Photodiagnosis and photodynamic therapy最新文献

Oral potential malignant disorders (OPMDs) have a high risk of malignant transformation and recurrence. This case reports describes a novel therapeutic strategy of Er:YAG laser-assisted photodynamic therapy (Er:YAG-PDT) combined with anti-programmed death protein-1 (anti-PD-1) immunotherapy for a patient with refractory OPMDs in the right lower gingiva following oral squamous cell carcinoma (OSCC) surgery on the contralateral side. Initial PDT alone showed limited efficacy, but after integrating Er:YAG laser pretreatment, the patient achieved significant lesion regression, with a complete final clearance. The 6-month follow-up showed good local lesion control in the patient peripheral blood analysis revealed elevated natural killer (NK) cell level and reduced regulatory T (Treg) cell percentage, suggesting activated adaptive immunity, while similar CD8⁺ T cell levels indicated maintained immune homeostasis. This case report highlights the potential of combined Er:YAG-PDT and anti-PD-1 therapy for OPMDs, while emphasizing the need for optimized monitoring and multi-modal strategies to prevent recurrence in high-risk patients.

Background: Macular neovascularization (MNV) etiology is multifactorial, but direct evidence linking it to abnormalities of large choroidal vessels is lacking. This study aimed to investigate the potential role of abnormal spatial relationships between large choroidal arteries and veins in the pathogenesis of MNV, particularly in eyes with large veins traversing the macular area.

Methods: This retrospective study analyzed 45 eyes from 45 patients (26 with chronic central serous chorioretinopathy [CSC] and 19 with pathologic myopia [PM]) exhibiting large macular veins without a normal venous watershed. All patients underwent simultaneous fundus fluorescein angiography and indocyanine green angiography (ICGA). Arterial and venous phase ICGA images were selected, nonlinearly registered, and superimposed using Fiji/ImageJ software to visualize spatial arteriovenous relationships.

Results: Spatial relationships between large choroidal arteries and veins were clearly discernible in significantly more PM eyes (18/19, 94.7%) than CSC eyes (6/26, 23.1%) (P < 0.0001). Among eyes with clear visualization, various spatial configurations were observed, including crossing, twisting, and independence. Crucially, in two distinct MNV cases-one secondary to chronic CSC (thick choroid) and one secondary to PM (thin choroid)-direct, large-caliber arteriovenous shunts were identified precisely at the MNV site using this imaging approach.

Conclusion: This study provides direct ICGA evidence that abnormal shunts between large choroidal arteries and veins represent a novel, previously underrecognized etiology for MNV formation. This anatomical anomaly may act as an upstream hemodynamic driver across different choroidal backgrounds (thick or thin), potentially altering local hemodynamics and promoting neovascularization. Investigating these underlying arteriovenous relationships could improve CNV risk stratification and inform future treatment strategies.

Objective: To evaluate the clinical outcomes and visual quality after Phorcides planned Contoura topography-guided femtosecond laser-assisted excimer laser in situ keratomileusis (TOPO-G FS-LASIK) for myopia and astigmatism correction.

Methods: Non-randomized retrospective study. 38 eyes in the high ocular residual astigmatism (HORA, >0.75D) group and 44 eyes in the low ocular residual (LORA, <0.75D) group were treated, and the accuracy was evaluated based on the Phorcides planned Contoura TOPO-G FS-LASIK. Routine examinations and specific tests, such as ocular aberrations, optical quality analysis system, a subjective visual quality questionnaire, and contrast sensitivity (CS), were measured and compared within and between groups preoperatively and postoperatively.

Results: At 6m postoperatively, manifest refractive spherical equivalent, uncorrected and corrected distance visual acuity, safety index, effectivity index, target-induced astigmatism, surgical-induced astigmatism, difference vector, angle of error, and correction index were similar in both HORA and LORA groups (P>0.05). Objective scatter index, modulation transfer function cut-off, visual acuity (VA) 100%, and all the CS were similar between the two groups preoperatively and postoperatively (P>0.05). But VA20%/9%, Strehl ratio, the CS of 1.5/3/6/12/18c/d in the HORA group, and 1.5/3/6c/d in the LORA group were significantly elevated 6m postoperatively. The subjective visual quality questionnaire scores were consistent both within and between groups preoperatively and 6m postoperatively.

