Laser therapy together with a fibrin biopolymer improves nerve and bone tissue regeneration

Prof. Dr. Rogério Leone Buchaim, Associate Professor, Department of Biological Sciences, University of São Paulo (FOB/USP), Bauru, SP, Brazil.

Profa. Dra. Daniela Vieira Buchaim, Professor, University of Marilia (UNIMAR), Marília, SP; and University Center of Adamantina (UniFAI), Adamantina, SP, Brazil.

A group of researchers from the Bauru School of Dentistry of the Universidade de São Paulo (FOB/USP) established a partnership with the Centro de Estudos de Venenos e Animais Peçonhentos (CEVAP) of the Universidade Estadual Paulista (UNESP) in 2010 to carry out a research supported by the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP). Over the last thirty years, CEVAP has developed the heterologous fibrin bioproduct consisting of a thrombin-like enzyme purified from the venom of Crotalus durissus terrificus snake and a cryoprecipitate rich in fibrinogen extracted from Bubalus bubalis buffaloes. This biopharmaceutical applied in experimental and clinical research motivated us to establish such partnership to study tissue regeneration. The first work of the group was published in 2015 using fibrin sealant as a nerve graft adhesive, associated with low-level laser therapy. The results demonstrated the similarities of the nerve regeneration process using suture technique, considered the “gold standard” of repair, with the axonal growth of the nerves repaired with the sealant, as well as the potential of laser therapy to collaborate as adjuvant or complementary therapy in the repair morphology of the lesion1.

The good results led us to further studies on nerve regeneration. New research evaluated the functional recovery of animal models in addition to the morphological analysis. The return of vibrissae movements of rats within a shorter postoperative period through laser therapy was observed. Moreover, regardless of suture or sealant repair, the quantitative data on the evaluation of nerves recovered from injury were similar2,3,4. Concerning lesions, mainly on the face, either nerve lesions or bone injuries, the sealant was applied as a means of stabilizing bone grafts in rat calvaria, also with laser therapy associated, and we observed the graft integration to the recipient area5.

Image: authors.

Figure 1. (A) Lesions of 8 mm on the skin of the dorsal region of rats filled with fibrin biopolymer (black arrow) in association with laser photobiomodulation (yellow arrow). (B-C) A bone defect of 8 mm in the calvaria of rats being filled with the biocomplex consisting of two scaffolds, the fibrin biopolymer and particulate biomaterial.

In surgeries that require bone grafts, a critical factor to be mentioned in their performance involves the maintenance of particulate materials in the recipient bed, as well as the invasion of soft tissues at the site that needs bone growth. In view of this, we started to test a new biocomplex, composed of synthetic or bovine particulate biomaterials associated with the sealant, which, due to its numerous applications, came to be called heterologous fibrin biopolymer6,7,8. It was noted that the biocomplex is a bioactive element, capable of interacting and modifying the receptor bed, providing a proactive microenvironment for cellular and vascular growth, favoring the action of osteoblasts (Figure 1). This combination of two scaffolds, as well as photobiomodulation therapy (current nomenclature of low-level laser therapy), are adjuvants and their association provides better morphophysiological quality and functional repair and shorter recovery time, as shown in the study A biocomplex to repair experimental critical size defects associated with photobiomodulation therapy published in the Journal of Venomous Animals and Toxins including Tropical Diseases (vol. 28)9.

Having this in mind, our group diversified and intensified experiments with the heterologous fibrin biopolymer, associating it with photobiomodulation, now as a scaffold for fat grafts and skin lesions, in combination with stem cells10,11,12,13,14, filling of alveoli teeth and in the late repair of facial nerve injuries. This multidisciplinary approach will contribute to the field of tissue engineering by showing future translational alternatives allowing safe and effective clinical trials.

