Laser therapy is increasingly used in modern medicine every year. This is due, on the one hand, to the creation of highly efficient laser systems, and, on the other hand, to the data obtained, indicating a high therapeutic efficacy of low-intensity laser radiation (LILR) in various pathological conditions of the body. Along with this, LILI is characterized by the absence of significant side effects, the possibility of combined use with other therapeutic agents, and a positive effect on the pharmacodynamics and pharmacokinetics of drugs.
Laser radiation is electromagnetic radiation of the optical range, which has the properties of coherence, monochromaticity, polarization and directivity. The use of low-energy laser radiation for physiotherapeutic purposes showed good tolerance by patients, the absence of pathological changes in the hematopoietic, cardiovascular and adaptive th systems. Helium-neon laser (GNL) radiation of low power - up to 20 mW, with a wavelength of 630 nm can affect the triggers of cellular regulation, change the state of the cell membrane with an increase in the functional activity of cells. The laser affects the electrical characteristics of the skin, increases its temperature by 1-3 ° C, leads to biophysical, biochemical, histological and ultrastructural changes.
Laser therapy methods are very diverse. Percutaneous, puncture laser therapy, laser hemotherapy, combined methods of exposure to LILI with other therapeutic agents are used.
To date, there is no consensus on the mechanisms of action of LLLT on the body, its individual systems and the pathological focus. It seems that the diversity and systemic nature of the secondary biochemical and physiological effects of laser blood irradiation is explained by the diversity of photoacceptors and triggered primary photobiological reactions at the molecular, subcellular, and cellular levels. In the process of interaction of laser radiation with a biological substrate, photobiological reactions occur that proceed in stages: absorption of a light quantum and intramolecular redistribution of energy (photophysical processes), intermolecular energy transfer and primary photochemical reactions, biochemical processes involving photoproducts, secondary photobiological reactions, and the general physiological response of the body to action of light.
There are several hypotheses about the mechanism of therapeutic action of LILI. The system of cellular interaction, as well as tissue and organ functioning, is based on the covalent transformation of membrane proteins. For example, the membrane-bound adenylate cyclase, which converts ATP to cyclic adenosine monophosphate (cAMP), contains domains that form the catalytic core. Any factor that changes the spatial structure of these domains, including LILI, can change the catalytic activity of the enzyme and increase the amount of cAMP. The latter, in turn, leads to a decrease in the intracellular concentration of the messenger of many metabolic processes - calcium ions. In cerebral ischemia, high concentrations of Ca 2+ in neurons is a trigger for impaired ion transport and activation of cytoplasmic enzymes (protein kinases, lipases, endonucleases), calcium-mediated excitotoxicity and the glutamate-calcium cascade, and also promotes platelet aggregation, activation of lipid peroxidation reactions ( LPO) and free radical oxidation. This information is consistent with one of the hypotheses, which is that the mechanism of the biological action of LILI is realized through the conformational rearrangement of biomembrane proteins, leading to a change in their functional activity, including cAMP. It is known that in vitro and in vivo LILI causes the activation of such enzymes as Ca 2+ - and Mg 2+ -ATPase, nicotinamide adenine dinucleotide (NAD) - and nicotinamide adenine dinucleotide phosphate (NADP) dehydrogenase, lactate and malate dehydrogenase, transaminases, increases the content of adenine nucleotides in the brain, which ensure the continuity of NAD reoxidation H and play an important role in aerobic and anaerobic energy generation. There is evidence that LILI changes the rate of metabolic processes in tissues, and the effect appears 5 minutes after its exposure.
A number of experimental studies have shown that the interaction of LILI with the components of the respiratory chain leads to their reactivation and stimulation of the synthesis of macroergs, since the chromophores of laser light in the human body are cytochromes α-α 3 and cytochrome oxidase. In the study of adaptation to hypoxia in rats, it was proved that an increase in the activity of enzymes and the content of the adenine nucleotide pool in brain tissues is a biochemical adaptation mechanism that reduces the energy deficit in cells. Therefore, by modulating the activity of the most important enzymatic systems, LILI has a compensatory and sanogenetic effect during cerebral hypoxia.
A number of works develop a concept according to which the mechanism of action of LILI is based on photosensitization of endogenous photoacceptors - porphyrins, which are part of hemoproteins (hemoglobin, myoglobin, ceruloplasmin, cytochromes) and metal-containing enzymes - superoxide dismutase (SOD), peroxidase, catalase. Under conditions of hypoxia, the number of endogenous porphyrins, which absorb radiation in the visible region of the spectrum, sharply increases in organs and tissues. They are highly active substances affecting all metabolic processes, intracellular signaling mechanisms, nitric oxide synthesis (NOS) and guanylate cyclase activity. Moreover, guanylate cyclase contains a porphyrin complex in its structure, which makes it a photoacceptor and causes an increase in the concentration of cyclic guanosine monophosphate (cGMP) during photostimulation, causing activation of cGMP-dependent protein kinase, which binds Ca 2+ in the platelet cytoplasm and inhibits their aggregation, and also causes a vasodilating effect. . The neuroprotective action in the wavelength range of red and infrared LILI is based, in addition, on its ability to inhibit lipid peroxidation of cell membranes, activate the enzymes of the antioxidant system - SOD and catalase.
In the same row are studies on the identification of primary photoacceptors of laser radiation and the mechanisms of primary photoreactions developing in vivo under the influence of intravenous laser blood irradiation (ILBI) GNL based on the study of absorption spectra in the ultraviolet and infrared regions. It was shown that GNL radiation is absorbed by blood hemoglobin, which is the primary photoacceptor of laser radiation with a wavelength of 632.8 nm. LILI simultaneously affects the structure of heme and hemoglobin polypeptide chains, which leads to conformational rearrangements of the hemoglobin molecule and changes in the oxygen transport function of blood.
The role of nitric monoxide (NO), synthesized by eNOS, is quite significant in the implementation of the therapeutic effect of LILI, given the fact that its synthesis decreases during postischemic reperfusion not only in the ischemic region, but also remotely. Synthesis of NO in the body is carried out by several isoforms of NOS, which include protoporphyrin IX. This enzyme is a photoacceptor of laser radiation, and eNOS can be considered as a target for LILI during blood irradiation. Stimulation of NO synthesis leads to a decrease in reperfusion damage to the endothelium by oxygen radicals, which are formed during ischemia-reperfusion, since NO neutralizes them, acting as an antioxidant. Violation of the balanced production of vasoconstrictors and NO during ischemia-reperfusion leads to a violation of the resumption of blood flow at the level of the microvasculature after ischemia (no-reflow phenomenon), which aggravates tissue hypoxia. In recent years, data have appeared on the NO-dependent endothelium-protective effect in ischemic adaptation associated with the prevention of the development of post-ischemic endothelial dysfunction. This effect is accompanied by a decrease in the adhesion of leukocytes and platelets to the endothelium of the ischemic tissue, maintaining the ability of blood vessels to dilate, which prevents the development of "no-reflow". Interesting information about the influence of moglobin on the concentration of NO in plasma, due to the fact that hemoglobin nitrosol complexes serve as a depot for NO. The vascular bed is a kind of "drain" for excess NO produced by the brain tissue. Nitric oxide also interacts with other hemoproteins, and ILBI promotes the release of NO from these compounds. It can also be assumed that NO is a mediator between laser radiation and enzymatic cellular systems of the body due to the stimulation of NO-dependent cGMP and the cascade of enzymatic reactions of cellular recovery during ILBI.
