Instituto de Física de São Carlos (IFSC/USP), Laboratório de Biofotônica, São Carlos, São Paulo, Brazil.
Photodiagnosis Photodyn Ther. 2012 Mar;9(1):60-8. doi: 10.1016/j.pdpdt.2011.09.001. Epub 2011 Oct 20.
The objective of this study was to improve the feasibility of applying topic 5-aminolevulinic acid (ALA) in photodiagnosis (PD) and treatment of condyloma caused by human papillomavirus (HPV) using two homemade handheld devices and to discuss the photodynamic therapy (PDT) as a suitable alternative for each of the cases studied. Both, protoporphyrin IX production and photodegradation were analyzed, and the pain experienced during the illumination was correlated with the light intensities.
A total of 40 women with different grades of lesions caused by HPV were chosen from patients of the School of Medicine of Ribeirão Preto (University of Sao Paulo) and of the Unit of Public Health of Araraquara, Sao Paulo.
We did not encounter any unexpected difficulties using our devices during the treatment. The existence of an easily observable reddish fluorescence with large intensity concentrated on the lesions is the clinical indication of the penetration and the selective concentration of protoporphyrin IX in the clinical and subclinical lesions rather than in the healthy tissue. The aesthetic results were much better than those obtained by conventional techniques as surgery or cryogenics, with no recurrence reported after two years of treatment.
Our results are proof for the various advantages using ALA cream for the PD and PDT in many different cases of condyloma by HPV. This study will be continued to investigate the PpIX photobleaching and the irradiance and fluence rate to optimize conducting the clinical trials, to improve the devices and therefore increase the treatment response.
本研究旨在提高两种自制手持式设备应用 5-氨基酮戊酸（ALA）在人乳头瘤病毒（HPV）所致尖锐湿疣的光诊断（PD）和治疗中的可行性，并探讨光动力疗法（PDT）作为研究病例的合适替代方法。对原卟啉 IX 的产生和光降解进行了分析，并将光照过程中的疼痛与光强度相关联。
共选择了来自圣保罗大学里贝朗普雷托医学院和圣保罗阿拉拉夸拉公共卫生单位的 40 名不同病变程度的 HPV 患者。
在治疗过程中，我们的设备没有遇到任何意外困难。存在易于观察的强红色荧光，其强度集中在病变部位，这是原卟啉 IX 穿透和选择性集中在临床和亚临床病变而不是健康组织中的临床指征。与传统技术（如手术或冷冻疗法）相比，美学效果要好得多，两年后无复发报告。
我们的结果证明了在 HPV 所致尖锐湿疣的 PD 和 PDT 中使用 ALA 乳膏的各种优势。这项研究将继续调查 PpIX 光漂白以及辐照度和剂量率，以优化临床试验、改进设备并提高治疗反应。
