Лазерное облучение крови как метод профилактики оральных мукозитов
Лазерное облучение крови как метод профилактики оральных мукозитов
Гусев Л.И., Притыко Д.А., Лукаш Е.Н. и др. Лазерное облучение крови как метод профилактики оральных мукозитов. Современная Онкология. 2019; 21 (2): 62–67. DOI: 10.26442/18151434.2019.2.190289
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Gusev L.I., Pritiko D.A., Lukash E.N. et al. Laser irradiation of blood as a method of prevention of oral mucositis. Journal of Modern Oncology. 2019; 21 (2): 62–67. DOI: 10.26442/18151434.2019.2.190289
Лазерное облучение крови как метод профилактики оральных мукозитов
Гусев Л.И., Притыко Д.А., Лукаш Е.Н. и др. Лазерное облучение крови как метод профилактики оральных мукозитов. Современная Онкология. 2019; 21 (2): 62–67. DOI: 10.26442/18151434.2019.2.190289
________________________________________________
Gusev L.I., Pritiko D.A., Lukash E.N. et al. Laser irradiation of blood as a method of prevention of oral mucositis. Journal of Modern Oncology. 2019; 21 (2): 62–67. DOI: 10.26442/18151434.2019.2.190289
Цель. Исследовать эффективность профилактики орального мукозита (ОМ) путем стимуляции фагоцитарной активности лейкоцитов (ФАЛ) и активизации выработки эндогенного фактора роста кератиноцитов методом лазерного облучения крови (ЛОК). Материалы и методы. В настоящее исследование вошли 44 пациента со злокачественными новообразованиями. 29 пациентам уже проводилась высокодозная полихимиотерапия (В-ПХТ), которая осложнялась развитием ОМ. 15 пациентам В-ПХТ до этого поступления еще не проводилась. В исследовании мы применяли методику определения состояния ФАЛ с
тест-объектом микрочастиц латекса. Исследование проводилось до начала В-ПХТ, после ЛОК и после химиотерапии. Воздействие лазерным излучением на кровь осуществляли путем наложения излучателя на кожу над крупными сосудами: зоны сонных артерий и вен, кубитальных, подключичных или подколенных. Результаты. Методика ЛОК проводилась в 92 курсах В-ПХТ. Стимуляция фагоцитов методом ЛОК показала, что проведение этой методики до начала химиотерапии во всех случаях приводит к положительному результату. У всех детей (n=44), которым проводилась стимуляция ФАЛ, ОМ не развился. Заключение. Впервые в мире все полученные нами результаты стали возможны только при внедрении в практику анализа определения ФАЛ и стимуляции ФАЛ и активизации выработки эндогенного фактора роста кератиноцитов ЛОК. Широкое внедрение данной методики позволит снизить затраты на лечение онкологических больных и повысить выживаемость.
Aim. Study the effectiveness of oral mucositis (OM) prevention by the stimulation of white cells phagocytic activity and activation of endogenous keratinocyte growth factor production by laser blood irradiation method (LBI). Materials and methods. This study covers 44 patients with malignant tumors. 29 patients have already passed the high-dose polychemotherapy complicated by OM development. 15 patients have not passed the high-dose polychemotherapy yet before this admission. In the study we applied the method of identification of the white cells phagocytic activity state using the test sheet of latex microparticles. The study was performed before high-dose polychemotherapy, after LBI and after chemotherapy. Blood exposure to laser irradiation was made by placing the emitter on skin above the large vessels: areas of carotid arteries and veins, cubital, subclavian or popliteal. Results. LBI technique was used in 92 courses of high-dose polychemotherapy. Stimulation of phagocytes by LBI method showed that application of this method before chemotherapy leads to the positive result in all cases. All children (n=44), that were subject to white cells phagocytic activity stimulation, had not OM. Conclusion. Blood test for white cells phagocytic activity gives a chance to determine the actual readiness of the body to resist infections. If it was impossible to predict oral mucositis development before, now implementation of white cells phagocytic activity determination method improves the effectiveness of such prognosis. Thus, first in the world, all results that we obtained became possible only due to implementation of the white cells phagocytic activity test and stimulation of the white cells phagocytic activity and activation of the endogenous keratinocyte growth factor production by laser blood irradiation method.
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________________________________________________
1. Dodds MJ. The pathogenesis and characterization of oral mucositis associated with cancer therapy. Oncol Nurs Forum 2004; 31 (Suppl. 4): 5–11.
