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Makuch S, Dróżdż M, Makarec A, Ziółkowski P, Woźniak M. An Update on Photodynamic Therapy of Psoriasis—Current Strategies and Nanotechnology as a Future Perspective. Int J Mol Sci 2022; 23:ijms23179845. [PMID: 36077239 PMCID: PMC9456335 DOI: 10.3390/ijms23179845] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 11/16/2022] Open
Abstract
Psoriasis (PS) is an immune-mediated skin disease with substantial negative effects on patient quality of life. Despite significant progress in the development of novel treatment options over the past few decades, a high percentage of patients with psoriasis remain undertreated and require new medications with superior long-term efficacy and safety. One of the most promising treatment options against psoriatic lesions is a form of phototherapy known as photodynamic therapy (PDT), which involves either the systemic or local application of a cell-targeting photosensitizing compound, followed by selective illumination of the lesion with visible light. However, the effectiveness of clinically incorporated photosensitizers in psoriasis treatment is limited, and adverse effects such as pain or burning sensations are frequently reported. In this study, we performed a literature review and attempted to provide a pooled estimate of the efficacy and short-term safety of targeted PDT in the treatment of psoriasis. Despite some encouraging results, PDT remains clinically underutilized. This highlights the need for further studies that will aim to evaluate the efficacy of a wider spectrum of photosensitizers and the potential of nanotechnology in psoriasis treatment.
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Affiliation(s)
- Sebastian Makuch
- Department of Clinical and Experimental Pathology, Wroclaw Medical University, 50-368 Wroclaw, Poland
- Correspondence:
| | - Mateusz Dróżdż
- Laboratory of RNA Biochemistry, Institute of Chemistry and Biochemistry, Freie Universität Berlin, Takustraße 6, 14195 Berlin, Germany
| | - Alicja Makarec
- Faculty of Biotechnology, University of Wroclaw, 50-383 Wroclaw, Poland
| | - Piotr Ziółkowski
- Department of Clinical and Experimental Pathology, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Marta Woźniak
- Department of Clinical and Experimental Pathology, Wroclaw Medical University, 50-368 Wroclaw, Poland
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Yang D, Lei S, Pan K, Chen T, Lin J, Ni G, Liu J, Zeng X, Chen Q, Dan H. Application of photodynamic therapy in immune-related diseases. Photodiagnosis Photodyn Ther 2021; 34:102318. [PMID: 33940209 DOI: 10.1016/j.pdpdt.2021.102318] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 04/09/2021] [Accepted: 04/26/2021] [Indexed: 02/06/2023]
Abstract
Photodynamic therapy (PDT) is a therapeutic modality that utilizes photodamage caused by photosensitizers and oxygen after exposure to a specific wavelength of light. Owing to its low toxicity, high selectivity, and minimally invasive properties, PDT has been widely applied to treat various malignant tumors, premalignant lesions, and infectious diseases. Moreover, there is growing evidence of its immunomodulatory effects and potential for the treatment of immune-related diseases. This review mainly focuses on the effect of PDT on immunity and its application in immune-related diseases.
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Affiliation(s)
- Dan Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Shangxue Lei
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Keran Pan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Ting Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Jiao Lin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Guangcheng Ni
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Jiaxin Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Xin Zeng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Hongxia Dan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China.
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Yoo SW, Oh G, Ahn JC, Chung E. Non-Oncologic Applications of Nanomedicine-Based Phototherapy. Biomedicines 2021; 9:113. [PMID: 33504015 PMCID: PMC7911939 DOI: 10.3390/biomedicines9020113] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/19/2021] [Accepted: 01/22/2021] [Indexed: 02/06/2023] Open
Abstract
Phototherapy is widely applied to various human diseases. Nanomedicine-based phototherapy can be classified into photodynamic therapy (PDT) and photothermal therapy (PTT). Activated photosensitizer kills the target cells by generating radicals or reactive oxygen species in PDT while generating heat in PTT. Both PDT and PTT have been employed for treating various diseases, from preclinical to randomized controlled clinical trials. However, there are still hurdles to overcome before entering clinical practice. This review provides an overview of nanomedicine-based phototherapy, especially in non-oncologic diseases. Multiple clinical trials were undertaken to prove the therapeutic efficacy of PDT in dermatologic, ophthalmologic, cardiovascular, and dental diseases. Preclinical studies showed the feasibility of PDT in neurologic, gastrointestinal, respiratory, and musculoskeletal diseases. A few clinical studies of PTT were tried in atherosclerosis and dry eye syndrome. Although most studies have shown promising results, there have been limitations in specificity, targeting efficiency, and tissue penetration using phototherapy. Recently, nanomaterials have shown promising results to overcome these limitations. With advanced technology, nanomedicine-based phototherapy holds great potential for broader clinical practice.
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Affiliation(s)
- Su Woong Yoo
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Jeollanam-do 58128, Korea;
| | - Gyungseok Oh
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju 61005, Korea;
| | - Jin Chul Ahn
- Medical Laser Research Center and Department of Biomedical Science, Dankook University, Cheonan 31116, Korea;
| | - Euiheon Chung
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju 61005, Korea;
- Department of Physics and Photon Science, Gwangju Institute of Science and Technology (GIST), Gwangju 61005, Korea
- AI Graduate School, Gwangju Institute of Science and Technology (GIST), Gwangju 61005, Korea
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Monfrecola G, Megna M, Rovati C, Arisi M, Rossi M, Calzavara-Pinton I, Fabbrocini G, Calzavara-Pinton P. A Critical Reappraisal of Off-Label Use of Photodynamic Therapy for the Treatment of Non-Neoplastic Skin Conditions. Dermatology 2020; 237:262-276. [PMID: 32554971 DOI: 10.1159/000507926] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 04/16/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In the past 30 years, topical photodynamic therapy (PDT) has been investigated for the treatment of a broad spectrum of cosmetic, inflammatory, and infectious skin conditions with variable, and often contrasting, results. However, the non-expert clinician may be in difficulty evaluating these results because different sensitizers, concentrations, formulations, light sources, and irradiation protocols have been used. In addition, many of these studies have poor quality design being case reports and uncontrolled studies of few cases. SUMMARY With the aim to clarify the potential usefulness of PDT for the treatment of infectious and inflammatory skin diseases as well as selected cosmetic indications, we searched for randomized controlled clinical trials, non-randomized comparative studies, retrospective studies, and case series studies with a number of at least 10 patients, published since 1990. Later, we reappraised the results in order to give a simple critical overview. Key Messages: Evidence from the literature seems to strongly support the use of ALA- and MAL-PDT for the treatment of common skin diseases such as acne, warts, condylomata, and Leishmania skin infection and for photorejuvenation, i.e., the correction of selected cosmetic changes of aging and photoaging. For other disorders, the level of evidence and strength of recommendation are lower, and controlled randomized studies with prolonged follow-ups are necessary in order to assess the clinical usefulness and other potential advantages over current treatment options.