Conclusions: Phorcides planned Contoura TOPO-G FS-LASIK achieved the predicted outcomes, demonstrating objective and universal applicability. Visual quality in the HORA group was significantly improved, especially the night vision and high-frequency spatial CS.

This study aimed to assess the efficacy and safety of 5-ALA-PDT for treating cervical LSIL and HR-HPV in women of childbearing age. A retrospective analysis was conducted on 237 patients (aged 20-40 years) who underwent 5-ALA-PDT at Minhang Hospital between 2022 and 2024. The treatment protocol involved topical application of 5-ALA, followed by 635-nm laser therapy at a power of 100 J/cm², administered over a duration of 30 min, and repeated in three sessions, with a spacing of one to two weeks between each session. Follow-up: 1 month (adverse reactions, cervical structure); 3-6/12 months (HR-HPV clearance, LSIL regression). The IBM SPSS 26.0 software was used for the analysis of the data, with a significance level of P<0.05 being established as significant. The HR-HPV clearance study revealed that the success rate increased from 67.09% (3-6 months) to 88.19% (12 months), with a higher success rate observed in younger patients (P=0.014/0.018). The following regressions were observed: LSIL regression of the cervical (98.82% to 99.44%), cervical canal (86.30% to 100%), and vaginal (82.25% to 96.77%) epithelium, with a 3-6-month cervical regression greater than that of other sites (P = 0.03). In this study, 65.82% of patients had no adverse reactions, with mild events (e.g., bleeding 22.78%, adhesions 14.34%) resolving within five days. The study concluded that 5-ALA-PDT is a safe and effective treatment for cervical LSIL combined with HR-HPV in women of childbearing age. This treatment promotes HR-HPV clearance and LSIL regression, preserves cervical structure, and accelerates HPV clearance in younger patients.

Background: Glioblastoma multiforme (GBM) is characterized by extensive tumor cell invasion into normal brain tissue leading to tumor recurrence despite present day treatment protocols. Photodynamic therapy (PDT) has been shown to inhibit glioma cell invasion, but the poor penetration of light in brain tissue has set limitations. Sonodynamic therapy (SDT), utilizing sensitizer activation by ultrasound (US), has been proposed as an alternative to PDT. The advantage of SDT is that US has much lower tissue attenuation compared to visible light, allowing treatment to tumor margins buried deep within the brain and non-invasively through the intact skull. This study evaluates the ability of SDT to inhibit glioma cell invasiveness in a 3D Matrigel matrix glioma cell assay.

Methods: Glioma cell spheroids were embedded between 2 layers of Matrigel solution. After gelation, the embedded spheroids are incubated in a medium containing sonosensitizer for 18 hours and then exposed to varying intensities and durations of US. Measurements of cell invasion distance were taken 4 days after the spheroids were embedded.

Results: SDT significantly inhibited cell invasiveness compared to untreated spheroids and spheroids treated with only US. If administered pre-implantation, SDT also inhibited subsequent cell invasion into the deposited Matrigel matrix. The effects of SDT applied repetitively at lower intensities, had a greater inhibitory effect than single shot treatment.

Conclusion: From this experimental study using GBM tumor spheroids, the results demonstrated that SDT significantly inhibited cell invasiveness and cell adhesion and had greater inhibitive effects when administered in repetitive form.

Extramammary Paget's disease (EMPD) is a rare cutaneous malignancy that poses significant therapeutic challenges due to its refractory nature and high recurrence rate. Although surgery remains the standard treatment, non-surgical alternatives are crucial for elderly patients with extensive lesions or multiple comorbidities. 5-Aminolevulinic acid photodynamic therapy (ALA-PDT) selectively targets and destroys tumor cells through the application of a photosensitizer and corresponding light source. Here, we report the case of a centenarian male with extensive primary perineogenital EMPD. He was unsuitable for surgery due to advanced age, poor general health, large lesion size, and sensitive anatomical location. The patient received ALA-PDT as long-term palliative treatment, with a total of 58 sessions over five years. This regimen achieved durable local control, was well-tolerated, and preserved the patient's quality of life. This is the oldest reported EMPD patient treated with ALA-PDT and the case with the highest cumulative number of ALA-PDT sessions. This suggests that ALA-PDT is a safe and effective long-term palliative treatment option for high-risk elderly patients.

