5-氨基酮戊酸-光动力疗法联合微波治疗尖锐湿疣的临床疗效

目的比较5-氨基酮戊酸-光动力疗法（5-aminolevulinic acid-mediated photodynamic therapy,ALA-PDT）和微波治疗尖锐湿疣的临床疗效。方法尖锐湿疣患者90例,分为3组,A组为特殊部位（尿道口、系带或宫颈部位）的疣体患者20例,采用5-ALA-PDT治疗,每周治疗一次,3次为一疗程。其余70例患者随机分为两组,每组35例,B组为采用ALA-PDT联合微波治疗组,根据疣体大小一次或分次清除疣体;C组为单纯微波治疗组。ALA-PDT微波治疗。末次治疗后7 d进行疗效评价,术后3个月随访评价复发率。结果 A组患者治疗后7 d的清除率为95.2%,总复发率为10.0%。B组和C组末次治疗后7 d的清除率均为100%,术后总的复发率分别为8.6%,28.6%,三组比较差异有显著意义（P〈0.05）。结论 ALA-PDT联合微波治疗尖锐湿疣疗效确切,复发率低。ALA-PDT可有效治疗特殊部位疣体,临床使用范围广。     

5-氨基酮戊酸-光动力疗法治疗复发性尖锐湿疣

目的评价5-氨基酮戊酸-光动力疗法（ALA-PDT）治疗复发性尖锐湿疣的临床疗效。方法复发性尖锐湿疣患者62例,以5-ALA水溶液湿敷患处,3 h后以635 nm半导体激光照射,能量密度261 J/cm2,照射时间20 min,每周治疗1次。治疗后6个月判断治愈率及不良反应。结果 62例患者治愈率为87.1%。主要的不良反应为局部可忍受的刺痛,1例患者肛门口处出现浅表瘢痕。结论 ALA-PDT治疗复发性尖锐湿疣安全可靠,疗效满意。     

5-氨基酮戊酸-光动力疗法治疗尖锐湿疣临床观察

目的 观察5-氨基酮戊酸-光动力疗法(ALA-PDT)治疗尖锐湿疣的疗效和安全性.方法 外生殖部尖锐湿疣患者28例,先后2次将5% ALA霜涂于病变处及其周围5 mm范围皮肤黏膜上,间隔2 h.第2次涂ALA霜后2 h,以功率300 mW、光斑直径15～20 mm、时间20 min、能量密度100 J/cm2、波长635nm半导体激光照射病损区.1周后判定疗效,随访1～3个月观察复发情况.结果 28例患者经过1～2次治疗后治愈26例,治愈率92.9%.随访3个月,复发9例,复发率34.6%.多数患者治疗后局部出现轻度水肿.结论 ALA-PDT可有效治疗外生殖器尖锐湿疣,降低皮损复发率,且不良反应少.     

5-氨基酮戊酸-光动力疗法治疗尖锐湿疣疗效观察

目的观察5-氨基酮戊酸-光动力疗法治疗尖锐湿疣的疗效。方法尖锐湿疣患者50例,病变主要见于尿道口,其次是宫颈口、包皮、大阴唇和肛周。病变及其周围先涂以20%的5-氨基酮戊酸凡士林霜,然后以波长632.8nm,功率100mW,光斑直径2～4cm,能量密度100mJ/cm2的He-Ne激光照射。结果尿道口处病变痊愈率为97.2%,复发率为2.8%;宫颈口处病变痊愈率为75%,复发率为25%;包皮处病变痊愈率为75%,复发率为25%;肛周治愈率为40%,复发率为60%。结论5-氨基酮戊酸-光动力疗法治疗尖锐湿疣疗效确切,复发率较低,其疗效与病变部位、治疗次数相关。     