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Affiliation(s)
- Giuseppe Monfrecola
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Chiara Rovati
- Dermatology Department, University of Brescia, Brescia, Italy
| | | | | | | | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Bruschi ML, da Silva JB, Rosseto HC. Photodynamic Therapy of Psoriasis Using Photosensitizers of Vegetable Origin. Curr Pharm Des 2020; 25:2279-2291. [PMID: 31258060 DOI: 10.2174/1381612825666190618122024] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/10/2019] [Indexed: 12/16/2022]
Abstract
Psoriasis is an immune-mediated, chronic and recurrent inflammatory skin disease, prevalent worldwide, and represents an important burden in life quality of patients. The most common clinical variant is termed as psoriasis vulgaris or plaque psoriasis, which with an individualized and carefully monitored therapy can decrease the patients' morbidity and improving their life quality. The aim is to achieve disease control, minimize the adverse drug effects, and tailor the treatment to individual patient factors. Photodynamic therapy (PDT) is based on local or systemic administration of a non-toxic photosensitizer followed by irradiation with a particular wavelength to generate reactive oxygen species (ROS), mainly highly cytotoxic singlet oxygen (1O2). The generation of these species results in the attack to substrates involved in biological cycles causing necrosis and apoptosis of affected tissues. Photosensitizers are found in natural products and also obtained by partial syntheses from abundant natural starting compounds. They can be isolated at low cost and in large amounts from plants or algae. Therefore, this manuscript reviews the use of molecules from vegetal sources as photosensitizer agents for the PDT of psoriasis. Psoriasis pathogenesis, management and treatment were reviewed. PDT principles, fundamentals and utilization for the treatment of psoriasis were also discussed. Photosensitizers for PDT of psoriasis are also reviewed focusing on those from vegetal sources. Despite the PDT is utilized for the treatment of psoriasis, very little amount of photosensitizers from plant sources are utilized, such as chlorophyll derivatives and hypericin; however, other natural photosensitizers such as curcumin, could also be investigated. They could constitute a very important, safe and cheap alternative for the successful photodynamic treatment of psoriasis.
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Affiliation(s)
- Marcos L Bruschi
- Laboratory of Research and Development of Drug Delivery Systems, Postgraduate Program in Pharmaceutical Sciences, Department of Pharmacy, State University of Maringa, Maringa, PR, Brazil
| | - Jéssica Bassi da Silva
- Laboratory of Research and Development of Drug Delivery Systems, Postgraduate Program in Pharmaceutical Sciences, Department of Pharmacy, State University of Maringa, Maringa, PR, Brazil
| | - Hélen C Rosseto
- Laboratory of Research and Development of Drug Delivery Systems, Postgraduate Program in Pharmaceutical Sciences, Department of Pharmacy, State University of Maringa, Maringa, PR, Brazil
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De Annunzio SR, Costa NCS, Mezzina RD, Graminha MAS, Fontana CR. Chlorin, Phthalocyanine, and Porphyrin Types Derivatives in Phototreatment of Cutaneous Manifestations: A Review. Int J Mol Sci 2019; 20:ijms20163861. [PMID: 31398812 PMCID: PMC6719085 DOI: 10.3390/ijms20163861] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/13/2019] [Accepted: 06/18/2019] [Indexed: 12/13/2022] Open
Abstract
Recent scientific research has shown the use of chlorin, phthalocyanines, and porphyrins derivatives as photosensitizers in photodynamic therapy in the treatment of various pathologies, including some of the major skin diseases. Thus, the main goal of this critical review is to catalog the papers that used these photosensitizers in the treatment of acne vulgaris, psoriasis, papillomavirus infections, cutaneous leishmaniasis, and skin rejuvenation, and to explore the photodynamic therapy mechanisms against these conditions alongside their clinical benefits.
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Affiliation(s)
- Sarah Raquel De Annunzio
- School of Pharmaceutical Sciences, São Paulo State University (Unesp), Araraquara, Rod. Araraquara-Jaú, km 01, Campus Ville, Araraquara 14800-903, São Paulo, Brazil
| | - Natalia Caroline Silva Costa
- School of Pharmaceutical Sciences, São Paulo State University (Unesp), Araraquara, Rod. Araraquara-Jaú, km 01, Campus Ville, Araraquara 14800-903, São Paulo, Brazil
| | - Rafaela Dalbello Mezzina
- School of Pharmaceutical Sciences, São Paulo State University (Unesp), Araraquara, Rod. Araraquara-Jaú, km 01, Campus Ville, Araraquara 14800-903, São Paulo, Brazil
| | - Márcia A S Graminha
- School of Pharmaceutical Sciences, São Paulo State University (Unesp), Araraquara, Rod. Araraquara-Jaú, km 01, Campus Ville, Araraquara 14800-903, São Paulo, Brazil
| | - Carla Raquel Fontana
- School of Pharmaceutical Sciences, São Paulo State University (Unesp), Araraquara, Rod. Araraquara-Jaú, km 01, Campus Ville, Araraquara 14800-903, São Paulo, Brazil.