According to a number of researchers, oxygen, due to its absorption band in the 630 nm region, actively absorbs red light and passes into a singlet (excited) state, which induces oxidative processes in tissues. According to some authors, oxygen molecules located in the interlipid space of cell membranes are the main acceptor of laser radiation. The resulting lipid hydroperoxides in the presence of reduced forms of iron initiate a chain reaction of oxidation of polyunsaturated fatty acids in cell membranes and blood plasma. Singlet oxygen formed as a result of photochemical reactions has various properties, in particular, it can damage cytoplasmic membranes, which is accompanied by corresponding physiological reactions at the level of the whole organism.
There is an opinion that in the absence of special receptors there is a non-specific field effect of LILI, the acceptors of which are the most important biopolymers: proteins, enzymes, lipids. At the same time, the therapeutic effect of laser exposure is explained by a reversible modification of the structure of cell components, a conformational change in the membrane and its regulatory function.
If all existing concepts primary mechanism effects of LILR on biological objects are based on the assumption of the photochemical nature of this phenomenon, then at present At the same time, another assumption has been developed, which is based on the idea of the effect on cells and organelles of gradient forces arising in the presence of spatial radiation intensity gradients. Moreover, according to the authors, the phenomenon occurs only when objects are illuminated with coherent light, when certain speckle structures appear, which form on the surface and in the depths of the object. In turn, gradient forces can cause various selective changes in the local concentration and composition of the medium, increase the partial temperature of microparticles, and lead to conformational changes in membranes and enzymes.
A concept is also being developed, according to which the photophysical process that determines the rearrangement of the spatial structure of various enzymes and membrane structures under the action of LILR is non-resonant interaction, and not the absorption of its quanta.
It is also possible that the action of red light is realized through changes in the properties of free and bound water in the cell. An attempt has been made to explain the physiological activity of red laser radiation by a spectrally non-specific field effect on body fluids.
In recent years, the hypothesis of the photodynamic mechanism of action of LILI has been considered, according to which the chromophores of laser radiation in the red region of the spectrum are endogenous porphyrins, known as photosensitizers, the content of which increases in many pathological processes. An increase in the intraleukocyte calcium content, which occurs under the influence of absorption by LILI porphyrins, triggers Ca 2+ -dependent reactions leading to prestimulation, the so-called priming, which in turn causes an increase in the production of various biologically active compounds, including nitric oxide. The latter is known to improve microcirculation, which is actively used in clinical medicine with a good effect.
The photoneurodynamic concept explains the universal nosologically non-specific therapeutic effect of GNL exposure by the processes of homeostatic motor-vegetative regulation.
The formation of a local biostimulating effect occurs as a result of the structural and functional rearrangement of biomembranes and increased activity of the main metabolic systems of the cell associated with the formation of macroergs. The stabilization of cell membranes observed under laser radiation conditions is due to metabolic shifts that lead to changes in the viscosity and stiffness of membranes, surface charge and membrane potential.
One of the methods of laser therapy is laser hemotherapy, including ILBI and transcutaneous laser blood irradiation (PTBI). N.F. Gamaleya believed that with light irradiation of blood, there are special ways of realizing this effect. Considering that blood is a polyfunctional system, performing in the body, among others, the function of an integrating medium, its irradiation ensures the response of the body as a whole. Consequently, the laser effect on the blood, better than other methods of irradiation, embodies in practice the ideas according to which LILI is not a means of treating certain diseases, but a tool for general stimulation of the body, used in many pathological conditions.
The whole set of changes in the blood observed during ILBI is considered as a response of the homeostasis regulation system to the development of pathological processes in individual organs and tissues, where laser radiation acts as a trigger that launches this mechanism through a system of non-specific regulation. Earlier S.V. Moskvin proposed and substantiated a model for the thermodynamic interaction of LILR with intracellular components, followed by intracellular release of calcium ions and the development of calcium-mediated processes.
Erythrocytes as porphyrin-containing cells are acceptors (chromophores) of laser radiation in the red region of the spectrum. This largely explains the positive effect of LILI on the rheological properties of blood: a decrease in erythrocyte aggregation and an increase in the ability of erythrocytes to deform due to changes in their physical and chemical properties(increasing the negative electrical charge on the membrane, modifying its structure and microrheology of the erythrocyte cytoplasm). Laser irradiation causes a structural rearrangement of the membranes of blood cells and has a membrane-stabilizing effect, leading to a change in the plastic characteristics of blood cells, a decrease in platelet aggregation and their sensitivity to thromboxane A 2, inhibition of the key enzymes of arachidonic acid - cyclooxygenase and thromboxane synthetase. The decrease in the aggregation potential of blood correlates with the improvement of its rheological properties under the action of laser hemotherapy. This intensifies blood circulation at the level of the microvasculature, increases oxygen delivery zones and activates aerobic metabolic processes, realizing the antihypoxic effect of LILI. Activation of microcirculation in LOK is also due to the normalization of colloid osmotic pressure in microvessels and a decrease in blood viscosity, vasodilation and stimulation of neovasculogenesis. As a result, reserve capillaries and collaterals are included in the blood flow, optimization of organ perfusion and an increase in the amount of available O 2 are achieved. In the process of laser hemotherapy, cerebral hemodynamics improves, which is characterized by an increase in the blood supply to the cerebral vessels and the linear velocity of blood flow, and stimulation of venous outflow. In addition, the sanogenetic changes in microcirculation during ischemia are based on the normalizing effect of laser irradiation on the activity of the autonomic nervous system with the optimization of the autonomic support for the functioning of organs and tissues, including the effect on the tone of the vascular wall and the normalization of nervous excitability.
The absence of a damaging effect of ILBI on the vascular endothelium was established. Comparative analysis the effectiveness of ILBI and intravenous use of rheologically active drugs showed the advantages of laser irradiation. Meanwhile, the effect of LILI on the resistance of erythrocytes is ambiguous. The minimum damaging effect of laser radiation on erythrocytes has been experimentally established. If laser exposure does not exceed certain critical doses, red blood cells repair light-induced damage to transition to a new steady state.
