Molecular Effects of Photodynamic Therapy for Photoaging

Orringer, Jeffrey S.; Hammerberg, Craig; Hamilton, Ted A.; Johnson, Timothy M.; Kang, Sewon; Sachs, Dana L.; Fisher, Gary J.; Voorhees, John J.

doi:10.1001/archderm.144.10.1296

Cited by 106 publications

(101 citation statements)

References 43 publications

(55 reference statements)

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“…Recently, Marmur, Phelps, and Goldberg 15 showed that ALA-IPL induced increase of type I collagen fibers in the photodamaged skin by ultrastructural analysis. In addition, Orringer et al 16 also demonstrated increase of type I and III procollagen in the photoaged skin after ALA-PDL. The results of the present study provide more precise histopathologic evidence for photorejuvenation with ALA-PDT in patients with AKs.…”

Section: Discussionmentioning

confidence: 91%

“…Recently, in an in vivo study of PDT using a pulsed dye laser in human skin, MMP-1 gene expression was acutely elevated and then returned to baseline levels within 24 hours. 16 However, it was also shown that MMP-2 expression was down-regulated 24 hours after Hexvix-mediated PDT in a medulloblastoma cell line (TE-671). 19 Our results regarding decreased levels of MMPs might be explained as follows.…”

Section: Discussionmentioning

confidence: 99%

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Photorejuvenation induced by 5-aminolevulinic acid photodynamic therapy in patients with actinic keratosis: A histologic analysis

Park

Sohn

Lee

et al. 2010

Journal of the American Academy of Dermatology

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Background: Repeated exposure to ultraviolet radiation from the sun results in premature photoaging. Photodynamic therapy (PDT) has been shown to be effective for treatment of photoaging, although the data from most studies have been based on clinical observation.Objectives: We investigated whether 5-aminolevulinic acid (ALA)-PDT induced histologic changes suggesting photorejuvenation.Methods: Fourteen patients with one to three actinic keratoses on the face were treated twice with ALA-PDT by using a 1200 W metal halogen lamp at 1-month intervals. Skin biopsy before and 1 month after the PDT was performed. Twenty-five pairs of specimens were obtained. We examined the specimens with routine and immunohistochemical staining and evaluated the parameters associated with photoaging by using image analysis.Results: After ALA-PDT, the mean epidermal thickness and dermal inflammatory infiltrate were reduced. The total collagen volume in the dermis significantly increased with expression of type I and III procollagen. The level of transforming growth factor b and transforming growth factor b type II receptors in the epidermis also increased. The elastotic material with co-localizing fibrillin-1 and tropoelastin expression in the dermis decreased after treatment. The expression of matrix metalloproteinases-1, -3, and -12 also decreased.Limitations: The study was limited by the small sample size.Conclusions: ALA-PDT resulted in histological changes indicating restoration of photoaged skin. These data suggest that ALA-PDT could be effective for photorejuvenation. ( J Am Acad Dermatol 2010;62:85-95.)

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Photorejuvenation induced by 5-aminolevulinic acid photodynamic therapy in patients with actinic keratosis: A histologic analysis

Park

Sohn

Lee

et al. 2010

Journal of the American Academy of Dermatology

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“…The change of procollagen I mRNA of 2.4-to 1.7-fold, correspondingly two and seven days after RF treatment of the skin [14], also cannot be responsible for any improvement in the skin's appearance, since the overexpression of the procollagen I protein in this case has to be even smaller than in the study of [13].…”

Section: Quasi-physiological and Pathological Conditionsmentioning

confidence: 82%

“…We will assume the physiological half-life time of the mature collagen in the dermis to be 15 years. The increase of the procollagen I protein in the dermis will be taken to be 2.4, as, for example, the maximum value measured after one skin rejuvenation treatment with photodynamic therapy recorded seven days after the procedure [13]. Assuming the whole procollagen I protein will be utilised to replace the mature protein and that the procollagen upregulation is constant during the whole time after the treatment (which is surely wrong and will cause us to significantly overestimate the results), the proportion of the mature collagen network that will be replaced during the first seven days after the treatment can be calculated to be approximately 0.15% (the upper-limit of the estimation).…”

Section: Quasi-physiological and Pathological Conditionsmentioning

confidence: 99%

Neocollagenesis in Non-Invasive Aesthetic Treatments

Kruglikov¹

2013

JCDSA

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Dermal neocollagenesis is often assumed to be the main reason of visible skin improvement after different non-invasive and minimal invasive aesthetic treatments. However, the very slow dynamics of the mature collagen remodelling in the extra cellular matrix (ECM) of dermis, with a half-life time of 15 years, renders every observable upregulation of collagen production insufficient to replace a significant part of the matrix during the short time in which it is claimed skin improvement takes place.

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“…The use of aminolevulenic acid (ALA)-photodynamic therapy (PDT) for the successful treatment of non-hyperkeratotic actinic keratosis is well documented [2]. The concurrent improvement in the photoaged appearance after ALA-PDT has been observed and reported [3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Photodynamic photorejuvenation of the face with a combination of microneedling, red light, and broadband pulsed light

2010

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BackgroundHigh efficacy and safety, coupled with in‐office, short contact protocols have made photodynamic therapy (PDT) with aminolevulenic acid (ALA) for the treatment of actinic keratoses a mainstay option over the last decade. Clinical improvement in photoaged skin has also been reported to accompany PDT treatments. The study objective was to maximize epidermal penetration and subsequent activation of ALA for the treatment of photodamaged facial skin, utilizing a microneedle roller prior to incubation and combined irradiation with red light and broadband pulsed light in a single treatment.Materials and MethodsA full‐face treatment of 21 patients was performed with 630 nm light and broadband pulsed light after multiple passes with a microneedle roller and 1‐hour ALA incubation. The primary endpoint was clinical improvement, scored during two separate live assessments by three physicians blinded to previous scores, using a 5‐point standardized photoaging scale. The secondary endpoint was evaluation of patient satisfaction based on a quartile scale comparing baseline to 6‐month post‐treatment photography.ResultsStatistically significant improvement was seen in the global photoaging scores, as well as sub‐components of the scale (fine lines, mottled pigmentation, sallowness, tactile roughness, and telangiectasias) at 3 months as compared with baseline live assessment, and at 6‐month live assessment compared with the 3 months. In addition, 90% of patients judged clinical improvement to be greater than 50% at 6 months compared to baseline photography.ConclusionUse of a microneedle roller to “pre‐treat” prior to application of ALA appears to be well tolerated and allows for even absorption and perhaps deeper penetration of ALA following a defined incubation period. Use of red light and broadband pulsed light allowed for deeper activation of ALA, potentially accounting for marked clinical improvement in photoaging. Lasers Surg. Med. 42:150–159, 2010. © 2010 Wiley‐Liss, Inc.

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Molecular Effects of Photodynamic Therapy for Photoaging

Cited by 106 publications

References 43 publications

Photorejuvenation induced by 5-aminolevulinic acid photodynamic therapy in patients with actinic keratosis: A histologic analysis

Photorejuvenation induced by 5-aminolevulinic acid photodynamic therapy in patients with actinic keratosis: A histologic analysis

Neocollagenesis in Non-Invasive Aesthetic Treatments

Photodynamic photorejuvenation of the face with a combination of microneedling, red light, and broadband pulsed light

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