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Wu M, Huang X, Gao L, Zhou G, Xie F. The application of photodynamic therapy in plastic and reconstructive surgery. Front Chem 2022; 10:967312. [PMID: 35936104 PMCID: PMC9353173 DOI: 10.3389/fchem.2022.967312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Photodynamic therapy (PDT) is a modern clinical treatment paradigm with the advantages of high selectivity, non-invasiveness, rare side-effect, no obvious drug resistance and easy combination with other therapies. These features have endowed PDT with high focus and application prospects. Studies of photodynamic therapy have been expanded in a lot of biomedical and clinical fields, especially Plastic and Reconstructive Surgery (PRS) the author major in. In this review, we emphasize the mechanism and advances in PDT related to the PRS applications including benign pigmented lesions, vascular malformations, inflammatory lesions, tumor and others. Besides, combined with clinical data analysis, the limitation of PDT and current issues that need to be addressed in the field of PRS have also been discussed. At last, a comprehensive discussion and outlooking represent future progress of PDT in PRS.
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Affiliation(s)
- Min Wu
- Department of Plastic and Reconstructive Surgery, School of Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Min Wu, ; Feng Xie,
| | - Xiaoyu Huang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Lu Gao
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Guoyu Zhou
- Department of Oral and Maxillofacial-Head Neck Oncology, School of Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Xie
- Department of Plastic and Reconstructive Surgery, School of Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Min Wu, ; Feng Xie,
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Gold MH, Goldberg DJ, Nestor MS. Current treatments of acne: Medications, lights, lasers, and a novel 650-μs 1064-nm Nd: YAG laser. J Cosmet Dermatol 2017; 16:303-318. [PMID: 28703382 DOI: 10.1111/jocd.12367] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 12/21/2022]
Abstract
The treatment of acne, especially severe acne, remains a challenge to dermatologists. Therapies include retinoids, antibiotics, hormones, lights, lasers, and various combinations of these modalities. Acne is currently considered a chronic rather than an adolescent condition. The appropriate treatment depends on the patient and the severity of disease. The purpose of this study was to review current therapies for acne of all severities and to introduce the 650-μs 1064-nm laser for the treatment of acne.
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Affiliation(s)
| | - David J Goldberg
- Skin Laser and Surgery Specialists of NY and NJ, Hackensack, NJ, USA
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Dong Y, Zhou G, Chen J, Shen L, Jianxin Z, Xu Q, Zhu Y. A new LED device used for photodynamic therapy in treatment of moderate to severe acne vulgaris. Photodiagnosis Photodyn Ther 2015; 13:188-195. [PMID: 26116283 DOI: 10.1016/j.pdpdt.2015.06.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 05/25/2015] [Accepted: 06/12/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study investigated the efficacy and safety of a newly designed LED device used in photodiagnosis and photodynamic therapy of moderate to severe acne vulgaris in Chinese patients. METHODS Forty-six patients with moderate to severe facial acne showing high degrees of fluorescence by ultraviolet light examination were illuminated during ALA-PDT with two wavelengths of light (543-548 nm, and 630±6 nm, respectively) after 2 h of incubation with ALA. Each patient received treatment once every 30 days for two or three sessions. Two independent investigators assigned an acne severity score at baseline, one week after each treatment, as well as 4, 8, and 12 weeks after the completion of treatment. Adverse effects were recorded during and after each treatment. All patients rated their satisfaction with the results of treatment at a 12-week follow up visit. RESULTS The ALA-PDL treatment regimen showed an overall effectiveness rate of 89.13% (41/46 patients). Some degree of clinical efficacy was seen in 71.42%, 86.67%, and 95.83% of patients with grades IV, V, and VI acne, respectively, and the rate of clinical effectiveness increased with increasing acne severity. When compared with baseline scores, significant reductions in acne scores were obtained at 8, and 12 weeks after completion of treatment. Maximum efficacy was shown at the 12 week follow up. No severe adverse events were observed. CONCLUSION ALA-PDT administered with the newly designed LED device was an effective treatment for moderate to severe acne vulgaris, and side effects were mild and reversible.
