Biological mechanisms and applications of photobiomodulation in wound care

Photobiomodulation (PBM) uses specific wavelengths and light intensities to stimulate biological processes within cells, offering a non-invasive method of initiating wound repair. At a cellular level, PBM modulates signalling molecules such as reactive oxygen species and displaces nitric oxide from cytochrome c oxidase in mitochondria, allowing cells to resume signalling and ATP synthesis. This mechanism holds merit as an adjunct to treatments for chronic wounds and radiation-induced fibrosis (RIF). Chronic wounds, such as diabetic foot ulcers, remain in an inflammatory state due to vascular issues and chemical-signalling problems. PBM addresses these through upregulating growth factors and promoting fibroblast activity. RIF is characterised by fibroblast dysregulation, vascular injury and chronic inflammation. There is currently no pharmacological agent that can target every stage of the disease. By regulating fibroblast function, promoting angiogenesis and reducing inflammation, PBM can aid in addressing multiple aspects of the disease. However, the clinical integration of PBM is currently limited by a lack of standardised protocols for PBM use in chronic wounds and RIF. Further studies are needed to establish a therapeutic window and standardise treatment guidelines for patient safety. Such studies will also provide data regarding large-scale cost-effectiveness and longevity of antifibrotic effects.