The effect of combined pulsed wave low‐level laser therapy and mesenchymal stem cell‐conditioned medium on the healing of an infected wound with methicillin‐resistant Staphylococcal aureus in diabetic rats

Abstract

This study aims to investigate the combined effects of Pulsed wave low-level laser therapy (PW LLLT) and human bone marrow mesenchymal stem cell-conditioned medium (hBM-MSC-CM) on the microbial flora and tensiometrical properties of an infected wound model with methicillin-resistant staphylococcal aureus (MRSA) in an experimental model for Type 1 diabetes mellitus (TIDM). TIDM was induced in rats by streptozotocin (STZ). One full-thickness excision was made on the backs of the rats. Next, the rats were divided into the following groups: Group 1 was the control (placebo) group; Group 2 received hBM-MSCs-CM four times; Group 3 were laser PWLLLT (890 nm, 80 Hz, 0.2 J/cm ); and Group 4 received hBM-MSCs-CM +LASER. Wounds were infected with MRSA. Microbiological examinations were performed on days 4, 7, and 15. Tensiometerical examinations were carried out on the 15th day. One-way analysis of variance showed that laser and CM alone and/or in combination significantly increases the tensiomerical properties of the repaired wounds compared with control wounds. A combination of PW laser and CM was statistically more effective than other treated groups. Two-way analysis of variance showed that laser and CM alone and/or in combination significantly decreases the colony-forming units (CFUs) compared with the control group. The application of hBM-MSC-CM and PWlaser alone and/or together significantly accelerates the wound-healing process in MRSA-infected cutaneous wounds in TI DM in rats. Additionally, a combined application of hBM-MSC-CM and PWlaser demonstrates a synergistic effect on the wound-healing process in MRSA-infected cutaneous wounds in Type I DM rats.

Photobiomodulation plus Adipose-derived Stem Cells Improve Healing of Ischemic Infected Wounds in Type 2 Diabetic Rats

“…We used the MRSA strain ATCC 25923. The procedure was fully described in our previous study 28,29 . A single colony of MRSA was inoculated into liquid medium to a final concentration of 2 × 10 8 cells/mL.…”

“…In these animal studies, the researchers administered Streptozotocin to create a rat model of DM1. In the first study, Kouhkheil et al reported the positive impacts of single or dual administration of photobiomodulation (890 nm, 80 Hz, 0.2 J/cm 2 ) and/or hBMMSC-conditioned medium (4 injections) on CFU and wound strength of a MRSA infected wound model in DM1 rats 28 . In the second study, Fridoni et al reported the beneficial effect of single or dual administration of photobiomodulation (890 nm, 80 Hz, 0.2 J/cm 2 ) and/or conditioned medium from hBMMSC (four injections) on stereological parameters in an MRSA infected wound model in DM1 rats 29 .…”

“…The authors showed that photobiomodulation (890 nm, 80 Hz, 0.324 J/cm 2 ) meaningfully hastened the repair of injured skin at the maturation step and significantly decreased colony forming units (CFUs) of bacteria in a non-genetic model of DM2 in rats 26 .More than 100 recognized factors are involved in the insufficiency of wound healing in patients with DM2 27 . The use of a mixture of therapeutic agents and biological biostimulators could assist with treatment of non-healing wounds and show a synergistic effect to improve the success of healing in different wound models [28][29][30] .In the present study we focused on the effects of photobiomodulation and ADS, alone and combined, on the maturation step of an ischemic, delayed healing, infected wound model in DM2 rats. The combined application of photobiomodulation and ADS could hasten the healing process and provide a treatment for severe cases of DFUs in patients with DM2.…”

“…More than 100 recognized factors are involved in the insufficiency of wound healing in patients with DM2 27 . The use of a mixture of therapeutic agents and biological biostimulators could assist with treatment of non-healing wounds and show a synergistic effect to improve the success of healing in different wound models [28][29][30] .…”

Combined therapy of photobiomodulation and adipose-derived stem cells synergistically improve healing in an ischemic, infected and delayed healing wound model in rats with type 1 diabetes mellitus

“…The outcomes of these experiments showed that PBM+CM prompted anti-inflammatory and angiogenic actions, and accelerated skin injury repair in a DM1 simulation of an MRSA-infected skin injury 30. The combination of CM and PBM revealed a synergistic influence 31. Here, we intend to assess the impact of PBM and ADS treatments, alone and in combination, on the maturation step of a repair course of ischemic, delayed healing, and infected wound simulations in rats with DM1.…”