Photoeradication of Helicobacter pylori using 5-aminolevulinic acid: Preliminary human studies

• Published in: Lasers in surgery and medicine Vol. 31; no. 1; pp. 18 - 22
• Main Authors: Wilder-Smith, Clive H., Wilder-Smith, Petra, Grosjean, Pierre, van den Bergh, Hubert, Woodtli, Alain, Monnier, Philippe, Dorta, Gian, Meister, Friedrich, Wagnières, Georges
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01.01.2002; Wiley-Liss
• Subjects: Adult; aminolevulinic acid (ALA); Aminolevulinic Acid - pharmacology; Aminolevulinic Acid - therapeutic use; antibacterial therapy; Biological and medical sciences; Biopsy; Diseases of the digestive system; Female; gastritis; Gastritis - complications; Gastritis - drug therapy; Gastritis - microbiology; Gastritis - radiotherapy; Gastroenterology. Liver. Pancreas. Abdomen; Gastroscopy; Helicobacter Infections - complications; Helicobacter Infections - drug therapy; Helicobacter Infections - microbiology; Helicobacter Infections - radiotherapy; Helicobacter pylori; Helicobacter pylori - drug effects; Helicobacter pylori - radiation effects; human; Humans; laser; Light; Low-Level Light Therapy - methods; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Peptic Ulcer - complications; Peptic Ulcer - drug therapy; Peptic Ulcer - microbiology; Peptic Ulcer - radiotherapy; photodynamic therapy; photosensitizer; Photosensitizing Agents - pharmacology; Photosensitizing Agents - therapeutic use; Phototherapy - methods; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Stomach - drug effects; Stomach - microbiology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Time Factors; Human; Stomach; White light; Spirillales; Treatment efficiency; Spirillaceae; Instrumentation therapy; Case control study; Phototherapy; Valeric acid(4-oxo); Infection; In vivo; Helicobacter pylori; Laser; Bacteriosis; Digestive diseases; Bacteria; Photosensitizer; Gastric disease
• ISSN: 0196-8092; 1096-9101
• DOI: 10.1002/lsm.10066

Background and Objectives Helicobacter pylori (HP) is an endemic pathogenic bacterium causing gastritits and gastroduodenal ulceration in humans and is linked to the development of gastric malignancies. These first human in vivo studies investigated the photoeradication of HP using laser and white light. Study Design/Materials and Methods In 13 HP‐positive volunteers, a zone of gastric antrum was irradiated with laser (410 nm, 50 J/cm2) or endoscopic white light (10 J/cm2) 45 minutes after oral 5‐aminolevulinic acid (5‐ALA) 20 mg/kg. HP‐eradication was assessed by biopsy urease test and HP‐culture from irradiated and control zones 5 minutes, 4 and 48 hours post‐irradiation. Results A maximum eradication effect was achieved at 4 hours post‐irradiation when 85% of biopsies in the monochromatic and 66% in the white light exposed zones, and 58 and 33% in the respective control zones were HP‐negative. Conclusions HP numbers were greatly reduced following exposure to 5‐ALA and either laser or white light in vivo. Photoeradication appears feasible, but further light dosimetry and the development of convenient application methods is required. Lasers Surg. Med. 31:18–22, 2002. © 2002 Wiley‐Liss, Inc.