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Oral 5-Aminolevulinic Acid Administration Allows Fluorescence of Cervix

Oral administration of 5-aminolevulinic acid (5-ALA) allows fluorescence of the cervix in patients with abnormal Pap smears and is well tolerated by patients.

Investigators from Massachusetts General Hospital in Boston, United States, suggest, "Future study is needed to demonstrate the successful identification of dysplastic lesions, with the ultimate goal of treating dysplasia of the lower genital tract with 5-ALA and light therapy."

They note that previous research indicates 5-ALA can be used topically to allow optical detection of cervical dysplasia. But uniformity of distribution and sensitivity/specificity were not optimal.

Studying the feasibility of oral 5-ALA administration in 14 patients with abnormal Pap smears, the researchers started the patients with a dosage of 10 milligrams per kilogram. Colposcopy was done in three patients at one hour, in three patients at two hours, in six patients at three hours and in two patients at four hours.

The investigators had planned to increase the dosage if fluorescence was not detected but it was detected at the first dosage.

Participants all tolerated 5-ALA well. There were no systemic side effects. No nausea or photosensitivity was reported.

The researchers found optimal fluorescence was achieved at the three-hour time point. "In some cases, fluorescence correlated with dysplasia on biopsy," they add.
Gynecologic Oncology, 2002; 85: 125-128. "Detection of Female Lower Genital Tract Dysplasia Using Orally Administered 5-Aminolevulinic Acid Induced Protoporphyrin IX: A Preliminary Study"

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