高频电刀联合氨基酮戊酸-光动力疗法治疗复发性肛周尖锐湿疣

目的探讨高频电刀联合5-氨基酮戊酸(ALA)-光动力疗法治疗复发性肛周尖锐湿疣的疗效以及优化疗效对策。方法肛周尖锐湿疣患者234例,随机分为3组,每组78例。第一组为高频电刀治疗组,以高频电刀烧灼疣体。第二组为光动力疗法治疗组,皮损区涂以20%ALA乳膏后4h,以He-Ne激光照射,距离5～10cm,照射时间20min,光斑直径1～4cm,能量密度100～130J/cm2。间隔7～10d治疗1次,共治疗3次。第三组为高频电刀联合光动力疗法治疗组,高频电刀祛除疣体后立即行光动力疗法治疗。末次治疗后第1周进行疗效评价,在治疗后3个月内对患者进行随访以评价复发率。结果3组患者治疗后疣体均完全消失,黏膜恢复正常。第一组复发率为55.1%,平均复发时间为24.6d;第二组复发率为11.5%,平均复发天数为56.7d;第三组复发率为9.0%,平均复发天数为80.1d。结论5-ALA-光动力疗法能有效治疗肛周尖锐湿疣,联合高频电刀治疗,能有效减少复发,延长复发时间。     

局部5-氨基酮戊酸光动力疗法治疗男性尿道口尖锐湿疣的临床疗效

目的评价局部5-氨基酮戊酸光动力疗法治疗尿道尖锐湿疣的临床疗效和安全性。方法男性尿道口尖锐湿疣患者84例,将20%氨基酮戊酸浸湿的无菌脱脂棉敷于尿道口,塑料薄膜封包4h,以波长635nm,功率260～300mW,能量密度100～120J/cm2的半导体激光照射20～30min。每7～10d治疗1次,共治疗3次,治疗后6个月评估治愈率、复发率及不良反应。结果尿道口的疣体治愈率为95.2%,复发率为4.8%。主要不良反应有轻度糜烂、疼痛、渗液,没有瘢痕、尿道狭窄和系统不良反应发生。结论 ALA-PDT疗法具有清除率高,复发率低,耐受性好的特点,是治疗尿道口尖锐湿疣的好方法。     

5-氨基酮戊酸光动力学疗法治疗Bowen病

目的探讨５－氨基酮戊酸（ＡＬＡ）光动力学疗法（ＰＤＴ）治疗Ｂｏｗｅｎ病的疗效。方法５例Ｂｏｗｅｎ病患者皮损发生于腹部及股部，面积３．２ｃｍ×３０ｃｍ至４．５ｃｍ×３０ｃｍ，均经病理组织学检查确诊。局部外用新鲜配制的２０％ＡＬＡ霜，３ｈ后用波长６３２．８ｎｍ的ＨｅＮｅ激光照射，激光机输出功率为１００ｍＷ，每次光剂量６０～１００Ｊ／ｃｍ２，照射时间８～１５ｍｉｎ。结果经１次（１例）和４次（４例）治疗后，患者皮损完全消退，恢复正常皮纹。随访６～１６个月，未见复发。结论ＡＬＡ－ＰＤＴ治疗Ｂｏｗｅｎ病简单、有效、耐受性好，为大面积Ｂｏｗｅｎ病的治疗提供了新思路     

5-氨基酮戊酸-光动力治疗女性宫颈尖锐湿疣

目的：探讨5－氨基酮戊酸光动力疗法对女性宫颈尖锐湿疣的临床疗效。方法：宫颈尖锐湿疣患者2例,采用光动力5．氨基酮戊酸疗法治疗。术前用20％5-ALA溶液在患处敷药固定药棉后进行封包3h后,用波长635nm的LED光治疗仪照射治疗,     

