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CHAPTER 1 tissue photoacceptors, which can trigger energy transfer, electron transfer, and/or ligand dissociation, broadly known as photochemistry (reviewed in de Freitas and Hamblin, 2016). Through 50 years of research, numerous studies have measured the heat change following light treatment to better understand its mechanisms. Due to mixed reports on temperature changes caused by irradiation (Gomes et al., 2017; Joensen et al., 2011), studies on the PBM mechanism mainly focus on the photochemistry aspect. This pathway is rather complicated, and a large number of molecules are involved; however, a simplified pathway is illustrated in Figure 1.5. The photons are first absorbed by photoacceptors, which undergo a series of energy/electron transfer changes (de Freitas and Hamblin, 2016; Karu, 1999). This leads to: 1) the production and/or upregulation of signalling molecules such as adenosine triphosphate [ATP] (Parkhomenko et al., 1993), cyclic adenosine monophosphate [cAMP] (Parkhomenko et al., 1993), ROS (Agostinis et al., 2011), NO (Karu et al., 2005), and Ca2+ (Santulli and Marks, 2015); and 2) activation of transcription factors such as nuclear factor kappa B [NK-κB] (Chen et al., 2011), receptor activator of nuclear factor kappa B ligand [RANKL] (Incerti Parenti et al., 2014), hypoxia inducible factor 1 α [HIF-1α] (Cury et al., 2013). Different effector molecules are then transcribed and translated for cell migration/proliferation, anti-inflammation, anti-apoptosis. While the downstream signalling cascade has been studied extensively, the first step in the proposed mechanistic pathway outlined in Figure 1.5 remains to be elucidated. Currently, there are two main hypotheses for the initiation of the signalling pathway, one is mitochondria focused (Section 1.2.2.1), while the other is not (Section 1.2.2.2). The current section will discuss each of these aforementioned hypotheses. Figure 1.5 Signalling pathway of photobiomodulation. 21PDF Image | Effects of Red Light Treatment on Spinal Cord Injury
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