2. Bensadoun RJ, Nair RG. Low-level laser therapy in the prevention and treatment of cancer therapy-induced mucositis: 2012 state of the art based on literature review and meta-analysis. Curr Opin Oncol 2012; 24: 363–70. DOI: 10.1097/CCO.0b013e 328352eaa3
3. Shenep JL, Kalwinsky DK, Hutson PR et al. Efficacy of oral sucralfate suspension in prevention and treatment of chemotherapy-induced mucositis. J Pediatr 1988; 113 (4): 758–63.
4. Solomon MZ, Dokken DL, Fleischman AR et al. For IPPC, 2002. The initiative for pediatric palliative care (IPPC): Background and goals. Newton, MA: Education Development Center, Inc. http://www.ippcweb.org/initiative.asp
5. Rosenthal DI. Consequences of mucositis-induced treatment breaks and dose reductions on head and neck cancer treatment outcomes. J Support Oncol 2007; 5: 23–31.
6. Keefe DM, Peterson DE, Schubert MM. Developing evidence based guidelines for the management of alimentary mucositis: process and pitfalls. Support Care Cancer 2006; 14: 492–8.
7. Keefe DM, Gibson RJ. Mucosal injury from targeted anti-cancer therapy. Support Care Cancer 2007; 15: 483–90.
8. Balmant NV, Reis SR, Oliveira JFP et al. Cancer incidence among adolescents and young adults (15 to 29 years) in Brazil. J Pediatr Hematol Oncol 2016; 38: e88–e96.
9. Guyatt GH, Oxman AD, Kunz R et al. GRADE: going from evidence to recommendations. BMJ 2008; 336: 1049–51. DOI: 10.1136/bmj.39493.646875.AE
10. Düzkaya DS, Uysal B, Yakut T. The Effect of Oral Care Using an Oral Health Care Guide on Preventing Mucositis in Pediatric Intensive Care. J Pediatr Nurs 2017; 36: 98–102.
11. Rojas de Morales T, Zambrano O, Rivera L et al. Oral-disease prevention in children with cancer: testing preventive protocol effectiveness. Medicina Oral 2001; 6: 326–34.
12. Sarzhevsky VO, Smirnova EG. Features of pathogenesis, clinical manifestations, prevention and treatment of mucositis in cancer patients. Bulletin of the National medical and surgical Center. N And Pirogov 2012; 7 (3): 123–8.
13. Raber-Durlacher JE, von Bultzingslowen I, Logan RM et al. Systematic review of cytokines and growth factors for the management of oral mucositis in cancer patients. Support Care Cancer 2013; 21: 343–55. DOI: 10.1007/s00520-012-1594-5
14. Paris F, Fuks Z, Kang A et al. Endothelial apoptosis as the primary lesion initiating intestinal radiation damage in mice. Science 2001; 293: 293–7.
15. Weber JB, Pinheiro AL, de Oliveira MG et al. Laser therapy improves healing of bone defects submitted to autologous bone graft. Photomed Laser Surg 2006; 24: 38–44.
16. Elad S, Raber-Durlacher JE, Brennan MT et al. Basic oral care for hematology-oncology patients and hematopoietic stem cell transplantation recipients: A position paper from the joint task force of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) and the European Society for Blood and Marrow Transplantation (EBMT). Support Care Cancer 2015; 23: 223–36.
17. El Bousaadani A, Eljahd L, Abada R et al. Prevention and treatment of mucositis in children with oral cancers: Practical recommendations. Cancer Radiother 2016; 20 (3): 226–30.
18. Yu W, Naim JO, Lanzafame RJ. The effect of laser irradiation on the release of bFGF from 3T3 fibroblasts. Photochem Photobiol 1994; 59: 167–70.
19. Grossman N, Schneid N, Reuveni H et al. 780 nm low power diode laser irradiation stimulates proliferation of keratinocyte cultures: involvement of reactive oxygen species. Lasers Surg Med 1998; 22: 212–8.
20. Moore P, Ridgway TD, Higbee RG et al. Effect of wavelength on low-intensity laser irradiation-stimulated cell proliferation in vitro. Lasers Surg Med 2005; 36: 8–12.
21. Agaiby AD, Ghali LR, Wilson R, Dyson M. Laser modulation of angiogenic factor production by T-lymphocytes. Lasers Surg Med 2000; 26: 357–63.
