1 Department of Dermatology, First Medical Center of Chinese PLA General Hospital, Beijing.
3 Key Laboratory of Immunity and Infection, Institute of Biophysics, Chinese Academy of Sciences, Beijing.
J Cutan Med Surg. 2019 Jul/Aug;23(4):370-379. doi: 10.1177/1203475419838548. Epub 2019 Apr 22.
5-aminolevulinic acid photodynamic therapy (PDT) for genital warts is effective, safe, and can prevent recurrence. It is believed that PDT can induce immune responses, but the mechanism is not completely understood.
The objectives of this article are to confirm the effect of PDT for genital warts on local immunity and to investigate the recruitment and significance of immune cells in tissues.
Local immune changes in T lymphocytes (CD3+, CD4+, CD8+), plasmacytoid dendritic cells (pDCs) (CD123+), and myeloid dendritic cells (CD1a+) after PDT in patients were evaluated by immunohistochemistry staining. Changes in mRNA levels of IFN-γ, IFN-α, IFN-ß, interferon-stimulated gene 15 kDa (ISG-15), Mx2, Toll-like receptor 9 (TLR9), and interferon regulatory factor 7 (IRF7) were analyzed by real-time quantitative polymerase chain reaction.
At 4 hours after PDT, CD4+ increased, accompanied by increased levels of mRNA expression of IFN-γ, but CD4+ and mRNA expression levels of IFN-γ were decreased at 24 hours after PDT. CD123+ pDCs showed an increasing trend. CD1a+ LCs in the epidermis gradually decreased, and DCs in the epidermis gradually increased. CD3+ infiltrated and migrated to the superficial dermis, but CD8+ did not change significantly after PDT. The mRNA expression levels of IFN-α, IFN-ß, ISG-15, Mx2, TLR9, and IRF7 showed an increasing trend after PDT. As compared with the patients without significantly increased IFN-α and IFN-ß after PDT sessions, patients with significant increases needed fewer sessions of PDT for remission.
PDT for genital warts can activate T lymphocyte-mediated, DC-related, and pDC-related immunity. The clinical efficacy of PDT for genital warts may be related to the increased levels of IFN-α and IFN-ß after treatment.
5-氨基酮戊酸光动力疗法（PDT）治疗生殖器疣安全有效，可预防复发。人们认为 PDT 可以诱导免疫反应，但机制尚不完全清楚。
本文旨在证实 PDT 治疗生殖器疣对局部免疫的影响，并研究组织中免疫细胞的募集和意义。
采用免疫组织化学染色法检测 PDT 后患者 T 淋巴细胞（CD3+、CD4+、CD8+）、浆细胞样树突状细胞（pDCs）（CD123+）和髓样树突状细胞（CD1a+）的局部免疫变化。采用实时定量聚合酶链反应分析 IFN-γ、IFN-α、IFN-β、干扰素刺激基因 15kDa（ISG-15）、Mx2、Toll 样受体 9（TLR9）和干扰素调节因子 7（IRF7）的 mRNA 水平变化。
PDT 后 4 小时，CD4+增加，同时 IFN-γmRNA 表达水平升高，但 PDT 后 24 小时 CD4+和 IFN-γmRNA 表达水平下降。CD123+pDC 呈上升趋势。表皮中的 CD1a+LC 逐渐减少，表皮中的 DC 逐渐增加。CD3+浸润并迁移至真皮浅层，但 PDT 后 CD8+无明显变化。IFN-α、IFN-β、ISG-15、Mx2、TLR9 和 IRF7 的 mRNA 表达水平呈上升趋势。与 PDT 后 IFN-α和 IFN-β 无明显增加的患者相比，这些指标明显增加的患者需要更少次数的 PDT 即可缓解。
PDT 治疗生殖器疣可激活 T 淋巴细胞介导、DC 相关和 pDC 相关免疫。PDT 治疗生殖器疣的临床疗效可能与治疗后 IFN-α和 IFN-β 水平升高有关。
