Phototherapy Devices Research Articles

Evaluation of Biological Effects and Transcriptome Changes Induced by LED-Based Narrow-Band UVB Phototherapy.

Ultraviolet (UV), particularly UVB, is widely used in the treatment of skin diseases including psoriasis, atopic dermatitis, vitiligo, mycosis fungoides and pruritus. Recently, there has been a trend of replacing broad-band UVB (BB-UVB) units with narrow-band UVB (NB-UVB), as studies have demonstrated that NB-UVB is more efficacious in the treatment of psoriasis. The purpose of this study is to evaluate the biological effects and transcriptome changes induced by light-emitting diode-based NB-UVB (NB-UVB LED) phototherapy. Cell viability and the cell migration ability were significantly decreased posttreatment, as well as apoptosis and ROS levels were remarkably increased. NB-UVB-induced S phase arrest was observed 12 h postirradiation. Bioinformatics analysis of transcriptome sequencing data revealed that NB-UVB LED irradiation induced dose-depended changes in multiple key signaling pathways, such as PI3K and cytoskeletal-related pathways. The depolymerization of cytoskeleton induced by NB-UVB was observed 24 h posttreatment. In addition, the expression levels of cytoskeleton-related proteins FN1, ITGB4, ITGA1, RAC2 and DOCK1 decreased significantly 12 h after irradiation. Our results indicated that NB-UVB LED may serve as a novel option for the development of NB-UVB phototherapy devices.

Diurnal Preference Contributes to Maximal UVB Sensitivity by the Hour of the Day in Human Skin In Vivo

Diurnal Preference Contributes to Maximal UVB Sensitivity by the Hour of the Day in Human Skin In Vivo

Design and realization of a dual-wavelength low level light therapy for acne and face rejuvenation treatment

Low-level light therapy (LLLT) uses the light of wavelength between 400–700 nm to treat acne, reduce inflammation, stimulate collagen production, and rejuvenate the facial skin. This study designed and constructed a dual-wavelength LED LLLT device for the facial treatment. The light spectrum, power density, uniformity, stability, and safety of the device were analyzed. The proposed system consisted of an LED array with 415 and 633 nm wavelengths. Human machine interface with embedded system was used to control light intensity and treatment time. The phototherapy device is designed to be curvaceously sized to suit the face shape of Asian people. The results showed that the LLLT device emitted 633±5 nm red and 415±5 nm blue light with a linear adjustable light power density of 0-18.56 mW/cm<sup>2</sup> and 0-3.70 mW/cm<sup>2</sup>, respectively. The spectrum distribution of the red and blue light was relatively constant over 30 minutes of operation. The uniformity and stability of red spectrum were about 89.9% and 95.08% and blue spectrum were 87.6% and 97.08%, respectively. The experimental face’s temperature was below 31.5 . For the future study, the LED phototherapy device will be applied for clinical research in collaboration with dermatologists.Low-level light therapy (LLLT) uses the light of wavelength between 400–700 nm to treat acne, reduce inflammation, stimulate collagen production, and rejuvenate the facial skin. This study designed and constructed a dual-wavelength LED LLLT device for the facial treatment. The light spectrum, power density, uniformity, stability, and safety of the device were analyzed. The proposed system consisted of an LED array with 415 and 633 nm wavelengths. Human machine interface with embedded system was used to control light intensity and treatment time. The phototherapy device is designed to be curvaceously sized to suit the face shape of Asian people. The results showed that the LLLT device emitted 633±5 nm red and 415±5 nm blue light with a linear adjustable light power density of 0-18.56 mW/cm<sup>2</sup> and 0-3.70 mW/cm<sup>2</sup>, respectively. The spectrum distribution of the red and blue light was relatively constant over 30 minutes of operation. The uniformity and stability of red spectrum were about 89.9% and 95.08% and blue spectrum were 87.6% and 97.08%, respectively. The experimental face’s temperature was below 31.5 . For the future study, the LED phototherapy device will be applied for clinical research in collaboration with dermatologists.

