TRIBUTE Professor Endre Mester, the Father of Photobiomodulation Professor Lajos Gáspár, DDS, PhD, , J Laser Dent 2009;17(3):146-148

Editor’s Note: During a recent visit to Romania to attend a conference, Dr. Steven Parker met with Professor Lajos Gáspár, an ALD member from Hungary. Both were invited speakers at the meeting and their discussions led to the recognition of the undisputed place of Professor Endre Mester (1903–1984) in the development of low-level laser application in medicine. Inspired by the work of Professor Mester, Professor Gáspár is credited with the first Hungarian PhD thesis in the field of laser research. In his own country, Professor Gáspár has pioneered the introduction of both high-power and low-power lasers in oral and dental surgery. The following reflects Professor Gáspár’s intimate association with Professor Mester’s family and provides testi- mony to the impact of Endre Mester as the father of photobiomodulation in low-level laser therapy.

Professor Endre Mester, MD, DSc, skin of laboratory rats and exposed was born in Budapest, Hungary, in them to a customized ruby laser, 1903. As a schoolboy, he excelled as based on Maiman’s earlier model. a violin player and developed an To his surprise, the tumor cells interest in medicine. With such were not destroyed by doses of diverse interests, he decided to sit what was presumed to be high- university entrance examinations power laser energy. Instead, it was in both medicine and music. He observed that in many cases the succeeded in gaining a place to skin incisions made to implant the read medicine at the University of abnormal cells appeared to heal Budapest. His continued interest in faster in treated animals, compared music was relegated to social enjoy- to incisions of control animals that 5

3 ment with friends on weekends. Professor Endre Mester, MD, DSc were not treated with light. Mester . Having successfully completed (1903-1984) was baffled as to how a device that O

N his undergraduate medical study was intended to destroy tumor cells ,

7 and graduation, he was invited to latter led to his gaining his PhD. had instead promoted tissue repair. 1 receive training in surgery as a Promotion led to his full professor- His custom-designed ruby laser L

O resident staff member of the 3rd ship and Director of the 2nd was weak and certainly not as V Department of Surgery at the Department of Surgery of powerful as he thought it to be. 9

0 University of Budapest. He subse- in Budapest Instead of being photo-ablative, the 0

2 quently obtained his first position and election as President of the low-power light had no effect on outside the university as head of Society of Hungarian Surgeons. the tumor. Indeed, it stimulated the | children’s surgery in St. Steven’s At Semmelweis, Mester started skin to heal faster. This fortuitous Hospital in Budapest. From there, laser research in 1965; this was encounter opened the field of mono- Y

R greater recognition beckoned and five years after the development of chromatic light treatment. T

S his next position was head of a the first laser by Theodore H. This casual observation led him I

T major hospital in Budapest, the Maiman1 and only two years after to design an experiment to ascer- N

E Bajcsy Zsilinszky. There he surgical laser applications had tain his suspicion that treatment D combined clinical work with admin- been pioneered by notable workers with red light accelerated healing of R 2 E istration, being appointed director such as Paul E. McGuff and Leon the surgical skin incisions he made S 3-4 A of the hospital. Goldman. to implant the cells. The experiment L During this period, Mester Like others of his era, Mester was successful as it showed that F

O undertook research and scientific attempted to use a “high-power” treatment with red light indeed L work in the field of abdominal laser to destroy malignant tumors. produced faster healing of the skin A

N surgery, with a special focus on bile Early in his experiments, he wounds. Baffled but fascinated by R

U duct surgery. His interest in the implanted tumor cells beneath the this development, he carried out O J

