Low-fluence photodynamic therapy combinations in the treatment of exudative age-related macular degeneration

AIM:To compare the efficacy of low-fluence photodynamic therapy(PDT) combinations in the treatment of age-related macular degeneration(AMD).· METHODS:Forty-five previously untreated eyes of 45 patients with exudative AMD whose best-corrected visual acuity(BCVA) was ≥0.3(Snellen) were enrolled.15 patients in Group I underwent low-fluence PDT(25J/cm2-300mW/cm2-83sec) and intravitreal pegaptanib combination,15 patients in Group II underwent PDT(50J/cm2-600mW/cm2-83sec) and intravitreal pegaptanib combination while,15 patients in Group III underwent intravitreal pegaptanib monotherapy.Complete ophthalmologic examinations were performed in pre and post treatment visits,and the results were statistically analised.A clinical activity score(CAS) was calculated by using changes in lesion size,amount of hemorrhage,staining pattern in FA and OCT measurement of intra/subretinal fluid.≤3 logMAR lines of decrease in BCVA and decrease in CAS were considered as successful treatment.· RESULTS:The mean age of 19 female(42.2%) and 26 male(57.8%) patients was(72.82±8.02) years.Mean follow-up was(13.93±5.87) months.Lesion type was occult in 28 eyes(62.2%).Treatment success rates according to BCVA assessments were 86.7%,80%,60% and mean BCVA decrease were 0.3,1.0,2.2 logMAR lines in Group I,II and III,respectively(P >0.05).According to the changes in central macular thickness and CAS,no difference was found among the study groups(P =0.850 and P =0.811,respectively).Patients treated with combination regimens had lower intravitreal injection frequencies(P =0.015).· CONCLUSION:Combination regimen with intravitreal pegaptanib and low-fluence PDT seems to be safe and effective in stabilizing the clinical activity and BCVA in exudative AMD.·

Tissue optical clearing enhances efficacy of vascular targeted photodynamic therapy of mouse dorsal skin

Vascular-targeted photodynamic therapy(V-PDT)is an effective treatment for port wine stains(PWS).However,repeated treatment is usually needed to achieve optimal treatment outcomes,possibly due to the limited treatment light penetration depth in the PWS lesion.The optical clearing technique can increase light penetration in depth by reducing light scattering.This study aimed to investigate the V-PDT in combination with an optical clearing agent(OCA)for the therapeutic enhancement of V-PDT in the rodent skinfold window chamber model.Vascular responses were closely monitored with laser speckle contrast imaging(LSCI),optical coherence tomography angiography,and stereo microscope before,during,and after the treatment.We further quantitatively demonstrated the effects of V-PDT in combination with OCA on the blood flow and blood vessel size of skin microvasculature.The combination of OCA and V-PDT resulted in significant vascular damage,including vasoconstriction and the reduction of blood flow.Our results indicate the promising potential of OCA for enhancing V-PDT for treating vascular-related diseases,including PWS.

Experimental study on the photodynamic treatment of choroidal neovasculization with nanophthaloc-yanine photosensitizer

AIM: To investigate the therapeutic effects of nanophthalocyanine photosensitizers on an experimental rat choroidal neovescularization (CNV) model, as well as to evaluate the cytotoxicity of which on human retinal pigment epithelia (HRPE) and human retinal endothelial cells (HRECs). METHODS: Two types of photosensitizers, G(1)-ZnPc(COOH)(8) and G(1)-ZnPc (COOH)(8)/m respectively, were administrated for photodynamic therapy (PDT) after a successful establishment of CNV model on Brown-Norway (BN) rats via fundus photocoagulation. The therapeutic effects of the two drugs were assessed through optical coherence tomography (OCT), fluorescein fundus angiography (FFA) and transmission electron microscopy (TEM). For cytotoxicity tests, cell counting kit-8 (CCK-8) assays and changes of mitochondrial transmembrane potential (Delta psi m) were conducted on HRPE and HRECs after initial uptake of the two drugs. RESULTS: Both photosensitizers demonstrated an improvement of vascular leakage and closure of CNV 1 week after PDT as confirmed by fundus image, OCT, FFA and TEM. Two weeks after PDT, G(1)-ZnPc (COOH)(8)/m showed a better CNV closure effect versus G(1)-ZnPc(COON)(8)(P<0.05). A significant difference (P<0.01) was found in uptake of the two drugs in HRPE and HRECs, with no difference between the drugs(P>0.05). Both photosensitizers showed cytotoxicity on HRPE, but G(1)-ZnPc(COOH)(8)/m induced a lower cell viability. CONCLUSION: G(1)-ZnPc (COOH)(8)/m mediated PDT is better than G(1)-ZnPc (COOH)(8) in CNV closure and also have the advantage of fast metabolism leading to less side effect.

