Objective To explore the effect of pyropheophorbide-a methyl ester-mediated photodynamic therapy (MPPa-PDT) on the apoptosis in human osteosarcoma cell line MG63 and the underlying mechanism. Methods Human osteosarcoma MG63 cells in logarithmic growth phase were divided into 4 groups: blank control group (control group), the MPPa treatment group (MPPa group), the light irradiation group (LED group), and MPPa-PDT treatment group (MPPa-PDT group). MPPa-PDT group and MPPa group were incubated with MPPa (0.75 μmol/ L) for 20 hours in dark condition; control group and LED group were incubated with equal volume of fresh medium for 20 hours in the same condition. After washing with PBS and replacement with fresh culture medium, LED group and MPPa-PDT group cells were exposed to light (4.8 J/cm2) for 120 seconds. After light exposure, all groups were cultured in dark condition again. Then cellular morphology changes were observed by an inverted phase contrast microscopy, endoplasmic reticulum morphology changes were observed by transmission electron microscopy, cellular apoptosis was detected by Hoechst33258 nuclear staining, cell apoptotic rate and the levels of Ca in cells were analyzed by flow cytometry, the expression of p-PERK, C/EBP homologous protein (CHOP), cleaved-Caspase-12 were assayed by Western blot. Results In MPPa-PDT group, the retracted and round cells were observed; Hoechst33258 nuclear staining showed nuclear condensation, fragmentation, and other typical apoptotic morphological changes; the cell apoptotic rate (48.76%±3.54%) was significantly higher than that of control group (5.04%±0.41%), MPPa group (5.33%±0.38%), and LED group (6.48%±0.46%) (P < 0.05); the levels of Ca2+ in cells (485.29±58.77) was also significantly higher than that of control group (97.24±4.77), MPPa group (97.95±6.30), and LED group (101.17±5.26) (P < 0.05); swelling endoplasmic reticulum was observed under transmission electron microscope; the expressions of p-PERK, CHOP, and cleaved-Caspase-12 gradually increased at 1, 3, and 6 hours after treatment respectively, which were significantly higher than those of the other groups (P < 0.05). There was no typical apoptotic morphological changes and endoplasmic reticulum morphological changes in control group, MPPa group, and LED group, and there was no significant difference in the above indexes among 3 groups (P > 0.05). Conclusion MPPa-PDT can significantly induce apoptosis in MG63 cells. The endoplasmic reticulum stress pathway is involved in the MPPa-PDT induced apoptosis.
ObjectiveTo systematically evaluate the efficacy and safety of photodynamic therapy (PDT) for acne vulgaris. MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched from inception to August 9th, 2013, to collect randomized controlled trials (RCTs) about PDT for acne vulgaris. References of included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of 8 RCTs involving 271 patients were included. Because the interventions of included RCTs were different, meta-analysis or descriptive analysis was conducted for studies with the same intervention. The results of meta-analysis showed that ALA-red light-PDT was better than red light alone in clinical remission rate (RR=1.78, 95%CI 1.30 to 2.43, P<0.05). The results of descriptive analysis showed that:the effect of ALA-IPL-PDT was better than IPL alone, the effect of MAL-red light-PDT was better than red light alone, and the effect of MAL-red light-PDT was similar to MAL-IPL-PDT. ConclusionCurrent evidence shows PDT is effective for acne vulgaris. Adverse reactions including burning pricking pain, erythema, hydroderma, hyperpigmentation and acneiform eruption etc. are tolerated by most patients. Due to limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Purpose To evaluate shortterm visual acuity effects of a single photodynamic therapy(PDT) treatment with Visudyne (CIBA Vision Corp, Duluth, Ga) for choroidal neovascularization (CNV) in age-related macular degeneration (AMD). Methods Definitely diagnostic AMD patients with classic CNV were treated with PDT (5 cases, 7 eyes). The data of visual acuity testing, ophthalmic examination, color photographs, optic coherence tomography, fluorescein angiograms and indocyanine green angiogram before