Skip to main content

Advertisement

SpringerLink
Log in

Radiological and biochemical effects (CTX-II, MMP-3, 8, and 13) of low-level laser therapy (LLLT) in chronic osteoarthritis in Al-Kharj, Saudi Arabia

  • Original Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

Abstract

Inflammation of synovial membrane and degeneration of articular cartilage in osteoarthritis (OA) lead to major changes in joint space width (JSW) and biochemical components such as collagen-II telopeptide (CTX-II) and matrix metallo protineases (MMP-3, 8, and 13). Low-level laser therapy (LLLT) is thought to have an analgesic effect as well as biomodulatory effect on microcirculation and cartilage regeneration in animal studies. The objective of this study was to examine the analgesic and biochemical effect of LLLT in patients with knee osteoarthritis. Subjects (n = 34) who fulfilled the selection criteria were randomly divided into active group (n = 17) and placebo group. Subjects in active group were irradiated laser with the frequency of 3 days per week for 4 weeks with the specific parameters on 8 different points on the joint at 1.5 J per point for 60 s for 8 points for a total dose of 12 J in a skin contact method. The placebo group was treated with the same probe with minimum emission of energy. Visual analog scale for pain intensity, joint space width, collagen-II telopeptide, and matrix metallo protinease-3, 8, and 13 was measured before treatment and at 4 and 8 weeks following treatment. Data are analyzed with mean values and standard deviation with p < 0.05. Baseline values of all outcome measures show insignificant difference (p > 0.05) in both groups which shows homogeneity. After 4- and 8-week treatment, active laser group shows more significant difference (p < 0.001) in all the parameters than the placebo laser group (p > 0.05). Our results show that low-level laser therapy was more efficient in reducing pain and improving cartilage thickness through biochemical changes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Felson DT, Lawrence RC, Hochberg MC et al (2000) Osteoarthritis: new insights. Part 2: treatment approaches. Ann Intern Med 133:726–737

    Article  CAS  PubMed  Google Scholar 

  2. Jordan K, Arden N, Doherty M et al (2003) EULAR recommendations 2003: an evidence based approach to the management of knee osteoarthritis: report of a task force of the standing committee for international clinical studies including therapeutic trials (ESCISIT). Ann Rheum Dis 62:1145–1155

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Felson DT, Zhang Y, Hannan MT et al (1995) The incidence and natural history of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum 38:1500–1505

    Article  CAS  PubMed  Google Scholar 

  4. Benito MJ, Veale DJ, FitzGerald O et al (2005) Synovial tissue inflammation in early and late osteoarthritis. Ann Rheum Dis 64:1263–1267

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Bondeson J, Wainwright SD, Lauder S et al (2006) The role of synovial macrophages and macrophage-produced cytokines in driving aggrecanases, matrix metallo proteinases, and other destructive and inflammatory responses in osteoarthritis. Arthritis Res Ther 8:187

    Article  Google Scholar 

  6. Kennedy A, Fearon U, Veale DJ, Godson C (2011) Macrophages in synovial inflammation. Front Immunol 2:52

    Article  PubMed  PubMed Central  Google Scholar 

  7. Yamairi F, Utsumi H, Ono Y, Komorita N, Tanaka M, Fukunari A (2011) Expression of vascular endothelial growth factor (VEGF) associated with histopathological changes in rodent models of osteoarthritis. J Toxicol Pathol 24:137–142

    Article  PubMed  PubMed Central  Google Scholar 

  8. Rübenhagen R, Schüttrumpf JP, Stürmer KM, Frosch KH (2012) Interleukin-7 levels in synovial fluid increase with age and MMP-1 levels decrease with progression of osteoarthritis. Acta Orthop 83:59–64

    Article  PubMed  PubMed Central  Google Scholar 

  9. Pelletier JP, Martel-Pelletier J, Abramson SB (2001) Osteoarthritis, an inflammatory disease: potential implication for the selection of new therapeutic targets. Arthritis Rheum 44:1237–1247

    Article  CAS  PubMed  Google Scholar 

  10. Pfander D, Jorgensen B, Rohde E et al (2006) The influence of laser irradiation of low-power density on an experimental cartilage damage in rabbit knee-joints: an in vivo investigation considering macroscopic, histological and immune histochemical changes. Biomed Tech 51(3):131–138

