What is the best treatment to decrease pro-inflammatory cytokine release in acute skeletal muscle injury induced by trauma in rats: low-level laser therapy, diclofenac, or cryotherapy?

Abstract

Currently, treatment of muscle injuries represents a challenge in clinical practice. In acute phase, the most employed therapies are cryotherapy and nonsteroidal anti-inflammatory drugs. In the last years, low-level laser therapy (LLLT) has becoming a promising therapeutic agent; however, its effects are not fully known. The aim of this study was to analyze the effects of sodium diclofenac (topical application), cryotherapy, and LLLT on pro-inflammatory cytokine levels after a controlled model of muscle injury. For such, we performed a single trauma in tibialis anterior muscle of rats. After 1 h, animals were treated with sodium diclofenac (11.6 mg/g of solution), cryotherapy (20 min), or LLLT (904 nm; superpulsed; 700 Hz; 60 mW mean output power; 1.67 W/cm(2); 1, 3, 6 or 9 J; 17, 50, 100 or 150 s). Assessment of interleukin-1β and interleukin-6 (IL-1β and IL-6) and tumor necrosis factor-alpha (TNF-α) levels was performed at 6 h after trauma employing enzyme-linked immunosorbent assay method. LLLT with 1 J dose significantly decreased (p < 0.05) IL-1β, IL-6, and TNF-α levels compared to non-treated injured group as well as diclofenac and cryotherapy groups. On the other hand, treatment with diclofenac and cryotherapy does not decrease pro-inflammatory cytokine levels compared to the non-treated injured group. Therefore, we can conclude that 904 nm LLLT with 1 J dose has better effects than topical application of diclofenac or cryotherapy in acute inflammatory phase after muscle trauma.

Effects of Photobiomodulation on Functionality in Wistar Rats with Sciatic Nerve Injury

“…The positive effects of LLLT on the muscle repair process after different types of injury are well established in the literature and include an improvement in collagen remodeling, modulation of the gene expression of myogenic regulatory factors, increases in the number of immature fibers and angiogenesis and a reduction in the tissue concentration of pro‐inflammatory cytokines . However, varied effects are achieved depending on the administration parameters, such as enhanced functioning , improvements in range of motion , the attenuation of dysesthesia and modulation of the concentration of inflammatory cytokines .…”

Photobiomodulation with 660-nm and 780-nm laser on activated J774 macrophage-like cells: Effect on M1 inflammatory markers

“…In animal models, photobiomodulation has been found to reduce the expression of TNF-α [17,41,42], IL-1β [15,41,42], IL-6 [41,42], COX-2 [43,44], iNOS [45,46] and NFκβ [45]. As macrophages are the key cells in the muscle repair process, the results presented herein suggest that the in vivo effects of photobiomodulation may be largely dependent on these cells and could indicate new therapeutic possibilities, not only for muscle injuries [1–8].…”

Pre-exercise low-level laser therapy improves performance and levels of oxidative stress markers in mdx mice subjected to muscle fatigue by high-intensity exercise

“…Several studies have demonstrated that low-level laser therapy (LLLT) has analgesic effects [11][12][13], modulates the levels of inflammatory mediators, and has anti-inflammatory effects [14][15][16]. Furthermore, recent animal studies [17][18][19] and human studies [10,20,21] have hinted at the possibility of LLLT in lowering the levels of CK, other muscle damage markers, and oxidative stress after exercise.…”