{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:13:42Z","timestamp":1790691222551,"version":"4.1.0"},"reference-count":35,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1995,1]]},"abstract":"<jats:p>The first study of photodynamic therapy in the human gastrointestinal tract using 5 aminolaevulinic acid (ALA) induced protoporphyrin IX as the photosensitising agent is described. Eighteen patients with colorectal, duodenal, and oesophageal tumours were studied. After 30-60 mg\/kg of ALA given orally, biopsy specimens of tumour and adjacent normal mucosa were taken 1-72 hours later. These specimens were examined by quantitative fluorescence microscopy for assessment of sensitisation with protoporphyrin IX. Ten patients were given a second dose of ALA a few weeks later and their tumours were treated with red laser light (628 nm). With 30 mg\/kg ALA, the highest fluorescence values were detected in the duodenum and oesophagus, and the lowest in the large bowel. Doubling the ALA dose in patients with colorectal tumours gave protoporphyrin IX fluorescence intensities similar to those in patients with upper gastrointestinal lesions and improved the tumour:normal mucosa protoporphyrin IX sensitisation ratio. The treated patients showed superficial mucosal necrosis in the areas exposed to laser light. Six patients had transient rises in serum aspartate aminotransferases, two mild skin photosensitivity reactions, and five mild nausea and vomiting. In conclusion, photodynamic therapy with systemically administered ALA may be a promising technique for the treatment of small tumours and areas of dysplasia such as in Barrett's oesophagus.<\/jats:p>","DOI":"10.1136\/gut.36.1.67","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"67-75","source":"Crossref","is-referenced-by-count":274,"title":["Photosensitisation and photodynamic therapy of oesophageal, duodenal, and colorectal tumours using 5 aminolaevulinic acid induced protoporphyrin IX--a pilot study."],"prefix":"10.1136","volume":"36","author":[{"given":"J","family":"Regula","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A J","family":"MacRobert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Gorchein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G A","family":"Buonaccorsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S M","family":"Thorpe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G M","family":"Spencer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A R","family":"Hatfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S G","family":"Bown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1995,1,1]]},"reference":[{"key":"ref_1","first-page":"2326","article-title":"Identification of singlet oxygen as the cytotoxic agent in the photoactivation of a murine tumour","volume":"36","author":"Weishaupt, K.R.; Gomer, C.J.; Dougherty, T.J.","year":"1976","unstructured":"Weishaupt KR, Gomer CJ, Dougherty TJ. Identification of singlet oxygen as the cytotoxic agent in the photoactivation of a murine tumour. Cancer Res 1976; 36: 2326-9.","journal-title":"Cancer Res"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/1011-1344(90)85069-9","article-title":"Photodynamic therapy to scientists and clinicians - one world or two?","volume":"6","author":"Bown, S.G.","year":"1990","unstructured":"Bown SG. Photodynamic therapy to scientists and clinicians - one world or two? Jf Photochem Photobiol B 1990; 6: 1-12.","journal-title":"Jf Photochem Photobiol B"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1111\/j.1751-1097.1987.tb04850.x","article-title":"The contrasting mechanisms of colonic collagen damage between photodynamic therapy and thermal injury","volume":"46","author":"Barr, H.; Tralau, C.J.; Boulos, P.B.; MacRobert, A.J.; Tilly, R.; Bown, S.G.","year":"1987","unstructured":"Barr H, Tralau CJ, Boulos PB, MacRobert AJ, Tilly R, Bown SG. The contrasting mechanisms of colonic collagen damage between photodynamic