MECHANISMS OF IMMUNOCORRECTIVE ACTION OF PHOTODYNAMIC THERAPY AND EXOSOMES OF MESENCHYMAL STEM CELLS IN PATIENTS WITH CHRONIC WOUNDS OF THE LOWER EXTREMITIES OF DIFFERENT GENESIS
Summary. Introduction. The treaonic wounds of the lower extremities today requires long-term use of antibiotic therapy, which aggravates the course of the wound process. In this regard, the search for new methods of treatment is underway. Low-intensity light exposure of various wavelengths of photodynamic therapy with photosensitizer photosensitizer Dimegin was used as a physical method, and multipotent mesenchymal-stromal cells and their exometabolites in exosomes form were used as a biological method.
The aim was to study the change of barrier function of oxygen-independent and oxygen-dependent phagocytosis and serum levels of vascular growth factor (VEGF) in patients with chronic wounds of the lower extremities before and after the application of complex light exposure and exosomes.
Materials and methods. Phagocytosis activity of neutrophils was investigated by assessing chemotaxis, adhesion and endocytosis and by determining reactive oxygen species (ROS) in oxygen-dependent phagocytosis using light and confocal microscopy. VEGF concentration was determined by ELISA.
Results: after photodynamic therapy using with red light (λ=660nm), activation of oxygen-independent and oxygen-dependent phagocytosis was observed, as well as an increase in the synthesis of vascular growth factor in patients with chronic wounds of the lower extremities. After the application of green light (λ=530nm) and the application of exosomes, the normalization of immune processes was observed, which led to the acceleration of regenerative processes in the wound.
Conclusions. Thus, after carrying out complex low-intensity light therapy and exosomes, it was possible to completely clear the wounds from necrosis in a short time.
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