Efficacy and safety of ALA-PDT in treatment of diabetic foot ulcer with infection

Li, Xinying; Kou, Huiling; Zhao, Chuanqi; Zhu, Fengjun; Yang, Yunchuan; Lu, Yuangang

doi:10.1016/j.pdpdt.2022.102822

Cited by 7 publications

(28 citation statements)

References 23 publications

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“…Study characteristics were summarized in Table 1. A total of 25 papers consisted of 9 case reports [16,18,19,[31][32][33][34][35][36], 5 pilot study [17,29,[37][38][39], 3 case series [40][41][42], 5 randomized controlled trials[28, [43][44][45][46] and 3 prospective observational studies [47][48][49]. Across the 25 included articles, a total of 335 patients were enrolled in all studies, ranging in age from 15 to 93 years.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, many studies have shown that ALA-PDT improves wound healing in humans. Human studies have suggested that ALA-PDT has an antimicrobial effect on bacteria isolated from chronic wounds in infected humans, improves ulcer healing and is well tolerated [28,29]. Thus, ALA-PDT may be a suitable alternative approach for various types of wounds.…”

Section: ____________________________________________________________...mentioning

confidence: 99%

“…Data on this table showed that studies assessed the clinical application of ALA-PDT on different types of human skin wounds, including six studies of skin cancers [31,33,36,37,43,44], five studies of chronic leg ulcers[28, 29,31,39,46], three studies of erosive pustular skin diseases [16,38,42], and two studies of bilateral erosive oral lichen planus symptoms [40,41].…”

Section: Disease Profilementioning

confidence: 99%

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5-Aminolevulinic Acid-Mediated Photodynamic Therapy on Wound Healing: A Systemic Review of Human Evidences

Huang,

Wang

2023

Journal of the American Podiatric Medical Association

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Backgrounds: Skin wounds are a kind of refractory disease frequently encountered in clinic, which brings enormous burden to patients. Great efforts to address the dilemma of wound healing have yielded some encouraging results, but they are still unsatisfactory. 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) has been developed as a promising noninvasive treatment for skin wounds. A systematic review was performed to determine the existing evidence base for the clinical use of ALA-PDT on refractory wounds. Methods: We conducted a PubMed search for English literature related to the clinical treatment of human skin ulcers by ALA-PDT published from 2012 to 2022, and performed a systematic review. Results: 25 studies were ultimately selected in the present review and summarized, including six studies of skin cancer, five studies of chronic leg ulcers, three studies of erosive pustular skin diseases, and two studies of erosive oral lichen planus symptoms. A total of 335 patients had approximately 355 ulcers, of which 315 ulcers received photodynamic therapy and 276 improved with ALA-PDT. 20% ALA solution, wavelength between 600 nm and 670 nm, energy density of 120 J/cm2, frequency of once per week and 3 sessions were the most selected therapeutic parameters. Generally, ALA-PDT for wounds was effective with main adverse events of mild to moderate pain, and follow-up was generally conducted within 1 year. Conclusions: This systematic review summarized the commonly used therapeutic parameters for ALA-PDT in the clinical treatment of skin wounds. After ALA-PDT alone or ALA-PDT combined with curettage, antibacterial and surgical treatment, all wounds healed well, and the adverse reactions were mainly mild to moderate pain, which could be relieved by cooling. ALA-PDT had proven to be a promising wound treatment modality through evidence of safety and efficacy.

