Hersentumoren: PDT - Photodynamische Therapie met speciale laser van NASA effectief bij hersentumoren bij kinderen

d.d. 17 januari 2004: Bron NASA website en website van Wisconsin Ziekenhuis:

Infrarood licht door Ledlights van NASA, getest tijdens ruimtevaart en bedoeld als hulp bij plantengroei helpen bij sneller herstel en voorkomen van wondjes in de mond en keel, brandwonden en andere bijwerkingen van chemo bij o.a. stamceltransplantie bij kinderen, aldus studie aan Medical College of Wisconsin. Ook met een speciale laser worden wondjes enz. met succes behandeld. De FDA heeft op basis van deze resultaten toestemming gegeven voor verder onderzoek en fase II en fase III trials.

Interessant is verder dat al in 1999 een fase II onderzoek is gestart met PDT via speciale Ledligths van NASA bij hersentumoren en eerste successen zijn al gemeld op de website. Bij deze PDT wordt in principe photofrin als fotosensitizer gebruikt maar ook twee andere fotosensitizers, nl. Lutetium Texaphyrin (Lutex) en Benzoporphyrin Derivative (BPD).

Hieronder de twee berichten die we van de website van NASA hebben gehaald:

NASA Space Technology Shines Light on Healing

Doctors at the Medical College of Wisconsin in Milwaukee have discovered the healing power of light with the help of technology developed for NASA's Space Shuttle. Using powerful light-emitting diodes, or LEDs, originally designed for commercial plant growth research in space, scientists have found a way to help patients here on Earth.

Doctors are examining how this special lighting technology helps hard-to-heal wounds, such as diabetic skin ulcers, serious burns, and severe oral sores caused by chemotherapy and radiation. The project includes laboratory and human trials, approved by the U.S. Food and Drug Administration and funded by a NASA Small Business Innovation Research contract through the Technology Transfer Department at NASA’s Marshall Space Flight Center in Huntsville, Ala.

"So far, what we've seen in patients and what we've seen in laboratory cell cultures, all point to one conclusion," said Dr. Harry Whelan, professor of pediatric neurology and director of hyperbaric medicine at the Medical College of Wisconsin. "The near-infrared light emitted by these LEDs seems to be perfect for increasing energy inside cells. This means whether you're on Earth in a hospital, working in a submarine under the sea or on your way to Mars inside a spaceship, the LEDs boost energy to the cells and accelerate healing."

Dr. Whelan’s findings will be summarized in upcoming issues of Space Technology and Applications International Forum 2001 and in The Journal of Clinical Laser Medicine and Surgery. Other related peer-reviewed journals have published articles on Whelan’s medical research with light-emitting diodes.

Dr. Whelan's NASA-funded research has already seen remarkable results using the light-emitting diodes to promote healing of painful mouth ulcers caused by cancer therapies such as radiation and chemotherapy. The treatment is quick and painless.

The wound-healing device is a small, 3.5-inch by 4.5-inch (89-millimeter by 114-millimeter), portable flat array of LEDs, arranged in rows on the top of a small box. A nurse practitioner places the box of LEDs on the outside of the patient's cheek about one minute each day. The red light penetrates to the inside of the mouth, where it seems to promote wound healing and prevent further sores in the patient's mouth.

"Some children who probably would have had to be fed intravenously because of the severe sores in their mouths have been able to eat solid food, " said Dr. David Margolis, an oncologist at Children's Hospital of Wisconsin in Milwaukee and an assistant professor of pediatrics at the Medical College of Wisconsin. Margolis, whose pediatric cancer patients are participating in the study, explained that, "Preventing oral mucositis improves the patients' ability to eat and drink and also may reduce the risk of infections in patients with compromised immune systems."

Dr. Whelan's collaboration with NASA began when Ronald Ignatius, owner of Quantum Devices Inc. in Barneveld, Wis., learned about Dr. Whelan's brain cancer surgery technique using drugs stimulated by laser lights. Laser-light surgical probes are costly and cumbersome in the operating room because they are heavy, with refrigerator-size optical, electrical and cooling systems.

Ignatius originally designed the lights for plant growth experiments through the Wisconsin Center for Space Automation and Robotics, a NASA commercial space center at the University of Wisconsin in Madison.

