Clinical research on one-third dose verteporfin photodynamic therapy in the treatment of chronic central serous chorioretinopathy

OBJECTIVE

To observe the curative effect and safety of one-third dose Verteporfin photodynamic therapy (PDT) in the treatment of chronic central serous chorioretinopathy (CSC).

PATIENTS AND METHODS

A total of 60 patients (68 eyes) treated in our hospital from January 2016 to December 2016 were selected in this study, and they were diagnosed with chronic CSC via fluorescein fundus angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT). Besides, patients were treated with one-third conventional dose Verteporfin PDT. The subfoveal choroidal thickness (SFCT), superior, inferior, nasal and temporal choroidal thickness at 1.5 mm away from macula central fovea, central choroidal capillary layer thickness, photoreceptor layer thickness, best corrected visual acuity (BCVA), subretinal fluid absorption, FFA and ICGA manifestations and complications of patients were observed and recorded before treatment and at 1, 3 and 6 months after treatment.

RESULTS

After PDT via one-third conventional dose of Verteporfin, patients were followed up for 1 month, 3 months, and 6 months. The SFCT of affected eyes was changed from (381.23 ± 83.29) μm before treatment to (385.31 ± 90.89) μm, (369.59 ± 75.60) μm and (374.08 ± 102.81) μm successively, and the differences were statistically significant (p < 0.001). Central choroidal capillary layer thickness and superior, inferior, nasal and temporal choroidal thickness at 1.5 mm away from macula central fovea (SCT1.5mm, ICT1.5mm, NCT1.5mm and TCT1.5mm) were significantly decreased at 1 month, 3 months and 6 months after treatment compared with those before treatment (p < 0.001). With the passage of time after treatment, the photoreceptor layer thickness of affected eyes was increased gradually, and the difference was statistically significant (F = 268.8, p < 0.0001). After PDT, BCVA had a statistically significant difference compared with that before treatment (p = 36.16, p < 0.001); BCVA at 3 months after treatment had no statistically significant difference compared with that at 6 months after treatment (p > 0.05). At 6 months after treatment, the subretinal fluid in 63 eyes (92.6%) completely subsided, and a little subretinal fluid was retained in 5 eyes (7.4%). FFA and ICGA showed the choroidal vessel dilatation in affected eyes after treatment and significantly improved moderate-advanced high fluorescein leakage compared with that before treatment. There were no obvious complications in the body and fundus during the follow-up period.

CONCLUSIONS

One-third dose Verteporfin PDT can improve BCVA, stop or reduce the choroidal vasodilatation and leakage, accelerate the absorption of serous subretinal fluid, and help the recovery of photoreceptor layer of patients with chronic CSC, which is safe and reliable.

p38 Mitogen-activated protein kinases is required for counteraction of 2-methoxyestradiol to estradiol-stimulated cell proliferation and induction of apoptosis in ovarian carcinoma cells via phosphorylation Bcl-2

INTRODUCTION

2-Methoxyestradiol (2ME2), a natural endogenous product of estradiol (E2) metabolism, has been shown to be a selective apoptotic agent for cancer cells but not for normal cells. In this study, we determined that 2ME2 counteracts E2-stimulated cell growth and induces apoptosis in ovarian carcinoma cells. In addition, we demonstrate that 2ME2 induces apoptosis via p38 and phospho-Bcl2 pathway.

METHODS

2ME2 and/or E2 were administered to the OVCAR-3 (human ovarian cancer) cell line. Cell growth inhibition was analyzed by [3H] Thymidine incorporation assay and DNA fluorometric assay. Cell apoptosis was tested by DNA fragmentation analysis and FACS. The signaling pathway was determined by a series of biochemical assays.

RESULTS

2ME2 inhibited estradiol-stimulated cell growth and induced apoptosis in an ovarian carcinoma cell line. MAPK and p38, but not JNK, were found to be critical mediators in this process. Expression of a dominant negative mutant of p38 kinase or p38 specific inhibitor, SB 203580, almost completely blocked the process. Furthermore, Bcl-2 phosphorylation was required for 2ME2-induced effects.

CONCLUSION

Our data suggest that 2ME2 inhibits E2-stimulated proliferation and induces apoptosis in ovarian carcinoma cells. Furthermore, activation of p38 and phosphorylation of Bcl-2 plays a critical role in the mechanism. 2ME2 therefore, may have a clinical application for the treatment of ovarian cancer.

[An experimental study on photosensitization of human liver cancer cells with sulfonated aluminum phthalocyanine (ALSPC)]

The photosensitizing effect of sulfonated aluminum phthalocyanine to human liver cancer cells was studied by determining the kinetics of its cellular uptake, its state of aggregation therein and its photocytotoxicitic effect on these cells. Fluorescence methods were used to measure the cellular uptake in cell extracts and intact cells in monolayer. Results exhibited that the cellular uptake increases with the incubation time of ALSPC and saturates at 24 hrs. This relation was in coincidence with that between ALSPC's photocytotoxic effect and the ALSPC incubation time. Although the average ALSPC concentration in cells is higher than the incubation concentration of ALSPC, laser fluorescence, experiments showed that the fluorescence peak of ALSPC in cells incubated in higher concentration coincides with that of its aqueous solution of low concentration, suggesting that ALSPC in cancer cells exists in monomer state. Characteristics of the photodamaging effect of ALSPC to cancer cells were studied by both the method of typen blue staining and that of isotope labeling, which showed similar results. Results of the isotope labeling experiments implies that the DNA is damaged in ALSPC photosensitization. The photodamage on cells was also studied with 3 T 3 mouse cells (conversion), showing agreeable results to that with liver cancer cells, which suggests that ALSPC's photocytotoxic effect is nonselective to cell types.