Salvage Photodynamic Therapy Is an Effective and Safe Treatment for Patients with Local Failure after Definitive Chemoradiotherapy for Esophageal Squamous Cell Carcinoma

Although chemoradiotherapy (CRT) is one curative treatment option for patients with esophageal squamous cell carcinoma (ESCC), local failure after CRT remains a major problem for patients’ curability. The aim of this study was to evaluate the efficacy and safety of photodynamic therapy (PDT) as a salvage treatment for local failure. From August 2007 to March 2012, 193 consecutive ESCC patients were treated with definitive CRT in Kyoto University Hospital. Eighteen of the patients with T2 or earlier T-stage local failure after CRT underwent salvage PDT. After the salvage PDT, 11 patients (61.1%) achieved a complete response at the primary site. Over a median follow-up period of 28.3 months, the 1-year survival and progression-free survival rates were 77.8% and 38.9%, respectively;and the 2-year survival and progression-free survival rates were 60.6% and 33.3%, respectively. Adverse events were mild esophageal stricture in seven (38.9%), esophageal obstruction because of necrotic tissue in nine (50.0%), and photosensitivity in three (16.7%) patients. There were no severe complications or treatment-related deaths. Salvage PDT may be a promising treatment option for the patients with a local residual or recurrent tumor after CRT for ESCC when the lesion is suspected to be in T2 or earlier.

Prevalence and treatment patterns of ranibizumab and photodynamic therapy in a tertiary care setting in Malaysia

AIM：To describe the prevalence and changes in treatment patterns of ranibizumab and photodynamic therapy（PDT） among retinal disease patients who attended the Ophthalmology Clinic in the tertiary care Hospital Selayang from 2010 to 2014.METHODS：Study subjects were recruited retrospectively using the Electronic Medical Record（EMR） database software in Hospital Selayang.Demographic data,medical history,diagnostic procedure,treatments and diagnosis of patients were recorded.RESULTS：The five-year analysis included 821 patients with a mean age of 65.9±11.73 y.Overall,there were a highernumber of males（63.1%） and a higher number of Chinese（47.4%） patients.Among the 821 patients,62.9% received ranibizumab injection followed by 19.2% PDT therapy and 17.9% had ranibizumab combined with PDT therapy.Age-related macular degeneration（AMD） and polypoidal choroidal vasculopathy（PCV） were the most common retinal eye diseases reported,recording prevalence of 25.0% and 45.6%,respectively.The trend in ranibizumab treatment was reported to increase while PDT showed a decrease in trend from year 2010 to 2014.In terms of treatment,following multiple logistic regression,AMD was associated with the subjects being more likely to have received ranibizumab monotherapy（P〈0.001） while PCV was associated with more likely to have received PDT（P〈0.001） and PDT combined with ranibizumab therapy（P〈0.001）.CONCLUSION：The tertiary care setting in Malaysia is consistent with management of patients from other countries whereby ranibizumab is the most common treatment given to patients with AMD,while PCV patients most commonly receive PDT and ranibizumab combined with PDT therapy.

A Minimally Invasive Surgery for Bone Metastases Using the Combination of Photodynamic Therapy and Hyperthermia Treatment

Cancer patients with bone metastases in their extremities may require surgical intervention to prevent deterioration in their quality of life due to a pathological fracture or severe bone pain. However, curative surgical interventions sometimes have severe complications due to the status of the original cancers. To avoid the decreased quality of life caused by bone metastasis, minimally invasive surgery that avoids additional surgical morbidity is required. We have established two therapeutic treatments for bone metastasis, a photodynamic acridine orange treatment (AOT) and an electronic magnetic hyperthermia treatment (EMHT). The present study investigated the clinical outcomes of combination therapy with EMHT and AOT for patients with bone metastases in their extremities. Methods: The study included 6 patients with 7 bone cancer metastasis locations. For bone metastases, all patients received intraregional tumor excision supported by AOT, in which photodynamic and radiodynamic therapy kills tumor cells during surgery with minimal damage to normal tissues. After the curettage, bone reconstruction was performed by using magnetic materials with calcium phosphate cement. EMHT was repeatedly performed after surgery. In EMHT, tumor cells are killed with an electric magnetic field generator, and bony union is promoted by electronic stimulation. Results: The mean duration of follow-up was 14 months. During the follow-up period, only one patient experienced a local recurrence, and this recurrence occurred 14 months after surgery. Bony union occurred in 4 of 5 cases (80%), and the pain score was significantly reduced after surgery. Conclusions: In the present study, AOT reduced the invasiveness of surgery. EMHT reduced the tumor growth without major complications and promoted bone formation after surgery. Our clinical results confirmed that EMHT and AOT combination therapy for bone metastasis can preserve limb function without local recurrence or bone absorption.