Blood coagulation is a cascade of enzymatic reactions that are realized along the internal and (or) external pathway through the activation of serine proteases (plasma coagulation factors). One of the factors that can have a modifying effect on altered hemocoagulation in cerebral ischemia is LOC, which realizes its action by changing the activity of various enzymatic systems. When exposed to cells and biostructures of the blood, a quantum of light of laser radiation modulates the action of enzymes of the blood coagulation system due to its selective absorption. LILI has a hypocoagulative and fibrinolytic effect, combined with the effect of accelerating blood flow in microvessels, which creates optimal conditions for the normalization of disturbed hemodynamics.
Experimental and clinical studies show that under the influence of LILI, endothelial restoration, reactivation of enzymes damaged under various pathological conditions, and activation of biosynthetic processes in enzymatic systems, enhancement of transcapillary blood circulation and improvement of energy metabolism, intensification of metabolism, normalization of the permeability of vascular tissue barriers and hemostatic, fibrinolytic activity of blood.
Along with the above biological effects, ILBI has an adaptogenic effect on the neurohumoral yu regulation, which is expressed in a modulating effect on the function of the pituitary-adrenal cortex system, immunocorrective and analgesic action.
Of interest are also data on the ultrastructural reorganization of neurons in the CNS under the action of LILI. We have shown that ILBI by infrared laser radiation with an output power of 2 mW after simulating cerebral ischemia not only prevents the development of destructive processes, but also activates the reparative reserves of cells, stimulating regeneration processes, which is an important mechanism of action of LILI that triggers the processes of intracellular and cellular regeneration in the CNS .
All of the above effects of laser radiation lead to the provision of the most favorable mode of functioning of metabolic processes in ischemic tissues, which indicates the expediency of using LILI in cerebral ischemia.
Thus, LILI has a pronounced multicomponent, pathogenetically substantiated effect in a number of pathological conditions. Due to the breadth of therapeutic effects and good tolerability, ILBI is a unique means of targeting the body. This method of treatment in combination with other therapeutic measures can be used for diseases characterized by polyetiology, complex multi-link pathogenesis, duration of recovery and refractoriness to ongoing therapy. The nature of the pathogenesis of acute and chronic cerebral ischemia opens up the possibility of effective use of laser hemotherapy in the acute stage of ischemic stroke and in chronic cerebrovascular diseases as a means of pathogenetic therapy, as well as to stimulate adaptive-compensatory processes in the body.
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The development of laser medicine makes high demands on the experimental substantiation of the use of lasers in the clinic. There is currently a large number of works devoted to the study of the impact of low-intensity laser radiation on biological objects. However, there is still no consensus on the most favorable physical characteristics of laser radiation for living tissues, such as wavelength, pulse repetition rate, and exposure time. As a result, the question of the optimal radiation dose has not been resolved. The problem is exacerbated by the fact that different tissues and organs have different sensitivity to laser radiation, due to the fact that their various biochemical components - enzymes, hormones, vitamins, pigments - have purely individual radiation absorption characteristics. Thus, the information available in the literature on the effect of low-energy radiation on living tissues and organs, including the thyroid gland, is contradictory, and the mechanism of action has not yet been disclosed.
The purpose of this study is to study the morphological changes in the follicular apparatus of the thyroid gland under the influence of infrared laser radiation.
To solve the tasks, white outbred male rats weighing 150-200 grams were irradiated daily with a MILA-1 infrared laser for five days, the time of each exposure was 5 minutes. The laser wavelength is 0.89 µm. The irradiation dose for one procedure was 59 J/cm2 of the irradiated surface, for the entire course - 295 J/cm2. Euthanasia of animals was carried out by an overdose of Nembutal anesthesia. The material was taken on the first (group 1), tenth (group 2) and thirtieth (group 3) days after the end of the treatment course. Morphometry of histological sections of the thyroid gland, stained with hematoxylin and eosin, was performed using the Ista-Video Test image analyzer. The cross-sectional area of the follicle, the area and optical density of the colloid, the cross-sectional area of thyrocytes were determined, and their number was counted in the cross section of the follicle. The significance of the observed changes was determined by Student's t-test, the relationship of signs was established using correlation analysis.
The thyroid gland of rats of the comparison group has a typical morphological structure. In control animals, a clear follicular organization of this organ is noted. A colloid of a homogeneous consistency completely fills most of the oval follicles. Thyrocytes have a cubic shape. The connective tissue layers between the lobules are moderately developed. The lumens of blood vessels of all groups, with rare exceptions, contain blood cells.
Thyroid follicles in rats of the first experimental group look smaller, more often rounded. Thyrocytes retain a cubic shape. At the same time, there is a tendency to increase the size of the lobules and reduce the connective tissue layers between them. Venous plethora is clearly expressed against the background of the absence of blood cells in the arterial bed and hemocapillaries. In animals of the second group, similar changes are observed, only some flattening of thyrocytes and an increase in the amount of connective tissue are noted. In rats of the third group, a decrease in the amount of connective tissue is again noted. Changes in the follicular epithelium and blood vessels persist at all times.
An analysis of the results of morphometry made it possible to establish that the area of the follicles remained unchanged in rats of groups 1 and 2, while in animals of the third group there was a significant decrease in this indicator. The area of the colloid in animals of all experimental groups does not change significantly, and the area of thyrocytes sharply increases by the first day, after which the value of this indicator decreases. So on the 10th day, the thyrocyte area reaches the control level, and on the 30th day it becomes significantly lower. The number of thyrocytes in the follicle does not change. The optical density of the colloid increases by the tenth day, after which, on the 30th day, it significantly decreases, but does not reach the level of the comparison group. Correlation analysis revealed positive correlations between follicle area and colloid area and number of thyrocytes and negative relationship with thyrocyte area in rats of the comparison group. The area of the colloid is also positively associated with the number of thyrocytes, negatively with their area and the optical density of the colloid. The area of thyrocytes is negatively related to their number. Based on the data obtained, it can be concluded that in intact rats the area of the follicle increases due to an increase in the number of thyrocytes, or due to the accumulation of colloid. With an increase in the functional activity of the organ, which is manifested in an increase in the area of secretory cells, the area of the follicles decreases due to an increase in their total number. In this case, enhanced reabsorption of the colloid occurs, resulting in a decrease in its area and optical density.
In animals of experimental groups 1 and 2, the number of correlations remains unchanged, but in some cases their sign changes. So in rats of the 1st group, the change in the area of the follicle occurs due to changes in all its components: the area of the colloid, the area and number of thyrocytes. This may indicate a certain increase in the function of the thyroid gland during its irradiation with a laser, which resulted in an increase in the area of thyrocytes. In animals of the 2nd group, negative relationships appear between the area of the follicle, the area of the colloid, the area of the thyrocyte and the number of thyrocytes in the follicle. This significantly increases the optical density of the colloid, therefore, there is a decrease in the function of the organ.
