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D’Ercole S, Carlesi T, Dotta TC, Pierfelice TV, D’Amico E, Tripodi D, Iezzi G, Piattelli A, Petrini M. 5-Aminolevulinic Acid and Red Led in Endodontics: A Narrative Review and Case Report. Gels 2022; 8:697. [PMID: 36354605 PMCID: PMC9689491 DOI: 10.3390/gels8110697] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/17/2022] [Accepted: 10/26/2022] [Indexed: 08/26/2023] Open
Abstract
The present study aims to discuss the main factors involving the use of 5-aminolevulinic acid together with red LED light and its application in endodontic treatment through a narrative review and a case report. Persistence of microorganisms remaining on chemical-mechanical preparation or intracanal dressing is reported as the leading cause of failure in endodontics. Photodynamic therapy has become a promising antimicrobial strategy as an aid to endodontic treatment. Being easy and quick to apply, it can be used both in a single session and in several sessions, as well as not allowing forms of microbial resistance. 5-aminolevulinic acid in combination with red LED light has recently been studied in many branches of medicine, with good results against numerous types of bacteria including Enterococuss faecalis. The case report showed how bacterial count of CFU decreased by half (210 CFU/mL), after 45 min of irrigation with a gel containing 5% of 5-aminolevulinic acid compared to the sample before irrigation (420 CFU/mL). The subsequent irradiation of red LED light for 7 min, the bacterial count was equal to 0. Thus, it is concluded that the use of 5-aminolevulinic acid together with red LED light is effective in endodontic treatment.
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Affiliation(s)
- Simonetta D’Ercole
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Teocrito Carlesi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Tatiane Cristina Dotta
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil
| | - Tania Vanessa Pierfelice
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Emira D’Amico
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Domenico Tripodi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International University for Health Sciences (Unicamillus), 00131 Rome, Italy
- Fondazione Villa Serena per la Ricerca, 65013 Città Sant’Angelo, Italy
- Casa di Cura Villa Serena, 65013 Città Sant’Angelo, Italy
| | - Morena Petrini
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
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Li A, Liang C, Xu L, Wang Y, Liu W, Zhang K, Liu J, Shi J. Boosting 5-ALA-based photodynamic therapy by a liposomal nanomedicine through intracellular iron ion regulation. Acta Pharm Sin B 2021; 11:1329-1340. [PMID: 34094837 PMCID: PMC8148057 DOI: 10.1016/j.apsb.2021.03.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/08/2020] [Accepted: 11/21/2020] [Indexed: 01/10/2023] Open
Abstract
5-Aminolevulinic acid (5-ALA) has been approved for clinical photodynamic therapy (PDT) due to its negligible photosensitive toxicity. However, the curative effect of 5-ALA is restricted by intracellular biotransformation inactivation of 5-ALA and potential DNA repair of tumor cells. Inspired by the crucial function of iron ions in 5-ALA transformation and DNA repair, a liposomal nanomedicine (MFLs@5-ALA/DFO) with intracellular iron ion regulation property was developed for boosting the PDT of 5-ALA, which was prepared by co-encapsulating 5-ALA and DFO (deferoxamine, a special iron chelator) into the membrane fusion liposomes (MFLs). MFLs@5-ALA/DFO showed an improved pharmaceutical behavior and rapidly fused with tumor cell membrane for 5-ALA and DFO co-delivery. MFLs@5-ALA/DFO could efficiently reduce iron ion, thus blocking the biotransformation of photosensitive protoporphyrin IX (PpIX) to heme, realizing significant accumulation of photosensitivity. Meanwhile, the activity of DNA repair enzyme was also inhibited with the reduction of iron ion, resulting in the aggravated DNA damage in tumor cells. Our findings showed MFLs@5-ALA/DFO had potential to be applied for enhanced PDT of 5-ALA.