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Affiliation(s)
- Yiyun Dong
- Department of Oral & Maxillofacial-Head & Neck Oncology, Lab of Laser Surgery, Cosmetic Laser Center of the Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Guoyu Zhou
- Department of Oral & Maxillofacial-Head & Neck Oncology, Lab of Laser Surgery, Cosmetic Laser Center of the Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
| | - Jinan Chen
- Cosmetic Laser Center of the Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Lingyue Shen
- Department of Oral & Maxillofacial-Head & Neck Oncology, Lab of Laser Surgery, Cosmetic Laser Center of the Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Zhao Jianxin
- Department of Oral & Maxillofacial-Head & Neck Oncology, Lab of Laser Surgery, Cosmetic Laser Center of the Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Qing Xu
- Department of Oral & Maxillofacial-Head & Neck Oncology, Lab of Laser Surgery, Cosmetic Laser Center of the Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Yulan Zhu
- Cosmetic Laser Center of the Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
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Abstract
INTRODUCTION Acne is the most common skin condition in the US. The mainstay of acne therapy includes: topical retinoids, topical antibiotics, benzoyl peroxide (BP), and oral isotretinoin for severe cases. Although these treatment options are highly effective they do have certain drawbacks. Current acne treatment regimens often require patients to use multiple medications, some of which may have irritating side effects. Furthermore, Propionibacterium acnes resistance to antibiotics has become an increasing problem due to the rise in antibiotic use. AREAS COVERED New therapies that have either been released onto the market or that are being developed include: adapalene-BP combination agent, dapsone 5% gel, minocycline foam, topical nitric oxide-releasing agent, cortexolone 17 α-propionate, and CIP isotretinoin. Some of these new therapies address the challenges faced with existing treatment options. For instance, the relatively new combination therapy, adapalene-BP, limits antibiotic resistance and also helps simplify treatment regimens. The newly developed topical nitric oxide-releasing agent also holds potential in limiting antibiotic resistance. EXPERT OPINION Many of the new therapies discussed in this paper are still in early stages of testing so it is difficult to predict their outlook; however, based on preliminary findings, these therapies seem to be promising.
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Affiliation(s)
- Imran Aslam
- Wake Forest School of Medicine, Center for Dermatology Research, Department of Dermatology, Medical Center Boulevard , Winston-Salem, NC 27157-1071 , USA
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Mei X, Shi W, Piao Y. Effectiveness of photodynamic therapy with topical 5-aminolevulinic acid and intense pulsed light in Chinese acne vulgaris patients. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2013; 29:90-6. [PMID: 23458393 DOI: 10.1111/phpp.12031] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/26/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Xingyu Mei
- Dermatology Department; Shanghai First People's Hospital; Shanghai; China
| | - Weimin Shi
- Dermatology Department; Shanghai First People's Hospital; Shanghai; China
| | - Yinglan Piao
- Dermatology Department; Tongji Hospital; Shanghai; China
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Sharma SK, Mroz P, Dai T, Huang YY, St. Denis TG, Hamblin MR. Photodynamic Therapy for Cancer and for Infections: What Is the Difference? Isr J Chem 2012; 52:691-705. [PMID: 23248387 PMCID: PMC3522418 DOI: 10.1002/ijch.201100062] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Photodynamic therapy (PDT) was discovered over one hundred years ago when it was observed that certain dyes could kill microorganisms when exposed to light in the presence of oxygen. Since those early days, PDT has mainly been developed as a cancer therapy and as a way to destroy proliferating blood vessels. However, recently it has become apparent that PDT may also be used as an effective antimicrobial modality and a potential treatment for localized infections. This review discusses the similarities and differences between the application of PDT for the treatment of microbial infections and for cancer lesions. Type I and type II photodynamic processes are described, and the structure-function relationships of optimal anticancer and antimicrobial photosensitizers are outlined. The different targeting strategies, intracellular photosensitizer localization, and pharmacokinetic properties of photosensitizers required for these two different PDT applications are compared and contrasted. Finally, the ability of PDT to stimulate an adaptive or innate immune response against pathogens and tumors is also covered.
