Recent advances in photodynamic diagnosis of gastriccancer using 5-aminolevulinic acid

Photodynamic diagnosis based on 5-aminolevulinic acidinduced protoporphyrin IX has been clinically applied in many fields based upon its evidenced efficacy and adequate safety. In order to establish a personalized medicine approach for treating gastric cancer patients, rapid intraoperative detection of malignant lesions has become important. Feasibility of photodynamic diagnosis using 5-aminolevulinic acid for gastric cancer patients has been investigated, especially for the detection of peritoneal dissemination and lymph node metastasis. This method enables intraoperative realtime fluorescence detection of peritoneal dissemination, exhibiting higher sensitivity than white light observation without histopathological examination. The method also enables detection of metastatic foci within excised lymph nodes, exhibiting a diagnostic accuracy comparable to that of a current molecular diagnostics technique. Although several complicating issues still need to be resolved, such as the effect of tissue autofluorescence and the insufficient depth penetration of excitation light, this simple and rapid method has the potential to become a useful diagnostic tool for gastric cancer, as well as urinary bladder cancer and glioma.

Development of a Photodynamic Diagnosis Method for Oral Squamous Cell Carcinoma Using 5-Aminolevulinic Acid and a Luminescence Plate Reader

Purpose: To establish a simple and accurate photodynamic diagnosis (PDD) method for oral squamous cell carcinoma (OSCC). Methods: OSCC cell lines HSC-2, HSC-3, HSC-4, and Sa3, and normal human oral keratinocytes (HOK) were used. First, we examined the amount of cells needed to detect differences in fluorescence intensities for PDD. OSCC cell lines were adjusted to concentrations of 1 × 104 (104), 1 × 105 (105), and 1 × 106 (106) cells/ml. The experimental groups comprised a group with 5-aminolevulinic acid (5-ALA (+)), and a group without 5-ALA (5-ALA (-)). For each OSCC cell line, 100 μl of each concentration of cells of the 5-ALA groups was seeded onto fluorescence plates, and fluorescence intensity was measured at 60-min intervals for 240 min. Results are expressed as the ratio of fluorescence intensity in 5-ALA (+) to 5-ALA (-). As cells at the concentration of 106 cells/ml provided the clearest results, fluorescence intensities of all cell lines were measured using this concentration at 20-min intervals for 700 min using the same methods. Results: The 5-ALA (+) to (-) ratio increased in a cell concentration-dependent manner at 240 min;the ratio was highest with 106 cells/ml and lowest with 104 cells/ml. With 106 cells/ml in the 5-ALA (+) group, fluorescence intensity increased in a metabolic time-dependent manner;the increase was highest in HSC-2 cells, followed by HSC-4 cells, HSC-3 cells, Sa3 cells, and HOK. Fluorescence intensity was significantly enhanced after 40 min in HSC-2, HSC-3, and HSC-4 cells, after 60 min in Sa3 cells, and after 100 min in HOK compared to the 5-ALA (-) group (P < 0.05). Moreover, fluorescence intensity was significantly increased in OSCC cell lines compared to HOK after 40 min. Conclusion: Early detection of OSCC is possible by screening only microplate reader measurements of fluorescence intensity for PDD.

Photodynamic Therapy of Cancer Cells with Methanesulfonate Salts of 5-Aminolevulinic Acid and Its Derivatives

A series of 5-aminolevulinic acid and its alkylester methanesulfonates was exploited to photodynamic therapy（PDT） of human lymphocytic cells, U-937 in vitro. The PDT efficiency is influenced by the concentration and incubation time. Generally, for ALA and its alkylester methanesulfonates, the cell survival rate decreases and the accumulation ability of PplX increases with the concentration and incubation time. We found that the longer carbon chain methanesulfonates（C5-S, C6-S, C8-S） exhibit better PDT effect than ALA methanesulfonate. This possibly provides a promising route to the clinical application ofPplX-mediated PDT to cancer cell.

