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Dantas JBDL, Fortuna T, Della Cella HR, Silva FLMDSD, Santana RC, Martins GB. Evaluation of the effect of Matricaria recutita monotherapy or in combination with photodynamic therapy on tissue repair in the dorsum of the tongue of rats. J Appl Oral Sci 2023; 31:e20230211. [PMID: 37909526 PMCID: PMC10609644 DOI: 10.1590/1678-7757-2023-0211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/09/2023] [Accepted: 09/11/2023] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVE The search for treatments that accelerate the healing of lesions is of constant interest. Matricaria recutita (chamomile) is a plant with antimicrobial, anti-inflammatory, and healing properties, and antimicrobial Photodynamic Therapy (aPDT) eradicates microorganisms, which favors tissue repair. This study aimed to evaluate the effect of the topical use of chamomile with or without aPDT on tissue repair in rats' tongues. METHODOLOGY A total of 75 male Wistar rats underwent standardized ulceration on the dorsum of the tongue using a punch of 5 mm diameter and were randomly allocated into the following groups: control (G1), chamomile fluid extract (G2), chamomile infusion (G3), aPDT (G4), and chamomile infusion + aPDT (G5). On the 3rd, 7th, and 14th days postoperatively, euthanasia was performed, and the ulcers were measured using calipers. The presence of edema, inflammatory infiltrate, cellularity, re-epithelialization, and characterization of total collagen were evaluated using sections stained with Hematoxylin and Eosin and Red Sirius. Histomorphometry analyses of the percentage of total collagen, the distance from the basal layer to the epithelial surface, and the thickness of the stratum corneum were performed. Descriptive (absolute/relative frequencies and modes) and exploratory analyses were performed. The associations between the groups and the presence of ulcers were analyzed with Fisher's exact test. All analyses were performed using the R program and statistical significance was set at p=0.05. RESULTS The G2 positively modulated the exudative and proliferative phases of repair, both clinically (p<0.0001) and histologically, whether in descriptive or inferential analyses (p<0.05). The G3 showed a significant difference in clinical parameters compared with G1 (p<0.0001). The G4 and G5 did not positively modulate tissue repair. CONCLUSION The chamomile fluid extract showed better outcomes for tissue repair in the rat tongue.
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Affiliation(s)
- Juliana Borges de Lima Dantas
- Universidade Federal da Bahia, Instituto de Ciências da Saúde, Programa de Pós-graduação em Processos Interativos dos Órgãos e Sistemas, Salvador, Bahia, Brasil
- Faculdade Adventista da Bahia, Laboratório de Histologia e Embriologia, Cachoeira, Bahia, Brasil
| | - Tila Fortuna
- Universidade Federal da Bahia, Instituto de Ciências da Saúde, Programa de Pós-graduação em Processos Interativos dos Órgãos e Sistemas, Salvador, Bahia, Brasil
| | - Hortência Resende Della Cella
- Universidade Federal da Bahia, Instituto de Ciências da Saúde, Programa de Pós-graduação em Processos Interativos dos Órgãos e Sistemas, Salvador, Bahia, Brasil
| | | | - Rejane Conceição Santana
- Universidade Federal da Bahia, Instituto de Ciências da Saúde, Programa de Pós-graduação em Processos Interativos dos Órgãos e Sistemas, Salvador, Bahia, Brasil
| | - Gabriela Botelho Martins
- Universidade Federal da Bahia, Instituto de Ciências da Saúde, Programa de Pós-graduação em Processos Interativos dos Órgãos e Sistemas, Salvador, Bahia, Brasil
- Universidade Federal da Bahia, Instituto Multidisciplinar de Reabilitação e Saúde, Salvador, Bahia, Brasil
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Zhao LT, Gao LM, Chen XD, Wu XY. A massive mandibular keloid with severe infection: What is your treatment? Photodiagnosis Photodyn Ther 2021; 33:102200. [PMID: 33516945 DOI: 10.1016/j.pdpdt.2021.102200] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/06/2021] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
A case report of massive mandibular keloid with severe infection induced by acne achieved resolution of skin lesions after combined treatment with surgery and high concentration single-dose 5-aminolevulinic acid photodynamic therapy (5-ALA PDT). The patient achieved satisfactory effects, after receiving combined treatment with radiotherapy, secondary healing, intralesional injection of glucocorticoids, and other treatments. The scar didn't exhibit growth in a follow-up check after a year. This case provides evidence that photodynamic therapy is effective in the treatment of massive mandibular keloid with severe infection.
