Selective photosensitizer localization in the human endometrium after intrauterine application of 5-aminolevulinic acid.
OBJECTIVE
Our purpose was twofold: to determine the distribution of the endogenous photosensitizer protoporphyrin IX in the uterus and to ascertain the time interval leading to maximal endometrial fluorescence after intrauterine instillation of 5-aminolevulinic acid.


METHODS
One milliliter of a 400 mg/ml 5-aminolevulinic acid-Hyskon solution was instilled into the uterine cavity of 27 women before hysterectomy. On frozen sections of uterine samples 5-aminolevulinic acid-induced fluorescence was measured with fluorescence microscopy.


RESULTS
5-Aminolevulinic acid-induced fluorescence could first be detected in the superficial endometrial glands 75 minutes after drug injection. In the endometrial gland stumps fluorescence intensity peaked 4 to 8 hours after 5-aminolevulinic acid instillation and was > 48 times higher than in the underlying myometrium.


CONCLUSIONS
Fluorescence in the endometrial glands suggests that selective photodynamic destruction of the endometrium may be possible 4 to 8 hours after intrauterine 5-aminolevulinic acid instillation.
Fehr
M K
MK
Beckman Laser Institute and Medical Clinic, University of California, Irvine 92715, USA.
Wyss
P
P
Tromberg
B J
BJ
Krasieva
T
T
DiSaia
P J
PJ
Lin
F
F
Tadir
Y
Y
D000622:Aminolevulinic Acid / Q000378:metabolism*; D004717:Endometrium / Q000378:metabolism*; D005260:Female; D006801:Humans; D008856:Microscopy, Fluorescence; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000378:metabolism*; D011524:Protoporphyrins / Q000378:metabolism*
D017319:Photosensitizing Agents; D011524:Protoporphyrins; D000622:Aminolevulinic Acid; C028025:protoporphyrin IX