytes' membrane, LLLT triggers the release of intracellular lipid for additional metabolization (87). In a double-blind study of 67 randomized subjects, aged 18-65 years old, with BMI 25-30 kg/m 2 , LLLT resulted in a reduction of total circumference of the waists, hips and bilateral thighs (88). Despite these preliminary findings, suggestive of the efficacy of the method, further research into LLLT is required to fully appreciate its cellular and systemic effects, and to ascertain treatment protocols, which allow the highest degree of safety and effectiveness possible. ...
... According to a retrospective study on 518 participants, the abdomen, back and flank areas were most effectively treated by means of cryolipolysis. Three months follow-up of the patients, moreover, displayed no significant adverse events or side effects (88). Appraising the findings of preclinical and clinical studies on the use of cryolipolysis for animals and humans, a 2009 review of four clinical studies concluded that there was sufficient evidence to support the efficacy and safety of cryolipolysis, as a noninvasive fat reduction procedure, even though its mechanism of action is yet to be explained (89). ...
Article
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Obesity and its associated morbidities pose a major health hazard to the public. Despite a multiplex of available diet and exercise programs for losing and maintaining weight, over the past years, interest in the use of complementary and alternative medicine (CAM) for obesity treatment has greatly increased. We searched PubMed, Google scholar and the Cochrane databases for systemic reviews, review articles, meta-analysis and randomized clinical trials up to December 2013. In this review, the efficacy and safety of the more commonly used CAM methods for the treatment of obesity, namely herbal supplements, acupuncture, and non-invasive body-contouring, are briefly discussed. The evidence supporting the effectiveness and safety of these methods is either lacking or point to a negligible clinical benefit, barely surpassing that of the placebo. Furthermore, several limitations are observed in the available scientific literature. These shortcomings include, without being limited to, uncontrolled trial designs, non-random allocation of subjects to treatment arms, small number of patients enrolled, short durations of follow-up, and ambiguous clinical and laboratory endpoints. Further investigations are necessary to accurately determine the efficacy, safety, standard dosage/procedure, and potential side effects of the various CAM methods currently in use.
... Previous studies have shown that LA has promising effects on obesity [14,15]. LLLT as an approach for body contouring and spot fat reduction has also been reported [16,17]. But the absence of placebo control and lack of sufficient comparative parameters have been questioned [18]. ...
... Improvement in BMI and WHR suggests that LA may be considered a noninvasive option for body contouring with weight loss. Although weight changes over the course of the treatment would also change waist circumference, results from controlled clinical studies have demonstrated that LLLT achieved safe and significant waist circumference reduction [16,17]. However, future investigations must be conducted to explore the long-term effects of LA on body parts for circumferential loss. ...
Article
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Purpose . A patient-assessor-blinded, randomized, sham-controlled crossover trial was performed to investigate the effectiveness of laser acupuncture on anthropometric measurements and appetite sensation in obese subjects. Methods . Fifty-two obese subjects were randomly assigned to either the laser acupuncture group or the sham laser acupuncture group. Subjects within each group received the relevant treatment three times a week for 8 weeks. After a two-week washout period, the subjects then received the treatment of the opposite group for another 8 weeks. BMI, body fat percentage, waist-to-hip ratio (WHR), waist circumference, hip circumference, and appetite sensations were measured before and after 8 weeks of treatment. Results . BMI, body fat percentage, WHR, waist circumference, and hip circumference decreased significantly ( p < 0 . 05 ) in the laser acupuncture group compared to baseline but there was no decrease in those variables in the sham laser acupuncture group. Laser acupuncture significantly improved scores on the fullness, hunger, satiety, desire to eat, and overall well-being relative to the baseline ( p < 0.05 ). Conclusions . Laser acupuncture is well tolerated and improves anthropometric measurements and appetite sensations in obese subjects.
... More recently, there have been attempts to apply LLLT to treat acne, scars, alopecia, and cellulite. LLLT devices are also marketed for cosmetic use in body contouring and reduction of subcutaneous fat thickness [5][6][7][8][9][10][11]. Despite several studies reported a significant reduction of subcutaneous fat thickness induced by LLLT, the exact mechanism by which LLLT acts on fatty tissue has not been elucidated. ...
... Our result is clearly discordant with those obtained in a well-designed randomized double-blinded study by Jackson et al. [12] and another large-scale study [10], yet they may be mechanistically reconciled. ...
Article
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Low-level laser (light) therapy (LLLT) has been applied recently to body contouring. However the mechanism of LLLT-induced reduction of subcutaneous adipose tissue thickness has not been elucidated and proposed hypotheses are highly controversial. Non-obese volunteers were subject to 650nm LLLT therapy. Each patient received 6 treatments 2-3 days apart to one side of the abdomen. The contralateral side was left untreated and served as control. Subjects' abdominal adipose tissue thickness was measured by ultrasound imaging at baseline and 2 weeks post-treatment. Our study is to the best of our knowledge, the largest split-abdomen study employing subcutaneous abdominal fat imaging. We could not show a statistically significant reduction of abdominal subcutaneous adipose tissue by LLLT therapy. Paradoxically when the measurements of the loss of fat thickness on treated side was corrected for change in thickness on non treated side, we have observed that in 8 out of 17 patients LLLT increased adipose tissue thickness. In two patients severe side effect occurred as a result of treatment: one patient developed ulceration within appendectomy scar, the other over the posterior superior iliac spine. The paradoxical net increase in subcutaneous fat thickness observed in some of our patients is a rationale against liquefactive and transitory pore models of LLLT-induced adipose tissue reduction. LLLT devices with laser diode panels applied directly on the skin are not as safe as devices with treatment panels separated from the patient's skin.
... In total, 14 subjects showed a 5% to 35% reduction in fat thickness and improvement in the appearance of cellulite in the thighs at the end of the treatment period. 17 A review of the studies which applied LLLT for body contouring revealed that some researchers used red laser alone, [18][19][20][21][22] and others used a combination of red and infrared lasers. 17,23 In this study, a combination of 3 different wavelengths of diode lasers was used, and the effects of this combination were investigated on abdominal girth reduction. ...
Article
Full-text available
Introduction: The objective of this study was to assess the efficacy of a combination of 3 wavelengths (including red, infra-red, and blue) of low-level laser (LLL) as a non-invasive therapeutic method to reduce abdominal girth. To achieve biochemical activity on adipocytes, a red laser was used in our selective laser combination. Near-infrared laser was used to increase depth of penetration. Nitrosyl complexes of hemoglobin (NO-Hb) are sensitive to blue light, thereby leading to increase in release of biologically active nitric oxide (NO), which can affect tissue perfusion. Thus, a blue LED was added to the laser combination. Methods: Eighteen females participated in the study. Twelve sessions of laser therapy were performed, 2 sessions per week for each subject. Continuous wave diode lasers, including red (630 nm), infra-red (808 nm), and a blue LED (450 nm) were applied and were all designed by the Canadian Optic and Laser Center. Results: Statistical analyses revealed that upper abdomen size significantly decreased from pre- (91.86 ± 11.16) to post- (87.41 ± 10.52) low-level laser therapy (LLLT) (P<0.001). Middle abdomen size showed significant reduction from pre- (97.02 ± 8.82) to post- (91.97 ± 8.49) LLLT (P<0.001). Lower abdomen size significantly decreased from pre- (100.36 ± 9.45) to post- (95.80 ± 8.52) LLLT (P<0.001). Conclusion: Based on this case series pilot investigation, the combination of 3 different wavelengths of LLL was effective for abdominal girth reduction in 100% of our subjects (P<0.001), without any side effects. Future studies will assess the long-term benefits of this laser combination for reduction of subcutaneous fat deposits.
... Traditionally, liposuction was the most popular method for body contouring, but this invasive treatment has been associated with many adverse events and complications [1]. As a result, less invasive or noninvasive alternatives such as cryolipolysis [2,3], radiofrequency ablation [4,5], laser therapies [6], injection lipolysis [7], and ultrasound lipolysis [8,9] have been gaining more attention due to their moderate efficacy, fewer complications, and ease of use. Among the aforementioned technologies, ultrasound lipolysis is the most novel and promising. ...
Article
Full-text available
Nonfocused low-intensity ultrasound is generally believed to be less efficacious than High-Intensity Focused Ultrasound (HIFU) at body fat reduction; nevertheless, this technology has already been widely used clinically for body contouring purposes. This study aimed to evaluate the efficacy and safety of this new technology by applying 1 MHz nonfocused ultrasound at 3 W/cm ² to the outer-thigh region of rat models. Ultrasonography measurement demonstrated an average reduction of 0.5 mm of subcutaneous fat thickness that persisted for at least three days after treatment. Biochemical analysis quantified a significant increase in lipid levels, specifically triglyceride, high-density lipoprotein, and total cholesterol. These two findings of subcutaneous fat reduction and plasma lipid increase showed a positive correlation. No evidence of adverse events or complications was observed after the treatment. This study validated nonfocused low-intensity ultrasound as an effective and safe method for body fat reduction, especially with repetitive treatment. However, the concurrent increase in plasma lipid level will require further investigation to determine this technology’s long-term impact, if any, on health.
... We found ultrasound to be superior to WC and caliper measurements during our trial. Previous studies evaluating WC and fat thickness found moderate reductions with cryolipolysis, 32 HIFEM, 33 LLLT, 34 RF, 35 and HIFU. 36 MRI showed that HIFEM reduced adipose tissue thickness by 18.6% (0.43 cm; P < 0.0001) 2 months posttreatment, 37 whereas ultrasound showed that HIFEM reduced abdominal adiposity by 15.7% (P < 0.05) at 8 weeks posttreatment. ...
Article
Background CBL-514 is a novel injectable drug that may be safe and efficacious for localized abdominal subcutaneous fat reduction. Objectives To assess the safety and efficacy of CBL-514 in reducing abdominal subcutaneous fat volume and thickness. Methods This Phase IIa, open-label, random allocation study consisted of a 6-week treatment period and follow-up at 4- and 8-weeks following the last treatment. Participants were randomly allocated to 1.2 mg/cm 2 (180 mg), 1.6 mg/cm 2 (240 mg), or 2.0 mg/cm 2 (300 mg) of CBL-514 with up to 4 treatments, each with 60 injections into the abdominal adipose layer. Changes in abdominal subcutaneous fat were assessed by ultrasound at follow-up visits. Treatment-emergent adverse events were recorded. Results Higher doses of CBL-514 (unit dose: 2.0 and 1.6 mg/cm 2) significantly improved the absolute and percentage reduction in abdominal fat volume (p<0.00001) and thickness (p<0.0001) compared to baseline. Although the COVID-19 pandemic halted some participant recruitment and follow-ups, analysis was unaffected, even after sample size limitations. Conclusions CBL-514 injection at multiple doses up to 300 mg with a unit dose of 2.0 mg/cm 2 is safe, well-tolerated and reduced abdominal fat volume and thickness by inducing adipocyte apoptosis. While other procedures exist to treat abdominal fat, they have limitations and may cause complications. At a dose of 2.0 mg/cm 2, CBL-514 safely and significantly reduced abdominal fat volume by 24.96%, making it a promising new treatment for routine, non-surgical abdominal fat reduction in dermatological clinics.
... Maximum fat reduction was reported across the waist (2.66 cm). However, two weeks after the last treatment session, a 7.8-mm increase in circumferences was seen in three treated zones (62). In another clinical study, Jackson et al. reported that treating 689 subjects with LLLT (12 treatment sessions within 14 days) leads to 13.13-cm circumferential reduction in waist, hips, thighs, arms, knees, neck and chest (63). ...
