Photobiomodulation as complementary therapy in the treatment of diabetic wounds: effects on exteroceptive pain sensitivity, healing process and possible molecular mechanisms

• Grant number: 18/18483-1
• Support Opportunities: Scholarships in Brazil - Doctorate
• Effective date (Start): January 01, 2019
• Effective date (End): December 15, 2023
• Field of knowledge: Biological Sciences - Physiology - General Physiology
• Principal Investigator: Camila Squarzoni Dale
• Grantee: Victória Regina da Silva Oliveira
• Host Institution: Instituto de Ciências Biomédicas (ICB). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated scholarship(s): 21/12393-3 - Effects of Photobiomodulation-activated TGF-B1 on MMP-9 mediated endothelial cell responses under hyperglycemic conditions, BE.EP.DR

Abstract

Diabetes Mellitus (DM) affects about 425 million people worldwide and Brazil currently occupies the fourth position. Among the various complications, diabetic patients are frequently affected by ulcers, responsible for about 60% of non-traumatic lower limb amputations, resulting in high morbidity and mortality, with significant losses in quality of life and with great socioeconomic impact. Conventional treatment for diabetic wounds is restricted to curative and debridement, which in addition to being painful, are generally long and depend on the active collaboration of patients, and it is necessary to develop additional treatment protocols capable of generating more benefits for these patients in the short time. Furthermore, it has been demonstrated that gene polymorphisms for matrix-9 metalloproteinase (MMP-9) in diabetic patients may be related to a greater susceptibility to the development of wounds and ulcers. Photobiomodulation therapy (PBM) has positive effects on the reduction of painful symptoms and cellular proliferation, favoring tissue repair and wound healing in diabetic patients. However, its mechanisms of action and treatment protocols are still very controversial in the literature. Therefore, knowing the genotypic profile of diabetic patients as well as studying the mechanisms involved in the effect of PBM on the healing of diabetic ulcers is of great importance for the development of specific treatment protocols with better short-term results. Considering that laser is a low cost therapy and does not present side effects, it is possible to generate direct changes in the treatment of these patients, reinforcing the use of PBM as an important tool for the clinical treatment of pain symptomatology and healing of wounds in diabetic patients. Based on this, this project aims to: a) to evaluate the therapeutic effect of PBM on exteroceptive sensitivity and wound healing in diabetic patients; b) to correlate the polymorphisms for the MMP-9 -1562 C/T gene with the development of wounds and prognosis of treatment of diabetic patients evaluated by PCR-RFLP; c) to evaluate, in vitro, the effect of PBM on matrix metalloproteinase concentration (MMP-9) by ELISA and on the healing profile by detecting VEGF, IL-6, IL-10 and TIMP-1 by western blotting, and d) to evaluate the involvement of PBM in the activation of the Erk1/2 and JNK-MAPK pathways in keratinocyte cultures of diabetic patients. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

ALONSO-MATIELO, HELOISA; GONCALVES, ELIZAMARA S.; CAMPOS, MARIANA; OLIVEIRA, VICTORIA R. S.; TONIOLO, ELAINE F.; ALVES, ADILSON S.; LEBRUN, IVO; DE ANDRADE, DANIEL C.; TEIXEIRA, MANOEL J.; BRITTO, LUIZ R. G.; et al. Electrical stimulation of the posterior insula induces mechanical analgesia in a rodent model of neuropathic pain by modulating GABAergic signaling and activity in the pain circuitry. Brain Research, v. 1754, MAR 1 2021. (17/25399-4, 15/17136-8, 18/18483-1, 17/07411-7, 15/23522-8)

ALONSO-MATIELO, HELOISA; DA SILVA OLIVEIRA, VICTORIA REGINA; DE OLIVEIRA, VICTHOR TEIXEIRA; DALE, CAMILA SQUARZONI. Pain in Covid Era. FRONTIERS IN PHYSIOLOGY, v. 12, FEB 2 2021. (17/25399-4, 18/18483-1)