The Probable Protective Effect of Photobiomodulation on the Inflammation of the Airway and Lung in COVID-19 Treatment: A Preclinical and Clinical Meta-Analysis

Raji, Hanieh; Arjmand, Babak; Rahim, Fakher

doi:10.1007/5584_2021_665

Part of the book series: Advances in Experimental Medicine and Biology ((CBTMED,volume 1376))

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Abstract

Preliminary studies also show that many of the fatalities of COVID-19 are due to over-activity of the immune system, and photobiomodulation (PBM) therapy mainly accelerates wound healing and reduces pain and inflammation. Therefore, this systematic review and meta-analysis was conducted to evaluate the probable effect of the PBM therapy on the lung inflammation or ARDS and accelerate the regeneration of the damaged tissue. We systematically searched major indexing databases, including PubMed/Medline, ISI web of science (WOS), Scopus, Embase, and Cochrane central, using standard terms without any language, study region, or type restrictions. Of the 438 studies found through initial searches, 13 met the inclusion criteria. After applying the exclusion criteria, the main properties of 13 articles on 384 animals included in this meta-analysis with a wide range of species include rat (n = 10) and rabbit (n = 3). The analysis revealed that PBM therapy reduced TNFα (SMD:-3.75, 95% CI: −4.49, −3.02, P < 0.00001, I² = 10%), IL-1β (SMD:-4.65, 95% CI: −6.15, −3.16, P < 0.00001, I² = 62%), and IL-6 (SMD:-4.20, 95% CI: −6.42, −1.97, P = 0.0002, I² = 88%) significantly compared with the model controls. Hence, PBM therapy increased IL-10 significantly compared with the model controls (SMD:-4.65, 95% CI: −6.15, −3.16, P < 0.00001, I² = 62%). PBM therapy also reduced MPO activity (SMD:-2.13, 95% CI: −3.38, −0.87, P = 0.0009, I² = 64%) and vascular permeability (SMD:-2.59, 95% CI: −4.40, −0.77, P = 0.0052, I² = 71%) in the lung using the Evans blue extravasation technique significantly compared with the model controls. This systematic review and meta-analysis revealed that the PBM therapy does utilize beneficial anti-inflammatory effect, modulation of the immune system, lung permeability, or bronchoalveolar lavage on lung damage in both animal models and clinical studies. However, animal model and clinical studies appear limited considering the quality of the included evidences; therefore, large clinical trials are still required.

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Abbreviations

ARDS :: Acute respiratory distress syndrome
BALF :: Bronchoalveolar lavage fluid
LLLT :: Low-level laser therapy
MERS :: Middle East respiratory syndrome
MOOSE :: Meta-analyses of Observational Studies in Epidemiology
MPO :: Myeloperoxidase
PBM :: Photobiomodulation
PML :: Pulmonary microvascular leakage
PRISMA :: Preferred Reporting Items for Systematic Reviews and Meta-analyses
SARS :: Severe acute respiratory syndrome
SARS-CoV-2 :: Severe acute respiratory syndrome coronavirus 2
SD :: Standard deviation
SMD :: Standardized mean difference
WOS :: ISI web of science

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Acknowledgments

This work was supported by the Air Pollution and Respiratory Diseases Research Center affiliated by Deputy of Research, Ahvaz Jundishapur University of Medical Sciences.

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This research was approved by the Ethics Committee of Ahvaz Jundishapur University of Medical Sciences.

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Systematic review and meta-analysis.

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Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Hanieh Raji
Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Babak Arjmand
Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Babak Arjmand & Fakher Rahim
PhD in Clinical Bioinformatics, Health Research Institute, Thalassemia and Hemoglobinopathies Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Fakher Rahim

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(emeritus) Ottawa Hospital Research Institute, Ottawa, ON, Canada
Kursad Turksen

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Raji, H., Arjmand, B., Rahim, F. (2021). The Probable Protective Effect of Photobiomodulation on the Inflammation of the Airway and Lung in COVID-19 Treatment: A Preclinical and Clinical Meta-Analysis. In: Turksen, K. (eds) Cell Biology and Translational Medicine, Volume 15. Advances in Experimental Medicine and Biology(), vol 1376. Springer, Cham. https://doi.org/10.1007/5584_2021_665

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DOI: https://doi.org/10.1007/5584_2021_665
Published: 16 December 2021
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