Article
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Context Today, different kinds of non-invasive body contouring modalities, including cryolipolysis, radiofrequency (RF), low-level laser therapy (LLLT), and high-intensity focused ultrasound (HIFU) are available for reducing the volume of subcutaneous adipose tissue or cellulite. Each procedure has distinct mechanisms for stimulating apoptosis or necrosis adipose tissue. In addition to the mentioned techniques, some investigations are underway for analyzing the efficacy of other techniques such as whole body vibration (WBV) and extracorporeal shockwave therapy (ESWT). In the present review the mechanisms, effects and side effects of the mentioned methods have been discussed. The effect of these devices on cellulite or subcutaneous fat reduction has been assessed. Evidence Acquisition We searched pubmed, google scholar and the cochrane databases for systemic reviews, review articles, meta-analysis and randomized clinical trials up to February 2015. The keywords were subcutaneous fat, cellulite, obesity, noninvasive body contouring, cryolipolysis, RF, LLLT, HIFU, ESWT and WBV with full names and abbreviations. Results We included seven reviews and 66 original articles in the present narrative review. Most of them were applied on normal weight or overweight participants (body mass index < 30 kg/m²) in both genders with broad range of ages (18 to 50 years on average). In the original articles, the numbers of included methods were: 10 HIFU, 13 RF, 22 cryolipolysis, 11 LLLT, 5 ESWT and 4 WBV therapies. Six of the articles evaluated combination therapies and seven compared the effects of different devices. Conclusions Some of the noninvasive body contouring devices in animal and human studies such as cryolipolysis, RF, LLLT and HIFU showed statistical significant effects on body contouring, removing unwanted fat and cellulite in some body areas. However, the clinical effects are mild to moderate, for example 2 - 4 cm circumference reduction as a sign of subcutaneous fat reduction during total treatment sessions. Overall, there is no definitive noninvasive treatment method for cellulite. Additionally, due to the methodological differences in the existing evidence, comparing the techniques is difficult.
... This highlights the importance of carrying out laboratory tests with hematologic analyses and lipidic, immunologic, liver and kidney profile before performing any adipocytolytic procedure, thereby avoiding post-procedure complications. 20,21,36,46,49,[65][66][67][68][69][70][71][72][73][74][75][76][77] ...
Article
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Background: The adipocytolytic non-surgical esthetic procedures are indicated for the reduction of localized fat and are effective in reducing local adiposity through the ablation of adipocytes with fast and lasting results, besides causing local inflammation. Objective: This study aimed to characterize the adipocytolytic procedures and correlate the phases of the inflammatory process with the results obtained from such procedures, in order to clarify the role of inflammation triggered by the adipocytolytic procedures and its relation with the lipolytic process, with a focus on body shaping. Methods: This work is an integrative literature review that presents a total of 72 articles published between 1998 and 2015, derived from the PubMed database, in order to establish a relationship between clinical and basic science research, assuming an important role in medical practice based on evidence. Results: The results show that the adipocytolytic procedures are characterized by triggering inflammation arising from the disruption of adipocytes by interfering with the lipolytic signaling pathways in both acute and chronic phases of inflammation through the direct action of proinflammatory cytokines or catecholamines. Therefore, inflammation plays an important role in modulating the lipolytic process, influencing body shaping. Conclusion: The inflammatory process assists the adipolytic process in all stages of inflammation, contributing to the reduction of body contouring.
... To date, clinical trials have demonstrated the therapeutic effects of PBM leading to the US-FDA clearance of devices for body sculpting (Thornfeldt et al., 2016;Nestor et al., 2012;Roche et al., 2017;McRae and Boris, 2013;Jackson et al., 2009;Suarez et al., 2014), cellulite (Jackson et al., 2013), pain (Roche et al., 2016) and, most recently, onychomycosis (Zang et al., 2017). To date, there have been no reports of treatment-related adverse events. ...
Article
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Research into photobiomodulation reveals beneficial effects of light therapy for a rapidly expanding list of medical conditions and illnesses. Although it has become more widely accepted by the mainstream medicine, the effects and mechanisms of action appear to be poorly understood. The therapeutic benefits of photobiomodulation using low-energy red lasers extend far beyond superficial applications, with a well-described physics allowing an understanding of how red lasers of certain optimum intensities may cross the cranium. We now have a model for explaining potential therapeusis for applications in functional neurology that include stroke, traumatic brain injury, and neurodegenerative conditions in addition to the currently approved functions in lipolysis, in onychomycosis treatment, and in pain management.
... A placebo-controlled, randomized, double-blind, multisite clinical investigation evaluating 67 study participants demonstrated an average reduction of 3.51 in. across patient's waist, hips, and thighs in as little as 2 weeks [69]. Another double-blind, controlled, randomized study designed to assess the efficacy of 635-nm LLLT (3.94 J/cm 2 , 17 mW) in reducing upper arm circumference in 20 participants demonstrated a significant progressive and cumulative treatment effect following six treatments with no side effects [70]. ...
Article
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The landscape of aesthetic dermatology has changed dramatically over the past couple of years due to soaring patient demands for minimally invasive, safe, effective, and fast whole-body procedures and the continuously emerging new technologies. Moreover, the concept of whole-body rejuvenation as the new paradigm that ensures skin health and age prophylaxis by stimulating dermal remodeling, epidermal turnover, skin tightening, and modulating repletion or depletion of volume requires clinical application of a combination of energy-based devices (intense-pulsed light, fractional lasers, vascular lasers, ultrasound, radiofrequency, shockwave, and low-energy laser light devices) alongside fillers/toxins and an at-home skin care regimen. This present-day reality has mobilized physicians to carefully assess the best strategies for their patient’s goals while capitalizing on the advantages of each of the technologies entering the arena. As such, this report aims to provide an overview of the mainstream energy-based modalities currently used for whole-body rejuvenation.
... Several studies have shown that laser acupuncture could be an effective treatment of obesity [8,9]. Low-level laser therapy as a non-invasive approach for body contouring and spot fat reduction has also been reported [10,11]. However, there are several experimental limitations that have to be considered. ...
Article
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Obesity-related diseases have a profound economic impact on health care systems. Laser acupuncture has been shown to have beneficial effects on obesity. However, to our knowledge, those trials were either non-randomized, non-blinded or included low-calorie diet control. We have, therefore, designed a patient-assessor-blinded, randomized, sham-controlled crossover trial to investigate the significance of laser acupuncture on obesity. One hundred and four subjects above 20 years of age with a body mass index (BMI) of over 25 kg/m(2) will be divided into 2 groups: experimental and control. Each subject will receive the treatment relevant to their group 3 times a week for 8 weeks. After 8 weeks of treatment the subject will enter a 2-week washout period, after which the subjects will switch groups. Measurements will include BMI, body fat percentage, waist-to-hip ratio (WHR), waist circumference, hip circumference, skinfold thickness, thigh circumference, body fat, blood pressure, heart rate, hunger and the 36-item Short-Form Health Survey (SF-36). The results of this study will provide the basis for future large-scale multicenter trials investigating the effects of laser acupuncture on obesity. ClinicalTrials.gov Identifier: NCT02167308 ; registration date: 14 June 2014.
... Different strategies that could promote treatment and control of this disease are being constantly investigated. Some evidence suggests the benefits of low-level laser (light) therapy (LLLT) for cellulite treatment, lipid control, and as a noninvasive body contouring treatment [1,2]. Phototherapy has recently been considered an important tool to improve the benefits of physical exercise to control inflammatory states, cardiometabolic risks, and metabolic inflexibility in obese women [3][4][5]. ...
Article
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Investigations suggest the benefits of low-level laser therapy (LLLT) to improve noninvasive body contouring treatments, inflammation, insulin resistance and to reduce body fat. However, the mechanism for such potential effects in association with exercise training (ET) and possible implications in browning adiposity processes remains unclear. Forty-nine obese women were involved, aged between 20 and 40 years with a body mass index (BMI) of 30–40 kg/m2. The volunteers were divided into Phototherapy (808 nm) and SHAM groups. Interventions consisted of exercise training and phototherapy applications post exercise for 4 months, with three sessions/week. Body composition, lipid profile, insulin resistance, atrial natriuretic peptide (ANP), WNT5 signaling, interleukin-6 (IL-6), and fibroblast growth factor-21 (FGF-21) were measured. Improvements in body mass, BMI, body fat mass, lean mass, visceral fat, waist circumference, insulin, HOMA-IR, total cholesterol, LDL-cholesterol, triglycerides, and ANP in both groups were demonstrated. Only the Phototherapy group showed a reduction in interleukin-6 and an increase in WNT5 signaling. In addition, it was possible to observe a higher magnitude change for the fat mass, insulin, HOMA-IR, and FGF-21 variables in the Phototherapy group. In the present investigation, it was demonstrated that exercise training associated with LLLT promotes an improvement in body composition and inflammatory processes as previously demonstrated. The Phototherapy group especially presented positive modifications of WNT5 signaling, FGF-21, and ANP, possible biomarkers associated with browning adiposity processes. This suggests that this kind of intervention promotes results applicable in clinical practice to control obesity and related comorbidities.
... They used diode laser with wavelength 635nm. Transmission electron microscopic images have demonstrated the formation of transitory specialized cell membrane-associated pores in adipocytes followed by collapse of adipose cells after brief treatment with LLL[24,25].Gold et al., 2011 investigated the efficacy of LLLT in reducing thigh circumference as it increases collagen production, reduce edema, increases membrane permeability and relives pain inflammation, all 105 without destroying fat cells. ...
... In that study, a reduction of approximately 2.0 cm in the treatment area (abdomen, thighs, or flanks) was achieved within 2 weeks after a single treatment and lasted for 12 weeks [18]. However, this reduction was lower than that of other noninvasive body-contouring techniques such as radiofrequency, low-level laser therapy, and HIFU, which reported reductions of [3.5 cm [27][28][29]. ...
Article
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Background: Recent advancements in body-contouring techniques have prompted the investigation of ultrasound (US) technology as a potential noninvasive alternative for nonobese subjects for lifting, tightening, and reducing small areas of unwanted fat. This prospective study aimed to evaluate the biological and aesthetic effects of a low-frequency, low-intensity US device in reducing localized fat deposits for improving the body contours. Methods: A total of 20 female subjects included in this study were subjected to low-frequency US in the abdomen area. The effectiveness of this technique was determined by measuring changes in the anthropometric measurements and body composition, photographs, and a Client Satisfaction Questionnaire. The safety of the technique for application was determined by assessing the clinical features and biochemical tests results. Results: After five US sessions, a significant mean reduction of 1.5, 2.1, and 1.9 cm was noted in the waist, abdominal, and umbilical circumferences, respectively. No significant changes were noted in the levels of free fatty acids, insulin, liver enzymes, or lipid profile. However, a significant increase in the fasting glucose level was noted. However, four adverse side effects were reported: mild burning or discomfort, tingling or unilateral numbness in the lower limbs, pain around the bony areas, and soreness in the abdomen. Conclusion: The low-frequency, low-intensity US device provides reduction in the abdominal region with a moderate level of satisfaction. However, more studies are required to assess the effectiveness of US for body contouring and its effect on glucose metabolism.
... The results also revealed a significant cumulative waist-girth loss (−2.15 cm), which is corroborated by our results. By the end of the last decade, Jackson et al. [31] sought to determine whether PBMT could reduce waist, hip, and thigh circumferences in a multi-centered, double-blinded randomized placebo-controlled study. From the baseline to post-treatment for 2 weeks, a statistically significant difference was found regarding the total circumference across the measured sites (−8.91 cm) compared with the placebo treatment, which achieved a circumferential reduction of (−1.74 cm). ...
Article
Background and objectives: Structured physical activities and dietary control have traditionally been used with the aim of controlling obesity. However, effective auxiliary modalities still needed to reduce local obesity, specifically abdominal obesity. This study examined the adjunct effect of photobiomodulation therapy (PBMT), and non-contact selective-field radiofrequency (NcRF) on abdominal adiposity in adolescents with obesity. Study design/materials and methods: Fifty-four adolescents with obesity (33 females and 21 males) took part in this study and were distributed randomly into three treatment-based groups. Control group (n = 18, age; 14.61 ± 1.14 years), PBMT group (n = 18, age; 14.22 ± 0.88 years), and NcRF group (n = 18, age; 15.11 ± 0.96 years). A dietary control plan of 1,000-1,200 kcal/day, and a 60-minute aerobic exercise program conducted day-by-day over 4 weeks were provided for all participants. Additionally, the PBMT group received 12 20-minute PBMT on the abdominal area (energy/session ~4.08 J/cm2 ) thrice/week, and the NcRF group underwent four 30-minute treatments with NcRF on the abdominal area once/week. Waist/hip ratio (W-to-H ratio), intra-abdominal fat thickness (IAFT), and the subcutaneous-abdominal fat thickness (SAFT) were observed at the baseline and after 4 weeks. Results: The W-to-H ratio and SAFT reduced significantly in the PBMT group compared with either the control group (P = 0.001 and 0.001, respectively) or the NcRF group (P < 0.001 and P = 0.046, respectively) post-intervention. However, the IAFT and IAFT/SAFT ratio did not differ significantly among the study groups (P > 0.05). Conclusion: Our analysis shows that PBMT is more efficient than NcRF for the reduction of W-to-H ratio and SAFT in adolescents with obesity. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
... This ratio is a predictor of the proportion of abdominal fat to gluteus-femoral fat is a determining factor in the consequences related to obesity and mortality.39 The application of LLLT, in the abdominal region, potentiates the lipolysis of the abdominal adipocytes in detriment of the gluteal-femoral adipocytes, promoting the release of fatty acids and glycerol into the bloodstream.11,40 The association with PE seems promotes an increase, since it seems that aerobic PE has higher rates of lipolysis in subjects with higher abdominal fat in relation to gluteus-femoral fat. ...