therapy and thermal injury. Photochem Photobiol 1987; 46: 795-800.","journal-title":"Photochem Photobiol"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/S0016-5107(93)70017-6","article-title":"Photodynamic therapy for treatment of early adenocarcinoma in Barrett's esophagus","volume":"39","author":"Overholt, B.; Panjehpour, M.; Tefftellar, E.; Rose, M.","year":"1993","unstructured":"Overholt B, Panjehpour M, Tefftellar E, Rose M. Photodynamic therapy for treatment of early adenocarcinoma in Barrett's esophagus. Gastrointest Endosc 1993; 39: 73-6.","journal-title":"Gastrointest Endosc"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/S0022-5347(17)41302-4","article-title":"Complications of whole bladder dihaematoporphyrin ether photodynamic therapy","volume":"141","author":"Harty, J.I.; Amin, M.; Wieman, T.J.; Tseng, M.T.; Ackerman, D.; Broghamer, W.","year":"1989","unstructured":"Harty JI, Amin M, Wieman TJ, Tseng MT, Ackerman D, Broghamer W. Complications of whole bladder dihaematoporphyrin ether photodynamic therapy. Jf Urol 1989; 141: 1341.","journal-title":"Jf Urol"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1016\/S0022-5347(17)38536-1","article-title":"The morphological and functional changes in rat bladder following photodynamic therapy with phthalocyanine photosensitisation","volume":"145","author":"Pope, A.J.; Bown, S.G.","year":"1991","unstructured":"Pope AJ, Bown SG. The morphological and functional changes in rat bladder following photodynamic therapy with phthalocyanine photosensitisation. Jf Urol 1991; 145: 1064-70.","journal-title":"Jf Urol"},{"key":"ref_7","first-page":"275","article-title":"Endogenous protoporphyrin IX, a clinically useful photosensitizer for photodynamic therapy","volume":"14","author":"Kennedy, J.C.; Pottier, R.H.","year":"1992","unstructured":"Kennedy JC, Pottier RH. Endogenous protoporphyrin IX, a clinically useful photosensitizer for photodynamic therapy. Jf Photochem Photobiol B 1992; 14: 275-92.","journal-title":"Jf Photochem Photobiol B"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1038\/bjc.1987.246","article-title":"Destruction of erythroleukaemic cells by photoactivation of endogenous porphyrins","volume":"56","author":"Malik, Z.; Lugaci, H.","year":"1987","unstructured":"Malik Z, Lugaci H. Destruction of erythroleukaemic cells by photoactivation of endogenous porphyrins. Br Jf Cancer 1987; 56: 589-95.","journal-title":"Br Jf Cancer"},{"key":"ref_9","first-page":"818","article-title":"Fluorescence distribution and photodynamic effect of ALA-induced PP IX in the DMH rat colonic tumour model","volume":"65","author":"Bedwell, J.; MacRobert, A.J.; Phillips, D.; Bown, S.G.","year":"1992","unstructured":"Bedwell J, MacRobert AJ, Phillips D, Bown SG. Fluorescence distribution and photodynamic effect of ALA-induced PP IX in the DMH rat colonic tumour model. BrJCancer 1992; 65: 818-24.","journal-title":"BrJCancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1002\/ijc.2910520318","article-title":"Distribution and photosensitizing efficiency of porphyrins induced by application of exogenous 5-aminolevulinic acid in mice bearing mammary carcinoma","volume":"52","author":"Peng, Q.; Moan, J.; Warloe, T.; Nesland, J.M.; Rimington, C.","year":"1992","unstructured":"Peng Q, Moan J, Warloe T, Nesland JM, Rimington C. Distribution and photosensitizing efficiency of porphyrins induced by application of exogenous 5-aminolevulinic acid in mice bearing mammary carcinoma. Int Jf Cancer 1992; 52: 433-43.","journal-title":"Int Jf Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/0140-6736(93)91347-O","article-title":"Photodynamic therapy of oral cancer: photosensitisation with systemic aminolaevulinic acid","volume":"342","author":"Grant, W.E.; Hopper, C.; MacRobert, A.J.; Speight, P.M.; Bown, S.G.","year":"1993","unstructured":"Grant WE, Hopper C, MacRobert AJ, Speight PM, Bown SG. Photodynamic therapy of oral cancer: photosensitisation with