Superpulsed 904 nm laser photobiomodulation combined with coenzyme Q10 synergistically augment burn wound healing

Abstract

The management of multifaceted burn wound imparts a huge health care burden. Innumerable complexities associated with non-healing burn wounds led to the search for new therapeutic healing modalities. Earlier, our studies have shown that photobiomodulation (PBM) with superpulsed 904 nm laser increased cellular proliferation, bioenergetics activation, reduced inflammation and nitroxidative stress during burn wound healing. Coenzyme Q10 (CoQ10), a mitochondrial electron carrier acts as a potent antioxidant, maintains redox balance and mitochondrial dysfunction. Multi-target therapy aims to accelerate healing of intractable impaired wounds, which could exhibit a synergistic effect to potentially affecting different phases of the repair process. The present study investigates the efficacy of 904 nm superpulsed laser-mediated PBM (200 ns pulse-width, 100 Hz frequency, 0.24 J/cm2 total energy density, 0.40 mW/cm2 average power density and 19.77 W/cm2 peak power density for 10 min once daily for 7 days post-wounding) and CoQ10 (0.6%, w/v) topical treatments individually and in combination on full-thickness burn wound healing in rats and further explore the underlying mechanisms of action. The dual treatment showed significant (p < 0.05) synergism in enhancing pro-reparative healing markers: wound closure, mitogenesis (DNA, protein), angiogenesis (HIF-1α, VEGF), re-epithelialization, collagen deposition and bioenergetics activation (mitochondrial activity, cytochrome c oxidase and ATP), redox homeostasis (increased Nrf2, HO1, TXNRD2, catalase, SOD and decreased reactive oxygen species, lipid peroxidation levels) as compared to the standalone treatment and burn control groups. The PBM-CoQ10 combination treatment demonstrated significantly (p < 0.05) increased cellular proliferation (TGF-β2), light-sensitive ion channel regulation (TRPV3) and cytoprotection (HSP90, GRP78) during burn wound repair. Collectively, the combined therapy of PBM and CoQ10 is highly effective than either treatment alone in augmenting burn wound healing by efficiently attenuating oxidative stress and enhancing cellular proliferation, collagen deposition and bioenergetics activation. The study shows that combined treatment distinctly augments full-thickness burn repair in rats, which could pave the path for multi-target therapy approaches for non-healing impaired wounds in clinical care.