Abstract
The inflammatory Muscle-skeletal disorders are responsible for a high economic impact on public health and Pharmacological treatments produce important renal and gastric toxicity especially. However, the real effects of topical NSAID’s still controversial. Photobiomodulation therapy has been used to treat musculo-skeletal conditions. The aim of this study was to evaluate the effects of Photobiomodulation on topical absorption of sodium diclofenac in healthy volunteers. Methods. The volunteers were selected after an assessment of their state of health. The study began with 12 volunteers with dark skin and 12 white skin. The study was designed to determinate the pharmacokinetic parameters. The volunteers received during hospitalization 5g diclofenac gel in the presence or not of photobiomodulation, following the randomization. A Laser Cluster with 14 laser diodes (100 mW/diode) delivered 3 Joules of Energy/diode (spot area 0.028 Cm2). Blood samples were taken for determination of plasmatic diclofenac concentration (0.5, 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, 14, 16, 18, 24h) by tandem mass spectrometry. Low Power Laser Therapy operating at a wavelength of 650 nm was effective to enhance the absorption of diclofenac emulgel in white-skinned individuals but not in black-skinned individuals. Maximum plasma concentrations were higher in the white-skinned group of volunteers who received low-power laser irradiation prior to drug application when compared to the placebo group.
Highlights
Muscle-skeletal disorders (MSD) are the burden of modern society and several treatments have been used to decrease pain, discomfort and improve function especially in acute phase of inflammation to treat the affected tissues (Khan et al, 2000).The treatment options for muscle-skeletal diseases include a wide variety of therapeutic modalities such as drug therapy, phototherapy, cryotherapy, eccentric exercise and others
In this work we studied the effects of photobiomodulation (PBM) using Laser irradiation operating in the spectral region of red on the pharmacokinetics of topical NSAIDs in healthy white and black skin volunteers
We recently demonstrated in an experimental setup of rat muscle trauma that photobiomodulation potentiated diclofenac absorption, and presented synergistic effect of laser associated with topical drug (De Paiva Carvalho et al, 2019)
Summary
Muscle-skeletal disorders (MSD) are the burden of modern society and several treatments have been used to decrease pain, discomfort and improve function especially in acute phase of inflammation to treat the affected tissues (Khan et al, 2000). The treatment options for muscle-skeletal diseases include a wide variety of therapeutic modalities such as drug therapy, phototherapy, cryotherapy, eccentric exercise and others. The side effects of anti-inflammatory drugs are quite evident more than never. We recently demonstrated in experimental studies that the most commonly used NSAID diclofenac presented serious deleterious effects in a rat model of collagenase-induced rat tendinitis, decreasing the elasticity of the tendons and increasing the risk of sudden ruptures (Marcos et al, 2012). The corticosteroids are widely used to treat MSD and alleviate pain. Its use does not appear to provide long term benefits, possibly leading to reduction in strength of the treated tissue (Andres & Murrel, 2008)
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