臨牀消化器内科 Vol.14 No.8(3-2)


特集名 レーザー内視鏡の理論と実際 --21世紀消化器内視鏡学への提言
題名 光線力学的治療(PDT) (2) PDTとアポトーシス
発刊年月 1999年 07月
著者 田尻 久雄 国立がんセンター東病院内視鏡部
【 要旨 】 ヒト膵癌細胞株移植ヌードマウスを用い,フォトフィリンを前処理として光線力学的治療(PDT)を行った.治療1週間後の病理組織学的変化では,PDT群はレーザー照射単独群に比べ有意な治療効果が認められた.DNA断片化およびTUNEL法によりPDT2時間後にアポトーシスが起きることが証明された.一方,培養ヒト癌細胞にPDTを行い,細胞内Ca2+濃度変化を共焦点レーザー顕微鏡下に経時的に観察した.Ca2+濃度は30分後より変化が認められ,1~2時間後に著明に増加した.PDT群のみにDNA断片化が治療1~3時間後に認められた.したがって,PDT後短時間でアポトーシスが起きるメカニズムには細胞内Ca2+濃度の動態が重要な因子と考えられた.bcl-2,p-53,抗Fas抗体の検討から,これらの機構は遺伝子制御を受けていないこと,Fasシグナル経路を介していないことが示唆された.
Theme Laser Endoscopy in Theory and Practice --Perspective of GI Endoscopy in the 21st Century
Title Apoptosis Induced by PDT
Author Hisao Tajiri Department of Endoscopy, National Cancer Center Hospital East
[ Summary ] The mode of cell death induced by photodynamic therapy (PDT) was investigated from the perspective of apoptosis. In an in vivo study using human pancreatic carcinoma, transplanted into nude mice, PDT showed significant therapeutic effects at seven days post treatment, as compared with laser irradiation alone when the mean of each overall split surface of the necrotic area was measured. The characteristic DNA ladder formation and TUNEL signals in nuclei of tumor cells were demonstrated two hours after PDT.However, no evidence of DNA ladder formation nor TUNEL signals was found in the untreated control group or in groups given laser irradiation alone. Additionally, we investigated chronological changes in intracellular Ca2+ concentrations during PDT-induced apoptosis, using human squamous cell carcinoma cells by in vitro. Extensive DNA fragmentation was recognized within two hours of PDT. The proportion of cells with DNA fragmentation on flow cytometric analysis was significantly increased to 44% and 78% one hour and two hours after PDT, respectively, compared to the control groups. Confocal laser scanning microscopy revealed a slight change in intracellular Ca2+ concentrations occurring at thirty minutes after PDT, and a subsequent marked increase in Ca2+ concentration one to two hours after PDT, but no change was observed in the cells exposed to laser irradiation only or the cells immediately after PDT. These findings suggest that an increase in intracellular Ca2+ concentrations may play an important role in the induction of PDT-induced apoptosis. Further work to clarify molecular mechanisms of PDT-induced apoptosis should be conducted. With development of new photosensitizers or laser appratus, it is expected that the therapeutic effects, the appropriate administration time or the concentrations of photo sensitizers, and treatment conditions can be decided objectively in relation to apoptosis.
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