Malunga-nomhlaza / unyango / iintlobo / utyando / i-photodynamic-sheet-sheet
Iziqulatho
Unyango lwe-Photodynamic kuMhlaza
Yintoni unyango lwe-photodynamic?
Unyango lwe-Photodynamic (PDT) lunyango olusebenzisa ichiza, elibizwa ngokuba yi-photosensitizer okanye i-photosensitizing agent, kunye nohlobo oluthile lokukhanya. Xa i-photosensitizers ivezwe kubude obuthile bokukhanya, ivelisa uhlobo lweoksijini ebulala iiseli ezikufuphi (1 ?? 3).
I-photosensitizer nganye yenziwe ngokukhanya kobude obuthile (3, 4). Le wavelength inquma ukuba ukukhanya kunokuhamba kangakanani emzimbeni (3, 5). Ke, oogqirha basebenzisa i-photosensitizers ezithile kunye nobude bokukhanya ukunyanga iindawo ezahlukeneyo zomzimba nge-PDT.
Isetyenziswa njani iPTT ukunyanga umhlaza?
Kwinyathelo lokuqala le-PDT kunyango lomhlaza, iarhente ye-photosensitizing igonyelwe kwigazi. Iarhente ifunxwa ziiseli kuwo wonke umzimba kodwa ihlala kwiiseli zomhlaza ixesha elide kunokuba ihlala kwiiseli eziqhelekileyo. Phantse iiyure ezingama-24 ukuya kwezingama-72 emva kwenaliti (1), xa uninzi lwearhente lishiye iiseli eziqhelekileyo kodwa lihlala kwiiseli ezinomhlaza, ithumba liyavezwa kukukhanya. I-photosensitizer kwi-tumor ithatha ukukhanya kwaye ivelise uhlobo olusebenzayo lweoksijini olutshabalalisa iiseli zomhlaza ezikufutshane (1 ?? 3).
Ukongeza ekubulaleni ngokuthe ngqo iiseli zomhlaza, i-PDT ibonakala ngathi iyancipha okanye itshabalalise amathumba ngezinye iindlela ezimbini (1 ?? 4). Ifotosensitizer inokonakalisa imithambo yegazi kwithumba, ngalo ndlela kuthintelwe umhlaza ekufumaneni izondlo eziyimfuneko. I-PDT nayo inokuwenza amajoni omzimba ahlasele iiseli zethumba.
Ukukhanya okusetyenziselwa iPTT kunokuvela kwilaser okanye eminye imithombo (2, 5). Ukukhanya kweLaser kunokuhanjiswa ngeentambo zefayibha (iifayibha ezincinci ezihambisa ukukhanya) ukuhambisa ukukhanya kwiindawo ezingaphakathi komzimba (2). Umzekelo, intambo ye-fiber optic inokufakwa nge-endoscope (ityhubhu ecekeceke, ekhanyisiweyo esetyenziselwa ukujonga izicwili ngaphakathi emzimbeni) kwimiphunga okanye kwindawo yokunyanga umhlaza kula malungu. Eminye imithombo yokukhanya ibandakanya ii-diode ezikhanyisa ukukhanya (ii-LEDs), ezinokusetyenziselwa amathumba angaphezulu, njengomhlaza wolusu (5).
I-PDT ihlala yenziwe njengenkqubo yezigulana ezingalaliswayo (6). I-PDT inokuphinda iphindwe kwaye inokusetyenziswa nezinye iindlela zonyango, ezinje ngoqhaqho, unyango ngemitha, okanye ichemotherapy (2).
I-extracorporeal photopheresis (ECP) luhlobo lwe-PDT apho umatshini usetyenziselwa ukuqokelela iiseli zegazi zesigulana, uzinyange ngaphandle komzimba kunye ne-photosensitizing agent, uziveze ekukhanyeni, emva koko uzibuyisele kwisigulana. I-US Food and Drug Administration (i-FDA) yamkele i-ECP ukunceda ukunciphisa ubunzima beempawu zesikhumba se-T-cell lymphoma engaphendulanga kolunye unyango. Izifundo ziyaqhubeka ukufumanisa ukuba ngaba i-ECP inokuba nesicelo esithile somhlaza wegazi, kunye nokunceda ukunciphisa ukwaliwa emva kokudluliselwa.
Zeziphi iintlobo zomhlaza eziphathwa ngoku nge-PDT?
Ukuza kuthi ga ngoku, i-FDA ivumile iarhente ye-photosensitizing ebizwa ngokuba yi-porfimer sodium, okanye i-Photofrin®, ukuze isetyenziswe kwi-PDT ukunyanga okanye ukukhulula iimpawu zomhlaza wesophageal kunye nomhlaza wesifo somhlaza ongaqhelekanga. I-Porfimer sodium ivunyiwe ukukhupha iimpawu zomhlaza wokuqaqanjelwa ngumhlaza xa umhlaza uphazamisa isopha okanye xa umhlaza ungenakuphathwa ngokwanelisayo ngonyango lwe-laser kuphela. I-Porfimer sodium isetyenziselwa ukunyanga umhlaza wamaphaphu ongekho mncinci kwizigulana ezinganyangekiyo kunyango oluqhelekileyo, kunye nokunciphisa iimpawu kwizigulana ezinomhlaza womhlaza wamaphaphu ongekho mncinci othintela indlela yomoya. Ngo-2003, i-FDA yamkela i-porfimer sodium yonyango lwezilonda ezingaphilanga kwizigulana ezine-Barrett esophagus, imeko enokubangela umhlaza wokuqina.