Aggregation-induced Emission Probe for Fluorescence/Photoacoustic Dual-modality Imaging and Photodynamic/Photothermal Treatment

The combination of near-infrared(NIR)fluorescence imaging(FLI)and photoacoustic imaging(PAI)can effectively compensate for each other’s inherent limitations,which can provide reliable and rich information on tumor biology.Therefore,the development of FL/PA dual-modality imaging probes is beneficial for achieving precision cancer diagnosis and treatment.Herein,we designed an efficient phototherapy agent methoxy bithiophene indene(OTIC),which was based on aggregation-induced emission(AIE)active fluorophores.To improve the water dispersion and enrichment of OTIC at the tumor site,OTIC nanoparticles(OTIC NPs)were prepared by a nanoprecipitation method.The balance between radiation and non-radiation energy dissipation was regulated by the strong donor-acceptor interaction and intramolecular motion.So OTIC NPs exhibited bright NIR fluorescence,photoacoustic signals,efficient generation of reactive oxygen species,and high photothermal conversion efficiency under NIR irradiation.Accurate imaging of the tumor and mice sentinel lymph nodes(SLNs)with OTIC NPs was visualized by NIR FL/PA dual-modal imaging.With the comprehensive imaging information provided by OTIC NPs in vivo,tumors were ablated under laser irradiation,which greatly improved the therapeutic efficacy.OTIC NPs would be possible to realize the precise guidance of FL/PA imaging for tumor treatment in the future clinical application.

Breast cancer as photodynamic therapy target: Enhanced therapeutic efficiency by overview of tumor complexity

Photodynamic therapy is a minimally invasive and clinically approved procedure for eliminating selected malignant cells with specific light activation of a photosensitizer agent. Whereas interstitial and intra-operative approaches have been investigated for the ablation of a broad range of superficial or bulky solid tumors such as breast cancer, the majority of approved photodynamic therapy protocols are for the treatment of superficial lesions of skin and luminal organs. This review article will discuss recent progress in research focused mainly on assessing the efficacies of various photosensitizers used in photodynamic therapy, as well as the combinatory strategies of various therapeutic modalities for improving treatments of parenchymal and/or stromal tissues of breast cancer solid tumors. Cytotoxic agents are used in cancer treatments for their effect on rapidly proliferating cancer cells. However, such therapeutics often lack specificity, which can lead to toxicity and undesirable side effects. Many approaches are designed to targettumors. Selective therapies can be established by focusing on distinctive intracellular(receptors, apoptotic pathways, multidrug resistance system, nitric oxidemediated stress) and environmental(glucose, pH) differences between tumor and healthy tissue. A rational design of effective combination regimens for breast cancer treatment involves a better understanding of the mechanisms and molecular interactions of cytotoxic agents that underlie drug resistance and sensitivity.

Advances in photosensitizer-related design for photodynamic therapy

Photodynamic therapy(PDT)is highly effective in treating tumors located near body surface,offering strong tumor suppression and low damage to normal tissue nearby.PDT is also effective for treating a number of other conditions.PDT not only provide a precise and selective method for the treatment of various diseases by itself,it can also be used in combination with other traditional therapies.Because PDT uses light as the unique targeting mechanism,it has simpler and more direct targeting capability than traditional therapies.The core material of a PDT system is the photosensitizer which converts light energy to therapeutic factors/substances.Different photosensitizers have their distinct characteristics,leading to different advantages and disadvantages.These could be enhanced or compensated by using proper PDT system.Therefore,the selected type of photosensitizer would heavily influence the overall design of a PDT system.In this article,we evaluated major types of inorganic and organic PDT photosensitizers,and discussed future research directions in the field.

