5-氨基酮戊酸光动力疗法治疗痤疮的机制

Mechanism of 5-aminolevulinic Acid Photodynamic Therapy in the Treatment of Acne Vulgaris

寻常痤疮是一种常见的毛囊皮脂腺单位的慢性炎症性疾病,对患者的身心健康均有显著的负面影响。5-氨基酮戊酸光动力疗法(ALA-PDT)目前已成为治疗重度痤疮的一种重要手段,尤其是对局部治疗和口服抗生素反应不佳且维A酸使用受到限制的患者。近年来的研究证实ALA-PDT通过多种机制发挥治疗痤疮的效应,包括抑制皮脂腺细胞生长和脂质分泌,抑制角质形成细胞分化、增殖,放大炎症反应,抑制固有免疫,以及抑制痤疮丙酸杆菌及调控皮肤微生态等。

Acne vulgaris is acommon,chronic inflammatory disease of the pilosebaceous unit.It has significant negative impact on the physical and mental wellbeing of the patients.Treatment of acne,especially of severe ones has been hampered by concerns about the long-term use of antibiotics or potential side effects of oral isotretinion.Increasingly,5-aminolevulinic acid photodynamic therapy(ALA-PDT)is gaining popularity as an alternative to treat severe acne,especially in patients with poor response to topical therapy,oral antibiotics or limited use of tretinoin.The mode of action of ALA-PDT on acne has not been well elucidated.Recent studies show that ALA-PDT exerts its effect through several mechanisms targeting essential pathogenesis in acne,including the inhibition of sebocyte growth and lipid secretion,inhibition of keratinocyte differentiation,proliferation,amplification of inflammatory response,suppression of innate immunity,suppression of Cutibacterium acnes and the modulation of skin microbiota.