Interesting Info on the RSRP - Low Level Light Therapy

[redhotoz]

From the Yahoo Rosacea Support Group, the Rosacea Support Research Pages (RSRP) just up-dated the page they have, which is titled "Red LED Lamps & Other Forms of Low-Level Light Therapy". Here's the link:

http://rosacea-research.org/wiki/index.php/Red_LED_Lamps_&_Other_Forms_of_Low-Level_Light_Therapy

I have copied it over but the links will not work. So if you are interested, please click on the RSRP link above to check it out further.

Many rosaceans find that treatment with all-red LED lamps provides relief from their rosacea symptoms. Studies suggest that low-level light in certain ranges, particularly the red range, from LED lamps and also from low-level lasers, has an anti-inflammatory effect.

From the following article discussing the inflammatory theory of rosacea:

Examining Inflammation as a Common Factor in Theories of Rosacea Pathophysiology

"Recent research has shown an increase of specific proinflammatory cytokines, including tumor necrosis factor (TNF-α) and interleukin (IL-1β), in biopsies of inflammatory lesions from acne patients.9 These cytokines trigger a chain of chemical responses in the body, including the release of certain matrix metalloproteinases (MMPs); specifically, MMP-1, -3, and -9.10,11 These MMPs are involved in collagen matrix degradation and inflammatory damage. The likely result is the development of papulopustular lesions. Owing to the similarities between these lesions in acne and rosacea, this evidence offers insight into the inflammatory nature of rosacea.

Two additional inflammatory mediators thought to incite the symptoms of rosacea are reactive oxygen species (ROS) and nitric oxide (NO). Clinical trial evidence reports that patients with severe rosacea have a reduced capacity to counter the negative effects of ROS; thus, experiencing an increased inflammatory response.11,12 This may also explain the connection between photodamage and rosacea since sun exposure is known to induce the release of ROS which subsequently activates MMPs.13 The role of NO involves vascular changes and is believed to be partially responsible for the erythema, edema, and telangiectatic symptoms of rosacea.11,13 Vasodilation plausibly results in vascular instability leading to increased vessel permeability, edema, and fixed vessels. This may worsen with increased sun exposure as an increase of NO in the keratinocytes has been linked with UVB rays.9"


Thus, according to the inflammatory theory of rosacea, since TNF-a (tumor necrosis factor) stimulates many of the other cytokines and enzymes involved in the inflammatory process and also in much of the tissue destruction we see with rosacea, decreasing TNF-a levels should theoretically help minimize the increased symptoms of inflammation we see with rosacea. Studies seem to support claims that low-level light therapy reduces levels of TNF-a.

Also, according to the inflammatory theory of rosacea, since rosaceans have a reduced capacity to counter the negative effects of reactive oxygen species (ROS), increasing levels of superoxide dismutase (SOD), which is key in the process of clearing ROS, should theoretically help to prevent or even reduce some of the damaging effects ROS has on rosacea affected tissues. Studies so far indicate that low-level light therapy increases levels of SOD. (See the page on GliSODin for more information about the effects of SOD on ROS).


Useful links:

Rosacea News:Light Emitting Diode-Based Therapy
Low-level laser therapy can reduce lipopolysaccharide-induced contractile force dysfunction and TNF-alpha levels in rat diaphragm muscle
Low-level laser therapy induces dose-dependent reduction of TNFalpha levels in acute inflammation
Effect of low intensity laser light in the red range on macrophage superoxide dismutase activity

I haven't highlighted any text, as I believe anyone who is interested will click on the first link and then the further links provided. I do hope this inspires some interesting discussion here on the Forum.

Please, please, please...I am so tired of the personal attacks when trying to discuss this topic. So please, please, please, let's keep it on topic!

Jen

[Twickle Purple]

Thanks for the info and links Jen.

I was reading up on metronidazole (http://www.skintherapyletter.com/2006/11.2/1.html) and I was struck by two general statements regarding Rosacea:

"Rosacea is one of the most common conditions seen by dermatologists. Its etiology and pathogenesis are unknown despite its high prevalence."

...

"In their review of randomized controlled trials of patients with moderate-to-severe rosacea in the Cochrane Database of Systemic Reviews, van Zuuren, et al. concluded that topical metronidazole is more effective than placebo, but that the quality of studies evaluating rosacea treatments was generally poor, and that good randomized controlled trials that include quality of life assessments are needed."

I found that last bit frustrating. If there are so many of us I would think that the opposite would be the case. I can only guess that it's because the Rosacea manifestation and treatment is so different for many of us. Maddening.

--

Thus, according to the inflammatory theory of rosacea, since TNF-a (tumor necrosis factor) stimulates many of the other cytokines and enzymes involved in the inflammatory process and also in much of the tissue destruction we see with rosacea, decreasing TNF-a levels should theoretically help minimize the increased symptoms of inflammation we see with rosacea. Studies seem to support claims that low-level light therapy reduces levels of TNF-a.