Photodynamic therapy (PDT) and photothermal therapy (PTT) are promising tumor treatment modalities which employ light activation to acquire high temperature and reactive oxygen species (ROS) for the annihilation of cancer cells. In this study, a bilirubin (BR)-gold nanoconjugate (BGNC) was synthesized, characterized, and analyzed as a photosensitizer for synergistic PTT/PDT of HeLa cancer cells. BGNC contained nanoparticles with an average diameter of 33 nm, a zeta potential of -18.6 mV, a band gap energy of 2.7 eV, and a photothermal conversion efficiency of 51.6%, with an intrinsic ROS-generating efficiency. BGNC benefits from the surface plasmon resonance (SPR) and ROS-producing properties of gold nanoparticles, and antioxidant and glutathione (GSH)-reducing properties of BR. Concentration-dependent effects for BGNC in decreasing Hela cell viability were assessed. Hela cell viability further lowered upon 808-nm laser light irradiation of BGNC. The ability of BGNC to generate ROS upon irradiation was confirmed in cell-free as well as cell-containing systems, with a 2.1-fold increment in intracellular ROS in treated cells with BGNC and light irradiation. BGNC also exhibited a concentration-dependent effect to deplete the GSH level. BGNC acted as a two-pronged photosensitizer agent, exhibiting enhanced anticancer efficacy by leveraging both phototherapy and the intrinsic properties of BR.

Background: Dental caries, a multifactorial disease, is primarily driven by acidogenic bacteria such as Streptococcus mutans (S.mutans) and Lactobacillus acidophilus (L.acidophilous). Conventional antimicrobial treatments may be insufficient for complete bacterial eradication. Non-thermal atmospheric pressure plasma (NTAPP) has emerged as a novel antimicrobial strategy. This study aimed to evaluate the antibacterial efficacy of NTAPP on S.mutans and L.acidophilous in carious dentin under clinical conditions.

Methods: A plasma jet device utilizing helium gas (purity 99.999%, nozzle diameter 3 mm, voltage 10 kV, frequency 6 kHz, flow rate 2 L/min) was employed to irradiate the Class I, II, and III cavities in 15 teeth with dentin caries extending no deeper than the middle third of the dentin. Carious dentin was excavated using an excavator immediately before and after plasma treatment. Plasma was applied from a 10 mm distance for one minute. Colony-forming unit (CFU) counts were determined for S. mutans and L. acidophilus. Statistical analysis was conducted using the Wilcoxon Signed-Rank Test (P value = 0.05).

Results: Helium Plasma irradiation resulted in a significant reduction in CFU counts for both S. mutans and L. acidophilus (P < 0.001). The reduction rates were 76.01 ± 25.17% for S. mutans and 76.14 ± 23.88% for L. acidophilus. No significant difference was observed in CFU reduction between the two bacterial species (P > 0.05).

Conclusion: Helium-based NTAPP demonstrated a significant antibacterial effect against S. mutans and L. acidophilus in this clinical study, suggesting its potential as an antibacterial treatment for dentin caries lesions.

Background: Antibiotic resistance among multidrug-resistant pathogens necessitates alternative antimicrobial strategies. Photodynamic therapy (PDT) and sonodynamic therapy (SDT), particularly with methylene blue (MB), show promise but remain underexplored in clinical contexts.

Methods: We conducted an in vitro evaluation of MB-PDT and SDT against Staphylococcus aureus, a major cause of skin and soft tissue infections. Assays included growth curve analysis, scanning electron microscopy (SEM) to assess bacterial ultrastructure. A pilot clinical study in 20 healthy volunteers assessed in vivo antimicrobial efficacy and tolerability under standardized conditions.

Results: In vitro, MB demonstrated antimicrobial activity under PDT, with further potentiation by SDT and repeated irradiation. SEM confirmed structural disruption and lysis of S. aureus following combination therapy. In vivo, both MB-PDT and PDT+SDT achieved significant bacterial log reductions compared with baseline (p < 0.0001), with the highest efficacy observed under repeated irradiation plus SDT. The most significant effect was observed with repeated irradiation (2 × 30 J.cm⁻²) in combination with ultrasound (1 MHz, 1 W/cm²), with an average reduction of 2.424 log₁₀ (SD = 0.652).

Conclusions: MB-mediated PDT and PDT+SDT are safe, well tolerated, and effective against S. aureus on skin. These approaches provide localized antimicrobial activity independent of antibiotic resistance and warrant further optimization for clinical application.