systemic aminolaevulinic acid. Lancet 1993; 342: 147-8.","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1042\/bj0640080","article-title":"Normal pathways, studied with the aid of 'N","volume":"64","year":"1956","unstructured":"Normal pathways, studied with the aid of 'N. BiochemJ 1956; 64: 80-90.","journal-title":"BiochemJ"},{"key":"ref_13","first-page":"41","article-title":"Oral versus intravenous administration of 5-aminolaevulinic acid for photodynamic therapy","volume":"68","author":"Loh, C.S.; MacRobert, A.J.; Bedwell, J.; Regula, J.; Krasner, N.; Bown, S.G.","year":"1993","unstructured":"Loh CS, MacRobert AJ, Bedwell J, Regula J, Krasner N, Bown SG. Oral versus intravenous administration of 5-aminolaevulinic acid for photodynamic therapy. Br7Cancer 1993; 68: 41-5 1."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1111\/j.1365-2362.1992.tb01482.x","article-title":"Sustained high plasma 5-aminolaevulinic acid concentration in a volunteer: no porphyric symptoms","volume":"22","author":"Mustajoki, P.; Timonen, K.; Gorchein, A.; Seppalainen, A.; Matikainen, E.; Tenhunen, K.","year":"1992","unstructured":"Mustajoki P, Timonen K, Gorchein A, Seppalainen A, Matikainen E, Tenhunen K. Sustained high plasma 5-aminolaevulinic acid concentration in a volunteer: no porphyric symptoms. Eur J Clin Invest 1992; 22: 407-11.","journal-title":"Eur J Clin Invest"},{"key":"ref_15","first-page":"13","article-title":"textbook of clinical pharmacology and drug therapy","author":"DG, Grahame Smith","year":"1992","unstructured":"Grahame Smith DG, Aronson JK, eds. Oxford textbook of clinical pharmacology and drug therapy. Oxford: Oxford University Press, 1992; 13-39."},{"issue":"12","key":"ref_16","first-page":"33","article-title":"Studies on urinary excretion of 8-aminolaevulinic acid and other haem precursors in lead workers and lead-intoxicated rabbits. Scand J7 Clin Lab","volume":"1960","author":"Haeger-Aronsen, B.","unstructured":"Haeger-Aronsen B. Studies on urinary excretion of 8-aminolaevulinic acid and other haem precursors in lead workers and lead-intoxicated rabbits. Scand J7 Clin Lab Invest 1960; 12 (suppl 47): 33-4.","journal-title":"Invest"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/1011-1344(93)80130-2","article-title":"Endogenous porphyrin distribution induced by 5 aminolaevulinic acid in the tissue layers of the gastrointestinal tract","volume":"20","author":"Loh, C.S.; Vernon, D.I.; MacRobert, A.J.; Bedwell, J.; Bown, S.G.; Brown, S.B.","year":"1993","unstructured":"Loh CS, Vernon DI, MacRobert AJ, Bedwell J, Bown SG, Brown SB. Endogenous porphyrin distribution induced by 5 aminolaevulinic acid in the tissue layers of the gastrointestinal tract. J Photochem Photobiol B 1993; 20: 47-54.","journal-title":"J Photochem Photobiol B"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1001\/archsurg.1989.01410010084018","article-title":"Photodynamic therapy for esophageal tumors","volume":"124","author":"MacCaughan, J.S.; Nims, T.A.; Guy, J.T.; Hicks, W.J.; Williams, T.E.; Laufman, L.R.","year":"1989","unstructured":"MacCaughan JS, Nims TA, Guy JT, Hicks WJ, Williams TE, Laufman LR. Photodynamic therapy for esophageal tumors. Arch Surg 1989; 124: 74-80.","journal-title":"Arch Surg"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1007\/BF01540400","article-title":"Endoscopic photodynamic therapy with hematoporphyrin derivative for primary treatment of gastrointestinal neoplasms in inoperable patients","volume":"35","author":"Patrice, T.; Foultier, M.T.; Yactayo, S.; Adam, F.; Galmiche, J.P.; Douet, M.C.","year":"1990","unstructured":"Patrice T, Foultier MT, Yactayo S, Adam F, Galmiche JP, Douet MC, et al. Endoscopic photodynamic therapy with hematoporphyrin derivative for primary treatment of gastrointestinal neoplasms in inoperable patients. Dig Dis Sci 1990; 35: 545-52.","journal-title":"Dig Dis Sci"},{"key":"ref_20","first-page":"283","article-title":"A multicentre phase