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7
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Wang B, Shi L, Zhang Y, Zhou Q, Zheng J, Szeimies R, Wang X. Gain with no pain? Pain management in dermatological photodynamic therapy. Br J Dermatol 2017; 177:656-665. [PMID: 28122416 DOI: 10.1111/bjd.15344] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2016] [Indexed: 12/30/2022]
Affiliation(s)
- B. Wang
- Department of Dermatology Ruijin Hospital School of Medicine Shanghai Jiaotong University Shanghai China
| | - L. Shi
- Institute of Photomedicine Shanghai Skin Disease Hospital Tongji University School of Medicine 1278 Baode Road Shanghai 200443 China
| | - Y.F. Zhang
- Institute of Photomedicine Shanghai Skin Disease Hospital Tongji University School of Medicine 1278 Baode Road Shanghai 200443 China
| | - Q. Zhou
- Institute of Photomedicine Shanghai Skin Disease Hospital Tongji University School of Medicine 1278 Baode Road Shanghai 200443 China
| | - J. Zheng
- Department of Dermatology Ruijin Hospital School of Medicine Shanghai Jiaotong University Shanghai China
| | - R.M. Szeimies
- Department of Dermatology and Allergology Vest Clinic Recklinghausen Germany
| | - X.L. Wang
- Institute of Photomedicine Shanghai Skin Disease Hospital Tongji University School of Medicine 1278 Baode Road Shanghai 200443 China
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Wang B, Xu YT, Zhang L, Zheng J, Sroka R, Wang HW, Wang XL. Protoporphyrin IX fluorescence as potential indicator of psoriasis severity and progression. Photodiagnosis Photodyn Ther 2017. [PMID: 28625924 DOI: 10.1016/j.pdpdt.2017.05.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES In psoriatic lesions, fluorescence diagnosis with blue light can detect protoporphyrin IX accumulation, especially after topical 5-aminolaevulinic acid (ALA) application. However, variable fluorescence distributions, interpersonal variations and long incubation time limit its wide application in clinic. This study is aimed to identify a consistent and convenient method to facilitate diagnosis and evaluation of psoriatic lesions. METHODS 104 psoriatic lesions from 30 patients were evaluated. Single lesion PSI scoring and fluorescence by macrospectrofluorometry were recorded on each lesion before and after treatment with narrow-band UVB. RESULTS Punctate red fluorescence, emitted mainly by protoporphyrin IX, is observed in some psoriatic lesions. According to psoriasis severity index, fluorescence-positive lesions are more severe than lesions without fluorescence. We found a significant positive correlation between psoriasis severity and fluorescence intensity from protoporphyrin IX. CONCLUSIONS Protoporphyrin IX-induced red fluorescence can be used as a novel and convenient approach for psoriasis diagnosis and progression evaluation.
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Affiliation(s)
- Bo Wang
- Department of Dermatology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yu-Ting Xu
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Li Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jie Zheng
- Department of Dermatology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Ronald Sroka
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China; Laser-Forschungslabor, LIFE-Center of University Hospital of LMU; Department of Urology, University of LMU, Munich, Germany
| | - Hong-Wei Wang
- Department of Dermatology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiu-Li Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
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Chen T, Zhang LW, Fu LX, Wu YB, Liu XY, Guo ZP. Systemic ALA-PDT effectively blocks the development of psoriasis-like lesions and alleviates leucocyte infiltration in the K14-VEGF transgenic mouse. Clin Exp Dermatol 2017; 42:849-856. [PMID: 28597992 DOI: 10.1111/ced.13148] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2016] [Indexed: 12/28/2022]
Affiliation(s)
- T. Chen
- Department of Dermatovenereology; Chengdu Second People's Hospital; Chengdu Sichuan China
- Department of Dermatovenereology; West PR China Hospital of Sichuan University; Chengdu Sichuan China
- Department of Dermatovenereology; Chengdu Qingbaijiang District People's Hospital; Chengdu Sichuan China
| | - L.-W. Zhang
- Department of Dermatovenereology; Chengdu Second People's Hospital; Chengdu Sichuan China
| | - L.-X. Fu
- Department of Dermatovenereology; Chengdu Second People's Hospital; Chengdu Sichuan China
| | - Y.-B. Wu
- Department of Dermatovenereology; Chengdu Second People's Hospital; Chengdu Sichuan China
| | - X.-Y. Liu
- Department of Dermatovenereology; Chengdu Second People's Hospital; Chengdu Sichuan China
| | - Z.-P. Guo
- Department of Dermatovenereology; West PR China Hospital of Sichuan University; Chengdu Sichuan China
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Zhang D, Zheng A, Li J, Wu M, Cai Z, Wu L, Wei Z, Yang H, Liu X, Liu J. Tumor Microenvironment Activable Self-Assembled DNA Hybrids for pH and Redox Dual-Responsive Chemotherapy/PDT Treatment of Hepatocellular Carcinoma. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2017; 4:1600460. [PMID: 28435778 PMCID: PMC5396159 DOI: 10.1002/advs.201600460] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 11/25/2016] [Indexed: 05/22/2023]
Abstract
Smart self-assembled "Turn-ON" DNA hybrids are employed, which could respond to tumor microenvironment stimuli for cancer cell specific real-time fluorescence imaging, tumor-specific synergistic photodynamic therapy and chemotherapy in hepatocellular carcinoma.
