Light Therapy Q&A with Dr. Cleber Ferraresi

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A Conversation with Dr. Cleber Ferraresi, Photobiomodulation Researcher

We caught up with Dr. Cleber Ferraresi, a leading photobiomodulation (PBM or low-level laser therapy) researcher in Brazil, and a member of Joovv’s Scientific Advisory Board. In this conversation, Dr. Ferraresi tells us about his background, his current work with PBM, how light can help athletes, and what he sees as the future for PBM and human health. You can see more Joovvin’ interviews with health leaders on the Joovv blog

Joovv: What is your current position?

Dr. Cleber Ferraresi: I am a full-time professor of the Biomedical Engineering post graduation program at Universidade Brasil (Brazil).

Joovv: What is your scientific background?

I am a physiotherapist and a Specialist in Exercise Physiology (UFSCar), with a Master's degree in Biotechnology (UFSCar), PhD in Biotechnology (UFSCar). My internships were at the University of Waterloo (under the supervision of professor Richard R. Hughson) and the Wellman Center for Photomedicine - Harvard Medical School (under the supervision of professor Michael R. Hamblin). My postdoctoral program was at the Wellman Center for Photomedicine - Harvard Medical School.

Joovv: When and why did you become interested in studying photobiomodulation? 

Dr. Cleber Ferraresi: During my graduate work in Physical Therapy (2004 – 2007), I started my scientific initiation as a researcher trainee under the supervision of professor Wouber Vieira (a PhD student of professor Nivaldo Parizotto at that time). We investigated the effects of low-level therapy on exercise performance of young women submitted to endurance training, which was only published years later (PMID 21870127). 

During the scientific initiation, I realized the large avenue of applicability of low-level laser therapy in health sciences, especially in sports and physical activity. The main research developed during my Master’s degree was a randomized clinical trial (PMID 21086010) showing for the first time that low-level laser therapy combined with a strength training program could increase muscle performance after 12 weeks. This study, along with others developed during my Master's program were presented in many conferences in Brazil and won several awards. However, although we achieved important results, I identified many gaps in literature that needed to be answered.    

Thus, I started my PhD in Biotechnology at UFSCar (2010-2014) under the supervision of professor Nivaldo Parizotto (graduated in physical therapy) and professor Vanderlei Bagnato (graduated in physics), combining two completely different areas of knowledge, but with a strong link between both: the light. During my PhD in Biotechnology, I conducted several studies using prototyped devices based on light-emitting diodes (LEDs) to increase human muscle performance. However, the basic science and the mechanisms of action behind the photobiomodulation effects investigated in several clinical trials remained unclear. At that time (2012), professor Nivaldo Parizotto was a postdoctoral research fellow of professor Michael R. Hamblin at Harvard. And during that same year, professor Hamblin edited one of the most important books in the field of photobiomodulation (Handbook of Photomedicine). For this book, I wrote a chapter about photobiomodulation therapy and muscle performance together with professor Parizotto. This was the first time that professor Hamblin heard my name and saw my work. 

At the end of 2012, I went to Harvard to be supervised by professor Hamblin, who provided training and conducive environment to explore the mechanisms of action of photobiomodulation therapy (PBMT) on the muscle tissue in animal models and in vitro assays. This was an amazing professional and personal experience for me.

After Harvard, I went to University of Waterloo  in Canada to conduct a second international internship. Professor Richard R. Hughson, one of the physiologists that works with NASA, accepted me in his lab and we investigated the effects of PBMT on the cardiovascular aspects of adaptation to exercise. This experience, similar to the one at Harvard, was very productive.  

Afterwards, I came back to Brazil, defended my thesis in 2014, and flew back to Harvard to start my postdoctoral with professor Hamblin. Throughout all of 2015, I conducted studies not only concerning the effects of PBMT on muscle tissue & exercise, but also ran several studies in other areas such as diabetes. This period was amazing, and filled with a lot of learning, many research interactions, and I experienced quite a bit of growth in the scientific, laboratorial, and personal areas.  

I would like to thank all my supervisors for the many opportunities and training I received that allowed me to build my critical thought and feed my desire to investigate all potential benefits that light can provide for our health and for our life. 

What are some of the health areas within photobiomodulation that you’ve been working on?

Dr. Cleber Ferraresi: I have worked mainly in the areas of muscle performance and physical activity. Moreover, the mechanisms of action of PBM on the biological tissues is a topic that fascinates me and has always attracted my attention. Other areas that I have investigated include diabetes mellitus, obesity, cardiorespiratory diseases, and pain.

Joovv: You’ve published numerous studies on PBM and athletic performance and recovery. In layman’s terms, how would you explain to an athlete how PBM could help them?

Dr. Cleber Ferraresi: I would say this: the light from PBM can boost the reactions inside your cells. In muscles, that leads to increased energy synthesis and enhancing the recovery process. You’ll feel a better disposition to perform exercises with less pain and fatigue. If you add PBM to your training programs, you can achieve higher performance levels than without it.   

Joovv: How do you use Joovv light therapy devices to conduct your research?

