Skin turbidity limits light based medical applications while increasing the risk of epidermal thermal injury. Collagen fibers are responsible for the majority of light scattering within skin. Chemicals, known as clearing agents, reduce tissue light scattering with the potential to increase the efficacy of light based imaging and therapeutic applications. Three hypotheses have been suggested for the clearing mechanism: index of refraction matching between clearing agent and collagen, tissue dehydration, and agent induced collagen structure perturbation. This study investigates optical clearing in skin while presenting a comprehensive clearing mechanism. Clearing was found to be a complex process with thermodynamic and kinetic components. Concentration gradients drive clearing agents to diffuse into skin and remove water. The introduction of clearing agents into the tissue reduces light scatter. The speed of clearing was found to increase with molecular size and number of hydroxyl groups. The molecular modeling program CHARMM suggests collagen affinity plays a major role in clearing agents’ ability to interact with collagen and remove bound water. Collagen solubility is a measure of clearing agent affinity for collagen and was found as a predictor of agent clearing potential. Increasing agent molecular size led to a greater reduction of fibrillogenesis with corresponding high collagen solubility. Raman spectroscopy quantified clearing agent induced dehydration of dermal collagen. Clearing agent ability to dehydrate dermal collagen corresponded with collagen affinity and the ability to clear tissue optically. The most effective clearing agents were found to remove bound water with the greatest efficacy. Replacement of collagen triple helix bound water by clearing agents with an index of refraction similar to collagen optically homogenizes skin tissue leading to a reduction in light scattering. Through dehydration of collagen with concomitant diffusion of clearing agent into collagen, the skin is homogenized leading to a large reduction in tissue light scattering.

京都大学 / 0048 / 新制・課程博士 / 博士(生命科学) / 甲第18426号 / 生博第306号 / 新制||生||40(附属図書館) / 31284 / 京都大学大学院生命科学研究科高次生命科学専攻 / (主査)教授 松崎 文雄, 教授 渡邉 大, 教授 松田 道行 / 学位規則第4条第1項該当 / Doctor of Philosophy in Life Sciences / Kyoto University / DFAM

Biomedical optics is a rapidly expanding field of research focusing on the development of methods to detect, diagnose, and treat disease using light. While there are a myriad of optical systems that have been developed for biological tissue imaging, optical diagnostics, and optical therapeutics, all of these methods suffer severely limited penetration depths due to attenuation of light by tissue constituent chromophores, including cells, water, blood, and protein structures. Tissue optical clearing is a recent area of study within biomedical optics and photonics, where chemical agents have been used to alter tissue optical properties, reducing optical absorption and scattering and enabling light delivery to and collection from deeper tissue regions. However, there are concerns as to the safety and efficacy of these chemical clearing agents in vivo, especially in the skin, where the projective barrier function of the stratum corneum must be removed. Mechanical optical clearing is a recently developed technology which utilizes mechanical loading to reversibly modify light transport through soft tissues, and much of the work published on this technique has focused on applications in skin tissue. This clearing technique enables deeper light delivery into soft tissues but does not require use of exogenous chemicals, nor does it compromise the skin barrier function. While this clearing effect is thought to be resultant from interstitial water and blood transport, the underlying mechanism has not been concretely identified nor characterized. The hypothesis of this body of work was that interstitial transport of tissue chromophores (e.g. water and blood) causes intrinsic optical property changes, reduces tissue optical absorption and scattering, and improves light delivery in diagnostic applications. To test this hypothesis, we first developed a mathematical framework to simulate mechanical optical clearing, using both mechanical finite element models and optical Monte Carlo simulations. By directly simulating interstitial water transport in response to loading, data from mechanical simulations was combined with optical Monte Carlo simulations, which enabled prediction of light transmission measurements made during mechanical indentation experiments. We also investigated changes in optical properties during mechanical indentation using diffuse reflectance spectroscopy. These studies used controlled flat indentation by a fiberoptic probe to dynamically measure intrinsic optical properties as they changed over time. Finally, we apply mechanical optical clearing principles to functional near-infrared spectroscopy for neuroimaging. By building a prototypical mechanical optical clearing device for measuring cerebral hemodynamics, we demonstrated that mechanical optical clearing devices modify measured cerebral hemodynamic signals in human subjects, improving signal quality. / Ph. D.

