Gonarthritis photodynamic therapy with chlorin e6 derivatives.
BACKGROUND
The new methods of osteoarthritis treatment are in constant demand due to the complexity of the early diagnosis and therapy. Specific features of Сhlorin e6 derivative (Ce6) accumulation in knee joint tissues and the efficiency of photodynamic therapy (PDT) of gonarthritis were studied.


METHODS
The experimental research was conducted on the model of posttraumatic gonarthritis on rabbits. The analysis of dynamics of change of Ce6 concentration in tissues of a knee joint was carried out by the method of fluorescent diagnostics. The intra-joint PDT was carried out using 662nm laser with energy density of 120-150J/cm(2) and a sapphire diffuser. An analysis of slices was conducted to confirm the anti-inflammatory effect through apoptosis.


RESULTS
The method of fluorescent spectroscopy revealed that the highest amount of Ce6 was accumulated in the synovial membrane of a damaged knee joint 2.5h after its intravenous introduction. On 14th day after gonarthritis modeling but before PDT the synovial membrane showed signs of synovitis. On 21st day after PDT the synovial membrane possessed noticeable villous structure, and no cells of inflammatory nature were observed.


CONCLUSIONS
Fluorescent diagnostics in knee joint tissues can be used in clinical practice of gonarthritis before, during and after PDT for monitoring the Ce6 accumulation and for treatment control. Optimal radiation energy density was determined to be 150J/cm(2). In the studied time intervals (5-25min) no dependency of PDT effect on irradiation time at the same energy density was observed. The analysis of results of clinical and morphological research shows that PDT is a low-invasive method of gonarthritis treatment with a high degree of efficiency and selectivity.
I.M. Sechenov First Moscow State Medical University, Trubetskaya st., 8-2, Moscow, 119991, Russia. Electronic address: zharova-mma@yandex.ru.
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Zharova
I.M. Sechenov First Moscow State Medical University, Trubetskaya st., 8-2, Moscow, 119991, Russia. Electronic address: s.ivannikov@icloud.com.
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Ivannikov
I.M. Sechenov First Moscow State Medical University, Trubetskaya st., 8-2, Moscow, 119991, Russia. Electronic address: tonenkovAM@yandex.ru.
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Tonenkov
SSC Laser Medicine FMBA of Russia, Studencheskaya st, 40, Moscow, 121165, Russia. Electronic address: seph04@yandex.ru.
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Stranadko
V.A. Nasonova Scientific Research Institute of Rheumatology, Russian Academy of Medical Sciences, Kashirskoye Highway, 34A, Moscow, 115522, Russia. Electronic address: lu.kk@yandex.ru.
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Semenova
N.N. Priorov Central Research Institute of Traumatology and Orthopedics, Russian Federation Ministry of Health, Priorov st., 10, Moscow, 127299, Russia. Electronic address: tvg2h@yandex.ru.
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Smorchkov
A.M. Prokhorov General Physics Institute, Russian Academy of Sciences, Vavilov Str., 38, Moscow, 119991, Russia. Electronic address: vi.makarov@physics.msu.ru.
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Makarov
A.M. Prokhorov General Physics Institute, Russian Academy of Sciences, Vavilov Str., 38, Moscow, 119991, Russia. Electronic address: igor.romanishkin@gmail.com.
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Romanishkin
A.M. Prokhorov General Physics Institute, Russian Academy of Sciences, Vavilov Str., 38, Moscow, 119991, Russia; National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Kashirskoe highway, 31, Moscow, 115409, Russia. Electronic address: nastya.ryabova@gmail.com.
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Ryabova
A.M. Prokhorov General Physics Institute, Russian Academy of Sciences, Vavilov Str., 38, Moscow, 119991, Russia; National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Kashirskoe highway, 31, Moscow, 115409, Russia. Electronic address: loschenov@mail.ru.
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Loschenov
D000818:Animals; D002735:Chlorophyllides; D004305:Dose-Response Relationship, Drug; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D008027:Light; D008297:Male; D010003:Osteoarthritis / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology*; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage; D011166:Porphyrins / Q000008:administration & dosage* / Q000493:pharmacokinetics; D011817:Rabbits; D014018:Tissue Distribution; D016896:Treatment Outcome
D002735:Chlorophyllides; D017319:Photosensitizing Agents; D011166:Porphyrins; C062985:phytochlorin
Chlorin e6; Diagnostics; Fluorescent; Gonarthritis; Photodynamic therapy