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other experiments in which he inflammatory prostaglandins, • Klara Barabas achieved a PhD in showed that experimental skin resulting in decreased inflammation. experimental and clinical double- defects, burns, and human cases of Since Mester first uncovered the blind evaluation of laser ulcers arising from diabetes, venous therapeutic value of red light, treatment of insufficiency, and infected wounds different wavelengths of light have • Timea Berki wrote a PhD thesis also healed faster in response to his been shown to promote healing of about immunological effects of laser treatment.5-7 skin, muscle, nerve, tendon, carti- laser irradiation on B-lympho- In direct opposition of contempo- lage, bone, and dental and cytes rary theory that the future of lasers periodontal tissues.9-19 In studies, • His elder son Adam Mester lay solely in the domain of resective when healing appears to be completed a PhD thesis about surgery, Mester had discovered a impaired, such tissues respond laser irradiation of T-lymphocytes. new application of laser energy – positively to the appropriate doses He is currently head of the repeated low-intensity laser irradia- of light, especially light that is National Laser Centre for biostim- tion to determine radio-biological within 600 to 1,000 nm wave- ulation-based wound and arthritis effects. He was the first to describe lengths. The evidence suggests that healing in Budapest, Hungary. the “biostimulation” effect of lasers. low-energy light speeds many It is inappropriate to consider Following his earlier observations stages of healing as it accelerates the development of low-level laser on skin, he developed studies into inflammation, promotes fibroblast therapy without the acknowledge- accelerated healing: hair growth in proliferation, enhances the ment of many other international mice, where depilated skin was synthesis of type I and type III researchers and clinicians. Equally, prepared for such irradiation procollagen mRNA, quickens bone it is pertinent to record that the studies, appeared to be faster after repair and remodeling, promotes basic investigations of Mester into a exposure to laser energies as low as re-vascularization of wounds, and phenomenon known as “biostimula- 1 Joule/cm2 per day.8 accelerates tissue repair in experi- tion” have shown that, far from Experimental research into laser mental and clinical models. active stimulation, many of the biostimulation continued most The inspiration showed by processes observed, such as pain actively during a period of 6 years Mester led to many Hungarian suppression, are in fact inhibition. and Mester was awarded a workers achieving eminence in the Therefore, it is now customary to Scientific Doctorate by the field of low-level laser therapy. His look at the area of low-level laser Hungarian Academy of Sciences in sons Andrew and Adam were co- therapy as “photobiomodulation” recognition of his work. His experi- workers, and Andrew, living in (PBM). The Academy of Laser mental studies showed that many California, published studies about Dentistry is proud of its association

different beneficial effects associ- neuro-olfactory biostimulation. with current leaders in the field, 3 ated with healing might be due to Lajos Hazay irradiated urinary such as Jan Tunér and Mary Dyson. . O

photobiostimulation. bladder ulcers using a low-level The growing interest in PBM in N ,

Mester measured effects of laser and a fiber-optic delivery clinical dentistry may lag that 7 different laser doses on the mucosal system. Attila Torok began work shown in other medical disciplines, 1 L

surface of dog’s intestinal mucosa. into duodenal ulcers and treated but opinions are gradually changing O He proved fibroblast activation led ulcerative colitis with a similar in areas outside Eastern Europe V 9 to increased collagen production. laser system. Judit Ortutay and investigations continue to drive 0 0

During healing of vasculitis ulcers in published rheumatologic studies. the understanding of nonablative, 2 rheumatoid arthritis patients, he Eniko Korchma published results coherent photonic energy as an observed anti-inflammatory and in oral and dental photobiomodula- adjunct to tissue healing. | pain-decreasing effects as well. tion. Judit Horvath wrote a book Professor Endre Mester passed Y

Measurement of increased phagocy- about experiences of a general away in 1984. His legacy is that his R T

tosis in granulocytes was shown to practitioner using low-level lasers. unforeseen results obtained using a S I be directly due to the effects of his Other notable Hungarian rudimentary laser device has led to T N low-level ruby laser. These observa- workers have achieved success a far-reaching and routine treat- E tions promoted in vitro studies of through Endre Mester: ment modality that is used in all D R lymphocytes, where systemic • Lajos Kovacs was awarded a branches of medicine and dentistry E S

immunological effects were proved. Scientific Doctor title with exper- on a daily basis. A He organized large numbers of imental and clinical studies in L F collaborator researchers to under- gynecology AUTHOR BIOGRAPHY O take widespread studies. Results • Gyorgy Szabo successfully Dr. Lajos Gáspár is currently an L A showed different laser effects on submitted a PhD thesis in ear- Associated Professor, Head of Ecto N R

anti-inflammatory versus pro- nose-throat biostimulation Derma Polyclinic at the University U O J