On the thirtieth day after the end of exposure, correlations appear between all the studied features. At the same time, the previously existing connections do not differ in sign from the control ones. Again, negative correlations were formed between the area of the follicle, the number of thyrocytes and the optical density of the colloid and a positive relationship between the optical density of the colloid and the area of thyrocytes. Since these changes occur against the background of a decrease in the area of follicles and the area of thyrocytes with a simultaneous increase in the optical density of the colloid, it can be assumed that after the withdrawal of the stimulating effect, the thyroid gland experiences functional stress, leading to a decrease in the function of this organ.
Based on the currently widespread hypothesis about the possible mechanism of laser action on biological objects, it can be assumed that changes in the energy activity of cell membranes, the activity of the nuclear apparatus of cells, redox processes, and basic enzyme systems have occurred in the cells of the thyroid gland. During the period of exposure, the organ probably adapted to life under the conditions of energy input from the outside, which caused some enhancement of the function, which manifested itself in an increase in the area of follicular cells in group 1 rats. After a sharp cancellation of the energy source from the outside, a decrease in secretory activity is observed. The changes observed on the 3rd day after exposure may indicate the presence of adaptive processes in the organ to a lower energy level. Based on the data obtained, the following conclusions can be drawn:
During the exposure to infrared laser radiation, structural changes are formed in the follicular apparatus of the thyroid gland, which indicate a certain increase in its function.
After the cancellation of the experimental exposure, morphological changes correspond to the hypofunctional state of the thyroid gland.
3. The laser radiation used in the work had a negative effect on the thyroid gland, since the stimulating effect was of a short-term nature, and the recovery period took a rather long period of time.
follicular thyroid radiation
Literature
- 1. Amirov N. B. The use of laser exposure for the treatment of internal diseases. // Kazan Medical Journal. 2001. T 31, No. 5, p. 369-372.
- 2. A. V. Mostovnikov, G. R. Mostovnikova, V. Yu. Plavskii, L. G. Plavskaya, and R. Morozova. P., Tretyakov SA On the mechanism of the therapeutic action of low-intensity laser radiation and a constant magnetic field. // Low-intensity lasers in medicine (mechanism of action, clinical application): Proceedings of the All-Union Symposium, in two parts. Obninsk, NIIMR AMS USSR, 1991, p. 67 - 70.
Department of Urology, RSMU, Moscow
Male secretory infertility in 30-50% of cases is the cause of infertility in marriage. The socio-economic significance of childbearing determines the high interest of modern andrology in the problem of reducing male fertility and in the search for new methods of treating spermatogenesis disorders.
It is known that etiopathogenetic methods of treatment of various forms of secretory infertility in some cases do not have the desired effect. Many authors explain this fact by the fact that some of the processes involved in the pathogenesis of infertility are not yet fully understood. A vivid example of this is the multiple discussions about the pathogenesis of infertility in varicocele: involvement of the venous system of the left kidney and left adrenal gland with characteristic hormonal changes, hemodynamic types of venous blood shunt into the pampiniform plexus, methods for diagnosing venous shunt and especially the relationship between instrumental research methods and laboratory data. It is known that there are still disputes about the effectiveness of surgery for varicocele in terms of restoring fertility in infertile men. An important question is also about the tactics of treating patients with idiopathic infertility and with a severe degree of oligoasthenoteratozoospermia observed in men with cryptorchidism. In vitro fertilization methods are not always effective in such patients due to the low quality of sperm, and in some cases it is necessary to use donor sperm. Thus, there is a need to search for new methods and forms of influence on the male reproductive organs in the treatment of various forms of secretory infertility.
Recently, due to the development and availability of low-intensity laser radiation (LILR) devices, quantum methods of treatment have become widely used in medical practice. Information about the positive effect of laser radiation on spermatogenesis and directly on sperm in vitro began to appear in the medical literature. It is known that the absorption of light energy by spermatozoa leads to the involvement of quantum energy in biochemical transformation reactions. In in vitro experiments, the effect of LILR on sperm led to an increase in the duration of motility due to an increase in fructolysis, oxidative activity and other enzyme systems.
These data suggest that LILI improves the functional state of spermatozoa through direct local action.
During recent years laser exposure to the testicles began to be used in inflammatory diseases of the scrotum, and in the literature there were no cases of pathological effects on the process of cell division of spermatogenesis. Nevertheless, the process of irradiation of the rapidly dividing germinal epithelium dictates the need to control the parameters of testicular tumor markers alphafetoprotein, human chorionic gonadotropin (AFP, r-hCG) when exposed to LILI, especially in men with cryptorchidism.
Materials and research methods. The study included 97 infertile men aged 18 to 53 years (mean age 30.5 years) and 11 fertile men (mean age 29.9 years) who made up the control group.
Of the 97 men, varicocele was detected in 53 people (mean age 30.5 years), hypogonadism was diagnosed in 27 men (mean age 31.3 years), primary in 12 men, secondary in 15 men, the diagnosis of "idiopathic infertility" was made in 17 men (mean age 32.1 years). True cryptorchidism of the inguinal form was revealed in 4 men (mean age 30.5 years) with primary hypogonadism.
Laboratory examination included the study of ejaculate, the hormonal status of peripheral blood, semen analysis and scraping from the urethra for the presence of sexually transmitted diseases by polymerase chain reaction and seed culture. Patients with infectious and inflammatory diseases of the genitourinary system were not included in the study.
To assess the structural state of the scrotum organs, testicular vessels, as well as to study hemodynamics in the pampiniform plexus, an ultrasound device with color Doppler mapping from ESAOTE S.p.A. was used. "Megas" and a linear probe LA 5 2 3 with a scanning frequency in the image mode of 7.5-10 MHz and a Doppler ultrasound frequency of 5.0 MHz.
Doppler ultrasound diagnostics was performed according to the method developed by E.B. Mazo and K.A. Tirsi (1999).
The laser therapeutic apparatus "Matrix-Urologist" with two laser emitters of the infrared range (wavelength 0.89 μm, pulse power up to 10 W, pulse repetition frequency from 80 to 3000 Hz) was used in the work. According to a technique based on the experience of using laser therapy by other researchers, all patients underwent bipolar laser irradiation of the testicles in lateral and longitudinal projections daily for 10 minutes. for each testicle for 10 days.
To assess the effectiveness of LILI, the latter was used both as monotherapy and in combination with surgical treatment for varicocele and in combination with hormonal stimulation in the presence of changes in hormonal status in primary and secondary hypogonadism. A control study of sperm and hormonal profile was carried out 1 and 2 months after laser therapy.