5-氨基酮戊酸光动力疗法联合CO2激光和咪喹莫特治疗尖锐湿疣的疗效观察

目的观察5-氨基酮戊酸光动力疗法（5-aminolaevulinic acid-based photodynamic therapy,ALA-PDT）、CO2激光、咪喹莫特联合治疗（简称三联疗法）尖锐湿疣疗效。方法尖锐湿疣患者109例,随机分两组。治疗组55例,先用CO2激光清除疣体,之后采用ALA-PDT治疗,ALA-PDT治疗后1周皮损处外用咪喹莫特乳膏;对照组54例,仅采用CO2激光清除疣体,治疗后1周皮损处外用咪喹莫特乳膏治疗。两组患者术后1、2、4和6个月随访,比较两组的疗效和复发率。结果治疗组的治愈率和6个月后的复发率分别是89.09%和10.91%。对照组的治愈率和6个月后的复发率分别是70.37%和29.63%。治疗组的治愈率明显高于对照组,而治疗组的复发率显著低于对照组,两组比较差异有显著意义（P〈0.05）。结论使用三联疗法治疗尖锐湿疣,能明显提高治愈率,降低复发率。     

5-氨基酮戊酸-光动力疗法治疗尖锐湿疣156例

尖锐湿疣（condyloma acuminatum,CA）是由人类乳头状瘤病毒（HPV）感染所致的一种性传播疾病,发病率较高,在我国的性病中居第2位。传统的激光、电灼、微波、液氮冷冻及外用腐蚀剂等物理治疗对局部组织破坏较大,且复发率高。5-氨基酮戊酸（ALA）一光动力疗法（PDT）是近年来治疗CA的一种新疗法。我科自2007年7月开始采用AIA—PDT治疗尖锐湿疣156例,取得了较好疗效,现报道如下。     

5-氨基酮戊酸光动力疗法治疗寻常痤疮的临床观察

目的观察5-氨基酮戊酸光动力疗法(ALA-PDT)治疗寻常痤疮的安全性及有效性。方法将90例中重度痤疮患者随机单盲分为两组:治疗组45例,给予ALA-PDT治疗,1次/10 d,共治疗2～4次;对照组45例,口服异维A酸胶囊,每次10 mg,2次/d,共治疗40 d。在治疗的第10、20、30及40天对两组患者进行疗效判断和比较,同时,记录治疗过程中出现的不良反应。结果治疗组患者经过2～4次治疗后,总有效率为97.8%;对照组治疗结束时总有效率为77.8%,治疗组疗效明显优于对照组(P<0.01)。另外,治疗组复发程度明显低于对照组,且病情控制时间明显延长。治疗组的所有皮损,包括粉刺、丘疹、脓疱、囊肿、结节等均比对照组明显减少。结论 ALA-PDT治疗中重度痤疮的疗效明显优于口服异维A酸胶囊,是一种简单、高效、不良反应轻微的治疗中重度寻常痤疮的新方法。     

5-氨基乙酰丙酸光动力杀伤人鼻咽癌细胞株的实验研究

目的 探讨5-氨基乙酰丙酸(5-ALA)光动力学效应(PDT)杀伤人鼻咽癌细胞株CNE2的可能性.方法 对培养的CNE2分别加入不同浓度的5-ALA(0.01、0.05、0.10、0.25、0.5、1.0、2.0、4.0mmol/L)孵育4h,予波长630nm的半导体激光照射,照射能量密度分别为20、10、5、2J/cm2,继续孵育6、12、24h,用四唑盐比色法分别测定细胞存活率.结果 5-ALA-PDT能有效杀伤人鼻咽癌CNE2细胞,其杀伤程度与照射后孵育时间、5-ALA浓度和激光剂量呈正相关(P＜0.01).激光照射后12h,激光能量为20J/cm2,5-ALA浓度为0.5mmol/L时,其杀伤作用最明显.结论 体外培养CNE2细胞对5-ALA介导的PDT敏感.     