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Affiliation(s)
- Da Zhang
- The Liver Center of Fujian ProvinceFujian Medical UniversityFuzhou350025P. R. China
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian ProvinceMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhou350025P. R. China
| | - Aixian Zheng
- The Liver Center of Fujian ProvinceFujian Medical UniversityFuzhou350025P. R. China
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian ProvinceMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhou350025P. R. China
| | - Juan Li
- The Key Lab of Analysis and Detection Technology for Food Safety of the MOEFujian Provincial Key Laboratory of Analysis and Detection Technology for Food SafetyCollege of ChemistryFuzhou UniversityFuzhou350002P. R. China
| | - Ming Wu
- The Liver Center of Fujian ProvinceFujian Medical UniversityFuzhou350025P. R. China
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian ProvinceMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhou350025P. R. China
| | - Zhixiong Cai
- The Liver Center of Fujian ProvinceFujian Medical UniversityFuzhou350025P. R. China
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian ProvinceMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhou350025P. R. China
| | - Lingjie Wu
- The Liver Center of Fujian ProvinceFujian Medical UniversityFuzhou350025P. R. China
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian ProvinceMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhou350025P. R. China
| | - Zuwu Wei
- The Liver Center of Fujian ProvinceFujian Medical UniversityFuzhou350025P. R. China
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian ProvinceMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhou350025P. R. China
| | - Huanghao Yang
- The Key Lab of Analysis and Detection Technology for Food Safety of the MOEFujian Provincial Key Laboratory of Analysis and Detection Technology for Food SafetyCollege of ChemistryFuzhou UniversityFuzhou350002P. R. China
| | - Xiaolong Liu
- The Liver Center of Fujian ProvinceFujian Medical UniversityFuzhou350025P. R. China
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian ProvinceMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhou350025P. R. China
| | - Jingfeng Liu
- The Liver Center of Fujian ProvinceFujian Medical UniversityFuzhou350025P. R. China
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian ProvinceMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhou350025P. R. China
- Liver Disease CenterThe First Affiliated Hospital of Fujian Medical UniversityFuzhou350005P. R. China
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Slomp AM, Barreira SM, Carrenho LZ, Vandresen CC, Zattoni IF, Ló SM, Dallagnol JC, Ducatti DR, Orsato A, Duarte MER, Noseda MD, Otuki MF, Gonçalves AG. Photodynamic effect of meso -(aryl)porphyrins and meso -(1-methyl-4-pyridinium)porphyrins on HaCaT keratinocytes. Bioorg Med Chem Lett 2017; 27:156-161. [DOI: 10.1016/j.bmcl.2016.11.094] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 11/29/2016] [Accepted: 11/30/2016] [Indexed: 01/19/2023]
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12
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Chen T, Fu LX, Guo ZP, Yin B, Cao N, Qin S. Involvement of high mobility group box-1 in imiquimod-induced psoriasis-like mice model. J Dermatol 2016; 44:573-581. [PMID: 27943400 DOI: 10.1111/1346-8138.13695] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 10/11/2016] [Indexed: 02/05/2023]
Abstract
In the previous work, we have indicated that HMGB1, a pro-inflammatory cytokine, is closely associated with the pathogenesis of psoriasis. To further clarify the role of HMGB1 in the pathogenesis of psoriasis, we investigated the direct function of HMGB1 application and HMGB1 blockade in imiquimod (IMQ)-induced psoriatic mouse model in this study. Mice were treated with imiquimod (IMQ) to induce psoriasis-like inflammation, and consecutively injected with recombinant HMGB1 or phosphate-buffered saline (PBS) i.d. Abundant cytoplasmic expression of HMGB1 was observed in lesional skin from IMQ-treated skin. The injection of HMGB1 into the IMQ-treated skin further aggravated the psoriasis-like disease, enhanced the infiltration of CD3+ T cells, myeloperoxidase+ neutrophils and CD11c+ dendritic cells, increased the number of γδ T cells, and upregulated the mRNA expression of interleukin (IL)-6, tumor necrosis factor (TNF)-α, interferon (IFN)-γ and IL-17 compared with the PBS injection. Finally, by using anti-HMGB1 monoclonal antibody or HMGB1 inhibitor glycyrrhizin, we indicated that HMGB1 blockade reduced the number of γδ T cells, suppressed the mRNA expression of IL-6, TNF-α, IFN-γ and IL-17, and moderated clinical and histological evolvement in the IMQ-treated skin. Our data suggest that HMGB1 may act as a pro-inflammatory cytokine, and contribute to the development of IMQ-induced psoriasis-like inflammation. HMGB1 blockade may represent a new direction in the suppression of psoriasis.
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Affiliation(s)
- Tao Chen
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, China.,Department of Dermatovenereology, West China Hospital of Sichuan University, Chengdu, China.,Department of Dermatovenereology, Chengdu Qingbaijiang Distinct People's Hospital, Chengdu, China
| | - Li-Xin Fu
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, China
| | - Zai-Pei Guo
- Department of Dermatovenereology, West China Hospital of Sichuan University, Chengdu, China
| | - Bin Yin
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, China
| | - Na Cao
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, China
| | - Sha Qin
- Department of Dermatovenereology, West China Hospital of Sichuan University, Chengdu, China
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The potential of photodynamic therapy (PDT)-Experimental investigations and clinical use. Biomed Pharmacother 2016; 83:912-929. [PMID: 27522005 DOI: 10.1016/j.biopha.2016.07.058] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/30/2016] [Accepted: 07/31/2016] [Indexed: 12/13/2022] Open
Abstract
Photodynamic therapy (PDT) is an intensively studied part of medicine based on free radicals. These reactive species, extremely harmful for whole human organism, are used for eradication numerous diseases. Specific structure of ill tissues causes accumulation free radicals inside them without attack remaining healthy tissues. A rapid development of medicine and scientific research has led to extension of PDT towards treatment many diseases such as cancer, herpes, acne and based on antimicrobials. The presented review article is focused on the aforementioned disorders with accurate analysis of the newest available scientific achievements. The discussed cases explicitly indicate on high efficacy of the therapy. In most cases, free radicals turned out to be solution of many afflictions. Photodynamic therapy can be considered as promising treatment with comparable effectiveness but without side effects characteristic for chemotherapy.
