Effect of Photobiomodulation Treatment in Individuals With Multiple Sclerosis:
1 other identifier
interventional
34
1 country
1
Brief Summary
Background: Multiple sclerosis (MS) is an autoimmune disease, for which the forms of treatment are medication and rehabilitation. However, in vitro and in vivo studies have demonstrated that photobiomodulation can be an effective treatment modality for inflammatory diseases, including MS. Photobiomodulation has a broad range of benefits, such as the avoidance of cell and tissue death, the stimulation of healing and injury repair, reductions in pain, edema and inflammation, cell proliferation and even apoptosis. The outcomes of photobiomodulation include the regeneration of cells, the stimulation of the growth of Schwann cells, a reduction in spasticity, functional improvements, a reduction in nitric oxide levels and the upregulation of the cytokine IL10, demonstrating that this therapeutic modality can offer neuro-protection. Methods: A randomized, controlled, double-blind, clinical trial is proposed. The patients will be divided into six groups. Groups 1 and 2 will receive sham and active photobiomodulation in the sublingual region, respectively. Groups 3 and 4 will receive sham and active photobiomodulation along the spinal cord, respectively. Group 5 will receive placebo treatment with photobiomodulation on the skin in the region of the radial artery with a specific bracelet. Group 6 will be treated with photobiomodulation on the skin in the region of the radial artery with a specific bracelet. Discussion: Treatment for MS is directed at the immune response and slowing the progression of the disease. This is one of the first clinical trials with sublingual and along the spinal cord photobiomodulation, which could help establish a new, promising treatment of the disease associated with pharmacological treatment.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P25-P50 for phase_2 multiple-sclerosis
Started Jan 2018
Shorter than P25 for phase_2 multiple-sclerosis
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
November 17, 2017
CompletedFirst Posted
Study publicly available on registry
December 4, 2017
CompletedStudy Start
First participant enrolled
January 1, 2018
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 31, 2018
CompletedStudy Completion
Last participant's last visit for all outcomes
February 28, 2019
CompletedOctober 11, 2018
October 1, 2018
12 months
November 17, 2017
October 10, 2018
Conditions
Outcome Measures
Primary Outcomes (3)
Oxidative stress
The concentration of endogenous nitrite will be evaluated in serum samples using the Total Nitric Oxide and Nitrate/Nitrite Parameter Assay Kit (R\&D) according to the manufacturer´s instructions. Briefly, 50 µL sample will be incubated in 96 well plates with the reaction diluent provided by the kit, Griess Reagent I and II for 10 min at room temperature. Reactions will be read at 540 nm.
Through study completion, about one year.
Tumor Necrosis Factor Alpha
The quantification of the serum levels of IL-10 and TNFα will be performed using the Human IL-10 and THF-alpha ELISA MAX (Biolegend), according to the manufacturer's instructions. Briefly, plates will be coated with the capture anti-IL-10 or anti-TNF-alpha monoclonal antibody for 18h at 8°C, washed and then incubated with the reagent provided by the kit to block non-specific binding and to reduce background. Samples will be added to each well at room temperature for 2h and after wash, detection antibody solution will be added. Reactions will be revealed with the Avidin-HRP solution and the absorbance will be read at 450nm.
Through study completion, about one year.
Interleukin-10
The quantification of the serum levels of IL-10 and TNFα will be performed using the Human IL-10 and THF-alpha ELISA MAX (Biolegend), according to the manufacturer's instructions. Briefly, plates will be coated with the capture anti-IL-10 or anti-TNF-alpha monoclonal antibody for 18h at 8°C, washed and then incubated with the reagent provided by the kit to block non-specific binding and to reduce background. Samples will be added to each well at room temperature for 2h and after wash, detection antibody solution will be added. Reactions will be revealed with the Avidin-HRP solution and the absorbance will be read at 450nm.
Through study completion, about one year.
Secondary Outcomes (1)
EDSS
Through study completion, about one year.
Study Arms (6)
Sham photobiomodulation in the sublingual region
SHAM COMPARATORA disposable plastic wrap will cover the application pen for the purposes of hygiene, and the laser will be placed for 10 minutes, without being turned on.