22. Storz P. Mitochondrial ROS-radical detoxification, mediated by protein kinase D. Trends Cell Biol 2007; 17: 13–8.
23. Koshelev V.N., Semina E.A., Kamalian A.B. Sravnitel'naia otsenka effektivnosti primeneniia chreskozhnogo i vnutrisosudistogo lazernogo oblucheniia krovi. Mater. Mezhdunar. konf. "Klinicheskoe i eksperimental'noe primenenie novykh lazernykh tekhnologii'. Mosсow–Kazan', 1995; р. 395–7 (in Russian).
24. Blokhina N.P., Itskovich A.I. Izmeneniia funktsional'nogo sostoianiia polimorfnoiadernykh fagotsitov u novorozhdennykh detei s ostrymi respiratornymi zabolevaniiami pod vliianiem lazernoi terapii. Materialy III Mezhdunarodnoi konferentsii: Aktual'nye voprosy lazernoi meditsiny i operatsionnoi endoskopii. Pod redaktsiei O.K.Skobelkina, A.A.Martino. Moscow–Vidnoe, 1994(b); р. 409–10 (in Russian).
25. Voronina O.Iu., Kaplan M.A., Stepanov V.A. Nerezonansnyi mekhanizm biostimuliruiushchego deistviia nizkointensivnogo lazernogo izlucheniia. Fizicheskaia meditsina. 1992; 2 (1–2): 40–50 (in Russian).
26. Gamaleia N.F., Stadnik V.Ia., Rudykh Z.M. et al. Eksperimental'noe obosnovanie i pervyi opyt primeneniia vnutrivennogo lazernogo oblucheniia krovi v onkologii. Eksperim. onkologiia. 1988; 10 (2): 60–3 (in Russian).
27. Durnov L.A., Balakirev S.A., Gusev L.I. et al. Primenenie nizko-intensivnogo lazernogo izlucheniia v detskoi onkologii (eksperimental'nye i klinicheskie issledovaniia). V1 mezhdunarodnaia nauchno-prakticheskaia konferentsiia po kvantovoi meditsine. Moscow, 6–10 dekabria 1999 g.; р. 160–5 (in Russian).
28. Durnov L.A., Gusev L.I., Balakirev S.A. et al. Nizkointensivnye lazery v detskoi onkologii. Vestn. Rossiiskoi Akademii med. nauk. 2000; 6: 24–7 (in Russian).
29. Zakharchenko S.V. Immunomoduliruiushchii i protivoretsidivnyi effekty magnitoinfrakrasnoi lazernoi terapii v kompleksnom lechenii legkoi bronkhial'noi astmy u detei. Avtoref. dis. … kand. med. nauk. Moscow, 2005 (in Russian).
30. Zemtsev I.Z., Lapshin V.P. Mekhanizmy ochishcheniia poverkhnosti biomembran ot toksicheskikh veshchestv pri lazernom obluchenii krovi i drugikh biotkanei. Materialy Mezhdunar. konf. "Novye napravleniia lazernoi meditsiny". Moscow, 1996; p. 323–25 (in Russian).
31. Zyrianov B.N.. Evtushenko V.A, Kitsmaniuk Z.D. Nizkointensivnaia lazernaia terapiia v onkologii. Tomsk: STT, 1998 (in Russian).
32. Karu T. Primary and secondary mechanisms of action of visible to near-IR radiation on cells. J Photochem Photobiol B 1999; 49: 1–17.
33. Lewis JC, Maldonado JE, Mann KG. Phagocytosis in human platelets: localization of acid phosphatase-positive phagosomes following latex uptake. Blood 1976; 47: 833–40.
34. Peterson DE, Barker NP, Akhmadullina LI et al. Phase II, randomized, doubleblind, placebo-controlled study of recombinant human intestinal trefoil factor oral spray for prevention of oral mucositis in pa-tients with colorectal cancer who are receiving fluorouracil-based chemotherapy. J Clin Oncol 2009; 27: 4333–8.
1 ГБУЗ «Научно-практический центр специализированной медицинской помощи детям им. В.Ф. Войно-Ясенецкого» Департамента здравоохранения г. Москвы, Москва, Россия;
2 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
*lig46@mail.ru
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Leonid I. Gusev*1, Denis A. Pritiko1, Elena N. Lukash1, Nadezhda M. Ivanova1, Elena Y. Sergeenko2
1 V.F. Voino-Yasenetski Scientific and Practical Center for Specialized Medical Care for Children, Moscow, Russia;
2 Pirogov Russian National Research Medical University, Moscow, Russia
*lig46@mail.ru