This PDF file contains the front matter associated with SPIE Proceedings Volume 8585, including the Title Page, Copyright information, Table of Contents, and the Conference Committee listing.

Over the last few years, low-level light therapy (LLLT) has shown an incredible suitability for a wide range of applications for central nervous system (CNS) related diseases. In this therapeutic modality light dosimetry is extremely critical so the study of light propagation through the CNS organs is of great importance. To better understand how light intensity is delivered to the most relevant neural sites we evaluated optical transmission through slices of rat brain point by point. We experimented red (λ = 660 nm) and near infrared (λ = 808 nm) diode laser light analyzing the light penetration and distribution in the whole brain. A fresh Wistar rat (Rattus novergicus) brain was cut in sagittal slices and illuminated with a broad light beam. A high-resolution digital camera was employed to acquire data of transmitted light. Spatial profiles of the light transmitted through the sample were obtained from the images. Peaks and valleys in the profiles show sites where light was less or more attenuated. The peak intensities provide information about total attenuation and the peak widths are correlated to the scattering coefficient at that individual portion of the sample. The outcomes of this study provide remarkable information for LLLT dose-dependent studies involving CNS and highlight the importance of LLLT dosimetry in CNS organs for large range of applications in animal and human diseases.

Low level laser therapy (LLLT) is used in several applications, including the reduction of inflammatory processes. It might be used to prevent the systemic inflammatory response syndrome (SIRS), which some patients develop after cardiopulmonary bypass (CPB) surgery. The objectives of this study were to investigate light distribution inside blood, in order to implement the LLLT during CPB, and, through this study, to determine the best wavelength and the best way to perform the treatment. The blood, diluted to the same conditions of CPB procedure was contained inside a cuvette and an optical fiber was used to collect the scattered light. Two wavelengths were used: 632.8 nm and 820 nm. Light distribution in blood inside CPB tubes was also evaluated. Compared to the 820 nm light, the 632.8 nm light is scattered further away from the laser beam, turning it possible that a bigger volume of blood be treated. The blood should be illuminated through the smallest diameter CPB tube, using at least four distinct points around it, in only one cross section, because the blood is kept passing through the tube all the time and the whole volume will be illuminated.

Low level light therapy (LLLT) has been widely reported to reduce pain and inflammation and enhance wound healing and tissue regeneration in various settings. LLLT has been noted to have both stimulatory and inhibitory biological effects and these effects have been termed Photobiomodulation (PBM). Several elegant studies have shown the key role of Cytochrome C oxidase and ROS in initiating this process. The downstream biological responses remain to be clearly elucidated. Our work has demonstrated activation of an endogenous latent growth factor complex, TGF-β1, as one of the major biological events in PBM. TGF-β1 has critical roles in various biological processes especially in inflammation, immune responses, wound healing and stem cell biology. This paper overviews some of the studies demonstrating the efficacy of PBM in promoting tissue regeneration.

The objective of this study was to elucidate cellular mechanisms of protection against laser-induced thermal killing utilizing an in vitro retina model. When exposed to a 1-sec pulse of 2-μm laser radiation 24 hr after illuminating hTERT-RPE cells with red light (preconditioning), the cells are more resistant to thermal challenge than unilluminated controls (adaptive response). Results of efforts to understand the physiology of this effect led us to two genes: Vascular Endothelial Growth Factor C (VEGF-C) and Micro RNA 146a (miR-146a). Transfecting wild type (WT) cells with siRNA for VEGF-C and miR-146a mRNA resulted in knockdown strains (VEGF-C(KD) and miR- 146a(-)) with 10% and 30% (respectively) of the constitutive levels expressed in the WT cells. To induce gene expression, WT or KD cells were preconditioned with 1.44 to 5.40 J/cm², using irradiances between 0.40 and 1.60 mW/cm² of either 671-nm (diode) or 637-nm (laser) radiation. Probit analysis was used to calculate threshold damage irradiance, expressed as ED50, between 10 and 100 W/cm² for the 2-μm laser pulse. In the WT cells there is a significant increase in ED50 (p 0.05) with the maximum response occurring at 2.88 J/cm² in the preconditioned cells. Neither KD cell strain showed a significant increase in the ED50, although some data suggest the response may just be decreased in the knockdown cells instead of absent. So far the response does not appear to be dependent upon either wavelength (637 vs. 671 nm) or coherence (laser vs. LED), but there is an irradiance dependence.