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Affiliation(s)
- Li-Tian Zhao
- 7, Department of Dermatology and Venereology, Affiliated Hospital of Nantong University, No 20 Xisi Road, Nantong, 226001, Jiangsu, China
| | - Li-Mu Gao
- 7, Department of Dermatology and Venereology, Affiliated Hospital of Nantong University, No 20 Xisi Road, Nantong, 226001, Jiangsu, China
| | - Xiao-Dong Chen
- 7, Department of Dermatology and Venereology, Affiliated Hospital of Nantong University, No 20 Xisi Road, Nantong, 226001, Jiangsu, China
| | - Xiao-Yan Wu
- 7, Department of Dermatology and Venereology, Affiliated Hospital of Nantong University, No 20 Xisi Road, Nantong, 226001, Jiangsu, China.
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An Insight into the Role of Non-Porphyrinoid Photosensitizers for Skin Wound Healing. Int J Mol Sci 2020; 22:ijms22010234. [PMID: 33379392 PMCID: PMC7795024 DOI: 10.3390/ijms22010234] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 12/22/2022] Open
Abstract
The concept behind photodynamic therapy (PDT) is being successfully applied in different biomedical contexts such as cancer diseases, inactivation of microorganisms and, more recently, to improve wound healing and tissue regeneration. The effectiveness of PDT in skin treatments is associated with the role of reactive oxygen species (ROS) produced by a photosensitizer (PS), which acts as a "double agent". The release of ROS must be high enough to prevent microbial growth and, simultaneously, to accelerate the immune system response by recruiting important regenerative agents to the wound site. The growing interest in this subject is reflected by the increasing number of studies concerning the optimization of relevant experimental parameters for wound healing via PDT, namely, light features, the structure and concentration of the PS, and the wound type and location. Considering the importance of developing PSs with suitable features for this emergent topic concerning skin wound healing, in this review, a special focus on the achievements attained for each PS class, namely, of the non-porphyrinoid type, is given.
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Civantos FJ, Karakullukcu B, Biel M, Silver CE, Rinaldo A, Saba NF, Takes RP, Vander Poorten V, Ferlito A. A Review of Photodynamic Therapy for Neoplasms of the Head and Neck. Adv Ther 2018; 35:324-340. [PMID: 29417455 DOI: 10.1007/s12325-018-0659-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Indexed: 12/14/2022]
Abstract
Photodynamic therapy (PDT) involves the use of a phototoxic drug which is activated by low powered laser light to destroy neoplastic cells. Multiple photosensitizers have been studied and tumors have been treated in a variety of head and neck sites over the last 30 years. PDT can effectively treat head and neck tumors, particularly those of the superficial spreading type, and the classic application of this technology has been in the patient with a wide field of dysplastic change and superficial carcinomatosis. Interstitial treatment has been used to treat more invasive cancer. Data is available from case series and institutional experiences, but very little randomized data is available. We review the mechanisms of action, historical development, available data, and current knowledge regarding PDT for the various head and neck subsites, and discuss possible future directions, with an emphasis on clinical application.
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Affiliation(s)
- Francisco J Civantos
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA.