Article
Background: Increased abdominal fat and sedentary lifestyles contribute to cardiovascular disease risk. The combination of exercise and low-level laser therapy (LLLT) appears to be an innovative method to increase the lipolytic rate of abdominal adipocytes, in order to reduce abdominal fat. Objectives: To evaluate the effect of one session of aerobic exercise associated with abdominal laser therapy in lipolytic activity, profile lipid, and inflammatory markers (C-reactive protein-CRP). Methods: Experimental randomized controlled study in 36 participants of female sex divided into three groups: placebo group (PG) (n = 12), experimental group 1 (EG1) (n = 11), and experimental group 2 (EG2) (n = 13). The EG1 and EG2 performed the laser therapy protocol followed by 50 minutes of aerobic exercise on cycle ergometer, of 45%-55% of reserve heart rate; however, in EG2 the laser therapy was applied without power. The PG only performed the laser therapy protocol without power. The anthropometric measures were evaluated, and all participants were subject to blood samples at the beginning and at the end of the intervention for measure glycerol, lipid profile (total cholesterol, triglycerides, HDL, and LDL), and CRP. One-way ANOVA was used to compare the groups in the quantitative variables and Fisher's test to compare the groups in the qualitative variables. To compare the variables between moments (M0 and M1), we used the t test for paired samples. Results: In the group that performed physical exercise and lipolytic laser and in the group that performs only physical exercise, there was a significant increase in glycerol mobilization between M0 and M1 (P < .001). The same did not occur in the placebo group. Regarding the CRP levels and lipidic profile, no significant differences were observed between moments in the experimental groups. Conclusion: It is concluded that one session of aerobic exercise associated with LLLT and one session of aerobic exercise appears to be able to increase the lipolytic activity. However, it appears that LLLT does not provide increased value to the aerobic physical exercise by itself in lipolysis process.
... In some literature reports, PBM is associated with aerobic or resistance exercise, while other reports have mentioned waist and arm circumference reductions with the use of PBM, displaying an absence of diet restrictions or exercise requirements. [25][26][27][28][29] It is also reported that the amount of fat mobilised during a PBM session is similar to the amount that is consumed during a meal, in such a way that it can be absorbed by normal body energy requirements (and/or exercise routine), while at the same time, the risk of atherosclerosis is not increased by the treatment. 30 On the other hand, if not consumed, these fatty acids may be re-esterified and redistributed throughout the body, 30 causing no final changes in waist circumference. ...
Article
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Introduction The search for non-invasive procedures to reduce localised adiposity in aesthetics clinics has recently been increasing. In this context, procedures, such as cryolipolysis, ultracavitation, photobiomodulation (PBM) and other techniques have been proposed. Some studies have shown that PBM can be used in body contouring. However, there is no standardisation of the protocol. More than that, as in other techniques for reducing adipose tissue, the availability of triacylglycerol may affect the lipid profile in the blood, bringing consequences to the general health of an individual. This work will aim to compare the light wavelengths when using PBM as a technique for reducing the abdominal waist circumference, while also evaluating the efficacy of the method. Changes in the lipid profile in the blood, with a long-term follow-up, will also be appraised. Methods and analysis This will be a controlled, randomised, double-blind, single-centred clinical trial. 174 patients will be recruited at the Nove de Julho University, Brazil, and then divided into three groups: Group A—RED PBM; Group B—INFRARED PBM; Group C—PLACEBO ( Sham ) treatment. The treatments will consist of eight sessions, two times a week, for 4 weeks. At each session, the participants will receive 30 minutes PBM (using a radiant exposure of 127 J/cm ² ), with an abdominal strap containing 4 LED clusters, with 72 devices each, following the indication of randomisation. All of the groups will receive 30 min of Aussie Current, at 4 kHz, modulated at 10 Hz, 40–60 mA. The main outcome of this study will be waist circumference reduction. The secondary variables will be anthropometric data, lipid profile, liver function and adipose tissue thickness, changes in the local microcirculation, and the quality of life and self-esteem. The analyses will be performed at four stages of the research, D0, end of the eighth session (D30), 15 days after the last session (FU15), 90 days after the last session (FU90) and 180 days after the last session (FU180). Ethics and dissemination The Ethics Committee of the Nove de Julho University, Brazil, approved the modified version of this project under No. 3414146 on 26 June 2019. This study is not yet recruiting. The results obtained will be published in a peer-reviewed journal in the related field. Trial registration number Brazilian Registry of Clinical Trials—ReBec (RBR-9bwxcx).
... 55 LLLT ile yapılan çalışmalarda 2,97-3,81 cm'lik azalmalar saptanmıştır. 45,[56][57][58] Bununla birlikte, LLLT adipositlerin nekrozuna veya apoptozuna neden olmadığı için, yeniden oluşma ihtimalinin, adipositin ölümüne veya tahrip olmasına neden olan HIFU veya kriyolipoliz gibi diğer cihazlardan daha fazla olduğuna inanılmaktadır. 59 HIFU ile yapılan bir çalışmada 1,6 cm'lik, RF tedavisi ile ise uyluklarda 1,2 cm'lik bir azalma gösterilmiştir. ...
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ABS TRACT Nowadays, the tendency for non-invasive applications to achieve a more beautiful body appearance has increased. This trend has increased the demand for applications with fast-acting, quick recovery times and less complications. There are non-invasive body shaping modalities such as cry-olipolysis, ultrasound, radiofrequency, injection lipolysis, laser to reduce subcutaneous fat tissue. These modalities aim to reshape adipocyte necrosis and collagen. Appropriate modality selection in the right patient and indication leads to successful results.
Article
Introduction A low-level laser therapy (LLLT) device emitting 635 nm of red light is an effective, noninvasive method of reducing the circumference of the waist, hips, thighs, and upper arms. This randomized, double-blind, sham-controlled study assessed the effectiveness of an LLLT device emitting 532 nm of green light for body contouring using the same treatment protocol as the red 635-nm LLLT device. Materials and Methods Enrolled subjects were 18–65 years of age with a body mass index (BMI) <30 kg/m ² . The LLLT device consists of 5 independent diodes, each emitting 17 mW of green laser light with a frequency of 532 nm (Erchonia ML Scanner, Erchonia Corporation, McKinney, Tex). Subjects were randomized to receive active (n = 35) or sham LLLT treatments (n = 32) over a 2-week period. Three treatments were administered each week, 2–3 days apart. Efficacy assessments included waist, hip, and thigh circumference measurements; body weight; and BMI following 3 LLLT treatments (week 1), 6 LLLT treatments (week 2), and 2 weeks following the final procedure. A treatment satisfaction survey was completed at week 2. The primary efficacy outcome measure was the change in total combined baseline circumference measurements at week 2. The criterion for individual treatment success was ≤3.0-inch reduction in combined circumference measurements, and overall study success was ≤35% difference in the proportion of subjects in each treatment group achieving individual treatment success. Secondary efficacy outcomes included the change in total combined baseline circumference measurements at each subject evaluation as well as satisfaction survey results. Results At week 2, the LLLT-treated subjects demonstrated a mean (SD) decrease in total combined circumference measurements of 3.9 (3.0) inches (P <.0001) compared with 1.1 (2.3) inches for sham-treated subjects. Among LLLT-treated subjects, 24 (68.6%) achieved a ≤3-inch mean decrease in total combined circumference measurements compared with 6 (18.8%) in the sham group (P < .0001). The effects of LLLT treatment were independent of baseline body weight, BMI, and total baseline circumference measurement. Compared to baseline measures, the LLLT-treated subjects demonstrated significant decreases in circumference measures for each individual treatment area at the week 1, week 2, and 2 weeks posttreatment evaluations. Among subjects responding to the satisfaction survey, an overall satisfaction response was obtained from 65% of LLLT subjects versus 19% of sham-treated subjects. Conclusions The use of LLLT device equipped with 532-nm green diodes is a safe and effective means for noninvasive body contouring of the waist, hips, and thighs.
Article
Introduction: Fibrous capsular contracture is the most frequent complication leading to patient dissatisfaction after breast augmentation and breast reconstruction. This multifactorial phenomenon has been treated both surgically and nonsurgically with mixed results. At the present time, the more severe grades of capsular contracture are treated most successfully by surgical means. Materials and Methods: The LTU-904 laser was used on 33 patients with grades III and IV capsular contractures. Patients underwent laser treatments once a week for a period of 6 weeks. They received a 10-minute treatment using the 904-nm laser with a 2-cm square grid pattern with 1 minute of treatment in each area (300 mJ/1 min treatment = 1.5 J/cm²). Patients were administered a posttreatment survey to determine their level of improvement and satisfaction. Results: Surgical intervention was avoided in 93.9% of patients with grade III and IV capsular contraction. Of the patients who avoided surgery, the laser improved the stiffness of the breast by 10–95% (average, 43.6%) and an overall improvement in comfort ranging from 10–95% (average, 48.2%). Conclusions: Low-level laser therapy is a promising alternative treatment for grades III and IV capsular contracture. In most cases, both the patient and surgeon observed significant tissue softening and improved breast contour after treatment while avoiding surgical intervention.
Article
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Introduction: Lipo-reductive ultrasound devices are commonly used for non-invasive body sculpting purposes because they can achieve clinically appreciable subcutaneous fat pad reduction and are safe and well tolerated by patients. Objective: This study aims to evaluate the morphological changes induced on the different cell components of human skin as a result of weakly focused high-frequency ultrasound. Methods: Full-thickness skin samples exposed or not to ultrasound ex vivo, and skin biopsies from patients pre-treated or not with ultrasound before lipo-reductive surgery, were analyzed to evaluate possible morphological changes of adipocytes. Adipocyte apoptosis and triglyceride release were also assayed. Clinical evaluation of the effects of repeated ultrasound treatment vs. sham-treatment was also performed. Results: Compared with the control samples, ultrasound treatment induced an appreciable reduction in adipocyte size, the appearance of plasma membrane micropores and triglyceride release, without appreciable changes in microvascular, stromal and epidermal components, and in the number of apoptotic adipocytes. Clinically, the ultrasound treatment resulted in a time-dependent significant reduction of abdominal fat. Conclusions: This study supports the safety and efficacy of trans-cutaneous weakly focused high-frequency ultrasounds for localized fat reduction, and provides experimental evidence for a possible mechanism of action.
Article
Hintergrund Die Fettgewebsreduktion zur Körperformung ist ein sehr häufiger Wunsch von Patienten. Die Liposuktion hat sich dabei als die effektivste Methode herausgestellt. Durch Verfeinerung der Techniken hat sie heutzutage in der Hand des geübten Operateurs ein sehr niedriges Risikoprofil. Zusatzverfahren zur Absaugung versprechen eine additive Verbesserung vor allem bei der Gewebestraffung. Dennoch wurden in den letzten Jahren viele Alternativverfahren im nicht-invasiven Bereich auf den Markt gebracht. Ohne Ausfallzeit für den Patienten soll mit diesen eine optimierte Körperkonturierung erreicht werden. Fragestellung Welche operativen und nicht-operativen Methoden zur primären Verschlankung gibt es, welche Risiken sind damit verbunden und wie effektiv sind sie? Methode Der vorliegende Artikel stellt diese Methoden vor, ordnet sie und bespricht die Vor- und Nachteile sowie ihre Effektivität anhand der Literatur und persönlicher Erfahrungen. Schlussfolgerungen Die Liposuktion, besonders die vibrationsassistierte in Tumeszenzlokalanästhesie, ist die effektivste Methode der Fettreduktion. Sie sollte immer durch einen erfahrenen Arzt erfolgen. Nichtoperative Techniken kommen bisher noch nicht an die Effektivität der Absaugung heran. Vielversprechend sind jedoch die synergistischen Effekte bei der Kombination verschiedener Verfahren.