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Key Words
- 5-ALA, 5-aminolevulinic acid
- 5-Aminolevulinic acid
- ALKBH2
- Biotransformation interference
- CH, cholesterol
- CLs, custom liposomes
- Ce6, chlorine e6
- DFO, deferoxamine
- DNA repair inhibition
- DOPC, 1,2-dioleoyl-sn-glycero-3-phosphocholine
- DOPE, dioleoyl phosphatidy lethanolamine
- DPPC, dipalmitoyl-sn-glycero-3-phosphocholine
- Drug delivery
- FBS, fetal bovine serum
- H&E, hematoxylin and eosin
- Iron ion regulation
- LMPA, low melting point agarose
- MFLs, membrane fusion liposomes
- Membrane fusion liposomes
- NMPA, normal melting point agarose
- PDT, photodynamic therapy
- PS, photosensitizers
- Photodynamic therapy
- PpIX, protoporphyrin IX
- ROS, reactive oxygen species
- SM, sphingomyelin
- TUNEL, terminal deoxynucleotidyl trans-ferase dUTP nick end labeling
- calcein-AM/PI, calcein-AM/ propidiumiodide
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Zhao W, Shan XF, Wang CL, Liu XZ, Li Z, Xiao HL, Li ZW, Zheng RT, Hou JL, Tian HQ. Topical 5-aminolevulinic acid photodynamic therapy for intra anal-rectal warts. J DERMATOL TREAT 2019; 31:241-244. [PMID: 30990345 DOI: 10.1080/09546634.2019.1594670] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: Condylomata acuminata (CA) are a common sexually transmitted disease. The recurrence rate of condyloma acuminatum using traditional treatments is higher than that of applying photodynamic therapy, and a variety of adverse reactions after treatment. At the same time, different parts of condyloma acuminatum after treatment recurrence rate is also different, especially for intra anal-rectal warts.Objective: To evaluate whether using photodynamic therapy (PDT) can effectively reduce recurrence of condylomata acuminata for intra anal-rectal warts.Methods: After the confirmation of the diagnosis of intra anal-rectal warts, the patients were treated with PDT with 5-aminolevulinic acid hydrochloride (ALA). PDT was performed with irradiation of 18-36 J/cm2 at an irradiance of 20-40 mW/cm2 with light-emitting diode (LED) light energy, wavelength 635 nm. We used a special PDT light equipment for intra anal-rectal area warts. PDT was repeated once every week for 4 weeks.Results: After PDT, the complete clearance rate was 76.1% (35 of 46 patients). At the end of the 12 weeks followed, recurrence occurred in five cases. We recorded pain in all 46 patients and the average visual analog scale (VAS) pain score was 6.96 ± 1.41 points.Conclusion: The treatment with PDT is effective in reducing the high rate of recurrence for intra anal-rectal warts. Pain is still a great challenge for the therapy.
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Affiliation(s)
- Wei Zhao
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
| | - Xiao-Feng Shan
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
| | - Chang-Liang Wang
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
| | - Xin-Zhou Liu
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
| | - Zhen Li
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
| | - Hai-Lu Xiao
- Jining Medical College Affiliated Hospital of Jining Medical University, Jining, China
| | - Zhong-Wei Li
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
| | - Rong-Tao Zheng
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
| | - Jian-Ling Hou
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
| | - Hong-Qing Tian
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
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Tarstedt M, Gillstedt M, Wennberg Larkö AM, Paoli J. Aminolevulinic acid and methyl aminolevulinate equally effective in topical photodynamic therapy for non-melanoma skin cancers. J Eur Acad Dermatol Venereol 2016; 30:420-3. [PMID: 26841041 DOI: 10.1111/jdv.13558] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 11/09/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Topical photodynamic therapy (PDT) is an effective treatment for superficial non-melanoma skin cancers. Two prodrugs, 5-aminolevulinic acid (ALA) and methyl aminolevulinate (MAL), are available for clinical use. There is, however, a lack of studies comparing the clinical effectiveness of these two prodrugs. OBJECTIVE The objective of the study was to compare the clinical response between ALA- and MAL-PDT when treating actinic keratosis (AK), Bowen's disease (BD), nodular basal cell carcinoma (nBCC) and superficial basal cell carcinoma (sBCC). METHODS During the period 2002-2009, patients with AK, BD, nBCC and sBCC were treated with ALA- and MAL-PDT at the Department of Dermatology at Karlskoga Hospital in Sweden using a fixed protocol. All patients were followed up approximately 6 months after treatment to evaluate the clinical results, which were analysed retrospectively. RESULTS In total, 116 patients with 203 tumours were treated with PDT during the study period. ALA- and MAL-PDT were used for 24 vs. 44 AK fields, 9 vs. 18 BD lesions, 19 vs. 25 nBCCs and 25 vs. 39 sBCCs. Response rates with ALA- and MAL-PDT, respectively, were 63% and 75% for AK, 89% and 78% for BD, 84% and 84% for nBCC and 88% and 87% for sBCC. There were no statistically significant differences in the complete clinical response rates for ALA- and MAL-PDT when used for any of the four lesion types. CONCLUSION ALA- and MAL-PDT appear to be equally effective in the treatment of AK, BD, nBCC and sBCC. Nevertheless, larger, prospective, randomized and controlled studies should be carried out to confirm these results.
