A review of photodynamic therapy in cutaneous leishmaniasis

Abstract

We present a review of six clinical studies investigating the use of photodynamic therapy (PDT) using porphyrin precursors for the treatment of Old World cutaneous leishmaniasis (CL). Thirty-nine patients with a total of 77 lesions received PDT using a range of treatment schedules following topical application of aminolevulinic acid (ALA) or methyl-aminolevulinate (MAL). The tissue response to PDT is accompanied by a mild burning sensation, erythema and reversible hypo- and hyperpigmentation. Few mechanistic studies have addressed the principles underlying the use of PDT for CL. All six reviewed papers suggest that PDT with porphyrin precursors is relatively effective in treating CL. Data are still limited, and PDT cannot at this point be recommended in routine clinical practice. The mechanism of action of this promising therapeutic modality needs to investigated further and additional controlled trials need to be performed.

Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis

“…In a large-scale study, Al-Gindan et al [101] obtained a cure rate of 27% [76]. Another physical treatment employed is photodynamic therapy (PDT) using porphyrin precursors as sensitizers to treat cutaneous leishmaniasis [102]. An advantage of PDT is the cosmetic result, and this treatment may prevent the development of drug resistance.…”

Enhanced photodynamic leishmanicidal activity of hydrophobic zinc phthalocyanine within archaeolipids containing liposomes

“…24 PDT has been widely used to eliminate diseased cells or pathogens, and has been employed with variable outcomes in experimental and clinical settings against CL. 25 PDT could avoid the problem of drug resistance, since the generated ROS could target multiple sites on the parasite. Currently, four main classes of PS -porphyrin derivatives, chlorins, porphycenes, and phthalocyanineshave been approved by the US Food and Drug Administration for the clinical treatment of cancer.…”

Antiparasitic effects of gold nanoparticles with microwave radiation on promastigotes and amastigotes ofLeishmania major

“…The effects of photodynamic therapy have also been studied in the treatment of CL [41][42][43]. The suggested mechanisms of action are direct toxic damage caused by the release of reactive oxygen species and the host immunomodulatory response [44]. Kosaka et al attributed the antiparasitic effects of PDT to host factors such as including its impacts on macrophages and its role in vascular injury [45].…”