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Efficacy of photodynamic therapy in the treatment of venous trophic ulcers: results from the experiment

https://doi.org/10.21518/1995-1477-2022-19-2-82-94

Abstract

Introduction. Today, antimicrobial photodynamic therapy (a-PDT) becomes more and more popular, because of it pronounced bactericidal activity, anti-inflammatory effect. At the same time, no animal model studies have been conducted on morphological changes in cells after exposure to PDT on venous ulcers (VU) when using different types of photosensitizers (PS). The problem of comparing morphological changes in tissues when using a-PDT vs conventional PDT have not yet been resolved.

Aim. Evaluation of the effectiveness of PDT and APDT in a comprehensive examination of trophic ulcers in an in vivo experiment and compare them with standard methods for the treatment of VLU.

Materials and мethods. A series of experiments was conducted on 21 rabbits, separated into 3 equal groups of 7 rabbits each. Venous trophic ulcer was originally modeled for all rabbits. To obtain a VU, we performed an additional ligation of v. femoralis. The control group received standard therapy for VU. The PDT group had PDT with Photosens. The a-PDT group underwent a-PDT using Cholosens. Every 3 days, picture of local inflammation, regeneration rate and ulcer volume were determined. A morphological study of VLU was carried out on the first, 9th and 15th days.

Results. The a-PDT group, day 15: 100% wound epithelization. Control group, day 21st: The volume of wounds decreased on average by 50%. The PDT group: 100% wound epithelization. The morphological study indicated a positive trend in the a-PDT group compared with PDT and control groups, which resulted in a decrease in the total mass of necrotic detritus, a change in the quantitative and qualitative composition of inflammatory infiltrate.

Conclusion. The data obtained indicate that the use of a-PDT is recommended in treatment of VLU. Both PDT and a-PDT methods showed better results in comparison with standard therapy.

About the Authors

B. V. Boldin
Pirogov Russian National Research Medical University
Russian Federation

Boris V. Boldin - Dr. Sci. (Med.), Professor, Head of Department of Intermediate Level Surgery No. 2.

1, Ostrovityanov St., Moscow, 117997



P. Yu. Turkin
Pirogov Russian National Research Medical University
Russian Federation

Pavel Yu. Turkin - Cand. Sci. (Med.), Associate Professor, Department of Intermediate Level Surgery No. 2.

1, Ostrovityanov St., Moscow, 117997



A. P. Oettinger
Pirogov Russian National Research Medical University
Russian Federation

Alexander P. Oettinger - Dr. Sci. (Med.), Professor, Head of Department of Organization of Biomedical Research Projects.

1, Ostrovityanov St., Moscow, 117997



V. Yu. Bogachev
Pirogov Russian National Research Medical University
Russian Federation

Vadim Yu. Bogachev - Dr. Sci. (Med.), Professor, Department of Intermediate Level Surgery No. 2.

1, Ostrovityanov St., Moscow, 117997



N. O. Somov
Pirogov Russian National Research Medical University
Russian Federation

Nikita O. Somov - Teaching Assistant, Department of Intermediate Level Surgery No. 2.

1, Ostrovityanov St., Moscow, 117997



S. G. Kuzmin
International Research and Clinical Center ‘Intermedbiophiskhim’; Research Institute of Organic Intermediates and Dyes
Russian Federation

Sergey G. Kuzmin - Deputy Director, International Research and CCI; Scientific Director, RIO Intermediates and Dyes.

Bldg. 1, 5/23, Nizhniy Kiselnyy Per., Moscow, 103752; 7, Likhachevskiy Proezd, Dolgoprudnyi, Moscow Region, 123995



V. B. Loschenov
Prokhorov General Physics Institute of the Russian Academy of Sciences
Russian Federation

Victor B. Loschenov - Dr. Sci. (Phys.-Math.), Professor, Prokhorov General Physics Institute RAS; Head of Laser Biospectroscopy Laboratory, Light-Induced Surface Phenomena Department, NSC.

38, Vavilov St., Moscow, 119991; Block L-2, 38, Vavilova St., Moscow, 125252



L. M. Mikhaleva
Avtsyn Research Institute of Human Morphology of Petrovsky National Research Centre of Surgery
Russian Federation

Liudmila M. Mikhaleva - Acad. RAS, Dr. Sci. (Med.), Professor, Director.

3, Tsyurupa St., Moscow, 117418



K. Yu. Midiber
Avtsyn Research Institute of Human Morphology of Petrovsky National Research Centre of Surgery; City Clinical Hospital No. 31; Peoples’ Friendship University of Russia
Russian Federation

Konstantin Yu. Midiber - Researcher, Clinical Morphology Laboratory, Avtsyn Research Institute of Human Morphology of PNRCS; Anatomopathologist, CCH No.31; Teaching Assistant, Department of Pathologic Anatomy at the Medical Institute, Peoples' FUR.

3, Tsyurupa St., Moscow, 117418,; Bldg. 1, 42, Lobachevskogo St., Moscow, 42119415,; 6, Miklukho-Maklai St., Moscow, 117198



References

1. Weller C.D., Richards C., Turnour L., Patey A.M., Russell G., Team V. Barriers and enablers to the use of venous leg ulcer clinical practice guidelines in Australian primary care: A qualitative study using the theoretical domains framework. Int J Nurs Stud. 2020;103:103503. https://doi.org/10.1016/j.ijnurstu.2019.103503.

2. Nicolaides A., Kakkos S., Baekgaard N., Comerota A., de Maeseneer M., Eklof B. et al. Management of chronic venous disorders of the lower limbs. Guidelines According to Scientific Evidence. Int Angiol. 2014;33(2):87–208. https://doi.org/10.23736/S0392-9590.18.03999-8.