Topical photodynamic therapy with 5-aminolevulinic acid for cervical high-risk HPV infection

ObjectiveTo investigate the clinical efficacy of 5-aminolevulinic acid photodynamic therapy (ALA–PDT) for cervical high-risk HPV (HR-HPV) infection.MethodsIn this prospective study, a total of 76 patients with persistent cervical HR-HPV infection were randomly divided into two groups. The treatment group (39 patients) received three treatments of ALA–PDT at two-week intervals. The control group (37 patients) received no treatment. All patients were followed up for 9 months. Hybrid Capture HPV DNA Assay and ThinPrep cytology test (TCT) were performed for both groups. Patients with abnormal TCT results received colposcopic biopsy before treatment and during follow-ups.ResultsHR-HPV remission rates were 64.10% (25/39) in the treatment group and 24.32% (9/37) in the control group at 3 month follow-up. Complete remission rates were 76.92% (30/39) and 32.40% (12/37), respectively, in the two groups at 9 month follow-up. There was a statistically significant difference between the two groups (P < 0.01). Conversion rates of abnormal TCT results were 81.81% (9/11) in the treatment group and 12.50% (1/8) in the control group at 3 months, and 90.90% (10/11) and 25.00% (2/8), respectively, at 9 months. Five of six patients with CIN I in the treatment group and no patients in the control group achieved complete response at 9 months. There was a statistically significant difference between the two groups (P < 0.01).ConclusionTopical ALA–PDT is an effective, safe and well tolerated treatment for cervical HR-HPV infection.     

Effect of 5-aminolevulinic acid photodynamic therapy on keratinocyte proliferation and apoptosis in condyloma acuminatum

BackgroundThe effect of 5-aminolevulinic acid photodynamic therapy on keratinocyte proliferation and apoptosis in condyloma acuminatum tissues was evaluated.MethodsAn immunohistochemical method and TdT-mediated dUTP nick end labeling were performed to detect the positive expression of the keratinocyte proliferation-related gene Ki-67 and apoptosis, respectively, in condyloma acuminatum tissues.ResultsOf 52 cases, 44 showed positive expression of Ki-67 in condyloma acuminatum keratinocytes before the treatment, with a positive expression rate of 84.62% (44/52), an expression strength of mostly ++ − +++, and a Ki-67 proliferation index of 80.26 ± 5.07%. After treatment, 22 cases showed positive expression of Ki-67 in condyloma acuminatum keratinocytes, with a positive expression rate of 42.31% (22/52), an expression strength of mostly − − ++, and a proliferation index of 42.67 ± 3.06%. The differences in the positive expression rate, expression strength, and proliferation index in the before- and after-treatment groups were statistically significant (χ² = 20.070, P < 0.001). For visible apoptotic cells in condyloma acuminatum keratinocytes before the 5-aminolevulinic acid photodynamic treatment, the expression strength was mostly + − ++, and the average apoptotic index was 13.94 ± 2.35%; after treatment, the expression strength was mostly ++ − +++, and the average apoptotic index was 73.88 ± 7.65%; the difference in the apoptotic index between the before and after treatment groups was statistically significant (P < 0.001).Conclusion5-Aminolevulinic acid photodynamic therapy can inhibit the proliferation and promote the apoptosis of keratinocytes, and represents an effective mechanism for treating condyloma acuminatum.     

The effect of hypoxia on photodynamic therapy with 5-aminolevulinic acid in malignant gliomas

