ЭНЦИКЛОПЕДИЯ ФОТОННОЙ МЕДИЦИНЫ И ФОТОННОГО КЛИМАТА
VICTOR OVSIANNIKOV
D. V. Efremov Scientific Research Institute of Electrophysical Apparatus, Saint Petersburg, Russia
The results of six-years’ investigation in low-energy laser therapy for viral hepatitis are presented. A special infrared laser was used for this purpose. It was determined that laser therapy in combination with basic and detoxification therapies accelerated the recovery of patients and increased the quality of treatment. Different schemes for application of the laser were used for the treatment of patients with hepatitis В and hepatitis С virus. The safety of laser therapy was examined and, the mechanism of therapeutic effect was proposed based upon clinical observations and laboratory examinations. It was shown that the application of the laser action to the body led to activation (or stimulation) of adaptation reactions in the body: to normalization of peroxide oxidation of lipids, to normalization of immune system activity and, to activation of the blood production system. Laser therapy of viral hepatitis increases the quality of treatment, and there were no apparent relapses of diseases.
Laser therapy of viral hepatitis has been used in St. Petersburg since 1993. It was proposed based on our clinical experience in laser treatment of some skin diseases [1] and some postoperative complications in oncology patients [2, 3], on investigation of laser activity on viruses in culture [4], on our theoretical notion about the mechanism of carcinogenesis [5-7] and interaction of laser radiation with tissue [1]. The parameters of laser radiation were determined from such observations as therapeutic effect, absence of negative side effects.
A special infrared laser with wavelength 890 nm was developed. It works in a periodic-pulse mode with an average power of 10-60 mW. It is easily transportable and can be operated by trained medical workers.
The method of laser therapy for viral hepatitis involves the laser irradiation of blood in cubital veins, liver and thymus (breast-bone area) [8]. All laser actions are produced transcutaneously without any tissue heating. Calculations show that the temperature of
Frontiers in Viral Hepatitis Ed. by RF Schinazi, J-P Sommadossi and CM Rice. 325 — 331 © 2003 Elsevier B.V. All rights reserved.
tissue will not increase more than 10С. The patients did not report feeling any heating during the period of laser treatment.
Investigations into the efficiency of laser therapy for viral hepatitis were conducted in the infectious clinics of two Medical Academies of St. Petersburg [9, 10]. The clinical observations (including general condition, intoxication, jaundice, hepatomegalia) and biochemical testing [including bilirubin levels (determined by Inderassik et al. method), choletelin (determined by Ilea method), β-lipoprotein (determined by Burstem and Samaill method), alaminotransferase (ALT) (determined by Reitman and Franckel method), Sublimate titer (determined by Greensted method), cell immunity of CD-cells (determined by Bach method)] were determined. Ultrasonic investigations of liver, gallbladder, pancreas and spleen were also conducted. The level of the anti-oxidation defense system was determined by measuring the concentration of thiol groups SH and SS in serum, by determining the ratio SH/SS, and by determining the intensity of free radical oxidation. The last was investigated by the method of inductance chemiluminescence of cells and serum.
In the first stage of our investigations, we specified parameters of laser activity and checked the efficiency of laser therapy (conducted by T. Sologub and N. Pustasheva). In the second stage, the efficiency of laser treatment for different forms and stages of viral hepatitis as well as the cell or humoral mechanisms of the therapeutic effect of laser treatment were determined (conducted by N. Kuznetsov and O. Masterova).
Laser therapy was proposed to patients who had clear symptoms of hyperfermentemia, changes in biochemical indexes, presence of markers of viral hepatitis HBsAg, HBeAg, anti-HBV core antibody, anti-HCV, and absence of markers for hepatitis A virus (anti-HAVgGM) or hepatitis delta virus (anti-HDV).
Laser treatment was applied against a background of basic and detoxification therapies. In the first stage of investigation (64 patients: 21 women and 43 men; 56 patients with acute viral hepatitis В and C, six patients with chronic viral hepatitis C, two patients with chronic viral hepatitis В with cirrhosis), it was shown that laser therapy led to positive results in acute and chronic forms of disease, but was ineffective in patients with chronic viral hepatitis with cirrhosis [9].
