PHOTODYNAMIC THERAPY WITH ENDOGENOUS PROTOPORPHYRIN .9. BASIC PRINCIPLES AND PRESENT CLINICAL-EXPERIENCE
PHOTODYNAMIC THERAPY WITH ENDOGENOUS PROTOPORPHYRIN .9. BASIC PRINCIPLES AND PRESENT CLINICAL-EXPERIENCE
复制标题
DOI：
10.1016/1011-1344(90)85083-9
复制
发表时间：
1990-06-01
影响因子：
5.4
通讯作者：
PROSS, DC
中科院分区：
文献类型：
--
作者：
KENNEDY, JC;POTTIER, RH;PROSS, DC
5-氨基乙酰丙酸（ALA）是血红素生物合成途径中原卟啉IX （Pp IX）的前体。当暴露于足够浓度的外源ALA时，某些类型的细胞具有大的合成ppix的能力。由于ppix转化为血红素的速度相对较慢，这些细胞倾向于积累具有光敏性的ppix浓度。ppix光敏作用可诱导表皮及其附属物细胞，但不能诱导真皮层细胞。此外，由于水溶液中的ALA很容易通过异常角蛋白，而不能通过正常角蛋白，因此将水溶液中的ALA局部应用于光化性角化病或浅表基底细胞癌或鳞状细胞癌可诱导主要局限于异常上皮的ppix光敏作用。随后暴露于光活化光下选择性地破坏这种病变。在我们正在进行的ala诱导ppix光动力治疗的临床试验中，对基底细胞癌进行一次治疗后，前80个病变的完全缓解率为90%，部分缓解率为7.5%。
5-Aminolaevulinic acid (ALA) is a precursor of protoporphyrin IX (Pp IX) in the biosynthetic pathway for haem. Certain types of cells have a large capacity to synthesize Pp IX when exposed to an adequate concentration of exogenous ALA. Since the conversion of Pp IX into haem is relatively slow, such cells tend to accumulate photosensitizing concentrations of Pp IX. Pp IX photosensitization can be induced in cells of the epidermis and its appendages, but not in the dermis. Moreover, since ALA in aqueous solution passes readily through abnormal keratin, but not through normal keratin, the topical application of ALA in aqueous solution to actinic keratoses or superficial basal cell or squamous cell carcinomas induces Pp IX photosensitization that is restricted primarily to the abnormal epithelium. Subsequent exposure to photoactivating light selectively destroys such lesions. In our ongoing clinical trial of ALA-induced Pp IX photodynamic therapy, the response rate for basal cell carcinomas following a single treatment has been 90% complete response and 7.5% partial response for the first 80 lesions treated.