BackgroundGlioblastoma (GBM) is a high-grade, poor prognosis tumor that is resistant to standard treatment. The presence of a small number of glioma stem cells (GSCs) surviving in the harsh microenvironment is responsible for their refractoriness. This study aimed to investigate the effect of a hypoxic environment on the sensitivity of GSCs to photodynamic therapy with 5-aminolevulinic acid (ALA-PDT).Materials and methodsSix human GSC lines, Mesenchymal types HGG13, HGG30, HGG1123, and Proneural types HGG146, HGG157, HGG528, were divided into two groups: normoxia (O₂ 21%)-cultured cells (Normoxia-GSCs), and hypoxia (O₂ 5%)-cultured cells (Hypoxia-GSCs). To compare the effects of different oxygen partial pressures on photoporphyrin Ⅸ (PpⅨ) biosynthetic activity, PpⅨ biosynthetic enzyme and transporter expression levels were examined by qRT-PCR; the intracellular PpⅨ concentration was determined using flow cytometry. Additionally, the sensitivity of these two groups of cells to ALA-PDT was evaluated in vitro.ResultsHypoxia-GSCs showed higher mRNA levels of FECH (ferrochelatase), which is required for iron synthesis to convert PpⅨ to heme, compared with Normoxia-GSCs. Flow cytometry revealed that the accumulation of PpⅨ in Hypoxia-GSCs reduced upon incubation with ALA. However, Hypoxia-GSCs showed less reduction in sensitivity to ALA-PDT than Normoxia-GSCs.ConclusionHypoxia-GSCs had lower intracellular PpⅨ accumulation than Normoxia-GSCs due to increased gene expression of FECH, and that their sensitivity to ALA-PDT was reduced less, despite accumulating lower concentrations of PpⅨ. ALA-PDT is a potentially effective therapy for hypoxia-tolerant GSCs that exist in hypoxia at 5% oxygen concentration.     

Effect of 5-aminolevulinic acid photodynamic therapy on Candida albicans biofilms: An in vitro study

BackgroundIn this study, the photoinactivation of 5-aminolevulinic acid (ALA) has been investigated on Candida albicans biofilms in vitro.MethodsAfter culture and proliferation of Candida albicans biofilms in vitro, the metabolic activity was confirmed using XTT reduction assay. Then, the suitable incubation time and concentration of ALA were determined by measuring PpIX accumulation quantities. Photosensitivity of the biofilms treated with ALA solution was studied in optical doses of 50, 100, 200 and 300 J/cm² while light irradiation was applied by a red light semiconductor. Finally, rapid immunofluorescence staining method using the LIVE/DEAD FungaLight Yeast Viability Kit and XTT assay were conducted to visualize and quantify the antifungal effect of ALA-PDT on Candida albicans biofilms.ResultsA 5 h incubation time and 15 mM ALA concentration were determined for this study. Photoinactivation of ALA-PDT on Candida albicans biofilms showed a significant increase of protoporphyrin IX (PpIX) in the biofilms. The metabolic activity of Candida albicans biofilms tread with ALA-PDT confirmed the inhibition efficacy compared with control groups. Upon radiation at 300 J/cm², cells in Candida albicans biofilms were 74.45% inhibited.ConclusionsPpIX can be absorbed in biofilm-grown Candida albicans in vitro and under appropriate parameters, photochemistry can be triggered by light in combination with ALA and inhibits Candida albicans biofilms effectively.     

Effects of 5-aminolevulinic acid photodynamic therapy on TLRs in acne lesions and keratinocytes co-cultured with P. acnes

ObjectiveTo investigate the effect of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) on the expression of Toll like receptors (TLRs) in human keratinocytes and its role in acne treatment.MethodsTLR2 and TLR4 expression in acne lesions before and after ALA-PDT were examined by immunohistochemical assay. Primary keratinocytes were obtained from acne lesions, co-cultured with P. acnes and then treated with ALA-PDT using red or blue LED. Cytokines production were examined by ELISA, TLR2 and TLR4 gene expression by real-time PCR, and TLR2 and TLR4 protein expression by Western-blot assay.ResultsThe overexpression of TLR2 and TLR4 in acne lesion were detected, which became negative or weaker after ALA-PDT. The infection of P. acnes in keratinocytes could significantly increase the levels of early inflammatory cytokines (e.g. IL-1α, TNF-α and IL-8) (P < 0.05). Such responses could be inhibited by ALA-PDT. P. acnes infection could also significantly increase TLR2 and TLR4 expressions in keratinocytes (P < 0.05), which could be down-regulated by ALA-PDT.ConclusionsALA-PDT could inhibit innate immune responses in keratinocytes treated with P. acnes via TLRs pathways.