Dr. Cleber Ferraresi: I have used Joovv’s light therapy devices for applications in sports performance & obesity, and in the investigation of the mechanisms of action of PBM on the metabolism of muscle cells. 

Joovv: Where do you see PBM in 20 years? What is your hope for the field?

Dr. Cleber Ferraresi: I expect to see PBM as a drug equivalent therapy to promote health for all people in all stages of their lives. This includes fighting pain and diseases such as, but not limited to, diabetes mellitus, obesity, high blood pressure, depression, Parkinson’s, and beyond, without any side effects. In this context, I would not be surprised if the term “photoceutical” become popular and emerged similar to the term,  “pharmaceutical”. Moreover, I expect to see PBMT as a prevention therapy mainly when combined with physical exercises. 

Joovv: Are there any patient stories that really stick out in your mind about the difference PBM has made in their life? 

Dr. Cleber Ferraresi: I treated a patient with a deep,serious injury in her leg after a mechanical trauma. She had infection in her injury with a high risk of amputation of her leg. Working together with a university nurse care service, we fought this injury with PBMT and she recovered rapidly. 

I also worked with professional volleyball players during a national championship in Brazil. In this study, we applied PBM as a preconditioning therapy (before each official match) to prevent muscle damage and increase performance during the competition (PMID 25722067). Although all volunteers were blinded (ie, they didn’t know if they were getting a real or sham treatment), almost all of them perceived the benefits of less muscle damage and fatigue immediately when PBM was applied.

Joovv:  You studied under Dr. Michael Hamblin during your time at Harvard, how did his tutelage help you become a great researcher?

Dr. Cleber Ferraresi: I studied two times at Harvard under supervision of professor Michael R. Hamblin. The first time, during my PhD (2012-2013), I worked on many important studies in the PBMT research field. Dr. Hamblin gave me total liberty to conduct studies in his lab. A thing that I will never forget was the day that he introduced me as his PhD student to all lab heads of the Wellman Center for Photomedicine and their respective facilities, which opened all doors for analyses that would be needed for studies of any kind. In all of our weekly meetings, every PhD students presented and discussed the progress and results of their experiments.

At the end of my internship, based on all of those discussions and exchanges of experience & knowledge, my critical thought process  about PBMT greatly improved, not only in the specific area of exercise and muscle performance, but also in the mechanisms of action, dosimetry, physiology, and integration among all subject areas. The most interesting thing that needs to be highlighted here was the natural and careful way Dr. Hamblin taught his students. 

After defending my thesis in Brazil, I came back to Harvard in 2015 to do my postdoctoral work under professor Hamblin’s supervision. At this time, my responsibilities in the lab increased along with the training I received at the Wellman Center for Photomedicine, which contributed a lot to my maturation as a researcher. As part of my training, beyond the commitment of developing my research, Dr. Hamblin gave me responsibilities such as purchasing planning & management of the lab supplies, and mentorship of new PhD students. These educational opportunities taught me how a principal investigator should manage his team with commitment, excellence, and disruptive research ideas. After finishing my postdoctoral studies, Dr. Hamblin and I still collaborate and have a very friendly relationship. 

Joovv:  A lot of PBM research has come out of Brazil over the last few decades. Why do you think Brazilian researchers and organizations are doing so much groundbreaking PBM work? 

Dr. Cleber Ferraresi: I agree that Brazilian researchers have contributed greatly to the PBM research area in the last few decades. I suppose this contribution is around 30% of the total PBM research production per year in the world.  

Here in Brazil, all public and private universities follow directions from the CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) – which translated means, Coordination for the Improvement of Higher Education Personnel. In these guidelines, there is a triad: teaching, research, and extension. Extension is the action of the university with the community that makes it possible to share, with the external public, the knowledge acquired through research developed at the institution. It is the articulation of scientific knowledge arising from teaching & research with the needs of the community where the university is inserted, interacting, and transforming social reality.

Thus, all universities and postgraduate programs in Brazil are committed to produce knowledge that can be applied or given back to the community for an improvement in their quality of life. In this context, PBM has emerged as a promising and non-invasive therapy with much applicability in health sciences such as in physical therapy, medicine, dentistry. 

Joovv: How do you use PBM for your own health and wellness? Do you recommend it to friends and family?

Dr. Cleber Ferraresi: I use photobiomodulation therapy after my daily workouts to speed up recovery and prepare my muscles for the next day of exercise. I recommend it to all my friends and family. But I always talk about device safety.

Joovv: What’s a big question you still have about PBM?

Dr. Cleber Ferraresi: Definitively, we (researchers) have much work to do concerning the discovery and understanding of all mechanisms of action of PBMT on biological tissues. Only after that we will be able to prescribe ideal doses of light for people according to their conditions and personal characteristics. We’vealready made great progress, but we need to keep going on.  

Joovv: What other health-related topics are you really curious about right now?

Dr. Cleber Ferraresi: Personalized dosimetry, blood irradiation, and their systemic effects on the human body. 

You can see more Joovvin’ interviews with health leaders on the Joovv blog