Melanoma is a pigmented tumor that originates from the melanocytes; pigmented cells present throughout the body, including skin and iris. The cutaneous form is the most common type, and it represents about 5% of the skin tumors diagnosed in Brazil. Although it does not have a high incidence, it represents about 80% to 85% of all skin tumor deaths. The second most frequent type of melanoma is ocular. It represents 5% of all melanoma cases and is a potentially lethal disease, especially when it causes metastasis. The main therapeutic approach for melanomas, in general, is surgery, with resection of the cutaneous lesion or enucleation in the case of ocular melanoma. Other techniques such as adjuvant immunotherapy, palliative chemotherapy, and radiotherapy are also used. However, they have low efficacy and several side effects. Photodynamic therapy is a therapeutic modality based on the interaction of light at specific wavelength and photosensitizer, in the presence of molecular oxygen, leading the cell to death. As melanoma is a pigmented cancer, it usually does not respond well to photodynamic therapy due to the high absorption of light on the surface of the tumor, making volumetric eradication impossible. This project investigated optical strategies for the diagnosis and treatment of melanoma. For the diagnosis, it was evaluated the fluorescence lifetime technique to differentiate melanoma and normal skin. A sensitivity of 99.4%, specificity of 97.4% and accuracy of 98.4% were achieved using linear discrimination analysis. For the cutaneous melanoma treatment, PDT combined to optical clearing agents (OCAs) was investigated. Vascular and cell-target photosensitizers were evaluated combined or not to OCAs. OCA improved PDT response in all pigmented tumors treated, but the best results were achieved when a dual-photosensitizer treatment combined to OCA was performed. The treatment of conjunctival melanoma was conducted using 2-photon excitation photodynamic therapy. The advantage of this technique is the use of infrared light, in a wavelength that melanin has a low absorption, improving the light penetration into the tumor. The tumor histology shows that apoptosis was induced only at the treatment site, with no damage to the surrounding tissue. Additionally, a single TPE-PDT session could treat the entire tumor. / O melanoma é um tumor pigmentado que surge dos melanócitos, células pigmentadas presentes em todo o corpo, incluindo a pele e a íris. A forma cutânea é a mais comum e representa cerca de 5% dos tumores cutâneos diagnosticados no Brasil. Embora não tenha uma alta incidência, representa cerca de 80% a 85% de todas as mortes por tumor de pele. O segundo tipo de melanoma mais frequente é o ocular. Representa 5% de todos os casos de melanoma e é uma doença potencialmente letal, especialmente em casos de metástase. A principal abordagem terapêutica para melanomas, em geral, é a cirurgia, com ressecção da lesão cutânea ou enucleação no caso do melanoma ocular. Outras técnicas, como imunoterapia adjuvante, quimioterapia paliativa e radioterapia também são usadas, porém, apresentam baixa eficiência e muitos efeitos colaterais. A terapia fotodinâmica é uma modalidade terapêutica baseada na interação da luz em um comprimento de onda específico e um fotossensibilizador, na presença de oxigênio molecular, levando a célula à morte. Como o melanoma é um câncer pigmentado, geralmente não responde bem à terapia fotodinâmica devido à alta absorção de luz na superfície do tumor, impossibilitando a erradicação volumétrica. Este projeto investigou estratégias ópticas para o diagnóstico e tratamento do melanoma. Para o diagnóstico, foi avaliada a técnica de tempo de vida de fluorescência para distinguir melanoma de pele normal. Utilizando análise de discriminação linear, obteve-se uma sensibilidade de 99,4%, especificidade de 97,4% e precisão de 98,4%. Para o tratamento de melanoma cutâneo, a PDT combinada com clareadores ópticos (OCAs) foi investigada. Um fotossensibilizador que tem como alvo vaso sanguíneo e um fotossensibilizador de alvo celular foram avaliados combinados ou não com OCAs. OCAs são soluções hiperosmóticas que desidratam o tecido, diminuindo o espalhamento da luz e melhorando a penetração de luz em profundidade. OCA melhorou a resposta de PDT em todos os tumores melanóticos tratados, mas os melhores resultados foram obtidos quando a PDT foi realizada com a combinação dos fotossensibilizadores e clareador óptico em uma única sessão. O tratamento do melanoma conjuntival foi realizado utilizando a terapia fotodinâmica por excitação de 2 fótons (TPE-PDT). A vantagem desta técnica é o uso de luz na região do infravermelho, em um comprimento de onda que melanina tem baixa absorção, melhorando a penetração de luz no tumor. A histologia do tumor mostrou que a apoptose foi induzida apenas no local do tratamento, sem danos no tecido adjacente. Além disso, uma única sessão de TPE-PDT foi capaz de tratar todo o tumor.

