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PBMT and topical diclofenac as single and combined treatment on skeletal muscle injury in diabetic rats: effects on biochemical and functional aspects

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Abstract

Physical exercise generates several benefits in a short time in patients with diabetes mellitus. However, it can increase the chances of muscle damage, a serious problem for diabetic patients. Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used to treat these injuries, despite the serious adverse effects. In this way, photobiomodulation therapy (PBMT) with low-level laser therapy (LLLT) and/or light emitting diode therapy (LEDT) can be used as an alternative in this case. However, its efficacy in tissue repair of trauma injuries in diabetes mellitus until now is unknown, as well as the combination between PBMT and NSAIDs. The objective of the present study was to evaluate the effects of NSAIDs and PBMT applied alone or combined on functional and biochemical aspects, in an experimental model of muscle injury through controlled trauma in diabetic rats. Muscle injury was induced by means of a single trauma to the animals’ anterior tibialis muscle. After 1 h, the rats were treated with PBMT (830 nm; continuous mode, with a power output of 100 mW; 3.57 W/cm2; 3 J; 107.1 J/cm2, 30 s), diclofenac sodium for topical use (1 g), or combination of them. Our results demonstrated that PBMT + diclofenac, and PBMT alone reduced the gene expression of cyclooxygenase-2 (COX-2) at all assessed times as compared to the injury and diclofenac groups (p < 0.05 and p < 0.01 respectively). The diclofenac alone showed reduced levels of COX-2 only in relation to the injury group (p < 0.05). Prostaglandin E2 levels in blood plasma demonstrated similar results to COX2. In addition, we observed that PBMT + diclofenac and PBMT alone showed significant improvement compared with injury and diclofenac groups in functional analysis at all time points. The results indicate that PBMT alone or in combination with diclofenac reduces levels of inflammatory markers and improves gait of diabetic rats in the acute phase of muscle injury.

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Acknowledgments

FAPESP - Process: 2014/23613-0.

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Authors and Affiliations

  1. Masters in Physical Therapy, Universidade do Sagrado Coração, Bauru, SP, Brazil

    Ligiane Souza dos Santos & Joyce Camilla Saltorato

  2. Graduation in Nutrition, Universidade do Sagrado Coração, Bauru, SP, Brazil

    Marina Gaiato Monte

  3. Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil

    Rodrigo Labat Marcos

  4. Laboratório de Biofotônica e Terapêutica Experimental, Instituto de Pesquisa e Desenvolvimento, Universidade do Vale do Paraíba, São José dos Campos, SP, Brazil

    Rodrigo Álvaro Brandão Lopes-Martins

  5. Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil

    Shaiane Silva Tomazoni

  6. Laboratory of Phototherapy in Sport and Exercise, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil

    Ernesto Cesar Pinto Leal-Junior

  7. Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil

    Ernesto Cesar Pinto Leal-Junior

  8. Laboratory of Physiology and Sport Performance (LAFIDE), School of Sciences, São Paulo State University - UNESP, Av. Eng. Luiz Edmundo C. Coube, Bauru, SP, 17033-360, Brazil

    Rodrigo Leal de Paiva Carvalho

Authors
  1. Ligiane Souza dos Santos
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  2. Joyce Camilla Saltorato
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  3. Marina Gaiato Monte
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  4. Rodrigo Labat Marcos
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  5. Rodrigo Álvaro Brandão Lopes-Martins
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  6. Shaiane Silva Tomazoni
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  7. Ernesto Cesar Pinto Leal-Junior
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  8. Rodrigo Leal de Paiva Carvalho
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Corresponding author

Correspondence to Rodrigo Leal de Paiva Carvalho.

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Conflict of interest

Professor Ernesto Cesar Pinto Leal-Junior receives research support from Multi Radiance Medical (Solon, OH, USA), a laser device manufacturer. Multi Radiance Medical had no role in the planning of this study, and the laser device used was not theirs. They had no influence on study design, data collection and analysis, decision to publish, or preparation of the manuscript. The remaining authors declare that they have no conflict of interests.

Ethical aspects

All experimental protocols were submitted and approved by the Animal Experimentation Ethics Committee of the Universidade Sagrado Coração (Protocol 3294021216).

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dos Santos, L.S., Saltorato, J.C., Monte, M.G. et al. PBMT and topical diclofenac as single and combined treatment on skeletal muscle injury in diabetic rats: effects on biochemical and functional aspects. Lasers Med Sci 34, 255–262 (2019). https://doi.org/10.1007/s10103-018-2580-z

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  • DOI: https://doi.org/10.1007/s10103-018-2580-z

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