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81.
82.
OBJECTIVE: To report a phase-1 study of patients with recurrent superficial bladder cancer treated with photodynamic therapy (PDT) using sequential mitomycin C and 5-aminolaevulinic acid (ALA). PATIENTS AND METHODS: Twenty-four patients were treated, the primary endpoint being the safety and tolerability of combined therapy at increasing doses of ALA and light. RESULTS: Mitomycin C instillation was followed by ALA concentrations of 6%, 8% or 10%; there was no effect on toxicity. The light dose, at a wavelength of 635 nm, was increased from zero to 25 J/cm(2), with the upper fluences producing transient symptoms. There were no episodes of skin photosensitivity or systemic toxicity. A total fluence of 25 J/cm(2) represented the upper light dose for the tolerability of this procedure by patients. There were no persistently high urinary symptom scores or reduction in functional bladder capacity up to > or =24 months of follow-up. In this group, cumulative tumour recurrences were none at 4, two at 8, six at 12, nine at 18 and 11 at 24 months after PDT, respectively. CONCLUSION: Sequential mitomycin C and ALA-PDT is a safe and well tolerated treatment, with potential for managing difficult-to-control superficial transitional cell carcinoma and carcinoma in situ of the bladder. 相似文献
83.
Chiara Savignano Cristina Rinaldi Vincenzo Tursi Cecilia Dolfini Miriam Isola Ugolino Livi Vincenzo De Angelis 《Transfusion and apheresis science》2017,56(4):520-524
Background
The addition of extracorporeal photochemotherapy (ECP) to standard immunosuppressive therapy has been suggested to be beneficial in the treatment of recurrent/persistent heart rejection.Methods
We reviewed medical data of heart transplant recipients who received ECP between 2010 and 2016 at our institution.Results
During the study period, eight patients underwent nine ECP courses. The median time from transplant to ECP was 18 months (range 9–54). Indications for ECP were recurrent rejection in 6 patients, persistent rejection in 1 patient and mixed rejection with hemodynamic compromise in 1 patient. Additional criteria for patients’ selection were represented by relevant comorbidities limiting the increase of immunosuppressive therapies. ECP was performed on an outpatient basis in 6 out of 8 patients. The median ECP duration was 12 months (range 1–18). Three out of 8 patients responded to ECP showing negative endomyocardial biopsies at the end of treatment. No additional rejection episodes were observed at their follow up (at 44, 72 and 31 months). Four of 8 patients failed to respond to ECP treatment, one patient has been judged not evaluable. Reduction of immunosuppressive therapies was obtained in all 3 responsive patients but also in 3 patients with a stable grade of rejection. The median duration of the follow up was 26 months (range 6–80). Two patients died at 6 and 21 months after beginning ECP. Survival after ECP was 78.2% at 26 months. No adverse effect or infectious complications associated with ECP were reported.Conclusions
The low response rate (37.5%) in our case series could be partially explained by patient selection, the treated patients representing a high-risk sub-set group. Further studies to provide evidence of a role for ECP in heart rejection treatment or prophylaxis are needed. 相似文献84.
M. Gunduz E. Atilla P.A. Atilla P. Topcuoglu O. Ilhan 《Transfusion Clinique et Biologique》2019,26(1):32-37
Objectives
Chronic graft versus host disease (GVHD) is one of the major obstacles to achieve success in allogeneic hematopoietic stem cell transplantation (allo-HSCT). Extracorporeal photochemotherapy (ECP) has been demonstrated to be an effective modality for the treatment of GVHD in previous studies but they vary in terms of initiation and duration. Our aim is to demonstrate the characteristics of our patients who received ECP for chronic GVHD to clarify the best treatment scheme.Material and methods
In this study, we retrospectively evaluated 34 patients with steroid refractory chronic GVHD (n = 34) who were treated with ECP between 2001 and 2015. The initiation of ECP was determined according to patient status and the physician's preference.Results
ECP was initiated early (≤ 3 months) as the preferred second-line treatment after failure of methylprednisolone treatment in 12 patients (35%), 22 steroid refractory patients (65%) received ECP later. In all cohorts, 10 (29%) and 14 (41%) of 34 patients achieved complete response (CR) and partial response (PR), respectively, with an overall response rate (ORR) of 70. Early initiation of ECP after chronic GVHD diagnosis (≤ 3 months vs more than 3 months) was associated with increased rates of response (92% vs 59%, P = 0.046) in which the severity of diseases were similar. Patients with skin involvement in early treatment group had statistically better response. Mild side effects were detected in only 6 patients (16%).Conclusion
ECP is a safe treatment modality and particularly effective when initiated soon after steroid failure in chronic GVHD. 相似文献85.