In regards to the TNF reference in your posted article (in italics above), in my reading on Enbrel (a tumor necrosis factor (TNF) blocker) I came across another study on LLLT specific to TNF (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16503786&query_hl=3&itool=pubmed_docsum):

OBJECTIVE: The aim of this study was to investigate if low-level laser therapy (LLLT) can modulate acute inflammation and tumor necrosis factor (TNFalpha) levels.

BACKGROUND DATA: Drug therapy with TNFalpha-inhibitors has become standard treatment for rheumatoid arthritis, but it is unknown if LLLT can reduce or modulate TNFalpha levels in inflammatory disorders.

METHODS: Two controlled animal studies were undertaken, with 35 male Wistar rats randomly divided into five groups each. Rabbit antiserum to ovalbumin was instilled intrabronchially in one of the lobes, followed by the intravenous injection of 10 mg of ovalbumin in 0.5 mL to induce acute lung injury. The first study served to define the time profile of TNFalpha activity for the first 4 h, while the second study compared three different LLLT doses to a control group and a chlorpromazine group at a timepoint where TNFalpha activity was increased. The rats in LLLT groups were irradiated within 5 min at the site of injury by a 650-nm Ga-Al-As laser.

RESULTS: There was a time-lag before TNFalpha activity increased after BSA injection. TNFalpha levels increased from < or =6.9 (95% confidence interval [CI], 5.6-8.2) units/mL in the first 3 h to 62.1 (95% CI, 60.8-63.4) units/mL (p < 0.001) at 4 h. An LLLT dose of 0.11 Joules administered with a power density of 31.3 mW/cm(2) in 42 sec significantly reduced TNFalpha level to 50.2 (95% CI, 49.4-51.0), p < 0.01 units/mL versus control. Chlorpromazine reduced TNFalpha level to 45.3 (95% CI, 44.0-46.6) units/mL, p < 0.001 versus control.

CONCLUSION: LLLT can reduce TNFalpha expression after acute immunocomplex lung injury in rats, but LLLT dose appears to be critical for reducing TNFalpha release.

--

My footnote to the above: RLT has the same benefits as laser just none of the drawbacks, according to Dr. Tiina Karu (http://www.redlighthealing.com/facts.htm) a renowned expert in this field of study.

"Monochromatic single wavelength light can only be produced in two ways - Low Power/Cold Laser (coherent light) or with a powerful light-emitting diode, LED (non-coherent light). Although much of the low power laser research is directly applicable to the use of LED's, LED's non-coherent light is entirely safe."

"Dr Tiina Karu, of the Laser Technology Centre of Russia, found in the late 80's that the non-coherent light (LED's) was found to be as effective as coherent light and without the risk associated with cold lasers."

[Steve95301]

Well, nobody's responded, so I'll give it a go.

This is a very new addition (http://rosacea-research.org/wiki/index.php/Special:Recentchanges) to the wiki, Oct 27/28 to be precise.

I think the author makes two very good points in his/her analysis, but also fails to make two major points.

First, the good points:

Thus, according to the inflammatory theory of rosacea, since TNF-a (tumor necrosis factor) stimulates many of the other cytokines and enzymes involved in the inflammatory process and also in much of the tissue destruction we see with rosacea, decreasing TNF-a levels should theoretically help minimize the increased symptoms of inflammation we see with rosacea. Studies seem to support claims that low-level light therapy reduces levels of TNF-a.

Good point. This should be added to the master list of things to investigate.

Also, according to the inflammatory theory of rosacea, since rosaceans have a reduced capacity to counter the negative effects of reactive oxygen species (ROS), increasing levels of superoxide dismutase (SOD), which is key in the process of clearing ROS, should theoretically help to prevent or even reduce some of the damaging effects ROS has on rosacea affected tissues. Studies so far indicate that low-level light therapy increases levels of SOD. (See the page on GliSODin for more information about the effects of SOD on ROS).

Second good point, somewhat better than the first. Undoubtedly, increased SOD levels, countering ROS, would be a great benefit to rosaceans.

Now, the two elephants in the room:

Recent research has shown an increase of specific proinflammatory cytokines, including tumor necrosis factor (TNF-α) and interleukin (IL-1β), in biopsies of inflammatory lesions from acne patients.9 These cytokines trigger a chain of chemical responses in the body, including the release of certain matrix metalloproteinases (MMPs); specifically, MMP-1, -3, and -9.10,11 These MMPs are involved in collagen matrix degradation and inflammatory damage. The likely result is the development of papulopustular lesions. Owing to the similarities between these lesions in acne and rosacea, this evidence offers insight into the inflammatory nature of rosacea.