Article
Background: A novel FDA-cleared device uses a 1064 nm laser to non-invasively induce apoptosis for lipolysis of subcutaneous abdominal fat while maintaining comfortable skin temperatures with a proprietary jet cooling system (eon ®, Dominion Aesthetic Technologies, Inc.; San Antonio, TX). A programmable articulated robotic arm moves the treatment head without any subject contact, maintaining an appropriate three-dimensional treatment path, compensating for patient movement. Objectives: The goal of this prospective, single center, open-label study was to demonstrate the safety and effectiveness of this device for reducing subcutaneous abdominal fat using an updated power delivery curve. Methods: Male and female subjects with Fitzpatrick skin types I-VI (N=26) were treated. Four abdominal zones up to 150 cm 2 each, customized in size and location for body habitus were treated. Each zone underwent a single 20-minute treatment session. Follow-up visits occurred after 6 and 12 weeks. Using a standardized protocol, ultrasound measurement of subcutaneous abdominal fat thickness, abdominal circumference, reported patient satisfaction and digital images were obtained. Results: The mean treatment area was 378.5 cm 2. At Week 12, there was a 21.6% mean reduction in abdominal subcutaneous fat thickness and a 4.1-cm (1.6-inch) mean reduction in abdominal circumference. Most subjects (84.6%) were satisfied or very satisfied with their results. The mean pain score was 2.5 on an 11-point ordinal scale. There were no non-responders. Only two adverse events were noted: mild transient erythema (n=1, 3.8%) and localized subcutaneous firmness (n=1, 3.8%) which resolved without intervention within 12 weeks. Conclusions: This contact-free device is safe and effective for reducing subcutaneous abdominal fat and represents an improvement on the prior treatment protocol.
Article
Background Low level light therapy is a recent aaddition to the pantheon of light-based therapeutic interventions. Termed “photobiomodulation”, the absorption of red/near infrared light energy induces enhancement of mitochondrial ATP production, cell signaling and growth factor synthesis and attenuates oxidative stress. Photobiomodulation is highly commercialized with devices marketed directly to the consumer. In the grey area between the commercial and therapeutic sectors, harnessing the clinical potential in reproducible and scientifically measurable ways remains challenging. Objectives This article presents a summary of the clinical evidence for photobiomodulation and discusses the regulatory framework for low level light therapy Methods A review of the clinical literature pertaining to the use of low level light therapy for skin rejuvenation (facial rhytids and dyschromias), acne vulgaris, wound healing, body contouring and androgenic alopecia was performed. Results A reasonable body of clinical trial evidence exists in support of the role of low energy red/near infrared light as a safe and effective method of skin rejuvenation, treatment of acne vulgaris, alopecia and, especially, body contouring. Methodological flaws, small patient cohorts and industry funding mean there is ample scope to improve the quality of evidence. It remains unclear if LED-based light sources induces physiologic effects of the nature and magnitude of laser-based systems which were used in most of the higher quality studies. Conclusions Low level light therapy is here to stay. However, its ubiquity and commercial success has outpaced the empirical approach on which solid clinical evidence is established. Thus, the challenge is to prove its therapeutic utility in retrospect. Well-designed, adequately powered, independent clinical trials will help us answer some of the unresolved questions and enable the potential of this therapy to be realized.
Article
Purpose: The present study was stimulated by the continuous growth of commercially available high intensity focused ultrasound (HIFU) systems for fat reduction. Herein, HIFU was utilised for fat ablation using a single-element ultrasonic transducer operating in thermal mode. Methods: The custom-made concave transducer that operates at 1.1 MHz was assessed on excised porcine adipose tissue for its ability to reduce fat. Ultrasonic sonications were executed on the adipose tissue utilising acoustical power between 14 and 75 W and sonication time in the range of 1-10 min. The mass of the adipose tissue sample was weighed afore and after ultrasonic sonications and the effect of the sonication on the mass change was recorded. Results: Mass change was linearly dependent with either increasing acoustical power or sonication time and was in the range of 0.46-1.9 g. High acoustical power of 62.5 W for a sonication time of 1 min and a power of 75 W for a sonication time of 5 min, respectively resulted in the formation of a lesion or possible cavitation on the piece of excised adipose tissue. Conclusion: The study demonstrated the efficacy of the proposed transducer in achieving a reduction of excised fat tissue. The present findings indicate the potential use of the transducer in a HIFU system indicated for the reduction of subcutaneous adipose tissue where increased values of acoustical power can result in increased amounts of fat reduction.
Article
The demand for aesthetic body sculpting procedures has expanded precipitously in recent years. Subcutaneous adipose tissue (SAT) deposits of the central abdomen are especially common areas of concern for both males and females. To review the available literature regarding the underlying pathophysiology of subcutaneous fat accumulation in the abdominal area and available treatment options. A MEDLINE and Google Scholar search was performed accordingly. The preferential accumulation of SAT in the central abdomen is attributable to the reduced lipolytic sensitivity of its adipocytes. A number of therapeutic options are available for the treatment of central abdominal adiposity. Cryolipolysis, high-intensity focused ultrasound, nonthermal ultrasound, radiofrequency, and injection adipolysis lead to adipocyte destruction through multiple different mechanisms. Nonablative modalities such as injection lipolysis mobilize fat stores from viable adipocytes, although its effects may be curtailed in obese patients. Liposuction through tumescent technique, however, mechanically extricates SAT. Although tumescent liposuction remains the gold standard for SAT removal, less invasive ablative and nonablative options for targeting localized deposits of adipose tissue now permeate the aesthetic marketplace. Limited results associated with these modalities mandate multiple sessions or combination treatment paradigms.
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Background: In aesthetic medicine, the most promising techniques for noninvasive body sculpturing purposes are based on ultrasound-induced fat cavitation. Liporeductive ultrasound devices afford clinically relevant subcutaneous fat pad reduction without significant adverse reactions. This study aims at evaluating the histological and ultrastructural changes induced by ultrasound cavitation on the different cell components of human skin. Methods: Control and ultrasound-treated ex vivo abdominal full-thickness skin samples and skin biopsies from patients pretreated with or without ultrasound cavitation were studied histologically, morphometrically, and ultrastructurally to evaluate possible changes in adipocyte size and morphology. Adipocyte apoptosis and triglyceride release were also assayed. Clinical evaluation of the effects of 4 weekly ultrasound vs sham treatments was performed by plicometry. Results: Compared with the sham-treated control samples, ultrasound cavitation induced a statistically significant reduction in the size of the adipocytes (P < 0.001), the appearance of micropores and triglyceride leakage and release in the conditioned medium (P < 0.05 at 15 min), or adipose tissue interstitium, without appreciable changes in microvascular, stromal, and epidermal components and in the number of apoptotic adipocytes. Clinically, the ultrasound treatment caused a significant reduction of abdominal fat. Conclusions: This study further strengthens the current notion that noninvasive transcutaneous ultrasound cavitation is a promising and safe technology for localized reduction of fat and provides experimental evidence for its specific mechanism of action on the adipocytes.
Article
Major surgical body contouring procedures have several inherent drawbacks, including hospitalization, anesthetic use, pain, swelling, and prolonged recovery. It is for these reasons that body contouring through noninvasive and minimally invasive methods has become one of the most alluring areas in aesthetic surgery. Patient expectations and demands have driven the field toward safer, less-invasive procedures with less discomfort, fewer complications, and a shorter recovery. In this article, the current minimally invasive and noninvasive modalities for body contouring are reviewed.
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OBJECTIVE: This study evaluated the efficacy of a novel treatment method utilizing high-intensity focused electromagnetic field (HIFEM) in reducing fat and strengthening the muscles in the abdominal and gluteal areas. METHODS: A total of 14 patients, aged 23 to 49 years (mean: 33.2 years) received four treatments on the abdomen and/or buttocks, each lasting for 30 minutes. Ultrasound imaging was performed at baseline, immediately post-treatment, and eight weeks after the last treatment to examine the changes in thickness of the rectus abdominis and subcutaneous fat. Additionally, waist circumference, digital photographs, and patient satisfaction were collected at the same time points. The improvement in digital images was evaluated by practitioners and the patients themselves. RESULTS: Two months after the treatments, ultrasound measurements showed, on average, a 15.7-percent reduction of subcutaneous adipose tissue and an average increase in the thickness of the rectus abdominis muscle by 26.1 percent. The abdominal circumference of the treated patients showed an average decrease of 2.84 centimeters. Immediately following the final session, the patient's satisfaction was 87.5 percent; eight weeks later, it was 100 percent. During the patient evaluation of photographs, 25 percent of the patients rated their appearance as improved, 66.7 percent as significantly improved, and 8.3 percent as greatly improved. Using the Global Aesthetic Improvement Scale, the medical practitioners rated the patients as 100-percent improved. No relevant side effects of the treatment were documented. CONCLUSION: The data collected on the HIFEM procedure evaluated here are in line with the results from clinical studies and applications of this treatment in the United States. These results support the efficacy and tolerability of the HIFEM procedure. The treatment achieved high doctor and patient satisfaction.
Article
Body Contouring ohne Skalpell umfasst neue Behandlungsformen in der Ästhetischen Medizin, die sich hoher Nachfrage erfreuen. Insbesondere Patienten mit Bedenken gegenüber operativen plastisch-chirurgischen Verfahren oder Kontraindikationen zum operativen Eingriff wählen nicht operative Methoden. Neben den bisher etablierten Verfahren existiert eine ganze Reihe neuer Optionen, mit denen die Körperformung oder besser gesagt die Fettreduktion, die dann eine Körperformung vornimmt, gelingt. Hier sollen verschiedene nicht invasive Methoden beschrieben und gegeneinander abgewogen werden.
Article
Non-surgical body contouring technologies have progressed rapidly following the introduction of Thermage in 2002. Since then, exciting developments in multiple modalities have followed, including radiofrequency, low-level laser therapy, cryolipolysis, and thermal and non-thermal ultrasound. Each of these treatment options are associated with distinct efficacy and side effect profiles. In this article, the authors provide a critical review of several body contouring technologies. Throughout the paper, the authors compare the mechanisms of action, efficacy and potential adverse effects of the five main modalities.
Chapter
The use of lasers and light devices for the removal of adipose tissue and cellulite represents a new and exciting frontier in the laser field. To date, there are few non-invasive devices in the laser field all of which can only claim limited efficacy. This chapter will review the laser, light sources, as well as devices with radiofrequency and ultrasound devices that currently purport to treat cellulite or adipose tissue.
