title: The cytotoxic and genotoxic potential of 5-aminolevulinic acid on lymphocytes: a comet assay study.
abstract: BACKGROUND
  5-aminolevulinic acid (ALA) and its hexylester (ALA-H) are the drugs currently used in photodynamic therapy (PDT). The side effect, especially the long-term side effect of these drugs is a problem of concern in this field, which has not been clearly understood yet.
  
  
  OBJECTIVE
  The normal lymphocytes and nasopharyngeal carcinoma (NPC) cells were used as the cell models to evaluate the side effects of ALA or ALA-H in the absence of light or under sub-lethal doses of light.
  
  
  METHODS
  The cytotoxic and DNA-damaging effects of ALA or ALA-H on lymphocytes and NPC cells were studied by means of the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and the alkaline comet assay. ALA at 0.75 mM concentration and ALA-H at 10-microM concentrations were selected in the studies. This is because under these concentrations, ALA- or ALA-H-mediated PDT can destroy most NPC cells in vitro. The intracellular distributions of the protoporphyrin IX (PpIX), induced by the ALA or ALA-H, were measured by the confocal laser scanning microscope to provide more information for understanding the DNA damage.
  
  
  RESULTS
  The incubation of 0.75 mM ALA or 10 microM ALA-H alone (without light) did not cause DNA damage as well as the considerable cytotoxic effect on NPC cells. However, after ALA (0.75 mM) incubation and without light irradiation, the serious cytotoxicity and remarkable DNA damage were found in lymphocytes. When the lymphocytes were incubated with ALA-H (10 microM) alone (in the absence of light), no DNA damage could be detected and a slight cytotoxic effect was found. Both ALA and ALA-H induced PpIX in the lymphocytes. The fluorescence images of PpIX intracellular localization demonstrated that the PpIX diffused into the nuclear region in ALA-(0.75 mM)-incubated lymphocytes but not existed in the nucleus of ALA-H(10 microM)- incubated lymphocytes, providing an explanation for the facts that ALA (0.75 mM) induced the DNA damage while ALA-H (10 microM) did not.
  
  
  CONCLUSIONS
  These results suggested that the genotoxic potential of lymphocytes seems high for ALA (0.75 mM) and could be excluded for ALA-H (10 microM).
authors.affiliation: Biomedical Science Section, School of Nursing, Hong Kong Polytechnic University, China. jychen@fudan.edu.cn
authors.forename: E S M
authors.initials: ES
authors.lastname: Chu
authors.forename: R W K
authors.initials: RW
authors.lastname: Wu
authors.forename: C M N
authors.initials: CM
authors.lastname: Yow
authors.forename: T K S
authors.initials: TK
authors.lastname: Wong
authors.forename: J Y
authors.initials: JY
authors.lastname: Chen
mesh_terms: D000368:Aged; D000622:Aminolevulinic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D045744:Cell Line, Tumor; D002470:Cell Survival / Q000187:drug effects / Q000528:radiation effects; D020552:Comet Assay; D004249:DNA Damage; D006801:Humans; D008214:Lymphocytes / Q000187:drug effects / Q000378:metabolism / Q000528:radiation effects; D008297:Male; D018613:Microscopy, Confocal; D009153:Mutagens / Q000009:adverse effects / Q000494:pharmacology; D009303:Nasopharyngeal Neoplasms / Q000473:pathology; D017319:Photosensitizing Agents / Q000009:adverse effects / Q000494:pharmacology; D011524:Protoporphyrins / Q000378:metabolism; D014466:Ultraviolet Rays
chemical_list: D009153:Mutagens; D017319:Photosensitizing Agents; D011524:Protoporphyrins; D000622:Aminolevulinic Acid; C028025:protoporphyrin IX; C419924:5-aminolevulinic acid hexyl ester