Wang Xiu-Li, Wang Hong-Wei, Huang Zheng, Stepp Herbert, Baumgartner Reinhold, Dannecker Christian, Hillemanns Peter
Shanghai Skin Diseases and STD Hospital, Shanghai, China, and University of Colorado at Denver, USA.
Photochem Photobiol. 2007 Sep-Oct;83(5):1069-73. doi: 10.1111/j.1751-1097.2007.00178.x.
The pharmacokinetics of 5-aminolevulinic acid (ALA)-induced protoporphyrin IX (PpIX) in lesions of urethral condylomata acuminata were investigated. Sixty patients (20 to 60 years old, 48 male and 12 female) were divided randomly into five groups and received topic application of different concentrations of ALA solution (0.5%, 1%, 3%, 5% or 10%). Biopsy was performed between 1 and 7 h and specimens were subjected to histological, PpIX fluorescence and human papillomavirus (HPV) DNA typing analyses. Fluorescence examination confirmed that ALA-induced PpIX fluorescence was dominantly distributed in the HPV-infected epidermis. In contrast, only a minimal amount of PpIX fluorescence was detected in the dermis. The maximal fluorescence intensity was detected at 5 h incubation. Higher ALA concentration (e.g. 5% and 10%) produced a stronger intensity. These results suggest that the topical application of 5-10% ALA solution for 3-5 h is the optimal condition for the photodynamic therapy of urethral condylomata acuminata. The selective damage of the condylomata acuminata lesions in the epidermis without damaging the dermis ensures a better control of recurrence and side effects such as ulceration or scarring. DNA typing showed that all patients were positive for low risk-HPV DNA and among them 18.3% of patients harbored high risk-HPV DNA.
研究了5-氨基酮戊酸（ALA）诱导的原卟啉IX（PpIX）在尿道尖锐湿疣病变中的药代动力学。60例患者（年龄20至60岁，男性48例，女性12例）被随机分为五组，接受不同浓度ALA溶液（0.5%、1%、3%、5%或10%）的局部应用。在1至7小时之间进行活检，标本进行组织学、PpIX荧光和人乳头瘤病毒（HPV）DNA分型分析。荧光检查证实，ALA诱导的PpIX荧光主要分布在HPV感染的表皮中。相比之下，在真皮中仅检测到极少量的PpIX荧光。在孵育5小时时检测到最大荧光强度。较高的ALA浓度（如5%和10%）产生更强的强度。这些结果表明，局部应用5-10%的ALA溶液3-5小时是尿道尖锐湿疣光动力治疗的最佳条件。表皮中尖锐湿疣病变的选择性损伤而不损伤真皮可确保更好地控制复发以及诸如溃疡或瘢痕形成等副作用。DNA分型显示，所有患者的低风险HPV DNA均为阳性，其中18.3%的患者携带高风险HPV DNA。