Low level laser therapy is used as a treatment of several conditions, including inflammatory processes and wound healing. Possible changes in mechanical properties of cells, caused by illumination, are investigated with optical magnetic twisting cytometry (OMTC), which is a technique used to evaluate mechanical properties in cell culture. Ferromagnetic micro beads are bound to cell cytoskeleton, the beads are magnetized vertically and a horizontal twisting magnetic field is applied causing a torque that moves the beads and deforms the cell, the beads rotate and displace. Based on the lateral displacement of the beads, elastic shear and loss moduli are obtained. Samples of human bronchial epithelial cell culture were divided in two groups: one was illuminated with a 660 nm red laser, 30 mW power, 0.75 W/cm² irradiance, during different time intervals, and the other one, the control group, was not illuminated. The values of the mechanical constants of the cells of the control group showed a tendency of increasing with the time out of the incubator. On the other hand, the illuminated group showed constancy on the behavior of both moduli, keeping the normal conditions of the cell culture. Those results indicate that illumination can induce cells to homeostasis, and OMTC is sensitive to observe departures from the steady conditions. Hence, OMTC is an important technique which can be used to aggregate knowledge on the light effect in cell cytoskeleton and even on the low level laser therapy mechanisms in inflammatory processes and/or wound healing.

Human oral cavity is colonized by a wide range of microorganisms, often organized in biofilms. These biofilms are responsible for the pathogenesis of caries and most periodontal diseases. A possible alternative to reduce biofilms is the photodynamic inactivation (PDI). The success of the PDI depends on different factors. The time required by the PS to remain in contact with the target cells prior to illumination is determinant for the technique’s efficacy. This study aimed to assess the interaction between the PS and the biofilm prior to the PDI. We used confocal microscopy and FLIM to evaluate the interaction between the PS and the biofilm’s microorganism during the pre-irradiation time (PIT). The study of this dynamics can lead to the understanding of why only some PSs are effective and why is necessary a long PIT for some microorganisms. Our results showed that are differences for each PIT. These differences can be the determinate for the efficacy of the PDI. We observed that the microorganism needs time to concentrate and/or transport the PS within the biofilm. We presented preliminary results for biofilms of Candida albicans and Streptococcus mutans in the presence of Curcumin and compared it with the literature. We observed that the effectiveness of the PDI might be directly correlated to the position of the PS with the biofilm. Further analyses will be conducted in order to confirm the potential of FLIM to assess the PS dynamics within the biofilms.

In this work, for the first time, we have demonstrated the biological effects upon in vitro growth of bacteria and human peripheral blood erythrocytes of the irradiation with speckle-like highly-gradient laser light. Measurements of the growth of Staphylococcus aureus with and without antibiotic irradiated with uniform or interference pattern of intensity spatial distribution have shown strong dependence on the spatial frequency of the irradiation. Maximum inhibition of the bacteria growth was achieved at the frequency 1000 fringes/mm. It was also found that human blood erythrocytes exposure to such radiation at the power density typical for laser phototherapy could damage the erythrocytes. A possible explanation of the photo-biological effects of laser speckle irradiation relying on the electron-ion processes similar to those that occur under inhomogeneous illumination in inorganic media and called photo-stimulated diffusion of ions (Dember effect) is proposed and discussed.

Photodynamic therapy (PDT) is a safe and alternative antimicrobial treatment that consists of a chemical agent, called photosensitizer, which can be activated by light of an appropriate wavelength to produce reactive oxygen species (ROS). PDT can be used for photoinactivation of bacteria in an attempt to overcome the problem of bacterial multidrug resistance. In particular, it is an effective antimicrobial treatment against infected wounds that have antibiotic resistance and wound infections would otherwise lead to mortality and morbidity. The main purpose of this study was to demonstrate the importance of PDT dosimetry (light dose and concentration of photosensitizer). If the dosimetry of PDT was not optimized properly, photoinactivation of bacteria cannot be achieved and even worse biostimulation on pathogens could be observed. This study investigated whether there is a biostimulative effect due to free oxygen radicals of PDT when light dose and photosensitizer concentration are too low. In this study, the biostimulative effect on P. aeruginosa strain was observed instead of the PDT effect, when 84 J/cm² of energy dose (809-nm diode laser) was applied with 20, 50, 100 and 150 μg/ml of ICG concentrations. The killing effect of PDT was observed with higher ICG concentrations, such as 200, 250 μg/ml of ICG. However the killing effect was not enough to destroy pathogen efficiently with these high concentrations of ICG.