Laser therapy was prescribed to patients after five to seven days in clinic. Most of these (75%) were in the main period of disease, and 25% were in the period of early convalescence (with persistent hyperfermentemia).
In the subsequent studies laser therapy was prescribed for all patients during the main period of disease. Identical groups of 20 patients (identical in sex, age, type of hepatitis) were u£ed as control groups. They received the traditional treatment without any laser treatment. The course of laser therapy took five to ten days. All patients tolerated it very well, without any subjective (reported) complaints or objective complications.
The general clinical condition of patients improved after two to four days of laser therapy. Symptoms of skin intoxication, skin itch and pain in the right hypochondrium vanished, and dimensions of the liver decreased. The symptom of intoxication in laser patients vanished four to five days earlier than in patients in the control group, and their recovery was five to seven days earlier.
The laboratory examinations showed that positive changes of all biochemical indices took place after five courses of laser therapy (on average). Examples of improvement of the general condition of patients are shown in Table 1.
Table 1. Clinical observations in patients with acute viral hepatitis В
|
The biochemical examinations of these patients at different stages of disease are shown in the Table 2.
Table 2. Biochemical examinations of patients with acute viral hepatitis В
Bilirubin μmole/l.h ALT Un/l Thymol
probe un
Period of disease Control group Laser group Control group Laser group Control group Laser group
|
All data from the biochemical examinations of patients from the laser group indicated a faster improvement than in the control group. The time to normalization of these parameters was shorter in the laser group.
The efficiency of laser therapy for patients with lingering forms of disease was investigated in the group of 50 patients with the acute form of viral hepatitis В (30 patients in the laser group and 20 patients in the control group). The bilirubin amount after the course of laser therapy was 17.2 ± 0.66 μmole/l.h in the laser group and 24 ± 2.4 μmole/l.h in the control group at the same time. The time to normalization was 52.5 ± 2.4 days in the laser group and 58.3 ± 2.4 days in the control group.
The investigation of thiol groups showed that concentration of the SH group in serum after the laser treatment increased 25%-30%, and the ratio of SH/SS concentrations increased from one up to four.
The investigation of the free radical oxidation processes by the method of inductance chemoluminescence of cells and serum led us to conclude that intensity of these processes in the blood of patients in the laser group was 30% less than in the control group. These results indicated an increased nonspecific resistance.
The investigation of immune status of patients was conducted in a group of 60 patients (30 — laser group and 30 — control group). After the course of laser therapy, CD-3 increased from 866 un. to 1238 un.; CD-4 increased from 546 un. to 781 un.
The laser treatment of patients with viral hepatitis С was carried out using different protocols in the two different clinics, resulting in different results. Patients in the first clinic (31 patients laser group and 20 patients control group) received the laser irradiation of liver, blood and thymus-breastbone. Laser treatment produced positive results in this group. Patients in the second clinic (20 patients laser group and 20 patients control group) received the laser irradiation of liver and blood in cubetal veins only. Laser therapy in this group led to apparent positive results, but the differences from the control patients were not statistically significant.
We know that the replication of HCV takes place in different organs, and this leads to damage in the different tissues. Therefore, the stimulation of the whole immune system is needed for the successful treatment of this disease. Irradiation of blood and liver is not enough for this purpose. The first protocol of laser treatment produced an improvement in the overall immune status of the patients and led to positive results in the treatment of HCV.
It is clear that the results of laser therapy depended on the stage of disease. We had the laser group of 48 patients: 20 patients with acute forms of hepatitis (eight — hepatitis B, 12 — hepatitis C) and 28 patients with chronic forms of hepatitis (nine — hepatitis B, 19 — hepatitis C). Statistically significant results (reduction of jaundice period and cytolytic period) were obtained in 83% of patients with acute hepatitis and in 68% of patients with chronic hepatitis.