Two additional inflammatory mediators thought to incite the symptoms of rosacea are reactive oxygen species (ROS) and nitric oxide (NO). Clinical trial evidence reports that patients with severe rosacea have a reduced capacity to counter the negative effects of ROS; thus, experiencing an increased inflammatory response.11,12 This may also explain the connection between photodamage and rosacea since sun exposure is known to induce the release of ROS which subsequently activates MMPs.13 The role of NO involves vascular changes and is believed to be partially responsible for the erythema, edema, and telangiectatic symptoms of rosacea.11,13 Vasodilation plausibly results in vascular instability leading to increased vessel permeability, edema, and fixed vessels. This may worsen with increased sun exposure as an increase of NO in the keratinocytes has been linked with UVB rays.

Now I knew NO was bad for rosaceans, but I had no idea it was this bad. Apparently it "involves vascular changes" and is partially responsible for "erythema, edema, and telangiectatic symptoms of rosacea."

Same goes for vasodilation. I knew it was bad, but I didn't know that it could "plausibly" result in "vascular instability leading to increased vessel permeability, edema, and fixed vessels."

Since LLLT increases NO levels and produces vasodilation, I don't understand why the author would fail to mention this in his/her analysis.

[Tricia]

Steve,

You bring up some good points and I too would be interested to know the relationship between LLLT and NO production. I currently use the all red Acne Lamp and while I think it does help, I can never be certain because I'm also under going laser treatments. Or maybe my progress would be better off without it? Who knows!

I am more interested in the TNF factor as there are very effective drugs out now for psiorasis that inhibit it. They would be relatively to test out as they are already FDA approved.......just a point of convincing a doctor to give it a try. Not too likely in this lawsuit happy world.

Seriously, wjy aren't people studying things like this for rosacea? Why isn't anything being studied except for new forms of Metrogel and Doxy? It just pisses me off!



Tricia

[clsykes00]

Seriously, wjy aren't people studying things like this for rosacea? Why isn't anything being studied except for new forms of Metrogel and Doxy? It just pisses me off!


In my opinion, the answer is simple; insurance companies do not cover treatments for rosacea. Therefore, the big pot of gold does not exist for drug companies/medical device companies/researchers.

[Guest]

Hi Steve,

I don't normally post over here, but I wanted to answer your question about NO level as it is a really good one. I put together the RLT info per a bunch of recent posts here and on the RSG about a potential mechanism of action for rosacea.

First of all, please understand that I have no medical background whatsoever. I've just done some googling on inflammation and try to stick to studies that seem to have some scientific merit. That said, here's my take on this:

Nitric oxide's role in inflammation is fairly complex and I'm not sure it is yet completely understood (or widely agreed upon). Still, some studies seem to suggest that most of the damage attributed to nitric oxide is actually caused by peroxynitrite, a powerful oxidant which is formed when nitric oxide combines with superoxide :

http://www.biochemsoctrans.org/bst/033/1394/bst0331394.htm#SCH1
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12102657&dopt=Abstract


Apparently superoxide dismutase and nitric oxide compete with each other to combine with nitric oxide:

http://bmc.ub.uni-potsdam.de/1476-5926-2-2/F1.htm

So potentially (and I'm theorizing here), as RLT increases levels of superoxide dismutase (SOD), the SOD combines with much of the superoxide radicals, letting NO levels temporarily increase (since they can't combine with the superoxide to form peroxynitrte anymore) until the TNF-a decreasing effects also kick in and NO induction is also reduced.

I'm wondering if this might explain some of the temporary increases in flushing some have mentioned as well (since they nitric oxide levels do seem to increase at least temporarily).

Anyway, hope this helps. It's certainly not definitive, and I'm certainly no expert, but it may help to explain how RLT seems to help some rosaceans.

Take care,
Dan (aka dfries2003)

[Tricia]

Dan,

Very interesting stuff! I'm confused though, would SOD be considered a good thing because it competes with the NO or a bad thing because it can also increase vasodilation?

I and many others are taking Glisodin and I'm wondering if this is ok?

And whoever mentioned the comment about the money not being there for drug that is a good point. However, new drugs come to market all the time for many diseases that end up being covered. I think the drug companies/doctors just feel that rosacea is pretty much a maintenance disease and have no idea of the severity of it and suffering it brings.

We need a good spokesperson!

Tricia

[Guest]

Hi Tricia,

Again, I don't have a medical background, but I belive GliSODin is beneficial. And I take GliSODin as well and find it very helpful. It seems to be a strong antioxidant that helps to clean up after all the reactive oxygen species (ROS) that are created in the chronic inflammation we seem to have with rosacea. It evidently does this along with catalase and glutathione peroxidase:

http://rosacea-research.org/wiki/index.php/GliSODin

As you can see by the above post too, SOD may also compete with nitric oxide in this process, to help prevent some of the damaging effects that peroxynitrite also seems to cause when it also tries to combine with the superoxide radicals itself.

Again, the info on nitric oxide is all kind of theoretical, and this is one reason I didn't want to include it in the RSRP. Still, I thought it might help to potentially explain Steve's questions...

Dan