We have previously shown that transcranial low level light therapy (LLLT) can ameliorate brain damage in mice subjected to traumatic brain injury and improve neurological function. We used a 810-nm laser and delivered 18 J/cm2 at an irradiance 25 mW/cm2. LLLT was either delivered once at 4 hours after controlled cortical impact TBI, once a day for 3 days, or once a day for 14 days. One and 3 applications of LLLT had beneficial effects on the mice, with 3 being better than 1, but 14 applications had no beneficial effect. We now report immunofluorescence studies in mouse brain sections that offer some explanation for this intriguing finding. Mice were injected with BrdU for 1 week before sacrifice (a marker for proliferating cells) and antibodies to double cortin (DCX-1,a marker of migrating neurons), Tuj-1 ( a marker of neuroprogenitor cells), BDNF (brain derived neurotrophic factor) and synapsin-1 ( a marker for newly formed synaptic connections between existing neurons). We found increased BrdU incorporation indicating proliferating cells in the dentate gyrus of the hippocampus, the subventricular layer of the lateral ventricle, as well as the brain tissue surrounding the cortical lesion. Interestingly these cells were more abundant at 7 days than at 28 days post TBI. Co-labeling of BrdU with Neu-N was performed indicating that the proliferating cells were in fact neuronal in nature. Mice with 3 laser treatments had much more BrdU incorporation than mice with 14. Upregulation of BDNF was seen at 7 days, and increased expression of DCX-1 and Tuj-1 was seen at 28 days in the lesion region, indication that neuroprogenitor cells may have migrated there from sites of neurogenesis. Increased syapsin-1 was seen in the cortex at 28 days indicating that neural plasticity may be stimulated by LLLT. Taken together these data suggest that transcranial LLLT may have applications beyond TBI in areas such as neurodegenerative disease and psychiatric disorders.

Irradiation by light in the far-red to near-infrared (NIR) region of the spectrum (photobiomodulation, PBM) has been demonstrated to attenuate the severity of neurodegenerative disease in experimental and clinical studies. The purpose of this study was to test the hypothesis that 670 nm PBM would protect against the loss of retinal function and improve photoreceptor survival in a rodent model of retinitis pigmentosa, the P23H transgenic rat. P23H rat pups were treated once per day with a 670 nm LED array (180 sec treatments at 50 mW/cm²; fluence 9 joules/cm²) (Quantum Devices Inc., Barneveld WI) from postnatal day (p) 16-20 or from p10-20. Sham-treated rats were restrained, but not exposed to NIR light. The status of the retina was determined at p22 by assessment of mitochondrial function, oxidative stress and cell death. In a second series of studies, retinal status was assessed at p30 by measuring photoreceptor function by ERG and retinal morphology by Spectral Domain Optical Coherence Tomography (SD-OCT). 670 nm PBM increased retinal mitochondrial cytochrome oxidase activity and upregulated the retina’s production of the key mitochondrial antioxidant enzyme, MnSOD. PBM also attenuated photoreceptor cell loss and improved photoreceptor function. PBM protects photoreceptors in the developing P23H retina, by augmenting mitochondrial function and stimulating antioxidant protective pathways. Photobiomodulation may have therapeutic potential, where mitochondrial damage is a step in the death of photoreceptors.

It is known that wavelength influences the outcome of many clinical protocols. Laser-phototherapy (LPT) and LEDs have been used on the treatment of pain of several origins including temporomandibular disorders - TMDs. TMDs are common painful multifactorial conditions affecting the temporomandibular joint whose treatment depends on the type and symptoms. Initially it requires pain control and for this, drugs, biting plates, oclusal adjustment, physiotherapy or their association are used. This work reports a series of patients of the Center of Biophotonics of the Federal University of Bahia over 10 years. Following standard anamneses, clinical and imaginologic examination and with the diagnosis of any type of TMD, the patients were set for light treatment. Treatment consisted of three sessions a week during six week. Prior irradiation, the patients were asked to score their pain using a VAS. λ780, λ 790, λ 830nm and/or λ660 and λ680nm lasers or LED were used on each session. Most patients were female (~43.6 years old). At the end of the 12 sessions the patients were again examined and score their pain using VAS. No other intervention was carried out during the treatment. The results were statistically analyzed and showed that most patients were asymptomatic or improved after treatment and that the association of wavelengths was very efficient on the symptomatic group. It is concluded that the association of both wavelengths was effective on pain reduction on TMJ disorders of several origins.

