Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark; Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark; Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
J Am Acad Dermatol. 2016 May;74(5):981-1004. doi: 10.1016/j.jaad.2015.12.008. Epub 2016 Feb 28.
Ablative fractional lasers enhance uptake of topical therapeutics and the concept of fractional laser-assisted drug delivery has now been taken into clinical practice.
We systematically reviewed preclinical data and clinical evidence for fractional lasers to enhance drug uptake and improve clinical efficacy.
We searched PubMed and Embase databases; 34 articles met the inclusion criteria. Studies were categorized into experimental preclinical studies and clinical trials, the latter graded according to level of evidence.
All preclinical trials (n = 16) documented enhanced topical drug uptake into skin after ablative fractional laser treatment. Clinical evidence encompassed 18 studies, of which 9 were randomized controlled trials and 2 were controlled trials, examining neoplastic lesions, photodamaged skin, scars, onychomycosis, and topical anesthetics. The highest level of evidence was reached for actinic keratoses treated with methylaminolevulinate for photodynamic therapy (level IB, 5 randomized controlled trials), substantiating superior and long-lasting efficacy versus conventional photodynamic therapy. No adverse events were reported, but ablative fractional laser-assisted drug delivery implies risks of systemic drug absorption, especially when performed over large skin areas.
Fractional laser-assisted drug delivery is beneficial in enhancing preclinical and clinical outcomes for certain skin conditions.
消融性微剥脱激光可增强局部治疗药物的吸收，因此微剥脱激光辅助药物递送的概念已被应用于临床实践。
我们系统地回顾了关于微剥脱激光增强药物吸收和改善临床疗效的临床前数据和临床证据。
我们检索了 PubMed 和 Embase 数据库；符合纳入标准的研究有 34 篇。研究分为实验性临床前研究和临床试验，后者根据证据水平进行分级。
所有临床前研究（n = 16）均记录了消融性微剥脱激光治疗后皮肤局部药物吸收增加。临床证据包括 18 项研究，其中 9 项为随机对照试验，2 项为对照试验，研究对象为肿瘤病变、光老化皮肤、瘢痕、甲真菌病和局部麻醉剂。5 项随机对照试验证实，5-氨基酮戊酸光动力疗法治疗光化性角化病的疗效优于传统光动力疗法，为最高级别证据（IB 级），证实了该方法对某些皮肤疾病具有较好和持久的疗效。未报告不良事件，但微剥脱激光辅助药物递送存在全身药物吸收的风险，特别是在大面积皮肤应用时。
微剥脱激光辅助药物递送有益于增强某些皮肤疾病的临床前和临床疗效。
