Prof. ENDRE MESTER, GODFATHER of LOW LEVEL LASER THERAPY

The 11th Annual NAALT (North American Association for Laser Therapy)  Conference takes place in Milwaukee, Wisconsin, September 22-24, 2011.  It promises to be an exciting meeting.  The keynote speakers are Dr. Roberta T. Chow from Sydney, Australia and Dr. Chukuka S. Enwemeka, Dean of the College of Health Sciences at the University of Wisconsin (Milwaukee).  Dr. Enwemeka has written extensively on wound repair using photobiomodulation and his topic will be 'Advances in Photobiomodulation of Tissue Repair'.1-2.  Dr. Roberta T. Chow has raised the profile of this therapy with her acclaimed article on Neck Pain treated with this modality and published in the Lancet and her topic will be 'Laser, Pain and the Peripheral Nervous system'.3

The theme of the conference is 'Shining Light on Inflammation & Repair from Basic Research to Clinical practice'.

In keeping with the conference theme, some information on the late Prof. Endre Mester (1903-1984) should be of interest.  I have taken much of this from the excellent editorial by Toshio Ohshiro, MD in Laser Therapy, Vol. 17, No.1, March 2008 and from The New Laser Therapy Handbook (Jan Tuner & Lars Hode).  Born on November 20, 1903 in Budapest, Hungary, Endre Mester is considered the "Godfather" of phototherapy.  Following in his grandfather's footsteps, he completed his medical studies in 1927 and then continued his studies in surgery at the Third Surgical Clinic in Budapest.  He became a Professor at Semmelweiss University in 1963.  The name Semmelweiss should trigger an immediate recognition for all those familiar with hand washing as a key instrument in preventing the spread of infection.  The name should also be a caution to those who challenge established medical practice.

As well as his duties in surgery and teaching, Dr. Mester was an avid researcher.  Theodore Maiman presented the first working ruby laser (July 07, 1960 Malibu, California).  A few years later, Dr. Mester acquired a ruby laser.  To investigate as to whether this new form of radiation was carcinogenic or not, he set up an experiment with two groups of mice whose backs were shaven.  One group was irradiated with his 694nm laser at a dose of 1J/cm2.  The other group was the control.  No cancers appeared but by the 10th irradiation the hair on the backs of the laser treated mice had grown back much faster than in the control group.  (Effects of laser of hair growth of mice Mester E, Szende B, Totas JG (1967) Kiserl Orvorstud 19).  This article was published in Hungarian which at that time was part of the Soviet Union and as such made little, if any, impact on western medical thinking but in fact is the basic research underpinning all the hair growth phototherapy equipment that is now flooding the cosmetic market.

He next devoted his attention to the effects of this modality on wound healing changing to a helium neon laser at 632.8nm. (HeNe).  From successful animal experiments, he moved to treating chronic ulcers in the human population,  Again, he was successful in treating ulcers of many months duration and where the patient had two extremities involved, the ulcer on the contra-lateral untreated side also healed although in this case at a slower rate. (Effects of laser rays on wound healing. Mester E, Spiry T, Szende B, Tota JG (1971) Am J Surg, 122:532-535).  From then on, he devoted himself to studying the phenomenon of low levels of laser stimulation.  He recognized that low doses stimulate while higher doses have no effect.  he successfully defended his dissertation on the "Biomedical Effects of the Laser" at the Hungarian Academy of Sciences and was awarded the degree of the doctor of Medical Science.  He became chief of the Laser research laboratory at the Postgraduate Medical School and continued working there until his death March 30, 1984.

His two sons, Adam and Andrew Mester, continued their father's work.  In 1989, they presented data on a total of 1,018 ulcer patients from their father's clinic.  All of the patients had proved resistant to conventional treatment techniques and a few had persisted for years.  Tratment was with 4J/cm2 and an average of 23 treatments was given twice  weekly.  Complete healing was achieved in 829 patients (81.4%) and only 23 patients failed to show any change.  (Mester AF and Mester A (1989): Wound healing. laser Therapy, 1:7-15.

Those of us who use phototherapy in our practices are deeply indebted to Professor  Mester.  Several trials have confirmed the efficacy of Low Level Light Therapy (LLLT) for wound healing. 4,5,6-7.  His initial foundation has steadily been built upon and his careful observances have allowed extension of this modality to many other areas of medicine.  Great progress in this therapy has been made in the face of marked skepticism.  Last year's NAALT conference dealt with the effects of light energy on the Nervous System.  It is now becoming clear that light can affect poorly functioning cells no matter where the location or what the function.  This year, NAALT returns to the basics.  Much has been learned since Professor Mester's death.  The cellular/molecular effects of photon energy are gradually being revealed.  A greater understanding of treatment dose for various conditions is being realized.  We now know that the effect of light energy on cells is not just one of stimulation but rather one of modulation.  Photobiomodulation aptly describes this therapy.  The significant of the Arndt Schultz Law in treating the client is becoming increasingly apparaent.8 

I am looking forward to the NAALT September conference to learn more about about this fascinating subject-a new paradigm in Medicine. 

Brian R. Bennett

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References:

     1. Enwemeka, CS (2004). the Efficacy of Low-Power Lasers in Tissue Repair and Pain Control: A Meta-analysis Study.

                      Photomedicine and Laser Surgery, Vol. 22, Number 4, 2004. 323-329.

              2.    Enwemeka, CS, et. al. (2009). Blue 470-nm light kills methicillin-resistant Staphylococcus aureu (MRSA) in vitro.

                     Photomed Laser Surg. April; 27(2): 221-6. 

              3.   Chow, RT, et.al. (2009). Efficacy of low-level laser therapy in the management of neck pain: a systematic review and

                    meta-analysis of randomized Placebo or active-treatment controlled trials.www.thelancet.com Vol. 374, December 05.

              4.  Gupta, AK, et.al. (1998). the use of low energy photon therapy (LEPT) in venous leg ulcers: a double-blind, placebo 

                    controlled study. Dermatol Surg. Dec. 24 (12): 1383-6.

              5.   Caetano, KS, et.al. (2009). Phototherapy Improves Healing of chronic Venous Ulcers.Photomed Laser surg. Jan. 16.

              6.   Minatel, DG, et.al. (2009). Phototherapy promotes healing of chronic diabetic leg ulcers that failed to respond to 

                    other therapies. Lasers Surg Med. Aug; 41(6):433-41.

              7.   Hopkins, JT, et.al. (2004). Low Level Laser Therapy Facilitates superficial Wound Healing in Humans: A Triple-

                    Blind , Sham-Controlled Study. J Athl Train. Sept; 39(3): 223-229.

              8.  Ying-Ying Huang, et.al. (2009). Biphasic Dose in Low level Light Therapy. Dose-Response (Prepress), formerly

                    Nonlinearity in Biology, Toxicology, and  Medicine. University of Massachusetts. ISSN:1559-3258. DOI:10-2203/

                    dose-response. 09-027.Hamblin.