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Treatment of HPV Infection‐Associated Cervical Condylomata Acuminata with 5‐Aminolevulinic Acid‐Mediated Photodynamic Therapy

The aim of this study was to investigate the efficacy of 5‐aminolaevulinic acid (ALA)‐mediated photodynamic therapy (PDT) in treatment of human papillomavirus (HPV)‐associated cervical condylomata. A total of 56 patients with cervical and external condylomata lesions were recruited for this open‐label study. HPV genotyping of exfoliated cells collected from the cervix and external lesions was performed. Cervical lesions were treated with PDT by applying ALA gel (10%) to the surface of the cervix for 4 h followed by irradiating with a 635 nm laser at 100 J cm−2. PDT was repeated at 2‐week intervals if lesion and HPV infection remained. Patients were followed up for 6–24 months. Genotyping analysis revealed four HPV subtypes (HPV6, 11, 16 and 18). The overall complete remission rate of 1–4 sessions of treatments was 98.2% and the corresponding HPV clearance rate was 83.9%. Ten cases showed complete removal of cervical lesions and HPV infection after a single treatment. Recurrence rate was 3.6%. Adverse effects were minimal and no structural complications were reported. In conclusion, topical ALA PDT is safe and effective for eradicating cervical HPV infection and eliminating condylomata lesion. Its definitive role in treating cervical condylomata deserves further investigation.

Therapeutic and immune effects of 5‐aminolevulinic acid photodynamic therapy on UVB‐induced squamous cell carcinomas in hairless mice

The therapeutic effects of 5‐aminolevulinic acid (ALA)‐mediated photodynamic therapy (PDT) on cutaneous squamous cell carcinoma (SCC) are not fully understood, and the usefulness of topical PDT in the treatment of SCC is still debatable. The most interesting aspect in SCC PDT is perhaps its potential in inducing antitumor immune responses. In this study, cutaneous SCCs were established by UVB irradiation of hairless mice and treated with multiple ALA PDT. Immunohistochemistry assays showed that ALA PDT could induce quick apoptosis, overexpression of TNFα and marked increases in DCs, CD4+ and CD8+ cells in tumor interstitium and subcutaneous connective tissues. However, a complete response was only achieved for small SCCs. The clinical value of ALA PDT‐induced specific antitumor immune responses in long‐term control of SCCs deserves further study.

Evaluation of collagen alteration after topical photodynamic therapy (PDT) using second harmonic generation (SHG) microscopy — in vivo study in a mouse model

Topical photodynamic therapy (PDT) mediated by 5-aminolevulinic acid (ALA) has been used for the treatment of age-related skin lesions for therapeutic or cosmetic purposes. The modulation of collagen component and structure might play a significant role in influencing treatment outcomes of PDT. In this study, the effect of multi-session low dose ALA PDT on skin rejuvenation was examined in a hairless mouse model. Changes in collagen and skin texture were investigated by histological examination and in vivo second harmonic generation (SHG) microscopy. Results indicated that multi-session PDT could improve the collagen density and arrangement of skin tissue. SHG microscopy combined with quantitative collagen analysis could provide a useful tool for the evaluation of collagen alteration induced by ALA PDT.

A prospective pilot study to evaluate combined topical photodynamic therapy and surgery for extramammary paget's disease.

Extramammary Pagets disease (EMPD) is a rare intra‐epithelial neoplasm. Surgical excision is the treatment of choice. The usefulness of topical photodynamic therapy (PDT) in the treatment of EMPD has been reported. The objective of this prospective pilot study was to investigate the feasibility of combined PDT and surgery in the treatment of EMPD.

Risk factors, psychological impacts and current treatments of acne in Shanghai area of China.

Abstract Acne is one complex skin disorders, which can lead to adverse psychological effects. Multiple factors are correlated with risk of acne and several treatments have been explored. The prevalence and risk factors are suspected to be varied in different populations with different genetic backgrounds and lifestyle. Therefore, this study investigated the risk factors, psychological impacts and current treatments of acne in Shanghai area of China by a retrospective questionnaire study. This study showed that the subjects with family history (especially paternal history) were prone to develop severe acne (p < 0.001). Besides, patients with severe acne might exhibit more severe psychological disorders (p < 0.001). The most frequently used methods were pharmacological treatments. These results indicate that acne is prone to induce severe psychological disorders, and could be affected by multiple factors. Furthermore, these results provide valuable reference for exploring the preventive measures and treatments of acne in Shanghai area of China.

