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光动力疗法联合 RLP068 和 630nm 红光 LED 治疗糖尿病足部溃疡:一项病例系列研究。

Photodynamic Therapy With RLP068 and 630-nm Red LED Light in Foot Ulcers in Patients With Diabetes: A Case Series.

机构信息

Private Clinic Villa dei Fiori, Acerra, Naples, Italy.

出版信息

Int J Low Extrem Wounds. 2024 Mar;23(1):99-103. doi: 10.1177/15347346211053403. Epub 2021 Oct 25.

Abstract

The management and healing of lower extremity ulcers have always been a complex health problem because the clinical course is typically chronic, the results are often poor, and the socioeconomic impact is considerable. The healing process of foot ulcers of people with diabetes is further hindered by the concomitant presence of obstructive arterial disease, neuropathy, and foot malformation. It is frequently associated with multiresistant infections and often results in micro/macro amputations. Photodynamic therapy employs a photosensitizer activated by light of a specific wavelength able to generate reactive oxygen species, which initiate further oxidative responses locally with components of the bacteria. The experience of the treatment center for the lower extremity ulcers in 17 persons with diabetes in Acerra (Italy) with photoactivated RLP068, reported here, corroborates the results of the clinical trials and of the previous case reports. In all cases, examined photodynamic therapy with photosensitizer RLP068 and red light at 630 nm was found to reduce lesion area and inflammation and to ensure the decrease of bacterial load, hence reducing treatment times and antibiotics use, improving patient outcomes, and reducing the incidence of amputations. The simultaneous combination of photodynamic therapy with other ancillary physical-based treatments such as therapeutic magnetic resonance or Bio-Electro-Magnetic-Energy-Regulation was observed to be safe, time-saving, and able to lead to faster healing.

摘要

下肢溃疡的管理和愈合一直是一个复杂的健康问题,因为其临床病程通常是慢性的,结果往往不佳,且具有相当大的社会经济影响。糖尿病患者足部溃疡的愈合过程还受到阻塞性动脉疾病、神经病变和足部畸形的同时存在的阻碍。其常伴有多重耐药感染,且常导致微/大截肢。光动力疗法使用一种光敏剂,这种光敏剂被特定波长的光激活后能够产生活性氧,这些活性氧会引发局部的进一步氧化反应,同时与细菌的成分相互作用。这里报告的意大利阿切尔拉(Acerra)下肢溃疡治疗中心对 17 名糖尿病患者使用光激活 RLP068 的治疗经验,与临床试验和之前的病例报告结果相符。在所有病例中,经光敏剂 RLP068 和 630nm 红光的光动力疗法都被发现可以减少病变面积和炎症,确保细菌负荷的降低,从而减少治疗时间和抗生素的使用,改善患者的治疗效果,并降低截肢的发生率。观察到光动力疗法与其他辅助基于物理的治疗方法(如治疗性磁共振或生物电磁能量调节)同时联合使用是安全、节省时间的,并能更快地促进愈合。

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