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  1. BUCHAIM, R.L., et al. Effect of low-level laser therapy (LLLT) on peripheral nerve regeneration using fibrin glue derived from snake venom. Injury [online]. 2015, vol. 46, no. 4, pp. 655-660 [viewed 3 June 2022]. https://doi.org/10.1016/j.injury.2015.01.031. Available from: https://www.injuryjournal.com/article/S0020-1383(15)00057-1/fulltext
  2. BUCHAIM, D.V., et al. The new heterologous fibrin sealant in combination with low-level laser therapy (LLLT) in the repair of the buccal branch of the facial nerve. Lasers in Medical Science [online]. 2016, vol. 31, no. 5, pp. 965-972 [viewed 3 June 2022]. https://doi.org/10.1007/s10103-016-1939-2. Available from: https://link.springer.com/article/10.1007/s10103-016-1939-2
  3. BUCHAIM, D.V., et al. Efficacy of Laser Photobiomodulation on Morphological and Functional Repair of the Facial Nerve. Photomedicine and Laser Surgery [online]. 2017, vol. 35, no. 8, pp. 442-449 [viewed 3 June 2022]. https://doi.org/10.1089/pho.2016.4204. Available from: https://www.liebertpub.com/doi/10.1089/pho.2016.4204
  4. ROSSO, M.P.O., et al. Stimulation of morphofunctional repair of the facial nerve with photobiomodulation, using the end-to-side technique or a new heterologous fibrin sealant. Journal of Photochemistry and Photobiology B: Biology [online]. 2017, vol. 175, pp. 20-28 [viewed 3 June 2022]. https://doi.org/10.1016/j.jphotobiol.2017.08.023. Available from: https://www.sciencedirect.com/science/article/abs/pii/S1011134417305730?via%3Dihub
  5. OLIVEIRA GONÇALVES, J.B., et al. Effects of low-level laser therapy on autogenous bone graft stabilized with a new heterologous fibrin sealant. Journal of Photochemistry and Photobiology B: Biology [online]. 2016, vol. 162, pp. 663-668 [viewed 3 June 2022]. https://doi.org/10.1016/j.jphotobiol.2016.07.023. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1011134416302354
  6. ROSSO, M.P.O., et al. Photobiomodulation therapy associated with heterologous fibrin biopolymer and bovine bone matrix helps to reconstruct long bones. Biomolecules [online]. 2020, vol. 10, no. 3, pp. 383 [viewed 3 June 2022]. https://doi.org/10.3390/biom10030383. Available from: https://www.mdpi.com/2218-273X/10/3/383
  7. BUCHAIM D., et al. Unique hetetologous fibrin biopolymer with hemostatic, adhesive, sealant, scaffold and drug delivery properties – a systematic review. Journal of Venomous Animals and Toxins including Tropical Diseases [online]. 2019, vol. 25, e20190038 [viewed 3 June 2022]. https://doi.org/10.1590/1678-9199-jvatitd-2019-0038. Available from: https://www.scielo.br/j/jvatitd/a/HDLmtVrKNs3mHFrHx8tB6kL/
  8. DELLA COLETTA, B.B., et al. Photobiomodulation therapy on the guided bone regeneration process in defects filled by biphasic calcium phosphate associated with fibrin biopolymer. Molecules [online]. 2021, vol. 26, no. 4, pp. 847 [viewed 3 June 2022]. https://doi.org/10.3390/molecules26040847. Available from: https://www.mdpi.com/1420-3049/26/4/847
  9. BUCHAIM, D.V., et al. A biocomplex to repair experimental critical size defects associated with photobiomodulation therapy. Journal of Venomous Animals and Toxins including Tropical Diseases [online]. 2022, vol. 28, e20210056 [viewed 3 June 2022]. https://doi.org/10.1590/1678-9199-jvatitd-2021-0056. Available from: https://www.scielo.br/j/jvatitd/a/yzKTwtLSyxhxhJb4xwtP5yP/
  10. FERREIRA, R.S.J., et al. Heterologous fibrin sealant derived from snake venom: from bench to bedside – an overview. Journal of Venomous Animals and Toxins including Tropical Diseases [online]. 2017, vol. 23, no. 1 [viewed 3 June 2022]. https://doi.org/10.1186/s40409-017-0109-8. Available from: https://jvat.biomedcentral.com/articles/10.1186/s40409-017-0109-8
  11. CRESTE, C.F.Z., et al. Highly effective fibrin biopolymer scaffold for stem cells upgrading bone regeneration. Materials [online]. 2020, vol. 13, no. 12, pp. 2747 [viewed 3 June 2022]. https://doi.org/10.3390/ma13122747. Available from: https://www.mdpi.com/1996-1944/13/12/2747
  12. FERREIRA, R.S. Autologous or heterologous fibrin sealant scaffold: which is the better choice? Journal of Venomous Animals and Toxins including Tropical Diseases [online]. 2014, vol. 20, pp. 31 [viewed 3 June 2022]. https://doi.org/10.1186/1678-9199-20-31. Available from: https://jvat.biomedcentral.com/articles/10.1186/1678-9199-20-31
  13. MOZAFARI, R., et al. Combination of heterologous fibrin sealant and bioengineered human embryonic stem cells to improve regeneration following autogenous sciatic nerve grafting repair. Journal of Venomous Animals and Toxins including Tropical Diseases [online]. 2018, vol. 24, no. 1 [viewed 3 June 2022]. https://doi.org/10.1186/s40409-018-0147-x. Available from: https://jvat.biomedcentral.com/articles/10.1186/s40409-018-0147-x
  14. ORSI, P.R., et al. A unique heterologous fibrin sealant (HFS) as a candidate biological scaffold for mesenchymal stem cells in osteoporotic rats. Stem Cell Research & Therapy [online]. 2017, vol. 8, no. 1 [viewed 3 June 2022]. https://doi.org/10.1186/s13287-017-0654-7. Available from: https://stemcellres.biomedcentral.com/articles/10.1186/s13287-017-0654-7

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BUCHAIM, D.V., et al. A biocomplex to repair experimental critical size defects associated with photobiomodulation therapy. Journal of Venomous Animals and Toxins including Tropical Diseases [online]. 2022, vol. 28, e20210056 [viewed 3 June 2022]. https://doi.org/10.1590/1678-9199-jvatitd-2021-0056. Available from: https://www.scielo.br/j/jvatitd/a/yzKTwtLSyxhxhJb4xwtP5yP/

Link(s)

Instagram: @rogerioedanielabuchaim, @unimaroficial, @unifaiadamantina, @fobuspbauru.

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Journal of Venomous Animals and Toxins including Tropical Diseases: https://www.jvat.org/

Journal of Venomous Animals and Toxins including Tropical Diseases – JVATITD: https://www.scielo.br/j/jvatitd/

 

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BUCHAIM, R.L. and BUCHAIM, D.V. Laser therapy together with a fibrin biopolymer improves nerve and bone tissue regeneration [online]. SciELO in Perspective | Press Releases, 2022 [viewed ]. Available from: https://pressreleases.scielo.org/en/2022/06/06/laser-therapy-together-with-a-fibrin-biopolymer-improves-nerve-and-bone-tissue-regeneration/

 

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