Effects of Different Types of Phototherapy Units on Neonatal Jaundice: A Cross-sectional Study

Introduction: Phototherapy is the mainstay of treatment of neonates who develop significant jaundice. Light-emitting diode and compact florescent lamp phototherapy units are the newer devices in the management of neonatal hyperbilirubinaemia. The advantage of light-emitting diode phototherapy includes portability, energy efficiency, less heat production, and durability. Blue and white phototherapy devices are more economical but generate more heat leading to hyperthermia and dehydration more often. Aim: To determine the efficacy and side effects of three modes of phototherapy units viz conventional blue and white light phototherapy, Compact Fluorescent Lamp (CFL) phototherapy, and Light-emitting Diode (LED) phototherapy on neonates having jaundice. Materials and Methods: This cross-sectional study was conducted in Department of Paediatrics at SRM Medical college Hospital and Research Centre (tertiary care teaching hospital), Kattankulathur, Tamil Nadu, India, from February 2021 to January 2022. A total of 150 neonates with hyperbilirubinaemia in the phototherapy range, American Academy of Paediatrics (AAP), were included in this study. Study subjects were divided into three groups of 50 neonates each to receive phototherapy using one of the three phototherapy devices, i.e., Blue and white light, CFL, LED phototherapy groups. Data of serum bilirubin levels were recorded at the beginning and end of phototherapy. The number of babies who required exchange transfusion and other clinical side effects among the study groups was recorded. Descriptive statistics were reported as Mean±SD for continuous variables, frequencies (percentage) for categorical variables. The One-way Analysis of Variance (ANOVA) test was used to determine the statistically significant differences between the means of three independent groups. Results: All the three type of phototherapy units generated statistically non significant mean flux (p-value=0.754). Mean difference (from the baseline bilirubin) at end of phototherapy for blue and white light group was 5.77±1.72 mg%, for CFL group was 5.48±1.32 mg%, and for LED group was 6.34±1.48 mg%. The difference was statistically significant in all three groups (p-value=<0.001). The reduction in serum bilirubin at the end of phototherapy was lesser in CFL group compared to blue and white light group and LED group. Conclusion: Light-emitting diode and blue and white light phototherapy units are more effective than compact fluorescent lamp phototherapy in treating neonatal hyperbilirubinaemia.

Antiangiogenic activity of photobiomodulation in experimental model using chorioallantoic embryonic membrane of chicken eggs.

The purpose of this study was to investigate the vascular effects of photobiomodulation using a light-emitting diode on the chorioallantoic embryonic membrane of chicken eggs grouped into different times of exposure and to detect the morphological changes induced by the light on the vascular network architecture using quantitative metrics. We used a phototherapy device with light-emitting diode (670 nm wavelength) as the source of photobiomodulation. We applied the red light at a distance of 2.5 cm to the surface of the chorioallantoic embryonic membrane of chicken eggs in 2, 4, or 8 sessions for 90 s and analyzed the vascular network architecture using AngioTool software (National Cancer Institute, USA). We treated the negative control group with 50 μl phosphate-buffered-saline (pH 7.4) and the positive control group (Beva) with 50 μl bevacizumab solution (Avastin, Produtos Roche Químicos e Farmacêuticos, S.A., Brazil). We found a decrease in total vessel length in the Beva group (24.96% ± 12.85%) and in all the groups that received 670 nm red light therapy (2× group, 34.66% ± 8.66%; 4× group, 42.42% ± 5.26%; 8× group, 38.48% ± 6.96%), compared with the negative control group. The fluence of 5.4 J/cm2 in 4 sessions (4×) showed more regular vessels. The number of junctions in the groups that received a higher incidence of 670 nm red light (4× and 8×) significantly decreased (p<0.0001). Photo-biomodulation helps reduce vascularization in chorioallantoic embryonic membrane of chicken eggs and changes in the network architecture. Our results open the possibility of future clinical studies on using this therapy in patients with retinal diseases with neovascular components, especially age-related macular degeneration.

