Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20230090-en
Brazilian Journal of Pain
Original Article

Application of vascular photobiomodulation therapy in individuals with low back pain and its relationship with global methylation

Aplicação da terapia por fotobiomodulação vascular em indivíduos com lombalgia e sua relação com a metilação global

Layse Rafaela Moroti-Perugini; Isadora Fernandes Cônsolo; Ana Francisca Rocha Feio-Ribeiro; Rodrigo Antonio Andraus; Regina Célia Poli

Downloads: 0
Views: 197

Abstract

BACKGROUND AND OBJECTIVES: Low back pain is among the most disabling conditions worldwide, and among the epigenetic factors, methylation in CpG islands of gene promoter regions can modulate gene expression, potentially correlating with the development of the disease and providing insights into the choice of treatment. The objective of this study was to assess the efficacy of therapy using modified ILIB related to DNA methylation processes in low back pain. Secondary objectives of this study included investigating pain intensity, gender, sociodemographic data, and physical-functional profile. 
METHODS: This prospective study was conducted in a municipality in the southern region of Brazil. The sample consisted of 30 participants of both genders, with an average age of 41.77 years. The following aspects were analyzed: anthropometric characteristics, global methylation using the ELISA method, pain level, physical activity level, functional disabilities, and hesitancy level related to work and physical activity-related activities. 
RESULTS: A statistically significant association was observed between methylation levels before and after treatment application for the experimental and placebo groups (p < 0.005), demonstrating a mean responsiveness between methylation and treatment (d = 0.5). However, there were no other statistically significant associations correlated with the other work variables. 
CONCLUSION: The results obtained in this study suggest the need for further research related to the identification of specific genes in methylation, as well as the standardization of dosimetry used for transcutaneous ILIB laser application in the radial artery.

Keywords

DNA methylation, Epigenetics, Low back pain, Low intensity light therapy, Pain

Resumo

JUSTIFICATIVA E OBJETIVOS: A lombalgia está entre as condições mais incapacitantes no mundo e; dentre os fatores epigenéticos, a metilação em ilhas CpG de regiões promotoras de genes pode modular a expressão gênica permitindo uma possível correlação ao desenvolvimento da doença, como também pode trazer esclarecimentos a respeito do tratamento a ser escolhido. O objetivo deste estudo foi verificar a eficácia da terapia através do uso do ILIB modificado relacionada ao processo de metilação de DNA na lombalgia. Os objetivos secundários deste estudo foram a investigação da intensidade da dor, sexo, dados sociodemográficos e perfil físico-funcional. 
MÉTODOS: Este estudo, desenvolvido em um município da região sul do Brasil, caracteriza-se como prospectivo. A amostra deste estudo foi composta por 30 participantes, de ambos os sexos, com idade média de 41,77 anos. Foram analisados os seguintes aspectos: características antropométricas, metilação global através do método ELISA, nível de dor, nível de atividade física, incapacidades funcionais e nível de hesitação para realizar atividades relacionada ao trabalho e atividade física. 
RESULTADOS: Observou-se associação estatisticamente significativa entre os níveis de metilação antes e a após aplicação do tratamento para grupo experimental e placebo (p<0,005) demostrando uma média responsividade entre as variáveis metilação e tratamento (d=0,5). No entanto, não houve nenhuma outra associação estatística correlacionada as demais variáreis do trabalho. 
CONCLUSÃO: Os resultados obtidos neste estudo sugerem que há necessidade mais estudos relacionados a identificação de genes específicos na metilação, além da necessidade de padronização de dosimetria utilizadas para aplicação do laser ILIB de forma transcutânea, em artéria radial.

Palavras-chave

Dor, Epigenética, Lombalgia, Metilação do DNA, Terapia com luz de baixa intensidade

References

1 Knezevic NN, Candido KD, Vlaeyen JWS, Van Zundert J, Cohen SP. Low back pain. Lancet. 2021;398(10294):78-92.

2 Suntsov V, Jovanovic F, Knezevic E, Candido KD, Knezevic NN. Can implementation of genetics and pharmacogenomics improve treatment of chronic low back pain? Pharmac. 2020;12(9):894.

3 Aroke EN, Jackson P, Meng L, Huo Z, Overstreet DS, Penn TM, Quinn TL, Cruz-Almeida Y, Goodin BR. Differential DNA methylation in Black and White individuals with chronic low back pain enrich different genomic pathways. Neurobiol Pain. 2022;25(11):100086.

4 Adhikari B, Starkweather A, Xu W, Acabchuk Rl, Ramesh D, Eze B, Yang Y, Yang Gs, Walker J, Laubenbacher R, Park CL. A feasibility study on yoga’s mechanism of action for chronic low back pain: psychological and neurophysiological changes, including global gene expression and DNA methylation, following a yoga intervention for chronic low back pain. Pilot Feasibility Stud. 2022;(8):142.

