Moy Wesley J, Yao Jonathan, de Feraudy Sébastien M, White Sean M, Salvador Jocelynda, Kelly Kristen M, Choi Bernard
Beckman Laser Institute and Medical Clinic, University of California, Irvine, California.
Department of Biomedical Engineering, University of California, Irvine, California.
Lasers Surg Med. 2017 Oct;49(8):767-772. doi: 10.1002/lsm.22677. Epub 2017 May 10.
Alternative treatments are needed to achieve consistent and more complete port wine stain (PWS) removal, especially in darker skin types; photodynamic therapy (PDT) is a promising alternative treatment. To this end, we previously reported on Talaporfin Sodium (TS)-mediated PDT. It is essential to understand treatment tissue effects to design a protocol that will achieve selective vascular injury without ulceration and scarring. The objective of this work is to assess skin changes associated with TS-mediated PDT with clinically relevant treatment parameters.
STUDY DESIGN/MATERIALS AND METHODS: We performed TS (0.75 mg/kg)-mediated PDT (664 nm) on Sprague Dawley rats. Radiant exposures were varied between 15 and 100 J/cm . We took skin biopsies from subjects at 9 hours following PDT. We assessed the degree and depth of vascular and surrounding tissue injury using histology and immunohistochemical staining.
TS-mediated PDT at 0.75 mg/kg combined with 15 and 25 J/cm light doses resulted in vascular injury with minimal epidermal damage. At light dose of 50 J/cm , epidermal damage was noted with vascular injury. At light doses >50 J/cm , both vascular and surrounding tissue injury were observed in the forms of vasculitis, extravasated red blood cells, and coagulative necrosis. Extensive coagulative necrosis involving deeper adnexal structures was observed for 75 and 100 J/cm light doses. Observed depth of injury increased with increasing radiant exposure, although this relationship was not linear.
TS-mediated PDT can cause selective vascular injury; however, at higher light doses, significant extra-vascular injury was observed. This information can be used to contribute to design of safe protocols to be used for treatment of cutaneous vascular lesions. Lasers Surg. Med. 49:767-772, 2017. © 2017 Wiley Periodicals, Inc.
需要采用替代疗法来实现对葡萄酒色斑（PWS）的持续且更彻底的清除，尤其是对于肤色较深的类型；光动力疗法（PDT）是一种有前景的替代疗法。为此，我们之前报道了替拉泊芬钠（TS）介导的光动力疗法。了解治疗对组织的影响对于设计一种能够实现选择性血管损伤而不产生溃疡和瘢痕的方案至关重要。本研究的目的是评估在具有临床相关性的治疗参数下，TS介导的光动力疗法所引起的皮肤变化。
研究设计/材料与方法：我们对斯普拉格 - 道利大鼠进行了TS（0.75mg/kg）介导的光动力疗法（664nm）。辐照剂量在15至100J/cm²之间变化。在光动力疗法后9小时从实验对象身上获取皮肤活检样本。我们使用组织学和免疫组织化学染色评估血管及周围组织损伤的程度和深度。
0.75mg/kg的TS介导的光动力疗法联合15和25J/cm²的光剂量导致血管损伤，同时表皮损伤最小。在50J/cm²的光剂量下，观察到在血管损伤的同时伴有表皮损伤。在光剂量>50J/cm²时，观察到血管和周围组织损伤，表现为血管炎、红细胞外渗和凝固性坏死。对于75和100J/cm²的光剂量，观察到广泛的凝固性坏死累及更深的附属结构。尽管这种关系并非线性，但观察到的损伤深度随着辐照剂量的增加而增加。
TS介导的光动力疗法可导致选择性血管损伤；然而，在较高光剂量下，观察到明显的血管外损伤。该信息可用于辅助设计用于治疗皮肤血管病变的安全方案。《激光外科与医学》49:767 - 772, 2017。©2017威利期刊公司
