Chen Yuqing, Guo Peng, Chen Lihong, He Dalin
Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Department of Obstetrics and Gynecology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.
Front Med (Lausanne). 2024 Jul 15;11:1370396. doi: 10.3389/fmed.2024.1370396. eCollection 2024.
Since the patients suffering from female lower genital tract diseases are getting younger and younger and the human papilloma virus (HPV) infection is becoming more widespread, the novel non-invasive precise modalities of diagnosis and therapy are required to remain structures of the organ and tissue, and fertility as well, by which the less damage to normal tissue and fewer adverse effects are able to be achieved. In all nucleated mammalian cells, 5-Aminolevulinic acid (5-ALA) is an amino acid that occurs spontaneously, which further synthesizes in the heme biosynthetic pathway into protoporphyrin IX (PpIX) as a porphyrin precursor and photosensitizing agent. Exogenous 5-ALA avoids the rate-limiting step in the process, causing PpIX buildup in tumor tissues. This tumor-selective PpIX distribution after 5-ALA application has been used successfully for tumor photodynamic diagnosis (PDD) and photodynamic therapy (PDT). Several ALA-based drugs have been used for ALA-PDD and ALA-PDT in treating many (pre)cancerous diseases, including the female lower genital tract diseases, yet the ALA-induced fluorescent theranostics is needed to be explored further. In this paper, we are going to review the studies of the mechanisms and applications mainly on ALA-mediated photodynamic reactions and its effectiveness in treating female lower genital tract diseases.
由于患有女性下生殖道疾病的患者越来越年轻化，且人乳头瘤病毒（HPV）感染日益普遍，因此需要新的非侵入性精确诊断和治疗方式，以保留器官和组织的结构以及生育能力，从而实现对正常组织的损伤更小、副作用更少。在所有有核哺乳动物细胞中，5-氨基乙酰丙酸（5-ALA）是一种天然存在的氨基酸，它在血红素生物合成途径中进一步合成原卟啉IX（PpIX），作为一种卟啉前体和光敏剂。外源性5-ALA避开了该过程中的限速步骤，导致PpIX在肿瘤组织中蓄积。5-ALA应用后这种肿瘤选择性的PpIX分布已成功用于肿瘤光动力诊断（PDD）和光动力治疗（PDT）。几种基于ALA的药物已用于ALA-PDD和ALA-PDT来治疗许多癌前疾病，包括女性下生殖道疾病，但ALA诱导的荧光诊疗仍需进一步探索。在本文中，我们将主要综述关于ALA介导的光动力反应的机制和应用及其在治疗女性下生殖道疾病中的有效性的研究。