OPTIMIZATIONS FOR 5-AMINOLEVULINIC ACID BASED PHOTODYNAMIC THERAPY IN PURGING LEUKEMIA CELL HL60

Objective To optimize experimental parameters for the photosensitization of 5-aminolevulinic acid (ALA) in promyelocytic leukemia cell HL60 and compare them with normal human peripheral blood mononuclear cell (PBMC). Methods ALA incubation time, wavelength applied to irradiate, concentration of ALA incubated, irradiation fluence may modulate the effect of 5-aminolevulinic acid based Photodynamic Therapy (ALA-PDT).The high-pressure mercury lamps of 400W served as light source, the interference filter of 410nm, 432nm, 545nm, 577nm were used to select the specific wavelength. Fluorescence microscope was used to detect the fluorescence intensity and location of protoporphyrin IX (PpIX) endogenously produced by ALA. MTT assay was used to measure the survival of cell. Flow cytometry with ANNEXIN V FITC kit (contains annexin V FITC, binding buffer and PI) was used to detect the mode of cell death. Results ① 1mmol/L ALA incubated 1×105/mL HL60 cell line for 4 hours, the maximum fluorescence of ALA induced PpIX was detected in cytomembrane. ② Irradiated with 410nm for 14.4J/cm2 can result in the minimum survivability of HL60 cell. ③ The main mode of HL60 cell death caused by ALA-PDT is necrosis. Conclusion ALA for 1mmol/L, 4 hours for dark incubation time, 410nm for irradiation wavelength, 14.4J/cm2 for irradiation fluence were the optimal parameters to selectively eliminate promyelocytic leukemia cell HL60 by ALA based PDT. The photosensitization of ALA based PDT caused the necrosis of HL60 cell, so it could be used for inactivation of certain leukemia cells.

Preliminary study of photodynamic diagnosis using 5-aminolevulinic acid in gastric and colorectal tumors

AIM:To investigate the utility of photodynamic diagnosis(PDD) using 5-aminolevulinic acid(5-ALA) to detect gastric/colorectal tumors.METHODS:This prospective single-center study investigated inter-subject variability in patients with early-stage gastric/colorectal tumor indicated for endoscopic resection.Subjects were patients with gastric or colorectal tumors who had undergone endoscopic resection between November 2012 and November 2013.Selection criteria included age 20-80 years,either sex,and provision of informed consent.Patients were orally administered 20 mg/kg of 5-ALA enteric-coated capsules(SBI ALApromo Co.,Tokyo,Japan).Administration of5-ALA was followed by endoscopic resection of gastric or colorectal tumors,and the resected specimens were examined using a video autofluorescence processor and a fluorescence endoscope(SAFE-3000 and EB-1970 AK,respectively;Pentax,Tokyo,Japan).The primary endpoint was the presence of fluorescence in tumors.Endoscopic,macroscopic,and histopathologic findings of tumors were assessed.We also evaluated adverse events of the present procedure as a secondary endpoint and examined each patient for the presence of known adverse effects of 5-ALA,namely,hematocytopenia,liver dysfunction,hypotension,nausea,and photosensitivity.RESULTS:We enrolled 10 patients(7 men,3 women)(n = 13 lesions:10 gastric/3 colorectal tumors).Fluorescence was detected in 7/13(53.8%) lesions.No significant differences in sex(male:55.6%vs female:50.5%,P = 1.00),age(67.1 ± 1.9 years vs 65.0 ±2.0 years,P= 0.45),tumor color(reddish:60.0%vs discolored:33.3%,P = 0.56),tumor diameter(15.0± 2.1 mm vs 14.2 ± 2.3 mm,P= 0.80),macroscopic type(protruded:70.0%vs depressed 0%,P = 0.07),histologic type(differentiated type:58.3%vs 0%,P = 0.46),invasion depth(mucosal layer:55.6%vs submucosal layer:33.3%,P = 1.00),lymphatic invasion(present:33.3%vs absent:50.0%,P= 1.00),venous invasion(present:0%vs absent:54.5%,P= 1.00) or procedure time of endoscopic resection(36.3 ± 8.3 min vs 36.7 ± 9.0 min,P = 0.98) were observed between the patients with and without fluorescence.Fluorescence detection rate tended to be high for elevated lesions.Liver dysfunction developed in 4/10(40.0%) patients.The extent of the liver dysfunction was a slight increase in transaminases and total bilirubin levels,which spontaneously improved in the patients.None of the patients developed photosensitivity.CONCLUSION:Results of this preliminary study suggest the utility of PDD using 5-ALA for screening of gastric and colorectal cancers.

