Université de Lorraine, Centre de Recherche en Automatique de Nancy, Unité Mixtes de Recherche 7039, Vandœuvre-lès Nancy Cedex, France.
J Urol. 2013 Aug;190(2):731-6. doi: 10.1016/j.juro.2013.01.046. Epub 2013 Jan 23.
We studied how to avoid irritative bladder symptoms after bladder photodynamic therapy, such as urgency, frequency and pain, which are associated with the inflammation and destruction of normal urothelium.
Rats bearing orthotopic bladder tumors were instilled with hexyl-aminolevulinate and illuminated with red light at a high vs low (100 vs 15 mW/cm(2)) fluence rate. Cystectomy specimens 48 hours after treatment were subjected to anatomopathological examination. Inflammatory reaction and apoptosis were evaluated. In vivo photobleaching was assessed during illumination at each fluence rate.
All superficial tumors were eradicated irrespective of light dose and fluence rate. High fluence rates induced necrosis with inflammatory reaction and absent normal urothelium. Low fluence rates did not provoke inflammation and resulted in apoptotic cell death with preserved urothelial integrity. This could be attributable to faster photobleaching of the photosensitizer in normal urothelium at low fluence rates.
Bladder photodynamic therapy at a low fluence rate minimizes side effects without hampering therapeutic efficacy.
我们研究了如何避免膀胱光动力疗法后出现刺激性膀胱症状，如尿急、尿频和疼痛，这些症状与正常尿路上皮的炎症和破坏有关。
将氨基酮戊酸注入患有原位膀胱癌的大鼠膀胱中，并以高（100 mW/cm(2)）与低（15 mW/cm(2)）两种不同的光通量率进行红光照射。治疗后 48 小时切除膀胱标本，进行解剖病理学检查。评估炎症反应和细胞凋亡。在每种光通量率下进行体内光漂白评估。
无论光剂量和光通量率如何，所有浅表肿瘤均被清除。高光通量率会引起炎症反应和无正常尿路上皮的坏死。低光通量率不会引起炎症，而是导致凋亡细胞死亡，同时保持尿路上皮完整。这可能归因于在低光通量率下，正常尿路上皮中的光敏剂更快地发生光漂白。
低光通量率的膀胱光动力疗法可最大程度地减少副作用，而不会影响治疗效果。