Development of a Phototherapy Device for Allergic Rhinitis Using LEDs Emitting Narrowband UVB

Development of a Phototherapy Device for Allergic Rhinitis Using LEDs Emitting Narrowband UVB

RANCANG BANGUN SENSOR BH1750 BERBASIS MIKROKONTROLLER SEBAGAI FOTOTERAPI PADA PENDERITA HIPERBILIRUBIN/BAYI KUNING

&#x0D; Phototherapy equipment is one type of physiotherapy equipment that is used to treat patients with Neonatal Jaundice. This tool works like an incandescent lamp in general, transmitting blue light directly to the baby's body which will then help reduce the amount of bilirubin that has accumulated in the baby's skin layer. born. This situation is experienced by many babies born prematurely and also babies who are breastfed late. Hyperbilirubinemia can be easily treated by the aforementioned light therapy. The light given by the tool is one type of light that is harmful to vision, so that in the process of irradiating the baby, an eye patch will be worn to protect the retina of the eye which is still in the process of being perfected. In the process, the author added a light reading feature/ photometer to measure the amount of light produced by the phototherapy device. The photometer is made by utilizing the BH1750 sensor with the function of reading light rays (any) in lux units, so that users can easily find out how many doses of light are produced in the therapy process.The measurement results from the photometer are displayed on the LCD, with the measurement of the light value in lux units of 266.67 Lux. The measurement results are stable with the irradiation distance between the lamp and the location of the sensor as much as 30 cm.

Neonatal Eye Shielding during Phototherapy: What Protects the Eye Better?

Phototherapy remains an important component of the management of unconjugated neonatal jaundice, a major cause of newborn morbidity. During phototherapy the toxic unconjugated form of bilirubin is converted to nontoxic form through action of light delivered by phototherapy. An important possible complication of phototherapy is retinal damage and therefore eye protective measures are taken during therapy to prevent this from occurring. Devices currently in use for phototherapy are capable of providing intensive phototherapy with the attendant increased risk of eye injury. The materials used in providing eye protection are varied among care providers. A dearth of information exists on shielding provided by the commonly used eye protectors during phototherapy, more so during intensive phototherapy. To evaluate the shielding provided by the different eye protectors commonly used in our setting under intensive phototherapy. Five materials in use for eye shielding were obtained. Using an institutional built light emitting diode phototherapy device, intensive phototherapy was provided and the irradiance at varying distances of 35 cm, 25 cm, 15 cm and 10 cm was measured using an Olympic bili meterTM Natus. At the distance of each measured irradiance the different eye protective materials were then placed one after the other over the surface of the measuring sensor of the meter and the irradiance measurement was recorded. Two measurements were taken for each material at each distance and the average irradiance measurement was then recorded for each of the materials tested at that distance. Five eye shielding materials in use were identified: black cotton fabric, white cotton fabric, black cotton fabric with foam, white cotton fabric with foam and gauze. The black cotton fabric with or without foam at the phototherapy device irradiances of 30, 46.3, 58.7 and 75.4 µw/m2/nm recorded 0 irradiance. Black cotton fabric with or without foam pad provided the most shielding under intensive phototherapy.

Irradiance footprint of phototherapy devices: a comparative study

BackgroundPhototherapy (PT) is the standard treatment of neonatal unconjugated hyperbilirubinemia. The irradiance footprint, i.e., the illuminated area by the PT device with sufficient spectral irradiance, is essential for PT to be effective. Irradiance footprint measurements are not performed in current clinical practice. We describe a user-friendly method to systematically evaluate the high spectral irradiance (HSI) footprint (illuminated area with spectral irradiance of ≥30 μW cm−2 nm−1) of PT devices in clinical practice.Materials and methodsSix commercially available LED-based overhead PT devices were evaluated in overhead configuration with an incubator. Spectral irradiance (µW cm−2 nm−1) and HSI footprint were measured with a radiospectrometer (BiliBlanket Meter II).ResultsThe average measured spectral irradiance ranged between 27 and 52 μW cm−2 nm−1 and HSI footprint ranged between 67 and 1465 cm2, respectively. Three, two, and one PT devices out of six covered the average BSA of an infant born at 22, 26–32, and 40 weeks of gestation, respectively.ConclusionSpectral irradiance of LED-based overhead PT devices is often lower than manufacturer’s specifications, and HSI footprints not always cover the average BSA of a newborn infant. The proposed measurement method will contribute to awareness of the importance of irradiance level as well as footprint measurements in the management of neonatal jaundice.ImpactWhile a sufficient spectral irradiance footprint is essential for PT to be effective, some PT devices have spectral irradiance footprints that are too small to cover the entire body surface area (BSA) of a newborn infant.This study introduces a user-friendly, accessible method to systematically evaluate the spectral irradiance level and footprint of PT devices.This study supports awareness on the role of the spectral irradiance footprint in the efficacy of PT devices. Irradiance footprint can be easily measured during phototherapy with the proposed method.