Clinical applications of 5-aminolevulinic acid-mediated fluorescence for gastric cancer

5-aminolevulinic acid(ALA) is a naturally occurring amino acid that is a protoporphyrin IX(Pp IX) precursor and a next-generation photosensitive substance. After exogenous administration of ALA, Pp IX specifically accumulates in cancer cells owing to the impaired metabolism of ALA to Pp IX in mitochondria, which results in a red fluorescence following irradiation with blue light and the formation of singlet oxygen. Fluorescence navigation by photodynamic diagnosis(PDD) using ALA provides good visualization and detection of gastric cancer lesions and is a potentially valuable diagnostic tool for gastric cancer for evaluating both the surgical resection margins and extension of the lesion. Furthermore, PDD using ALA might be used to detect peritoneal metastases during preoperative staging laparoscopy, where it could provide useful information for the selection of a therapeutic approach. Another promising application for this modality is in the evaluation of lymph node metastases. Photodynamic therapy(PDT) using ALA to cause selective damage based on the accumulation of a photosensitizer in malignant tissue is expected to be a non-invasive endoscopic treatment for superficial early gastric cancer. ALA has the potential to be used not only as a diagnostic agent but also as a therapeutic drug, resulting in a new strategy for cancer diagnosis and therapy. Here, we review the current use of PDD and PDT in gastric cancer and evaluate its future potential beyond conventional modalities combined with a light energy upconverter, a light-emitting diode and nearinfrared rays as light sources.

Effects of Illumination Intensity, 5-aminolevulinic Acid Concentration and Their Interaction on Chlorophyll Fluorescence Parameters and Yield of Summer Maize

[Objective] This study aimed to investigate the influence of illumination intensity, 5-aminolevulinic acid （ALA） concentration and their interaction on chlorophyll fluorescence parameters and yield of summer maize. [Method] Two illumination intensity levels and five ALA concentrations were applied in the experiment using 2x5 completely balanced program. The two illumination intensity levels were natural light （So） and 60% shade （SO, and five ALA concentrations were 0, 1, 10, 25 and 50 mg/L. [Result] The relative chlorophyll content of leaf （SPAD）, the optimal/maximal quantum yield of PS II （Fv/Fm）, the photochemical quenching coefficient （qP）, electron transport rate （ETR）, grain number per cob and grain weight per cob in $1 treatment were significantly reduced compared with that in So. However, the non- photochemical quenching coefficient （qN） was significantly increased. The responses of these parameters to ALA were different under So and $1 treatments. The SPAD, Fv/Fm, qP, ETR, grain number and grain weight per cob were firstly increased, but then decreased following the raise of ALA concentration, ranging from 0 to 50 mg/L, whereas qN showed opposite trend. The effect of the interaction of illumination in- tensity and ALA concentration on these parameters was significant （P〈0.05）. Under natural light, summer maize could obtain higher SPAD, Fv/Fm, qP and ETR and lower qN combined with low concentration of ALA. However, high concentration of ALA was needed under shading to get the same results. [Conclusion] Soaking seed in suitable concentration of ALA can reduce the yield loss of summer maize caused by short-term shading in seedling stage.

Effects of Exogenous 5-Aminolevulinic Acid and 24-Epibrassinolide on Cd Accumulation in Rice from Cd-Contaminated Soil

High grain-Cd-accumulating rice variety Yongyou 9 was planted in Cd-contaminated farmland in Taizhou City, Zhejiang Province, China to study the effects of 5-aminolevulinic acid(ALA) and24-epibrassinolide(EBR) on Cd accumulation in brown rice. Results showed that the exogenous ALA and EBR had no significant effects on agronomic traits, soil pH and total Cd content in soil, but had some effects on the available Cd content in soil, and significantly influenced the Cd accumulation in the different parts of rice. Results also showed that 100 mg/L exogenous ALA significantly reduced the Cd accumulation in brown rice to blow the food safety standard(0.2 mg/kg), and also significantly reduced the Cd contents in the roots and culm of rice. However, 200 mg/L exogenous ALA treatment increased the Cd content in brown rice remarkably. In addition, 0.15 mg/L EBR treatment increased Cd accumulation in roots, culm, leaves and brown rice notably, whereas 0.30 mg/L exogenous EBR treatment reduced the Cd accumulation in brown rice properly, but it was not significant. Therefore,proper concentration of ALA can effectively reduce the Cd accumulation in brown rice, which can be used as an effective technical method for the safe production of rice in Cd polluted farmland.

