[Photodynamic therapy. The fields of applications and prospects for the further development in otorhinolaryngology]

TISSUE IMMUNE CELLS AND THEIR ROLE IN THE HEALING PROCESS OF INFECTED RADIATION ULCERS UNDER THE IMPACT OF PHOTODYNAMIC THERAPY (EXPERIMENTAL STUDY)

OBJECTIVE

to study the effect of antibacterial photodynamic therapy (PDT) on the dynamics of tissue neutrophilic leukocytes CD18 and tissue macrophages ED1 in the tissues of infected radiation ulcer during the stages of sponta- neous healing and in the treatment of PDTMaterials and methods. Infected radiation ulcer was modeled by local X-ray irradiation of the rat thigh skin at a dose of 85.0 Gy, followed by applying to the surface of the ulcer bacterial suspension of S. аureus. PDT was performed using a «Barva-LED/630» photonic apparatus and a methylene blue photosensitizer. The effect of PDT on the state of cellular immunity was determined using an immunohistochemical method based on the quantitative indices of neutrophilic leukocytes CD18 and ED1 macrophages during the stages of healing of an infected radiation ulcer.

RESULTS

In the course of spontaneous healing of the ulcer (control I), the dynamics of changes in the relative vo- lume of tissue neutrophil leukocytes CD18 and ED1 macrophages in the lesion zone, a decrease in the CD18 / ED1 index more than 2 times indicated that switching of the neutrophil response to macrophage occurred before 52nd days of observations. When infected with S. аureus X-ray (control II), the switching of the neutrophil response to the macrophage did not occur during the entire observation period. When using PDT in the case of S. аureus infected ulcer (experimental group), the decrease in the CD18 / ED1 index was determined from the 21st day of observation.

CONCLUSIONS

The positive effect of the antibacterial PDT method of infected S. аureus radiation ulcers was manifes- ted by complete microbial decontamination of the wound, reduction of phases of the wound process, complete hea- ling of radiation ulcers.The use of PDT has led to the death of bacteria, a decrease in the number of neutrophilic leukocytes and an increase in macrophages in the lesion area, the switching of the neutrophilic response to the reaction of monocyte-macrophage cells in the early stages of healing.

Comparison of photodynamic therapy efficiency using radiation sources with different wavelengths in the treatment of sinusitis

Inflammatory diseases of the sinuses – one of the most common nosologies in the practice of otorhinolaryngologist; its pathogenesis is well studied, and treatment recommendations are detailed. Following them, however, cannot completely prevent chronic disease or recurrence. Antimicrobial photodynamic therapy is a promising method of treating sinusitis, which has proved its effectiveness, but has not yet been widely used. This work describes our experience in photodynamic therapy with chlorin e6 of chronic sinusitis using a new laser diode-based irradiation source. For patients who had previous sinus surgery an adapter for penetration into the sinus through anastomosis was developed and tested. First group of the patients underwent photodynamic therapy (PDT) according to the conventional scheme, using a laser with a wavelength of 662 nm; while the second one underwent PDT using a 405 nm laser. With daily washing of the nasal sinus, the period of inflammation relief (evaluated by the absence of pathological discharge during washing) amounted to 3.8 full days on average in the first group of patients, compared to 5.4 days on average for the second group. We carried out the comparative analysis of the treatment results based on clinical assessment and radiological evaluation (CT) at the time of discharge from the hospital and 1 month later.