Smith Tia K, Choi Bernard, Ramirez-San-Juan Julio C, Nelson J Stuart, Osann Kathryn, Kelly Kristen M
Beckman Laser Institute, University of California, Irvine, California 92612, USA.
Lasers Surg Med. 2006 Jun;38(5):532-9. doi: 10.1002/lsm.20335.
Previous in vitro studies demonstrated the potential utility of benzoporphyrin derivative monoacid ring A (BPD) photodynamic therapy (PDT) for vascular destruction. Moreover, the effects of PDT were enhanced when this intervention was followed immediately by pulsed dye laser (PDL) irradiation (PDT/PDL). We further evaluate vascular effects of PDT alone, PDL alone and PDT/PDL in an in vivo rodent dorsal skinfold model.
STUDY DESIGN/MATERIALS AND METHODS: A dorsal skinfold window chamber was installed surgically on female Sprague-Dawley rats. One milligram per kilogram of BPD solution was administered intravenously via a jugular venous catheter. Evaluated interventions were: control (no BPD, no light), PDT alone (576 nm, 16 minutes exposure time, 15 minutes post-BPD injection, 10 mm spot), PDL alone at 7 J/cm2 (585 nm, 1.5 ms pulse duration, 7 mm spot), PDL alone at 10 J/cm2, PDT/PDL (PDL at 7 J/cm2), and PDT/PDL (PDL at 10 J/cm2). To assess changes in microvascular blood flow, laser speckle imaging was performed before, immediately after, and 18 hours post-intervention.
Epidermal irradiation was accomplished without blistering, scabbing or ulceration. A reduction in perfusion was achieved in all intervention groups. PDT/PDL at 7 J/cm2 resulted in the greatest reduction in vascular perfusion (56%).
BPD PDT can achieve safe and selective vascular flow reduction. PDT/PDL can enhance diminution of microvascular blood flow. Our results suggest that PDT and PDT/PDL should be evaluated as alternative therapeutic options for treatment of hypervascular skin lesions including port wine stain birthmarks.
既往体外研究表明苯并卟啉衍生物单酸环A（BPD）光动力疗法（PDT）在血管破坏方面具有潜在应用价值。此外，在该干预后立即进行脉冲染料激光（PDL）照射（PDT/PDL）时，PDT的效果会增强。我们在体内啮齿动物背部皮褶模型中进一步评估单独使用PDT、单独使用PDL以及PDT/PDL对血管的影响。
研究设计/材料与方法：通过手术在雌性斯普拉格 - 道利大鼠身上安装背部皮褶窗室。通过颈静脉导管静脉注射每千克1毫克的BPD溶液。评估的干预措施包括：对照组（不使用BPD，不光照）、单独使用PDT（576纳米，照射时间16分钟，BPD注射后15分钟开始，光斑直径10毫米）、单独使用7 J/cm²的PDL（585纳米，脉冲持续时间1.5毫秒，光斑直径7毫米）、单独使用10 J/cm²的PDL、PDT/PDL（7 J/cm² 的PDL）以及PDT/PDL（10 J/cm² 的PDL）。为评估微血管血流变化，在干预前、干预后即刻以及干预后18小时进行激光散斑成像。
实现了表皮照射且未出现水疱、结痂或溃疡。所有干预组的灌注均有所降低。7 J/cm² 的PDT/PDL导致血管灌注降低幅度最大（56%）。
BPD PDT可实现安全且选择性地减少血管血流。PDT/PDL可增强微血管血流的减少。我们的结果表明，对于包括葡萄酒色斑胎记在内的高血管性皮肤病变的治疗，应将PDT和PDT/PDL作为替代治疗选择进行评估。