Improved 5-Aminolevulinic Acid Production with Recombinant Escherichia coli by a Short-term Dissolved Oxygen Shock in Fed-batch Fermentation

5-Aminolevulinic acid （ALA） is a common precursor for tetrapyrrole compounds in all kinds of organ isms and has wide applications in agriculture and medicines. In this study, a new strategy, i.e. short-term dissolved oxygen （DO） shock during aerobic fermentation, was introduced to produce 5-aminolevulinic acid with a recombi-nant E. coli. Effects of duration time of DO shock operation on plasmid concentration, intracellular ALA synthase （ALAS） activity and ALA production were investigated in Erlenmeyer shake flasks. The results indicated that both ALAS activity and ALA yield were enhanced in an anaerobic operation of 45 rain in the early exponential phase during fermentation, while they decreased when the anaerobic operation time was further increased to 60 rain. The DO shock protocol was confirmed with the fed-batch fermentation in a 15 L fermenter and the ALA production achieved 9.4 g.L-1 （72 mmol.L-1）, which is the highest yield in the fermentation broth reported up to now.

Study on Insecticidal Activities and Effect on Three Kinds of Enzymes by 5-Aminolevulinic Acid on Oxya chinensis

Insecticidal activities and effects on three enzymic activities caused by 5-aminolevulinic acid （ALA） on Oxya chinensis were studied. Fourth-instar nymphs of O. chinensis were treated with different doses ofALA （A1,250 mM; A2, 450 mM; A3,750 mM; A4, 1 000 mM）. Mortality and the activities of acetylcholinesterase （ACHE）, glutathione S-transferase （GSTs）, and glutathione peroxidase （GPx） were determinated. The mortality of O. chinensis rose with an increasing dose of ALA. The mortality of high-dose treatments A3 and A4 reached 66.19 and 80.21%, respectively. The value of LD50 was 3.61 （3.29-3.93） mg·g^-1 body weight （95% confidence interval）. Biochemical studies showed that the activities of AChE and GPx in the A4 treatment declined by 51.53 and 42.82% in the female, and 42.65 and 43.85% in the male compared to the control, respectively, and the degree of decline reached a significant level at P 〈 0.05. Meanwhile, the GSTs activities of O. chinensis enhanced with increasing dose of ALA. The GSTs activities of female and male O. chinensis in the A4 treatment remarkably increased by 171.05 and 97.42% compared to the control （P〈 0.05）. ALA had an obviously toxic effect on O. chinensis. Moreover, ALA caused the photoinactivation of AChE and GPx, which induced nerve transmission blocking and the capability to defend oxidation damage declining. Meanwhile, a high dose of ALA could activate GSTs, which caused a feedback inhibition of the insect to the phototoxic substance.

Insight into 5-aminolevulinic acid-induced modulation of cellular antioxidant metabolism to confer salinity and drought tolerance in maize

The current study investigated the comparative oxidative damage in twomaize seedlings induced by saline,drought,and combined stress and the ameliorative role of two different doses(20 and 80μM)of 5-aminolevulinic acid(ALA)against the above-mentioned stresses.Hydroponically grown 10-day-old maize(Zea mays,var.BARI Hybrid Maize-7(BHM-7)and BARI Hybrid Maize-9(BHM-9))seedlings were exposed to 12 dS/m of saline solution,200 mM mannitol-induced drought stress alone and their combined stress for 7 days.Result revealed that individual stresses retard the plant growth to some degrees,however,their combined stress has more detrimental effects,which might be correlated with lipid peroxidation(MDA)-induced oxidative stress in seedlings,enhanced Na+/K+ratio,and augmented generation of superoxide(O_(2)•^(−))and hydrogen peroxide(H_(2)O_(2)).In contrast,exogenous ALA supplementation at 20μM concentration markedly recovered from chlorosis and growth inhibition,substantially scavenged reactive oxygen species(ROS)and MDA by preserving ionhomeostasis and relaxing oxidative stress,also,by boosting catalase(CAT)and glutathione S-transferase(GST),and exclusively via depressing the activity of lipoxygenase(LOX)antioxidant enzyme.On the contrary,80μM ALA made things worse,nevertheless,higher activities shown by other antioxidant enzymes,like,superoxide dismutase(SOD),ascorbate peroxidase(APX),peroxidase(POD),and glutathione peroxidase(GPX),which were related to lessen the oxidative damage by highly produced O_(2)•^(−)and H_(2)O_(2) under combined stress.Non-denaturing gel electrophoresis was done for further confirmation.However,ALA importantly increased the photosynthetic pigment contents in both genotypes irrespective of doses.Nevertheless,GST might have assisted the plants to escape from the herbicidal effect by detoxification.However,in the combined stress condition,high ALA concentration may have some positive role to play.Our findings also showed that BHM-9 performed better than BHM-7.Therefore,ALA at lower concentration was effective for single stress of saline and drought,while higher concentration can improve plant survival under combined stress.