| | - Barış Karakullukcu
- The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Merrill Biel
- University of Minnesota, Minneapolis, MN, USA
- Ear, Nose and Throat Specialty Care of Minnesota, Minneapolis, MN, USA
| | - Carl E Silver
- Department of Surgery, University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | | | - Nabil F Saba
- Department of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Robert P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Vincent Vander Poorten
- Otorhinolaryngology-Head and Neck Surgery and Department of Oncology, Section Head and Neck Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
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Sperandio FF, Simões A, Aranha ACC, Corrêa L, Orsini Machado de Sousa SC. Photodynamic therapy mediated by methylene blue dye in wound healing. Photomed Laser Surg 2011; 28:581-7. [PMID: 20961226 DOI: 10.1089/pho.2009.2601] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE We sought to investigate the wound-healing process after photodynamic therapy (PDT) mediated by methylene blue dye (MB). BACKGROUND DATA Few scientific studies show the PDT roles in wound healing. MATERIALS AND METHODS One hundred rats were given a circular wound on the back, inflicted with a 6-mm-diameter punch. The animals were divided into four groups: control (no treatment); dye (topical application of MB); laser (InGaAlP, 117.85 J/cm(2), 100 mW, 660 nm, single point); and PDT (topical application of MB followed by laser irradiation). After 1, 3, 5, 7, and 14 days, the cutaneous wounds were photographed and assessed with histopathologic examination by using light microscope. Changes seen in edema, necrosis, inflammation, granulation tissue, re-epithelialization, and number of young fibroblasts were semiquantitatively evaluated. The wound-area changes were measured with special software and submitted to statistical analysis. RESULTS The laser group demonstrated the smallest wound area at 14 days after the surgical procedure (p < 0.01). Concerning complete re-epithelialization, the laser group showed it at 5-7 days after surgery, whereas the PDT and the other groups showed it at 14 days. CONCLUSIONS Laser interaction with tissue is somehow changed when exposed to the MB. PDT mediated by MB was not prejudicial to wound healing, as no delay occurred compared with the control group.
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Tanaka H, Hashimoto K, Yamada I, Masumoto K, Ohsawa T, Murai M, Hirano T. Interstitial photodynamic therapy with rotating and reciprocating optical fibers. Cancer 2001; 91:1791-6. [PMID: 11335905 DOI: 10.1002/1097-0142(20010501)91:9<1791::aid-cncr1198>3.0.co;2-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) is an effective treatment modality that allows selective destruction of malignant tumor cells. However, because of the difficulty in exposing deeper areas of tumors, the modality has strictly limited indications. In this study, the authors introduce a new method for delivering laser light to a three-dimensional, wide area with the purpose of improving the therapeutic value of PDT. METHODS Three patients with squamous cell carcinoma of the tongue were treated with the present course. After administering porfimer sodium, laser-proof tubes were inserted through the tumor, and optical fibers were passed through the tubes. Pulse laser was emitted from the obliquely prepared fiber tip and distributed toward the target area while rotating and reciprocating the optical fiber. RESULTS Two patients achieved a complete response without any complications or functional disabilities. The third patient, however, had a partial response and required surgery. CONCLUSIONS The results indicate the capability of distributing laser light to an entire area of solid tumor. However, the ideal dose of laser light for the treatment of tumors remains unknown. Interstitial PDT will be more efficacious and reliable after the dosimetry is established.
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Affiliation(s)
- H Tanaka
- Department of Oral and Maxillofacial Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Jayasree RS, Gupta AK, Rathinam K, Mohanan PV, Mohanty M. The influence of photodynamic therapy on the wound healing process in rats. J Biomater Appl 2001; 15:176-86. [PMID: 11261599 DOI: 10.1106/9335-q0nc-5xcq-kbyk] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
In photodynamic therapy (PDT), photosensitisers (PS) are used along with lasers for the treatment of tumors. The combined effect of photosensitisers and lasers on the wound healing process is studied using delta-aminolevulinic acid (ALA) (5 mg/kg) and hematoporphyrin derivative (HPD) (5 mg/kg) as photosensitisers in the open excision wounds of rats. The lasers used were He-Ne laser (3 J/cm2) and Nd:YAG laser (30 J/cm2). This study is important for understanding the healing process involved after PDT. Open excision wounds treated with He-Ne lasers in animals that received ALA as photosensitiser showed complete wound closure at the earliest by 13 +/- 1 days, and with results obtained for HPD and the combination of lasers with complete closing by 14 +/- 1 days. However, the control group of animals that received ALS or HPD with no laser treatment showed wound healing on the twentieth and eighteenth days with a deviation of one day and two days, respectively. ALA with the combination of Nd:YAG and He-Ne lasers and HPD with He-Ne laser alone does not show quicker wound healing effects. Histopathological results also gave similar results. Tensile strength measurements do not vary significantly from control group to the test group. ALA along with He-Ne laser of HPD along with the combination of He-Ne and low power Nd-YAG lasers are found to be ideal methods for quickening the wound healing process in rat.