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Affiliation(s)
- Sulbha K. Sharma
- Wellman Center for Photomedicine Massachusetts General Hospital Boston, MA (USA)
| | - Pawel Mroz
- Wellman Center for Photomedicine Massachusetts General Hospital Boston, MA (USA)
- Department of Dermatology Harvard Medical School Boston, MA (USA)
| | - Tianhong Dai
- Wellman Center for Photomedicine Massachusetts General Hospital Boston, MA (USA)
- Department of Dermatology Harvard Medical School Boston, MA (USA)
| | - Ying-Ying Huang
- Wellman Center for Photomedicine Massachusetts General Hospital Boston, MA (USA)
- Department of Dermatology Harvard Medical School Boston, MA (USA)
- Aesthetic and Plastic Center of Guangxi Medical University Nanning (P. R. China)
| | - Tyler G. St. Denis
- Wellman Center for Photomedicine Massachusetts General Hospital Boston, MA (USA)
- Columbia University New York City, NY (USA)
| | - Michael R. Hamblin
- Wellman Center for Photomedicine Massachusetts General Hospital Boston, MA (USA)
- Department of Dermatology Harvard Medical School Boston, MA (USA)
- Harvard-MIT Division of Health Sciences and Technology Cambridge, MA (USA)
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SHAABAN DALIA, ABDEL-SAMAD ZEINAB, EL-KHALAWANY MOHAMED. Photodynamic therapy with intralesional 5-aminolevulinic acid and intense pulsed light versus intense pulsed light alone in the treatment of acne vulgaris: a comparative study. Dermatol Ther 2012; 25:86-91. [DOI: 10.1111/j.1529-8019.2012.01427.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Liu A, Moy RL, Ross EV, Hamzavi I, Ozog DM. Pulsed Dye Laser and Pulsed Dye Laser–Mediated Photodynamic Therapy in the Treatment of Dermatologic Disorders. Dermatol Surg 2012; 38:351-66. [DOI: 10.1111/j.1524-4725.2011.02293.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Harris F, Pierpoint L. Photodynamic therapy based on 5-aminolevulinic acid and its use as an antimicrobial agent. Med Res Rev 2011; 32:1292-327. [PMID: 21793017 DOI: 10.1002/med.20251] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Exogenous 5-aminolevulinic acid (ALA) is taken up directly by bacteria, yeasts, fungi, and some parasites, which then induces the accumulation of protoporphyrin IX (PPIX). Subsequent light irradiation of PPIX leads to the inactivation of these organisms via photodamage to their cellular structures. ALA uptake and light irradiation of PPIX produced by host cells leads to the inactivation of other parasites, along with some viruses, via the induction of an immune response. ALA-mediated PPIX production by host cells and light irradiation result in the inactivation of other viruses via either the induction of a host cell response or direct photodynamic attack on viral particles. This ALA-mediated production of light-activated PPIX has been extensively used as a form of photodynamic therapy (PDT) and has shown varying levels of efficacy in treating conditions that are associated with microbial infection, ranging from acne and verrucae to leishmaniasis and onychomycosis. However, for the treatment of some of these conditions by ALA-based PDT, the role of an antimicrobial effect has been disputed and in general, the mechanisms by which the technique inactivates microbes are not well understood. In this study, we review current understanding of the antimicrobial mechanisms used by ALA-based PDT and its role in the treatment of microbial infections along with its potential medical and nonmedical applications.
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Affiliation(s)
- Frederick Harris
- School of Forensic and Investigative Sciences, University of Central Lancashire, Preston, Lancashire, United Kingdom. fharris1@.ac.uk
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Piérard-Franchimont C, Paquet P, Piérard GE. New approaches in light/laser therapies and photodynamic treatment of acne. Expert Opin Pharmacother 2011; 12:493-501. [PMID: 21269242 DOI: 10.1517/14656566.2011.547476] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Acne is a domain in which the technology and understanding of light/laser therapeutic procedures have advanced considerably. The aim of the paper was to revisit adjunctive physical treatments of acne, including light/laser treatments and photodynamic therapy. This review summarizes findings about such treatment modalities with particular emphasis on efficacy and safety. A number of laser/light-based modalities have been developed to meet the increasing demand for new acne treatments. The current devices correspond, on the one hand, to light-emitting diode therapy and, on the other hand, to the 532-nm potassium titanyl phosphate laser, the 585- and 595-nm pulsed dye laser, the 1450-nm diode laser, the 1320-nm Nd:YAG laser and intense pulsed light. Photodynamic therapy is also available. It is claimed that light/laser treatments might induce a faster response compared with the 1-3 months needed for response to traditional oral and topical treatments. In conclusion, pulsed dye laser shows efficacy in some patients with mild to moderate acne. The relative effectiveness compared with other treatments is unconfirmed; from the published information, evidence-based efficacy assessment of light/laser therapies in acne remains almost impossible.