Yeyiphi imida ye-PDT?
Ukukhanya okufunekayo ukuvula uninzi lweefotosensitizers akunakudlula ngaphezulu kwesinye kwisithathu se-intshi yeethishu (isentimitha enye). Ngesi sizathu, i-PDT ihlala isetyenziselwa ukunyanga ama-tumors ngaphakathi okanye phantsi nje kwesikhumba okanye kuludwe lwamalungu angaphakathi okanye imingxunya (3). I-PDT nayo ayisebenzi kangako ekunyangeni amathumba amakhulu, kuba ukukhanya akunakudlula kude kula mathumba (2, 3, 6). I-PDT lunyango lwasekhaya kwaye ngokubanzi alunakusetyenziselwa ukunyanga umhlaza osele usasazekile (imetastasised) (6).
Ngaba iPDT inayo nayiphi na ingxaki okanye iziphumo ebezingalindelekanga?
I-sodium ye-Porfimer yenza ulusu kunye namehlo athambekele ekukhanyeni malunga neeveki ezi-6 emva konyango (1, 3, 6). Ke, abaguli bayacetyiswa ukuba baphephe ukukhanya kwelanga ngokuthe ngqo kunye nokukhanya okungaphakathi okuqaqambileyo okungenani iiveki ezi-6.
Iifotoensitizers zihlala zakha amathumba kwaye ukukhanya okusebenzayo kugxile kwithumba. Ngenxa yoko, ukonakala kwinyama esempilweni kuncinci. Nangona kunjalo, i-PDT inokubangela ukutsha, ukudumba, iintlungu, kunye nokonzakala kwizicubu ezinempilo ezikufutshane (3). Ezinye iziphumo ebezingalindelekanga ze-PDT zinxulumene nendawo enyangiweyo. Zingabandakanya ukukhwehlela, ingxaki yokuginya, iintlungu zesisu, ukuphefumla okubuhlungu, okanye ukuphefumla kancinci; Iziphumo ebezingalindelekanga zihlala zisesokwexeshana.
Liyintoni ikamva le-PDT?
Abaphandi bayaqhubeka nokufunda iindlela zokuphucula ukusebenza kwe-PDT kwaye bayandise kwezinye i-cancer. Uvavanyo lwezonyango (izifundo zophando) ziyaqhubeka ukuvavanya ukusetyenziswa kwe-PDT yomhlaza wobuchopho, ulusu, iprotate, umlomo wesibeleko, kunye ne-peritoneal cavity (indawo esiswini enamathumbu, isisu, nesibindi). Olunye uphando lujolise kuphuhliso lweefotosensitizers ezinamandla ngakumbi (1), ngakumbi ekujolise kuzo iiseli zomhlaza (1, 3, 5), kwaye zenziwe kukukhanya okunokungena kwizicubu kwaye kunyange amathumba anzulu okanye amakhulu (2). Abaphandi baphanda neendlela zokuphucula izixhobo (1) kunye nokuhanjiswa kwesibane esisebenzayo (5).
Izalathiso ezikhethiweyo
- IDolmans DE, Fukumura D, Jain RK. Unyango lwe-Photodynamic kumhlaza. Umhlaza woPhononongo lweNdalo 2003; 3 (5): 380-387. [PubMed Abstract]
- UWilson BC. Unyango lwe-Photodynamic kumhlaza: imigaqo. Ijenali yaseCanada yeGastroenterology 2002; Isityh. 16 (6): 393--396. [PubMed Abstract]
- Vrouenraets MB, Visser GW, Snow GB, van Dongen GA. Imigaqo esisiseko, ukusetyenziswa kwe-oncology kunye nokuphuculwa kokukhetha kunyango lwe-photodynamic. Uphando lwe-Anticancer 2003; 23 (1B): 505-522. [PubMed Abstract]
- UDougherty TJ, uGomer CJ, uHenderson BW, et al. Unyango lwe-Photodynamic. Ijenali yeZiko loMhlaza leSizwe 1998; 90 (12): 889–905. [PubMed Abstract]
- UGudgin Dickson EF, uGoyan RL, uPottier RH. Imikhombandlela emitsha kunyango lwe-photodynamic. Iiselfowuni kunye neMolekyuli yeBiology 2002; 48 (8): 939-954. [PubMed Abstract]
- ICapella MA, iCapella LS. Ukukhanya kuxhathiso lwee-multidrug: unyango lwe-photodynamic yamathumba amelana neziyobisi. Ijenali yeSayensi yezeByomedical 2003; 10 (4): 361-366. [PubMed Abstract]
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