The influence of laser treatment on the peroxide oxidation of lipids was investigated in a group of 150 patients with lingering forms of viral hepatitis В and C. For analysis purposes the patients were divided into two groups: the first with low indices of immune status (CD-3 — 866 ± 36 un., CD-4 — 546 ± 51 un., CD-8 — 308 ± 18 un.) before treatment, and the second with normal indices of immune status before treatment. Laser treatment led to increases in these indexes in the first group (CD-3 — 1238 ± 61 un., CD-4 — 781 ± 18 un., CD-8 — 501 ± 10 un.). In the second group these indices were lower at the beginning of treatment and increased to normal values in the period of early convalescence.
More than 300 patients with viral hepatitis have received laser treatment, and for most of them it gave positive results. We did not observe relapses of disease after laser therapy. All these results indicate that laser therapy can normalize a morphologic structure of live tissue and increase immune reactivity of the patient.
For the purpose of discussion about the mechanism of laser therapeutic action, we take into account the results of laser treatment of HIV/AIDS patients [11-13].
There were several hypotheses about the primary action of low-energy laser radiation on a living tissue. They involved the effect of cell metabolism stimulation by activation of some cellular enzyme, conformation of intracellular fluid or biopolymers, activation of singlet oxygen, and temperature changes of cell membranes.
We suppose that laser radiation action on living cells can stimulate (normalize) the energy cycle of cells in cases in which they have been changed as a result of disease [1]. Some cellular molecules can receive the needed energy by means of absorption of laser radiation energy. If the cells have normal metabolic processes, the laser energy is dispersed in the tissue. The total laser energy is not enough for thermal action on tissue. This assumption can explain most of the phenomena of laser therapy. It helped us to calculate the parameters of laser radiation that were needed for irradiation of any patient area and permitted us to propose the appropriate protocol of laser treatment for the different stages and forms of viral hepatitis.
It is known that laser action on tissue can lead to increased microcirculation of blood in irradiated areas. The effect of increasing microcirculation can help to regenerate the damaged cells of the liver. At the same time, laser action on blood can lead to photo modification of the membranes of blood cells. It can lead to increased membrane permeability and to greater levels of biologically active substances in the blood stream, thereby affecting other organs, such as the adrenal gland.
Our analysis shows that by means of our special laser we could input enough laser energy for normalization of metabolism in blood, liver and bone marrow cells. This could lead to improved regeneration of liver cells, but only in the thin layer of liver.
Our investigation has shown that localized laser therapy could influence the immune and blood-production systems in patients [3]. During the laser irradiation of the thymus- breastbone, we could stimulate (normalize) the function of the thymus, which regulates many processes in the body. At the same time laser activity on the bone marrow cells could result in increasing the production of new, healthy blood cells, bone marrow being the source of new blood cells and the thymus being the site of lymphocyte maturation. We observed rapid positive changes in patients’ blood and an improvement in their immune status.
Analysis of laser treatment of HIV/AIDS patients showed that normalization of blood components and immune status of patients takes place after a very short time — one course of laser therapy.
Investigation of the anti-oxidation defense system showed stimulation under laser therapy and normalization of the processes of peroxide oxidation of lipids. Perhaps this effect plays an important role in therapeutic efficacy of laser treatment. N. Kuznetsov and O. Masterova were the first who recognized this relationship.
We are not able to point out a single mechanism of therapeutic efficacy of laser treatment for viral hepatitis patients. Perhaps all the above-mentioned effects are present, and the real mechanism is as complex as the human organism itself. But now we can confirm that laser therapy can stimulate the defense mechanisms of the body, and that this leads to a shortening of the patient’s recovery period, and to increasing the quality of life.
Innocuousness and safety of laser therapy
Laser therapy is a new and not widespread modality. Thus, questions of safety and tolerance are very important. We did not observe untoward effects or results from laser therapy in our protocols. The wavelength was chosen from the conditions of disposition of an object of irradiation. Visible radiation can be used for action at the skin’s surface, or for superficial damage, but radiation near the infrared spectrum is more convenient for action under the skin, at the level of tissue or organs. Ultraviolet laser radiation cannot be recommended for therapy, because it can change the genetic properties of living cells [5]. Infrared laser radiation did not affect the genetic properties of cells, and using it is safe in this respect. Laser irradiation must produce therapeutic effects and should not heat tissue, so its power is limited from mW to n · 100 mw. Some investigation has shown that at higher laser intensities, the suppression of cellular metabolism can occur.
