Treatment of herpes labialis by photodynamic therapy

Abstract

Background: Lesions of herpes labialis are caused by the herpes simplex virus type 1 and cause pain and aesthetic compromise. It is characterized by the formation of small vesicles that coalesce and rupture forming extremely painful ulcers, that evolve to crusts, dry desquamations until their complete remission. Currently the treatment of these lesions is done with acyclovir. Although it diminishes the symptomatology, it causes viral resistance and does not prevent the recurrence of the lesions. It is known that antimicrobial photodynamic therapy (aPDT) has numerous advantages, among them: the reduction of the time of remission, and does not cause resistance. This protocol will determine the effectiveness of PDT in lesions of herpes labialis. Materials and methods: A total of 30 patients with herpes labialis in the prodromal stage of vesicles, ulcers, and crusts will be selected to participate in the study and randomized into 2 groups: G1 control and G2 experimental. After signing Research Ethics Committee and TA, patients in group G1 will undergo the standard gold treatment for herpes labialis with acyclovir and simulated PDT treatment. Patients in the experimental G2 group will be treated simulating the gold standard treatment of herpes labialis (placebo) and PDT. In all patients, saliva samples will be collected for analysis of cytokines, and will be performed exfoliative cytology in the lesions. The pain will be assessed through a pain scale and a questionnaire of quality of life related to oral health (OHIP-14) will be given to them. Patients will continue to be followed up after 7 days, 1 month, 3 months, and 6 months; if there is a recurrence of the lesion, they will contact the researchers. Clinical registration: clinicaltrials.gov - NCT 04037475. Registered on July 2019.

Graft‐versus‐host disease and herpes simplex virus oral injuries in onco‐hematological patient: Case report

“…The main advantages of aPDT are related to the absence of side effects, of antimicrobial resistance and/or drug interactions, in addition to its low cost. 6,9,10 The main obstacles to the use of aPDT include lack of specific training, time consuming sessions, individualization of effective dose protocols and applications, the availability of the photosensitizer and the light source device, in addition to the collaboration of patients to attend the frequent sessions. 6,[9][10][11] On the other hand, hospitalization can increase treatment engagement since routine medications and medical appointments provide opportunities for aPDT applications.…”

“…Thus, it is being reported as an effective choice for the treatment of lesions caused by viruses of the Herpes Family. 9,12 Melo et al reported a case in which aPDT was used in conjunction with antibiotics to treat bacterial infection associated with primary teeth in a 1-year-old baby diagnosed with Myelodysplastic Syndrome. The photosensitizer agent used was MB with a concentration of 0.01% associated with red wavelength low-power laser.…”

Laser dentistry in daily practice during the COVID-19 pandemic: Benefits, risks and recommendations for safe treatments

“…There are antecedents in which the use of photodynamic antimicrobial chemotherapy significantly decreased the viral load in different types of oral viruses. [30][31][32][33][34][35] Antimicrobial photodynamic therapy (aPDT) is a form of phototherapy that is performed using nontoxic, lightsensitive compounds with selectively exposed/absorbed laser light, which become toxic to target pathogens. The efficacy of PDT was demonstrated in recent clinical research on periopathogens, [36][37][38] carious bacteria, 39,40 onychomycosis, 41,42 and paracoccidiodomycosis.…”

“…44 The PDI can use many compounds with potential photodynamic antiviral activity, ranging from plant extracts (psoralen), eosin, curcumin, and hypericin (St. John's wort), to synthetic compounds. 45 The sensitivity of viruses to photodynamic therapy was reported for herpes infections, 30,31 HPV infections (papillomatosis), [32][33][34] cytomegalovirus CMV, 35 and other viruses. 46 Many studies showed that enveloped viruses are significantly more sensitive to photodynamic destruction than non-enveloped ones.…”

Photodynamic therapy and Photobiomodulation as adjuvant treatment of oral and facial manifestations in patients with COVID-19 hospitalized in the intensive care unit: a case series

“…In aPDT, photosensitizers as methylene or toluidine blue, with concentrations of 0.01% or 0.005% are used in resonance with red laser light, generating reactive oxygen species highly toxic to microorganisms (Christina et al, 2020;La Selva et al, 2020;Ramalho et al, 2021).…”