With recent developments in photosensitizers and light delivery systems,topical 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) has become the fourth alternative therapeutic approach in the management of...With recent developments in photosensitizers and light delivery systems,topical 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) has become the fourth alternative therapeutic approach in the management of oral leucoplakia (OLK) due to its minimally invasive nature,efficacy,and low risk of systemic side effects and disfigurement.This report presents step-by-step guidelines for applying topical ALA-PDT in the management of OLK based on both the clinical experience of the authors and a systematic review of the current literature.Studies using protocols with standardized parameters and randomized clinical trials at multiple centres with adequate sample sizes and both interim and long-term follow-ups are needed before universally applicable guidelines can be produced in this field.展开更多
基金supported by grants from the National Natural Science Foundation of China (81572663, 81621062, 81730030, 81771081 and 81520108009)the 111 Project of MOE (B14038), Chinathe National Health Planning Commission of China (201502018)
文摘With recent developments in photosensitizers and light delivery systems,topical 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) has become the fourth alternative therapeutic approach in the management of oral leucoplakia (OLK) due to its minimally invasive nature,efficacy,and low risk of systemic side effects and disfigurement.This report presents step-by-step guidelines for applying topical ALA-PDT in the management of OLK based on both the clinical experience of the authors and a systematic review of the current literature.Studies using protocols with standardized parameters and randomized clinical trials at multiple centres with adequate sample sizes and both interim and long-term follow-ups are needed before universally applicable guidelines can be produced in this field.
文摘目的:检测5-氨基酮戊酸-光动力疗法(ALA-PDT)治疗前后尖锐湿疣皮损凋亡相关因子(Fas、caspase3、Bcl-2)及促炎症细胞因子(CCL-20、TNF-α、IL-1)的表达,探讨AL A-PDT治疗尖锐湿疣的可能机理。方法:收集10例尖锐湿疣患者ALA-PDT治疗前后皮损(同时以正常健康者皮肤组织对照),采用荧光定量PCR检测其Fas、caspase3、Bcl-2、CCL-20、TNF-α、IL-1 mRNA表达;Western blot检测其Fas、caspase3、Bcl-2、CCL-20、TNF-α、IL-1蛋白表达。结果:尖锐湿疣皮损组织内Fas、caspase3、Bcl-2、CCL-20、TNF-α、IL-1 mRNA和蛋白表达均高于正常皮肤组织(P<0.05);与治疗前比较,治疗后Bcl-2、CCL-20、TNF-α、IL-1 m RNA和蛋白表达水平明显降低(P<0.01),Fas、caspase3 m RNA和蛋白表达水平明显升高(P<0.01)。结论:AL A-PDT是一种能有效治疗尖锐湿疣的方法,它可诱导细胞表面凋亡蛋白Fas、caspase3的表达、减少凋亡抑制因子Bcl-2的表达,从而可能依靠内源性途径(线粒体介导的凋亡)和外源性途径(死亡受体介导的凋亡)促进尖锐湿疣角质形成细胞凋亡;并可能通过抑制促炎细胞因子CCL-20、TNF-α、IL-1而发挥局部免疫调节作用。