    Article  Google Scholar 

  11. Cho HJ, Lim SC, Kim SG et al (2004) Effect of low-level laser therapy on osteo arthropathy in rabbit. In Vivo 18:585–591

    PubMed  Google Scholar 

  12. Herman JH, Khosla RC (1988) In vitro effects of Nd: YAG laser radiation on cartilage metabolism. J Rheumatol 15:1818–1826

    CAS  PubMed  Google Scholar 

  13. Santangelo KS, Nuovo GJ, Bertone AL (2012) In vivo reduction or blockade ofinterleukin-1β in primary osteoarthritis influences expression of mediators implicated in pathogenesis. Osteoarthritis Cartil 20:1610–1618

    Article  CAS  Google Scholar 

  14. Biniecka M, Kennedy A, Ng VT et al (2011) Successful tumor necrosis factor (TNF) blocking therapy suppresses oxidative stress and hypoxia-induced mitochondrial mutagenesis in inflammatory arthritis. Arthritis Res Ther 15:R121

    Article  Google Scholar 

  15. Karsdal MA, Sumer EU, Wulf H et al (2007) Induction of increased cAMP levels in articular chondrocytes blocks matrix metallo proteinase mediated cartilage degradation, but not aggrecanase-mediated cartilage degradation. Arthritis Rheum 56:1549–1558

    Article  CAS  PubMed  Google Scholar 

  16. Sondergaard BC, Henriksen K, Wulf H et al (2006) Relative contribution of matrix metallo protease and cysteine protease activities to cytokine-stimulated articular cartilage degradation. Osteoarthr Cartil 14:738–748

    Article  CAS  PubMed  Google Scholar 

  17. Reijman M, Hazes JMW, Bierma-Zeinstra SMA et al (2004) A new marker for osteoarthritis: cross-sectional and longitudinal approach. Arthritis Rheum 50:2471–2478

    Article  CAS  PubMed  Google Scholar 

  18. Kellgren JH, Lawrence JS (1957) Radiological assessment of rheumatoid arthritis. Ann Rheum Dis 16:485–493

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Revill SI, Robinson JO, Rosen M, Hogg MI (1976) The reliability of a linear analogue for evaluating pain. Anaesthesia 31:1191–1198

    Article  CAS  PubMed  Google Scholar 

  20. Peterfy C, Li J, Zaim S et al (2003) Comparison of fixed-flexion positioning with fluoroscopic semi-flexed positioning for quantifying radiographic joint space width in the knee: test-retest reproducibility. Skelet Radiol 32:128–132

    Article  CAS  Google Scholar 

  21. Christgau S, Garnero P, Fledelius C et al (2001) Collagen type II C-telopeptide fragments as an index of cartilage degradation. Bone 29(3):209–215

    Article  CAS  PubMed  Google Scholar 

  22. Hunter DJ, Eckstein F (2009) Exercise and osteoarthritis. J Anat 214(2):197–207

    Article  PubMed  PubMed Central  Google Scholar 

  23. Alves ACA, Albertini R, dos Santos SA et al (2014) Effect of low-level laser therapy on metalloproteinase MMP-2 and MMP-9 production and percentage of collagen types I and III in a papain cartilage injury model. Lasers in Med Sci 29(3):911–919

    Google Scholar 

  24. Ling PX, Zhang LN, Jin Y, He YL, Zhang TM (2009) Effects of a hyaluronic acid and low molecular weight heparin injection on osteoarthritis in rabbits. Drug Discov Ther 3:146–150

    CAS  PubMed  Google Scholar 

  25. World Association of Laser Therapy (WALT) (2006) Consensus agreement on the design and conduct of clinical studies with low-level laser therapy and light therapy for musculoskeletal pain and disorders. Photomed Laser Surg 24:761–762

    Article  Google Scholar 

  26. Bjordal JM, Couppe C, Chow RT, Tuner J, Ljunggren EA (2003) A systematic review of low level laser therapy with location-specific doses for pain from chronic joint disorders. Aust J Phys 49:107–116

    Google Scholar 

  27. Hegedus B, Viharos L, Gervain M, Gälfi M (2009) The effect of low-level laser in knee osteoarthritis: a double-blind, randomized, placebo-controlled trial. Photomed Laser Surg 27:577–584