A Photosensitivity Insecticide, 5-Aminolevulinic Acid, Exerts EffectiveToxicity to Oxya chinensis (Orthoptera: Acridoidea)

5-Aminolevulinic acid （ALA）, a major photosensitivity insecticide, has attracted increasing attention as a new type of highly efficient, environmental friendly pesticide to be used to control the pest. To examine whether or not ALA acts effectively to grasshopper, Oxya chinensis and elucidate the detoxification mechanism of ALA, the susceptibility to ALA was assessed in O. chinensis and two major metabolic detoxification enzymes including glutathione S-transferases （GSTs） and general esterases （ESTs）-specific activities were compared in different development stages and different body sections of O. chinensis treated by ALA and the control. The results showed that the ALA exhibited obvious toxicity to the grasshopper in different development stages. In the low-dose treatment （0.0597 mmol L-1）, the mortalities of O. chinensis reached a significant level （55.5% in the 1st instar nymphs, 61.4% in the 2nd instar nymphs, 71.4% in the 3rd instar nymphs, and 64.4% in the 4th instar nymphs. But, there was no dose-dependent toxic effect. Thereby, we proposed that ALA has the potential for acting as photosensitivity insecticide for controlling O. chinensis. GSTs activity assays using CDNB and DCNB as substrates indicated that the thorax and abdomen of the different instar nymphs treated by ALA showed 1.52-5.56 fold significantly increased GSTs activities compared with the control. However, for the ESTs-specific activity assay, there was no significant difference between O. chinensis treated by ALA and the control within different instar nymphs, when a-NA, a-NB and b-NA were used as substrates. Therefore, GSTs-mediated metabolic detoxification as evidenced by significantly increased GSTs activities might contribute to protect against oxidative damage and oxidative stress by ALA in O. chinensis.

The Role of 5-Aminolevulinic Acid (5-ALA) and Sleep

Objective: To determine if there is a relationship between the administration of the dietary supplement containing 5-Aminolevulinic Acid (5-ALA) and sleep. Methods: A double-blind, randomized parallel-group study was conducted. It was a 4-month study of 40 participants between the ages of 40 and 70. Males and females were recruited equally. There were 20 in each group who had existing sleep disorders. The tool used to measure participant sleep improvement included the Pittsburgh Insomnia Rating Scale-20 Question (PIRS-20). Improved sleep is reflected when the total PIRS-20 score is lower. Results: Improvement in sleep in the group taking 50 mg 5-ALA, compared to controls, was significant. The mean change, from baseline through week 6, was -5.67 units less on the sleep scale than the control group with a p value of 0.001. The mean change from week 6 to week 10 when the participant was no longer taking the supplement was 4.55 units higher than the control group with a p value of 0.062, which is of borderline significance. Conclusions: There is a relationship between the administration of dietary supplements containing 5-ALA and sleep. The results of this study suggest that 5-ALA is associated with improved sleep. The mechanism for sleep improvement needs to be explored. Further research is warranted.

5-Aminolevulinic Acid (5-ALA): Analysis of Preclinical and Safety Literature

Problem: 5-ALA has been used for many years at relatively high dose amounts in single doses for photodynamic therapy and immunofluorescence of tumors. An analysis of compiled data relating to safety and any side-effects about the use of 5-ALA at low doses has not yet been published. Purpose: This report analyzes data about the safety of the use of 5-Aminolevulinic Acid (5-ALA) in low doses as a supplement over an extended period of time. Methods: This investigation is a systematic analysis of the current literature ((Medline, and SBI) and snowballing techniques) related to the safety and efficacy of 5-ALA in animals and humans. Clinical trials in progress using 5-ALA were also analyzed. Constant comparative analyses were used to synthesize the findings. Results: The safety of low-dose 5-ALA as a supplement has been demonstrated by animal and human studies. The results suggest that none of the investigations document the presence of symptoms or abnormal laboratory results of clinical significance. The minor laboratory changes documented were judged not clinically significant.

