Vascular photodynamic therapy : a multifactorial approach to inhibit intimal hyperplasia

The Wellman Laboratories of Photomedicine at the Massachusetts General Hospital in Boston is an internationally known institute for the development and application of laser in medicinco Besides fundamental research which investigates the interaction of light with cells and molecules, a great deal of studies arc performed towards clinical application to treat human diseases. For this reason, all known medical specialties are involved in research programmes examining the use of laser for their purposes: from ophtalmologists, using photodynamic therapy to treat choroidal neovascularization, oncologists to photochemically target and remove breast cancer cells from bone marrow, urologist to detect bladder cancer with fluorescence, gastroenterologists to treat Barret's oesophagus to dermatologists removing latloes and treating multiple skin diseases with the laser. The application of laser to treat vascular diseases was started decades ago, but more recently the concept of photodynamic therapy was introduced by the research group of Dr. LaMuraglia to prevent restenosis. As a research fellow in surgery I joined this group in 1994 and our research goal was to better understand how photodynamic therapy affects the vascular wall. The results from these investigations are presented in tllis thesis. The first part gives an outline of the problem of restenosis, the concept of photodynamic therapy and aims of the study. The following chapters describe how photodynamic therapy interacts with biological factors that regulate the vascular healing process. Finally, considerations for possible clinical use are discussed.

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