The results of the examination and treatment. The results of the survey included in the work of infertile patients revealed that the main violations of sperm parameters were mobility (a + b) and the number of morphologically normal forms, the viability of spermatozoa decreased to a lesser extent. A decrease in the concentration of spermatozoa was found only in patients with hypergonadotropic or primary hypogonadism. It should be noted that the most pronounced changes in spermatogenesis were found in patients of this group. In patients with left-sided varicocele, a statistically significant decrease in mobility and the number of morphologically normal spermatozoa, as well as an increase in progesterone levels, was found, which correlates with literature data.
Thus, after local low-intensity laser therapy and analysis of the data obtained, it can be concluded that all patients included in this study had a significant increase in sperm viability (p
In the control group, consisting of fertile men, a significant increase in the viability of spermatozoa was also revealed (p
Table 1. Parameters of spermograms and hormonal profile before and after LILI for fertile men in the control group
In the group of patients with left-sided varicocele after local exposure to LILI on the testes, compared with the initial data, the concentration of spermatozoa slightly increased, mobility significantly increased (a + b) (p
Table 2. Results of treatment with laser radiation in men with left-sided varicocele in comparison with the results of combined treatment of the Ivanissevich operation and exposure to LILI
After analyzing the results of the local effect of LILI on the testicles of patients with varicocele, it was found that 53% of men from this group improved spermogram parameters, i.e. the studied indicators increased in comparison with the initial ones. In 37% of men with left-sided varicocele, there was a slight improvement or improvement in not all parameters of spermograms, which was regarded as a result without changes. And in 10% of patients, spermograms deteriorated. According to domestic and foreign literature, after surgical treatment of varicocele, improvement in spermograms occurs in 51-79% of patients. Thus, the data obtained indicate that LILI has a rather effective effect on the reproductive organs of men with varicocele. The level of LH in the peripheral blood of men with varicocele significantly increased.
Analyzing the treatment data of a group of men with hypergonadotropic hypogonadism, we can conclude that there is an increase in the number of morphologically normal spermatozoa (p
Table 3 Results of treatment with laser radiation in men with hypergonadotropic or primary hypogonadism
In the group of patients with secondary hypogonadism, sperm motility significantly increased (p
Table 4. Results of treatment with laser radiation and hormonal stimulation in men with hypogonadotropic or secondary hypogonadism
It should be noted that laser therapy for patients with hypogonadotropic hypogonadism was carried out in combination with hormonal stimulation with Pregnil 5000 (chorionic gonadotropin) intramuscularly, once every 5 days for a month.
In the group of patients with idiopathic infertility, LILI was used as monotherapy, there was a significant increase in the mobility of p
Table 5. Data of statistical processing of the results of treatment with the use of laser radiation in men with idiopathic infertility
Conclusion. Thus, laser exposure to the testicles in normospermia leads to an increase in the number of viable forms from 83% to 88%, mobility from 54% to 62%, and the number of morphologically normal forms of spermatozoa from 56% to 64%. The level of B-hCG and AFP in the blood of fertile men indicates the safety of LILI exposure to the testes. The impact of LILI on the testes occurs both at the exocrine and endocrine levels, as evidenced by the improvement in sperm parameters and the decrease in FSH levels in all examined patients.
Local laser irradiation of the testicles as a monotherapy for varicocele increases the concentration of active-motile forms from 25% to 37%, the number of morphologically normal forms from 27% to 39%. The effectiveness of infertility treatment increases with the combination of the Ivanissevich operation and LILI.
Local laser irradiation of the testicles in men with primary hypogonadism increases the number of morphologically normal forms from 7% to 10%, with secondary hypogonadism, mobility improves from 19% to 23%. Patients with a severe degree of oligoasthenoteratozospermia, usually found in men with primary and secondary hypogonadism included in the IVF program, may undergo a course of LILI to improve the quality of sperm parameters.
In idiopathic infertility, the use of local laser therapy causes an increase in sperm motility (a + b) from 19% to 34% and an increase in the number of morphologically normal forms of spermatozoa from 13% to 23%.
Durnov L.A.*, Grabovshchiner A.Ya.**, Gusev L.I.*, Balakirev S.A.*
* Russian Cancer Research Center. N.N. Blokhin, RAMS;
**Association "Quantum Medicine", Moscow
Often in the literature on low-intensity laser therapy for various diseases, oncology is in the first place in the list of contraindications. This approach to oncological diseases is due to the fact that the effect of low-intensity laser radiation (LILI) on malignant neoplasms is still unclear. Researchers have been studying this factor since the late 1970s.
Studies conducted by various scientists have shown the following negative results of such exposure.
- Stimulation of cell growth of Ehrlich's ascitic carcinoma in experiments in vitro was observed when exposed to a He-Ne laser (Moskalik K. et al. 1980).
- The stimulating effect on the tumor of various types of LILI was found in tumor-bearing animals (Moskalik K. et al. 1981).
- Stimulation of the growth of Harding-Nassi melanoma, adenocarcinoma 765 and sarcoma 37 was noted when exposed to He-Ne (633 nm) and pulsed nitrogen lasers (340 nm) (Ilyin A 1980, 1981, 1983; Pletnev S. 1980, 1985, 1987).
- Stimulation of the growth of benign tumors of the mammary glands in experimental rats was obtained under the influence of a He-Ne laser (Panina N. et al., 1992).
- Stimulation of growth and an increase in the frequency of metastasis of such tumors as: Pliss lymphosarcoma, B-16 melanoma, Ehrlich ascitic carcinoma, Lewis lung adenocarcinoma, were observed when they were exposed to a He-Ne laser (Zyryanov B. 1998).
- Growth stimulation in some cases and inhibition in others were noted during experiments on the effects of LILI (480 nm and 640 nm) on cultured cells of human malignant tumors (melanoma, tumors of the breast and colon) (Dasdia T. et al. 1988).
Similar results were obtained when LILR was applied to colonies of various malignant cells with an argon laser or a dye laser pumped by an argon laser with a power density of 8.5-5.0 mW/cm KB. (Fu-Shou Yang et.al., 1986).
On the other hand, studies have also shown the positive results of such an impact.
- Inhibition of transplanted tumors by irradiation with a cadmium-helium laser (440 nm) at DM 30 J (Ilyina AI., 1982).
- The inhibitory effect of a helium-neon laser on living cells of Lewis carcinoma is higher at an earlier start and longer duration of the course of irradiation (Ivanov AV., 1984; Zakharov SD, 1990).
- When exposed to a semiconductor laser (890 nm) on transplantable Walker's sarcoma in rats and breast cancer in mice, a slowdown in tumor growth by 37.5% was noted at DM 0.46 J/cm2, while at DM 1.5 J/cm2, the effect was not observed. discovered (Mikhailov V.A., 1991).
- With non-radically removed soft tissue sarcoma in operated animals, followed by irradiation with a helium-neon laser, inhibition of the tumor process was noted. An increase in the life span of animals two times compared with the control group was recorded (Dimant IN, 1993).