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Chen T, Fu LX, Zhang LW, Yin B, Zhou PM, Cao N, Lu YH. Paeoniflorin suppresses inflammatory response in imiquimod-induced psoriasis-like mice and peripheral blood mononuclear cells (PBMCs) from psoriasis patients. Can J Physiol Pharmacol 2016; 94:888-94. [PMID: 27348512 DOI: 10.1139/cjpp-2015-0483] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Psoriasis is one of the most common immune-mediated chronic inflammatory skin disorders, characterized by hyperproliferation of keratinocytes, dilation and growth of dermal capillary vasculature, and cellular infiltration of T cells, dendritic cells (DCs), and neutrophils. Paeoniflorin (PF), the principal component of total glucosides of paeony (TGP), displays anti-inflammatory and antioxidant properties in several animal models. In this study, we investigated the anti-inflammatory effects and mechanisms of PF in imiquimod (IMQ)-induced psoriasis-like mouse model. The effects of PF on inflammatory cytokine expression in peripheral blood mononuclear cells (PBMCs) from patients with psoriasis vulgaris were also observed. Our results indicated that PF effectively attenuated the clinical and histopathologic changes in IMQ-induced psoriasis-like mouse model. Furthermore, PF reduced the infiltration of T cells, CD11c+DCs, and neutrophils in lesional skin. In addition, PF also significantly decreased the mRNA expression of inflammatory cytokines, such as IL-17, INF-γ, IL-6, and TNF-α, in IMQ-induced psoriasis-like mouse model and PBMCs from patients with psoriasis vulgaris. Hence, our data suggest that PF can inhibit leukocyte infiltration and decrease the expression of inflammatory cytokines such as IL-17, INF-γ, IL-6, and TNF-α. PF might be a candidate drug for the treatment of psoriasis.
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Affiliation(s)
- Tao Chen
- Department of Dermatovenereology, Chengdu Second People’s Hospital, Chengdu, 610017 Sichuan, China
- Department of Dermatovenereology, Chengdu Qingbaijiang Distinct People’s Hospital, Chengdu 610300, Sichuan, China
| | - Li-xin Fu
- Department of Dermatovenereology, Chengdu Second People’s Hospital, Chengdu, 610017 Sichuan, China
| | - Li-wen Zhang
- Department of Dermatovenereology, Chengdu Second People’s Hospital, Chengdu, 610017 Sichuan, China
| | - Bin Yin
- Department of Dermatovenereology, Chengdu Second People’s Hospital, Chengdu, 610017 Sichuan, China
| | - Pei-mei Zhou
- Department of Dermatovenereology, Chengdu Second People’s Hospital, Chengdu, 610017 Sichuan, China
| | - Na Cao
- Department of Dermatovenereology, Chengdu Second People’s Hospital, Chengdu, 610017 Sichuan, China
| | - Yong-hong Lu
- Department of Dermatovenereology, Chengdu Second People’s Hospital, Chengdu, 610017 Sichuan, China
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Gozali MV, Yi F, Zhang JA, Liu J, Wu HJ, Xu Y, Luo D, Zhou BR. Photodynamic therapy inhibit Fibroblast Growth Factor-10 induced keratinocyte differentiation and proliferation through ROS in Fibroblast Growth Factor Receptor-2b pathway. Sci Rep 2016; 6:27402. [PMID: 27273653 PMCID: PMC4895211 DOI: 10.1038/srep27402] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 05/18/2016] [Indexed: 12/22/2022] Open
Abstract
5-aminolevulinic acid-photodynamic therapy (ALA-PDT) is known to be effective in several skin diseases such as acne, actinic keratoses, condyloma acuminata. However, some detailed mechanisms of ALA-PDT to treat these skin diseases still remain elusive. In this study, we aimed to investigate mechanism of ALA-PDT in in-vitro and in-vivo models. For in vitro, we use human keratinocyte cell line (HaCaT) cells. CCK-8 was used to detect cell proliferation activity, immunofluorescence and western blotting method to detect the content of keratin (K)1, K6, K16, protein kinase C (PKC), fibroblast growth factor receptor-2b (FGFR2b) protein, ELISA and RT-PCR to detect expression of interleukin (IL) 1α in the cell supernatant, and detect reactive oxygen species (ROS). For in vivo, we use 20 rabbits to induce hyperkeratosis acne model in their ear. Dermatoscope was used to see follicle hyperkeratosis and skin biopsy to analyze histology and immunohistochemical of PKC, FGFR2b, K1, K6 and K16. Results from this study suggest that ROS stimulated by ALA-PDT lead to inhibition of FGFR2b pathway in PKC downstream to cause reduction of IL1α expression, and eventually, keratinocytes differentiation and proliferation. Our data thus reveal a treatment mechanism of ALA-PDT underlying hyperkeratosis related dermatoses.
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Affiliation(s)
- Maya Valeska Gozali
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Fei Yi
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Jia-An Zhang
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Juan Liu
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Hong-Jin Wu
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yang Xu
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Dan Luo
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Bing-Rong Zhou
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
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Sezer E, Böer-Auer A, Cetin E, Tokat F, Durmaz E, Sahin S, Ince U. Diagnostic utility of Ki-67 and Cyclin D1 immunostaining in differentiation of psoriasis vs. other psoriasiform dermatitis. Dermatol Pract Concept 2015; 5:7-13. [PMID: 26336616 PMCID: PMC4536874 DOI: 10.5826/dpc.0503a02] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 05/03/2015] [Indexed: 11/13/2022] Open
Abstract
Background: Differentiation of psoriasis from non-psoriasis psoriasiform dermatitis (NPPD) may be difficult for dermatopathologists, as lack of distinctive histopathological features in a subset of cases may cause confusion in diagnosis. Objective: As the prototype of psoriasiform dermatitis, psoriasis is a hyperproliferative skin disorder with increased epidermal turnover compared with NPPD, we investigated the role of proliferation markers, Ki-67 and Cyclin D1 as diagnostic tools to differentiate psoriasis from other psoriasiform dermatitis. Methods: Histopathological specimens of psoriasis (n = 35) and NPPD (n = 36, 14 pityriasis rubra pilaris, 12 pityriasis rosea and 10 lichen simplex) cases were reviewed and immunohistochemically stained for Ki-67 and Cyclin D1. Ki-67 and Cyclin D1 positive cells were counted for suprabasal, and total epidermal immunostaining per mm2. Results: Suprabasal and total epidermal cell counts for Ki-67 were found to be significantly higher in the psoriasis group compared with the NPPD group (p < 0.05). An important and interesting feature was the presence of a cut-off value for the suprabasal/total epidermal cell count ratio of 75% for Ki-67 immunostaining, which was higher in all patients having psoriasis (range, 77.1% – 92.4%) and lower in all NPPD cases (range, 21.0% – 73.3%). However, suprabasal Cyclin D1 cell counts were higher in the psoriasis group compared with the NPPD group (p < 0.05), total epidermal Cyclin D1 cell counts were not statistically significant in either group (p = 0.167), and a cut-off value for suprabasal/total epidermal cell count ratio to distinguish these two entities was not detected using this immunostain. Conclusions: We suggest that Ki-67 is a more sensitive marker than Cyclin D1 in terms of having a cutoff value of 75% for the suprabasal/total epidermal immunoreactive cell count ratio, which we believe could be useful for dermatopathologists in differentiating psoriasis from other psoriasiform dermatitis.