Adjunctive efficacy of probiotics in the treatment of experimental peri‐implant mucositis with mechanical and photodynamic therapy: a randomized,cross‐over clinical trial 下载免费PDF全文
86.
光动力疗法对实验性视网膜母细胞瘤细胞植瘤超微结构的影响 总被引:4,自引:0,他引:4
目的:评价血卟啉衍生物(HPD)介导的光动力疗法(PDT)对裸鼠眼内视网膜母细胞瘤(KB)移植瘤超微结构的影响。方法:将15只裸小鼠视网膜细胞瘤眼内动物模型眼分成A、B、C、D及E五组,其中A和B组为观察组,即既给光敏剂HPD又照光,但光照剂量不同,A组为150mw/cm^2,B组为300mw/cm^2;C组不给光敏剂,只照光;D组只给光敏剂HPD,不照光;E组为未作任何处理的对照组。血卟啉衍生物剂量为5mg/kg,经尾静脉注射给药。照光时机为光敏剂注射后72小时。照光仪的绿激光小为532nm。照光后24小时摘除眼球作透射电镜检查。结果:①实验组A:肿瘤细胞结构不完整,胸质呈浓缩状。核膜不完整,核染色质浓缩成块或裂解成碎片;②实验组B:肿瘤细胞破坏程度更明显,看不到完整的细胞轮廓,也见不到膜性结构及细胞器,仅见一些呈浓缩状态的片状物质,见不到完整的细胞核。③对照组E组:未见组织或细胞损害。瘤细胞轮廓清晰,胞膜完整。胞质内有丰富的线粒体、粗面内质网、核糖体。核膜完整,核间隙未见明显增宽。C组的D组瘤细胞超微结构的改变状况同E组。结论:本研究结果提示:血卟啉衍生物介导的光动力作用对裸鼠眼内RB移植瘤具有显著的杀伤作用,高照光剂量下肿瘤细胞坏死程度更明显。 相似文献
87.
Long-term growth arrest of PUVA-treated fibroblasts in G2/M in the absence of p16(INK4a) p21(CIP1) or p53 总被引:1,自引:0,他引:1
Ma W Hommel C Brenneisen P Peters T Smit N Sedivy J Scharffetter-Kochanek K Wlaschek M 《Experimental dermatology》2003,12(5):629-637
Premature aging of the skin is a prominent side-effect of psoralen photoactivation, a therapy used for different skin disorders. Recently, we demonstrated that treatment of fibroblasts with 8-methoxypsoralen and ultraviolet A irradiation resulted in growth arrest with morphological and functional changes reminiscent of replicative senescence. To further elucidate the underlying molecular mechanisms, we analysed the cell-cycle phases of the growth-arrested fibroblasts. After PUVA treatment, fibroblasts arrested in G2/M, in contrast to spontaneously senesced fibroblasts arresting in a cell-cycle phase with many features similar to G1. To address the role of the cell-cycle controlling genes p16(INK4a), p21(CIP1) and p53, we analysed the expression of these genes. p16(INK4a), p21(CIP1) and p53 protein levels increased substantially with different time kinetics in growth-arrested fibroblasts. Because p16(INK4a), p21(CIP1) and p53 are involved in replicative senescence, we applied the PUVA regimen to fibroblasts deficient in either of these genes. p16(INK4a), p21(CIP1) and p53 null mutant fibroblast strains underwent growth arrest with a senescent phenotype similar to wild-type human fibroblasts. Based on these results, we propose that redundant or alternate pathways are involved in the response of dermal fibroblasts to PUVA treatment resulting in a phenocopy of replicative senescence in vitro. 相似文献
88.