Successful treatment of penile condyloma acuminata accompanied with lichen planus with photodynamic therapy

Condyloma acuminata and lichen planus are different cutaneous diseases with disparate etiologies. Simultaneous appearance of two diseases in the same area is rare. This report aims to share the clinical and pathological features of a rare case; introduce an effective and safe therapy of it so as to broaden the therapeutic spectrum of Photodynamic Therapy (PDT) indications.

Severe acne in monozygotic twins treated with photodynamic therapy

Acne is a common skin disease in adolescence. It is a chronic inflammatory disease of the pilosebaceous units, which mainly occurs on the face and upper parts of the trunk. Based on severity of the lesions, acne can be mild, moderate or severe. Severe acne is usually featured with a protracted course and residual scars. Photodynamic therapy (PDT) has been demonstrated to be effective in severe acne recently. We report a case of monozygotic twins with severe acne who were successfully treated with PDT.

Aminoleveulinate photodynamic therapy (ALA-PDT) for Bowen’s disease in a SLE patient: Case report and literature review

We reported a rare case of topical 5-aminolevulinic acid (ALA)-photodynamic therapy (PDT) in the treatment of a systemic lupus erythematosus (SLE) patient with lower limb multiple Bowens disease (BD). At the end of the treatment, an excellent clinical response was observed and no recurrence of rash after 2 months of treatment. The recovery time was prolonged only after the first treatment, however, no photosensitive phenomena were observed during and after the treatment. This is the first report to describe ALA-PDT for patient-confirmed photosensitivity in an Asian patient. Whether PDT is contraindicated for SLE remains to be discussed, although our findings show that PDT can be used as an alternative therapy for SLE patients with BD who cannot tolerate surgery.

Induction of apoptosis in HPV16 E7 transfected human keratinocyte by ALA-mediated photodynamic therapy

BACKGROUND AND OBJECTIVE 5-Aminolevulinic acid (ALA)-mediated photodynamic therapy (ALA-PDT) is effective for the treatment of condyloma and intraepithelial neoplasia associated with human papillomaviruses (HPV). However, the mechanism of PDT on HPV-infected host cells is not fully understood. The aim of this in vitro study was to examine ALA-PDT induced apoptosis in a high-risk HPV E7 gene transfected cell line. MATERIALS AND METHODS HPV16 E7 gene obtained from HPV16 positive human cervical carcinoma was transfected into a human keratinocyte cell line. PpIX generation and ALA-PDT-induced apoptosis and mitochondrial damage were investigated in vitro. RESULTS Fluorescence examination showed that HPV16E7 transfected cells could produce PpIX fairly quickly in the presence of 1mM ALA. Apoptosis occurred after ALA-PDT at dose levels of 4, 8, and 12 J/cm(2). Mitochondrial potential collapse occurred as early as 2 h post PDT. ALA-PDT induced a relatively weak and shorter caspase-9 activation but a strong and long lasting caspase-3 activation. However, mRNA levels of caspase-9 and -3 genes in cells treated with ALA-PDT were unchanged. CONCLUSION This in vitro study demonstrated that HPV16 E7 transfected keratinocytes could generate PpIX in the presence of ALA. Under light irradiation, ALA-PDT could induce mitochondrial-dependent apoptosis in HPV16 E7 transfected cells.

Topical photodynamic therapy of squamous cell carcinomas in a hairless mouse model

Objectives: To examine therapeutic effects of 5-aminolevulinate (ALA)-mediated photodynamic therapy (PDT) on UVB-induced cutaneous squamous cell carcinomas (SCCs) in a mouse model. Materials and methods: Cutaneous SCCs were established by UVB (280-320 nm) irradiation of hairless mice. In situ fluorescence measurement was used to monitor PpIX formation after the topical application of various concentrations of ALA cream to determine the optimal ALA dose. Therapeutic responses of SCCs to multiple sessions of ALA PDT were examined histologically and quantitatively. TUNEL staining was used to examine apoptosis caused by PDT. Results: After repeated exposure for 18 to 22 weeks (4-5 days/week), multiple nodular and verrucous hyperplasia lesions of various sizes developed at the exposed area. After four sessions of ALA PDT (8% ALA, 3 h incubation, 30 J/cm2 at 20 mW/cm2) a total of 84% of complete response was achieved for small SCCs (1-4 mm, thickness <2.5 mm). TUNEL staining showed that PDT-induced apoptotic cells were distributed evenly from the basal to stratum corneum layers. Conclusions: Topical ALA PDT can trigger apoptosis in SCCs, inhibit SCC growth, and reduce the size and number of tumors in the hairless mouse model. The true clinical value of ALA PDT for the treatment of cutaneous SCC deserves further investigation.