- Pronounced changes in the structure of the primary tumor, up to the death of the cellular elements of the tumor, were recorded during laser blood irradiation. Metastases in these animals were significantly less compared to the control group (Gamaleya N.F., 1988).
We presented the results of experimental studies in order to make it clear why it is impossible to influence LILI on neoplasms in the clinic, since the results are unpredictable.
As a result of the research of scientists, the biological effects of low-intensity laser radiation (LILR) are described, which are of great importance in practical medicine, since, unlike high-power laser radiation, LILI does not damage body tissues. On the contrary, low-intensity laser radiation has an anti-inflammatory, immunocorrective, analgesic effect, promotes wound healing, and restores balance between the components of the nervous system. The source of the diversity of these effects are the mechanisms of the body's response to laser radiation.
Laser radiation is perceived by photoacceptors, or, more simply, special sensitive molecules involved in maintaining the balance inside the cell, each human cell. After the interaction of laser radiation and a sensitive molecule in the cell, the metabolism and energy is activated, which makes it possible for it to fully perform its functions, and at a certain stage of development - to divide, forming healthy offspring.
The method of exposure to low-intensity laser radiation on the body depends on the type and localization of the pathological process. There are the following methods of laser therapy: 1) laser blood irradiation 2) external (percutaneous) exposure, 3) laser reflexotherapy (LIL impact on acupuncture points, 4) intracavitary exposure.
Laser irradiation of blood.
This technique was developed in the 80s at the Novosibirsk Research Institute of Circulatory Pathology under the guidance of Academician E.N. Meshalkin and was originally used as intravascular laser blood irradiation (ILBI) (Meshalkin E.N. et al. 1981, Korochkin I.M. et al. 1984). The mechanism of the therapeutic action of laser blood irradiation is common in various pathologies (Gafarova G.A. et al. 1979). The pronounced effect of laser blood irradiation is associated with the influence of LILI on metabolism. At the same time, the oxidation of energy materials - glucose, pyruvate, lactate - increases, which leads to an improvement in microcirculation and oxygen utilization in tissues. Changes in the microcirculation system are associated with vasodilation and changes in the rheological properties of blood due to a decrease in its viscosity and a decrease in the aggregate activity of erythrocytes. It was noted that when the fibrinogen level is exceeded by 25-30%, after laser exposure, its decrease by 38-51% is noted, and at its low levels before treatment, its increase by 100% is noted (Korochkin I.M. et al. 1984 , Moskvin S.V. et al. 2000).
Laser irradiation of blood has a stimulating effect on hematopoiesis in the form of an increase in the amount of hemoglobin, erythrocytes and leukocytes (Gamaleya N.F. 1981, Gamaleya N.F. et al. 1988). There is a stimulation of the non-specific defense system - the functional and phagocytic activity of lymphocytes increases. Interestingly, when blood lymphocytes of cancer patients are irradiated, stimulation of T-cells is more pronounced than when they are irradiated in healthy people (Gamaleya N.F. et al. 1986, Pagava K.I. 1991).
When LILI acts on the blood, the T-system of immunity is stimulated. The helper activity of T-lymphocytes increases and the suppressor activity of T-lymphocytes decreases, the content of B-lymphocytes normalizes, the level of the CEC decreases, the imbalance of immunoglobulins is eliminated (Meshalkin E.N. 1983, Zyryanov B.N. et al. 1998). The immunocorrective effect of laser blood irradiation is explained by an increase in the production of endogenous immunotransmitter interleukin-1 (IL-1) by blood cells (Zhiburt EB et al. 1998). Studies conducted at the Russian Cancer Research Center of the Russian Academy of Medical Sciences confirm these data. Mononuclear cells (MNCs) were exposed to LILR for 20 and 40 min. As a result, when studying the cytotoxicity of MNCs, it was found that exposure to laser radiation for 20 min. does not lead to a significant increase in the killer properties of MNC donors. An increase in the ability of donor MNCs to lyse tumor cells of the K-562 line was noted with an increase in radiation exposure to 40 min. Under these conditions, the cytolytic potential of MNCs increased on average from 31±8% to 57±5% (p
Exposure to laser irradiation increases the ability of MNCs to release IL-1 and TNF. In particular, with an exposure of 20 min. there is a tendency to an increase in the concentration of the studied cytokines in the MNC supernatant compared to the initial level, and an increase in the exposure time leads to a more pronounced ability of donor MNCs to release IL-1 and TNF.
Thus, LILI leads to the activation of MNCs in the blood of donors, i.e. increases their cytotoxic activity and induces the ability of MNCs to release cytokines (IL-1 and TNF), which play an important role in the development of the body's immune response (L.A. Durnov et al. 1999).
Table 1
Effect of laser radiation on cytotoxic activity (%) of mononuclear cells and induction of cytokine release (pg/ml)
The present study was carried out using the MILTA device in the following mode: frequency 5000 Hz, session exposure duration 5 minutes. The research will be continued. it seems interesting to study the modes of 50 and 1000 Hz and the exposure time interval of 2 min.
With the development of laser technology, intravascular laser blood irradiation has been replaced by supravascular (percutaneous) effects on the blood. For intravascular blood irradiation, low-power helium-neon (He-Ne) lasers are usually used, requiring replaceable disposable quartz-polymer light guides. This is due to the fact that a certain technical difficulty was the effect on relatively deep-seated structures (in particular, vessels), since the penetration depth of laser radiation is small. It depends on the wavelength (from 20 μm in the violet part of the spectrum to 70 mm in the near infrared), and the need to "get" deeper tissues requires an increase in exposure power. This problem is successfully solved in laser devices operating in a pulsed mode. The most proven in this respect are gallium arsenide (Ga-As) lasers operating in high-frequency pulsed mode.
The duration of the flash of a pulsed laser is milliseconds, which makes it possible to influence the tissue with the power necessary to irradiate deep structures without the risk of damaging surface structures.
Modern laser devices are equipped with special magnetic nozzles with an optimal shape of a constant magnetic field (CMF). In addition to the therapeutic effect of magnetotherapy, PMF gives a certain orientation to molecular dipoles, building them along its lines of force directed deep into the irradiated tissues. This leads to the fact that the bulk of the dipoles are located along the light flux, contributing to an increase in the depth of its penetration (Illarionov V.E., 1989). Mostovnikov V.A. et al. (1981) explain the effect of the high biological activity of two physical factors by the fact that their action on the membranes and components of cells involved in the regulation of metabolic processes leads to a rearrangement of the spatial structure of the membrane and, as a consequence, its regulatory functions.
The therapeutic effect of CLOK is explained by the following factors:
- Improving microcirculation: platelet aggregation is inhibited, their flexibility increases, the concentration of fibrinogen in plasma decreases and fibrinolytic activity increases, blood viscosity decreases, the rheological properties of blood improve, oxygen supply to tissues increases.