photodynamic therapy and 1 week ,1 month after it were used to evaluate the effects of a single treatment of PDT with Visudyne. Results The visual acuity of all the treated eyes at the follow-up examination at 1 month after PDT were not reduced. Distinct reduction of fluorescein leakage from CNV was noted in all patients by 1 week after PDT. Fluorescein leakage from a portion of the CNV reappeared by 1 month after treatment in 2 eyes. Conclusion PDT with Visudyne achieved short-term cessation of fluorescein leakage from CNV without loss of vision or growth of classic CNV in some patwo ients with AMD. (Chin J Ocul Fundus Dis,2000,16:213-216)
Central serous chorioretinopathy (CSC) is a common macular disease, mainly manifested as a plasma detachment of the macula. Photodynamic therapy (PDT) is an effective treatment for CSC, but with the shortage of the photosensitizer Verteporfin, the effective treatment of CSC has become a common concern for ophthalmologists. In this paper, based on the latest research results on the relationship between the changes in the thickness of the outer nuclear layer and the natural course of the disease and PDT therapy, we propose that patients with CSC should receive effective treatment as early as possible to prevent irreversible damage to visual function due to the thinning of the outer nuclear layer. In addition to PDT, it is recommended that laser photocoagulation or subthreshold micropulse laser treatment of the leaking spot should be considered first, depending on the presence of the leaking spot and its location in relation to the macula center. Anti-vascular endothelial growth factor therapy can be considered if there is a combination of choroidal neovascularization and/or polypoidal choroidal vasculopathy. Other treatments that have not been demonstrated to be effective in evidence-based medicine are not recommended.
ObjectiveTo observe the clinical effect of prolonged photodynamic therapy (PDT) irradiation time combined with intravitreal injection of ranibizumab in the treatment of circumscribed choroidal hemangioma (CCH).MethodsA retrospective clinical study. From March 2012 to March 2018, 51 eyes of 51 patients diagnosed in Shenzhen Eye Hospital were included in the study. Among the patients, the tumor of 36 eyes were located in macular area, of 15 eyes were located outside macular area (near center or around optic disc). All patients underwent BCVA, color fundus photography, FFA, ocular B-scan ultrasonography and OCT examinations. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logMAR visual acuity. OCT showed 48 eyes with macular serous retinal detachment. of 36 eyes with tumor located in macular area, the logMAR BCVA was 0.05±0.05, the tumor thickness was 4.5±2.2 mm, the diameter of tumor was 9.7±3.6 mm. Of 15 eyes with tumor located outside macular area, the logMAR BCVA was 0.32±0.15, the tumor thickness was 3.8±1.4 mm, the diameter of tumor was 7.7±1.9 mm. PDT was performed for all eyes with the irradiation time of 123 s. After 48 h, all patients received intravitreal injections of 0.5 mg ranibizumab (0.05 ml). At 1, 3 and 6 months after treatment, the same equipment and methods before treatment were used for related examination. BCVA, subretinal effusion (SRF), tumor leakage and size changes were observed. BCVA, tumor thickness and diameter before and after treatment were compared by t test.ResultsAt 6 months after treatment, the tumor was becoming smaller without scar formation. FFA showed that the blood vessels in the tumor were sparse compared with those before treatment, and the fluorescence leakage domain was reduced. OCT showed 43 eyes of macular serous detachment were treated after the combined treatment. The logMAR BCVA were 0.16±0.15 and 0.55±0.21 of the eyes with tumor located in or outside macular area, respectively. The difference of logMAR BCVA between before and after treatment was significant (t=－2.511, －2.676; P=0.036, 0.040). Both the tumor thickness (t=3.416, 3.055; P=0.011, 0.028) and diameter (t=4.385, 4.171; P=0.002, 0.009) of CCH patients were significantly reduced compared with that before treatment.ConclusionThe tumor of CCH can be reduced by prolonged PDT irradiation time combined with intravitreal injection of ranibizumab.