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Section: Methodsmentioning

confidence: 99%

Section: ____________________________________________________________...mentioning

confidence: 99%

Section: Disease Profilementioning

confidence: 99%

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5-Aminolevulinic Acid-Mediated Photodynamic Therapy on Wound Healing: A Systemic Review of Human Evidences

Huang,

Wang

2023

Journal of the American Podiatric Medical Association

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“…Human trials that evaluated the effects of PDT in chronic wounds have yielded promising results. Most of the previous studies were traditional high-dose PDT: the ALA concentration was usually around 20%, the wavelength most commonly used was in visible red range (620-720) nm [69], and the irradiation dose was generally greater than or equal to 80 J/cm 2 [70][71][72][73][74][75][76]. If the PS used was MAL (Metvix ® ), the light dose was generally 37 J/cm 2 [77][78][79].…”

Section: Human Trialsmentioning

confidence: 99%

Positive effects of low‐dose photodynamic therapy with aminolevulinic acid or its methyl ester in skin rejuvenation and wound healing: An update

Zhang

Liu

Wang

2023

Journal of Biophotonics

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In dermatology, photodynamic therapy (PDT) is widely used in skin tumors, infections, etc., because of the killing effect triggered by toxic reactive oxygen species (ROS). However, the ROS concentration is determined by various photosensitizer concentrations and formulations, as well as various irradiation parameters. Low‐dose PDT leads to sufficiently low ROS level, which results in biological effects that are the exact opposite of the killing potency. Therefore, in recent years, low‐dose PDT has been exploited in improving aging and wound. Low‐dose ALA/MAL PDT might improve aging through promoting the proliferation of fibroblasts, blocking DNA damage, counteracting oxidative stress, inhibiting melanogenesis, and remodeling lymphatic vessels in aged skin. Promoting fibroblasts and epidermal stem cells proliferation and migration, promoting granulation tissue formation and angiogenesis and regulating the inflammatory process might be the mechanisms of low‐dose ALA/MAL PDT in wound healing. Nevertheless, the positive effects of low‐dose PDT have not been thoroughly investigated in dermatology, and high‐quality studies are still needed to fill the relevant vacancy.

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“…Recent investigations focused on the application of aPDT within the context of infected diabetic foot ulcers (DFUs) have exhibited auspicious outcomes in terms of infection mitigation and facilitative contributions to the wound healing process. The majority of these inquiries have been conducted employing phthalocyanines or phenothiazines as photosensitizers (PS) [8][9][10][11][12][13][14]. Methylene blue (MB), a derivative of phenothiazine, stands out for its characteristics of low toxicity, cost-effectiveness, and easy commercial availability [7,15].…”

Section: Introductionmentioning

confidence: 99%

Adjuvant effect of antimicrobial photodynamic therapy (aPDT) in the treatment of diabetic foot ulcers: A case series

Ferreira,

Cecatto,

Perez

et al. 2024

Journal of Biophotonics

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This study aimed to evaluate the clinical evolution of patients with diabetic foot ulcer treated with antimicrobial photodynamic therapy (aPDT) using the Bates‐Jensen (BJ) scale. A total of 21 patients were monitored, with an average age of 58 years. Patients underwent the standard treatment protocol of the institution, supplemented with aPDT utilizing 0.01% methylene blue (MB) and laser irradiation (660 nm, 100 mW, 6 J per point). Following aPDT, the lesions were protected with hydrofiber dressings containing silver. The Bates‐Jensen Scale was employed at pre‐treatment and post‐aPDT sessions to assess lesion progression. The results demonstrated a significant difference between pre‐ and post‐treatment values in the overall BJ score. The use of MB in aPDT proved to be an effective, safe, well‐tolerated treatment with high patient adherence and the potential for implementation in the care of diabetic foot conditions.

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Efficacy and safety of ALA-PDT in treatment of diabetic foot ulcer with infection

Cited by 7 publications

References 23 publications

5-Aminolevulinic Acid-Mediated Photodynamic Therapy on Wound Healing: A Systemic Review of Human Evidences

5-Aminolevulinic Acid-Mediated Photodynamic Therapy on Wound Healing: A Systemic Review of Human Evidences

Positive effects of low‐dose photodynamic therapy with aminolevulinic acid or its methyl ester in skin rejuvenation and wound healing: An update

Adjuvant effect of antimicrobial photodynamic therapy (aPDT) in the treatment of diabetic foot ulcers: A case series

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