title: Effects of photodynamic therapy mediated by nanoemulsion containing chloro-aluminum phthalocyanine: a histologic and immunohistochemical study in human gingiva.
abstract: BACKGROUND
  Photodynamic therapy (PDT) uses photosensitizing agents, which are delivered in target cells, followed by local application of visible light in specific wavelengths. This reaction produce reactive oxygen species able to induce cell death by apoptosis or necrosis, injured to the local vasculature, and exert important effects on the immune system.
  
  
  OBJECTIVE
  The present work evaluated the clinical findings, histomorphological alterations and immunodetection of VEGF after PDT using chloro-aluminum phthalocyanine (AlClPc) entrapped in a lipid nanoemulsion in a split-mouth clinical trial.
  
  
  METHODS
  Eight healthy volunteers with clinical indication for extraction were included in the study. Seven days before the extraction 40 ul of nanoemulsion AlClPc 5μM was injected into gingival tissue followed by irradiation with diode laser, the contralateral side was used as control. Tissue specimens were removed seven days after the PDT and divided into two groups (test and control groups) for histological and immunohistochemical analysis. Patients were monitored at days, 0, 7, 14 and 30 to assess adverse effects of the therapy.
  
  
  RESULTS
  The therapy was well tolerated by all patients. Adverse effects were short-time and completely reversible. Areas of edema, vascular congestion, and intense vascularization were viewed in gingival samples that received PDT. Additionally, dystrophic calcification was observed in subepithelial region. VEGF showed moderate to strong immunostaining in specimens subjected to PDT.
  
  
  CONCLUSIONS
  Taken together, the results showed that the protocol used in this study mediated by nanoemulsion containing AlClPc is safe for clinical application in gingival tissue and suggests that VEGF is increased after PDT.
authors.affiliation: DDS, PhD, Post-Graduate Program, Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, Brazil. Electronic address: maiaramoraes@gmail.com.
authors.forename: Maiara
authors.initials: M
authors.lastname: de Moraes
authors.affiliation: DDS, MSc, Post-Graduate Program, Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, Brazil. Electronic address: r.roseane@hotmail.com.
authors.forename: Roseane Carvalho
authors.initials: RC
authors.lastname: de Vasconcelos
authors.affiliation: Department of Genetics and Morphology, Institute of Biological Sciences, University of Brasília, Brasília/DF, Brazil. Electronic address: jplongo82@gmail.com.
authors.forename: João Paulo Figueiró
authors.initials: JP
authors.lastname: Longo
authors.affiliation: Department of Genetics and Morphology, Institute of Biological Sciences, University of Brasília, Brasília/DF, Brazil.
authors.forename: Luis Alexandre
authors.initials: LA
authors.lastname: Muehlmann
authors.affiliation: Department of Genetics and Morphology, Institute of Biological Sciences, University of Brasília, Brasília/DF, Brazil. Electronic address: razevedo@unb.br.
authors.forename: Ricardo Bentes
authors.initials: RB
authors.lastname: de Azevedo
authors.affiliation: Department of Clinical and Toxicological Analysis, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil. Electronic address: telmaml@yahoo.com.br.
authors.forename: Telma Maria Araújo Moura
authors.initials: TM
authors.lastname: Lemos
authors.affiliation: DDS, PhD, Professor of the Post-Graduate Program, Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, Brazil. Electronic address: antoniolisboa@uol.com.br.
authors.forename: Antonio de Lisboa Lopes
authors.initials: Ade L
authors.lastname: Costa
mesh_terms: D000328:Adult; D004655:Emulsions; D005260:Female; D005881:Gingiva / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D007211:Indoles / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D054023:Lasers, Semiconductor; D008297:Male; D008875:Middle Aged; D053758:Nanoparticles; D009942:Organometallic Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D013997:Time Factors; D014081:Tooth Extraction; D042461:Vascular Endothelial Growth Factor A / Q000187:drug effects*
chemical_list: D004655:Emulsions; D007211:Indoles; D009942:Organometallic Compounds; D017319:Photosensitizing Agents; D042461:Vascular Endothelial Growth Factor A; C044797:chloroaluminum phthalocyanine
keywords: Photochemotherapy; Photodynamic therapy; Photosensitizing agents; Vascular endothelial growth Factor A