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Affiliation(s)
- Engin Sezer
- Department of Dermatology, Acibadem University School of Medicine, Istanbul, Turkey
| | | | - Emel Cetin
- Department of Pathology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Fatma Tokat
- Department of Pathology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Emel Durmaz
- Department of Dermatology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Sedef Sahin
- Department of Dermatology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Umit Ince
- Department of Pathology, Acibadem University School of Medicine, Istanbul, Turkey
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Reinhard A, Sandborn WJ, Melhem H, Bolotine L, Chamaillard M, Peyrin-Biroulet L. Photodynamic therapy as a new treatment modality for inflammatory and infectious conditions. Expert Rev Clin Immunol 2015; 11:637-57. [DOI: 10.1586/1744666x.2015.1032256] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Abstract
INTRODUCTION Photodynamic therapy for psoriasis showed promise in the early 1990s with reports of plaque clearance following topical aminolevulinic acid - photodynamic therapy (ALA-PDT). METHODS In December 2013, we conducted a systematic search of the PubMed Medline database using the keywords "psoriasis" and "photodynamic therapy". RESULTS Numerous clinical studies have failed to demonstrate a consistent, efficacious response to topical ALA-PDT. Furthermore, severe pain and burning sensations were repeatedly reported, many cases being intolerable for patients. DISCUSSION The variability in clinical response and the painful side effects have made topical ALA-PDT an unsuitable treatment option for chronic plaque psoriasis. Nonetheless, early clinical studies of other modalities such as topical hypericin and methylene blue, as well as systemic ALA and verteporfin, have shown that these photosensitizers are efficacious and much better tolerated than topical ALA. CONCLUSION With the current landscape of phototherapy dominated by psoralen combined with ultraviolet A (PUVA) and narrow-band ultraviolet B (NB-UVB), an alternative light therapy utilizing the visible spectrum is certainly promising and a worthwhile endeavor to pursue.
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Affiliation(s)
- Young M Choi
- David Geffen School of Medicine , UCLA, Los Angeles, CA , USA and
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Maytin EV, Honari G, Khachemoune A, Taylor CR, Ortel B, Pogue BW, Sznycer-Taub N, Hasan T. Vitamin D Combined with Aminolevulinate (ALA)-Mediated Photodynamic Therapy (PDT) for Human Psoriasis: A Proof-of-Principle Study. Isr J Chem 2012; 52:767-775. [PMID: 23264699 DOI: 10.1002/ijch.201200005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We previously showed that select agents (methotrexate or Vitamin D), when administered as a preconditioning regimen, are capable of promoting cellular differentiation of epithelial cancer cells while simultaneously enhancing the efficacy of 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT). In solid tumors, pretreatment with Vitamin D simultaneously promotes cellular differentiation and leads to selective accumulation of target porphyrins (mainly protoporphyrin IX, PpIX) within diseased tissue. However, questions of whether or not the effects upon cellular differentiation are inexorably linked to PpIX accumulation, and whether these effects might occur in hyperproliferative noncancerous tissues, have remained unanswered. In this paper, we reasoned that psoriasis, a human skin disease in which abnormal cellular proliferation and differentiation plays a major role, could serve as a useful model to test the effects of pro-differentiating agents upon PpIX levels in a non-neoplastic setting. In particular, Vitamin D, a treatment for psoriasis that restores (increases) differentiation, might increase PpIX levels in psoriatic lesions and facilitate their responsiveness to ALA-PDT. This concept was tested in a pilot study of 7 patients with bilaterally-matched psoriatic plaques. A regimen in which calcipotriol 0.005% ointment was applied for 3 days prior to ALA-PDT with blue light, led to preferential increases in PpIX (~130%), and reductions in thickness, redness, scaling, and itching in the pretreated plaques. The results suggest that a larger clinical trial is warranted to confirm a role for combination treatments with Vitamin D and ALA-PDT for psoriasis.
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Affiliation(s)
- Edward V Maytin
- Department of Dermatology, Cleveland Clinic, Cleveland, OH ; Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH ; Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA
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Abstract
Localized resistant plaques of psoriasis often remain despite highly effective anti-psoriasis treatment. Intralesional therapy is often used to treat various malignant, infectious or inflammatory cutaneous diseases, including psoriasis. Despite the presence of many review articles on the treatment of psoriasis, no articles exist which review the use of intralesional therapy for psoriasis. In this article, we review the published literatures of intralesional therapy for psoriasis. Corticosteroids, methotrexate, cyclosporin, biologics, botulinum toxin type-A, 15-hydroxyeicosatetraenoic acid, and chemotherapy agents such as 5-fluorouracil are discussed. Also, agents which may be used intralesionally and have the potential to treat psoriasis will also be reviewed such as bleomycin, vincristine or vinblastine, mitomycin-C, aminophylline, 5-aminolevulinic acid, rituximab, bevacizumab and pentoxifylline are included.
