School of Physics and Astronomy, University of St. Andrews, St. Andrews, Fife, UK.
Photochem Photobiol. 2011 Jan-Feb;87(1):242-9. doi: 10.1111/j.1751-1097.2010.00829.x. Epub 2010 Nov 15.
The characteristics of protoporphyrin IX (PPIX) fluorescence in superficial basal cell carcinoma (sBCC) and carcinoma in situ (Bowen's Disease, BD) following application of 5-aminolaevulinic acid (5-ALA) and its methyl ester (methyl aminolevulinate [MAL]) before, during and after photodynamic therapy (PDT) were investigated in 40 patients. Photosensitizer prodrug penetration can limit PDT efficacy and understanding the characteristics of PPIX fluorescence through fluorescence spectroscopy, may improve knowledge of photosensitizer delivery. Fluorescence intensity was assessed quantitatively, and the rate of photobleaching was determined by fitting an exponential decay. As a secondary end-point, PDT-induced pain was also measured continuously during treatment using a novel hand-held device, known as a pain logger. In vivo PPIX fluorescence was shown to decrease during irradiation, allowing the in vivo photobleaching of PPIX to be monitored. No significant difference was found between ALA- or MAL-induced PPIX fluorescence in lesions of sBCC and BD (P>0.05), indicating no detectable difference in PPIX kinetics for the two prodrugs as assessed by these measures. Pain, as assessed by the logger device, showed high interindividual variability and pain levels tended to be higher initially, decreasing during treatment. No difference was seen in pain experienced during ALA-or MAL-PDT (P>0.05).
在接受 5-氨基酮戊酸（5-ALA）及其甲酯（甲氨基酮戊酸[MAL]）预处理、治疗期间和治疗后，对 40 例患者的浅表基底细胞癌（sBCC）和原位癌（鲍文病，BD）中卟啉 IX（PPIX）荧光的特征进行了研究。光敏剂前体药物的渗透会限制 PDT 的疗效，通过荧光光谱法了解 PPIX 荧光的特征，可能会提高对光敏剂传递的认识。通过定量评估荧光强度，并通过拟合指数衰减来确定光漂白率。作为次要终点，使用称为疼痛记录器的新型手持式设备在治疗过程中连续测量 PDT 引起的疼痛。体内 PPIX 荧光在照射过程中减弱，允许监测体内 PPIX 的光漂白。ALA 或 MAL 诱导的 sBCC 和 BD 病变中的 PPIX 荧光无显著差异（P>0.05），表明两种前体药物的 PPIX 动力学无明显差异，这些措施可以评估。通过记录器设备评估的疼痛显示出高度的个体间变异性，并且疼痛水平最初较高，在治疗过程中逐渐降低。ALA 或 MAL-PDT 期间的疼痛无差异（P>0.05）。