Our research into laser effects on viruses in vitro has shown that virus infectivity remained unchanged under the low-energy laser radiation, if the initial virus activity was normal. Our practice of using laser treatment represents a new and different direction in the practice of medicine: infectious disease, surgery, oncology, neurology. Our results show that laser therapy does not lead to any negative side effects or any complications, provided the clinical application of lasers is made in conjunction with calculation of laser actions.
It ought to be mentioned that laser therapy methods can lead to negative results or to complications if used incorrectly. Therefore we are prepared to collaborate on international projects using laser treatment methods. We could visit foreign clinics for teaching and demonstrating laser treatment for such diseases as viral hepatitis or HIV.
Acknowledgments
The author acknowledges the Ministry of Atomic Energy of the Russian Federation for supporting his work.
References
- Ovsiannikov VA and Krasavtseva LV. Application of Laser in the Practice of an Out-Patient Clinic. V. 141, No. 7, p. 114-116, 1988.
- Ovsiannikov VA, Barchuk AS, Gelfond ML. Quantum-Genetic Mechanism of Carcinogenesis and Laser Selective Action on Tumor. New-Delhi, India, 1994, Report Thesis v. 1, p.356.
- Ovsiannikov VA. Analysis of the Low-Energy Laser Treatment of Some Cancer and Infectious Diseases. V. 15, No. 1, p. 39-44, 1997.
- Ovsiannikov VA and Shitikova GM. Laser Radiation Action on Viruses. International Conference, Odessa, USSR, Report Thesis p. 361, 1992.
- Ovsiannikov VA. Quantum-Genetic Theory of Carcinogenesis. Preprint NIIEFA K- 0646, Moscow, CNIIatominform, 1984.
- Ovsiannikov VA. About Quantum-Genetic Theory of Carcinogenesis. Voprosy Oncologii V.32, No. 9, p. 72-74, 1986.
- Ovsiannikov VA. About Possible Mechanism of Carcinogenesis and Laser Selective Action upon Metastases. Izvestiya Akad. Nauk USSR Ser. Phys. V. 52, No. 2, p. 312, 1988.
- Ovsiannikov VA, Petrov IB, Pustashova NN, Sologub TV, Kuznetsov N1, Masterova OA. Laser Therapy ofViral Hepatitis. Laser & Technology V. 6, No. 3, p. 115-119, 1996.
- Ovsiannikov VA, Kuznetsov N1, Masterova OA, Pustashova NN. Using laser treatment for viral hepatitis. — International Congress “Laser and Health - 99”, Moscou, Russia, 1999. Report thesis p. 333.
- Clinico-immunologic Substanationof Low-Energy Laser Radiation Using for Viral Hepatitis Treatment in Complex Therapies. Dissertation St Petersburg, 2000.
- Ovsiannikov VA, Sizova NV, Maslov VP, Gnevasheva GI. The Treatment of HIV/AIDS Patients by Means of Laser Action. Report at XI Intern. Conference on AIDS, Vancouver, 1996, Report Thesis V. 2, p. 88.
- Ovsiannikov VA, Sizova NV, Maslov VP, Gnevasheva GI. About Mechanism of Laser Treatment of HIV Patients. Report at IV Intern. Conference on AIDS, Manila, Philippines, 1997, Report Thesis p. 89.
- Ovsiannikov VA, Sizova NV, Maslov VP, Rakhmanova AG. Efficiency of Laser Therapy for HIV-patients. — International Congress “Laser and Health - 99”, Moscou, Russia, 1999. Report thesis p. 385.
- Victor Ovsiannikov et al. Laser Therapy of Infectious Diseases: Results and Mechanism of therapeutic Action. -Proceeding of SPIE Vjlume 4606, Vol. 2, No. 35, p. 131 - 137.