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Affiliation(s)
- Ting-Shun Wang
- Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
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21
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Carrascosa J, López-Estebaranz J, Carretero G, Daudén E, Ferrándiz C, Vidal D, Belinchón I, Sánchez-Regaña M, Puig L. Documento de consenso de fototerapia en psoriasis del Grupo Español de Psoriasis: ultravioleta B de banda estrecha (UVBBE), láser y fuentes monocromáticas de excímeros y terapia fotodinámica. ACTAS DERMO-SIFILIOGRAFICAS 2011; 102:175-86. [DOI: 10.1016/j.ad.2010.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Accepted: 11/10/2010] [Indexed: 01/22/2023] Open
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Kleinpenning M, Otero M, van Erp P, Gerritsen M, van de Kerkhof P. Efficacy of blue light vs. red light in the treatment of psoriasis: a double-blind, randomized comparative study. J Eur Acad Dermatol Venereol 2011; 26:219-25. [DOI: 10.1111/j.1468-3083.2011.04039.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wang XL, Wang HW, Yuan KH, Li FL, Huang Z. Combination of photodynamic therapy and immunomodulation for skin diseases--update of clinical aspects. Photochem Photobiol Sci 2011; 10:704-11. [PMID: 21336342 DOI: 10.1039/c0pp00373e] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In dermatology, photodynamic therapy (PDT) has become a well established treatment modality which has been shown to be effective and safe for many skin and mucosal disorders. Pre-clinical and clinical studies demonstrate that, in addition to the direct local cytotoxicity and vascular effects, PDT can induce various host immune responses. Recent clinical data also show that improved clinical outcomes can be obtained through the sequential use of PDT and immunomodulation. This article will provide an update on the current status of such a combination in dermatological applications.
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Affiliation(s)
- Xiu-Li Wang
- PDT Center, Shanghai Skin Diseases and STD Hospital, Shanghai, P R China
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24
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Garg AD, Krysko DV, Vandenabeele P, Agostinis P. DAMPs and PDT-mediated photo-oxidative stress: exploring the unknown. Photochem Photobiol Sci 2011; 10:670-80. [PMID: 21258717 DOI: 10.1039/c0pp00294a] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Damage-associated molecular patterns (DAMPs) or cell death associated molecular patterns (CDAMPs) are a subset of endogenous intracellular molecules that are normally hidden within living cells but become either passively released by primary and secondary necrotic cells or actively exposed and secreted by the dying cells. Once released, DAMPs are sensed by the innate immune system and act as activators of antigen-presenting cells (APCs) to stimulate innate and adaptive immunity. Cancer cells dying in response to a subset of conventional anticancer modalities exhibit a particular composition of DAMPs at their cell surface, which has been recently shown to be vital for the stimulation of the host immune system and the control of residual disease. Photodynamic therapy (PDT) for cancer has long been shown to be capable of killing malignant cells and concomitantly stimulate the host immune system, properties that are likely linked to its ability of inducing exposure/release of certain DAMPs. PDT, by evoking oxidative stress at specific subcellular sites through the light activation of organelle-associated photosensitizers, may be unique in incorporating tumour cells destruction and antitumor immune response in one therapeutic paradigm. Here we review the current knowledge about mechanisms and signalling cascades leading to the exposure of DAMPs at the cell surface or promoting their release, the cell death mechanism associated to these processes and its immunological consequences. We also discuss how certain PDT paradigms may yield therapies that optimally stimulate the immune system and lead to the discovery of new DAMPs.
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Affiliation(s)
- Abhishek D Garg
- Department of Molecular Cell Biology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
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25
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Carrascosa J, López-Estebaranz J, Carretero G, Daudén E, Ferrándiz C, Vidal D, Belinchón I, Sánchez-Regaña M, Puig L. Narrowband UV-B, Monochromatic Excimer Laser, and Photodynamic Therapy in Psoriasis: A Consensus Statement of the Spanish Psoriasis Group. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s1578-2190(11)70782-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Kleinpenning MM, Kanis JH, Smits T, van Erp PEJ, van de Kerkhof P, Gerritsen RMJP. The effects of keratolytic pretreatment prior to fluorescence diagnosis and photodynamic therapy with aminolevulinic acid-induced porphyrins in psoriasis. J DERMATOL TREAT 2010; 21:245-51. [PMID: 19832289 DOI: 10.3109/09546630903271548] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Psoriasis lesions accumulate protoporphyrin IX (PpIX) with a variable distribution within plaques due to variations in hyperkeratosis causing differences in penetration of cream or light. OBJECTIVES To study the effects of different keratolytic pretreatments in PpIX-induced fluorescence diagnosis (FDAP) and during photodynamic therapy (PDT). METHODS Two psoriasis plaques of 10 patients were treated with either topical retinoic acid or with a hydrocolloid dressing. The hydrocolloid dressing gave the best results. Subsequently, two different contralateral plaques of eight patients were pretreated with a hydrocolloid dressing or the standard pretreatment, salicylic acid in petrolatum, during the 6 weeks of PDT. Biopsies were investigated with respect to stratum corneum thickness, proliferation, differentiation and inflammation. RESULTS Irritation and point bleedings were noticed after retinoic acid. A hydrocolloid dressing induced the best clinical improvement. Therefore, it was used as alternative pretreatment for psoriasis prior to PDT. We observed significant clinical and immunohistochemical improvement of psoriasis in the salicylic acid as well as the hydrocolloid dressing pretreated plaques. CONCLUSIONS Salicylic acid in petrolatum and a hydrocolloid dressing prior to FDAP and PDT induce improvement of hyperkeratosis. Thus, a hydrocolloid dressing is a good alternative to the current keratolytic pretreatment regime.
