Wyss P, Tromberg B J, Wyss M T, Krasieva T, Schell M, Berns M W, Tadir Y
Beckman Laser Institute and Medical Clinic, Irvine, CA 92715.
Am J Obstet Gynecol. 1994 Nov;171(5):1176-83. doi: 10.1016/0002-9378(94)90128-7.
The goal of this study was to determine the optimal parameters for photodynamic endometrial destruction with topically applied 5-aminolevulinic acid, a precursor for the endogenous synthesis of the fluorescent photosensitizer protoporphyrin IX.
5-Aminolevulinic acid pharmacokinetics were measured in rat and rabbit models by analyzing tissue frozen sections 3 to 12 hours after topical administration. Dose-response studies were conducted for 100 to 400 mg/ml 5-aminolevulinic acid. Photodynamic therapy was performed intraluminally, and tissue morphologic features were evaluated 3 and 7 days after treatment.
Peak fluorescence was observed 3 hours after topical administration. Glandular fluorescence significantly exceeded stromal and myometrial in all studies, particularly for 200 mg/ml 5-aminolevulinic acid. Histologic studies revealed persistent epithelial destruction with minimal regeneration.
Topical 5-aminolevulinic acid photodynamic therapy can be used for highly effective, long-lasting destruction of endometrial epithelium. However, optical dosimetry can vary, particularly in the rabbit model, and this appears to have an impact on long-term reepithelialization.
本研究的目的是确定用局部应用的5-氨基乙酰丙酸（一种内源性合成荧光光敏剂原卟啉IX的前体）进行光动力子宫内膜破坏的最佳参数。
通过在局部给药后3至12小时分析组织冰冻切片，在大鼠和兔模型中测量5-氨基乙酰丙酸的药代动力学。对100至400mg/ml的5-氨基乙酰丙酸进行剂量反应研究。腔内进行光动力治疗，并在治疗后3天和7天评估组织形态学特征。
局部给药后3小时观察到荧光峰值。在所有研究中，腺体荧光显著超过基质和肌层荧光，特别是对于200mg/ml的5-氨基乙酰丙酸。组织学研究显示上皮持续破坏且再生极少。
局部5-氨基乙酰丙酸光动力疗法可用于高效、持久地破坏子宫内膜上皮。然而，光剂量测定可能会有所不同，特别是在兔模型中，这似乎对长期再上皮化有影响。