UVB phototherapy in the treatment of vitiligo: State of the art and clinical perspectives.

Vitiligo is a chronic pigmentary skin disorder that results in white, hypopigmented macules and patches. It causes a considerable psychological and emotional burden on the affected individuals and their families. Several therapeutic options have been employed in vitiligo including topical and oral drugs, surgical techniques, and phototherapy which is considered the cornerstone treatment. Different wavelengths and modalities are available, but narrowband UVB (NB-UVB) is considered the safest and the most effective phototherapy alternative. NB-UVB acts on multiple steps in vitiligo pathogenesis, and it is capable of inducing stabilization and repigmentation of vitiligo lesions. Technological advances have led to the development of both new phototherapy devices and new medical and surgical therapeutic options that can be combined with phototherapy to achieve optimal results. There is no standard treatment, and individual patient and disease characteristics should be considered. We review the current evidence in what concerns UVB phototherapy for vitiligo treatment, including novel combination treatments that may help to provide the best care for these patients.

Effect of Transcranial Near-Infrared Light 1068 nm Upon Memory Performance in Aging Healthy Individuals: A Pilot Study.

Background: We present a pilot study of near-infrared (NIR) 1068 nm transcranial photobiomodulation therapy (PBM-T). Impact upon motor function, memory, and processing speed in healthy individuals, older than 45 years of age, was evaluated. Methods: PBM-T was performed at home using a transcranial phototherapy device, a helmet that comprised 14 air cooled light emitting diode panel arrays, with a peak wavelength of 1068 nm, full width at half maximum bandwidth of 60 nm and total average optical output power of 3.8 W. The device was used for 6 min twice daily on age-matched middle-aged subjects with normal intellectual function. The US Food and Drug Administration (FDA)-approved computerized assessment tool Automated Neuropsychological Assessment Metrics (ANAM) was adopted to quantify a series of cognitive and motor activities in the participating groups. Results: A significant improvement in motor function, memory performance, and processing speed was observed in healthy individuals with PBM-T compared to the placebo group. No adverse effects were reported. Conclusions: PBM-T may be a promising new approach to improve memory in healthy middle-aged individuals. ClinicalTrials.gov ID: NCT04568057.

Wearable Flexible Phototherapy Device for Knee Osteoarthritis

Knee osteoarthritis (OA) is a highly prevalent and disabling disease that causes pain and gradual degeneration of the articular cartilage. Phototherapy is a new physiotherapy treatment, more effective and stable than other non-pharmacologic management. Conventional phototherapy devices typically suffer from unintelligent and bulky equipment, while existing phototherapy methods require maintain a certain phototherapy distance. Here, we introduce a wearable flexible phototherapy device worn on a knee for osteoarthritis, incorporating a phototherapy adhesive patch and a control box. The phototherapy adhesive patch is capable of softly laminating onto the curved surfaces of the knee skin to increase the effects of phototherapy. We describe the LED array, constant current drive module, key control module, and power supply module that serve as the foundations for the control box. The weight of the device is only 101.8 g. The irradiance of the device can be adjusted linearly and irradiance of the designed phototherapy device based on LED can reach 13 mW/cm2. The maximum temperature of the surface of the light source is 31.2 °C. The device proposed in this work exhibits satisfactory stability, promising a potential in phototherapy.

Preliminary observations of a system for determination of phototherapy exposure over a neonate body shape

While it is possible to determine the irradiance and spectral content for a given neonatal phototherapy device at various locations over a neonate's surface, this does not allow estimation of the total rate of energy delivery within a specific spectral range over the neonate's exposed body surface. A series of 192 blue wavelength enhanced silicon photodiodes was distributed over the surface of a commercially available newborn body shape and connected to a specially designed interface circuit. Placement of photosensors over the surface of the baby shape was determined with consideration of the surface area of twelve specific anatomical areas where each was allocated 16 individual photodiodes. Calibration of detection channels for specific wavelength intervals was undertaken using a Bentham dmc150 spectroradiometer system and also a separate hand held spectroradiometer. This made it possible to estimate the effective integrated dose rate in Watts for specific wavelength intervals such as 460 nm to 490 nm as identified by the American Academy of Pediatrics for phototherapy lamp devices. This allowed identification of dose rate contributions from specific anatomical areas. Initial observations are reported for a range of phototherapy lamp systems and the findings are discussed in terms of their predicted relative clinical effectiveness. Options are also discussed in relation to the future development of the reported measurement system.

