A Basic Guide To The Cells Which Are Affected By Low Level Laser Therapy

In this article I will refer to low level laser therapy as lllt. Before, we touched on how low level laser therapy works, now we can begin to look at the different cells that lllt affects and at what stage in the healing process these cells are key. 

In using lllt we can set different pulsating frequencies according to what our patient needs. For example for the treatment of wrinkles we would consider using the wavelength that would encourage the production and healing of fibroblasts as they produce collagen. Using different wavelengths can also activate, stimulate or inhibit certain cells, enabling a more specialised treatment.

Fibroblasts

There are four main types of tissue; nervous, connective, epithelial and muscle. Fibroblasts are found in connective tissue which is the structural framework of animal cells. They produce collagen and elastic fibres. Fibroblasts are essential in the two stages of healing; the proliferative stage and the re-modeling stage.  Using lllt can stimulate fibroblasts which encourage the formation of new fibres and secretion of collagen proteins. This ultimately aids in strengthening, building and the realigning of tissue.

Macrophage

Macrophage are white blood cells which are the first line of defence against foreign material, cellular debris and pathogens, this includes cancer and tumour cells. They attack and break up the foreign substances leaving way for other cells (lymphocytes) to destroy and complete the process. Macrophage also stimulate lymphocytes (which destroy foreign material) and other immune cells in the immune system.  Macrophage play an important role in all three stages of healing; the acute inflammatory phase, the proliferative stage and the re-modeling stage. Using lllt to stimulate macrophage is paramount as it encourages the destruction of foreign material and cellular debris, clearing the way for new cells to form.

Lymphocytes

Lymphocytes are similar to Macrophage. They are white blood cells within the immune system and are natural killer cells, they complete the process of destroying foreign material, cellular debris and pathogens.

Leukocytes

Leukocytes (also known as white blood cells) are made by bone marrow and the thymus, some of which can develop into macrophage when faced with cellular debris as indicated above. They are found in the blood and in the lymphatic system and are independent, living-cell organisms which ultimately defend the body against infectious disease and foreign material. Stimulating these cells with lllt is important, because like the macrophage they are important in the destruction of foreign material and cellular debris.

Mast Cells

Mast cells belong to a group of Leucocytes which act out a protective role within the immune system. Primarily they act as a warning system and when confronted with injury or infection they release chemicals and cause inflammation; these chemicals are called Histamine and Heparin. Histamine causes capillary walls to become more permeable and let substances through whereas Heparin prevents blood from clotting and allows blood to flow freely to the area of injury or infection. Mast cells are key in the acute inflammatory stage and stimulation of these cells by lllt enforces their protective role in the fight against pathogens.

Platelets

In the event of a wound, the body’s first reaction is to send platelets to the affected area to stop the bleeding. Lllt can assist in this by focusing a very high pulsating frequency to inhibit the bleeding.

Neutrophils

Neutrophils are the most common type of white blood cells and are found in the blood stream. They are plentiful and fast acting, arriving at the scene of infection within the hour. They are the predominant cells in pus which accounts for the whitish colour. Neutrophils are important in the acute inflammatory phase and using lllt can strengthen the cells in attacking invading pathogens.

Keratinocytes

Keratinocytes are predominant cells in the epidermis and form a barrier against pathogens, heat, uv light and water loss. Renewal of these cells is between 21 – 30 days. Keratinocytes are important within the second stage of healing; the proliferative phase. Lllt can strengthen these cells and help in forming the barrier against pathogens, heat, uv and water loss.

Myofibroblasts

Myofibroblasts are cells that have characteristics of a smooth muscle cell. They aid in the alignment of collagen fibres and strengthen wounds by contracting the wound edges in the proliferative phase. Using lllt can transform fibroblasts into Myofibroblasts.

Endothelium

These cells line the interior surface of blood vessels throughout the circulatory system. They enable the blood to be pumped further by decreasing turbulence and are important in the proliferative phase and the re-modeling stage.

Osteoblasts

Osteoblasts are actually specialised fibroblasts which form bones, this is because they primarily produce collagen. Osteblasts decrease with age but can constantly remodel due to the minerals that they get. Using lllt on bones, especially within fractures and breaks, can encourage the production of osteoblasts therefore speeding up the healing process and of course stimulating the process if for some reason the bone is not mending.

