Laser de baixa potência no tratamento da artrite induzida por zymosan

Abstract

Rheumatoid Arthritis (AR) is a chronic inflammatory disease, characterized by joint inflammation and associated with motor and labor incapacity. Since treatment strategies could present a serious side effects and not always achieved clinic improvement, the Low Level Laser Therapy (LLLT) have being considered as an alternative to arthritis treatment, due to its anti-inflammatory and healing abilities. However, LLLT anti-inflammatory mechanisms in biological tissues is not completely understood. Then, this study aimed to evaluate immunological mechanisms and contribution of matrix metaloproteinases (MMPs) and its inhibitor (TIMP) on inflammation resolution process induced by LLLT. Arthritis was induced in C57BL/6 mice by zymosan injection into periarticular region. Experimental animals were divided in 4 groups (n=8): (ZY) arthritis induced by zymosan and untreated; (ZY + 3Jcm-2) arthritis induced by zymosan and treated with LLLT at 3Jcm-2; (ZY + 30Jcm-2) arthritis induced by zymosan and treated with LLLT at 30Jcm-2; (ZY + DEXA) arthritis induced by zymosan and treated with dexamethasone. LLLT parameters were: 830nm, 10mW energy densities at 3 Jcm-2 e 30 Jcm-2, in continuous wave emission mode. Irradiation sections and dexamethasone treatment were carried out 4 days consecutively, starting 5 hours after arthritis induction. Animals were euthanized 24h after the last treatment section and the following analysis were procedure at ankle: morphological, cytokine mRNA relative levels, chemokines, MMPs and TIMP2 by RT-qPCR, quantification of cytokines tissue expression by ELISA and MMP13 and TIMP2 by imunohistochemistry. In popliteal lymph node, leukocytes populations were identificated and quantificated by flow cytometry. Morphological analysis showed inflammatory infiltration at adjacent connective tissue of joints, after zymosan injection. After LLLT, it was observed cytokines tissue expression decrease and mRNA levels alteration of important cytokines and chemokines in pathophisiology of AR, depending of energy density used. The ZY + 3Jcm-2 group showed an increase leukocytes populations, as well as, higher expression of costimulatory proteins in macrophages and dendritic cells of popliteal lymph node. Additionally, it was observed higher Treg population in LLLT groups than ZY group. More, ZY + 30Jcm-2 showed higher Treg CD8+ population presenting CD25high. LLLT decreased mRNA levels of almost MMPs analyzed and increased of TIMP2, except for ZY + 3Jcm-2 group in which was observed MMP13 and TIMP2 tissue expression increase. Taken togheter, all results showed that LLLT, at both energy densities used, presente positive anti-inflammatory effects for RA treatment, since it decreases the levels of cytokines, chemokines and MMPs at inflammed tissues. LLLT could also alter number and phenotype leukocytes in lymph node, especially Treg cells.