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