PubMed · 3222999
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O Manuwald. 1988. [Lead pollution and its effect on students].. https://pubmed.ncbi.nlm.nih.gov/3222999/
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delta-Aminolevulinic acid (ALA) causes cells to accumulate protoporphyrin IX (Proto) and heme. Exposure to light in vitro causes intracellular Proto to initiate formation of singlet oxygen molecules, leading to self-destruction. This photoactivated destruction by ALA in vitro is enhanced by addition of the tetrapyrrole modulator 1,10-phenanthroline (Oph), which increases cellular accumulation of Proto. Here we significantly extend this idea by evaluating the efficacy of ALA and Oph photodynamic therapy of solid tumors in vivo. Methylcholanthrene-induced fibrosarcoma (Meth-A) cells were used, which lead to the formation of solid tumors when implanted into syngeneic recipients. Initially, suspensions of Meth-A cells were treated in vitro with combinations of ALA and Oph. Meth-A cells in suspension accumulated 6-fold greater amounts of Proto (P < 0.05) after 3-h incubation with ALA and Oph than when incubated with ALA alone, and were also more susceptible to subsequent photoactivated cell lysis in vitro. Similarly, solid Meth-A tumors grown in syngeneic BALB/c mice accumulated significant (P < 0.05) amounts of Proto 3 h after in vivo treatment with ALA, and Oph synergized with ALA to significantly (P < 0.05) enhance the induction of Proto in these tumors. ALA and Oph-based phototreatment of mice bearing Meth-A solid tumors resulted in necrosis of tumors, as determined by a significant reduction in both size and histopathology, with little damage to surrounding normal tissue. These data directly demonstrate the experimental usefulness of Proto modulators for ALA-based photodynamic therapy in the treatment of solid tumors in vivo and provide a rationale for their potential application in a multitude of tumor types.
The applicability and limitations of a photodynamic threshold model, used to describe quantitatively the in vivo response of tissues to photodynamic therapy, are currently being investigated in a variety of normal and malignant tumour tissues. The model states that tissue necrosis occurs when the number of photons absorbed by the photosensitiser per unit tissue volume exceeds a threshold. New Zealand White rabbits were sensitised with porphyrin-based photosensitisers. Normal brain or intracranially implanted VX2 tumours were illuminated via an optical fibre placed into the tissue at craniotomy. The light fluence distribution in the tissue was measured by multiple interstitial optical fibre detectors. The tissue concentration of the photosensitiser was determined post mortem by absorption spectroscopy. The derived photodynamic threshold values for normal brain are significantly lower than for VX2 tumour for all photosensitisers examined. Neuronal damage is evident beyond the zone of frank necrosis. For Photofrin the threshold decreases with time delay between photosensitiser administration and light treatment. No significant difference in threshold is found between Photofrin and haematoporphyrin derivative. The threshold in normal brain (grey matter) is lowest for sensitisation by 5 delta-aminolaevulinic acid. The results confirm the very high sensitivity of normal brain to porphyrin photodynamic therapy and show the importance of in situ light fluence monitoring during photodynamic irradiation.
Acute intermittent porphyria (AIP) is a human disease resulting from a dominantly inherited partial deficiency of the heme biosynthetic enzyme, porphobilinogen deaminase (PBGD). The frequency of the trait for AIP is 1/10,000 in most populations, but may be markedly higher (1/500) in psychiatric patients. The clinical expression of the disease is characterized by acute, life-threatening attacks of 'porphyric neuropathy' that include abdominal pain, motor and sensory neurological deficits and psychiatric symptoms. Attacks are frequently precipitated by drugs, alcohol and low caloric intake. Identical symptoms occur in other hepatic porphyrias. To study the pathogenesis of the neurologic symptoms of AIP we have generated Pbgd-deficient mice by gene targeting. These mice exhibit the typical biochemical characteristics of human AIP, notably, decreased hepatic Pbgd activity, increased delta-aminolevulinic acid synthase activity and massively increased urinary excretion of the heme precursor, delta-aminolevulinic acid after treatment with drugs such as phenobarbital. Behavioural tests reveal decreased motor function and histopathological findings include axonal neuropathy and neurologic muscle atrophy.