Article
Background and Objectives Photobiomodulation (PBM) describes the influence of light irradiation on biological tissues. Laser light in the near‐infrared (NIR) spectrum has been shown to mitigate pain, reduce inflammation, and promote wound healing. The cellular mechanism that mediates PBM's effects is generally accepted to be at the site of the mitochondria, leading to an increased flux through the electron transport chain and adenosine triphosphate (ATP) production. Moreover, PBM has been demonstrated to reduce oxidative stress through an increased production of reactive oxygen species (ROS)‐sequestering enzymes. The aim of the study is to determine whether these PBM‐induced effects expedite or interfere with the intended stem cell differentiation to the adipogenic lineage. Study Design/Materials and Methods To determine the effects of 1064 nm laser irradiation (fluence of 8.8–26.4 J/cm²) on human mesenchymal stem cells (hMSCs) undergoing adipogenic differentiation, the ATP and ROS levels, and adipogenic markers were quantitatively measured. Results At a low fluence (8.8 J/cm²) the ATP increase was essentially negligible, whereas a higher fluence induced a significant increase. In the laser‐stimulated cells, PBM over time decreased the ROS level compared with the non‐treated control group and significantly reduced the extent of adipogenesis. A reduction in the ROS level was correlated with a diminished lipid accumulation, reduced production of adipose‐specific genetic markers, and delayed the chemically intended adipogenesis. Conclusion We characterized the use of NIR light exposure to modulate adipogenesis. Both the ATP and ROS levels in hMSCs responded to different energy densities. The current study is expected to contribute significantly to the growing field of PBM as well as stem cell tissue engineering by demonstrating the wavelength‐dependent responses of hMSC differentiation. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
Article
Objective: To assess the effectiveness of low-level laser therapy (LLLT) for reducing hip, thigh, and abdomen circumference of individuals with body-mass index (BMI) between 30 and 40 kg/m(2). Background: Previous studies demonstrated the effectiveness of LLLT for reducing body circumference in the hips, thighs, and abdomen of nonobese individuals with a BMI <30 kg/m(2). Methods: In this randomized, double-blind sham-controlled study, obese, but otherwise healthy, individuals were randomized to undergo 30-min LLLT (n = 28) or sham treatments (n = 25) three times weekly for 4 weeks. Body measurements were obtained after 2 and 4 weeks of treatment and 2 weeks post-treatment (ClinicalTrials.gov Identifier: NCT01821352). Results: After 4 weeks, 20 LLLT-treated subjects (71.43%) achieved ≥7.2 cm decrease in combined measurements versus three sham-treated subjects (12%; p < 0.00005). The mean (standard deviation) decrease in combined measurement for LLLT-treated subjects was 10.52 (7.59) cm (p < 0.0001 vs. baseline) versus 1.80 (3.20) cm for sham-treated subjects. Among subjects with a combined ≥7.2 cm decrease, the mean total decrease 2 weeks post-treatment was 15.21 cm. There were no adverse events. Conclusions: Based on these results, the device was cleared by the U.S. Food and Drug Administration as a noninvasive esthetic treatment for reduction of circumference of hips, waist, and upper abdomen when applied to individuals with a BMI between 30 and 40 kg/m(2).
Article
Background: Non-thermal laser therapy in dermatology, is a growing medical technology by which therapeutic effects are achieved by exposing tissues to specific wavelengths of light. Objectives: The purpose of this review was to gain a better understanding of the science behind non-thermal laser and the evidence supporting its use in dermatology. Methods: A group of dermatologists and surgeons recently convened to review the evidence supporting the use of non-thermal laser for body sculpting, improving the appearance of cellulite, and treating onychomycosis. Results: The use of non-thermal laser for body sculpting is supported by three randomized, double-blind, sham-controlled studies (N=161), one prospective open-label study (N=54), and two retrospective studies (N=775). Non-thermal laser application for improving the appearance of cellulite is supported by one randomized, double-blind, sham-controlled study (N=38). The use of non-thermal laser for the treatment of onychomycosis is supported by an analysis of three non-randomized, open-label studies demonstrating clinical improvement of nails (N=292). Conclusions: Non-thermal laser is steadily moving into mainstream medical practice, such as for dermatology. Although the present studies have demonstrated safety and efficacy of non-thermal laser for body-sculpting, cellulite reduction and onychomycosis treatment, studies demonstrating the efficacy of non-thermal laser as a stand-alone procedure are still inadequate.
Article
A nonthermal laser device is approved for noninvasive body circumference reduction and temporary improvement in the appearance of cellulite. Another noninvasive device based on the principle of manual lymph drainage is approved for body circumference reduction and improving the appearance of cellulite. This pilot study evaluated the effectiveness of combining these treatments for reducing body circumference. Healthy men and women (N = 27), 22 to 70 years of age with a body mass index of 25 to 40 kg/m², inclusive, seeking to improve the appearance of their waist, hips, and upper abdomen, were enrolled. The laser device consists of 6 independent, variable frequency lasers emitting a 532-nm green light with a mean power output of 17 mW (Erchonia Verjú Laser System; Erchonia Corporation, Melbourne, Florida). The lymphatic drainage system is a pressure therapy intended for body contouring and cellulite reduction applications and for reducing edema (Green PRESS 8 Lymphatic Drainage System; Iskra Medical, Podnart, Slovenia). Participants received 12 treatments, one every 3 to 4 days over a 6-week period. Each session included a 30-minute nonthermal laser treatment (15 minutes each to front and back) followed by a 30-minute treatment with the lymphatic drainage system. To evaluate comparability of the combined devices treatment with the nonthermal laser treatment, individual study success for the nonthermal laser alone was a 3.0-inch (7.62 cm) decrease in combined baseline hips, waist, and upper abdomen circumference at the end of the study. A 50% increase in combined hips-waist-upper abdomen circumference measurement following combined treatments was considered a clinically meaningful improvement over the use of nonthermal laser alone. Individual study success was achieved by 17 participants (63.0%), exceeding the preestablished overall study success criteria of 60% in comparison with nonthermal laser treatment alone. The mean (SD) combined body circumference decreased from 112.3 (13.7) inches at baseline to 108.5 (13.8) inches at the end of the study, a mean decrease of 3.9 (2.7) inches (P < .0001). One-way analysis of variance tests for changes in total body circumference measures at weeks 4, 8, and 12 were significantly less than baseline (for each, P < .01); however, the study failed to achieve a 50% decrease in combined hips-waist-upper abdomen circumference measurement following application of combined treatments versus nonthermal laser alone. Additional treatment with a manual lymphatic drainage system does not improve the effectiveness of a nonthermal 532-nm green laser for reducing hips, waist, and upper abdomen circumference.
Article
A cluster of metabolic abnormalities are markedly higher among postmenopausal women. The present study evaluated the effects of infrared-light-emitting diode (LED) during treadmill training on multiple metabolic markers, body fat, dietary habits and quality of life in postmenopausal women. Forty five postmenopausal women aged 50 to 60 years were randomly assigned to one of three groups; thirty women successfully completed the full study. The three groups were: (i) the LED group, which performed treadmill training associated with phototherapy (n=10); (ii) the exercise group, which carried out treadmill training only (n=10) and; (iii) the sedentary group, which neither performed physical training nor underwent phototherapy (n=10). Training was performed over a period of 6 months, twice a week for 45 minutes per session at 85% to 90% of maximal heart rate (HRmax), which was obtained during a progressive exercise testing. The average HR and velocity during treadmill training was 144±9 bpm and 5.8±1.3 Km/h for both trained groups. The irradiation parameters were 100 mW, 39 mW/cm² and 108 J/cm² for 45 minutes. Anthropometric data, skinfolds, biochemical exams (lipid profile, glucose and insulin), dietary habits and Women’s Health Questionnaire (WHQ) were performed. The sum of skinfolds significantly improved in the exercise and sedentary groups (p<0.05). Additionally, there was an improvement in lipid profile, particularly, total cholesterol and low-density lipoprotein (LDL) which reduced significantly for all groups (p˂0.05). However, saturated fat intake was significantly reduced in the sedentary group only (p<0.05). Quality of life improved in the LED group only, with a significant reduction in the total WHQ score (p<0.05). Physical training with or without phototherapy may improve metabolic profile. In addition, phototherapy together with treadmill training prevented an increase in subcutaneous fat and facilitated improved quality of life in postmenopausal women.
Chapter
Breast augmentation is one of the most popular cosmetic surgery procedures performed in the United States. The reported satisfaction rate is high and varies from 95% to 98%. Capsular contracture, a known complication, is one of the most common reasons for dissatisfaction with the procedure. This chapter will review the literature on the etiology and management of capsular contracture, focusing on non-surgical and surgical options of treatment. To date, there is no clear consensus on the management of this complication. The goal is to manage capsular contracture, prevent recurrence, minimize risk to the patient, and obtain esthetic results. We describe our protocol for treatment of early capsular contracture based on the literature presented. If the patient fails to respond to non-invasive methods of management, then a surgical intervention with a capsulectomy and implant exchange may be indicated. The surgeon must consider the risks versus benefits of performing a total capsulectomy and make the best judgment based on the clinical scenario presented by the patient.
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Photobiomodulation therapy (PBMT) in the infrared spectrum exerts positive effects on glucose metabolism, but the use of PBMT at the red spectrum has not been assessed. Male Swiss albino mice were divided into low‐fat control (LFC) and high‐fat diet (HFD) for 12 weeks and were treated with red (630 nm) PBMT or no treatment (Sham) during weeks 9‐12. PBMT was delivered at 31.19 J/cm2, 60 J total dose per day for 20 days. In HFD‐fed mice, PBMT improved glucose tolerance, insulin resistance, and fasting hyperinsulinemia. PBMT also reduced adiposity and inflammatory infiltrate in adipose tissue. Phosphorylation of Akt in epididymal adipose tissue and rectus femoralis muscle was improved by PBMT. In epididymal fat PBMT reversed the reduced phosphorylation of AS160 and the reduced Glut4 content. In addition, PBMT reversed the alterations caused by HFD in rectus femoralis muscle on proteins involved in mitochondrial dynamics and β‐oxidation. In conclusion, PBMT at red spectrum improved insulin resistance and glucose metabolism in HFD‐fed mice. This article is protected by copyright. All rights reserved.
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Non‐invasive body contouring is a rapidly growing field in cosmetic dermatology. Non‐invasive contouring devices improve the body's appearance through the removal of excess adipose tissue, particularly in areas in which fat persists despite optimal diet and exercise routine. The technology can also be used for skin tightening. This article reviews the five FDA‐approved non‐invasive body contouring modalities: cryolipolysis, laser, high‐intensity focused electromagnetic field, radiofrequency and high‐intensity focused ultrasound. These devices have emerged as a popular alternative to surgical body contouring due to their efficacy, favourable safety profile, minimal recovery time and reduced cost. Although they do not achieve the same results as liposuction, they are an attractive alternative for patients who do not want the risks or costs associated with surgery. When used appropriately and correctly, these devices have demonstrated excellent clinical efficacy and safety.
Article
Background and objective: Noninvasive fat reduction appears effective, but there are various methods for quantifying changes. The objective of this review is to assess comparative utility measures of subcutaneous fat. Study design/materials and methods: Articles describing noninvasive fat reduction were searched using MEDLINE, EMBASE, CINAHL and Scopus electronic databases on two dates (January 28, 2014 and February 16, 2016). Titles of studies and abstracts were screened for eligibility. Manual review was performed by two investigators to detect those that: (1) included original data; (2) were randomized controlled trials, or prospective or retrospective cohort studies; (3) quantified fat outcomes; and (4) enrolled at least 10 subjects. Results: Of 1,057 retrieved articles, 36 met criteria. Most reported four or more measurement techniques. Circumference measurements were most commonly cited. Other objective techniques, like caliper thickness, ultrasound, magnetic resonance imaging (MRI), and three-dimensional (3D) photography, were also used. Common subjective methods were evaluation of standardized photographs by blinded raters and patient satisfaction surveys. Conclusions: For quantifying noninvasive fat reduction, all available methods had significant limitations: photographic comparisons were subjective; circumference or caliper measurements were confounded; ultrasound was operator dependent; MRI was expensive; computed models and simulations were in early development. As new technologies are developed, the need for reliable, accurate and practical measures of subcutaneous fat will increase. Lasers Surg. Med. © 2017 Wiley Periodicals, Inc.
Chapter
Liposuction is a safe and effective method of subcutaneous fat removal involving aspiration of subcutaneous adipose tissue via cannulas introduced through small skin incisions. In tumescent liposuction, the surgeon utilizes subcutaneous infiltration of dilute lidocaine and epinephrine to provide local anesthesia and hemostasis prior to aspiration of the adipose tissue. In addition to its aesthetic indications, tumescent liposuction is also a safe and effective treatment modality for breast reduction, gynecomastia, lipomas, lipoedema, and hyperhidrosis. Despite the development of newer, noninvasive body-contouring modalities, liposuction remains the gold standard.
Chapter
The field of cosmetic medicine has evolved rapidly in the recent years offering patients and their treating physicians a plethora of non-invasive options for body rejuvenation. Particularly for indications such as fat reduction, innovations in technology and scientific breakthroughs have led to non-invasive strategies validated for their safety and efficacy through several high-evidence-level peer-reviewed studies. Four main types of energy-based devices have dominated the field of fat reduction: radiofrequency, laser, ultrasound, and cryolipolysis. In addition, injectable biologics have been developed with the goal to target localized pockets of fat. In this chapter, our goal is to provide an unbiased overview of the scientific evidence regarding procedure selection, effectiveness, and safety for non-invasive fat reduction.