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Pathology of the effect of the laser tion accelerates wound healing in Educational Center, Budapest, beam on the skin. Nature diabetic rats. Wound Repair Regen Hungary. He has published 120 arti- 1963;197(4870):912-914. 2001;9(3):248-255. cles about lasers and 9 books and 16 book chapters about dentistry, and 5. Mester E, Ludány G, Sellyei M, 13. Mester E, Korényi-Both A, Spiry T, has given more than 600 presenta- Szende B, Tota J. The simulating Tisza S. The effect of laser irradia- effect of low power laser rays on tion on the regeneration of muscle tions. His special honors include: biological systems. Laser Rev fibers (preliminary report). Z Exp President of the Biomedical Optics 1968;1:3. Chir 1975;8(4):258-262. Committee of Academy of Sciences Hungary, Secretary General of the 6. Mester E, Spiry T, Szende B, Tota 14. Shamir MH, Rochkind S, Sandbank Hungarian Medical Laser and Optics JG. Effect of laser rays on wound J, Alon M. Double-blind randomized healing. Am J Surg 1971;122(4):532- study evaluating regeneration of the Society, National Representative 535. rat transected sciatic nerve after (Hungary) of the World Federation suturing and postoperative low- 7. Mester E, Mester AF, Mester A. The for Laser Dentistry (WFLD) and the power laser treatment. J Reconstr biomedical effects of laser applica- International Society for Oral Laser Microsurg 2001;17(2):133-137. Applications (SOLA). Professor tion. Lasers Surg Med 1985;5(1):31-39. 15. Enwemeka CS, Cohen E, Duswalt Gáspár can be contacted by e-mail at EP, Weber DM. The biomechanical 8. Mester E, Szende B, Tota JG. [email protected]. effects of Ga-As laser photostimula- Lasersugár hatása egerek szorének” tion on tendon healing. Laser Ther növekedésére [Effect of laser on hair Disclosure: Professor Gáspár has no 1995;6:181-188. commercial relationships relative to growth of mice]. Kisérl Orvostud 1967;19:628-631. Hungarian. 16. Houghton PE, Brown JL. Effect of this manuscript. low level laser on healing of 9. Kana JS, Hutschenreiter G, Haina wounded fetal mouse limbs. Laser D, Waidelich W. Effect of low-power R EFERENCES Ther 1999;11(2):54-70. 1. Maiman TH. Stimulated optical density laser radiation on healing of radiation in ruby. Nature open skin wounds in rats. Arch Surg 17. Akai M, Usuba M, Maeshima T, 1960;187(4736):493-494. 1981;116(3):293-296. Shirasaki Y, Yasuoka S. Laser’s effect on bone and cartilage change 10. Halevy S, Lubart R, Reuvani H, 2. McGuff PE, Bushnell D, Soroff HS, induced by joint immobilization: An Grossman N. Infrared (780 nm) low Deterling RA Jr. Studies of the experiment with animal model. level laser therapy for wound surgical applications of laser (light Lasers Surg Med 1997;21(5):480-484. amplification by stimulated emis- healing: In vivo and in vitro studies. sion of radiation). Surg Forum Laser Ther 1997;9:159-164. 18. Ozawa Y, Shimizu N, Kariya G, Abiko Y. Low-energy laser irradia- 1963;14:143-145. 11. Rezvani M, Robbins MEC, Hopewell tion stimulates bone nodule JW, Whitehouse EM. Modification of 3 3. Goldman L, Blankey DJ, Kindel DJ formation at early stages of cell . Jr, Franke EK. Effect of the laser late dermal necrosis in the pig by

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