Ranibizumab alone or in combination with photodynamic therapy vs photodynamic therapy for polypoidal choroidal vasculopathy: a systematic review and Meta-analysis

AIMTo compare the efficacy of intravitreal ranibizumab (IVR) alone or in combination with photodynamic therapy (PDT) vs PDT in patients with symptomatic polypoidal choroidal vasculopathy (PCV).METHODSA systematic search of a wide range of databases (including PubMed, EMBASE, Cochrane Library and Web of Science) was searched to identify relevant studies. Both randomized controlled trials (RCTs) and non-RCT studies were included. Methodological quality of included literatures was evaluated according to the Newcastle-Ottawa Scale. RevMan 5.2.7 software was used to do the Meta-analysis.RESULTSThree RCTs and 6 retrospective studies were included. The results showed that PDT monotherapy had a significantly higher proportion in patients who achieved complete regression of polyps than IVR monotherapy at months 3, 6, and 12 (All P&#x02264;0.01), respectively. However, IVR had a tendency to be more effective in improving vision on the basis of RCTs. The proportion of patients who gained complete regression of polyps revealed that there was no significant difference between the combination treatment and PDT monotherapy. The mean change of best-corrected visual acuity (BCVA) from baseline showed that the combination treatment had significant superiority in improving vision vs PDT monotherapy at months 3, 6 and 24 (All P&#x0003c;0.05), respectively. In the mean time, this comparison result was also significant at month 12 (P&#x0003c;0.01) after removal of a heterogeneous study.CONCLUSIONIVR has non-inferiority compare with PDT either in stabilizing or in improving vision, although it can hardly promote the regression of polyps. The combination treatment of PDT and IVR can exert a synergistic effect on regressing polyps and on maintaining or improving visual acuity. Thus, it can be the first-line therapy for PCV.

OPTICAL COHER ENCE TOMOGRAPHY OF ADIPOSE TISSUE AT PHOTODYNAMIC/PHOTOTHERMAL TRE ATMENT IN VITRO

Temporal changes in structure and refractive index distribution of adipose tissue at photo-dynamic/photothermal treatment were studied with OCT in vitro.Ethanol-water solutions of indocyanine green(ICG)and brilliant green(BG)were used for fat tissue staining.CW laser diode(808 nm)and LED light source(442 and 597 nm)were used for ir adiation of stained tissue slices.The data received supporting the hypothesis that photodynamic/photothermal treatment,induces fat cell lipolysis during a certain period of time after light exposure.

中医外治法联合光动力治疗中重度痤疮的疗效及安全性

目的探讨中医外治法联合5-氨基酮戊酸光动力治疗中重度痤疮的有效性及安全性。方法根据纳排标准将入选的52例中重度痤疮患者按治疗方式不同分为治疗组及对照组,治疗组给予患者中医外治法联合光动力治疗,对照组仅给予光动力治疗,每组治疗3次,疗程共计6周。比较两组治疗的有效率、不良反应、患者生活质量改善等情况。结果第12周,两组患者痤疮综合分级系统评分较治疗前均明显降低,且治疗组低于对照组(P<0.05);治疗组有效率(92.30%)显著高于对照组(84.70%,P<0.05),治疗组主要不良反应为预处理时可耐受的疼痛。两组共有的主要不良反应为照光时的疼痛、照光后一过性红斑、水肿等,经对症处理可好转,安全性较好。结论中医外治法联合光动力治疗中重度痤疮疗效确切,起效快,优于单独光动力治疗,且具有良好的安全性,值得临床推广应用。

Mitochondria-targeted Janus mesoporous nanoplatform for tumor photodynamic therapy

Photodynamic therapy(PDT)is an effective treatment method for tumors.But the specifically accumulated of photosensitizer was very difficult in the tumor site,which greatly limited the efficacy of PDT.Here,mitochondria-targeted Janus mesoporous nanoplatform(JPMO-Pt-CTPP-ZnPc)for PDT was prepared,the nanoplatform has uniform size(275 nm)and good dispersion and biocompatibility.The confocal laser scanning microscopy(CLSM)revealed the signal of ZnPc of JPMO-Pt-CTPP-ZnPc were higher than JPMO-Pt-ZnPc in tumor cells,and flow cytometry results showed the cell uptake efficiency of JPMO-Pt-CTPP-ZnPc was 2.5-fold higher than that of JPMO-Pt-ZnPc.This revealed the modification of CTPP significantly improves the targeting ability of the nanoplatform.In vitro anti-tumor experiment showed the JPMO-Pt-CTPP-ZnPc significantly inhibited the growth of tumor cells upon the irradiation of low-power laser,and the survival rate of cells incubated with 60μg/mL JPMO-Pt-CTPP-ZnPc was only 3%.Simultaneously,compared with JPMO-Pt-ZnPc(not modified with mitochondria targeting molecules CTPP),the PDT efficacy of JPMO-Pt-CTPP-ZnPc was significantly better,as it has targeted mitochondria in cells.

