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Int. J. Mol. Sci. 2016, 17, 309 7 of 10 Int. J. Mol. Sci. 2016, 17, 309 7 of 10 Table 3. PpIX-weighted full spectrum and PpIX light doses in two hours of daylight outside and Table 3. PpIX-weighted full spectrum and PpIX light doses in two hours of daylight outside and inside inside the greenhouse during different weather conditions. Lamp Type Lamp Type Greenhouse—outside Clear blue sky the greenhouse during different weather conditions. Greenhouse—inside Clear blue sky 4.58 32.9 Greenhouse—inside Clear blue sky 4.58 32.9 8.5 Greenhouse—inside Heavily overcast 1.18 8.5 Greenhouse—inside Heavily overcast 1.18 Fluence Rate–Full Spectrum Fluence Rate–Full Spectrum 2 Fluence-PpIX Light PpIX Weighted (mW/cm ) Fluence-PpIX Light 2 Dose in 2 h (J/cm ) PpIX Weighted (mW/cm2) Dose in 2 h (J/cm2) 6.07 43.7 Greenhouse—outside Clear blue sky 6.07 43.7 Greenhouse—outside Heavily overcast 1.69 12.1 Greenhouse—outside Heavily overcast 1.69 12.1 100 10 1 300 320 340 360 380 400 420 440 460 480 500 520 540 560 580 600 620 640 nm Outside greenhouse Inside greenhouse 2.3 Discussion 2.3. Discussion Figure 6. Spectra of daylight outside and inside the greenhouse–overcast (11 June 2015). Figure 6. Spectra of daylight outside and inside the greenhouse–overcast (11 June 2015). A number of different light sources have tentatively been used for PDT including lasers, filtered A number of different light sources have tentatively been used for PDT including lasers, filtered xenon arc and metal halide lamps, fluorescent lamps and light-emitting diodes [1]. We have xenon arc and metal halide lamps, fluorescent lamps and light-emitting diodes [1]. We have measured measured the absorption spectra from five different light sources, which might be usable for indoor the absorption spectra from five different light sources, which might be usable for indoor “daylight” “daylight” PDT. It is well known that continuous activation of PpIX by daylight during its PDT. It is well known that continuous activation of PpIX by daylight during its development reduces development reduces treatment-related pain compared to that resulting from conventional PDT [1], treatment-related pain compared to that resulting from conventional PDT [1], but the weather does not but the weather does not always allow daylight PDT. Our measurements show that only the always allow daylight PDT. Our measurements show that only the overhead projector is able to give overhead projector is able to give the optimal flu2ence (PpIX-weighted) of 3.5–8 J/cm2 found in earlier theoptimalfluence(PpIX-weighted)of3.5–8J/cm foundinearlierstudiesofPDTtreatmentofactinic studies of PDT treatment of actinic keratoses. Surprisingly, the results from the healthy volunteers keratoses. Surprisingly, the results from the healthy volunteers show that it is possible to photobleach show that it is possible to photobleach the developed PpIX using four of the five light sources even the developed PpIX using four of the five light sources even though the PpIX light dose is as low as though 2the PpIX light dose is as low as 0.2 J/cm2. This means that 2the suggested threshold dose of 0.2J/cm.Thismeansthatthesuggestedthresholddoseof3.5–8J/cm maybesetsomewhatlower[1]. 3.5–8 J/cm2 may be set somewhat lower [1]. We also measured the illuminance in lux because this We also measured the illuminance in lux because this measurement is easier for others to repeat as measurement is easier for others to repeat as it can be done without special knowledge. We carried it can be done without special knowledge. We carried out illumination by changing the distances out illumination by changing the distances between the light sources to the subject in order to between the light sources to the subject in order to determine the number of lux needed to achieve a determine the number of lux needed to achieve a complete photobleach. The red LED panel is not complete photobleach. The red LED panel is not usable for a complete photobleach since the intensity usable for a complete photobleach since the intensity is not high enough. Regarding the white LED is not high enough. Regarding the white LED lamp 12,000 lux is needed for a complete photobleach lamp 12,000 lux is needed for a complete photobleach in two hours while only 5000 lux is required in two hours while only 5000 lux is required for the other three light sources (Figure 4). A study by for the other three light sources (Figure 4). A study by Wiegell et al. using Xenon H4 light bulbs Wiegell et al. using Xenon H4 light bulbs showed that the minimal light intensity needed to prevent showed that the minimal light intensity needed to prevent accumulation of PpIX which still resulted accumulation of PpIX which still resulted in an effective treatment of actinic keratoses was higher than in an effective t2reatment of actinic keratoses was higher than 0.5–3.7 mW/cm2 or 1000–8000 lux [12]. 0.5–3.7mW/cm or1000–8000lux[12].Onlytheoverheadprojectorwasabletodeliverfluenceofthis Only the overhead projector was able to deliver fluence of this magnitude. Regardless of this, four of magnitude. Regardless of this, four of the five light sources were able to photobleach PpIX in healthy the five light sources were able to photobleach PpIX in healthy skin. Halogen light has previously skin. Halogen light has previously been used as a light source for PDT [8,9]. A disadvantage of using been used as a light source for PDT [8,9]. A disadvantage of using halogen light is the production of halogen light is the production of heat, which can prove uncomfortable for the patients. A solution heat, which can prove uncomfortable for the patients. A solution could be halogen light with less could be halogen light with less intensity. The other three light sources produce an insignificant amount intensity. The other three light sources produce an insignificant amount of heat. However, in this study there was only a 3 °C increase in skin temperature after illumination with the halogen light. μW/cm2/nmPDF Image | Alternatives to Outdoor Daylight for Photodynamic Therapy
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