Summary Sparing of normal tissue, mouse tail skin, by fractionation of light treatment in photodynamic therapy has been demonstrated in BDF1 mice injected with 2mg tetrasodium-meso-tetra(4-sulphophenyl) porphine dodecahydrate i.v. When the time between 2 fractions of 67.5 Jcm-2 and 90Jcm-2 was increased to 2 and 4 days respectively the incidence of necrosis fell to that expected after a single fraction. Blood flow in the tail skin 5 days after the second light fraction, as measured by the clearance of an intradermally injected solution of 133xenon in 0.9% saline, returned to control values when the time between 2 fractions was 2 days with 67.51Jcm-2 fractions, and 3 days with 90Jcm-2 fractions. al., 1987) and chloroaluminium phthalocyanine (Ben Hur et al., 1985).Evidence that environmental conditions may modulate the expression of this sublethal damage initially came from studies on the effect of temperature on the shapes of cell survival curves following PDT. Moan et al. (1979a) noted that following exposure to HP, irradiation of NHIK cells in vitro at 4°C resulted in more efficient inactivation than irradiation at 37°C and there was no shoulder on the cell survival curve. Subsequently, Gomer et al. (1985) demonstrated an inhibition of repair of 'potentially lethal damage' when Chinese hamster lung fibroblasts that had received prolonged exposure to HPD, were held post-irradiation at 4°C or in the presence of the metabolic inhibitor caffeine.Attempts to measure repair of sub-lethal damage by splitdose experiments in vitro have been reported by Moan et al. (1979a), who found that for NHIK cells exposed to light in the presence of HP, a given total light dose was more efficient when it was fractionated than when given in a single exposure. Subsequently however, Christensen et al. (1985) used the same cell line to demonstrate that relative survival after two doses was a complex function of the interval between doses and that 'sparing' occurred with a 3 h interval. Bellnier & Lin (1985) found that survival of EJ human urinary bladder carcinoma cells rapidly increased with interval between two light fractions, reaching a maximum at 9 h.The aim of the present study was to determine whether or not fractionation of light treatment resulted in sparing of tissue in vivo, using as a model normal mouse tail skin. (Sacchini et al., 1987). Tissue injury was assessed using two endpoints:1. the incidence of tail necrosis, as described by Moore et al. (1986); and 2. blood flow in the mouse tail skin 5 days after a second light fraction as measured by the clearance of 133xenon injected intradermally. There is evidence that impairment of vascular function is an important mechanism resulting in damage to both malignant and normal tissues. A previous study found an initial impairment in blood flow following PDT but this returned to normal by day 5 at low light doses. However, at light doses greater than the threshold for skin necrosis, there was increasing impairment of blood flow on day 5 (Benstead & Moore, 1988).
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