MRI-guided photothermal/photodynamic immune activation combined with PD-1 inhibitor for the multimodal combination therapy of melanoma and metastases

Non-invasive image-guided precise photothermal/photodynamic therapy(PTT/PDT)has been proven to be an effective local treatment modality but incompetent against metastases.Hence,the combination of local PTT/PDT and systemic immunotherapy would be a promising strategy for tumor eradication.Herein,a magnetic resonance imaging(MRI)-visualized PTT/PDT agent(SIDP NMs)was constructed,and the efficacy of its multimodal combination with a programmed cell death 1(PD-1)inhibitor in the treatment of melanoma and metastases was studied.Due to the hydrophobic encapsulation of indocyanine green within the micellar core,SIDP NMs exhibited excellent photothermal/photodynamic properties and stability under an 808 nm near-infrared laser.In vitro cell experiments showed that SIDP NMs had a good killing effect.After incubating with B16-F10 cells for 24 h and irradiating with an 808-nm laser for 10 min,cell viability decreased significantly.Magnetic resonance imaging experiments in melanoma-bearing mice have shown that the dynamic distribution of SIDP NMs in tumor tissue could be monitored by T2WI and T2-MAP non-invasively due to the presence of superparamagnetic iron oxide nanocrystal in SIDP NMs.When the 808 nm laser was irradiated at the maximum focusing time point shown by MRI,the temperature of the tumor area rapidly increased from 32℃to 60.7℃in 5 min.In mouse melanoma ablation and distant tumor immunotherapy studies,SIDP NMs provided excellent MRI-guided PTT/PDT results and,when combined with PD-1 inhibitor,have great potential to cure primary tumors and eradicate metastases.

Activating MoO_(3) nanobelts via aqueous intercalation as a near-infrared type I photosensitizer for photodynamic periodontitis treatment

Although molybdenum trioxide nanomaterials have been widely explored as nanoagents for biomedical applications against bacteria through photothermal therapy,chemodynamic therapy,and catalytic therapy,their utilization as photosensitizers for photodynamic therapy(PDT)have been rarely reported so far.Herein,we report the activation of MoO_(3) nanobelts via aqueous co-intercalation of Na+and H_(2)O into their van der Waals gaps as a near-infrared Type I photosensitizer for photodynamic periodontitis treatment.The Na^(+)/H_(2)O intercalation of MoO_(3) nanobelts can shorten its length,generate rich oxygen vacancies,and enlarge its interlayer gaps.Such structural changes thus can induce the color change from white to dark blue with a strong near-infrared(NIR)absorption.When used as a photosensitizer,the I-MoO_(3−x) nanobelts exhibit much higher activities for the generation of superoxide radical(·O_(2)^(−))under an 808 nm laser irradiation than that of the pristine MoO_(3) nanobelts.Therefore,the prepared I-MoO_(3)−x nanobelts show a spectral antibacterial activity against Escherichia coli and Saccharomyces aureus,thus yielding a good clinical therapeutic effect on periodontitis.Our study proves that aqueous intercalation can be a simple but powerful strategy to activate layered MoO_(3) nanomaterials for high-performance PDT.

壳聚糖-姜黄素光动力协同作用对圣女果食源性致病菌的灭活效果

食源性致病菌是人类健康的主要威胁之一。本研究旨在探讨壳聚糖(chitosan,Chi)协同姜黄素(curcumin,Cur)介导的光动力处理(photodynamic treatment,PDT)对致病菌的灭活效果。在确定Chi的最低抗菌剂量后,比较PDT和Chi-PDT的杀菌效果,进而评价Cur浓度和光照时间对Chi-PDT灭活金黄色葡萄球菌(Staphylococcus aureus)、蜡样芽孢杆菌(Bacillus cereus)、大肠杆菌(Escherichia coli O157:H7)和沙门氏菌(Salmonella Typhimurium)的影响。同时,探究Chi与PDT的协同作用机制以及Chi-PDT对混合致病菌的灭活作用、对圣女果表面Salmonella的灭活作用和对圣女果品质的影响。结果表明:Chi可以通过增强细菌与Cur的相互作用从而增强PDT灭活效果。Chi-PDT的灭菌效果具有Cur浓度和光照时间依赖性,0.05%(质量分数,下同)Chi结合15μmol/L Cur处理后光照20 min可分别使S.aureus和B.cereus的菌落总数减少7.90、7.60(lg(CFU/mL)),而对E.coli和Salmonella则分别需要0.05%Chi-100μmol/L Cur和0.05%Chi-25μmol/L Cur处理后光照20 min才能达到相似的抑菌效果。Chi-PDT处理可使4种混合菌的菌落总数减少6.00(lg(CFU/mL)),比PDT单独处理时的抑菌量高5.09(lg(CFU/mL)),表明无论是对于单一菌还是混合菌,Chi-PDT协同作用都比PDT单独处理具有更好的灭菌效果。Chi-PDT可使圣女果表面Salmonella的菌落总数减少1.62(lg(CFU/果)),Chi-Cur涂膜协同PDT处理在圣女果保藏期间显示出了较好的抑菌效果,且不影响其色泽、硬度和质量损失率。因此,Chi-Cur协同PDT处理是食品杀菌和果蔬保藏领域中颇具潜力的食品保鲜技术。