5-Aminolevulinic Acid Improves Water Content and Reduces Skin Wrinkling

5-Aminolevulinic acid (ALA) is a natural amino acid that is used as a raw material for the biosynthesis of red-blood-cell hemoglobin in humans and animals. ALA is the subject of research in a wide range of human health care fields, including skin care and medicine. This study investigated whether and to what extent cosmetics containing ALA (skin lotions and creams) improved facial-skin condition in women. As such, a double-blind controlled experiment was conducted among 45 women aged 47.0 ± 1.72 years. Participants were divided into two intervention groups, including those who used cosmetics containing ALA (C-ALA, n = 22) and those who used cosmetics without ALA (W-ALA, n = 23). Specifically, participants were instructed to use their assigned cosmetics twice per day (morning and evening) after washing their faces before each application. Inner skin condition and skin-water content were evaluated via VISIA-Evolution and Multi Display Devices at baseline and after four and eight weeks of use. The experiment lasted for a total of eight weeks. A baseline comparison at week four showed that skin moisture content increased significantly for the C-ALA group (p = 0.021). Further, wrinkling significantly decreased at week four among participants in the C-ALA group who were evaluated as having many wrinkles at baseline (p = 0.034). These findings suggest that cosmetics containing ALA have moisturizing effects and reduce wrinkling caused by dryness.

Comparison of photodynamic therapy for skin cancers and pre-cancers with δ-aminolevulinic acid

Objective:The aim of the study was to compare the effects of photodynamic therapy(PDT) with δ-aminolevulinic acid(ALA) for patients with different kinds of skin cancers and pre-cancers.Methods:The present study enrolled seventyfive cases,which included 17 cases of actinic keratosis(AK),9 cases of Bowen's disease,11 cases of superficial basal cell carcinomas(BCC),23 cases of nodule basal cell carcinomas and 15 cases of squamous cell carcinomas(SCC),and every patient had single lesion.All patients were treated with 20% ALA topically and He-Ne laser weekly for three times,and followed up 1-3 years.Results:After therapy,the rates of complete reaction(CR) were 100% in AK lesions,77.8% in Bowen's diseases,90.9% in superficial BCCs,47.8% in nodule BCCs,and 50.3% in SCCs,which had significant differences among these five kinds of lesions(H = 18.27,P < 0.05).The therapeutic effectiveness of ALA-PDT for AK was superior to that of Bowen's disease(Q = 4.364,P < 0.05),superficial BCC(Q = 5.55,P < 0.01),SCC(Q = 8.94,P < 0.01) and nodule BCC(Q = 17.91,P < 0.01);the effect of Bowen's disease was better than that of SCC(Q = 7.8,P < 0.01),nodule BCC(Q = 13.44,P < 0.01);the effect of superficial BCC was better than that of SCC(Q = 9.73,P < 0.01),nodule BCC(Q = 16.28,P < 0.01),but similar with Bowen's disease(Q = 0.96,P > 0.05);the effect of SCC was better than that of nodule BCC(Q = 17.74,P < 0.01).Conclusion:Our study shows that therapeutic effectiveness of ALA-PDT for AK is best in five diseases,and Bowen's disease and superficial BCC are secondary,while nodule BCC and SCC are at the bottom.

Preoperative Prediction of Whether Intraoperative Fluorescence of Protoporphyrin IX Can Be Achieved by 5-Aminolevulinic Acid Administration

Protoporphyrin IX (PPIX) fluorescence-guided brain tumor resection, using 5-aminolevulinic acid (5-ALA), is among the most valuable tools for determining tumor removal area. However, PPIX fluorescence is not necessarily achieved during an operation visually even when 5-ALA is used, and we do not know until tumor exposure to the excitation light of the ultraviolet region whether PPIX fluorescence has been achieved. When a particular biopsy and frozen section diagnosis is made, the reason for lack of PPIX fluorescence in the tissue cannot be judged. We do not know whether the tumor fails to fluoresce or no fluorescence is seen because it is not the main body of the tumor. We investigated whether the presence or absence of tumor fluorescence could be predicted by examining urinary porphyrin before surgery, at the time of intraoperative fluorescence diagnosis using 5-ALA. The urine of brain tumor patients 2 hours after 5-ALA administration was irradiated with a 405 ± 1 nm laser light. The patients were divided into a fluorescent urine group and negative fluorescent urine group. Red fluorescence was observed in response to the 405 ± 1 nm laser beam for all tumors in the fluorescent urine group. Clear red fluorescence was not observed even with 405 ± 1 nm laser beam irradiation in any tumors in the negative fluorescent urine group. Preoperative prediction of the intraoperative fluorescence of PPIX can be achieved by observation of urine 2 hours after 5-ALA administration with exposure to a 405 ± 1 nm laser light.

