Niu Y, Xin Z, Lin G, Ding P, Pan J, Feng Y, Guo Y
Male Reproductive and Sexual Medicine, Department of Urology, The Second Hospital of Tianjin Medical University; Tianjin Institute of Urology, Tianjin 300211, China.
Department of Urology, Peking University First Hospital, Beijing 100034, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2025 Aug 18;57(4):627-632. doi: 10.19723/j.issn.1671-167X.2025.04.001.
Low-level laser therapy (LLLT), a noninvasive photobiomodulation technique, employs red or near-infrared (NIR) light (600-1 000 nm) with power outputs ranging from 5 to 500 mW. It exerts therapeutic effects through molecular mechanisms, specifically the activation of cytochrome C oxidase (CCO) and the modulation of intracellular signaling pathways. By enhancing mitochondrial adenosine triphosphate (ATP) synthesis, LLLT mitigates oxidative stress, regulates the reactive oxygen species (ROS)/glutathione peroxidase (GSH-Px)/superoxide dismutase (SOD) axis, and activates key pathways, including phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) and mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK). These mechanisms confer antioxidant, anti-inflammatory, and pro-regenerative properties to LLLT, making it a viable intervention for dermatological conditions, oncological therapies, and musculoskeletal disorders. Recent preclinical studies underscore LLLT' s potential in male reproductive health. Specifically, it ameliorates cavernosal fibrosis and endothelial dysfunction in erectile dysfunction (ED) models by upregulating the PI3K/Akt and MAPK/ERK pathways. In the context of sperm biology, LLLT enhances motility and acrosomal integrity in both fresh and cryopreserved spermatozoa. This is achieved through mitochondrial metabolic reprogramming, such as CCO-mediated electron transport chain activation, redox homeostasis restoration, and epigenetic modulation involving DNA methylation and histone acetylation. Additionally, LLLT alleviates scrotal heat-induced oligospermia by promoting seminiferous epithelial differentiation, elevating serum testosterone levels, and suppressing lipid peroxidation. These findings highlight the translational potential of LLLT in regenerative medicine, particularly for male sexual and reproductive disorders. Future research efforts should focus on interdisciplinary collaborations spanning life sciences, engineering, and physics. The goal is to optimize laser parameters, including wavelength, irradiance, and treatment duration, and establish standardized protocols. Rigorous preclinical and clinical investigations are paramount to validate the safety, efficacy, and long-term outcomes of LLLT, ultimately paving the way for its integration into precision medicine frameworks for urological and reproductive therapies.
低强度激光疗法（LLLT）是一种非侵入性光生物调节技术，采用功率输出范围为5至500毫瓦的红色或近红外（NIR）光（600 - 1000纳米）。它通过分子机制发挥治疗作用，特别是激活细胞色素C氧化酶（CCO）和调节细胞内信号通路。通过增强线粒体三磷酸腺苷（ATP）合成，LLLT减轻氧化应激，调节活性氧（ROS）/谷胱甘肽过氧化物酶（GSH-Px）/超氧化物歧化酶（SOD）轴，并激活关键通路，包括磷脂酰肌醇3-激酶/蛋白激酶B（PI3K/Akt）和丝裂原活化蛋白激酶/细胞外信号调节激酶（MAPK/ERK）。这些机制赋予LLLT抗氧化、抗炎和促再生特性，使其成为皮肤病、肿瘤治疗和肌肉骨骼疾病的可行干预措施。最近的临床前研究强调了LLLT在男性生殖健康方面的潜力。具体而言，它通过上调PI3K/Akt和MAPK/ERK通路，改善勃起功能障碍（ED）模型中的海绵体纤维化和内皮功能障碍。在精子生物学方面，LLLT增强新鲜和冷冻保存精子的活力和顶体完整性。这是通过线粒体代谢重编程实现的，如CCO介导的电子传递链激活、氧化还原稳态恢复以及涉及DNA甲基化和组蛋白乙酰化的表观遗传调节。此外，LLLT通过促进生精上皮分化、提高血清睾酮水平和抑制脂质过氧化来减轻阴囊热诱导的少精子症。这些发现突出了LLLT在再生医学中的转化潜力，特别是对于男性性和生殖障碍。未来的研究工作应侧重于生命科学、工程学和物理学的跨学科合作。目标是优化激光参数，包括波长、辐照度和治疗持续时间，并建立标准化方案。严格的临床前和临床研究对于验证LLLT的安全性、有效性和长期结果至关重要，最终为将其纳入泌尿外科和生殖治疗的精准医学框架铺平道路。