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Affiliation(s)
- Marloes M Kleinpenning
- Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Tyrrell J, Campbell S, Curnow A. Validation of a non-invasive fluorescence imaging system to monitor dermatological PDT. Photodiagnosis Photodyn Ther 2010; 7:86-97. [DOI: 10.1016/j.pdpdt.2010.03.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2009] [Revised: 03/09/2010] [Accepted: 03/14/2010] [Indexed: 12/29/2022]
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Parera E, Gallardo F, Toll A, Gil I, Sánchez-Schmidt J, Pujol R. Inflammatory linear verrucous epidermal nevus successfully treated with methyl-aminolevulinate photodynamic therapy. Dermatol Surg 2010; 36:253-6. [PMID: 20402956 DOI: 10.1111/j.1524-4725.2009.01401.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Elisabet Parera
- Department of Dermatology, Hospital del Mar, IMAS, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Fernández-Guarino M, Harto A, Sánchez-Ronco M, García-Morales I, Jaén P. Pulsed dye laser vs. photodynamic therapy in the treatment of refractory nail psoriasis: a comparative pilot study. J Eur Acad Dermatol Venereol 2009; 23:891-5. [DOI: 10.1111/j.1468-3083.2009.03196.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Smits T, van Laarhoven A, Staassen A, van de Kerkhof P, van Erp P, Gerritsen MJ. Induction of protoporphyrin IX by aminolaevulinic acid in actinic keratosis, psoriasis and normal skin: preferential porphyrin enrichment in differentiated cells. Br J Dermatol 2009; 160:849-57. [DOI: 10.1111/j.1365-2133.2008.09012.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gattu S, Rashid RM, Wu JJ. 308-nm excimer laser in psoriasis vulgaris, scalp psoriasis, and palmoplantar psoriasis. J Eur Acad Dermatol Venereol 2009; 23:36-41. [DOI: 10.1111/j.1468-3083.2008.02942.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Photodynamic therapy (PDT) uses light-activated drugs to treat diseases ranging from cancer to age-related macular degeneration and antibiotic-resistant infections. This paper reviews the current status of PDT with an emphasis on the contributions of physics, biophysics and technology, and the challenges remaining in the optimization and adoption of this treatment modality. A theme of the review is the complexity of PDT dosimetry due to the dynamic nature of the three essential components -- light, photosensitizer and oxygen. Considerable progress has been made in understanding the problem and in developing instruments to measure all three, so that optimization of individual PDT treatments is becoming a feasible target. The final section of the review introduces some new frontiers of research including low dose rate (metronomic) PDT, two-photon PDT, activatable PDT molecular beacons and nanoparticle-based PDT.
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Affiliation(s)
- Brian C Wilson
- Division of Biophysics and Bioimaging, Ontario Cancer Institute and Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.
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AKILOV OE, KOSAKA S, MAYTIN EV, HASAN T. Prospects for the use of differentiation-modulating agents as adjuvant of photodynamic therapy for proliferative dermatoses. J Dermatol 2008; 35:197-205. [DOI: 10.1111/j.1346-8138.2008.00445.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fernández-Guarino M, García-Morales I, Harto A, Montull C, Pérez-García B, Jaén P. Terapia fotodinámica: nuevas indicaciones. ACTAS DERMO-SIFILIOGRAFICAS 2007. [DOI: 10.1016/s0001-7310(07)70091-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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36
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Kleinpenning MM, Smits T, Ewalds E, van Erp PEJ, van de Kerkhof PCM, Gerritsen MJP. Heterogeneity of fluorescence in psoriasis after application of 5-aminolaevulinic acid: an immunohistochemical study. Br J Dermatol 2007; 155:539-45. [PMID: 16911278 DOI: 10.1111/j.1365-2133.2006.07341.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Psoriasis has been shown to highly accumulate protoporphyrin IX (PpIX), but a variable distribution within plaques after fluorescence diagnosis is seen. It is unknown what causes this heterogeneity of fluorescence in psoriatic skin, despite adequate keratolytic treatment. Variations in fluorescence might explain the variable and the mostly partial clinical response of psoriasis seen after photodynamic therapy (PDT). OBJECTIVES This study examines morphological and immunohistochemical differences in inhomogeneous PpIX-induced fluorescence in stable plaque psoriasis. MATERIALS AND METHODS Fourteen patients with stable plaque psoriasis were included in this study. In each patient one psoriatic plaque was incubated with 20% 5-aminolaevulinic acid (ALA) ointment for 3 h after keratolytic treatment. Fluorescence diagnosis with ALA-induced porphyrins (FDAP) was performed and subsequently high- and low-fluorescent psoriatic skin samples were biopsied. Biopsies were investigated with respect to histological hyperkeratosis (thickness of stratum corneum), proliferation (Ki-67 antigen), keratinization (K10, filaggrin) and inflammation (CD3). Digital images acquired with FDAP were analysed using image analysis software. RESULTS Inhomogeneous fluorescence was seen in 12 of the 14 plaques. A significantly thicker stratum corneum was found in low-fluorescent psoriatic skin compared with highly fluorescent skin. Fluorescence intensity and thickness of the stratum corneum proved to be negatively correlated. The variable-fluorescent parts of the lesional psoriatic skin showed no differences in epidermal proliferation, keratinization or inflammation. CONCLUSIONS Heterogeneous ALA-induced fluorescence in psoriasis plaques related to inhomogeneous distribution of PpIX in the epidermis may result from differences in penetration of ALA and/or light within a plaque caused by differences in stratum corneum thickness. The variable clinical response seen after PDT in psoriasis could be explained by this. These findings are consistent with the general assumption that optimal desquamation prior to FDAP or PDT is required for the most favourable results.
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Affiliation(s)
- M M Kleinpenning
- Department of Dermatology, Radboud University Nijmegen Medical Center, Rene Descartesdreef 1, 6525 GL Nijmegen, the Netherlands.
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Fernández-Guarino M, García-Morales I, Harto A, Montull C, Pérez-García B, Jaén P. Photodynamic Therapy: New Indications. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/s1578-2190(07)70471-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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