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Principes d’application clinique de la photothérapie dynamique

Principles of clinical photodynamic therapy

  • Published:
Acta Endoscopica

Résumé

La thérapie photodynamique (PDT) nécessite la conjonction d’un médicament (photosensibilisateur), d’une source lumineuse et d’un diffuseur de lumière. Le photosensibilisateur est excité par la lumière à une longueur d’onde propre et produit des formes réactives de l’oxygène, qui attaquent des structures sub-cellulaires. Les photosensibilisateurs accumulés sélectivement dans les tissus pathologiques peuvent être utilisés pour détruire ce tissu, qu’il soit visible ou non. Dans ce but, une lumière intense mais sub-thermique au tissu est distribuée de façon homogène grâce à des diffuseurs de lumière adaptés à la forme de l’organe (plat, cylindrique, sphérique). Les recherches et le développement de tous les composants essentiels de la PDT ont accompli d’énormes progrès tant en termes d’efficacité, que de fiabilité et de rentabilité.

Plusieurs photosensibilisateurs ont déjà été approuvés dans différents pays et d’autres sont en cours. Une expérience clinique considérable a été rapportée dans le traitement de l’œsophage de Barrett et le traitement palliatif des cholangiocarcinomes semble très prometteur.

Summary

The implementation of Photodynamic Therapy (PDT) requires a drug (photosensitizer), a light source and a light applicator. By light activation of the photosensitizer, reactive oxygen species are produced that induce damage to sub-cellular structures. Photosensitizers with a preferential accumulation in pathological tissue may thus be used to destroy this tissue whether visible or not. With this aim, intense but non-thermal light is homogenously irradiated onto the target tissue with appropriate light applicators for flat, cylindrical or spherical organ geometries. Recent research and development of all necessary components has brought about significant progress in efficiency, reliability and cost effectiveness.

Several photosensitizers have already obtained drug approval for certain applications, further can be anticipated for the near future. Considerable clinical experience has been reported for the treatment of Barrett’s esophagus and palliative treatment of cholangiocarcinoma is very promising.

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    H. Stepp

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Stepp, H. Principes d’application clinique de la photothérapie dynamique. Acta Endosc 33, 493–509 (2003). https://doi.org/10.1007/BF03002415

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