Topical photodynamic therapy significantly reduces epidermal Langerhans cells during clinical treatment of basal cell carcinoma

Br J Dermatol. 2012 May;166(5):1112-5. doi: 10.1111/j.1365-2133.2012.10823.x. Epub 2012 Apr 4.

Abstract

Background: Topical photodynamic therapy (PDT) is a widely applied treatment for basal cell carcinoma (BCC). PDT-induced immunosuppression leading to reduced antitumour immune responses may be a factor in treatment failure.

Objectives: To examine the impact of topical PDT on leucocyte trafficking following clinical treatment of BCC.

Methods: Superficial BCCs in eight white caucasian patients were treated with methyl aminolaevulinate (MAL)-PDT. Biopsies for immunohistochemical assessment were taken from BCCs pre-PDT, 1 h and 24 h post-PDT and from untreated healthy skin.

Results: Treatment of BCC with MAL-PDT produced a rapid neutrophil infiltration, commencing by 1 h and significantly increased at 24 h post-PDT (P < 0·05 compared with baseline). An associated increase in the number of blood vessels expressing E-selectin was observed at 1 h and 24 h post-PDT (both P < 0·05 compared with baseline). In contrast, the number of epidermal Langerhans cells fell sharply by 1 h post-PDT, and remained significantly reduced at 24 h post-PDT (both P < 0·05 compared with baseline).

Conclusions: Reduction of Langerhans cells during clinical treatment of BCC might potentially impact negatively on antitumour responses through reduced activation of tumour-specific effector cells. Investigation of modified PDT protocols with the aim to minimize immunosuppressive effects while maintaining antitumour efficacy is warranted.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Cutaneous
  • Aged
  • Aminolevulinic Acid / administration & dosage
  • Aminolevulinic Acid / analogs & derivatives*
  • Carcinoma, Basal Cell / drug therapy*
  • Carcinoma, Basal Cell / pathology
  • Female
  • Humans
  • Langerhans Cells / pathology*
  • Male
  • Middle Aged
  • Neutrophil Infiltration
  • Photochemotherapy / methods*
  • Photosensitizing Agents / administration & dosage*
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / etiology

Substances

  • Photosensitizing Agents
  • methyl 5-aminolevulinate
  • Aminolevulinic Acid