Photodynamic Therapeutic Effect during 5-Aminolevulinic Acid-Mediated Photodynamic Diagnosis-Assisted Transurethral Resection of Bladder Tumors.

IF 1.8 Q3 UROLOGY & NEPHROLOGY Advances in Urology Pub Date : 2024-07-20 eCollection Date: 2024-01-01 DOI:10.1155/2024/7548001
Nobutaka Nishimura, Makito Miyake, Sayuri Onishi, Tomomi Fujii, Tatsuki Miyamoto, Mitsuru Tomizawa, Takuto Shimizu, Yosuke Morizawa, Shunta Hori, Daisuke Gotoh, Yasushi Nakai, Kazumasa Torimoto, Nobumichi Tanaka, Kiyohide Fujimoto
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Abstract

Background: Photodynamic diagnosis-assisted transurethral resection of bladder tumors (PDD-TURBT) enhances detection of elusive lesions compared to standard white light-transurethral resection of bladder tumors (WL-TURBT). If minimal light exposure during PDD-TURBT induces the accumulation of reactive oxygen species (ROS), potentially resulting in phototoxicity in small lesions, apoptosis may be triggered in residual small tumors, allowing them to escape resection. We investigated the hypothesis of a potential photodynamic therapeutic effect during PDD-TURBT.

Methods and materials: Our study, conducted between January 2016 and December 2020 at Nara Medical University Hospital, focused on a specific emphasis on ROS production. Immunohistochemical analysis for thymidine glycol and N ε -hexanoyl-lysine was performed on 69 patients who underwent 5-aminolevulinic acid-mediated PDD-TURBT and 28 patients who underwent WL-TURBT. Additionally, we incrementally applied the minimal irradiation energy to T24 and UM-UC-3 cells treated with 5-aminolevulinic acid using instruments similar to those used in PDD-TURBT and evaluated intracellular ROS production and phototoxicity.

Results: Immunohistochemical analysis revealed a significant increase in production of thymidine glycol and N ε -hexanoyl-lysine within the PDD-TURBT group. In T24 and UM-UC-3 cells treated with 5-aminolevulinic acid and light exposure, immunofluorescent staining demonstrated a dose-dependent increase in intracellular ROS production. In addition, higher irradiation energy levels were associated with a greater increase in ROS production and phototoxicity, as well as more significant decrease in mitochondrial membrane potential.

Conclusion: Although the irradiation energy used in PDD-TURBT did not reach the levels commonly used in photodynamic therapy, our findings support the presence of a potential cytotoxic effect on bladder lesions during PDD-TURBT.

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在 5-Aminolevulinic Acid 光动力诊断辅助下经尿道切除膀胱肿瘤的光动力治疗效果。
背景:与标准的白光经尿道膀胱肿瘤切除术(WL-TURBT)相比,光动力诊断辅助经尿道膀胱肿瘤切除术(PDD-TURBT)可提高对难以发现的病灶的检测能力。如果 PDD-TURBT 期间的最小光照射会诱导活性氧(ROS)的积累,从而可能导致小病灶的光毒性,那么残留的小肿瘤可能会触发凋亡,从而逃脱切除。我们研究了 PDD-TURBT 期间潜在光动力治疗效果的假设:我们的研究于 2016 年 1 月至 2020 年 12 月在奈良医科大学附属医院进行,重点关注 ROS 的产生。我们对 69 例接受 5-aminolevulinic acid 介导的 PDD-TURBT 的患者和 28 例接受 WL-TURBT 的患者进行了胸腺嘧啶乙二醇和 N ε -己酰赖氨酸的免疫组化分析。此外,我们还使用与 PDD-TURBT 类似的仪器,对接受 5-aminolevulinic acid 治疗的 T24 和 UM-UC-3 细胞逐步施加最小辐照能量,并评估细胞内 ROS 的产生和光毒性:免疫组化分析表明,在 PDD-TURBT 组中,胸苷乙二醇和 N ε -己酰基赖氨酸的产生量显著增加。在用 5-氨基乙酰丙酸和光照射处理的 T24 和 UM-UC-3 细胞中,免疫荧光染色显示细胞内 ROS 生成的增加呈剂量依赖性。此外,辐照能量越高,ROS 生成和光毒性增加越多,线粒体膜电位下降越明显:尽管 PDD-TURBT 使用的辐照能量没有达到光动力疗法常用的水平,但我们的研究结果支持 PDD-TURBT 对膀胱病变存在潜在的细胞毒性作用。
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来源期刊
Advances in Urology
Advances in Urology UROLOGY & NEPHROLOGY-
CiteScore
2.90
自引率
0.00%
发文量
17
审稿时长
15 weeks
期刊介绍: Advances in Urology is a peer-reviewed, open access journal that publishes state-of-the-art reviews and original research papers of wide interest in all fields of urology. The journal strives to provide publication of important manuscripts to the widest possible audience worldwide, without the constraints of expensive, hard-to-access, traditional bound journals. Advances in Urology is designed to improve publication access of both well-established urologic scientists and less well-established writers, by allowing interested scientists worldwide to participate fully.
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A Review of Electronic Early Warning Systems for Acute Kidney Injury. Patient Demographics and Major Adverse Cardiovascular Events after Androgen Deprivation Therapy for Prostate Cancer. Complications and Influential Perioperative Factors Associated with SpaceOAR Hydrogel Placement. Photodynamic Therapeutic Effect during 5-Aminolevulinic Acid-Mediated Photodynamic Diagnosis-Assisted Transurethral Resection of Bladder Tumors. Effects of the Surgical Ligation of the Ureter in Different Locations on the Kidney over Time in the Rat Model.
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