Dual red and near-infrared LED therapy inhibits MRSA biofilm in otitis media

Otitis media (OM), particularly when caused by methicillin-resistant Staphylococcus aureus (MRSA), can become refractory due to biofilm formation, which contributes to resistance against conventional antimicrobial treatments. Photobiomodulation using light-emitting diode (LED) therapy has recently emerged as a promising non-antibiotic strategy for managing refractory infections by targeting biofilm-associated pathology. However, especially in the context of MRSA-induced OM, its therapeutic efficacy and underlying mechanisms remain incompletely elucidated. In this study, we established a rat model of OM by inoculating MRSA (5 × 10⁸ CFUs) into the middle ear via the tympanic membrane. Red and near-infrared (NIR) LED irradiation (655/842 nm; 163.2 W/m²; 30 min/day for 5 days) was administered 1 week after infection. Scanning electron microscopy revealed a marked reduction in MRSA biofilm structures, and biofilm biomass was significantly decreased, as assessed by crystal violet staining. Quantitative real-time polymerase chain reaction (qRT-PCR) analysis demonstrated significant downregulation of fib, icaB, icaC, and icaD, key genes crucial for bacterial adhesion and biofilm development. Histological assessment further showed decreased mucosal thickening and macrophage infiltration, supported by reduced ionized calcium-binding adapter molecule 1 (Iba1) expression. These findings suggest that dual red and NIR LED therapy effectively suppresses MRSA biofilm formation and inflammation in OM, indicating its potential as a novel non-antibiotic therapy for biofilm-associated OM that may help manage persistent or treatment-resistant cases in clinical settings.