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Affiliation(s)
- M Tarstedt
- Department of Dermatology, Karlskoga Hospital, Karlskoga, Sweden
| | - M Gillstedt
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A-M Wennberg Larkö
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - J Paoli
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Gong Y, Labh S, Jin Y, Diao HY, Li XL, Liu ZY, Shi YL. Needle-free injection of 5-aminolevulinic acid in photodynamic therapy for the treatment of non-melanoma skin cancer. Dermatol Ther 2016; 29:255-62. [PMID: 26811297 DOI: 10.1111/dth.12335] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Yu Gong
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Sony Labh
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Yi Jin
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Hong-Yue Diao
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Xiu-Li Li
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Zhi-Yu Liu
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Yu-Ling Shi
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
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Zhao J, Zeng W, Cao Y, Liang X, Huang B. Immunotherapy of HPV infection-caused genital warts using low dose cyclophosphamide. Expert Rev Clin Immunol 2014; 10:791-9. [DOI: 10.1586/1744666x.2014.907743] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Shi H, Zhang X, Ma C, Yu N, Wang J, Xia L, Ge X, Liu M, Duan A. Clinical analysis of five methods used to treat condylomata acuminata. Dermatology 2013; 227:338-45. [PMID: 24216675 DOI: 10.1159/000355351] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 08/23/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Treatments for condylomata acuminata (CA) include pharmacotherapy and surgical therapies, but each treatment has its limitations. The aim of this study was to investigate the virus clearance rate, wart cure rate and safety of 5 methods on CA. METHODS 361 patients diagnosed with CA were divided into groups A (<0.5 cm), B (0.5-2.0 cm) and C (>2.0-4.0 cm) according to the maximum diameter of their lesion. Five treatments were compared in each group, and the clinical outcomes were evaluated during follow-ups. RESULTS A 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is preferred if the maximum lesion diameter is <0.5 cm and an ALA-PDT plus cryotherapy treatment is preferred for lesions 0.5-2.0 cm. For lesions >2.0- 4.0 cm, an ALA-PDT retreatment (after cryotherapy or CO2 laser treatment) should be the first choice. CONCLUSIONS The treatments for CA should be chosen according to the maximum diameter of each patient's lesion.
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Affiliation(s)
- Huijuan Shi
- Department of Dermatovenereology, Ningxia Medical University General Hospital, Yinchuan, China
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Li X, Wang X, Gu J, Ma Y, Liu Z, Shi Y. Needle-free injection of 5-aminolevulinic acid in photodynamic therapy for the treatment of condylomata acuminata. Exp Ther Med 2013; 6:236-240. [PMID: 23935753 PMCID: PMC3735532 DOI: 10.3892/etm.2013.1092] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 04/19/2013] [Indexed: 12/02/2022] Open
Abstract
The external application of 5-aminolevulinic acid (ALA) in photodynamic therapy (PDT) results in a shallow penetration depth in thick or extensive condylomata acuminata (CA) lesions, thus demonstrating a poor therapeutic effect for those patients. To compare the efficacy of needle-free injection with external application of ALA in PDT for the treatment of CA, 160 CA patients with thick or extensive warts received ALA-PDT by means of external application or needle-free injection of ALA, respectively. The complete response (CR) rate and recurrence rate in the two groups were analyzed. The CR rate after the first treatment in the needle-free injection group (68.8%) was significantly higher compared with that in the external application group (52.5%; P=0.035). The recurrence rates in the needle-free injection group and external application group were 4.1 and 15.4%, respectively (P=0.022). The needle-free injection of ALA increases the therapeutic effect of PDT for CA patients with thick or extensive lesions. It shortens the treatment time and reduces the recurrence rate, and has great potential in the treatment of CA.
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Affiliation(s)
- Xiuli Li
- Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
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Armoškaitė V, Jakštas V, Ivanauskas L, Ražukas A, Ramanauskienė K, Briedis V. Application of HPLC-ELSD for the Quantification of 5-Aminolevulinic Acid after Penetration into Human Skin Ex Vivo. ANAL LETT 2013. [DOI: 10.1080/00032719.2012.733898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Harms FA, de Boon WMI, Balestra GM, Bodmer SIA, Johannes T, Stolker RJ, Mik EG. Oxygen-dependent delayed fluorescence measured in skin after topical application of 5-aminolevulinic acid. JOURNAL OF BIOPHOTONICS 2011; 4:731-739. [PMID: 21770036 DOI: 10.1002/jbio.201100040] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Revised: 06/26/2011] [Accepted: 06/27/2011] [Indexed: 05/31/2023]
Abstract
Mitochondrial oxygen tension can be measured in vivo by means of oxygen-dependent quenching of delayed fluorescence of protoporphyrin IX (PpIX). Here we demonstrate that delayed fluorescence is readily observed from skin in rat and man after topical application of the PpIX precursor 5-aminolevulinic acid (ALA). Delayed fluorescence lifetimes respond to changes in inspired oxygen fraction and blood supply. The signals contain lifetime distributions and the fitting of rectangular distributions to the data appears more adequate than mono-exponential fitting. The use of topically applied ALA for delayed fluorescence lifetime measurements might pave the way for clinical use of this technique.
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Affiliation(s)
- Floor A Harms
- Department of Anesthesiology, Laboratory of Experimental Anesthesiology, ErasmusMC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Mi X, Chai W, Zheng H, Zuo YG, Li J. A randomized clinical comparative study of cryotherapy plus photodynamic therapy vs. cryotherapy in the treatment of multiple condylomata acuminata. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2011; 27:176-80. [DOI: 10.1111/j.1600-0781.2011.00592.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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