title: Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy.
abstract: Photobiomodulation (PBM) also known as low-level laser (or light) therapy (LLLT), has been known for almost 50 years but still has not gained widespread acceptance, largely due to uncertainty about the molecular, cellular, and tissular mechanisms of action. However, in recent years, much knowledge has been gained in this area, which will be summarized in this review. One of the most important chromophores is cytochrome c oxidase (unit IV in the mitochondrial respiratory chain), which contains both heme and copper centers and absorbs light into the near-infra-red region. The leading hypothesis is that the photons dissociate inhibitory nitric oxide from the enzyme, leading to an increase in electron transport, mitochondrial membrane potential and ATP production. Another hypothesis concerns light-sensitive ion channels that can be activated allowing calcium to enter the cell. After the initial photon absorption events, numerous signaling pathways are activated via reactive oxygen species, cyclic AMP, NO and Ca2+, leading to activation of transcription factors. These transcription factors can lead to increased expression of genes related to protein synthesis, cell migration and proliferation, anti-inflammatory signaling, anti-apoptotic proteins, antioxidant enzymes. Stem cells and progenitor cells appear to be particularly susceptible to LLLT.
authors.affiliation: Programa de Pós-Graduação Interunidades Bioengenharia, University of São Paulo, São Carlos - SP, Brazil; Wellman Center for Photomedicine, Harvard Medical School, Boston, MA 02114, USA.
authors.forename: Lucas Freitas
authors.initials: LF
authors.lastname: de Freitas
authors.affiliation: Wellman Center for Photomedicine, Harvard Medical School, Boston, MA 02114, USA; Department of Dermatology, Harvard Medical School, Boston, MA 02115, USA; Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA 02139, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Hamblin
keywords: Cytochrome c oxidase; Light sensitive ion channels; Low Level Light Therapy; Mechanism; Mitochondria; Photobiomodulation