- Reduction or disappearance of ischemia in organ tissues. Cardiac output increases, total peripheral resistance decreases, coronary vessels dilate.
- Normalization of energy metabolism of cells subjected to hypoxia or ischemia, preservation of cellular hemostasis.
- Anti-inflammatory effect due to inhibition of the release of histamine and other inflammatory mediators from mast cells, normalization of capillary permeability, reduction of edematous and pain syndromes.
- Correction of immunity: an increase in the overall level of T-lymphocytes, lymphocytes with suppressive activity, an increase in the content of T-helpers in the absence of a decrease in the level of leukocytes in peripheral blood.
- Influence on the processes of lipid peroxidation in the blood serum: a decrease in the blood content of malondialdehyde, diene conjugates, cipher bases and an increase in tocopherol.
- Normalization of lipid metabolism: increase in lipoprotein lipase, decrease in the level of atherogenic lipoproteins.
Experimental and clinical studies have shown that the effectiveness of transcutaneous laser blood irradiation (PLBI) and ILBI is approximately the same (Koshelev VN et al. 1995). However, the simplicity of the PRBI technique, non-invasiveness, availability in any conditions, high therapeutic efficacy - all these factors have made it possible to widely introduce PRBI into medical practice.
Transcutaneous laser blood irradiation is used as an analgesic, antioxidant, desensitizing, biostimulating, immunostimulating, immunocorrective, detoxifying, vasodilating, antiarrhythmic, antibacterial, antihypoxic, decongestant and anti-inflammatory agent (Moskvin S.V. et al. 2000).
One of the first researchers who studied the effectiveness of laser blood irradiation in cancer patients were scientists from the Tomsk Research Institute of Oncology. When working out the mode of laser exposure, an exposure of 30 minutes was used. and 60 min. once within 5 days. No significant differences were found in these groups. No complications or side effects were recorded. Accelerated healing of postoperative wounds was noted, and the analysis of long-term results showed that the frequency and timing of relapses in the group of patients who underwent laser blood irradiation were significantly lower compared to the control group.
At the Research Institute of Pediatric Oncology and Hematology, the Russian Cancer Research Center of the Russian Academy of Medical Sciences, a study was made of the effectiveness of PLBI by studying the dynamics of cellular immunity in children who received chemotherapy for various malignant neoplasms. The impact of LILI was carried out on large vessels in the cubital and popliteal areas. The frequency of LILI was 50 Hz, the time interval for older children was 15...20 minutes. (blood irradiation was carried out by two terminals simultaneously). A total of 2 to 4 sessions were performed. In patients who received more than 2 sessions, there was an increase in the number of mature T-lymphocytes, T-suppressors and lymphocytes. A clear trend towards positive dynamics was noted. No complications or side effects were noted in any of the patients. For kids younger age calculation of the LILI dose is carried out individually.
The frequency of 50 Hz during laser blood irradiation was not chosen by chance. Researchers Zemtsev I.Z. and Lapshin v.p. (1996), studying the mechanisms of cleaning the surface of biomembranes from toxic substances, revealed that depolarization of membrane activity (as a result of laser blood irradiation), accompanied by their “washing”, occurs at a frequency of LILI pulses below 100 Hz.
External (local) impact.
When a pathological focus is localized on the skin or visible mucous membranes, LILI acts directly on it. In the Research Institute of Pediatric Oncology and Hematology, low-intensity laser therapy is widely used in the treatment of stomatitis, inflammation of the nasopharynx, phlebitis, long-term non-healing postoperative wounds, bedsores. More than 280 patients have been treated. Damage to the oral mucosa and gastrointestinal tract is a serious problem for children receiving chemotherapy. The mucous membrane of the oral cavity with stomatitis is painful, defects of various sizes and depths form on it, which limits or makes it completely impossible to eat. In severe cases, this leads to a long break in anticancer therapy. In the treatment of stomatitis, rinses from decoctions of herbs, solutions of medicines have been and are being used, but these remedies require a long investment of time. As a rule, the effect of this type of treatment is noted for 7-10 days. In the treatment of LILI, the effect is achieved in 3-5 days.
In the treatment of post-radiation skin reactions, a positive effect was achieved in all cases. Comparison of the terms of the complete disappearance of local manifestations in children who underwent polyfactorial quantum (magnetic-infrared-laser) therapy with historical control showed that under the influence of LILI, the recovery time was reduced by 28%.
The main contraindications for percutaneous laser blood irradiation are blood diseases with bleeding syndrome, thrombocytopenia below 60,000, acute febrile conditions, coma, active tuberculosis, hypotension, decompensated conditions of the cardiovascular, excretory, respiratory and endocrine systems.
In the local treatment of such complications of chemo-radiation therapy as: stomatitis, gingivitis, radioepitheliitis, as well as bedsores, sluggish wound processes, the above diseases and conditions are not an absolute contraindication.
An absolute contraindication for local application of LILI is the area of localization of the malignant process.
Low-intensity laser radiation (LILR) has been used in dermatology and cosmetology for a long time and successfully. Over forty years...
Low-intensity laser radiation (LILR) has been used in dermatology and cosmetology for a long time and successfully. For more than forty years, it has been available to all those who apply for various skin diseases or cosmetic problems. During this time, both deep scientific research and practical work have proven the healing power of laser therapy and the extremely beneficial effect of LILI not only on the skin, but also on the body as a whole [Moskvin S.V., 2000].
Previously, most specialists used laser radiation as a therapeutic factor, using only those lasers that were at their disposal, while not realizing the truly unique therapeutic possibilities of laser therapy in full. On the other hand, the peculiarities of cosmetology as a direction not only of a therapeutic, but also a preventive plan urgently required the development of new, most effective equipment based on the latest methodological approaches. Some years joint work scientists, engineers and cosmetologists made it possible not only to create such a specialized technical base for these tasks, but also to develop truly effective, “working” methods.
The most convenient (and effective) for cosmetology are devices that can be used to influence several radiation modes, conduct laser therapy sessions using successively emitting heads with different wavelengths, powers and other parameters. All these requirements are fully met by the laser therapeutic devices "Matrix" and "LASMIK®", which were chosen as the basis of the laser physiotherapy complex "Matrix-Cosmetologist". The material presented in the book is focused on the use of this particular complex with an optimal set of emitting heads and nozzles (taking into account its unique capabilities), but a number of proposed methods involve the use of other lasers. This is especially true for the treatment of various dermatological diseases. In any case, the choice of a specific technique always remains with the specialist.
When laser radiation interacts with the integument of the human body, part of the optical energy is reflected and scattered in space. And the other part is absorbed by biological tissues. The nature of this interaction, in particular the depth of radiation penetration, depends on many factors (wavelength, properties of the skin and underlying tissues, methods of exposure, etc.) and determines the effectiveness of laser therapy in general.
