5-aminolevulinic acid-mediated photodynamic diagnosis using fluorescence ureterorenoscopy for urinary upper tract urothelial carcinoma ∼Preliminary prospective single centre trial∼

Fukuhara, Hideo; Kurabayashi, Atsushi; Furihata, Mutsuo; Setuda, Shouhei; Takahashi, Kiwamu; Murakami, Kiyotaka; Tanaka, Toru; Inoue, Keiji

doi:10.1016/j.pdpdt.2019.101617

Cited by 21 publications

(18 citation statements)

References 26 publications

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“…5-ALA PDD has also been reported to be useful for the diagnosis of upper urinary tract tumors, including CIS lesions, in a preliminary prospective single-center trial [ 6 , 87 ]. In an analysis of 31 biopsy specimens, the sensitivity of 5-ALA PDD ureterorenoscopy was apparently higher than that of conventional ureterorenoscopy using a white light source.…”

Section: 5-ala-pddmentioning

confidence: 99%

5-Aminolevulinic Acid-Induced Protoporphyrin IX Fluorescence Imaging for Tumor Detection: Recent Advances and Challenges

Harada

Murayama

Takamatsu

et al. 2022

IJMS

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5-Aminolevulinic acid (5-ALA) is a natural amino acid and a precursor of heme and chlorophyll. Exogenously administered 5-ALA is metabolized into protoporphyrin IX (PpIX). PpIX accumulates in cancer cells because of the low activity of ferrochelatase, an enzyme that metabolizes PpIX to heme. High expression of 5-ALA influx transporters, such as peptide transporters 1/2, in cancer cells also enhances PpIX production. Because PpIX radiates red fluorescence when excited with blue/violet light, 5-ALA has been used for the visualization of various tumors. 5-ALA photodynamic diagnosis (PDD) has been shown to improve the tumor removal rate in high-grade gliomas and non-muscular invasive bladder cancers. However, 5-ALA PDD remains a challenge as a diagnostic method because tissue autofluorescence interferes with PpIX signals in cases where tumors emit only weak signals, and non-tumorous lesions, such as inflammatory sites, tend to emit PpIX fluorescence. Here, we review the current outline of 5-ALA PDD and strategies for improving its diagnostic applicability for tumor detection, focusing on optical techniques and 5-ALA metabolic pathways in both viable and necrotic tumor tissues.

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Section: 5-ala-pddmentioning

confidence: 99%

5-Aminolevulinic Acid-Induced Protoporphyrin IX Fluorescence Imaging for Tumor Detection: Recent Advances and Challenges

Harada

Murayama

Takamatsu

et al. 2022

IJMS

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“…22,[24][25][26][27][29][30][31] However, there is no consensus as to whether ALA-PDD improved the progression-free survival rate. 22,25,29,31,32 In addition to the indications related to the bladder, ALA-PDD has also been shown to be effective in the diagnosis of ureteropelvic ducted in Japan demonstrated that ALA-PDD was as effective as in the bladder, 33 and other studies are being conducted to examine the use of ALA-PDD in other types of cancers.…”

Section: Photodynamic Diagnosis (Pdd)mentioning

confidence: 99%

“…In addition to the indications related to the bladder, ALA‐PDD has also been shown to be effective in the diagnosis of ureteropelvic UC in recent studies. An investigator‐initiated clinical study conducted in Japan demonstrated that ALA‐PDD was as effective as in the bladder, 33 and other studies are being conducted to examine the use of ALA‐PDD in other types of cancers.…”

Section: Introductionmentioning

confidence: 99%

Current status of photodynamic technology for urothelial cancer

et al. 2021

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In a recent study, Malik and Lugaci 1 described the research and development of 5-aminolevulinic acid (5-ALA) as a new-generation photosensitizer with high tumor specificity. The use of 5-ALA-based photodynamic technology has since been examined in a number of studies worldwide, such as in photodynamic diagnosis (PDD), in which it is used to detect tumors by illuminating the lesion with a specific wavelength of light to produce fluorescence after administration of 5-ALA; photodynamic therapy (PDT), in which it is used to induce cell death; and in photodynamic screening (PDS), in which porphyrin excretion in the blood and urine is used as a tumor biomarker. Thus, a number of applications using 5-ALA are expected to emerge in the clinical setting. | 5-Aminolevulinic acid (5-ALA) as a photosensitizer5-ALA is a natural amino acid produced in plants and animals, and it is a common precursor of hemoglobin and chlorophyll (Figures 1, 2).Endogenous 5-ALA is generated from glycine and succinyl CoA in the mitochondria by an enzymatic reaction induced by the 5-ALA synthetic enzyme, whereas exogenous 5-ALA may also be introduced into cells by its administration. In normal cells, both endogenous and exogenous 5-ALA produce a precursor through the same biosynthetic and metabolic pathways in the cytoplasm, and the precursor is transported to the mitochondria via the ATP-binding cassette (ABC) subfamily B member 6 (ABCB6) to produce protoporphyrin IX (PpIX). Subsequently, ferrochelatase catalyzes the insertion of ferrous iron into PpIX to form

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“…The natural access throughout the urethra and the well-developed ureteroscopy technics provide the possibility of accessing the tumors without needing insertion with minor aggressiveness. The use of the photosensitizer has helped to improve tumor detection in this setting [17][18][19][20].…”

Section: Agent Cancer Types Administrationmentioning

confidence: 99%

Developments in Vascular-Targeted Photodynamic Therapy for Urologic Malignancies

et al. 2020

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With improved understanding of cancer biology and technical advancements in non-invasive management of urological malignancies, there is renewed interest in photodynamic therapy (PDT) as a means of focal cancer treatment. The application of PDT has also broadened as a result of development of better-tolerated and more effective photosensitizers. Vascular-targeted PDT (VTP) using padeliporfin, which is a water-soluble chlorophyll derivative, allows for tumor-specific cytotoxicity and has demonstrated efficacy in the management of urologic malignancies. Herein, we describe the evolution of photodynamic therapy in urologic oncology and the role of VTP in emerging treatment paradigms.

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5-aminolevulinic acid-mediated photodynamic diagnosis using fluorescence ureterorenoscopy for urinary upper tract urothelial carcinoma ∼Preliminary prospective single centre trial∼

Cited by 21 publications

References 26 publications

5-Aminolevulinic Acid-Induced Protoporphyrin IX Fluorescence Imaging for Tumor Detection: Recent Advances and Challenges

5-Aminolevulinic Acid-Induced Protoporphyrin IX Fluorescence Imaging for Tumor Detection: Recent Advances and Challenges

Current status of photodynamic technology for urothelial cancer

Developments in Vascular-Targeted Photodynamic Therapy for Urologic Malignancies

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