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Current Advances in 5-Aminolevulinic Acid Mediated Photodynamic Therapy

  • Laser Therapy (J Jagdeo, Section Editor)
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Abstract

Kennedy and Pottier discovered that photodynamic therapy (PDT) could be carried out using a procedure consisting of topical application of the porphyrin-precursor, 5-aminolevulinic acid (ALA) to the skin, followed after some time by illumination with various light parameters in the 1980s. Since then, ALA-PDT has expanded enormously and now covers most aspects of dermatological disease. The purpose of this review is to discuss a range of ingenious strategies that investigators have devised for improving the overall outcome (higher efficiency and lower side effects) of ALA-PDT. The big advance of using ALA esters instead of the free acid to improve skin penetration was conceived in the 1990s. A variety of more recent innovative approaches can be divided into three broad groups: (a) those relying on improving delivery or penetration of ALA into the skin; (b) those relying on ways to increase the synthesis of protoporphyrin IX inside the skin; (c) those relying on modification of the illumination parameters. In the first group, we have improved delivery of ALA with penetration-enhancing chemicals, iontophoresis, intracutaneous injection, or fractionated laser. There is also a large group of nanotechnology-related approaches with ALA being delivered using liposomes/ethosomes, ALA dendrimers, niosomes, mesoporous silica nanoparticles, conjugated gold nanoparticles, polymer nanoparticles, fullerene nanoparticles, and carbon nanotubes. In the second group, we can find the use of cellular differentiating agents, the use of iron chelators, and the effect of increasing the temperature. In the third group, we find methods designed to reduce pain as well as improve efficiency including fractionated light, daylight PDT, and wearable light sources for ambulatory PDT. This active area of research is expected to continue to provide a range of intriguing possibilities.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Acknowledgments

MR Hamblin was supported by US NIH grant R01AI050875.

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Authors and Affiliations

  1. Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, 02114, USA

    Connor Thunshelle & Michael R. Hamblin

  2. Harvard College, Cambridge, MA, 02138, USA

    Connor Thunshelle

  3. Southwest Hospital, Third Military Medical University, Chongqing, 40038, China

    Rui Yin & Qiquan Chen

  4. Department of Dermatology, Harvard Medical School, Boston, MA, 02115, USA

    Michael R. Hamblin

  5. Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, 02139, USA

    Michael R. Hamblin

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  1. Connor Thunshelle
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Correspondence to Michael R. Hamblin.

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Dr. Connor Thunshelle, Dr. Rui Yin, Dr. Qiquan Chen, and Dr. Michael R Hamblin declare that they have no conflict of interest.

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Thunshelle, C., Yin, R., Chen, Q. et al. Current Advances in 5-Aminolevulinic Acid Mediated Photodynamic Therapy. Curr Derm Rep 5, 179–190 (2016). https://doi.org/10.1007/s13671-016-0154-5

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