"The LEDs needed to grow plants in space produced the same wavelengths of light the doctor needed to remove brain tumors," said Ignatius. "Plus, when we developed the LEDs for NASA, they had to be lightweight to fly aboard the shuttle and have small cooling systems. These traits make the LED surgery probes easier to use in the operating room and thousands of dollars cheaper than laser systems."

Quantum Devices altered the surgical probe to emit longer wavelengths of red light that stimulate a photodynamic drug called Benzoporphyrin Derivativeä . Doctors at the Children's Hospital of Wisconsin recently completed the first-ever surgery with the improved probe and medicine. The drug also has fewer side effects after surgery. The ongoing brain surgery study is described in a 1999 peer-reviewed journal article in Pediatric Neurosurgery.

"At NASA, we work with companies like Quantum Devices to take technologies developed for use in space and bring the benefits back home to Earth," said Helen Stinson of Marshall’s Technology Transfer Department. "NASA is proud to support a program that helps children with brain cancer -- and promises to help even greater numbers of people with technology to accelerate the healing process."

In the laboratory, Whelan and his team have shown that skin and muscle cells grown in cultures and exposed to the LED infrared light grow 150 to 200 percent faster than ground control cultures not stimulated by the light. Scientists are trying to learn how cells convert light into energy, and identify which wavelengths of light are most effective at stimulating growth in different kinds of cells.

To expand the wound healing study, Whelan -- a commander and diving medical officer in the U.S. Navy reserve assigned to Naval Special Warfare Command (Naval Special Warfare Group TWO) -- is working with doctors at Navy Special Warfare Command centers in Norfolk, Va., and San Diego, Calif. They reported a 40 percent improvement in patients who had musculoskeletal training injuries treated with the light-emitting diodes.

A wound-healing device was placed on the USS Salt Lake City submarine and other subs belonging to Submarine Squadron ELEVEN, where doctors are currently studying the effects of LED light on crewmembers’ injuries in the unique submarine environment.

The LED research project will continue for the next 18 months, with doctors studying 100 patients at two major teaching affiliates of the Medical College of Wisconsin. Researchers will continue to examine the influence of LEDs on cells grown in the laboratory, and will explore the benefits that LEDs might provide to counteract possible cell damage caused by exposure to harmful radiation and weightlessness during long space missions.

Bron: NASA website:

Space Research Shines A Light On Tumors To Save Lives
Special lighting technology developed for NASA’s commercial plant growth experiments in space may soon help treat cancer and save lives on Earth.

A treatment technique called Photodynamic Therapy is using tiny pinhead-size Light Emitting Diodes (LEDs) -- developed for NASA Space Shuttle plant growth experiments -- to activate light-sensitive, tumor-treating drugs.

Experiments indicate that when special tumor-fighting drugs are illuminated with LEDs, the tumors are more effectively destroyed than with conventional surgery. The light source, consisting of 144 of the tiny diodes, is compact -- the size of a small human finger about one-half-inch in diameter -- and mechanically more reliable than lasers and other light sources used to treat cancer. The entire light source and cooling system is only the size of a medium suitcase.

NASA funded contracts through the Small Business Innovation Research Program to demonstrate the feasibility of using LEDs in cancer treatment. The program is managed by the Technology Transfer Office at Marshall Space Flight Center in Huntsville, Ala. The LEDs developed for Marshall Center by Quantum Devices, Inc. of Barneveld, Wis., were first intended for use in food growth experiments in space. In the new application, they form the tip of a new nine-inch neural probe.

"This new probe illuminates through all nearby tissues," said Dr. Harry Whelan, pediatric neurologist of the Children’s Hospital of Wisconsin, and professor of neurology at the Medical College of Milwaukee, Wis. "We’ve used lasers too," he added, "but they are often unreliable and limited in color spectrum. Lasers are also very expensive and lose power in their fiberoptic cables."

The LED probe can be used for hours at a time and remains cool to the touch. The entire LED unit can be purchased for a fraction of the cost of a laser.

