gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

The therapeutic effect of ALA-PDT on meningiomas: an in vitro study on primary cell cultures

Meeting Abstract

  • M. El-Khatib - Neurochirurgische Klinik der Medizinischen Einrichtungen der HHU Düsseldorf
  • C. Tepe - Neurochirurgische Klinik der Medizinischen Einrichtungen der HHU Düsseldorf
  • H.J. Steiger - Neurochirurgische Klinik der Medizinischen Einrichtungen der HHU Düsseldorf
  • W. Stummer - Klinik und Poliklinik für Neurochirurgie des Universitätsklinikum Münster

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocMI.04.03

doi: 10.3205/11dgnc201, urn:nbn:de:0183-11dgnc2019

Published: April 28, 2011

© 2011 El-Khatib et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: ALA-PDT (photo dynamic therapy) is established in different diseases as a successful therapy modality. Various benign and malignant skin diseases are targets of ALA-PDT in dermatology. In neurosurgery there are already some reports of good results after ALA-PDT in localized recurrent Glioblastomas (GBM). Recently, two groups reported 5-ALA induced fluorescence in meningiomas. The aim of our study was to verify 5-ALA induced fluorescence in primary meningioma cell cultures and to determine the therapeutic effect of ALA-PDT.

Methods: Intra-operatively obtained tumor material was processed within 24 h for the cell culture. EMA (endothelin membrane antigen) immunohistochemistry was performed after the first passage to verify meningioma growth. For the ALA-PDT we seeded 5000 cells in each of 20 wells of an empty 96-well-plate. Each block of four wells was inoculated with 150 µl of 0 µg/ccm, 25 µg/ccm (=3.25 µg ALA), 50 µg/ccm (=7.5 µg ALA) and 100 µg/ccm (=15 µg ALA) 5-ALA solutions. One block as a negative control without ALA and without PDT. After incubation of the well plate for three hours we used the Ceralas 635 Laser System by Biolitec GmbH (635 nm, 1 W, 10min) for PDT. The therapeutic response was controlled and analysed by the WST-1 cell proliferation assay 90 min after PDT.

Results: We performed ALA-PDT in 13 primary cultured meningiomas (11 WHO I, 1 WHO II and 1 WHO III meningiomas). EMA positivity was demonstrated in 10 primary cell cultures. The remaining three were EMA negative. In these cultures, no therapeutic effect of PDT was observed. All ten EMA positive cultures showed a significant decrease of living meningioma cells depending on the ALA dose. The mean portion of surviving cells documented by the WST-1 assay was 100% (no ALA), 68% (3.25 µg ALA), 24% (7.5 µg ALA), 14% (15 µg ALA) and 100% for the negative control. The LD 50 was 50 µg/ccm (=7.5 µg/5000 cells). The therapeutic effect of ALA PDT did not correlate with WHO grading.

Conclusions: There is a positive therapeutic effect of ALA-PDT on primary cell cultures of meningiomas in vitro. Uptake and response did not depend on degree of malignancy or subtype. ALA-PDT may thus be an option for recurrent or inoperable meningiomas.