Melanoma is a pigmented tumor that originates from the melanocytes; pigmented cells present throughout the body, including skin and iris. The cutaneous form is the most common type, and it represents about 5% of the skin tumors diagnosed in Brazil. Although it does not have a high incidence, it represents about 80% to 85% of all skin tumor deaths. The second most frequent type of melanoma is ocular. It represents 5% of all melanoma cases and is a potentially lethal disease, especially when it causes metastasis. The main therapeutic approach for melanomas, in general, is surgery, with resection of the cutaneous lesion or enucleation in the case of ocular melanoma. Other techniques such as adjuvant immunotherapy, palliative chemotherapy, and radiotherapy are also used. However, they have low efficacy and several side effects. Photodynamic therapy is a therapeutic modality based on the interaction of light at specific wavelength and photosensitizer, in the presence of molecular oxygen, leading the cell to death. As melanoma is a pigmented cancer, it usually does not respond well to photodynamic therapy due to the high absorption of light on the surface of the tumor, making volumetric eradication impossible. This project investigated optical strategies for the diagnosis and treatment of melanoma. For the diagnosis, it was evaluated the fluorescence lifetime technique to differentiate melanoma and normal skin. A sensitivity of 99.4%, specificity of 97.4% and accuracy of 98.4% were achieved using linear discrimination analysis. For the cutaneous melanoma treatment, PDT combined to optical clearing agents (OCAs) was investigated. Vascular and cell-target photosensitizers were evaluated combined or not to OCAs. OCA improved PDT response in all pigmented tumors treated, but the best results were achieved when a dual-photosensitizer treatment combined to OCA was performed. The treatment of conjunctival melanoma was conducted using 2-photon excitation photodynamic therapy. The advantage of this technique is the use of infrared light, in a wavelength that melanin has a low absorption, improving the light penetration into the tumor. The tumor histology shows that apoptosis was induced only at the treatment site, with no damage to the surrounding tissue. Additionally, a single TPE-PDT session could treat the entire tumor. / O melanoma é um tumor pigmentado que surge dos melanócitos, células pigmentadas presentes em todo o corpo, incluindo a pele e a íris. A forma cutânea é a mais comum e representa cerca de 5% dos tumores cutâneos diagnosticados no Brasil. Embora não tenha uma alta incidência, representa cerca de 80% a 85% de todas as mortes por tumor de pele. O segundo tipo de melanoma mais frequente é o ocular. Representa 5% de todos os casos de melanoma e é uma doença potencialmente letal, especialmente em casos de metástase. A principal abordagem terapêutica para melanomas, em geral, é a cirurgia, com ressecção da lesão cutânea ou enucleação no caso do melanoma ocular. Outras técnicas, como imunoterapia adjuvante, quimioterapia paliativa e radioterapia também são usadas, porém, apresentam baixa eficiência e muitos efeitos colaterais. A terapia fotodinâmica é uma modalidade terapêutica baseada na interação da luz em um comprimento de onda específico e um fotossensibilizador, na presença de oxigênio molecular, levando a célula à morte. Como o melanoma é um câncer pigmentado, geralmente não responde bem à terapia fotodinâmica devido à alta absorção de luz na superfície do tumor, impossibilitando a erradicação volumétrica. Este projeto investigou estratégias ópticas para o diagnóstico e tratamento do melanoma. Para o diagnóstico, foi avaliada a técnica de tempo de vida de fluorescência para distinguir melanoma de pele normal. Utilizando análise de discriminação linear, obteve-se uma sensibilidade de 99,4%, especificidade de 97,4% e precisão de 98,4%. Para o tratamento de melanoma cutâneo, a PDT combinada com clareadores ópticos (OCAs) foi investigada. Um fotossensibilizador que tem como alvo vaso sanguíneo e um fotossensibilizador de alvo celular foram avaliados combinados ou não com OCAs. OCAs são soluções hiperosmóticas que desidratam o tecido, diminuindo o espalhamento da luz e melhorando a penetração de luz em profundidade. OCA melhorou a resposta de PDT em todos os tumores melanóticos tratados, mas os melhores resultados foram obtidos quando a PDT foi realizada com a combinação dos fotossensibilizadores e clareador óptico em uma única sessão. O tratamento do melanoma conjuntival foi realizado utilizando a terapia fotodinâmica por excitação de 2 fótons (TPE-PDT). A vantagem desta técnica é o uso de luz na região do infravermelho, em um comprimento de onda que melanina tem baixa absorção, melhorando a penetração de luz no tumor. A histologia do tumor mostrou que a apoptose foi induzida apenas no local do tratamento, sem danos no tecido adjacente. Além disso, uma única sessão de TPE-PDT foi capaz de tratar todo o tumor.