III trial of photodynamic therapy (PDT) vs Nd: YAG laser in the treatment of malignant dysphagia","volume":"39","author":"Lightdale, C.; Heier, S.; Marcon, N.; McCaughan, J.; Nava, H.; Overholt, B.","year":"1993","unstructured":"Lightdale C, Heier S, Marcon N, McCaughan J, Nava H, Overholt B, et al. A multicentre phase III trial of photodynamic therapy (PDT) vs Nd:YAG laser in the treatment of malignant dysphagia. Gastrointest Endosc 1993; 39: A283.","journal-title":"Gastrointest Endosc"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1007\/BF02030738","article-title":"Evaluation of PDT in gastric cancer","volume":"1","author":"Kato, H.; Kawaguchi, M.; Konaka, C.","year":"1986","unstructured":"Kato H, Kawaguchi M, Konaka C. Evaluation of PDT in gastric cancer. ILasers Med Sci 1986; 1: 67-74.","journal-title":"ILasers Med Sci"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1002\/bjs.1800770132","article-title":"Photodynamic therapy for colorectal cancer: a quantitative pilot study","volume":"77","author":"Barr, H.; Krasner, N.; Boulos, P.B.; Chatlani, P.; Bown, S.G.","year":"1990","unstructured":"Barr H, Krasner N, Boulos PB, Chatlani P, Bown SG. Photodynamic therapy for colorectal cancer: a quantitative pilot study. BrJ Surg 1990; 77: 93-6.","journal-title":"BrJ Surg"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1002\/1097-0142(19860201)57:3<677::AID-CNCR2820570347>3.0.CO;2-V","article-title":"Photodynamic therapy in patients with colorectal cancer","volume":"57","author":"Herrera-Ornelas, L.; Petrelli, N.J.; Mittelman, A.; Dougherty, T.J.; Boyles, D.G.","year":"1986","unstructured":"Herrera-Ornelas L, Petrelli NJ, Mittelman A, Dougherty TJ, Boyles DG. Photodynamic therapy in patients with colorectal cancer. Cancer 1986; 57: 677-84.","journal-title":"Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/BF02547812","article-title":"Extended necrosis of the oesophageal wall after photodynamic therapy: report of two cases","volume":"8","author":"Hochain, P.; Ducrotte, P.; Touchais, J.Y.; Hecketsweiler, Paillot B.; P.","year":"1993","unstructured":"Hochain P, Ducrotte P, Touchais JY, Paillot B. Hecketsweiler P. Extended necrosis of the oesophageal wall after photodynamic therapy: report of two cases. Lasers Med Sci 1993; 8: 147-50.","journal-title":"Lasers Med Sci"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1002\/lsm.1900100514","article-title":"Cutaneous phototoxic occurrences in patients receiving Photofrin","volume":"10","author":"Dougherty, T.J.; Cooper, M.T.; Mang, T.S.","year":"1990","unstructured":"Dougherty TJ, Cooper MT, Mang TS. Cutaneous phototoxic occurrences in patients receiving Photofrin. Lasers Surg Med 1990; 10: 485-8.","journal-title":"Lasers Surg Med"},{"key":"ref_26","first-page":"890","article-title":"Enterohepatic circulation and conversion of protoporphyrin to bile","volume-title":"pigment in man. Proc Soc Exp Biol Med 1968","volume":"127","author":"Ibrahim, G.W.; Watson, C.J.","unstructured":"Ibrahim GW, Watson CJ. Enterohepatic circulation and conversion of protoporphyrin to bile pigment in man. Proc Soc Exp Biol Med 1968; 127: 890-5."},{"key":"ref_27","first-page":"421","article-title":"Metabolic fate of exogenous delta-aminolevulinic acid in Dubin-Johnson syndrome","volume":"94","author":"Kondo, T.; Kuchiba, K.; Shimuzu, Y.","year":"1979","unstructured":"Kondo T, Kuchiba K, Shimuzu Y. Metabolic fate of exogenous delta-aminolevulinic acid in Dubin-Johnson syndrome. Jf Lab Clin Med 1979; 94: 421-8.","journal-title":"Jf Lab Clin Med"},{"key":"ref_28","first-page":"795","article-title":"Excretion of porphyrins in urine and bile after the administration of delta-aminolevulinic acid","volume":"92","author":"Shimizu, Y.; Ida, S.; Naruto, H.; Urata, G.","year":"1978","unstructured":"Shimizu Y, Ida S, Naruto H, Urata G. Excretion of porphyrins in urine and bile after the administration of delta-aminolevulinic acid. J Lab Clin Med 1978; 92: 795-802.","journal-title":"J