Timing of 5-aminolaevulinic acid-induced photodynamic therapy for the treatment of patients with Barrett’s oesophagus

Hinnen, P.; Rooij, Felix W.M. de; Hop, Wim C. J.; Edixhoven, Annie; Dekken, Herman van; Wilson, J. H. P.; Siersema, Peter D.

doi:10.1016/s1011-1344(02)00324-x

Cited by 12 publications

(5 citation statements)

References 27 publications

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“…Vit D pretreatment may also increase the effective depth for light penetration (currently limited to <5 mm deep with red light sources), since more cells can accumulate PpIX concentrations that exceed the threshold for phototoxic killing. Drug delivery per se should not be an issue; ALA has a well‐established pharmacokinetic profile after oral delivery and provides easily detectable PpIX levels within breast tumors in patients 3–6 h after ALA ingestion . Oral delivery of ALA also appears to be very safe; the only concern is skin photosensitivy for 24–36 h after ingestion, requiring strict sun avoidance.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D enhances the efficacy of photodynamic therapy in a murine model of breast cancer

2015

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Cutaneous metastasis occurs more frequently in breast cancer than in any other malignancy in women, causing significant morbidity. Photodynamic therapy (PDT), which combines a porphyrin-based photosensitizer and activation by light, can be employed for breast cancer (especially cutaneous metastases) but tumor control after PDT has not surpassed traditional treatments methods such as surgery, radiation, and chemotherapy up to now. Here, we report that breast cancer nodules in mice can be effectively treated by preconditioning the tumors with 1α, 25-dihydroxyvitamin D3 (calcitriol; Vit D) prior to administering 5-aminolevulinate (ALA)-based PDT. Breast carcinoma tumors (MDA-MB-231 cells implanted subcutaneously in nude mice) received systemic Vit D (1 μg/kg) for 3 days prior to receiving ALA. The addition of Vit D increased intratumoral accumulation of protoporphyrin IX (PpIX) by 3.3 ± 0.5-fold, relative to mice receiving ALA alone. Bioluminescence imaging in vivo and immunohistochemical staining confirmed that tumor-specific cell death after ALA-PDT was markedly enhanced (36.8 ± 7.4-fold increase in TUNEL-positive nuclei; radiance decreased to 14% of control) in Vit D pretreated tumors as compared to vehicle-pretreated tumors. Vit D stimulated proliferation (10.7 ± 2.8-fold) and differentiation (9.62 ± 1.7-fold) in tumor cells, underlying an augmented cellular sensitivity to ALA-PDT. The observed enhancement of tumor responses to ALA-PDT after low, nontoxic doses of Vit D supports a new combination approach that deserves consideration in the clinical setting, and offers potential for improved remission of cutaneous breast cancer metastases.

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Section: Discussionmentioning

confidence: 99%

Vitamin D enhances the efficacy of photodynamic therapy in a murine model of breast cancer

2015

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“…In our study, BE tissue showed increased PpIX fluorescence with increasing time, which is in agreement with known in vivo observations. The BE tissue showed no significantly reduced PpIX fluorescence after 23 h, which indicates a slower PpIX clearance compared to in vivo observations [ 25 – 28 ]. This increased clearance time might be caused by the topical bolus administration of ALA.…”

Section: Discussionmentioning

confidence: 61%

“…Furthermore, the ALA diffusion into the tissue and redistribution within the egg might be prolonged in the CAM model. The in vivo kinetics were already studied [ 25 – 28 ]; therefore, we focused on studying the CAM model as a preclinical approach for fluorescence diagnostics with special interest in photosensitizer. This preclinical model benefits from no patient hazard, and it is a more physiological approach then studying cells in vitro.…”

Section: Discussionmentioning

confidence: 99%

Fluorescence characteristics of human Barrett tissue specimens grafted on chick chorioallantoic membrane

et al. 2015

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To improve (pre)malignant lesion identification in Barrett’s esophagus (BE), recent research focuses on new developments in fluorescence imaging and spectroscopy to enhance tissue contrast. Our aim was to validate the chorioallantoic membrane (CAM) model as a preclinical tool to study the fluorescence characteristics such as autofluorescence and exogenously induced fluorescence of human Barrett’s tissue. Therefore, esophageal biopsy specimens from Barrett’s patients were freshly grafted onto the CAM of fertilized hen’s eggs to simulate the in vivo situation. The BE biopsy specimens stayed between 1 and 9 days on the CAM to study the persistence of vitality. Fluorescence spectroscopy was performed using six excitation wavelengths (369, 395, 400, 405, 410, 416 nm). Obtained autofluorescence spectra were compared with in vivo spectra of an earlier study. Exogenous administration of 5-aminolevulinic-acid to the biopsy specimens was followed by fluorescence spectroscopy at several time points. Afterwards, the biopsy specimens were harvested and histologically evaluated. In total, 128 biopsy specimens obtained from 34 patients were grafted on the CAM. Biopsy specimens which stayed on average 1.7 days on the CAM were still vital. Autofluorescence spectra of the specimens correlated well with in vivo spectra. Administered 5-aminolevulinic-acid to the biopsy specimens showed conversion into protoporphyrin-IX. In conclusion, we showed that grafting freshly collected human BE biopsy specimens on the CAM is feasible. Our results suggest that the CAM model might be used to study the fluorescence behavior of human tissue specimens. Therefore, the CAM model might be a preclinical research tool for new photosensitizers.

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“…Moreover, it allows a time window for the administration and thus is likely to increase patient compliance. This time span also appears to be when the ratio of PpIX in Barrett's epithelium compared to squamous epithelium is at its greatest [10]. We propose that the ALA be taken by patients at home, because self-administration in a comfortable setting is likely to increase patient acceptability.…”

Section: Discussionmentioning

confidence: 98%

Comparison of high- vs low-dose 5-aminolevulinic acid for photodynamic therapy of Barrett?s esophagus

et al. 2004

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Timing of 5-aminolaevulinic acid-induced photodynamic therapy for the treatment of patients with Barrett’s oesophagus

Cited by 12 publications

References 27 publications

Vitamin D enhances the efficacy of photodynamic therapy in a murine model of breast cancer

Vitamin D enhances the efficacy of photodynamic therapy in a murine model of breast cancer

Fluorescence characteristics of human Barrett tissue specimens grafted on chick chorioallantoic membrane

Comparison of high- vs low-dose 5-aminolevulinic acid for photodynamic therapy of Barrett?s esophagus

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