Snellman E Rantanen T Sundell J 《Photodermatology, photoimmunology & photomedicine》2000,16(5):207-210
BACKGROUND: The cumulative artificial ultraviolet (UV) exposure dose of dermatological patients was prospectively monitored in clinical conditions for a total of 2 years (August 1997 - July 1999). We focused on whole body UV treatments, i.e. the trioxsalen (TMP) bath PUVA, the broad-band UVB, and the UVA plus UVB phototherapy. METHODS: Irradiance of the UV devices was calibrated with a spectroradiometer. The cumulative UV doses received by the patients were recorded. A visual analog scale scoring system (VAS) was employed to assess the improvement of various skin conditions at the end of the treatment course. RESULTS: The analysis included 265 patients (141 females and 124 males) and a total of 311 UV treatment courses. Treatments consisted of 86 courses of TMP bath PUVA for psoriasis with a mean cumulative UVA dose of 3.54 J/cm2 and an improvement rate of 89%. For other conditions, 30 courses were needed, with a cumulative UVA dose of 1.47 J/cm2 and an improvement rate of 76%. Altogether, 47 UVB courses were undertaken for psoriasis, and the mean cumulative unweighted UV dose was 2.20 J/cm2, equivalent to 85 standard erythema doses (SED), and an improvement rate of 85%. A total of 25 UVB courses was used for other skin conditions with a mean UV dose of 1.05 J/ cm2, equivalent to 40 SED, and an improvement rate of 71%. A total of 123 courses of UVA plus UVB phototherapy were completed, resulting in a mean cumulative dose of 73.01 J/cm2 for UVA and 0.75 J/cm2 for the unweighted UVB, equivalent to 29 SED. The VAS improvement rate was 85%. CONCLUSION: The exceptionally low mean cumulative UVA dose in the TMP bath PUVA, taken together with the previous report showing no increase in the risk of squamous cell carcinoma or cutaneous malignant melanoma after TMP bath PUVA, suggests that TMP bath PUVA is an effective and safe therapeutic option. 相似文献
89.
Schiener R Behrens-Williams SC Pillekamp H Peter RU Kerscher M 《Photodermatology, photoimmunology & photomedicine》2001,17(4):156-158
BACKGROUND/AIMS: Up to now no data have been available concerning whether there is a significant correlation between skin phototypes and the minimum phototoxic dose (MPD) after bath water delivery of 8-MOP. METHODS: The skin phototype of each of 46 patients was determined based on the individual past history of solar-induced burning and tanning. In addition, the MPD of each patient was assesed after photosensitization with a warm water bath (37 degrees C, 98.6 degrees F) containing 1.0 mg/l 8-methoxypsoralen (8-MOP). Statistical analysis was performed using a Mann-Whitney U-test and Spearman rank order correlation. RESULTS: The median MPD in patients with skin phototype II was 2.0 J/cm2 (range < or =0.5 to > or =3.5) versus 1.5 J/cm2 (range 1.0 to > or =3.5) in patients with skin phototype III. There was a considerable overlap between both groups. No significant difference was detected comparing both groups (P=0.7326) and Spearman rank order correlation revealed no correlation between skin phototype and MPD. CONCLUSION: Erythemal sensitivity in PUVA bath therapy, measured as MPD, is not correlated with sun-reactive skin phototype in skin types II and III. Thus skin phototype is not a suitable indicator for the initial UVA dose in PUVA bath photochemotherapy. 相似文献
90.
Tokura Y Seo N Tomida M Sarukawa M Hashizume H Takigawa M Moriwaki S 《Experimental dermatology》2002,11(6):564-572
Treatment of cells with psoralen and ultraviolet A light (UVA) modulates their cytokine production. As extracorporeal photochemotherapy has been reported to induce cytokine production by monocytes, we quantified interleukin-8 (IL-8), a representative chemokine produced by monocytes, in culture supernatants from human peripheral blood mononuclear cells (PBMC) treated with 8-methoxypsoralen (8-MOP) and UVA. Lipopolysaccharide stimulated IL-8 production in 8-MOP-phototreated PBMC more efficiently than those untreated or treated with 8-MOP or UVA. More interestingly, when cultured with T-cell-stimulating anti-CD3 and anti-CD28 antibodies, 8-MOP/UVA-treated PBMC produced enhanced amounts of IL-8 with an increased level of IL-8 mRNA expression. Depletion of CD4 but not CD8 T cells from PBMC abrogated this augmented IL-8 elaboration, and CD4 T cells per se secreted no substantial amount of IL-8 even upon CD3/CD28 stimulation. Thus, 8-MOP/UVA-treated CD4 T cells stimulated monocytes to secrete IL-8. The IL-8 overproduction was induced by direct contact of monocytes with 8-MOP/UVA-treated CD4 T cells but not by cytokines from the treated CD4 T cells. These findings imply that in extracorporeal photochemotherapy, monocytes effectively produce IL-8 by cell-to-cell contact with 8-MOP/UVA-treated malignant CD4 T cells. The augmentation of monocyte cytokine/chemokine production by 8-MOP/UVA may be one of the mechanisms underlying the therapeutic efficacy of extracorporeal photochemotherapy. 相似文献