Abstract
ALA-mediated Photodynamic Therapy (ALA-PDT) is one of the most promising fields in Photodynamic therapy (PDT) research for cancer treatment. 5-aminolaevulinic acid (ALA) is the prodrug of the photosensitiser Protoporphyrin IX (PpIX). After ALA administration, cells generate PpIX through the haem biosynthetic pathway. Although the exact reasons for ALA/PpIX selectivity are unknown, it is believed that due to the special regulation of haem enzymes, PpIX is accumulated in the tumours. Both ALA and its derivative ALA Methyl ester, are mainly used in dermatology. Besides, ALA-PDT has been employed for palliative and even curative treatment of endoscopically accessible tumours. Lung, oesophagus, gastric and bladder carcinomas, and also oral premalignant lesions, gynaecological intraepithelial neoplasias and Barrett's oesophagus are the conditions mostly treated with ALA-PDT. However, due to the limited penetration of ALA and light, non-dermatologic uses of ALA-PDT have not moved beyond phase I clinical trials. On the other hand, ALA-induced PpIX fluorescence is successfully employed for the Photodynamic Diagnosis (PDD) or assistance in cytoreductive surgery (Fluorescence-guided Resection, FGR). ALA has been approved for the FGR of hi...Continue Reading
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