半导体激光在牙周非手术治疗的应用研究进展

慢性牙周炎是由菌斑微生物引起得慢性炎症性疾病,去除菌斑结石是牙周非手术治疗的金标准。然而彻底清创难度较大,尤其在一些复杂的解剖位点,过度刮治又可能造成健康牙骨质的丧失导致术后根面敏感。研究表明半导体激光因其波长(630~1064 nm)接近血红素和黑色素的吸收峰值,在有血液的环境中能发挥最佳性能,在口腔领域具有广泛的应用前景。在牙周非手术治疗时半导体激光有软激光疗法、光动力疗法及低能量激光疗法3种治疗模式,可单一使用也可组合使用。虽然半导体激光无法代替机械治疗去除结石,但是其通过光热效应、光化学效应、生物刺激等作用可以去除感染的牙周袋上皮、改变微循环促进创面愈合及止血止痛等。半导体激光治疗效果取决于合适的治疗剂量,需精准掌控输出强度,控制照射时间,避免引起组织的热损伤。未来还需在分子水平上对其进行广泛的研究,了解组织的反应,同时还需更多高质量、大样本的随机对照试验来规范激光在牙周炎中的使用。

声光动力非热杀菌技术的作用机制及应用研究进展

声光动力技术是在光动力技术的基础上衍生和发展起来的一种新型非热杀菌技术,对微生物的灭活效果具有协同增效作用。本文综述声光动力非热杀菌技术的作用机制、影响因素,以及在食品加工中的应用,并展望了声光动力非热杀菌技术发展及亟需解决的技术瓶颈,旨在为非热杀菌技术应用于健康食品的保鲜保质提供参考。

外用光敏剂光动力疗法治疗光线性角化病的研究进展

外用光敏剂光动力疗法(Photodynamic therapy,PDT)是在治疗区域应用光敏剂,暴露于特定波长的光源,并由此形成对非典型角质形成细胞有毒害作用的活性氧,进而选择性破坏病变组织的治疗技术。光动力疗法是一种不断发展的技术,尤其适用皮损面积广泛、多发或不能耐受手术的患者。光动力疗法由于其对病变组织有良好的选择性,对周围正常组织影响小,且痛苦小,不会导致瘢痕形成等优点,已逐渐在临床治疗光线性角化病中广泛应用及推广。本文就外用光敏剂PDT在光线性角化病治疗中的研究进展做一综述。

光动力治疗光线性角化病临床应用进展

光线性角化病(actinic keratosis,AK)是一种临床常见的癌前病变,多好发于曝光部位,常伴区域性癌化,可进展为鳞状细胞癌,在临床上需积极干预、全程管理。光动力疗法(photodynamic therapy,PDT)是AK常用的治疗方式之一,通过利用光敏剂和特定波长的光在氧的作用下发生光动力效应,通过直接杀伤、免疫调节等作用清除AK皮损以及亚临床皮损。PDT治疗AK有效安全、美容效果好,特别适合于头面部、多发、面积大的皮损及区域性癌化。PDT治疗AK可用红光、蓝光、日光、强脉冲光等多种光源激发,其中改良无痛红光PDT通过调整敷药时间、光照剂量等参数以降低治疗过程中的疼痛,在不影响疗效的前提下,提高患者的耐受性,充分发挥了PDT治疗AK的优势。本文将简要介绍PDT治疗AK的作用机制,详细阐述治疗参数、区域性面治疗理念,对比不同类型光动力的疗效及安全性,全面了解PDT治疗AK的临床应用进展。