Lab Clin Med"},{"key":"ref_29","first-page":"289","article-title":"Porphyrogenic effects and induction of heme oxygenase in vivo by b-aminolevulinic acid","volume":"676","author":"Anderson, K.E.; Drummond, G.S.; Freddara, U.; Sardana, M.K.; Sassa, S.","year":"1981","unstructured":"Anderson KE, Drummond GS, Freddara U, Sardana MK, Sassa S. Porphyrogenic effects and induction of heme oxygenase in vivo by b-aminolevulinic acid. Biochim BiophysActa 1981; 676: 289-99.","journal-title":"Biochim BiophysActa"},{"key":"ref_30","first-page":"1407","article-title":"Kinetics of porphyrin accumulation in cultured epithelial cells exposed to ALA","volume":"25","author":"Fukada, H.; Batlle, A.M.C.; Riley, P.A.","year":"1993","unstructured":"Fukada H, Batlle AMC, Riley PA. Kinetics of porphyrin accumulation in cultured epithelial cells exposed to ALA. IntJfBiochem 1993; 25: 1407-10.","journal-title":"IntJfBiochem"},{"key":"ref_31","first-page":"33","article-title":"Fluorescence studies of 5-aminolaevulinic acid induced protoporphyrin IX and sulphonated aluminium","volume-title":"phthalocyanine tissue distributions. Proc SPIE 1993","volume":"2081","author":"MacRobert, A.J.; Judd, M.D.; Regula, J.; Grant, W.E.; Bown, S.G.","unstructured":"MacRobert AJ, Judd MD, Regula J, Grant WE, Bown SG. Fluorescence studies of 5-aminolaevulinic acid induced protoporphyrin IX and sulphonated aluminium phthalocyanine tissue distributions. Proc SPIE 1993; 2081: 33-40."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/0016-5085(92)90860-2","article-title":"Selective accumulation of endogenously produced porphyrins in a liver metastasis model in rats","volume":"103","author":"R, Van Hillegersberg; den Berg JWO, Van; WJ, Kort; OT, Terpstra; JHP, Wilson","year":"1992","unstructured":"Van Hillegersberg R, Van den Berg JWO, Kort WJ, Terpstra OT, Wilson JHP. Selective accumulation of endogenously produced porphyrins in a liver metastasis model in rats. Gastroenterology 1992; 103: 647-51.","journal-title":"Gastroenterology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/1011-1344(93)80127-U","article-title":"Porphyrins, porphyrias, cancer and photodynamic therapy - a model for carcinogenesis","volume":"20","author":"del C AM, Batlle","year":"1993","unstructured":"Batlle del C AM. Porphyrins, porphyrias, cancer and photodynamic therapy - a model for carcinogenesis. J Photochem Photobiol 1993; 20: 5-22.","journal-title":"J Photochem Photobiol"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1007\/BF01307557","article-title":"Regression of Barrett's esophagus by laser ablation in an anacid environment","volume":"38","author":"Sampliner, R.E.; Hixson, U.; Fennerty, M.B.; Garewal, H.S.","year":"1993","unstructured":"Sampliner RE, Hixson U, Fennerty MB, Garewal HS. Regression of Barrett's esophagus by laser ablation in an anacid environment. Dig Dis Sci 1993; 38: 365-8.","journal-title":"Dig Dis Sci"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1042\/cs0720103","article-title":"8-Aminolaevulinic acid in plasma, cerebrospinal fluid, saliva and erythrocytes: studies in normal, uraemic and porphyric subjects","volume":"72","author":"R, Gorchein A.Webber","year":"1987","unstructured":"Gorchein A. Webber R. 8-Aminolaevulinic acid in plasma, cerebrospinal fluid, saliva and erythrocytes: studies in normal, uraemic and porphyric subjects. Clin Sci 1987; 72: 103-12.","journal-title":"Clin Sci"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.36.1.67","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T07:16:33Z","timestamp":1765005393000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.36.1.67"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,1]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[1995,1,1]]},"published-print":{"date-parts":[[1995,1]]}},"alternative-id":["10.1136\/gut.36.1.67"],"URL":"https:\/\/doi.org\/10.1136\/gut.36.1.67","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,1]]}}}