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Photochemical & Photobiological Sciences Vol - 7 Issue - 2

Photochemical & Photobiological Sciences Vol -6

Photochemical & Photobiological Sciences Vol -5

Photochemical & Photobiological Sciences Vol -4

Photochemical & Photobiological Sciences Vol -3

Photochemical & Photobiological Sciences Vol -2

ALA and its clinical impact, from bench to bedside

Content Provider	Royal Society of Chemistry (RSC)
Author	Krammer, Barbara Plaetzer, Kristjan
Copyright Year	2008
Abstract	ALA-induced protoporphyrin IX (PpIX) is used for fluorescence diagnosis (ALA-FD) and for fluorescence-guided resection of both (pre)malignant and non-malignant diseases. ALA is also applied in photodynamic therapy (ALA-PDT) of superficial (pre)malignant lesions in dermatology, urology, neurosurgery, otorhinolaryngology, gynecology and gastroenterology. Today, ALA is approved as Levulan® for actinic keratoses, the ALA-methyl ester Metvix® for actinic keratoses and basal cell carcinoma, the ALA-hexyl ester Hexvix® for the diagnosis of bladder cancer and Gliolan® for malignant glioma. The use of ALA for PDT and FD was established around 25 years ago, with most of the fundamental knowledge gained at the “bench” and implemented at the “bedside” due to the diligence of a few researchers within the first 10 years of research. After 1993 ALA research was taken up by many groups. For patient treatment, several factors are relevant. Administered mainly in a topical or oral form, ALA penetrates tissue in a sub-optimal way, which is currently improved by special techniques and the use of ALA-esters. PpIX accumulation is elevated in many malignant tissues, several tissue abnormalities, and in mucosa. It is also found at elevated levels in macrophages, dendritic cells and activated lymphocytes. Following sufficient PpIX accumulation in the target cells, irradiation is carried out which may be accompanied by a burning sensation at the treatment site. Due to a saturation process of PpIX formation and rapid photobleaching during irradiation the risk of overtreatment is relatively low. Pharmacokinetical studies have demonstrated a low systemic photosensitivity and excretion of PpIXvia natural routes.
Starting Page	283
Ending Page	289
Page Count	7
File Format	HTM / HTML PDF
ISSN	1474905X
Volume Number	7
Issue Number	3
Journal	Photochemical & Photobiological Sciences
DOI	10.1039/b712847a
Language	English
Publisher	Royal Society of Chemistry
Access Restriction	Open
Subject Keyword	Lipoic acid Fluorescence Otorhinolaryngology Neurosurgery Aminolevulinic acid Urology Mucous membrane Gynaecology Ester Gastroenterology Topical medication Photobleaching Actinic keratosis Dendritic cell Photosensitivity Photodynamic therapy Dermatology Levulan Basal-cell carcinoma Bladder cancer Hexvix Glioma ALA Methyl aminolevulinate Protoporphyrin IX Macrophage
Content Type	Text
Resource Type	Article
Subject	Physical and Theoretical Chemistry

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Photodynamic Therapy for Basal Cell Carcinoma: The Clinical Context for Future Research Priorities

Comparative Study of Photodynamic Therapy with Topical Methyl Aminolevulinate versus 5-Aminolevulinic Acid for Facial Actinic Keratosis with Long-Term Follow-Up.

Topical photodynamic therapy with porphyrin precursors—assessment of treatment-associated pain in a retrospective study

How Much Protoporphyrin IX Must Be Activated to Obtain Full Efficacy of Methyl Aminolevulinate Photodynamic Therapy? Implication for Treatment Modifications

Topical photodynamic therapy

Correlation between protoporphyrin IX fluorescence intensity, photobleaching, pain and clinical outcome of actinic keratosis treated by photodynamic therapy.

Analyzing effects of photodynamic therapy with 5-aminolevulinic acid (ALA) induced protoporphyrin IX (PPIX) in urothelial cells using reverse phase protein arrays

Increase in protoporphyrin IX after 5-aminolevulinic acid based photodynamic therapy is due to local re-synthesis

REVIEW Review of photodynamic therapy in actinic keratosis and basal cell carcinoma

ALA and its clinical impact, from bench to bedside

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Photodynamic Therapy for Basal Cell Carcinoma: The Clinical Context for Future Research Priorities

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ALA and its clinical impact, from bench to bedside