Brauncajs Małgorzata, Ksiąszczyk Krzysztof, Lewandowska-Polak Anna, Gorzela Katarzyna, Grzegorczyk Janina
Department of Microbiology and Laboratory Medical Immunology, Medical University of Lodz, Lodz, Poland.
Internal Medicine Ward, Pabianice Medical Centre, Pabianice, Poland.
Postepy Dermatol Alergol. 2018 Dec;35(6):582-586. doi: 10.5114/ada.2018.77609. Epub 2018 Nov 8.
Low-level laser therapy is used in managing chronic wounds including pressure ulcers. Less is known about its impact on the healing process if an inhibitive agent e.g. bacterial infection takes place. Modulating non-specific immunity processes might eliminate bacteria if laser therapy is applied.
To investigate the impact of low-level laser therapy on pressure ulcer dynamics considering an infectious agent and cathelicidin LL-37 concentration.
The study comprised 6 patients with pressure ulcers ranging from stage II to III in Torrance classification and 12 patients without pressure ulcers. Venous blood sample and decubitus wound swab were taken - in study groups A at baseline and after 2 weeks; in control group B once - at a specific point of time. The swabs served for species identification. Drug susceptibility of isolated pathogens and cathelicidin LL-37 in serum concentration were measured.
In study group A, the following bacteria predominantly occurred: , while in control group B, excluding one MRSA case, (physiological flora) were present. HLGR resistance mechanisms were detected when analyzing drug susceptibility panels. Study group A findings demonstrated a statistically significant difference between the levels of cathelicidin LL-37 concentration at baseline and at the end.
There is insufficient information to accurately determine the effect of LLLT on pressure ulcer dynamics considering an infectious agent. These effects may occur if innate immunity processes are modulated so that laser therapy might eliminate bacteria indirectly.
低强度激光疗法用于治疗包括压疮在内的慢性伤口。如果发生抑制性因素，如细菌感染，其对愈合过程的影响则鲜为人知。如果应用激光疗法，调节非特异性免疫过程可能会消除细菌。
考虑感染因素和抗菌肽LL-37浓度，研究低强度激光疗法对压疮动态变化的影响。
本研究包括6例托伦斯分类为II至III期的压疮患者和12例无压疮患者。研究组A在基线和2周后采集静脉血样本和褥疮伤口拭子；对照组B在特定时间点采集一次。拭子用于菌种鉴定。测量分离病原体的药敏性和血清中抗菌肽LL-37的浓度。
在研究组A中，主要出现以下细菌： ，而在对照组B中，除1例耐甲氧西林金黄色葡萄球菌病例外， （生理性菌群）存在。分析药敏试验结果时检测到耐高浓度庆大霉素的耐药机制。研究组A的结果表明，基线时和结束时抗菌肽LL-37浓度水平存在统计学显著差异。
考虑感染因素时，没有足够的信息来准确确定低强度激光疗法对压疮动态变化的影响。如果调节先天免疫过程，可能会产生这些影响，从而使激光疗法可能间接消除细菌。
