NASA Light-Emitting Diodes for the Prevention of Oral Mucositis in Pediatric Bone Marrow Transplant Patients

Abstract

Objective: The purpose of this study was to determine the effects of prophylactic near-infrared light therapy from light-emitting diodes (LEDs) in pediatric bone marrow transplant (BMT) recipients. Background Data: Oral mucositis (OM) is a frequent side effect of chemotherapy that leads to increased morbidity. Nearinfrared light has been shown to produce biostimulatory effects in tissues, and previous results using nearinfrared lasers have shown improvement in OM indices. However, LEDs may hold greater potential for clinical applications. Materials and Methods: We recruited 32 consecutive pediatric patients undergoing myeloablative therapy in preparation for BMT. Patients were examined by two of three pediatric dentists trained in assessing the Schubert oral mucositis index (OMI) for left and right buccal and lateral tongue mucosal surfaces, while the patients were asked to rate their current left and right mouth pain, left and right xerostomia, and throat pain. LED therapy consisted of daily treatment at a fluence of 4 J/cm 2 using a 670-nm LED array held to the left extraoral epithelium starting on the day of transplant, with a concurrent sham treatment on the right. Patients were assessed before BMT and every 2-3 days through posttransplant day 14. Outcomes included the percentage of patients with ulcerative oral mucositis (UOM) compared to historical epidemiological controls, the comparison of left and right buccal pain to throat pain, and the comparison between sides of the buccal and lateral tongue OMI and buccal pain. Results: The incidence of UOM was 53%, compared to an expected rate of 70-90%. There was also a 48% and 39% reduction of treated left and right buccal pain, respectively, compared to untreated throat pain at about posttransplant day 7 (p < 0.05). There were no significant differences between sides in OMI or pain. Conclusion: Although more studies are needed, LED therapy appears useful in the prevention of OM in pediatric BMT patients. 319

Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients

“…Two non-laser light-therapy devices were reported in the literature for the prevention of OM in HSCT patient population: light-emitting diode (LED) and broad band visible light therapy [21,22]. As to LED, there are accumulating data showing that there is no difference in the interaction of a laser and a LED with the human tissue [36][37][38][39][40].…”

Blue and red light combination LED phototherapy for acne vulgaris in patients with skin phototype IV

“…The beneficial effects of red light on the skin have been suggested by many studies [35][36][37][38][39][40][41][42][43][44][45]. It has been demonstrated by an in vitro study that red light influenced cytokine release from macrophages, which consequently stimulated fibroblast proliferation [35].…”

“…A series of comprehensive studies performed by Whelan et al [43][44][45] demonstrated that 670 nm LED treatment upregulated tissue regeneration genes and accelerated wound closure. Their study also showed that the expression of genes coding cytokines and their receptors was downregulated after red LED treatment.…”

670 nm Laser Light and EGCG Complementarily Reduce Amyloid-β Aggregates in Human Neuroblastoma Cells: Basis for Treatment of Alzheimer's Disease?

“…However, in vivo transfer of the irradiance level found to be effective in vitro at 670 nm needs careful adjustment. In view of the documented clinical evidence for the deep tissue penetration of 670-nm light, 37 and the reported clinical success in transcranial application of combinations of red and NIR light, it appears reasonable to extend the current tests and investigate the clearance of Ab by combinations of wavelengths, in particular 670 nm and NIR. Expectedly, the functional interplay and complementary effects of laser irradiation and drug treatment are not restricted to the drug EGCG, but might also be an interesting combination for other therapeutic compounds.…”