Effect of 5-aminolevulinic acid photodynamic therapy on keratinocyte proliferation and apoptosis in condyloma acuminatum

https://doi.org/10.1016/j.pdpdt.2017.03.003Get rights and content

Highlights

Abstract

Background

The effect of 5-aminolevulinic acid photodynamic therapy on keratinocyte proliferation and apoptosis in condyloma acuminatum tissues was evaluated.

Methods

An immunohistochemical method and TdT-mediated dUTP nick end labeling were performed to detect the positive expression of the keratinocyte proliferation-related gene Ki-67 and apoptosis, respectively, in condyloma acuminatum tissues.

Results

Of 52 cases, 44 showed positive expression of Ki-67 in condyloma acuminatum keratinocytes before the treatment, with a positive expression rate of 84.62% (44/52), an expression strength of mostly ++ − +++, and a Ki-67 proliferation index of 80.26 ± 5.07%. After treatment, 22 cases showed positive expression of Ki-67 in condyloma acuminatum keratinocytes, with a positive expression rate of 42.31% (22/52), an expression strength of mostly − − ++, and a proliferation index of 42.67 ± 3.06%. The differences in the positive expression rate, expression strength, and proliferation index in the before- and after-treatment groups were statistically significant (χ2 = 20.070, P < 0.001). For visible apoptotic cells in condyloma acuminatum keratinocytes before the 5-aminolevulinic acid photodynamic treatment, the expression strength was mostly + − ++, and the average apoptotic index was 13.94 ± 2.35%; after treatment, the expression strength was mostly ++ − +++, and the average apoptotic index was 73.88 ± 7.65%; the difference in the apoptotic index between the before and after treatment groups was statistically significant (P < 0.001).

Conclusion

5-Aminolevulinic acid photodynamic therapy can inhibit the proliferation and promote the apoptosis of keratinocytes, and represents an effective mechanism for treating condyloma acuminatum.

Introduction

Condyloma acuminatum is a common, clinical, sexually transmitted disease that is caused by human papilloma virus infection [1]; the infectiousness of the disease is strong, it proliferates quickly, and relapse after treatment is common. Although the wart can be removed by traditional methods such as chemotherapy, application of an 80–90% trichloroacetic acid solution or radiotherapy, application of a 0.5% podophyllotoxin solution, immunotherapy, and cryotherapy with liquid nitrogen, their efficacy is controversial [10], [11], [12], [13], and the human papilloma virus subclinical and latent infection cannot be eliminated. 5-Aminolevulinic acid photodynamic therapy is a new method for treating condyloma acuminatum, as well as carcinoma [2]. It has the advantages of causing less trauma, with a lower recurrence rate of the disease. However, the exact mechanism of 5-aminolevulinic acid photodynamic therapy is unclear; in particular, there has been no study on its effects on condyloma acuminatum cutin cell proliferation and apoptosis. In this study, cutin cell proliferation and apoptosis of condyloma acuminatum tissues before and after 5-aminolevulinic acid photodynamic therapy were assessed to determine the effect of the therapy at the cellular level.

Section snippets

Materials

Fifty-two cases (33 males and 19 females) of condyloma acuminatum from the Dermatology & Venereology Clinic of the First Affiliated Hospital of Zhengzhou University were included in the study. The age range of the patients was 18–60 years, with an average of 33.15 years; the course of disease was 15–120 days, with an average of 51.89 days. The clinical manifestations were typical, the cases were positive (white) by acetic acid wash, the histopathological diagnoses were definite, and the cases

Clinical appearance of the warty lesions after treatment

The warty lesions after treatment (Photo 2) were smaller than those before treatment (Photo 1), and there were fewer warts after treatment.

Expression of Ki-67 in condyloma acuminatum tissues before and after treatment

Among the 52 cases, 44 showed positive expression of Ki-67 in the condyloma acuminatum keratinocytes, with a positive expression rate of 84.62% (44/52), and an expression strength of mostly ++ − +++ (Photo 3); after treatment, 22 cases showed positive expression of Ki-67 in the condyloma acuminatum keratinocytes, with a positive expression rate of 42.31%

Discussion

Condyloma acuminatum is commonly diagnosed in the clinic. According to an epidemiological survey, about 75% of those who are sexually active are infected with the human papilloma virus [3]. More than 30 million people a year are newly infected with condyloma acuminatum worldwide, currently making it the sexually transmitted disease with the fastest annual growth rate. Condyloma acuminatum is highly infectious, reproduces quickly, and commonly relapses after treatment; it has been reported that

Conclusion

Our results provide visible evidence that inhibiting the proliferation of cutin cells and promoting apoptosis in condyloma acuminatum tissues is one of the mechanisms through which 5-aminolevulinic acid photodynamic therapy affects condyloma acuminatum.

Acknowledgements

We would like to thank all the authors of the studies we included in our analysis, which helped us synthesize this meta-meta-analysis.

References (15)

There are more references available in the full text version of this article.

Cited by (0)

This study was funded by a project supported by the National Natural Science Foundation of China (Authorized Number: 81650026).

View full text