Study On Local Immune Response Of 5-Aminolevulinic Acid Photodynamic Therapy Of Condyloma Acuminatum

Research background:Condyloma acuminatum is a common sexually transmitted disease. It is closely related to human papillomavirus infection and immune status. The traditional treatment can not be effective in preventing recurrence, but only to remove the warts.5-aminolevulinic acid photodynamic therapy has been widely used in the treatment of condyloma acuminatum, not only got efficacy and safety, but also had the role of prevention of recurrence. Now that the immune response in particular the local immune response may play an important role in the photodynamic therapy of condyloma acuminatum, but the mechanism is not completely clear.Objective:The research is on the change of the number and distribution of T lymphocytes, plasmacytoid dendritic cells, myeloid dendritic cells and the expression levels of related cytokines before and after photodynamic therapy in patients with condyloma acuminatum, in order to identify the impact of local immunity after photodynamic treatment.Methods:1. The distribution changes of CD3+, CD4+, CD8+T cells in tissues of 20 condyloma acuminatum patients before and 4 hours,24 hours after PDT was detected by immunohistochemical method. The mRNA expression level changes of IFN-Y in tissues of 20 condyloma acuminatum patients before and 4 hours,24 hours after PDT was detected by real time PCR.2. The distribution changes of CD123+plasmacytoid dendritic cells in tissues of 20 condyloma acuminatum patients before and 4 hours,24 hours after PDT was detected by immunohistochemical method. The mRNA expression level changes of IFN-a, IFN-B, ISG-15, Mx-2, TLR9, IRF7 in tissues of 20 condyloma acuminatum patients before and 4 hours,24 hours after PDT was detected by real time PCR.3. The distribution changes of CD1a+myeloid dendritic cells in tissues of 20 condyloma acuminatum patients before and 4 hours,24 hours after PDT was detected by immunohistochemical method.4. Analysis of the clinical efficacy of PDT with the mRNA expression level of IFN-a, IFN-β increased.Results:1. Compared with normal foreskin, the nunbers of CD3+, CD8+cells were increased in tissue of condyloma acuminatum (P<0.05); There is no significant difference of CD4+cells in tissue lesions between condyloma acuminatum and the contrast; There is a significant increase in the number of CD3+cells after PDT(P<0.01), and the distribution is shifted to the superficial dermis; The number of CD4+cells at 4 hours after PDT treatment have increased (P<0.01), the expression level of IFN-Y also increased; There is no significant change of the number, distribution, morphology of CD8+cells before and after PDT.2. There is no significant difference of CD123+plasmacytoid dendritic cells in tissue lesions between condyloma acuminatum and the contrast; There is a significant increase in the number of CD123+plasmacytoid dendritic cells after PDT(P<0.01) and the expression levels of IFN-a, IFN-B, ISG-15, Mx-2, TLR9, IRF7 also increased after PDT.3. Compared with normal foreskin, the nunber of CD1a+LC in epidermis were reduceed in tissue of condyloma acuminatum (P<0.01); The number of CDla+LC in epidermis gradually reduced(P<0.01), and the number of CD1a+DC in dermis gradually increased after photodynamic therapy.4. The number of cured times in patients that IFN-a, IFN-B significantly increased after photodynamic therapy reduced compared with that IFN-a, IFN-B not significantly increased (P<0.05).Conclusion:1. T lymphocytes immune may play a role in the immunological effects of photodynamic treatment of condyloma acuminatum, the number of CD4+cells increased may be correlated the expression level of IFN-Y increased after treatment.2. pDC associated immunological effects in photodynamic therapy of condyloma acuminatum also play a role, the number of CD123+pDC cells increased in local tissue, and the expression levels of IFN-α, IFN-B, ISG-15, Mx-2, TLR9, IRF7 also increased; There may be a correlation between the them. It may enhance the local immune.3. The number of CD1a+LC in epidermis gradually reduced(P<0.01), and the number of CD1a +DC in dermis gradually increased after photodynamic therapy, considering dendritic cells in the process also play a role in immune response, such as antigen presentation.4. PDT clinical efficacy of treatment of genital warts may be positively correlated with treatment IFN-a, IFN-β elevated levels.