Benefits of the isolated or combined use light and biomaterials on bone healing have been suggested. Our group has used several models to assess the effects of laser on bone. A Raman spectral analysis on surgical bone defects grafted or not with Hydroxyapatite (HA), treated or not with LED was carried out. 40 rats were divided into 4 groups. On Group I the defect was filled with the clot. On Group II, the defect was filled with the HA. On groups III the defect was filled with Clot and further irradiated with LED and on group IV the defects was filled with the HA and further irradiated with LED. LED (λ850 ± 10nm, 150mW, A= 0.5cm², 68s, 20 J/cm² per session, 140 J/cm² per treatment) was applied at 48 h intervals during 15 days. Specimens were taken after 15 and 30 days after surgery and kept on liquid nitrogen, and underwent Raman analysis. For this, the peak of hydroxyapatite (~960 cm^-1) was used as marker of bone mineralization. Significant difference was observed at both times (p<0.05). When the biomaterial was used higher peaks were observed. Association with LED further improved the intensity. Conclusion: It is concluded that LED light improved the effect of the HA.

Dental bleaching is a much requested procedure in clinical dental practice and widely related to dental esthetics. The literature is contradictory regarding the effects of bleaching agents on the morphology and demineralization of enamel after bleaching. The aim of this study was to analyze in vitro by scanning electron microscopy (SEM) the effect of hydrogen peroxide at 20% at neutral pH, cured by the green LED, to evaluate the action of these substances on dental enamel. We selected 15 pre-molars, lingual surfaces were sectioned and previously marked with a central groove to take the experimental and control groups on the same specimen. The groups were divided as follows. The mesial hemi-faces were the experimental group and distal ones as controls. For morphological analysis were performed 75 electron micrographs SEM with an increase of X 43, X 220 and X 1000 and its images were evaluated by tree observers. Was also performed quantitative analysis of the determination of the surface atomic composition of the samples through microanalysis with the aid of scanning electron microscopy. The use of hydrogen peroxide at a concentration of 20% at photoactivated green LED showed no significant changes in mineral composition of the samples or the dental morphological structure of the same when compared to their controls, according to the study protocol.

Leishmaniasis, a protozoan parasitic disease that remains a major worldwide health problem with high endemicity in developing countries. Treatment of cutaneous Leishmaniasis (CL) should be decided by the clinical lesions, etiological species and its potential to develop into mucosal Leishmaniasis. High cost, systemic toxicity, and diminished efficacy due to development of parasite resistance are the serious drawbacks of current treatment options. Thus, identifying new, effective, and safer anti-leishmanial drug(s) is of paramount importance. The aim of this study was to verify the effectiveness of PACT in vitro, as a new technique for the treatment of Leishmaniasis. For this, semiconductor laser (λ = 660nm, 40mW, 8.4J/cm², CW) associated to phenothiazine’s derivatives (5 and 10 μg/ml, TBO, Methylene Blue or Phenothiazine) on the promastigotes form of Leishmania braziliensis in a single session was used. Viability of the parasites was assessed in quadruplicates of each group. The samples were removed and analyzed in a hemocytometer 72h after PACT. We found an important decrease in the number of viable parasites on all treated groups in comparison to their controls. The results of present study showed significant percentage of lethality (above 92%) of the protocol. The 98.33% of lethality was achieved with 10 μg/ml of FTZ. No lethality was seen on groups treated neither with laser nor with each compounds separately. The results are promising and indicative that the use of PACT may be a powerful treatment of Leishmaniasis when compared to already available ones.

The aim of this study was to evaluate the efficacy of the laser photobiomodulation (FBML) in prevention and treatment of oral mucositis induced by chemotherapy protocols CMF (cyclophosphamide, methotrexate, 5-Fluouracil) and FAC (5 Fluouracil + Adriamycin + Cyclophosphamide) in cancer patients breast. We selected 28 patients treated at the Center for High Complexity (CACON), who underwent 6 cycles of 21 days of treatment, with diagnosis of infiltrating ductal carcinoma (ICD C50.9). Were randomly divided into three groups: Group A - eight patients (Protocol FAC + Dental protocol of CACON + Laser), Group B - 6 patients (Protocol CMF + Dental protocol of CACON + Laser), Group C - was divided into two sub-groups: Group C1 with 8 patients (Control Group 1: FAC + Dental protocol o CACON) and group C2 with 6 patients (control group 2: Protocol CMF + Dental protocol of CACON). Patients in Group A and B were use of preventive FBML 24 hours before the start of chemotherapy cycle, then every 48 hours and was extended up to one week following completion of chemotherapy. The groups A and B, presented oral mucositis grade 0 (64.29%) p = 0.07, grade I (7.14%), grade II (14.29%), grade III (7.14 %), grade IV (7.14%) compared to group C, who presented mucositis grade 0 (35.71%) in the initial evaluation with p = 0.10, grade I (21.43%), grade II (28.57%), grade III (14.29%), grade IV (0.00%), patients who used the FBML as a preventive and therapeutic showed a reduction and pain relief in 42.86%. It is concluded that the low power laser when used preventively or as therapy and showed immediate relief of pain and accelerate tissue repair.

