Biodistribution of protoporphyrin IX in female genital erosive lichen planus after topical application of hexaminolevulinate

Anne Lise Ording Helgesen; Petter Gjersvik; Qian Peng; Vlada Vasovic; Are Hugo Pripp; Peter Jebsen; Tom Tanbo; Trond Warloe

doi:10.1016/j.pdpdt.2014.01.005

Biodistribution of protoporphyrin IX in female genital erosive lichen planus after topical application of hexaminolevulinate

Photodiagnosis Photodyn Ther. 2014 Jun;11(2):113-7. doi: 10.1016/j.pdpdt.2014.01.005. Epub 2014 Feb 14.

Authors

Anne Lise Ording Helgesen¹, Petter Gjersvik², Qian Peng³, Vlada Vasovic³, Are Hugo Pripp⁴, Peter Jebsen³, Tom Tanbo⁵, Trond Warloe⁶

Affiliations

¹ National Resource Centre for Women's Health, Division for Women's and Children's Health, Oslo University Hospital, 0424 Oslo, Norway; Department of Dermatology, Oslo University Hospital, 0424 Oslo, Norway; Institute for Clinical Medicine, University of Oslo, Box 1171 Blindern, 0318 Oslo, Norway. Electronic address: anneliseord@yahoo.no.
² Department of Dermatology, Oslo University Hospital, 0424 Oslo, Norway; Institute for Clinical Medicine, University of Oslo, Box 1171 Blindern, 0318 Oslo, Norway.
³ Department of Pathology, Oslo University Hospital, 0424 Oslo, Norway.
⁴ Department of Biostatistics and Epidemiology, Oslo University Hospital, 0424 Oslo, Norway.
⁵ Institute for Clinical Medicine, University of Oslo, Box 1171 Blindern, 0318 Oslo, Norway; Department of Gynaecology, Oslo University Hospital, 0424 Oslo, Norway.
⁶ Department of Internal Medicine, Oslo University Hospital, 0424 Oslo, Norway.

PMID: 24530993
DOI: 10.1016/j.pdpdt.2014.01.005

Abstract

Genital erosive lichen planus (GELP) is a chronic inflammatory disease, in women characterized by painful vulvar and vaginal erosions. To prepare for a clinical trial on photodynamic treatment (PDT), we applied hexyl 5-aminolevulinate hydrochloride (HAL) in clinically normal and affected mucosa in 12 women with GELP using two different doses (6.25 or 50mg/ml). Biopsies were taken after 30 min and 3h. The biodistribution of HAL, measured as photoactive protoporphyrin IX (PpIX), was studied using non-invasive superficial fluorescence measurements and microscopic fluorescence photometry. More PpIX was detected after application of 12.5mg HAL than after 100mg, with large inter-individual variations. PpIX levels after 3h were overall higher than after 30 min. PpIX fluorescence was not detected in skin distant to the genital area. In conclusion, 6.25mg/ml HAL applied for 3h seems adequate for HAL absorption and conversion to PpIX in submucosal inflammatory and epithelial cells and can be used in a PDT trial of GELP.

Keywords: Erosive lichen planus; Genital; Hexylaminolevulinate.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Administration, Topical
Aminolevulinic Acid / administration & dosage
Aminolevulinic Acid / analogs & derivatives*
Aminolevulinic Acid / pharmacokinetics
Dose-Response Relationship, Drug
Female
Genital Diseases, Female / drug therapy*
Genital Diseases, Female / metabolism*
Genital Diseases, Female / pathology
Humans
Lichen Planus / drug therapy*
Lichen Planus / metabolism*
Lichen Planus / pathology
Metabolic Clearance Rate / drug effects
Photochemotherapy / methods
Photosensitizing Agents / administration & dosage
Photosensitizing Agents / pharmacokinetics
Protoporphyrins / metabolism*
Tissue Distribution / drug effects
Treatment Outcome

Substances

Photosensitizing Agents
Protoporphyrins
Aminolevulinic Acid
protoporphyrin IX
5-aminolevulinic acid hexyl ester