ObjectiveTo understand the research advance of photodynamic therapy (PDT) on cholangiocarcinoma. MethodDomestic and international publications online which involving the research of PDT on cholangiocarcinoma in recent years were reviewed. Results①PDT was a new therapy on tumor from the tissue and cell level, which could destroy the target tissue and cell under the photochemical reaction and kill the tumor cell according to the characteristics of the selective intake of tumor tissue on particular photosensitizer. It could mainly induce tumor cell apoptosis and necrosis, destroy the tumor microvascular, stimulate the immune and inflammatory response.②PDT on the research level of the treatment of cholangiocarcinoma had achieved fairly good curative effects, which could make the tumor shrinkage, reduce the harm to normal bile duct cell, and prolong the survival, improve the survival rate and the quality of life.③Proliferating cell nuclear antigen (PCNA), vascular endothelial growth factor-C (VEGF-C), and cyclooxygenase-2 (COX-2) played important roles in the development of cholangiocarcinoma. PDT could inhibit the expressions of PCNA, VEGF-C, and COX-2, and then could promote cell apoptosis, and then inhibit cell proliferation. ConclusionsPDT is a new technology in treatment of malignant tumor, which whether used alone or combined with other methods has less adverse reaction and could obviously improve the local symptoms in treatment of cholangiocarcinoma. But many problems about PDT need to be solved at present, in the base areas, such as research and development of new photosensitizer and precise mechanism of killing tumor, in the clinical applications, such as selection and application of photosensitizer, ways and parameters of the laser, formulation of treatment plans and the reduction of the complications.
目的 评估光动力疗法联合曲安奈德治疗渗出型老年性黄斑变性（AMD）的临床疗效及对患者生活质量的影响。 方法 将2007年12月－2010年12月就诊的35例（38只眼）渗出型AMD患者采用随机数字表法随机分为两组，治疗组18例（20只眼）采用光动力疗法联合玻璃体腔内注射曲安奈德治疗，对照组17例（18只眼）单用光动力疗法。评估患者视力和眼底影像学改变，同时也评估对患者生活质量的影响。两组均随访12个月。 结果 随访12个月后，光动力疗法联合曲安奈德治疗组视力不变者8例9只眼，占45.0%；视力提高者9例10只眼，占50.0%；视力下降者1例1只眼，占5.0%。吲哚青绿血管造影结果显示，脉络膜新生血管（CNV）渗漏停止7例7只眼，占35.0%；持续渗漏或渗漏增加者1例1只眼，占5.0%；渗漏减少者11例12只眼，占60.0%。光动力疗法治疗组视力不变者6例6只眼，占33.3%；视力提高者4例5只眼，占27.8%；视力下降者7例7只眼，占38.9%。吲哚青绿血管造影结果显示，CNV渗漏停止3例3只眼，占16.7%；持续渗漏或渗漏增加者5例6只眼，占33.3%；渗漏减少者9例9只眼，占50.0%。联合治疗组与单用光动力疗法组在视力改变方面差异有统计学意义（χ2=4.67，P=0.03），在吲哚青绿血管造影结果方面差异有统计学意义（χ2=3.35，P=0.01）。中文译本低视力者生存质量量表评估生活质量治疗组平均得分（102.02 ± 16.20）分，对照组平均得分为（91.27 ± 11.81）分，两组比较差异有统计学意义（P＜0.05）。 结论 光动力疗法联合曲安奈德治疗渗出型AMD疗效优于单用光动力疗法。
Objective To explore application value of photodynamic therapy (PDT) in treatment of unresectable hilar cholangiocarcinoma. Method The literatures about PDT in the treatment of the unresectable hilar cholangiocarcinoma in the PubMed, MedLine, Embase, CNKI, and Wanfang databases were reviewed. Results The PDT combined with stent or chemotherapy was the main method in the treatment of the unresectable hilar cholangiocarcinoma, which could make the tumor down-staging, obviously reduce the jaundice, improve the quality of life, improve the survival rate, prolong the stent patency and be treated repeatedly. Especially, it was suitable for the patients with elderly, poor health, intolerance of surgery, could partly replace the R1 or R2 operation of hilar cholangiocarcinoma and avoid the risk of surgery and postoperative complications. The therapeutic effective of the PDT was related to the early therapy and times of therapy. However, the shortcomes of the PDT were that the depth of killing tumor was not enough and there was a certain incidence of adverse reaction. Conclusions Therapeutic effect of PDT combine with stent or chemotherapy for unresectable hilar cholangiocarcinoma is better than that of single therapy. It is expected to be a first-line scheme of palliative treatment for unresectable hilar cholangiocarcinoma.