Dose–Response Relationship of Photobiomodulation Therapy on Matrix Metalloproteinase in Healing Dynamics of Diabetic Neuropathic Ulcers—An in vivo Study

• Published in: Photochemistry and photobiology 2023-07, Vol.99 (4), p.1172-1180
• Main Authors: Karkada, Gagana, Maiya, G Arun, Arany, Praveen, Rao KG, Mohandas, Adiga, Shalini, Kamath, Shobha U.
• Format: Article
• Language: English
• Subjects: Animals; Clinical trials; Diabetes; Diabetes Mellitus; Diabetic neuropathy; Dosage; In vivo methods and tests; Inflammation; Light therapy; Low-Level Light Therapy - methods; Matrix metalloproteinase; Matrix Metalloproteinases; Metalloproteinase; Prospective Studies; Rats; Rats, Wistar; Sciatic nerve; Therapy; Ulcers; Wound Healing
• ISSN: 0031-8655; 1751-1097
• DOI: 10.1111/php.13754

Individuals with diabetic foot ulcers have overlapped the inflammatory, proliferative and remodeling phase, making the tissue vulnerable to delayed healing responses. We aimed to establish the dose–response relationship of photobiomodulation therapy of different doses and matrix metalloproteinases in the healing dynamics of diabetic neuropathic ulcers. Diabetes was induced in 126 Albino Wistar rats, and neuropathy was induced to the hind paw by a sciatic nerve injury method. An excisional wound was created on the neuropathy‐induced leg. Photobiomodulation therapy of dosages 4, 6, 8, 10, 12 and 15 J cm−2 and wavelength 655 nm and 808 nm was irradiated. Photobiomodulation therapy of dosages 4, 6 and 8 J cm−2 showed better wound healing properties with optimized levels of matrix metalloproteinases‐1 and 8. We observed a strong dose response in the experimental group treated with 6 and 8 J cm−2. The findings from the present study conclude that photobiomodulation therapy of dosages 4, 6 and 8 J cm−2 is suggestive of usefulness in diabetic neuropathic ulcer healing. Markers like matrix metalloproteinases may give a clear direction on response to the therapy. Based on the findings from the present study, we recommend to validate the findings for safety and efficacy in future through human prospective randomized controlled clinical trials. Photobiomodulation therapy (PBMT) for the healing of diabetic neuropathic ulcer: Induction of neuropathy was done by the sciatic crush injury method. An excisional wound of depth 0.1 cm and area 2 cm2 was created on the neuropathy‐induced leg in all the animals. Experimental group animals were irradiated with PBMT of Scanning LASER 655 nm and probe LASER 808 nm. Control group animals were kept un‐irradiated.