Review of literature: Role of 5-aminolevulinic acid and sleep

Objective: To determine if current peer-reviewed literature supports the existence of a relationship between the administration of dietary supplements containing 5-Aminolevulinic Acid (5-ALA) and sleep. Methods: Conceptual analysis of a systematically defined group of data is based on publications in referred journals. Constant comparative analyses were used to analyze the data. Detailed analyses were used to identify trends that led to qualifying relationships between the use of 5-ALA and heme. In addition, the relationship among heme, melatonin, and sleep were explored. Since there were no published data related to 5-ALA and sleep, an analysis of what is known about 5-ALA and heme was undertaken. Results: Currently, within the scope of this review, no literature available directly connecting 5-ALA and sleep was found. Research indicates that 5-ALA has an indirect relationship with intra-cellular energy production, which could result in a wide range of effects fromcellular to endocrine to neurologic to behavioral. In addition, there is evidence that 5-ALA may influence tryptophan and serotonin levels. Conclusion: While there are no studies on 5-ALA and sleep were found, current research suggests several potential mechanisms by which 5-ALA could influence sleep. The mechanisms suggest the potential for 5-ALA to assist in the adjustment of a person’s circadian cycle, endocrine function, or neurologic function in order to allow for better sleep in a natural way. In doing so, it may provide for a safer alternative to currently available sleep medication. Further research is needed to explore this possibility.

Low Frequency Ultrasonication Induced Antitumor Effect in 5-Aminolevulinic Acid Treated Malignant Glioma

We investigated the feasibility of sonodynamic therapy for glioma by low frequency ultrasoundwith5-aminolevulinic acid (5-ALA), a precursor of protoporphyrin IX (PpIX) in heme synthetic process. In vivo tumor model was made by inoculating human glioma cell line U87-MG subcutaneously in nude mice. The tumor was sonicated by 25-kHz ultrasound 4 hours following administration of 5-ALA. The tumor size decreased in 5-ALA administered (ALA(+)US(+)) mice, while increased in non-5-ALA administrated (ALA(-)US(+)) mice and non-sonicated mice (ALA(+)US(-)). The immunohistochemical analysis revealed an apoptotic change in tumor tissue of ALA(+)US(+) mice. The results showed the therapeutic effect of 25 kHz ultrasound for the glioma in 5-ALA administered tumor-bearing mice by inducing apoptotic change of tumor cells. This is a first report to elucidate the feasibility of therapeutic use of 25 kHz, relatively low frequency, ultrasound in sonodynamic therapy using 5-ALA as a sonosensitizer precursor. The utilization of this frequency will contribute to the development of sonodynamic therapy for gliomas and the spread of this technique in many hospitals that possess ultrasonic aspirators.

Effects of 5-Aminolevulinic Acid (ALA) on Zinnia hybrida Growth and Phytoremediation Effects in Oil-Contaminated Soil

In this study, we compared plant height, weight, soil TPH concentration, and soil DHA level after 18 weeks of Zennia hybrida cultivation with four different concentrations of 5-Aminolevulinic acid (ALA)-based liquid fertilizer: 1500-fold, 5000-fold, and 8000-fold dilutions, along with a non-treatment control of diluted ALA. The plants of ALA-treated were significantly taller than the non-treatment control. The plants of ALA-treated plants were higher in shoot fresh weight, shoot dry weight, and root dry weight than the non-treatment control. The plot of ALA-based liquid fertilizer with the 5000-fold dilution was significantly highest in shoot fresh weight, shoot dry weight, and root dry weight. ALA-treated plants were lower in the soil Total Petroleum Hydrocarbon (TPH) concentration than the non-treatment control. The plot of ALA-based liquid fertilizer with the 5000-fold was significantly lowest in the TPH concentration. In addition, ALA-treated plants were higher in the soil dehydrogenase activity (DHA) than the non-treatment control. The plot of ALA-based liquid fertilizer with the 5000-fold was significantly highest in the TPH concentration. This study indicated that ALA-applied zinnia-grown oil-contaminated soil is more effective than not. The remediation in oil-contaminated soil with ALA-based liquid fertilizer is more effective than the non-treatment control;furthermore, ALA application with 5000-fold dilution was most suitable in oil-contaminated soil among other plots.