Effects of photobiomodulation therapy and topical non-steroidal anti-inflammatory drug on skeletal muscle injury induced by contusion in rats—part 2: biochemical aspects

Abstract

Muscle injuries trigger an inflammatory process, releasing important biochemical markers for tissue regeneration. The use of non-steroidal anti-inflammatory drugs (NSAIDs) is the treatment of choice to promote pain relief due to muscle injury. NSAIDs exhibit several adverse effects and their efficacy is questionable. Photobiomodulation therapy (PBMT) has been demonstrated to effectively modulate inflammation induced from musculoskeletal disorders and may be used as an alternative to NSAIDs. Here, we assessed and compared the effects of different doses of PBMT and topical NSAIDs on biochemical parameters during an acute inflammatory process triggered by a controlled model of contusion-induced musculoskeletal injury in rats. Muscle injury was induced by trauma to the anterior tibial muscle of rats. After 1 h, rats were treated with PBMT (830 nm, continuous mode, 100 mW of power, 35.71 W/cm; 1, 3, and 9 J; 10, 30, and 90 s) or diclofenac sodium (1 g). Our results demonstrated that PBMT, 1 J (35.7 J/cm), 3 J (107.1 J/cm), and 9 J (321.4 J/cm) reduced the expression of tumor necrosis factor alpha (TNF-α) and cyclooxygenase-2 (COX-2) genes at all assessed times as compared to the injury and diclofenac groups (p < 0.05). The diclofenac group showed reduced levels of COX-2 only in relation to the injury group (p < 0.05). COX-2 protein expression remained unchanged with all therapies except with PBMT at a 3-J dose at 12 h (p < 0.05 compared to the injury group). In addition, PBMT (1, 3, and 9 J) effectively reduced levels of cytokines TNF-α, interleukin (IL)-1β, and IL-6 at all assessed times as compared to the injury and diclofenac groups (p < 0.05). Thus, PBMT at a 3-J dose was more effective than other doses of PBMT and topical NSAIDs in the modulation of the inflammatory process caused by muscle contusion injuries.

Strategies for optimising musculoskeletal health in the 21st century

“…Therefore, finding alternatives to these therapies for high-risk patients seems to be the logical option. Some possibilities may be topical NSAIDs, which have fewer side effects [119] or other modalities such as photobiomodulation (low level laser therapy; LLLT) [120]. Animal studies suggest that at the right dose, laser therapy can be more effective at modulating the inflammatory process, than topical NSAIDs which treat pain alone [120].…”

PBMT and topical diclofenac as single and combined treatment on skeletal muscle injury in diabetic rats: effects on biochemical and functional aspects

“…According to de Paiva Carvalho [10], who also observed similar results in muscle lesions, but in nondiabetic rats, the most interesting result in an antiinflammatory therapy is the decrease in COX-2. Tomazoni et al [15], using the same injury protocol and the same parameters of PBMT, demonstrated a decrease in the gene expression of COX-2 in non-diabetic animals. Our findings are in agreement with several studies that demonstrate a decrease in inflammatory markers in different experimental models of diseases [15,[21][22][23][24].…”

“…Tomazoni et al [15], using the same injury protocol and the same parameters of PBMT, demonstrated a decrease in the gene expression of COX-2 in non-diabetic animals. Our findings are in agreement with several studies that demonstrate a decrease in inflammatory markers in different experimental models of diseases [15,[21][22][23][24]. Ramos et al [25] found that PBMT (3 J) decreased gene expression of inflammatory markers after stretch muscle injury.…”

“…It is known that hyperglycemia can generate an imbalance in the production of growth factors, an increase in the inflammatory process, and impair cellular functions, thus causing a delay in the process of tissue repair [2,3]. According to Tomazoni et al [14,15], NSAID therapy is the most commonl y u s e d t r e a t m e n t f o r m u s c u l a r l e s i o n s a n d photobiomodulation therapy (PBMT) is effective in reducing inflammatory markers, as well as improving repair of injured musculoskeletal tissue, at the energy density of 107.1 J/cm 2 and total energy of 3 J.…”

“…PBMT seems to work very well in traumatic muscle injuries. Recently, in two studies, Tomazoni et al [14,15] demonstrated the efficacy of PBMT in the repair of trauma injuries, regarding morphological, biochemical, and functional aspects, using an 830-nm laser and a dose of 3 J. Furthermore, works can be found in the literature with positive results of treatment with photobiomodulation therapy in wound healing and cryolesions [16,17].…”