Abstract
BackgroundPhotodynamic therapy (PDT) using 5-aminolevulinic acid (ALA) has previously shown promising results in cancerous cell destruction. The present study was conducted to evaluate the efficacy of this treatment option on oral epithelial dysplasia in Wistar rats. Furthermore, microscopic effects of systemic versus topical administration of ALA before laser illumination was assessed.Material and MethodsThirty male Wistar rats (200- 250 grams) were used in the present study. Tongue dysplasia was induced by a daily delivery of a 20 ppm solution of 4-nitroquinoline -1- oxide (4NQO) for 3 months. Then, rats were divided into 3 groups of 10 including, group 1 that was received systemic ALA-based PDT (30 mg/kg ALA), group 2 that was received topical ALA-based PDT (20% ALA solution) and group 3 (control) which was left untreated. Tongue specimens were fixed for histopathological evaluation and dysplasia was graded at microscopic level. Data was compared between various treatment groups using Mann Whitney test (p<0.05).ResultsThe rate of atypical dysplastic cells was decreased significantly in both topical (p= 0.006) and systemic (p= 0.001) treatment groups compared to control group. Furthermore, systemic use of ALA resulted in a remarkable destruction of dysplastic cells compared to its topical application (p=0.045). Nevertheless, some evidence of muscle destruction was documented in systemic ALA group.ConclusionsIt seems that ALA mediated PDT is an effective treatment option for the destruction of dysplastic cells. However, the extent of this effect depends on the mode of ALA administration before light illumination. Key words:Photodynamic therapy, 5-aminolevulinic acid, Dysplasia, Potentially malignant disorders.
Highlights
Oral epithelial dysplasia has been defined as the presence of architectural and cytological alterations with an increased likelihood of progression to cancer (1)
Qualitative assessment of samples in the control group showed a higher score of dysplasia in posterior areas of rats’ tongue
The results showed that topical and systemic aminolevulinic acid (ALA)-based Photodynamic therapy (PDT) treatment significantly reduced the rate of dysplasia (p
Summary
Oral epithelial dysplasia has been defined as the presence of architectural and cytological alterations with an increased likelihood of progression to cancer (1). The present study was conducted to examine the efficacy of topical and systemic ALA-based PDT in a rat experimental model of tongue epithelial dysplasia. After 12 weeks, rats’ oral tissues, especially posterior lateral borders of the tongues, in the control group was inspected macroscopically to detect clinical changes such as leukoplakia or erythroplakia. Rats were superficially anesthetized and a swab which was impregnated with ALA solution was rubbed onto the posterior one third of lateral border of rats’ tongues. This procedure was repeated two hours later.
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