Skin, blood vessels, subcutaneous adipose tissue, fiber and skeletal muscles do not equally absorb optical radiation of different wavelengths. The penetration depth of optical radiation gradually increases with the transition from the ultraviolet part of the radiation spectrum to the infrared region. Low-intensity laser radiation used in physiotherapy can belong to different spectral ranges, but the most commonly used laser radiation is red and infrared spectra, which has the highest penetrating power and mild biological and therapeutic effects. As a result of this - the greatest therapeutic latitude, a distinct and long-lasting therapeutic effect and a cosmetic effect. It is these qualities that have led to interest in LILI with such spectral parameters.
In almost all diseases, regardless of etiology and pathogenesis, as well as aging, there is a violation of microhemo- and lymphatic circulation. As a result, the normal ratio between the cellular, interstitial, circulatory and lymphatic spaces of the internal environment of the body is disturbed. Breakdown of the microcapillary mechanism (spasm of capillaries, decrease in their number and density, shunting of blood and lymph in the precapillary area, deterioration of the rheology of the transported medium) leads to edema, tissue hypoxia, underoxidation of metabolic products and their accumulation, disruption of the functions of the collagen pool, accumulation in tissues hydrolytic products, depletion of antioxidant and immunocompetent systems, etc.
The effect of low-intensity laser radiation on biological tissues depends on the activation of biochemical reactions induced by laser light, as well as on the physical parameters of the radiation. Under the influence of LILR, the atoms and molecules of biological tissues pass into an excited state, more actively participate in physical and physico-chemical interactions. Various complex organic molecules can act as a photoacceptor: proteins, enzymes, nucleic acids, phospholipids, etc., as well as simple inorganic molecules (oxygen, carbon dioxide, water). Selective or predominant excitation of certain atoms or molecules is determined by the wavelength and frequency of LILI. For the visible range, chromatoform (light-absorbing) groups of protein molecules serve as photoacceptors. Infrared LILI is predominantly absorbed by protein, water, oxygen, and carbon dioxide molecules.
Energy absorption leads to a sharp increase in the intracellular concentration of Ca 2+ and stimulation of calcium-dependent processes: acceleration of the course of intracellular biochemical reactions of the free radical type, an increase in the content of free forms of biologically active molecules that are not associated with proteins and crystallization water, activation of the accumulation and release of ATP, restoration of cell membranes, activation of proliferation, etc. Thus, there is a non-specific stimulation of the biochemical activity of tissues exposed to laser irradiation. Many molecular LILR acceptors are associated with cell membranes and, passing into an electronically excited state, increase the bioenergetic activity of cell membrane complexes and enzymatic systems fixed on membranes that support vital activity and synthetic processes in the cell (Fig. 73).
Analysis of changes in intracellular biochemical processes that occur under the influence of LILI shows that there is an increase in oxidative phosphorylation of glucose (Krebs cycle) and an increase in ATP production. This is due to the activation of the chain of respiratory enzymes of the mitochondria (cytochromes) and the acceleration of the movement of electrons along this chain, as a result of which the energy potential of the cell increases. Stimulation of various intracellular enzymatic processes, life support systems leads to an increase in oxygen metabolism. Under the influence of LILI, oxygen tension in tissues and its utilization by cells increase. There is a pronounced increase in local blood circulation, blood flow velocity, an increase in the number of collaterals and functioning capillaries. As a result, the supply of tissues with oxygen increases to the required level and the excess "metabolic demand" stimulated by LILI is satisfied. An increase in the activity of oxygen metabolism enhances the energy and plastic processes in the cell.
It is known that adenosine triphosphoric acid (ATP) plays the role of a universal photobiological energy accumulator. At the basis of a variety of life functions associated with consumption ATP energy, lie:
1) energy supply of chemical bonds of biological compounds (the basis for the synthesis of various chemical compounds);
2) mechanical work (cell division, motor activity of muscles);
3) bioelectrical processes (ensuring the functions of cell membranes).
Biological membranes of cells play a vital role as a kind of structural barrier between the body and the environment. Violation of the membrane can lead to disruption of the cells and even their death. Laser radiation prevents this process by influencing the antioxidant defense mechanism.
Cell proliferation (division) is a continuous process. The proliferation rate depends on the cell type. It is important that laser radiation not only enhances proliferation, which makes it possible to remove “old” cells from the body and replace them with young ones, but, most importantly, restores the biorhythm of the division of various groups of cells in tissues and their interaction.
Laser exposure, of course, manifests itself as a multilevel effect on the body: from the appearance of excited states and conformational rearrangement of molecules, changes in the oxygen balance and activity of redox processes, changes in the cell membrane potential, changes in the pH of the intercellular fluid, microcirculation, etc., to the appearance of the level of the organism of response complex adaptive neuroreflex and neurohumoral reactions with the activation of the immune system.
When exposed to low-intensity laser radiation on human surface biological tissues (skin, subcutaneous adipose tissue, fat accumulations and muscles), the following positive changes occur:
Elimination of concomitant or parallel inflammatory processes;
Strengthening local and general immunity, and as a result of this, antibacterial action;
Slowing down the aging of cells and extracellular connective tissue;
Improving elasticity and reducing the density of the epidermis and dermis;
Increase in the thickness of the epidermal layer and the dermoepidermal junction due to an increase in the number of mitoses and a decrease in desquamation;
Reconstruction of the dermis by streamlining the structure of elastic collagen fibers with the restoration of the water sector and a decrease in the amount of colloidal masses;
An increase in the number of sweat and sebaceous glands with the normalization of their activity while maintaining homogeneity, the restoration of the mass of adipose tissue in parallel with the normalization of metabolic processes in it;
Fixation of accumulations of adipose tissue in its natural place, an increase in muscle mass with an improvement in metabolic processes and, as a result of the above changes, a decrease in the degree of sagging (ptosis);
Stimulation of hair growth by enhancing microcirculation and improving tissue nutrition.
The listed effects of laser therapy can only be achieved with its systematic and long-term use!
The first results can sometimes be obtained already in the 2nd or 3rd procedure, but in most cases only after 10-30 sessions. To consolidate the result obtained in cosmetology, it is necessary to conduct preventive courses 3-4 times a year, each of which consists of at least 10 sessions. In the treatment of various dermatological diseases methodological approaches differ significantly, they are presented in the relevant sections.
Thus, laser therapy and laser prophylaxis is a dynamic process that takes place under the supervision of specialists: a cosmetologist or dermatologist who has specialized in laser therapy.
In our Center of Medicine and Aesthetics "TRISH-clinic" Low-intensity laser radiation (LILI) performed only by doctors who have passed special education. In each case, the doctor determines the appropriateness of the procedure.