Can exchange transfusion be replaced by double-LED phototherapy?

Phototherapy is a conventional treatment for neonatal jaundice and widely considered as a safe procedure. Recent developments in light-emitting diode (LED) phototherapy devices have made more effective treatments possible. Exchange transfusion (ET) is typically applied for cases of refractory severe hyperbilirubinemia despite its risk of various complications. Since the therapeutic effect of phototherapy is correlated with its irradiance, ET may be avoided by performing phototherapy with higher irradiation. Recently, we adopted double-LED phototherapy as a bridging treatment to ET to treat a case of severe hyperbilirubinemia. In this case, the continual increase of bilirubin levels was suppressed immediately after its administration, and ET was not required. Throughout the treatment, no complications or increase in oxidative stress was observed. In addition, neurodevelopment was appropriate for the patient’s age at the 1-year follow-up, and no findings of kernicterus, including physical and magnetic resonance imaging findings, were observed. We hypothesized that double-LED phototherapy may be a good treatment strategy to replace ET for infants with severe hyperbilirubinemia; however, further investigations regarding safety issues including acute and long-term complications are needed before clinical adaptation.

RANCANG BANGUN SENSOR BH1750 BERBASIS MIKROKONTROLLER SEBAGAI FOTOTERAPI PADA PENDERITA HIPERBILIRUBIN/BAYI KUNING

Phototherapy equipment is one type of physiotherapy equipment that is used to treat patients with Neonatal Jaundice. This tool works like an incandescent lamp in general, transmitting blue light directly to the baby's body which will then help reduce the amount of bilirubin that has accumulated in the baby's skin layer. born. This situation is experienced by many babies born prematurely and also babies who are breastfed late. Hyperbilirubinemia can be easily treated by the aforementioned light therapy. The light given by the tool is one type of light that is harmful to vision, so that in the process of irradiating the baby, an eye patch will be worn to protect the retina of the eye which is still in the process of being perfected. In the process, the author added a light reading feature/ photometer to measure the amount of light produced by the phototherapy device. The photometer is made by utilizing the BH1750 sensor with the function of reading light rays (any) in lux units, so that users can easily find out how many doses of light are produced in the therapy process.The measurement results from the photometer are displayed on the LCD, with the measurement of the light value in lux units of 266.67 Lux. The measurement results are stable with the irradiation distance between the lamp and the location of the sensor as much as 30 cm.

White LED phototherapy as an improved treatment for neonatal jaundice.

With the aim of improving phototherapy for neonatal jaundice (hyperbilirubinemia), this study investigates the degradation of unconjugated bilirubin under irradiance by conventional light and by white, red, green, and blue LED sources in vitro. The absorption spectra of bilirubin under these different light sources are compared. The results demonstrate that white LED phototherapy promotes more efficient bilirubin degradation than conventional blue-light therapy. This study provides a basis for the design of novel phototherapy devices for the treatment of hyperbilirubinemia.

Seeing the Treatment of Psoriasis in a New Light: A Novel Medical Device Utilizing Localized Coal Tar and Narrowband UVB for Targeted Treatment of Plaque Psoriasis.

Given the high costs of systemic psoriasis therapies, studies have also shown that phototherapy achieves significant cost savings by replacing or delaying drug-based systemic treatment in patients with moderate to severe disease. However, this modality is often underutilized mainly due to the lack of phototherapy treatment centers across the country. Home phototherapy was designed to fill this treatment gap and allow patients to be treated with phototherapy despite living in areas that may not have a formal treatment facility. Inspired by the Goeckerman regimen, a preliminary pilot study showed that a novel, home phototherapy device utilizing a mobile phone-controlled L.E.D UVB light source and an occlusive hydrogel patch containing coal tar was superior to control as well as both NB-UVB alone and a coal tar dressing alone.Visit the Psoriasis Resource Center for more on this topic.

Phototherapy Using a Light-Emitting Fabric (BUBOLight) Device in the Treatment of Newborn Jaundice: Protocol for an Interventional Feasibility and Safety Study.