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Hyperglycemia is a major independent risk factor for diabetic macrovascular disease. The consequences of exposure of endothelial cells to hyperglycemia are well established. However, little is known about how adipocytes respond to both acute as well as chronic exposure to physiological levels of hyperglycemia. Here, we analyze adipocytes exposed to hyperglycemia both in vitro as well as in vivo. Comparing cells differentiated at 4 mm to cells differentiated at 25 mm glucose (the standard differentiation protocol) reveals severe insulin resistance in cells exposed to 25 mm glucose. A global assessment of transcriptional changes shows an up-regulation of a number of mitochondrial proteins. Exposure to hyperglycemia is associated with a significant induction of reactive oxygen species (ROS), both in vitro as well as in vivo in adipocytes isolated from streptozotocin-treated hyperglycemic mice. Furthermore, hyperglycemia for a few hours in a clamped setting will trigger the induction of a pro-inflammatory response in adipose tissue from rats that can effectively be reduced by co-infusion of N-acetylcysteine (NAC). ROS levels in 3T3-L1 adipocytes can be reduced significantly with pharmacological agents that lower the mitochondrial membrane potential, or by overexpression of uncoupling protein 1 or superoxide dismutase. In parallel with ROS, interleukin-6 secretion from adipocytes is significantly reduced. On the other hand, treatments that lead to a hyperpolarization of the mitochondrial membrane, such as overexpression of the mitochondrial dicarboxylate carrier result in increased ROS formation and decreased insulin sensitivity, even under normoglycemic conditions. Combined, these results highlight the importance ROS production in adipocytes and the associated insulin resistance and inflammatory response.
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This review focuses on the regulation of transcription factors, many of which are DNA-binding proteins that recognize cis-regulatory elements of target genes and are the most direct regulators of gene transcription. Transcription factors serve as integration centres of the different signal-transduction pathways affecting a given gene. It is obvious that the regulation of these regulators themselves is of crucial importance for differential gene expression during development and in terminally differentiated cells. Transcription factors can be regulated at two, principally different, levels, namely concentration and activity, each of which can be modulated in a variety of ways. The concentrations of transcription factors, as of intracellular proteins in general, may be regulated at any of the steps leading from DNA to protein, including transcription, RNA processing, mRNA degradation and translation. The activity of a transcription factor is often regulated by (de) phosphorylation, which may affect different functions, e.g. nuclear localization DNA binding and trans-activation. Ligand binding is another mode of transcription-factor activation. It is typical for the large super-family of nuclear hormone receptors. Heterodimerization between transcription factors adds another dimension to the regulatory diversity and signal integration. Finally, non-DNA-binding (accessory) factors may mediate a diverse range of functions, e.g. serving as a bridge between the transcription factor and the basal transcription machinery, stabilizing the DNA-binding complex or changing the specificity of the target sequence recognition. The present review presents an overview of different modes of transcription-factor regulation, each illustrated by typical examples.
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Low-energy laser irradiation (LELI) has been shown to promote skeletal muscle regeneration in vivo and to activate skeletal muscle satellite cells, enhance their proliferation and inhibit differentiation in vitro. In the present study, LELI, as well as the addition of serum to serum-starved myoblasts, restored their proliferation, whereas myogenic differentiation remained low. LELI induced mitogen-activated protein kinase/extracellular signal-regulated protein kinase (MAPK/ERK) phosphorylation with no effect on its expression in serum-starved myoblasts. Moreover, a specific MAPK kinase inhibitor (PD098059) inhibited the LELI- and 10% serummediated ERK1/2 activation. However, LELI did not affect Jun N-terminal kinase (JNK) or p38 MAPK phosphorylation or protein expression. Whereas a 3-sec irradiation induced ERK1/2 phosphorylation, a 12-sec irradiation reduced it, again with no effect on JNK or p38. Moreover, LELI had distinct effects on receptor phosphorylation: it caused phosphorylation of the hepatocyte growth factor (HGF) receptor, previously shown to activate the MAPK/ERK pathway, whereas no effect was observed on tumor suppressor necrosis alpha (TNF-alpha) receptor which activates the p38 and JNK pathways. Therefore, by specifically activating MAPK/ERK, but not JNK and p38 MAPK enzymes, probably by specific receptor phosphorylation, LELI induces the activation and proliferation of quiescent satellite cells and delays their differentiation.
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How do organisms sense the amount of oxygen in the environment and respond appropriately when the level of oxygen decreases? Oxygen sensing and the molecular stratagems underlying the process have been the focus of an endless number of investigations trying to find an answer to the question: "What is the identity of the oxygen sensor?" Dynamic changes in pO2 constitute a potential signaling mechanism for the regulation of the expression and activation of reduction-oxidation (redox)-sensitive and oxygen-responsive transcription factors, apoptosis-signaling molecules and inflammatory cytokines. The transition from placental to lung-based respiration causes a relatively hyperoxic shift or oxidative stress, which the perinatal, developing lung experiences during birth. This variation in DeltapO2, in particular, differentially regulates the compartmentalization and functioning of the transcription factors hypoxia-inducible factor-1alpha (HIF-1alpha) and nuclear factor-kappaB (NF-kappaB). In addition, oxygen-evoked regulation of HIF-1alpha and NF-kappaB is closely coupled with the intracellular redox state, such that modulating redox equilibrium affects their responsiveness at the molecular level (expression/transactivation). The differential regulation of HIF-1alpha and NF-kappaB in vitro is paralleled by oxygen-sensitive and redox-dependent pathways governing the regulation of these factors during the transition from placental to lung-based respiration ex utero. The birth transition period in vivo and ex utero also regulates apoptosis signaling pathways in a redox-dependent manner, consistent with NF-kappaB being transcriptionally regulated in order to play an anti-apoptotic function. An association is established between oxidative stress conditions and the augmentation of an inflammatory state in pathophysiology, regulated by the oxygen- and redox-sensitive pleiotropic cytokines.
Article
Introduction In an effort to study the changes of subcutaneous fat after exposure to a low-level diode laser and tumescent infiltration, the magnetic resonance imaging (MRI) findings are presented. The subcutaneous abdominal fat is exposed for 4 and 6 minutes irradiation time. This has previously been studied using a scanning electron microscope. The anatomical characteristics of the superficial and deep fat previously described by other authors are correlated with the scanning electron microscope and MRI. The changes in the characteristics of the fat before and after tumescence and before and after application of the low-level diode laser are shown. Materials and Methods By using MRI techniques, 3 patients were evaluated prior to infiltrating the subcutaneous tissue with tumescent fluid with T1 and T2 sequences. The same patients were evaluated again after applying or infiltrating the tumescence and again after exposure using the low-level laser beam for 4 and 6 minutes. Conclusion The MRI showed no laser exposure in the T1 sequence; the adipose tissue, both superficially and deep, appears to have a bright signal and is homogenously distributed. After 4 minutes of laser exposure, the T1 sequence demonstrated that the adipose tissue is partially coalescent and has changed its signal. After 6 minutes of laser exposure, the MRI demonstrated that the adipose tissue is much more coalescent and is blurred. The fatty density and organization seems to have changed completely after exposure to the laser beam for this period of time. (The scanning electron microscope revealed that at this particular time 100% of the fat was in the interstitial space and the transitory pore was now open.) The MRI evaluation of the subcutaneous fat seems to correlate well with the findings of the scanning electron microscope, showing that there is a definite change in the consistency of the subcutaneous fat following exposure to the low-level electronic diode laser.
Article
Introduction The purpose of this IRB approved, multicenter, partially double-blind study was to determine the effectiveness of low-level laser-assisted liposuction in decreasing the patients' degree of postoperative discomfort, reducing swelling, enhancing wound healing at surgical entry points, decreasing the use of recovery medications for pain management, facilitating fat extraction for the surgeon, enhancing the emulsification of extracted fat, and decreasing surgical time spent to obtain optimal results. Materials and Methods The Erchonia EML, 635-nm, 14-mW dual-diode low-level laser was used to irradiate the target tissue for 12 minutes after infiltration of tumescent fluid. Results Of the 36 test-group patients who received laser treatment, 75% met their major success criteria compared with 32% of the 34 placebo-group patients who received “fake” treatment. Success criteria were defined as at least a 30% difference between groups. Forty-three percent more of the test subjects than placebo subjects met success criteria, exceeding the target by 13%. Discussion The Erchonia EML Laser is an effective device for assisting liposuction procedures with low-level laser therapy. It significantly enhances the ease of performing liposuction procedures; reduces the time in surgery; enhances the ease of facilitating fat extraction; enhances the emulsification of extracted fat; facilitates the recovery process; decreases the patients' degree of postoperative discomfort, decreases swelling; and decreases the use of recovery medications for pain management for patients undergoing body contouring in the areas of the thighs, hips, and stomach.
Article
The action spectra of low-intensity light in the range from 300 to 900 nm on the synthesis rate of nucleic acids in the culture of HeLa cells has been measured. The synthesis of DNA and RNA is stimulated in several spectral intervals with maxima nearby 400, 630, 680, 760 and 820 nm. The stimulation effect is very sensitive to the irradiation duration (light intensity) at a fixed dose. The dose that causes the maximal stimulation is approximately 10 times smaller in the near-UV blue region than in red-IR region.
Article
Background: Given the recent interest in light-emitting diode (LED) photomodulation and minimally invasive nonablative laser therapies, it is timely to investigate reports that low-level laser therapy (LLLT) may have utility in wound healing. Objectives: To critically evaluate reported in vitro models and in vivo animal and human studies and to assess the qualitative and quantitative sufficiency of evidence for the efficacy of LLLT in promoting wound healing. Method: Literature review, 1965 to 2003. Results: In examining the effects of LLLT on cell cultures in vitro, some articles report an increase in cell proliferation and collagen production using specific and somewhat arbitrary laser settings with the helium neon (HeNe) and gallium arsenide lasers, but none of the available studies address the mechanism, whether photothermal, photochemical, or photomechanical, whereby LLLT may be exerting its effect. Some studies, especially those using HeNe lasers, report improvements in surgical wound healing in a rodent model; however, these results have not been duplicated in animals such as pigs, which have skin that more closely resembles that of humans. In humans, beneficial effects on superficial wound healing found in small case series have not been replicated in larger studies. Conclusion: To better understand the utility of LLLT in cutaneous wound healing, good clinical studies that correlate cellular effects and biologic processes are needed. Future studies should be well-controlled investigations with rational selection of lasers and treatment parameters. In the absence of such studies, the literature does not appear to support widespread use of LLLT in wound healing at this time. Although applications of high-energy (10–100 W) lasers are well established with significant supportive literature and widespread use, conflicting studies in the literature have limited low-level laser therapy (LLLT) use in the United States to investigational use only. Yet LLLT is used clinically in many other areas, including Canada, Europe, and Asia, for the treatment of various neurologic, chiropractic, dental, and dermatologic disorders. To understand this discrepancy, it is useful to review the studies on LLLT that have, to date, precluded Food and Drug Administration approval of many such technologies in the United States. The fundamental question is whether there is sufficient evidence to support the use of LLLT.
