Low level laser therapy for treating tuberculosis.

BACKGROUND: The main treatment for tuberculosis is antituberculous drugs. Low energy laser therapy is used as an adjunct to antituberculous drugs, predominantly in the former Soviet Union and India. OBJECTIVES: To assess the benefits and harms of low level laser therapy for treating tuberculosis in randomized and quasi-randomized controlled trials. To seek information about potential benefits or harms from observational studies. SEARCH STRATEGY: We searched the Cochrane Infectious Diseases Group specialized trials register (up to June 2001), the Cochrane Controlled Trials Register (Issue 1, 2001), MEDLINE (1966 to December 2001), EMBASE (1988 to December 2001), CINAHL (up to November 2001), PEDro (up to November 2001), the Science Citation Index (up to December 2001), National Centre for Science Information at the Indian Institute of Science (15 April 2002), electronic catalogue of the Central Medical Library (Moscow; 1988 to January 2002), the internet using 'Google' (21 January 2002), and reference lists of articles. We contacted relevant organizations and researchers. SELECTION CRITERIA: (1) Randomized and quasi-randomized controlled trials comparing low level laser therapy with no low level laser therapy in people with tuberculosis. We also conducted a subsidiary analysis of of the potential benefits and harms from observational studies. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. We contacted study authors for additional information. Adverse event information was collected from the studies. MAIN RESULTS: No randomized or quasi-randomized controlled trials met the inclusion criteria for the review. The potential benefits and harms from 29 observational studies involving over 3500 people are described. REVIEWER'S CONCLUSIONS: We have not identified any well designed trials using low level laser therapy (LLLT) to treat tuberculosis. Therefore, the use of LLLT to treat tuberculosis is not supported by reliable evidence.

[Low-intensity laser irradiation in patients with urinary tuberculosis]. / Nizkointensivnoe lazernoe izluchenie u bol'nykh tuberkulezom mochevoi sistemy.

Combined surface radiation of renal projection area and intravascular laser radiation of blood (AZOR-2K unit) were used in combined treatment of 54 patients with urinary tuberculosis. Analysis of immunological and hematological indices of peripheral blood of patients before and after the combined treatment showed that low-intensity laser radiation activates local system of T-helpers which after specific antigenic impact differentiate into T-helpers-1. The latter synthesize in loco gamma-interferon, TNF-alpha and beta and IL-2 stimulating bactericidal mechanisms directed at destruction of M. tuberculosis and resolution of the infection focus.

[Low-intensity laser radiation in combined treatment of urinary system tuberculosis]. / Nizkointensivnoe lazernoe izluchenie v kompleksnom lechenii tuberkuleza mochevoi sistemy.

Combined treatment using low-intensity laser radiation (LILR) was performed in 125 patients with urinary tuberculosis: 54 patients had combined intravascular blood laser radiation (IBLR) and external renal laser radiation, 71 patients were exposed to IBLR with an AZOR-2K device. The use of LILR in the combined treatment contributed to the stabilization of a specific process, to significant renal functional improvement, and a reduction of a postoperative period from 26 to 20 days.

[Helium-neon laser radiation in the therapy of urinary bladder and ureteral tuberculosis]. / Gelii-neonovoe lazernoe izluchenie v terapii tuberkuleza mochevogo puzyria i mochetochnika.

The paper presents a comparative assessment of conventional therapy methods and the author's proposed treatment by using low-intensity helium-neon laser radiation in combination with endovesical submucous administration of tuberculostatics and glucocorticosteroids into the area of lesion in patients with tuberculosis of the bladder and intramural ureter.

[Intravascular laser radiation of blood in the multimodality treatment of patients with urogenital tuberculosis]. / Vnutrisosudistoe lazernoe obluchenie krovi v kompleksnom lechenii bol'nykh tuberkulezom mochepolovykh organov.

Laser therapy was performed in 45 patients with tuberculosis of the urinary system and male genitals. The radiation was found to have a positive action on the patients' general condition and short-term immunomodulating effect. Following a month, immunological parameters became baseline or near-baseline. In the course of 5 years there was an exacerbation of tuberculosis in 2 (4 +/- 3%) patients who had received laser therapy and in 8-18% routinely treated without laser therapy.

[Laser therapy of tuberculous cystitis]. / Lazeroterapiia tuberkuleznykh tsistitov.

The outcomes of using low-energy helium-neon laser radiation in a complex management of 21 patients with complicated forms of nephrotuberculosis are illustrated. LG-75 laser (with 0.63 nm wavelength and 25 mW power) was used in this case. The effects appeared as a larger bladder capacity, cystoscopic picture normalization and an overall cessation of dysuria were observed as a result of 5 to 12 sessions of bladder mucosa radiation.