In conclusion there are many cells which can be affected and influenced by lllt. When treating it is not just a case of stimulating all of these cells, it needs careful consideration as to which cells we need to activate, stimulate or inhibit, how deep within the tissue we need to reach and for what length time would be needed to achieve optimum results.

By Kate Wakefield

How Low Level Laser Therapy Works

For those of you wishing to understand some of the science behind how low level laser works, then this article will hopefully shed some light. I have tried to explain this process in a way that can be easily understood.  In the article I will refer to low level laser therapy as lllt.

Mitochondria are found within cells and are also know as the cells ‘power house’ as they generate and supply ATP (energy). Within the mitochondria you will find cytochrome c oxidase which is an enzyme. The cytochrome c oxidase absorbs electrons from food and attaches them to oxygen which in turn produces ATP. When the mitochondria are stressed it produces mitochondria nitric oxide which displaces oxygen from the cytochrome c oxidase. This reduction of oxygen inhibits production of ATP and leads to a build up of oxidative stress. Oxidative stress is damage to the cells from free radicals.

Cytochrome c oxidase is the major absorber of red and near infared light and so when the light is applied, the mitochondria nitric oxide is displaced and thus increases ATP production and decreases oxidative stress. Anti-inflammatory effects are also seen from the displacement of the mitochondria nitric oxide.

The absorption of light also causes intercellular effects such as an increased exchange of calcium, enzyme activation and secretion of growth factors. The cells that are affected are neutorphils, macrophages, fibroblasts, mast cells, endothelial cells, keratincytes and lymphocytes which are all essential to the immune system and for tissue regeneration.

Lllt therapy can also produce a reaction within other cells that are far away from the local area of treatment. Once the light has been absorbed by the cytochrome c oxidase, photons can be secreted and travel through the blood to other areas. Another effect of lllt is analgesia (pain relief) where using an inhibiting pulsating frequency, as opposed to a stimulating frequency,  can reduce ATP production which in turn produces a nerve block. It should be noted however that although an analgesic effect can be extremely beneficial to the patient, getting to the primary cause of the problem should be the target to provide long lasting benefit. However when treating patients with hereditary diseases, such as arthritis, providing pain relief would be favorable.

By Kate Wakefield

Equine Biomechanics and Other Interesting Stories

The course with Gillian Higgins was excellent. Many topics were covered which ranged from bones to muscles, conformation to asymmetrical riders and horses and then to top it all off a bit of history about the army. It is here I might add that the course was situated in the Animal Defence Centre, Melton Mowbray. This is where the Kings Troop's horses come for their vacation where they either get turned away or hunt for the winter season. Also the army's farriers perform most of their training here to become a farrier. On our tour around the centre we were told that the horses take the rank of their mount, so for example if the solider was a corporal, the horse would be a corporal and if the solider was a sergeant the horse would be a sergeant. Another interesting fact is a tradition that has lasted since Napoleonic times. It is said that in the battles, soldiers used to tell their superiors that their horses had died (even though their horses were still alive) just so they could receive money to buy another horse. So to stop this fraud a new rule was passed that if your horse died in battle, you must remove the feet with an ax, therefore proving to the superiors that your horse had actually died. Still to this day if an army horse dies, the legs are removed from the knee down and kept for veterinary specimens. In a ceremonial  march, if you glance at the back you, will still see a solider carrying double headed ax, one with an ax head and one with a spike. The spike for killing the horse in battle (like they used to do in Napoleonic times if the horse was seriously injured) and the ax for removing the feet. It is just amazing the traditions that we hold and truly fascinating.

'Biomechanics' course with 'Horses Inside Out'

On the 10th and 11th of September I will be attending Gillian Higgins's 'Biomechanics' course in Melton Mowbray, Leicestershire. The course will cover the horse's anatomy, tendons and ligaments, posture, strength and suppleness and how an asymmetrical rider can affect the horse's way of going.

What makes this course so special is that the skeletal and muscular frame will actually be painted onto the horse which will show how the muscles and bones work together.

I am really looking forward to the course and will let you know how I get on!