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Affiliation(s)
- R S Jayasree
- Department of Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
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Belmont MJ, Marabelle N, Mang TS, Wax MK. Effect of photodynamic therapy on the critical primary ischemic time of fasciocutaneous flaps. Laryngoscope 1999; 109:886-90. [PMID: 10369276 DOI: 10.1097/00005537-199906000-00008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) may be used as an adjuvant intraoperative therapy to improve locoregional control. PDT has been shown to delay wound healing. This raises concern about PDTs effect on survival of fasciocutaneous flaps. OBJECTIVE Evaluate the effect of 1) PDT on the critical ischemic time in a rat fasciocutaneous flap model and 2) photosensitizer activation by the surgical light source. DESIGN A fasciocutaneous flap, based on the left inferior epigastric vessels, was used. Ischemic times of 2, 4, 6, 8, 10, and 12 hours were induced by clamping the vascular pedicle. Animals were randomly divided into five groups: ischemia only, group I; light treatment to wound bed, group II; Photofrin before surgery with the flap elevated without a fiber optic head light, group III, or with a headlight, group IV; Photofrin prior to surgery with light treatment to the wound bed, group V. Flap survival was assessed on postoperative day 7. RESULTS The critical primary ischemic time of group V (PDT) was significantly less (P < .05) than groups I, II, III, and IV. There was no statistical difference in the critical primary ischemic time when a fiber optic headlight was used (group III vs. group IV). CONCLUSION Intraoperative PDT significantly reduces the critical primary ischemic time of the rat fasciocutaneous flap. White light illumination of the operative field does not result in photosensitizer activation and has no effect on the critical primary ischemic time.
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Affiliation(s)
- M J Belmont
- Department of Otolaryngology-Head and Neck Surgery, State University of New York at Buffalo, USA
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Kübler A, Finley RK, Born IA, Mang TS. Effect of photodynamic therapy on the healing of a rat skin flap and its implication for head and neck reconstructive surgery. Lasers Surg Med Suppl 1996; 18:397-405. [PMID: 8732579 DOI: 10.1002/(sici)1096-9101(1996)18:4<397::aid-lsm9>3.0.co;2-n] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND OBJECTIVE Photodynamic therapy (PDT) may as adjuvant therapy by used to reduce tumor recurrence in the head and neck with surgery, given intraoperatively after resection. A concern with the use of intraoperative PDT is the possible effect on wound healing, especially on the healing of myocutaneous skin flaps, which are widely used to reconstruct defects following resections for head and neck cancer. STUDY DESIGN/ MATERIALS AND METHODS: A flap, based on the inferior epigastric artery, was prepared in thirty male Lewis rats. Group I did not receive any further treatment but the wound was left open for 20 minutes. Group II was injected with 5mg/kg Photofrin, 48 hours prior to the operation and also did not receive any further treatment. The wound bed and wound borders of group III were treated with 630nm light of different dosages, delivered by an argon dye laser. Animals in group IV received 5mg/kg Photofrin 48 hours prior to the operation and their wound beds were treated with the same light dosages as group III. After the treatment all flaps were replaced into the wound bed and the incisions were closed. Biopsies for histological analysis were taken at several time points; and on day 21, biopsies for wound tensile strength measurements were taken. RESULTS The wound healing in group I, II, and III appeared normal and there were no differences seen between these groups. Also, the tensile strength did not differ significantly. The flaps of group IV showed serous effusion, epidermal necrosis, and weaker tensile strength (P = .04 and .02 for the light doses of 50 J/sq cm and 75 J/sq cm respectively) at a specific time point. CONCLUSION The results of this study demonstrate that PDT given immediately before flap reconstruction will result in delayed wound healing. These results should be considered when contemplating the use of PDT as adjuvant intraoperative therapy for tumor surgery requiring flap reconstruction after ablative surgery.
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Affiliation(s)
- A Kübler
- Department of Oral, Facial, and Maxillary Surgery, University of Heidelberg, Germany
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Bonnett R. Morris Berenbaum—an appreciation. Lasers Med Sci 1993. [DOI: 10.1007/bf02547846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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