局部5-氨基酮戊酸光动力疗法治疗增生性瘢痕的进展(2)
4小结
综上所述，大多导致瘢痕形成的因素同时也是创伤修复的必要条件，然而其中任何一个环节超过生理需要的增加都有可能导致瘢痕的产生。由于增生性瘢痕的类肿瘤性，越来越多的学者开始关注PDT作用于增生性瘢痕模型的疗效中，并取得了初步成就，其中ALA及其酯化衍生物MAL为现今最为常用的光敏剂。但病理性瘢痕的形成是一个长期的过程，关于ALA-PDT防治增生性瘢痕的研究仍停留在早期阶段，远期疗效有待学者进一步研究证实。此外，ALA-PDT治疗瘢痕的机制还有待进一步深入了解，对于光敏剂的种类、剂量、给药途径的选择以及光动力学治疗的途径、激光的最佳波长、照射的最佳功率密度及能量密度仍需进一步探究。
[参考文献]
[1]Gauglitz GG,Korting HC,Pavicic T,et al. Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies [J].Mol Med,2011,17(1-2):113-125.
[2]Cai H,Gu Y,Sun Q,et al.Effect of hematoporphyrin monomethyl ether-mediated photodynamic therapy on hypertrophic scar fibroblasts [J].Photodermatol Photoimmunol Photomed,2011,27(2):90-96.
[3]Moan J，Peng Q.An outline of the hundred-year history of PDT [J].Anticancer Res,2003,23(5A):3591-3600.
[4]Lang K,Schulte KW,Ruzicka T,et al. Aminolevulinic acid (Levulan) in photodynamic therapy of actinic keratoses [J].Skin Therapy Lett,2001,6(10):1-2.
[5]Mendoza J,Sebastian A,Allan E,et al. Differential cytotoxic response in keloid fibroblasts exposed to photodynamic therapy is dependent on photosensitiser precursor, fluence and location of fibroblasts within the lesion[J].Arch Dermatol Res,2012, 304(7):549-562.
[6]谭赵云,赵柏程,钱利，等.VEGF和TSP-1在病理性瘢痕中的表达及其意义[J].中国美容整形外科杂志,2008,19(5):348-352.
[7]Saczko J,Chwilkowska A,KulbackaJ,et al.Photooxidative action in cancer and normal cells induced by the use of photofrin in photodynamic therapy[J].Folia Biol (Praha),2008,54(1):24-29.
[8]Jarvi MT,Niedre MJ,Patterson MS,et al. Singlet oxygen luminescence dosimetry (SOLD) for photodynamic therapy: current status, challenges and future prospects [J].Photochem Photobiol,2006,82(5): 1198-1210.
[9]Brancaleon L,Moseley H.Lasers and non-laser light sources for photodynamic therapy [J].Lasers Med Sci,2002,17(3):173-186.
[10]Britton JE,Goulden V,Stables G,et al. Investigation of the use of the pulsed dye laser in the treatment of Bowen's disease using 5-aminolaevulinic acid phototherapy [J].Br J Dermatol,2005,153(4):780-784.
[11]Ibbotson SH,Jong C,Lesar A,et al. Characteristics of 5-aminolaevulinic acid-induced protoporphyrin IX fluorescence in human skin in vivo[J].Photodermatol Photoimmunol Photomed,2006,22(2):105-110.
[12]George S,Kishen A.Influence of Photosensitizer Solvent on the Mechanisms of Photoactivated Killing of Enterococcus faecalis[J].Photochem Photobiol,2007,84(3):734-740.
[13]陶灵,李世荣,刘剑毅,等.JAK-STATs通路在CTGF刺激人增生性瘢痕成纤维细胞增殖分化中的作用 [J].中国美容医学,2008,17(11): 1642-1644.
[14]Bux S,Madaree A.Keloids show regional distribution of proliferative and degenerate connective tissue elements [J]. Cells Tissues Organs,2010,191(3):213-234.
[15]Phan TT, Sun L, Bay BH, et a1. Dietary compounds inhibit proliferation and contraction of keloid and hypertrophic scar derived fibroblasts in vitro：therapeutic implication for excessive scarring[J].J Tauma,2003,54(6):1212-1224.
[16]蔡宏,顾瑛,曾晶,等.HMME-PDT对兔耳增生性瘢痕块成纤维细胞增殖能力及其超微结构的影响 [J].中国激光医学杂志,2008,17(3):157-161.
