Dose-response Relationship of Photobiomodulation Therapy on Matrix Metalloproteinase in Healing Dynamics of Diabetic Neuropathic Ulcers- An in Vivo Study.

Individuals with diabetic foot ulcers have overlapped the inflammatory, proliferative, and remodeling phase, making the tissue vulnerable to delayed healing responses. We aimed to establish the dose-response relationship of photobiomodulation therapy of different doses and matrix metalloproteinases in the healing dynamics of diabetic neuropathic ulcers. Diabetes was induced in 126 Albino Wistar rats, and neuropathy was induced to the hind paw by a sciatic nerve injury method. An excisional wound was created on the neuropathy-induced leg. Photobiomodulation therapy of dosage 4, 6, 8, 10, 12, and 15J/cm 2 and wavelength 655 nm, 808 nm was irradiated. Photobiomodulation therapy of dosages 4, 6, and 8J/cm 2 showed better wound healing properties with optimized levels of matrix metalloproteinases-1 and 8. We observed a strong dose-response in the experimental group treated with 6 and 8J/ cm 2 . The findings from the present study conclude that photobiomodulation therapy of dosages 4, 6, and 8J/cm 2 is suggestive of usefulness in diabetic neuropathic ulcer healing. Markers like matrix metalloproteinases may give a clear direction on response to the therapy. Based on the findings from the present study, we recommend to validate the findings for safety and efficacy in future through human prospective randomized controlled clinical trials.