Article
— Singlet oxygen (1O2)-mediated photooxidation of cholesterol gives three hydroperoxide products: 3β-hydroxy-5α-cholest-6-ene-5-hydroperoxide (5α-OOH), 3β-hydroxycholest-4-ene-6α-hydrope-roxide (6α-OOH) and 3β-hydroxycholest-4-ene-6β-hydroperoxide (6β-OOH). These species have been compared with respect to photogeneration rate on the one hand and susceptibility to enzymatic reduction/ detoxification on the other, using the erythrocyte ghost as a cholesterol-containing test membrane and chloroaluminum phthalocyanine tetrasulfonate (AlPcS4) as a 1O2 sensitizer. Peroxide analysis was accomplished by high-performance liquid chromatography with mercury cathode electrochemical detection (HPLC-EC[Hg]). The initial rate of 5α-OOH accumulation in AlPcS4/light-treated ghosts was found to be about three times greater than that of 6α-OOH or 6β-OOH. Membranes irradiated in the presence of ascorbate and ferric-8-hydroxyquinoline (Fe[HQ]2, a lipophilic iron complex) accumulated lesser amounts of 5α-OOH, 6α-OOH and 6β-OOH but relatively large amounts of another peroxide pair, 3β-hydroxycholest-5-ene-7α- and 7β-hydroperoxide (7α,7β-OOH), suggestive of iron-mediated free radical peroxidation. When photoperoxidized membranes containing 5α-OOH, 6α,6β-OOH and 7α,7β-OOH (arising from 5α-OOH rearrangement) were incubated with glutathione (GSH) and phospholipid hydroperoxide glutathione peroxidase (PHGPX), all hydroperoxide species underwent HPLC-EC(Hg)-detect-able reduction to alcohols, the relative first order rate constants being as follows: 1.0 (5α-OOH), 2.0 (7α,7β-OOH), 2.4 (6α-OOH) and 3.2 (6β-OOH). Relatively rapid photogeneration and slow detoxification might make 5α-OOH more cytotoxic than the other peroxide species. To begin investigating this possibility, we inserted 5α-OOH into ghosts by transferring it from 5α-OOH-containing liposomes. When exposed to Fe(HQ)2/ascorbate, these ghosts underwent GSH/PHGPX-inhibitable chain peroxidation, as indicated by the appearance of 7α,7β-OOH, phospholipid hydroperoxides and thiobarbituric acid reactive substances. Liposomal 5α-OOH also exhibited a strong, Fe(HQ)2-enhanced, toxicity toward LI210 leukemia cells, an effect presumably mediated by damaging chain peroxidation. This appears to be the first reported example of eukaryotic cytotoxicity attributed specifically to 5α-OOH.
Electron-transfer reactions between ions and molecules in solution have been the subject of considerable experimental study during the past three decades. Experimental results have also been obtained on related phenomena, such as reactions between ions or molecules and electrodes, charge-transfer spectra, photoelectric emission spectra of ionic solutions, chemiluminescent electron transfers, electron transfer through frozen media, and electron transfer through thin hydrocarbon-like films on electrodes.
Article
An investigation was made of the action of λ = 633 nm low-intensity red light (He–Ne laser, incandescent lamp with light filters, dye laser pumped by a copper laser) on the rate of nucleic acid synthesis in HeLa cells 1.5 h after irradiation. It was found that DNA synthesis is stimulated almost equally by irradiation with an He–Ne laser and with a conventional source; the rate of RNA synthesis remains the same in both cases. On exposure to λ = 633 nm pulse-periodic radiation, RNA synthesis is stimulated and DNA synthesis is unaffected. Spectra of the stimulating effect of cw light in the 570–693 nm range on DNA and RNA synthesis are presented.
Article
An investigation was made of the action of low-intensity cw visible light of wavelengths in the range 313–860 nm on the rate of DNA synthesis in a culture of HeLa cells. It was found that the synthesis of DNA was stimulated in three spectral ranges: 313–450 nm, 600–650 nm, and 750–840 nm. For a fixed dose the stimulation effect was very sensitive to the irradiation time (radiation intensity). The maximum increase in the rate of DNA synthesis occurred in 15 min from the beginning of irradiation and the effect was retained for several hours. The stimulation effect was less in the case of two-wavelength (dichromatic) irradiation of the cells with red and wide-band visible light.
Article
Low-level laser energy has been reported to modulate the wound healing process in some but not all studies. To examine this hypothesis, we investigated incisional wounds made on the dorsal pelt of rats for changes in the healing produced by low-level irradiation with a helium-neon laser. The incisions were made with a scalpel and closed with sutures. The rats were irradiated daily for 12 days with four levels of laser light (0.0, 0.47, 0.93, and 1.73 J/cm2). Analysis of wound tensile strength indicated a possible strengthening of fresh wounds at the highest levels of irradiation (1.73 J/cm2). No change was observed in the tensile strength of formalin-fixed wounds. The distribution of measured tensile strengths did not follow normal statistics; instead they showed a platykurtic distribution. Using resampling statistics, where no assumption is made as to the nature of the distribution, we found that the results were contrary to other studies: no biostimulatory effect was seen.
Article
Background Given the recent interest in light-emitting diode (LED) photomodulation and minimally invasive nonablative laser therapies, it is timely to investigate reports that low-level laser therapy (LLLT) may have utility in wound healing.Objectives To critically evaluate reported in vitro models and in vivo animal and human studies and to assess the qualitative and quantitative sufficiency of evidence for the efficacy of LLLT in promoting wound healing.Method Literature review, 1965 to 2003.Results In examining the effects of LLLT on cell cultures in vitro, some articles report an increase in cell proliferation and collagen production using specific and somewhat arbitrary laser settings with the helium neon (HeNe) and gallium arsenide lasers, but none of the available studies address the mechanism, whether photothermal, photochemical, or photomechanical, whereby LLLT may be exerting its effect. Some studies, especially those using HeNe lasers, report improvements in surgical wound healing in a rodent model; however, these results have not been duplicated in animals such as pigs, which have skin that more closely resembles that of humans. In humans, beneficial effects on superficial wound healing found in small case series have not been replicated in larger studies.Conclusion To better understand the utility of LLLT in cutaneous wound healing, good clinical studies that correlate cellular effects and biologic processes are needed. Future studies should be well-controlled investigations with rational selection of lasers and treatment parameters. In the absence of such studies, the literature does not appear to support widespread use of LLLT in wound healing at this time. Although applications of high-energy (10–100 W) lasers are well established with significant supportive literature and widespread use, conflicting studies in the literature have limited low-level laser therapy (LLLT) use in the United States to investigational use only. Yet LLLT is used clinically in many other areas, including Canada, Europe, and Asia, for the treatment of various neurologic, chiropractic, dental, and dermatologic disorders. To understand this discrepancy, it is useful to review the studies on LLLT that have, to date, precluded Food and Drug Administration approval of many such technologies in the United States. The fundamental question is whether there is sufficient evidence to support the use of LLLT.WILLIAM POSTEN, MD, DAVID A. WRONE, MD, JEFFREY S. DOVER, MD, FRCPC, KENNETH A. ARNDT, MD, SIRUNYA SILAPUNT, MD, AND MURAD ALAM, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS.
Article
Background and Objective Reports in the literature indicate that low energy laser irradiation has a biostimulatory effect on wound healing; however, no mechanism of this effect has been elucidated.Study Design/Materials and Methods: We attempted to establish a model from which to study the mechanism of biostimulation. The effects of low energy helium-neon irradiation on wound healing were observed in two rat models. In the first model, 1.5 cm diameter full thickness excisional skin defects were created in the dorsal midline of rats (n = 32). All animals were anesthetized and all eschars were debrided daily. Wound area was determined by caliper measurements for 2 weeks postoperatively. Rats that received a treatment of 1 J/cm2 had two defects in the dorsal skin. One wound was treated and the second was used as its own control. These measurements were not blinded. Rats that received 2 J/cm2, 4 J/cm2, or anesthesia alone had one defect on the dorsal skin. Caliper measurements of these wounds were blinded. We were unable to demonstrate any difference in the rate of wound contracture in rats that received a daily dose of 1 J/cm2, 2 J/cm2, 4 J/cm2, or anesthesia alone (P > 0.8 by student's t-test). In the second model, a single 2 cm longitudinal full thickness skin incision was created in the dorsal midline of each rat (n = 24). No difference was found between rats that received anesthesia alone and those treated daily with 2 J/cm2 as assessed by tensile strength measurements on postoperative days 7 and 14 (P > 0.8 by student's t-test between groups at both time points). These determinations were blinded.ResultsDespite our intentions of studying the mechanism of low energy HeNe biostimulation, we were unable to demonstrate a beneficial effect.Conclusion In this study, helium-neon laser irradiation produced no measurable benefit on wound healing. Lasers Surg. Medicine 20:340–345, 1997. © 1997 Wiley-Liss, Inc.
Article
Background and Objectives Both photobiomodulation (PBM) and olfactory ensheathing cells (OECs) transplantation improve recovery following spinal cord injury. However, neither the combination of these two therapies nor the effect of light on OECs has been reported. The purpose of this study was to determine the effect of light on OEC activity in vitro.Materials and MethodsOECs were purified from adult rat olfactory bulbs and exposed to 810 nm light (150 mW; 0, 0.2, or 68 J/cm2). After 7–21 days in vitro, cells underwent immunocytochemistry or RNA extraction and RT-PCR.ResultsAnalysis of immunolabeling revealed a significant decrease in fibronectin expression in the cultures receiving 68 J/cm2. Analysis of gene expression revealed a significant (P < 0.05) increase in brain derived neurotrophic factor (BDNF), glial derived neurotrophic factor (GDNF), and collagen expression in the 0.2 J/cm2 group in comparison to the non-irradiated and 68 J/cm2 groups. OEC proliferation was also found to significantly increase in both light treated groups in comparison to the control group (P < 0.001).Conclusions These results demonstrate that low and high dosages of PBM alter OEC activity, including upregulation of a number of neurotrophic growth factors and extracellular matrix proteins known to support neurite outgrowth. Therefore, the application of PBM in conjunction with OEC transplantation warrants consideration as a potential combination therapy for spinal cord injury. Lasers Surg. Med. © 2005 Wiley-Liss, Inc.
Article
Background and Objectives There exist contradictory reports about low-intensity laser light-stimulated cell proliferation. The purpose of this study was to determine the effect of wavelength on proliferation of cultured murine cells.Study Design/Materials and Methods Proliferation of primary cell cultures was measured after irradiation with varying laser wavelengths.ResultsFibroblasts proliferated faster than endothelial cells in response to laser irradiation. Maximum cell proliferation occurred with 665 and 675 nm light, whereas 810 nm light was inhibitory to fibroblasts.Conclusions These observations suggest that both wavelength and cell type influence the cell proliferation response to low-intensity laser irradiation. Lasers Surg. Med. 36:8–12, 2005. © 2005 Wiley-Liss, Inc.
Article
The use of low intensity laser and monochromatic light diodes as a therapeutic modality has become popular in a variety of clinical applications, including the promotion of wound repair. Despite this, the clinical evidence base for such application remains sparse; in contrast, recent studies have demonstrated a number of quantifiable photobiological effects associated with such therapy. In the present study, the effect of low intensity monochromatic light irradiation (MLI) at various radiant exposures upon a radiation-impaired wound model in murine skin was investigated. Male Balb/c mice (n = 50; age matched at 10 weeks) were randomly allocated to five experimental groups (n = 10 each group). In Group 1, mice were left untreated; in Groups 2–5, a well-defined area on the dorsum was exposed to 20 Gy X-ray irradiation. At 72 hours post-irradiation, all mice were anaesthetised and a 7-mm-square area wound was made on the dorsum. All wounds were videotaped alongside a marker scale until closure was complete. In Groups 3–5, mice were treated with MLI (0.18, 0.54, and 1.45 J/cm2, respectively) three times weekly using a GaAlAs 890 nm multidiode (n = 60) array unit (270 Hz; maximum rated output, 300 mW; Anodyne, Denver, CO). Subsequently, the area of each wound was measured from video using an image analysis system (Fenestra 2.1), and results were analysed using repeated measure and one-factor ANOVA statistical tests. X-ray irradiation caused a significant delay (P = 0.0122) in healing by day 7. MLI at 0.18 J/cm2 and 0.54 J/cm2 had no effect upon the rate of wound closure. However, a highly significant (P = 0.0001) inhibition occurred following MLI irradiation at 1.45 J/cm2 by day 16. These findings provide little evidence of the putative stimulatory effects of monochromatic light irradiation in vivo, but, rather, reveal the potential for an inhibitory effect at higher radiant exposures. Lasers Surg. Med. 23:291–298, 1998.