Photobiomodulation in the sublingual region
ACTIVE COMPARATORA disposable plastic wrap will cover the application pen for the purposes of hygiene, and the region will be irradiated for 10 minutes.
Sham photobiomodulation along the spinal cord
SHAM COMPARATORTranscutaneous irradiation of the spinal cord will be pretended on segments corresponding to the nerve roots of the lumbosacral plexus (T12-S5) and cervicothoracic plexus (C5-T1-2). Twenty points will be wakely irradiated for 30 seconds (total treatment time: 10 minutes).
Photobiomodulation along the spinal cord
ACTIVE COMPARATORTranscutaneous irradiation of the spinal cord will be performed on segments corresponding to the nerve roots of the lumbosacral plexus (T12-S5) and cervicothoracic plexus (C5-T1-2). Twenty points will be irradiated for 30 seconds (total treatment time: 10 minutes).
Sham Photobiomodulation in the radial artery
SHAM COMPARATORIntravascular laser irradiation will be applied to the skin in the region of the radial artery with a specific turned-off bracelet of the DMC laser Therapy EC model.
Photobiomodulation in the radial artery
ACTIVE COMPARATORIntravascular laser irradiation will be applied to the skin in the region of the radial artery with a specific bracelet of the DMC laser Therapy EC model.
Interventions
In the group submitted to sublingual irradiation, disposable plastic wrap will cover the application pen for the purposes of hygiene, and irradiation will take 10 minutes.
Transcutaneous irradiation of the spinal cord will be performed on segments corresponding to the nerve roots of the lumbosacral plexus (T12-S5) and cervicothoracic plexus (C5-T1-2). Twenty points will be irradiated for 30 seconds (total treatment time: 10 minutes).
Intravascular laser irradiation will be applied to the skin in the region of the radial artery with a specific bracelet of the DMC laser Therapy EC model.
Eligibility Criteria
You may qualify if:
- Diagnosis of MS;
- Age between 18 and 60 years;
- Currently undergoing pharmacological treatment;
- Capable of understanding and following verbal instructions;
- score of \< 7 on the Expanded Disability Status Scale;
- No restriction will be imposed regarding gender.
You may not qualify if:
- Other autoimmune diseases;
- Neoplasias;
- Heart failure;
- Respiratory failure;
- Renal insufficiency;
- Hepatic insufficiency;
- Acquired immunodeficiency syndrome;
- Patients with relapses of the disease will be excluded from the study.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
UNINOVE
São Paulo, São Paulo, 01504-001, Brazil
Related Publications (2)
Silva T, Alencar RC, de Souza Silva BC, Viana ECOM, Fragoso YD, Gomes AO, Cristina Chavantes M, Deana AM, Gallo JMAS, Fernandes KPS, Mesquita-Ferrari RA, Bussadori SK. Effect of photobiomodulation on fatigue in individuals with relapsing-remitting multiple sclerosis: a pilot study. Lasers Med Sci. 2022 Oct;37(8):3107-3113. doi: 10.1007/s10103-022-03567-3. Epub 2022 May 2.
PMID: 35499744DERIVEDSilva T, Fragoso YD, Destro Rodrigues MFS, Gomes AO, da Silva FC, Andreo L, Viana A, Teixeira da Silva DF, Chavantes MC, Tempestini Horliana ACR, De Angelis K, Deana AM, Branco LP, Santos Fernandes KP, Motta LJ, Mesquita-Ferrari RA, Bussadori SK. Effects of photobiomodulation on interleukin-10 and nitrites in individuals with relapsing-remitting multiple sclerosis - Randomized clinical trial. PLoS One. 2020 Apr 7;15(4):e0230551. doi: 10.1371/journal.pone.0230551. eCollection 2020.
PMID: 32255785DERIVED
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- phase 2
- Allocation
- RANDOMIZED
- Masking
- DOUBLE
- Who Masked
- PARTICIPANT, OUTCOMES ASSESSOR
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Principal Investigator
Study Record Dates
First Submitted
November 17, 2017
First Posted
December 4, 2017
Study Start
January 1, 2018
Primary Completion
December 31, 2018
Study Completion
February 28, 2019
Last Updated
October 11, 2018
Record last verified: 2018-10