3. Darwin E., Liu G., Kirsner R.S., Lev-Tov H. Examining risk factors and preventative treatments for first venous leg ulceration: a cohort study. J Am Acad Dermatol. 2021;84(1):76–85. https://doi.org/10.1016/j.jaad.2019.12.046.

4. Serra R., Ielapi N., Barbetta A., de Franciscis S. Skin tears and risk factors assessment: a systematic review on evidence based medicine. Int Wound J. 2018;15(1):38–42. https://doi.org/10.1111/iwj.12815.

5. Vasudevan B. Venous leg ulcers: Pathophysiology and Classification. Indian Dermatol Online J. 2014;5(3):366–370. https://doi.org/10.4103/2229-5178.137819.

6. Amir O., Liu A., Chang A.L.S. Stratification of highest-risk patients with chronic skin ulcers in a Stanford retrospective cohort includes diabetes, need for systemic antibiotics, and albumin levels. Ulcers. 2012. https://doi.org/10.1155/2012/767861.

7. Raffetto J.D., Ligi D., Maniscalco R., Khalil R.A., Mannello F. Why Venous Leg Ulcers Have Difficulty Healing: Overview on Pathophysiology, Clinical Consequences, and Treatment. J Clin Med. 2020;10(1):29. https://doi.org/10.3390/jcm10010029.

8. Bowler P., Murphy C., Wolcott R. Biofilm exacerbates antibiotic resistance: Is this a current oversight in antimicrobial stewardship? Antimicrob Resist Infect Control. 2020;9(1):162. https://doi.org/10.1186/s13756-020-00830-6.

9. Katorkin S., Nasyrov M. Local Treatment and Preoperative Preparation of Venous Trophic Ulcers Using Photodynamic Therapy. Novosti Khirurgii. 2015;23(2):182–188. (In Russ.) Available at: https://cyberleninka.ru/article/n/primenenie-fotodinamicheskoy-terapii-vmestnom-lechenii-i-predoperatsionnoy-podgotovke-troficheskih-yazv-venoznoy-etiologii.

10. Szeimies R.M., Karrer S. Photodynamic therapy-trends and new developments. Hautarzt. 2021;72(1):27–33. (In German.) https://doi.org/10.1007/s00105-020-04737-6.

11. Mosti G., Picerni P., Licau M., Mattaliano V. Photodynamic therapy in infected venous and mixed leg ulcers: a pilot experience. J Wound Care. 2018;27(12):816–821. https://doi.org/10.12968/jowc.2018.27.12.816.

12. Corsi A., Lecci P.P., Bacci S., Cappugi P., Pimpinelli N. Early activation of fibroblasts during PDT treatment in leg ulcers. G Ital Dermatol Venereol. 2016;151(3):223-9. Available at: https://pubmed.ncbi.nlm.nih.gov/24927172.

13. Gunaydin G., Gedik M.E., Ayan S. Photodynamic Therapy – Current Limitations and Novel Approaches. Front Chem. 2021;9:691697. https://doi.org/10.3389/fchem.2021.691697.

14. Torabi S., Joharchi K., Kalhori K.A., Sohrabi M., Fekrazad R. Evaluation of antimicrobial photodynamic therapy on wounds infected by Staphylococcus aureus in animal models. Photodiagnosis Photodyn Ther. 2020:102092. https://doi.org/10.1016/j.pdpdt.2020.102092.

15. Sun Y., Ogawa R., Xiao B.H., Feng Y.X., Wu Y., Chen L.H. et al. Antimicrobial photodynamic therapy in skin wound healing: A systematic review of animal studies. Int Wound J. 2020;17(2):285–299. https://doi.org/10.1111/iwj.13269.

16. Sahu K., Sharma M., Gupta P.K. Modulation of inflammatory response of wounds by antimicrobial photodynamic therapy. Laser Therapy. 2015;24(3):201–208. https://doi.org/10.5978/islsm.15-OR-13.

17. Zinatullin R.M. Gizatullin T.R., Pavlov V.N., Kataev V.A., Farkhutdinov R.R., Baymurzina Yu.L. et al. Method for simulating trophic wound in experiment. Patent RU 2510083 C1, 2014. (In Russ.) Available at: https://rusneb.ru/catalog/000224_000128_0002510083_20140320_C1_RU/?ysclid=lagz5nm34e40515536.

18. Lipatovaa A.A. Yusova E.A. Lukyanets. Supramolecular complexation of the cationic derivative of Zn (II) phthalocyanine and sodium alginate in mixed aqueous solutions. Photochem Photobiol Sci. 2018;364:588–594. Available at: www.elsevier.com/locate/jphotochem.

19. Karner L., Drechsler S., Metzger M., Hacobian A., Schädl B., Slezak P. et al. Antimicrobial photodynamic therapy fighting polymicrobial infections – a journey from in vitro to in vivo. Photochem Photobiol Sci. 2020;19(10):1332–1343. https://doi.org/10.1039/d0pp00108b.


Review

For citations:


Boldin B.V., Turkin P.Yu., Oettinger A.P., Bogachev V.Yu., Somov N.O., Kuzmin S.G., Loschenov V.B., Mikhaleva L.M., Midiber K.Yu. Efficacy of photodynamic therapy in the treatment of venous trophic ulcers: results from the experiment. Ambulatornaya khirurgiya = Ambulatory Surgery (Russia). 2022;19(2):82-94. (In Russ.) https://doi.org/10.21518/1995-1477-2022-19-2-82-94

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