Abstract
Neuropathic pain is characterized by an uncertain etiology and by a poor response to common therapies. The ineffectiveness and the frequent side effects of the drugs used to counteract neuropathic pain call for the discovery of new therapeutic strategies. Laser therapy proved to be effective for reducing pain sensitivity thus improving the quality of life. However, its application parameters and efficacy in chronic pain must be further analyzed. We investigated the pain relieving and protective effect of Photobiomodulation Therapy in a rat model of compressive mononeuropathy induced by Chronic Constriction Injury of the sciatic nerve (CCI). Laser (MLS-MiS) applications started 7 days after surgery and were performed ten times over a three week period showing a reduction in mechanical hypersensitivity and spontaneous pain that started from the first laser treatment until the end of the experiment. The ex vivo analysis highlighted the protective role of laser through the myelin sheath recovery in the sciatic nerve, inhibition of iNOS expression and enhancement of EAAT-2 levels in the spinal cord. In conclusion, this study supports laser treatment as a future therapeutic strategy in patients suffering from neuropathic pain induced by trauma.
Highlights
Neuropathic pain is the result of damage to the nervous system, spinal cord and other central nervous system regions[1,2,3]
Based on the results described above, to further investigate the effectiveness of near infrared (NIR) laser radiation in nerve protection and myelin sheath regeneration, Myelin Basic Protein (MBP) expression was evaluated by immunocytochemistry (Fig. 5)
Our previous studies showed the effectiveness of NIR laser therapy in reducing Constriction Injury of the sciatic nerve (CCI)-induced pain in the rat[32]
Summary
Neuropathic pain is the result of damage (due to injury or disease) to the nervous system (including nerves), spinal cord and other central nervous system regions[1,2,3]. The possibility to apply laser therapy in so many different pathological states depends on the effects that radiation has on important biological processes. A number of studies in literature have reported that laser radiation is effective in improving cell energy metabolism through ATP synthesis increase[25,26,27]. Further insights into the action mechanisms underlying enhanced cell energy metabolism were provided in a proteomic study, carried out on myoblasts exposed to near infrared (NIR) laser radiation (808 and 905 nm), where an increase in ATP-binding proteins and Protein Phosphatase 1 (PP1) was observed[28]. The analgesic effect is due to other mechanisms acting on the production of anti-nociceptive substances (endorphins), peripheral nerve conduction and the transmission of nociceptive stimuli, as demonstrated by the rapid analgesic effect evoked by laser radiation in animal models of persistent pain[18,29,30,31]
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