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Photodynamic therapy for localized infections--state of the art. Photodiagnosis Photodyn Ther 2010; 6:170-88. [PMID: 19932449 DOI: 10.1016/j.pdpdt.2009.10.008] [Citation(s) in RCA: 494] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Revised: 10/27/2009] [Accepted: 10/28/2009] [Indexed: 12/22/2022]
Abstract
Photodynamic therapy (PDT) was discovered over 100 years ago by observing the killing of microorganisms when harmless dyes and visible light were combined in vitro. Since then it has primarily been developed as a treatment for cancer, ophthalmologic disorders and in dermatology. However, in recent years interest in the antimicrobial effects of PDT has revived and it has been proposed as a therapy for a large variety of localized infections. This revival of interest has largely been driven by the inexorable increase in drug resistance among many classes of pathogen. Advantages of PDT include equal killing effectiveness regardless of antibiotic resistance, and a lack of induction of PDT resistance. Disadvantages include the cessation of the antimicrobial effect when the light is turned off, and less than perfect selectivity for microbial cells over host tissue. This review will cover the use of PDT to kill or inactivate pathogens in ex vivo tissues and in biological materials such as blood. PDT has been successfully used to kill pathogens and even to save life in several animal models of localized infections such as surface wounds, burns, oral sites, abscesses and the middle ear. A large number of clinical studies of PDT for viral papillomatosis lesions and for acne refer to its antimicrobial effect, but it is unclear how important this microbial killing is to the overall therapeutic outcome. PDT for periodontitis is a rapidly growing clinical application and other dental applications are under investigation. PDT is being clinically studied for other dermatological infections such as leishmaniasis and mycobacteria. Antimicrobial PDT will become more important in the future as antibiotic resistance is only expected to continue to increase.
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Abstract
Acne vulgaris is a common skin disorder that affects most individuals at some point in their lives. It may result in significant morbidity, including cutaneous scarring and psychological impairment. Current treatments include topical retinoids, benzoyl peroxide, topical and systemic antibiotics, and systemic isotretinoin. There are growing concerns of rising antibiotic resistance, significant side effects of isotretinoin therapy, and lack of safe and effective treatment for pregnant females. Recent advances in the pathogenesis of acne have led to a greater understanding of the underlying inflammatory mechanisms and the role the Propionibacterium acnes and biofilms. This has led to the development of new therapeutic targets. This article reviews emerging treatments of acne, including topical picolinic acid, topical antibiotic dapsone, systemic zinc salts, oral antibiotic lymecycline, new formulations of and synergistic combinations of benzoyl peroxide, photodynamic therapy with topical photosensitizers and potential acne vaccines.
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Affiliation(s)
- Kirk A James
- UNC School of Medicine- Dermatology, Chapel Hill, North Carolina 27516, USA
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Oh SH, Ryu DJ, Han EC, Lee KH, Lee JH. A Comparative Study of Topical 5-Aminolevulinic Acid Incubation Times in Photodynamic Therapy with Intense Pulsed Light for the Treatment of Inflammatory Acne. Dermatol Surg 2009; 35:1918-26. [DOI: 10.1111/j.1524-4725.2009.01315.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jung JY, Choi YS, Yoon MY, Min SU, Suh DH. Comparison of a Pulsed Dye Laser and a Combined 585/1,064-nm Laser in the Treatment of Acne Vulgaris. Dermatol Surg 2009; 35:1181-7. [PMID: 19175372 DOI: 10.1111/j.1524-4725.2008.34427.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Jae Yoon Jung
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
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Abstract
Lasers and optical technologies play a significant role in aesthetic and reconstructive surgery. The unique ability of optical technologies to target specific structures and layers in tissues to effect chemical, mechanical, or thermal changes makes them a powerful tool in cutaneous rejuvenation, hair removal, fat removal, and treatment of vascular lesions such as port-wine stains, among many other procedures. With the development of adjunct techniques such as epidermal cooling, lasers and optical technologies have become more versatile and safe. The constant improvement of existing applications and the emergence of novel applications such as photodynamic therapy, nanoparticles, spectroscopy, and noninvasive imaging continue to revolutionize aesthetic medicine by offering a minimally invasive alternative to traditional surgery. In the future, therapies will be based on individualized, maximum, safe radiant exposure to deliver optimal dosimetry. Lasers and optical technologies are headed toward safer, easier, more quantifiable, and more individualized therapy.
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Affiliation(s)
- Edward C Wu
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, 1002 Health Sciences Rd E, Irvine, CA 92612, USA
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