5 Tomé RFF, Silva DFB, Dos Santos CAO, Vasconcelos Neves G, Rolim AKA, Castro Gomes DQ. ILIB (intravascular laser irradiation of blood) as an adjuvant therapy in the treatment of patients with chronic systemic diseases-an integrative literature review. Lasers Med Sci. 2020;35(9):1899-907.

6 Hamblin MR. Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS Biophys. 2017;4(3):337-61.

7 Zein R, Selting W, Hamblin MR. Review of light parameters and photobiomodulation efcacy: dive into complexity. J Biomed Opt. 2018;23:1.

8 Guyatt GH, Townsend M, Berman LB, Keller JL. A comparison of Likert and visual analogue scales for measuring change in function. J Chronic Dis. 1987;40(12):1129-33.

9 Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine (Phila Pa 1976). 2000;25(24):3115-24.

10 Benedetti TRB, Antunes PC, Rodrigues-Añez CR, Mazo GZ, Petroski EL. Reprodutibilidade e validade do questionário internacional de atividade física (IPAQ) em homens idosos. Rev Bras Med Esporte. 2007;13(1):11-6.

11 Cleland JA, Fritz JM, Brennan GP. Predictive validity of initial fear avoidance beliefs in patients with low back pain receiving physical therapy: is the FABQ a useful screening tool for identifying patients at risk for a poor recovery? Eur Spine J. 2008;17(1):70-9.

12 Gryzinska M, Blaszczak E, Strachecka A, Jezewska-Witkowska G. Analysis of age-related global DNA methylation in chicken. Biochem Genet. 2013;51(7-8):554-63.

13 Jones PA. Functions of DNA methylation: islands, start sites, gene bodies and beyond. Nat Rev Genet. 2012;13(7):484-92.

14 Jin Z, Liu Y. DNA methylation in human diseases. Genes Dis. 2018;5(1):1-8.

15 Cao G, Yang S, Cao J, Tan Z, Wu L, Dong F, Ding W, Zhang F. The role of oxidative stress in intervertebral disc degeneration. Oxid Med Cell Longev. 202212;2022:2166817.

16 Takenaka S, Sukenaga N, Ohmuraya M, Matsuki Y, Maeda L, Takao Y, Hirose M. Association between neuropathic pain characteristics and DNA methylation of transient receptor potential ankyrin 1 in human peripheral blood. Medicine (Baltimore). 2020;99(8):e19325.

17 Gombert S, Rhein M, Winterpacht A, Münster T, Hillemacher T, Lefer A, Frieling H. Transient receptor potential ankyrin 1 promoter methylation and peripheral pain sensitivity in Crohn’s disease. Clin Epigenetics. 2019;12(1):1.

18 Voisin S, Eynon N, Yan X, Bishop DJ. Exercise training and DNA methylation in humans. Acta Physiol (Oxf). 2015;213(1):39-59.

19 Satoh K, Ginsburg E, Vonderhaar BK. Msx-1 and Msx-2 in mammary gland development. J Mammary Gland Biol Neoplasia. 2004;9(2):195-205.

20 Li X, Xiao B, Chen XS. DNA methylation: a new player in multiple sclerosis. Mol Neurobiol. 2017;54(6):4049-59.

21 Guimarães LS, Costa LDCM, Araujo AC, Nascimento DP, Medeiros FC, Avanzi MA, Leal-Junior ECP, Costa LOP, Tomazoni SS. Photobiomodulation therapy is not better than placebo in patients with chronic nonspecific low back pain: a randomised placebo-controlled trial. Pain. 2021;162(6):1612-20.

22 Ay S, Doğan ŞK, Evcik D. Is low-level laser therapy effective in acute or chronic low back pain? Clin Rheumatol. 2010;29(8):905-10.

23 da Silva Leal MV, Lima MO, Nicolau RA, de Carvallho TMT, Abreu JAC, Pessoa DR, Arisawa EALS. effect of modified laser transcutaneous irradiation on pain and quality of life in patients with diabetic neuropathy. Photobiomodul Photomed Laser Surg. 2020;38(3):138-44.

24 da Silva JGF, Dos Santos SS, de Almeida P, Marcos RL, Lino-Dos-Santos-Franco A. Effect of systemic photobiomodulation in the course of acute lung injury in rats. Lasers Med Sci. 2021;36(5):965-73.

25 Dos Santos Malavazzi TC, Fernandes KPS, Lopez TCC, Rodrigues MFSD, Horliana ACRT, Bussadori SK, Mesquita-Ferrari RA. Effects of the invasive and non-invasive systemic photobiomodulation using low-level laser in experimental models: a systematic review. Lasers Med Sci. 2023;38(1):137.

26 Xiao J. (Ed.) Physical exercise for human health. Adv Experimental Med Biol. 2020.
 


Submitted date:
07/07/2023

Accepted date:
10/10/2023

65a6dfe9a9539578931c02e4 brjp Articles

BrJP

Share this page
Page Sections