biophBiomedical PhotonicsBiomedical Photonics2413-9432Non-profit partnership for development of domestic photodynamic therapy and photodiagnosis10.24931/241-9432-2024-13-3-42-46bioph-661Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESФотодинамическая терапия в профилактике ВПЧ- индуцированных рецидивов предрака и начального рака шейки маткиPhotodynamic therapy in the prevention of HPV-induced recurrences of precancer and initial cancer of the cervixТрушинаО. И.TrushinaO. I.

Москва

Moscow

o.trushina@list.ruФилоненкоЕ. В.FilonenkoE. V.

Москва

Moscow

НовиковаЕ. Г.NovikovaE. G.

Москва

Moscow

МухтарулинаС. В.MukhtarulinaS. V.

Москва

Moscow

«Московский научно-исследовательский онкологический институт им. П.А. Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Министерства здравоохранения Российской ФедерацииРоссияP.A. Herzen Moscow Oncology Research Center – branch of FSBI NMRRC of the Ministry of Health of the Russian FederationRussian Federation2024011120241334246Copyright © Трушина О.И., Филоненко Е.В., Новикова Е.Г., Мухтарулина С.В., 20242024Трушина О.И., Филоненко Е.В., Новикова Е.Г., Мухтарулина С.В.Trushina O.I., Filonenko E.V., Novikova E.G., Mukhtarulina S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pdt-journal.com/jour/article/view/661

Фотодинамическая терапия (ФДТ) обладает противовирусной активностью и является эффективным методом профилактики цервикальных ВПЧ-ассоциированных рецидивов. В нашем исследовании была оценена эффективность профилактической противорецидивной ФДТ культи шейки матки на втором этапе после высокой ампутации шейки матки у 65 пациенток с клиническим диагнозом carcinoma in situ и 35 – с диагнозом РШМ 1А1 ст. В качестве фотосенсибилизатора использовали аппликационно препарат на основе 5-аминолевулиновой кислоты (5-АЛК) в виде 12%-го геля в дозе 0,1 мг/см2. Облучение проводили через 4 ч (световая доза – 150 Дж/ см2). Полная эрадикация ДНК ВПЧ была достигнута у 94% пациенток. В остальных 6% наблюдениях противовирусный эффект зарегистрирован в виде эрадикации одного или двух типов при множественном инфицировании ВПЧ с доминированием 16 и 18 штаммов, или значительном снижении вирусной нагрузки. Сроки наблюдения составили от 3 до 10 лет. Стойкий противовирусный эффект в течение всего периода наблюдения сохранялся у 93 (93%) женщин. Таким образом, ФДТ культи шейки матки с 5-АЛК обеспечивает выраженный противовирусный эффект на втором этапе лечения предопухолевой и начальной опухолевой патологии шейки матки за счет селективного накопления фотосенсибилизатора в инфицированных клетках с последующим их прямым фототоксическим и фотохимическим разрушением до базальных и парабазальных слоев эпителия, в которых происходит репликация вируса.

Photodynamic therapy (PDT) has antiviral activity and is an effective method for preventing cervical HPV-associated relapses. In our study, we assessed the effectiveness of prophylactic anti-relapse PDT of the cervical stump at the second stage after high amputation of the cervix in 65 patients with a clinical diagnosis of carcinoma in situ and 35 with a diagnosis of cervical cancer stage 1A1. As a photosensitizer, a drug based on 5-aminolevulinic acid (5-ALA) in the form of a 12% gel at a dose of 0.1 mg/cm2 was used. Irradiation was performed after 4 hours (light dose – 150 J/ cm2). Complete eradication of HPV DNA was achieved in 94% of patients. In the remaining 6% of observations, the antiviral effect was registered as eradication of one or two types in case of multiple HPV infection with dominance of strains 16 and 18, or a significant decrease in the viral load. The observation periods ranged from 3 to 10 years. A persistent antiviral effect was maintained throughout the observation period in 93 (93%) women. Thus, PDT of the cervical stump with 5-ALA provides a pronounced antiviral effect at the second stage of treatment of precancerous and initial tumor pathology of the cervix due to the selective accumulation of the photosensitizer in infected cells with their subsequent direct phototoxic and photochemical destruction to the basal and parabasal layers of the epithelium, in which virus replication occurs.

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The authors declare that there are no conflicts of interest present.