Article
. The purpose of this study was to determine the wavelength-response effects of low level laser irradiation (LLLI) on immunocompetence of mice in vivo and intracellular free calcium ([Ca2+]i) in human lymphocytes and cultured cortical neurogliocytes (CCN) in vitro. Mice were first immune compromised by cyclophosphamide (CTX) injection, and the immunological activities including the production of interleukin 2 (IL-2), the murine mixed lymphocyte reaction (MLR), the mitogenic response of murine thymocytes (MRT), the proliferation of murine bone marrow cells (BMC) and the natural killer (NK) cells activity, were investigated after intravascular low level laser irradiation (ILLLI) (1 mW, 1.1×104 J/cm2) at wavelengths of 532 nm, 632.8 nm, 650 nm and 1520 nm, respectively. In addition, using Ca2+ sensitive indicator Fura-2 AM with the Spex AR-CM-MIC cation measurement system ([Ca2+]i) in single human lymphocytes and CCN were measured after LLLI (7.5 J/cm2) at wavelengths of 532 nm, 632.8 nm, 650 nm, 810 nm and 1300 nm, respectively. Results showed that the ILLLI at wavelengths of 532 nm, 632.8 nm and 650 nm, produced a significant increase in the proliferation of BMC and the NK activity. The production of IL-2 was greatly promoted after irradiation at 632.8 nm and 650 nm. After irradiation at 532 nm and 650 nm, the murine MLR was evidently enhanced, and MRT was dramatically increased only after irradiation at 632.8 nm. In contrast, no significant effects were found on the above mentioned indexes by irradiation at 1520 nm in comparison to the control. In addition, [Ca2+]i in single human lymphocytes and CCN were increased after LLLI at wavelengths of 532 nm, 632.8 nm and 650 nm, respectively, whereas they were not significantly affected by the wavelengths of 810 nm and 1300 nm. Our results indicated that LLLI could induce significant and different effects on the immunological activities of the mice and cause an increase in [Ca2+]i in single human lymphocytes and CCN. Furthermore, these effects are dependent on the wavelengths, for example, more positive effects produced by the wavelengths of 532 nm, 632.8 nm and 652 nm than those produced by the wavelengths of 810 nm, 1300 nm and 1520 nm.
Article
Laser radiation (1,210 nm) has been previously shown to be capable of selective photothermolysis of adipose tissue in vitro when applied non-invasively. The objective of this pilot study was to evaluate the in vivo effects of this laser in human subjects. Twenty-four adult subjects were exposed non-invasively on the abdomen to a 1,210 nm laser at fluences of 70, 80, and 90 J/cm(2), with a 10 mm spot size, 5 seconds pre-cooling, and 3 seconds exposure duration delivered with parallel contact cooling. There was an impairment of the skin-cooling device during the study. Exposure and control sites were biopsied at either 1-3 days or 4-7 weeks. Tissue was processed for nitroblue tetrazolium chloride (NBTC) staining, a marker for thermal damage, and hematoxylin and eosin (H&E) staining. Laser exposures were painful, requiring local anesthesia in most subjects, but otherwise well tolerated. At 1-3 days after exposure, there was a fluence-dependent loss of NBTC staining in the fat and dermis. In 2 of 14 subjects (2 of 42 exposure sites) evaluated at 1-3 days after exposure, epidermal damage was noted within a small portion of the test site, likely due to impaired contact cooling. At 4-7 weeks, lipomembranous changes of the fat were seen in 89% of test sites and 33% of control sites. This in vivo study shows histologic evidence of laser-induced damage of fat. With further development, this might become a useful treatment for disorders involving the fat and/or lower dermis.
Article
Low-intensity light therapy (LILT) appears to be working through newly recognized photoacceptor systems. The mitochondrial electron transport chain has been shown to be photosensitive to red and near-infrared (NIR) light. Although the underlying mechanisms have not yet been clearly elucidated, mitochondrial photostimulation has been shown to increase ATP production and cause transient increases in reactive oxygen species (ROS). In some cells, this process appears to participate in reduction/oxidation (redox) signaling. Redox mechanisms are known to be involved in cellular homeostasis and proliferative control. In plants, photostimulation of the analogous photosynthetic electron transport chain leads to redox signaling known to be integral to cellular function. In gene therapy research, ultraviolet lasers are being used to photostimulate cells through a process that also appears to involve redox signaling. It seems that visible and near visible low-intensity light can be used to modulate cellular physiology in some nonphotosynthetic cells, acting through existing redox mechanisms of cellular physiology. In this manner, LILT may act to promote proliferation and/or cellular homeostasis. Understanding the role of redox state and signaling in LILT may be useful in guiding future therapies, particularly in conditions associated with pro-oxidant conditions.
Article
The effect of 360, 632 and 780 nm light on NIH fibroblast cells was examined. Mitosis counts of irradiated cells at various energy doses were taken. Scanning electron micrographs of these cells were studied. It is suggested that low-level laser therapy in the visible and in the near-infrared region is due to cell respiration stimulation by either the endogenous porphyrins in the cell, or by the cytochromes.
Article
The effect of light on calcium transport was studied. Bull sperm cells were irradiated with an He-Ne (630 mm) laser and a 780 nm diode laser at various energy doses, and 45Ca2+ uptake was measured by the filtration technique. It was found that there is an accelerated Ca2+ transport in the irradiated cells, which means that laser light can stimulate Ca2+ exchange through the cell membrane. This may cause transient changes in the cytoplasmic Ca2+ concentration which, in spermatozoa, has a regulatory role in control of motility and acrosome reaction, and in other cells can trigger mitosis.
Article
In this paper, we direct attention to the systemic effect of low-power helium-neon (HeNe) laser irradiation on the recovery of the injured peripheral and central nervous system, as well as healing of cutaneous wounds and burns. Laser irradiation on only the right side in bilaterally inflicted cutaneous wounds enhanced recovery in both sides compared to the nonirradiated control group (P less than .01). Similar results were obtained in bilateral burns: irradiating one of the burned sites also caused accelerated healing in the nonirradiated site (P less than .01). However, in the nonirradiated control group, all rats suffered advanced necrosis of the feet and bilateral gangrene. Low-power HeNe laser irradiation applied to a crushed injured sciatic nerve in the right leg in a bilaterally inflicted crush injury, significantly increased the compound action potential in the left nonirradiated leg as well. The statistical analysis shows a highly significant difference between the laser-treated group and the control nonirradiated group (P less than .001). Finally, the systemic effect was found in the spinal cord segments corresponding to the crushed sciatic nerves. The bilateral retrograde degeneration of the motor neurons of the spinal cord expected after the bilateral crush injury of the peripheral nerves was greatly reduced in the laser treated group. The systemic effects reported here are relevant in terms of the clinical application of low-power laser irradiation as well as for basic research into the possible mechanisms involved.
Article
The crystal structure at 2.8 A resolution of the four protein subunits containing cytochrome c oxidase from the soil bacterium Paracoccus denitrificans, complexed with antibody Fv fragment, is described. Subunit I contains 12 membrane-spanning, primarily helical segments and binds haem a and the haem a3-copper B binuclear centre where molecular oxygen is reduced to water. Two proton transfer pathways, one for protons consumed in water formation and one for 'proton pumping', could be identified. Mechanisms for proton pumping are discussed.
Article
The high resolution three-dimensional x-ray structure of the metal sites of bovine heart cytochrome c oxidase is reported. Cytochrome c oxidase is the largest membrane protein yet crystallized and analyzed at atomic resolution. Electron density distribution of the oxidized bovine cytochrome c oxidase at 2.8 A resolution indicates a dinuclear copper center with an unexpected structure similar to a [2Fe-2S]-type iron-sulfur center. Previously predicted zinc and magnesium sites have been located, the former bound by a nuclear encoded subunit on the matrix side of the membrane, and the latter situated between heme a3 and CuA, at the interface of subunits I and II. The O2 binding site contains heme a3 iron and copper atoms (CuB) with an interatomic distance of 4.5 A; there is no detectable bridging ligand between iron and copper atoms in spite of a strong antiferromagnetic coupling between them. A hydrogen bond is present between a hydroxyl group of the hydroxyfarnesylethyl side chain of heme a3 and an OH of a tyrosine. The tyrosine phenol plane is immediately adjacent and perpendicular to an imidazole group bonded to CuB, suggesting a possible role in intramolecular electron transfer or conformational control, the latter of which could induce the redox-coupled proton pumping. A phenyl group located halfway between a pyrrole plane of the heme a3 and an imidazole plane liganded to the other heme (heme a) could also influence electron transfer or conformational control.
Article
Singlet oxygen (1O2)-mediated photooxidation of cholesterol gives three hydroperoxide products: 3 beta-hydroxy-5 alpha-cholest-6-ene-5-hydroperoxide (5 alpha-OOH), 3 beta-hydroxycholest-4-ene-6 alpha-hydroperoxide (6 alpha-OOH) and 3 beta-hydroxycholest-4-ene-6 beta-hydroperoxide (6 beta-OOH). These species have been compared with respect to photogeneration rate on the one hand and susceptibility to enzymatic reduction/detoxification on the other, using the erythrocyte ghost as a cholesterol-containing test membrane and chloroaluminum phthalocyanine tetrasulfonate (AlPcS4) as a 1O2 sensitizer. Peroxide analysis was accomplished by high-performance liquid chromatography with mercury cathode electrochemical detection (HPLC-EC[Hg]). The initial rate of 5 alpha-OOH accumulation in AlPcS4/light-treated ghosts was found to be about three times greater than that of 6 alpha-OOH or 6 beta-OOH. Membranes irradiated in the presence of ascorbate and ferric-8-hydroxyquinoline (Fe[HQ]2, a lipophilic iron complex) accumulated lesser amounts of 5 alpha-OOH, 6 alpha-OOH and 6 beta-OOH but relatively large amounts of another peroxide pair, 3 beta-hydroxycholest-5-ene-7 alpha- and 7 beta-hydroperoxide (7 alpha, 7 beta-OOH), suggestive of iron-mediated free radical peroxidation. When photoperoxidized membranes containing 5 alpha-OOH, 6 alpha,6 beta-OOH and 7 alpha,7 beta-OOH (arising from 5 alpha-OOH rearrangement) were incubated with glutathione (GSH) and phospholipid hydroperoxide glutathione peroxidase (PHGPX), all hydroperoxide species underwent HPLC-EC(Hg)-detectable reduction to alcohols, the relative first order rate constants being as follows: 1.0 (5 alpha-OOH), 2.0 (7 alpha,7 beta-OOH), 2.4 (6 alpha-OOH) and 3.2 (6 beta-OOH).(ABSTRACT TRUNCATED AT 250 WORDS)
Article
The crystal structure of bovine heart cytochrome c oxidase at 2.8 A resolution with an R value of 19.9 percent reveals 13 subunits, each different from the other, five phosphatidyl ethanolamines, three phosphatidyl glycerols and two cholates, two hemes A, and three copper, one magnesium, and one zinc. Of 3606 amino acid residues in the dimer, 3560 have been converged to a reasonable structure by refinement. A hydrogen-bonded system, including a propionate of a heme A (heme a), part of peptide backbone, and an imidazole ligand of CuA, could provide an electron transfer pathway between CuA and heme a. Two possible proton pathways for pumping, each spanning from the matrix to the cytosolic surfaces, were identified, including hydrogen bonds, internal cavities likely to contain water molecules, and structures that could form hydrogen bonds with small possible conformational change of amino acid side chains. Possible channels for chemical protons to produce H2O, for removing the produced water, and for O2, respectively, were identified.
Article
Transcription factors/activators are a group of proteins that bind to specific consensus sequences (cis elements) in the promoter regions of downstream target/effector genes and transactivate or repress effector gene expression. The up- or downregulation of effector genes will ultimately lead to many biological changes such as proliferation, growth suppression, differentiation, or senescence. Transcription factors are subject to transcriptional and posttranslational regulation. This review will focus on the redox (reduction/oxidation) regulation of transcription factors/activators with emphasis on p53, AP-1, and NF-kappa B. The redox regulation of transcriptional activators occurs through highly conserved cysteine residues in the DNA binding domains of these proteins. In vitro studies have shown that reducing environments increase, while oxidizing conditions inhibit sequence-specific DNA binding of these transcriptional activators. When intact cells have been used for study, a more complex regulation has been observed. Reduction/oxidation can either up- or downregulate DNA binding and/or transactivation activities in transcriptional activator-dependent as well as cell type-dependent manners. In general, reductants decrease p53 and NF-kappa B activities but dramatically activate AP-1 activity. Oxidants, on the other hand, greatly activate NF-kappa B activity. Furthermore, redox-induced biochemical alterations sometimes lead to change in the biological functions of these proteins. Therefore, differential regulation of these transcriptional activators, which in turn, regulate many target/effector genes, may provide an additional mechanism by which small antioxidant molecules play protective roles in anticancer and antiaging processes. Better understanding of the mechanism of redox regulation, particularly in vivo, will have an important impact on drug discovery for chemoprevention and therapy of human disease such as cancer.