ABSTRACT
Objectives: We systematically reviewed randomized controlled trials (RCTs) of the effect of low-level laser therapy (LLLT) versus placebo in patients with temporomandibular disorder (TMD). Methods: A systematic search of multiple online sources electronic databases was undertaken. The methodological quality of each included study was assessed using the modified Jadad scale, and the quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Results: A total of 31 RCTs were included. Total modified Jadad scale scores showed that the methodological quality was high in 30 studies and low in 1 study. Combining data from all clinically heterogeneous studies revealed positive effects of LLLT on pain relief, regardless of the visual analogue scale (VAS) score or the change of VAS score between the baseline and the final follow-up time point, while dosage analyses showed discrepant results about the effects of high or low doses for patients with TMD. Follow-up analyses showed that LLLT significantly reduced pain at the short-term follow-up. Temporomandibular joint function outcomes indicated that the overall effect favored LLLT over placebo. Conclusion: This systematic review suggests that LLLT effectively relieves pain and improves functional outcomes in patients with TMD.
Subject(s)
Laser Therapy/methods , Temporomandibular Joint Disorders/therapy , Follow-Up Studies , Humans , Outcome Assessment, Health Care , Randomized Controlled Trials as Topic , Visual Analog ScaleABSTRACT
Neutrophils, immune cells crucial for protecting against invading pathogens, are important in sepsis. Neutrophil migration is regulated by chemokine receptors and their cognate ligands. Our previous study investigated the effect of nbutanol extract from Folium isatidis on lipopolysaccharide (LPS)induced septic shock. The present study stimulated neutrophils with LPS to explore the influence of LPS on cell. Neutrophils were then pretreated with nbutanol extract from Folium isatidis followed by LPS to examine the effect of this extract on neutrophil chemotaxis. The results showed that LPS decreased the expression levels of CXCchemokine receptor (CXCR)1, CXCR2 and Lselectin (CD62L), and increased the expression of interleukin8 (IL8) by neutrophils. The addition of nbutanol extract from Folium isatidis inhibited this LPSinduced downregulation of CXCR1, CXCR2 and CD62L, and decreased the expression of IL8 on neutrophils. In addition, nbutanol extract promoted myeloperoxidase activity in neutrophils. Taken together, LPS downregulated the expression of chemokine receptors, leading to the failure of neutrophils to migrate to sites of infection. The addition of nbutanol extract, which promoted the ability of neutrophils to migrate, is a natural product and potential therapeutic agent with which to target neutrophil chemotaxis during LPS stimulation.
Subject(s)
1-Butanol/pharmacology , Gene Expression Regulation/drug effects , Neutrophils/drug effects , Neutrophils/metabolism , Plant Extracts/pharmacology , Receptors, Interleukin-8A/genetics , Receptors, Interleukin-8B/genetics , 1-Butanol/chemistry , Adult , Biomarkers , Chemotaxis/drug effects , Chemotaxis/immunology , Female , Humans , Interleukin-8/genetics , Interleukin-8/metabolism , Male , Neutrophils/immunology , Peroxidase/genetics , Peroxidase/metabolism , Plant Extracts/chemistry , Receptors, Interleukin-8A/metabolism , Receptors, Interleukin-8B/metabolism , Young AdultABSTRACT
Sepsis, which is caused by severe infection, is an important cause of mortality, but effective clinical treatment against sepsis is extremely limited. As the main component of the outer membrane of Gram-negative bacteria, lipopolysaccharide (LPS) plays a major role in inflammatory responses. Studies have shown beneficial pharmacological effects for Folium isatidis. The present study further illuminated the effects of n-butanol extract from Folium isatidis in LPS-induced septic shock and identified the main active chemical components. Our study showed that pretreatment with n-butanol extract from Folium isatidis not only significantly inhibited LPS-induced tumor necrosis factor-α and interleukin-6 production but also markedly and dose dependently enhanced the recruitment of MyD88, the phosphorylation of extracellular signal-regulated kinase, and the degradation of IκB-α. Additionally, the extract exhibited dramatic protective effects against lung injury and death in mice with septic shock. Eight main active compounds were identified, including organic acids, glycoside, indolinones, and flavonoids. These findings provide a perspective on the respiratory protection offered by n-butanol extract from Folium isatidis in LPS-induced sepsis and outline a novel therapeutic strategy for the treatment of sepsis.
