The Institute for Research in Military Medicine (IRMM), Faculty of Medicine of The Hebrew University of Jerusalem and Israel Defense Forces Medical Corps, Ein Kerem, POB 12272, Jerusalem, 9112001, Israel.
Institute for Medical Research-Israel-Canada (IMRIC), Faculty of Medicine of The Hebrew University of Jerusalem, Ein Kerem, POB 12272, Jerusalem, 9112001, Israel.
Lasers Surg Med. 2020 Nov;52(9):863-872. doi: 10.1002/lsm.23225. Epub 2020 Feb 17.
Photobiomodulation (PBM), a non-ionizing, non-thermal irradiation, used clinically to accelerate wound healing and inhibit pain, was previously shown to increase blood flow. However, some individuals respond to PBM, but others do not. The purpose of this study was to investigate factors affecting this patient-specific response using advanced, noninvasive methods for monitoring microcirculatory activity.
STUDY DESIGN/MATERIALS AND METHODS: In this prospective, randomized controlled clinical trial (NCT03357523), 20 healthy non-smoking volunteers (10:10 males:females, 30 ± 8 years old) were randomized to receive either red- (633 nm and 70 W/cm ) or near-infrared light (830 nm and 55 mW/cm ) over the wrist for 5 minutes. Photoplethysmography, laser Doppler flowmetry, and thermal imaging were used to monitor palm microcirculatory blood volume, blood flow, and skin temperature, respectively, before, during, and 20 minutes after irradiation. Participants with skin temperature change ≥0.5°C from baseline were considered "responders".
Near-infrared PBM was found to induce a 27% increase in microcirculatory flow that increased to 54% during the 20-minute follow-up period (P = 0.049 and P = 0.004, respectively), but red light PBM did not increase the median flow. Only 10 of 20 participants were responders by thermal imaging (i.e., ≥0.5°C from baseline), and their initial skin temperature was between 33 and 37.5°C. The non-responders had either "hot" hands (≥37.5°C) or "cold" hands (≤33°C). In responders, the meantime to 20% increase in microcirculatory blood volume and blood flow was less than 2.5 minutes after initiation of PBM irradiation.
We demonstrated that PBM induces arteriolar vasodilatation that results in both immediate and long-lasting increased capillary flow and tissue perfusion in healthy individuals. This response was wavelength-dependent and modified by skin temperature. These findings regarding physiological parameters associated with sensitivity or resistance to PBM provide information of direct relevance for patient-specific therapy. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
光生物调节（PBM）是一种非电离、非热辐射，临床上用于加速伤口愈合和抑制疼痛，先前已显示可增加血流量。然而，一些个体对 PBM 有反应，而另一些则没有。本研究旨在使用先进的非侵入性方法监测微循环活动来研究影响这种患者特异性反应的因素。
研究设计/材料和方法：在这项前瞻性、随机对照临床试验（NCT03357523）中，将 20 名健康非吸烟志愿者（10:10 名男性：女性，30±8 岁）随机分为两组，分别接受腕部红色（633nm 和 70W/cm）或近红外光（830nm 和 55mW/cm）照射 5 分钟。光体积描记法、激光多普勒流量测量法和热成像分别用于监测照射前、照射中和照射后 20 分钟的手掌微循环血液量、血流和皮肤温度。皮肤温度变化从基线增加≥0.5°C 的参与者被认为是“有反应者”。
近红外 PBM 被发现诱导微循环流量增加 27%，在 20 分钟的随访期间增加到 54%（P=0.049 和 P=0.004），但红光 PBM 未增加中位数流量。只有 20 名参与者中的 10 名通过热成像（即，与基线相比增加≥0.5°C）被认为是有反应者，他们的初始皮肤温度在 33 至 37.5°C 之间。无反应者的手部要么“热”（≥37.5°C），要么“冷”（≤33°C）。在有反应者中，微循环血液量和血流增加 20%的时间少于 PBM 照射开始后 2.5 分钟。
我们证明 PBM 诱导小动脉扩张，导致健康个体的毛细血管流量立即和长期增加，组织灌注增加。这种反应与波长有关，并受皮肤温度的调节。这些关于与 PBM 敏感性或抗性相关的生理参数的发现为特定于患者的治疗提供了直接相关的信息。激光外科学与医学。© 2020 威利期刊，公司