[17]李昕,周兆平,张文杰,等. 5-氨基酮戊酸介导的光动力对人增生性瘢痕成纤维细胞的影响 [J].中国整形外科杂志,2011,22(7):405-408. (常梦玲 马晓荣 欧阳天祥)
综上所述，大多导致瘢痕形成的因素同时也是创伤修复的必要条件，然而其中任何一个环节超过生理需要的增加都有可能导致瘢痕的产生。由于增生性瘢痕的类肿瘤性，越来越多的学者开始关注PDT作用于增生性瘢痕模型的疗效中，并取得了初步成就，其中ALA及其酯化衍生物MAL为现今最为常用的光敏剂。但病理性瘢痕的形成是一个长期的过程，关于ALA-PDT防治增生性瘢痕的研究仍停留在早期阶段，远期疗效有待学者进一步研究证实。此外，ALA-PDT治疗瘢痕的机制还有待进一步深入了解，对于光敏剂的种类、剂量、给药途径的选择以及光动力学治疗的途径、激光的最佳波长、照射的最佳功率密度及能量密度仍需进一步探究。
[参考文献]
[1]Gauglitz GG,Korting HC,Pavicic T,et al. Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies [J].Mol Med,2011,17(1-2):113-125.
[2]Cai H,Gu Y,Sun Q,et al.Effect of hematoporphyrin monomethyl ether-mediated photodynamic therapy on hypertrophic scar fibroblasts [J].Photodermatol Photoimmunol Photomed,2011,27(2):90-96.
[3]Moan J，Peng Q.An outline of the hundred-year history of PDT [J].Anticancer Res,2003,23(5A):3591-3600.
[4]Lang K,Schulte KW,Ruzicka T,et al. Aminolevulinic acid (Levulan) in photodynamic therapy of actinic keratoses [J].Skin Therapy Lett,2001,6(10):1-2.
[5]Mendoza J,Sebastian A,Allan E,et al. Differential cytotoxic response in keloid fibroblasts exposed to photodynamic therapy is dependent on photosensitiser precursor, fluence and location of fibroblasts within the lesion[J].Arch Dermatol Res,2012, 304(7):549-562.
[6]谭赵云,赵柏程,钱利，等.VEGF和TSP-1在病理性瘢痕中的表达及其意义[J].中国美容整形外科杂志,2008,19(5):348-352.
[7]Saczko J,Chwilkowska A,KulbackaJ,et al.Photooxidative action in cancer and normal cells induced by the use of photofrin in photodynamic therapy[J].Folia Biol (Praha),2008,54(1):24-29.
[8]Jarvi MT,Niedre MJ,Patterson MS,et al. Singlet oxygen luminescence dosimetry (SOLD) for photodynamic therapy: current status, challenges and future prospects [J].Photochem Photobiol,2006,82(5): 1198-1210.
[9]Brancaleon L,Moseley H.Lasers and non-laser light sources for photodynamic therapy [J].Lasers Med Sci,2002,17(3):173-186.
[10]Britton JE,Goulden V,Stables G,et al. Investigation of the use of the pulsed dye laser in the treatment of Bowen's disease using 5-aminolaevulinic acid phototherapy [J].Br J Dermatol,2005,153(4):780-784.
[11]Ibbotson SH,Jong C,Lesar A,et al. Characteristics of 5-aminolaevulinic acid-induced protoporphyrin IX fluorescence in human skin in vivo[J].Photodermatol Photoimmunol Photomed,2006,22(2):105-110.
[12]George S,Kishen A.Influence of Photosensitizer Solvent on the Mechanisms of Photoactivated Killing of Enterococcus faecalis[J].Photochem Photobiol,2007,84(3):734-740.
[13]陶灵,李世荣,刘剑毅,等.JAK-STATs通路在CTGF刺激人增生性瘢痕成纤维细胞增殖分化中的作用 [J].中国美容医学,2008,17(11): 1642-1644.
[14]Bux S,Madaree A.Keloids show regional distribution of proliferative and degenerate connective tissue elements [J]. Cells Tissues Organs,2010,191(3):213-234.
[15]Phan TT, Sun L, Bay BH, et a1. Dietary compounds inhibit proliferation and contraction of keloid and hypertrophic scar derived fibroblasts in vitro：therapeutic implication for excessive scarring[J].J Tauma,2003,54(6):1212-1224.
[16]蔡宏,顾瑛,曾晶,等.HMME-PDT对兔耳增生性瘢痕块成纤维细胞增殖能力及其超微结构的影响 [J].中国激光医学杂志,2008,17(3):157-161.
[17]李昕,周兆平,张文杰,等. 5-氨基酮戊酸介导的光动力对人增生性瘢痕成纤维细胞的影响 [J].中国整形外科杂志,2011,22(7):405-408. (常梦玲 马晓荣 欧阳天祥)