Optimization of topical photodynamic therapy with 3,7-bis(di-n-butylamino)phenothiazin-5-ium bromide for cutaneous leishmaniasis
✍ Scribed by Oleg E. Akilov; Wajeeha Yousaf; Sebastian X. Lukjan; Sarika Verma; Tayyaba Hasan
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 321 KB
- Volume
- 41
- Category
- Article
- ISSN
- 0196-8092
No coin nor oath required. For personal study only.
✦ Synopsis
Abstract
Background and Objective
Photodynamic therapy (PDT) has evolved as a promising therapeutic measure for the treatment of cutaneous leishmaniasis (CL). In particular, phenothiazine compounds have demonstrated efficacy for PDT of CL. The objective of our present study is to define the use of a new specific phenothiazine photosensitizer, 3,7‐bis(di‐n‐butylamino)phenothiazin‐5‐ium bromide (PPA904) applied topically as a cream to treat CL.
Materials and Methods
To establish the optimal conditions for this treatment, we compared two different ways to improve current regimens of PDT with PPA904 cream (500 µM of PPA904 in Unguentum M) by changing the duration of topical application, and by administration of several consecutive PDT procedures. An initial regimen recommended by the manufacturer (Photopharmica Co. Ltd., Leeds, UK) was maintained as a control: the cream was applied topically for 30 minutes at a final concentration of PPA904 at 500 µM, and the designated treatment area was irradiated with a broad band light source of 665±15 nm at a fluence of 50 J/cm^2^ (50 mW/cm^2^).
Results
The best curative PPA904‐PDT regimen was achieved under the conditions of a longer duration of topical application time (90 minutes) and several (three) consecutive treatments with 4‐day intervals between treatments. The mechanisms responsible for such improvements (kinetics of drug penetration, depth of necrosis of the CL lesions after PDT, and daily changes in the parasitic load after PDT) are discussed in the present study.
Conclusion
Topical PPA904‐PDT, implemented as described above, is a promising treatment for CL, and clinical studies will be initiated to establish efficacy in humans. Lasers Surg. Med. 41:358–365, 2009. © 2009 Wiley‐Liss, Inc.