Enhancing wound healing in recalcitrant leg ulcers with aminolevulinic acid-mediated antimicrobial photodynamic therapy.
Photodiagnosis Photodyn Ther. 2020 Dec 17:102149. Epub 2020 Dec 17. PMID: 33346057
Chronic leg ulcers affect millions of people around the world. It is imperative to search for alternative, effective treatments for such challenging ulcers. We reported the success of aminolevulinic acid-mediated antimicrobial photodynamic therapy (APDT) to enhance wound healing of chronic ulcers of 3 patients who were refractory to conventional treatments. These ulcers heal after one to three sessions of APDT and there was no recurrence for more than 29 months. Interestingly, no bacteria were isolated from the ulcers after APDT treatment. In vitro, APDT inactivated all bacteria isolated from the patients. APDT conditioned medium containing IL-6 enhanced keratinocyte migration. The results suggest in addition to bactericidal effects, APDT also alters the wound microenvironment. APDT may be an effective alternative treatment for patients with recalcitrant infected ulcers.