BackgroundNeonatal jaundice is a common condition occurring in 60%-80% of all healthy-term and late-preterm neonates. In the majority of cases, neonatal jaundice resolves spontaneously and causes no harm; however, in some neonates, significant hyperbilirubinemia can develop and lead to kernicterus jaundice, a serious neurological disease. Phototherapy (PT) is the preferred treatment for jaundice; however, to be effective, PT devices need to have a broad light emission surface to generate no or little heat and to provide an optimal wavelength and light intensity (420-490 nm and ≥30 µW/cm²/nm, respectively).ObjectiveThis study aimed to investigate the feasibility, safety, and level of satisfaction of parents and health care teams with the BUBOlight device, an innovative alternative to conventional hospital PT, in which luminous textiles have been incorporated in a sleeping bag.MethodsThis interventional, exploratory, simple group, nonrandomized, single-center trial will be conducted at Lille Hospital. In total, 10-15 neonates and their parents will be included to obtain evaluable data from 10 parent-neonate pairs. Neonates weighing more than 2500 g at birth and born with ≥37 weeks of amenorrhea that required PT in accordance with the guidelines of the National Institute For Health and Clinical Excellence will receive one 4-hour session of illumination. Total serum bilirubin and transcutaneous bilirubin levels were obtained at the start and 2 hours after the end of PT. Cutaneous and rectal temperatures, heart rate, and oxygen saturation will be measured at the beginning and during PT. The number of subjects is therefore not calculated on the basis of statistical assumptions. We aim to obtain a minimum proportion of 90% (ie, 9 of 10) of the neonates included, who have been able to undergo 4-hour PT without unacceptable and unexpected toxicities. We will calculate the mean, median, quartiles, minimum and maximum values of the quantitative parameters, and the frequency of the qualitative parameters. The rate of patients with no unacceptable and unexpected toxicities (ie, the primary endpoint) will be calculated.ResultsThe first patient is expected to be enrolled at the end of 2020, and clinical investigations are intended for up to June 2021. The final results of this study are expected to be available at the end of 2021.ConclusionsOur findings will provide insights into the safety and feasibility of a new PT device based on light-emitting fabrics for the treatment of newborn jaundice. This new system, if proven effective, will improve the humanization of neonatal care and help avoid mother-child separation.Trial RegistrationClinicalTrials.gov NCT04365998; https://clinicaltrials.gov/ct2/show/NCT04365998International Registered Report Identifier (IRRID)PRR1-10.2196/24808

English

The first report on the use of phototherapy for treatment of neonates with jaundice was published more than 20 years ago. Since then, phototherapy has been used extensively in the treatment of neonatal hyperbilirubinaemia. Phototherapy is the use of visible light for the treatment of hyperbilirubinaemia in the newborn. There are different types of phototherapy systems in use in recent times. Effectiveness of phototherapy depends on several factors which should be considered while delivering phototherapy to a jaundiced neonate. Effective phototherapy has decreased the need for exchange transfusion. Proper nursing care enhances the effectiveness of phototherapy and minimises complications. Jaundice is benign in most of the cases, but because of potential bilirubin toxicity, strict and close monitoring is required. Prompt recognition and intervention of the infants at increased risk for developing hyperbilirubinaemia forms the first step in management. The focus is to prevent development of severe hyperbilirubinaemia by early recognition and initiation of treatment. Counselling of parents, especially mother also plays a major role in the treatment of neonatal jaundice. Recommended guidelines are intended to be used by hospitals and treating paediatricians, neonatologists and advanced practice nurses trained in neonatology. Phototherapy devices include fluorescent, halogen, fibreoptic or light emitting diode light sources. Each type has its own benefits and side effects. Many studies were available comparing the efficacy of various types of phototherapy systems. The purpose of this review article was to provide a conceptual review on role of phototherapy in neonatal jaundice, different types of phototherapy systems in use, recent advances and probable side effects of phototherapy. KEY WORDS Bilirubin, Hyperbilirubinaemia, Jaundice, Neonatal Intensive Care, Newborn, Phototherapy

503 Ex vivo preclinical testing of a wearable UVA phototherapy device

503 Ex vivo preclinical testing of a wearable UVA phototherapy device