Dos Santos Ligiane Souza, Saltorato Joyce Camilla, Monte Marina Gaiato, Marcos Rodrigo Labat, Lopes-Martins Rodrigo Álvaro Brandão, Tomazoni Shaiane Silva, Leal-Junior Ernesto Cesar Pinto, de Paiva Carvalho Rodrigo Leal
Masters in Physical Therapy, Universidade do Sagrado Coração, Bauru, SP, Brazil.
Graduation in Nutrition, Universidade do Sagrado Coração, Bauru, SP, Brazil.
Lasers Med Sci. 2019 Mar;34(2):255-262. doi: 10.1007/s10103-018-2580-z. Epub 2018 Jul 10.
Physical exercise generates several benefits in a short time in patients with diabetes mellitus. However, it can increase the chances of muscle damage, a serious problem for diabetic patients. Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used to treat these injuries, despite the serious adverse effects. In this way, photobiomodulation therapy (PBMT) with low-level laser therapy (LLLT) and/or light emitting diode therapy (LEDT) can be used as an alternative in this case. However, its efficacy in tissue repair of trauma injuries in diabetes mellitus until now is unknown, as well as the combination between PBMT and NSAIDs. The objective of the present study was to evaluate the effects of NSAIDs and PBMT applied alone or combined on functional and biochemical aspects, in an experimental model of muscle injury through controlled trauma in diabetic rats. Muscle injury was induced by means of a single trauma to the animals' anterior tibialis muscle. After 1 h, the rats were treated with PBMT (830 nm; continuous mode, with a power output of 100 mW; 3.57 W/cm; 3 J; 107.1 J/cm, 30 s), diclofenac sodium for topical use (1 g), or combination of them. Our results demonstrated that PBMT + diclofenac, and PBMT alone reduced the gene expression of cyclooxygenase-2 (COX-2) at all assessed times as compared to the injury and diclofenac groups (p < 0.05 and p < 0.01 respectively). The diclofenac alone showed reduced levels of COX-2 only in relation to the injury group (p < 0.05). Prostaglandin E levels in blood plasma demonstrated similar results to COX2. In addition, we observed that PBMT + diclofenac and PBMT alone showed significant improvement compared with injury and diclofenac groups in functional analysis at all time points. The results indicate that PBMT alone or in combination with diclofenac reduces levels of inflammatory markers and improves gait of diabetic rats in the acute phase of muscle injury.
体育锻炼能在短时间内给糖尿病患者带来诸多益处。然而，它会增加肌肉损伤的几率，这对糖尿病患者来说是个严重问题。非甾体抗炎药（NSAIDs）虽有严重不良反应，但仍被广泛用于治疗这些损伤。在这种情况下，低强度激光疗法（LLLT）和/或发光二极管疗法（LEDT）的光生物调节疗法（PBMT）可作为一种替代方法。然而，到目前为止，其在糖尿病创伤损伤组织修复中的疗效以及PBMT与NSAIDs的联合应用情况尚不清楚。本研究的目的是在糖尿病大鼠可控创伤性肌肉损伤的实验模型中，评估单独或联合应用NSAIDs和PBMT对功能和生化方面的影响。通过对动物胫前肌进行单次创伤诱导肌肉损伤。1小时后，对大鼠进行PBMT（830纳米；连续模式，输出功率100毫瓦；3.57瓦/平方厘米；3焦；107.1焦/平方厘米，30秒）、外用双氯芬酸钠（1克）或两者联合治疗。我们的结果表明，与损伤组和双氯芬酸钠组相比，PBMT + 双氯芬酸钠组以及单独使用PBMT组在所有评估时间点均降低了环氧合酶 - 2（COX - 2）的基因表达（分别为p < 0.05和p < 0.01）。单独使用双氯芬酸钠仅与损伤组相比显示COX - 2水平降低（p < 0.05）。血浆中前列腺素E水平显示出与COX2相似的结果。此外，我们观察到在所有时间点的功能分析中，PBMT + 双氯芬酸钠组和单独使用PBMT组与损伤组和双氯芬酸钠组相比有显著改善。结果表明，单独使用PBMT或与双氯芬酸钠联合使用可降低炎症标志物水平，并改善糖尿病大鼠在肌肉损伤急性期的步态。