Dr. Whelan has obtained Food and Drug Administration approval to use the LED probe in the removal of children’s brain tumors on a trial basis. Dr. Whelan’s technique to remove these tumors involves injecting the patient’s bloodstream with a drug called Photofrin II. Photofrin II attaches to the unwanted tissues and permeates into them, leaving the surrounding tissues unaffected. Dr. Whelan then places the new solid-state LED probe near the affected tissue to illuminate the tumor and activate the Photofrin II drug. Once activated by the light, the drug destroys the tumor’s cells, leaving the tender brain stem tissues virtually untouched.

"We’re very happy to be a part of this innovative procedure," said Rose Allen, manager of the Space Product Development Office at the Marshall Center. "It is exciting to see how NASA’s commercial space research results in benefits on Earth. Who would have thought that experiments searching for ways to improve agricultural products would lead to a medical procedure that saves children’s lives?" said Allen.

"The LED technology developed by NASA offers new hope to children with cancer," Dr. Whelan said. "Every one of our cases will be a critical case with no hopeful alternatives. We think this new probe will help give children with tumors a chance to live healthy, happy lives."

After Whelan concludes the FDA clinical trials, he anticipates full approval of what soon could be the operating technique of the future. Further research combining LEDs and promising new drugs are showing the possibilities of deeper tumor penetration with the probe, faster reaction times and shortened patient sensitivities to sunlight.

LEDs, as a low-energy light source were used on NASA’s second United States Microgravity Laboratory Spacelab mission in October 1995, as part of the Astroculture Plant Growth Facility. The experiment was led by Dr. Raymond J. Bula of the Wisconsin Center for Space Automation and Robotics in Madison, Wis., a NASA Commercial Space Center. Commercial Space Centers, supported by NASA, pursue opportunities for continued growth of U.S. industry through the use of space.

"NASA has played a number of important roles," Dr. Whelan said. "NASA has funded the development of these LEDs for space research over the years," he added. "If it wasn’t for the pre-existence of all that technology, it wouldn’t have been possible for us to walk right in and use it to treat cancer."

NASA’s Space Product Development Program works in partnership with the scientific community and commercial industry to support the 19 U.S. universities designated by NASA as Commercial Space Centers. The Space Products Development Office is part of the Microgravity Research Program at the Marshall Center.

Here are the full-length articles in Space Tech. & App. Int’l. Forum - 2001 (vol. 552:35-45),
1999 (vol. 458:3-15) & 2000 (vol. 504:37-43).
Whelan, H.T. Buchmann, E.V. Dhokalia, A. Kane, M.P. Whelan, N.T. Wong-Riley, M.T. Eells, J.T. Gould, L.J. Hammamieh, R. Das, R. Jett, M. "Effect of NASA light-emitting diode irradiation on molecular changes for wound healing in diabetic mice" Journal of Clinical Laser Medicine & Surgery.21(2):67-74,2003.

Eells, J.T. Henry, M.M. Summerfelt, P. Wong-Riley, M.T.T. Buchmann, E.V. Kane, M. Whelan, N.T. Whelan, H.T. "Therapeutic photobiomodulation for methanol-induced retinal toxicity" Proceedings of the National Academy of Sciences.100(6):3439-44,2003.
Wong-Riley, M.T. Bai, X. Buchmann, E. Whelan, H.T. "Light-emitting diode treatment reverses the effect of TTX on cytochrome oxidase in neurons" Neurochemistry.12(14):3033-7,2001.
Whelan, H.T. Smits, R.L. Buchmann, E.V. Whelan, N.T. Turner, S.G. Margolis, D.A. Cevenini, V. Stinson, H. Ignatius, R. Martin, T. Cwiklinski, J. Philippi, A.F. Graf, W.R. Hodgson, B. Gould, L. Kane, M. Chen, G. Caviness, J. "Effect of NASA light-emitting diode (LED) irradiation on wound healing" Journal of Clinical Laser Medicine & Surgery.19(6):305-13,2001.
Whelan, H.T. Connelly, J.F. Hodgson, B.D. Barbeau, L. Post, A.C. Bullard, G. Buchmann, E.V. Kane, M. Whelan, N.T. Warwick, A. Margolis, D. "NASA Light-emitting diodes for the prevention of oral mucositis in pediatric bone marrow transplant patients" Journal of Clinical Laser Medicine & Surgery.20(6):319-24,2002.

Photo dynamische therapie, PDT, hersentumoren