The objective of this study was to evaluate the bactericidal effect of photodynamic antimicrobial chemotherapy (PACT) using phenothiazinium dye (Toluidine blue O and methylene blue) at a low concentration of 1μg/mL irradiated with the red laser at doses of 2.4 e 4.8 J/cm² on strain of Staphylococcus aureus (ATCC 23529) in vitro. For this research, tests were performed in triplicate and the samples were distributed into six test groups: (L_-P_-) Negative control (L1₊P_-) and (L2₊P_-) bacterial suspensions were irradiated with laser energy 2.4 and 4.8 J/cm² respectively in the absence of photosensitizer; (L1₊P₊) and (L2₊P₊) bacterial suspensions were irradiated with laser in the presence of 1μg/ml of photosensitizer and finally (L_-P₊) bacterial suspensions only in the presence of phenothiazinium dye. Therefore, were analyzed the potential bactericidal PACT by counting of colony-forming units and analyzed statistically (ANOVA, Tukey test, p<0.05). The results showed that the negative control group when compared with laser group (L2₊P_-) it was observed a statistically significant increase (p<0.01) which L2₊P_- showed a higher number of CFU, on the other hand when compared to L1₊P_- no statistically significant difference was found, relation to the groups submitted to PACT, only showed a statistically significant reduction relative to the group irradiated L2₊P₊ (p<0.01) that showed a decrease in the number of CFU. There was no statistically significant difference between the groups submitted to PDT (L1₊P₊ and L2₊P₊). Although the results of this study have shown a reduction in average number of colony forming units by the appropriate laser-dye treatment combination, it needs further investigation.

The goal of this project is to explore the role of nitric oxide (NO) in regulating the response of hTERT-RPE to low-level exposures to red light. Exposure to low-level red light has been shown to positively affect wound healing, reduce pain, and encourage cell proliferation. The current explanation for this effect is described as an interaction between the photons and cytochrome c oxidase (Cco), which plays a role in regulation of intracellular NO levels in addition to being the mitochondrial protein complex where reduction of oxygen occurs in the process of oxidative phosphorylation. Exposure to 2.88 J/cm² of 671-nm and 637-nm light shows a two-fold increase in NO immediately after exposure, and a 56% increase in ATP measured at ~5 h post exposure. Levels of NF-κB mRNA and protein were measured at six and 24 h, respectively, and found to increase six fold, correlating with increases in NO levels. Light-stimulated increased levels of NO also correlated with an 11-fold increase in Bcl-2 and a 70% decrease in Bax mRNA levels, relative to controls. NF-κB promotes cell growth and Bcl-2 is an apoptosis suppressor protein. Bax is a positive apoptotic effector protein. These results support the hypothesis that light-induced changes in the intracellular levels of NO play a role in the beneficial effects of low-level light photobiomodulation

The objective of this study was to contribute to PDT development by researching alternative light sources using redorange LED light at doses of 2.4 e 4.8 J/cm² to evaluate the bactericidal effect of photodynamic antimicrobial chemotherapy (PACT) using phenothiazinium dye (Toluidine blue O and methylene blue) at a low concentration of 1μg/mL on strain of Staphylococcus aureus (ATCC 23529) in vitro. For this research, tests were performed in triplicate and the samples were distributed into six test groups: (L_-P_-) Negative control (L1₊ P_-) and (L2₊ P_-) bacterial suspensions were irradiated with laser energy 2.4 and 4.8 J/cm² respectively in the absence of photosensitizer; (L1 ₊ P₊) and (L2 ₊ P₊) bacterial suspensions were irradiated with laser in the presence of 1μg/ml of photosensitizer and finally (L_-P₊) bacterial suspensions only in the presence of phenothiazinium dye. Therefore, were analyzed the potential bactericidal PACT by counting of colony-forming units and analyzed statistically (ANOVA, Tukey test, p<0.05). The results demonstrated that comparing the LED group (L2 ₊ P_-) with negative control group, LED group (L1₊ P_-) and photosensitizer group there was a statistically significant (p<0.0001, p<0.01 and p<0.001, respectively) that the group treated only with LED (energy density of 4.8J/cm²) increased the average of CFU counts. The negative control group when compared to the groups submitted to PDT only showed a statistically significant reduction (p<0.01) relative to the group (L2₊P₊) that showed a decrease in the number of CFU. There was no statistically significant difference between the groups submitted to PDT (L1₊P₊ and L2₊P₊). Although the results of this study have shown a reduction in average number of colony forming units by the appropriate LED-dye treatment combination, it needs further investigation.