    Article  PubMed  PubMed Central  Google Scholar 

  28. Pallotta RC, Bjordal JM, Frigo L et al (2012) Infrared (810-nm) low-level laser therapy on rat experimental knee inflammation. Lasers Med Sci 27:71–78

    Article  PubMed  Google Scholar 

  29. Javadieh F, Bayat M, Torkaman G (2010) Evaluation of low-level laser therapy with a He-Ne laser on the healing of an osteo chondral defect using a biomechanical test. Photomed Laser Surg 28:423–428

    Article  PubMed  Google Scholar 

  30. Kempson GE (1980) The mechanical properties of articular cartilage. In: Sokoloff L (ed) The joints and synovial fluid. Academic, New York, pp 177–238

    Chapter  Google Scholar 

  31. Poole AR (1995) Imbalances of anabolism and catabolism of cartilage matrix components in osteoarthritis. In: Kuettner KE, Goldberg VM (eds) Osteo arthritic disorders. Rosemont, Illinois: American Association of Orthopaedic Surgeons, 247–260.

  32. McDougall S, Dallon J, Sherratt J, Maini P (2006) Fibroblast migration and collagen deposition during dermal wound healing: mathematical modeling and clinical implications. Philos Transact A Math Phys Eng Sci 364:1385–1405

    Article  CAS  Google Scholar 

  33. Sobol E, Zakharkina O, Baskov A et al (2009) Laser engineering of spine discs. Laser Phys 19:825–835

    Article  CAS  Google Scholar 

  34. Domm C, Fay J, Schunke M, Kurz B (2000) Re differentiation of dedifferentiated joint cartilage cells in alginate culture. Effect of intermittent hydrostatic pressure and low oxygen partial pressure. Orthopade 29:91–99

    CAS  PubMed  Google Scholar 

  35. Poole AR (1995) Imbalances of anabolism and catabolism of cartilage matrix components in osteoarthritis. In: Kuettner KE, Goldberg VM (eds) Osteoarthritic disorders. American Association of Orthopaedic Surgeons, Rosemont, pp 247–260

    Google Scholar 

  36. Wu JJ, Lark MW, Chun LE, Eyre DR (1991) Sites of stromelysin cleavage in collagen types II, IX, X, and XI of cartilage. J Biol Chem 266:5625–5628

    CAS  PubMed  Google Scholar 

  37. Naito K, Takahashi M, Kushida K, Suzuki M et al (1999) Measurement of matrix metallo proteinases (MMPs) and tissue inhibitor of metalloproteinases-1(TIMP-1) in patients with knee osteoarthritis: comparison with generalized osteoarthritis. Rheumatology 38:510–515

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported financially by the Prince Sattam Bin Abdul Aziz University, AL-Kharj, Saudi Arabia. We are grateful for the support of the staff members of the physiotherapy department who provide us with the information necessary to perform this study and, finally, to all people who generously participated in this study.

Author information

Authors and Affiliations

  1. Department of Physical Therapy and Health Rehabilitation, Prince Sattam Bin Abdul Aziz University, Al-Kharj, Saudi Arabia

    Gopal Nambi S, Walid Kamal & Julie George

  2. Radiology and Medical Imaging Department, Prince Sattam Bin Abdul Aziz University, Al-Kharj, Saudi Arabia

    Elbagir Manssor

Authors
  1. Gopal Nambi S
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Walid Kamal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Julie George
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Elbagir Manssor
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gopal Nambi S.

Ethics declarations

Funding source

Authors are grateful to the Deanship of scientific Research, Prince Sattam Bin Abdul Aziz University, Al-Kharj, Saudi Arabia for the financial support to carry out this project no 2015/01/4375.

Research funding program: Specialized Research Grant program (Health)

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

S, G., Kamal, W., George, J. et al. Radiological and biochemical effects (CTX-II, MMP-3, 8, and 13) of low-level laser therapy (LLLT) in chronic osteoarthritis in Al-Kharj, Saudi Arabia. Lasers Med Sci 32, 297–303 (2017). https://doi.org/10.1007/s10103-016-2114-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10103-016-2114-5

Keywords

Search

Navigation