Local Photodynamic Therapy Reduces Tissue Hyperplasia in an Experimental Restenosis Model

Abstract— Local photodynamic therapy may have potential in preventing myointimal hyperplasia after angioplasty. In this study, the effect of photodynamic therapy was evaluated in an experimental model of restenosis. Standardized unidirectional arterial injury with a directional atherectomy catheter was performed in porcine arteries. Animals were randomly allocated to four groups: group 1, unidirectional injury only; group 2, injury followed by local delivery of photosensitizer; group 3, injury followed by local exposure to monochromatic light; and group 4, where injury was followed by local drug delivery of photosensitizer and subsequent exposure to light (photodynamic therapy). Seven, 14 or 21 days after treatment, all experimental vessels were excised, fixed and processed for histology. An inflammatory and myoproliferative response was observed after injury in vessels from groups 1, 2 and 3. In group 4, after injury followed by photodynamic therapy, the myoproliferative response was significantly reduced. Thus, in this study, tissue hyperplasia after unidirectional injury was effectively suppressed by photodynamic therapy.     

用于光动力治疗的四苯基卟啉衍生物研究进展

四苯基卟啉(TPP)衍生物的重要用途之一是用于光动力治疗(PDT)来破坏肿瘤组织.本文综述了近年来可用于光动力治疗的四苯基卟啉(TPP)衍生物的合成.通过对TPP衍生物进行官能团修饰,可以改善其物理、化学及生物性质,从而合成出可能用于PDT的卟啉衍生物.     

EFFICACY OF PHOTODYNAMIC THERAPY ON ORIGINAL AND RECURRENT RAT MAMMARY TUMORS

Abstract— Photodynamic therapy has demonstrated efficacy toward primary, metastatic and recurrent human tumors. Here, we investigated the ability of photodynamic therapy, using Photofrin, to inhibit growth of R3230AC mammary adenocarcinomas when tumors were treated as original implants and again as lesions recurring at the initial treatment site. The results demonstrate that both initial implants and lesions recurring after the first photodynamic treatment respond similarly to the same photodynamic therapy protocol, with mean tumor volume doubling times of ˜ 11 days in both cases. Cells cultured from original tumor implants or tumors that recurred after photodynamic treatment accumulate equivalent amounts of [¹⁴C]polyhematoporphyrin. Single cell suspensions prepared from either original or recurrent tumors from animals administered 5 mg/kg Photofrin and exposed to light in vitro displayed comparable phototoxicity. Additionally, examination of tumors by light microscopy revealed no morphological differences between the original tumor implants and the recurrent lesions. Taken together, these data indicate that lesions which recurred at the site of the initial photodynamic treatment were not resistant to a second identical course of photodynamic therapy.     

Photodynamic treatment with fractionated light decreases production of reactive oxygen species and cytotoxicity in vitro via regeneration of glutathione

Photodynamic therapy removes unwanted or harmful cells by overproduction of reactive oxygen species (ROS). Fractionated light delivery in photodynamic therapy may enhance the photodynamic effect in tumor areas with insufficient blood supply by enabling the reoxygenation of the treated area. This study addresses the outcome of fractionated irradiation in an in vitro photodynamic treatment (PDT) system, where deoxygenation can be neglected. Our results show that fractionated irradiation with light/dark intervals of 45/60 s decreases ROS production and cytotoxicity of PDT. This effect can be reversed by addition of 1,3-bis-(2-chlorethyl)-1-nitrosurea (BCNU), an inhibitor of the glutathione reductase. We suggest that the dark intervals during irradiation allow the glutathione reductase to regenerate reduced glutathione (GSH), thereby rendering cells less susceptible to ROS produced by PDT compared with continuous irradiation. Our results could be of particular clinical importance for photodynamic therapy applied to well-oxygenated tumors.     

Down-regulation of Bcl-2 and Akt induced by combination of photoactivated hypericin and genistein in human breast cancer cells

Presented experiment considers combination of genistein and photodynamic therapy with hypericin with a view to achieve higher therapeutic outcome in human breast adenocarcinoma cell lines MCF-7 and MDA-MB-231, both identified in our conditions as photodynamic therapy resistant. Since genistein is known to suppress Bcl-2 expression, we predicted that photodynamic therapy with hypericin might benefit from mutual therapeutic combination. In line with our expectations, combined treatment led to down-regulation of Bcl-2 and up-regulation of Bax in both cell lines as well as to suppression of Akt and Erk1/2 phosphorylation induced by photoactivated hypericin in MCF-7 cells. Although Akt and Erk1/2 phosphorylation was not stimulated by photodynamic therapy with hypericin in MDA-MB-231 cells, it was effectively suppressed in combination. Variations in cell death signaling favoring apoptosis were indeed accompanied by cell cycle arrest in G₂/M-phase, activation of caspase-7, PARP cleavage and increased occurrence of cells with apoptotic morphology of nucleus. All these events corresponded with suppression of proliferation and significantly lowered clonogenic ability of treated cells. In conclusion, our results indicate that pre-treatment with tyrosine kinase inhibitor genistein may significantly improve the effectiveness of photodynamic therapy with hypericin in MCF-7 and MDA-MB-231 breast cancer cells.     

Photodynamic Therapy of Oligoethylene Glycol‐Dendronized Reduction‐Sensitive Porphyrins

Graphene oxide (GO ) and its functionalized derivatives have attracted increasing attention in medical treatment. Herein, a reduction sensitive PEI‐GO ‐SS ‐TPP was synthesized for photodynamic therapy. More than 80% porphyrin release was observed in the presence of 10 mmol•L⁻¹ DTT in one day. The confocal laser scanning microscopy confirmed that the cell uptake efficiency of PEI‐GO‐SS‐TPP was remarkably enhanced as compared to free porphyrin which was significantly dependent on incubation time. For photodynamic therapy, GSH‐OEt could effectively increase the photodynamic therapy efficiency of PEI‐GO ‐SS ‐TPP . Compared with free porphyrin, the toxicity from PEI‐GO ‐SS ‐TPP is much higher with a low IC₅₀ (2.1 µg/mL ) value. All results indicate that the PEI‐GO ‐SS ‐TPP PSs are promising for photodynamic therapy.     

The effect of photodynamic therapy alone and in combination with misonidazole or X-rays for management of a retinoblastoma-like tumour

Abstract— The effect of photodynamic therapy alone and combined with misonidazole or X-rays has been investigated in an intraocular retinoblastoma-like tumor. Tumour control rate was achieved up to 33% and depended both on the light energy doses and the Photofrin II doses. Misonidazole injected prior to light irradiation did not enhance the photodynamic therapy response, although the misonidazole was uptaken by the tumor tissue. The combination of X-rays and photodynamic therapy demonstrated both in vivo and in vitro not more than a simple additive effect and there was no difference between X-rays given before or after the light irradiation.     

Complexes of ferromagnetic fluids with photoditazin and their promising applications in photodynamic therapy

Nanosized complexes of ferroparticles with a sensitizer photoditazin (used in photodynamic therapy in oncology) have been synthesized and studied by small-angle neutron scattering. The structure of the complexes was determined, and the influence of the biocompatible polymer pluronic investigated. Clinical tests revealed increased efficiency of the complexes compared with the starting photoditazin. The complexes can be used as the first magnetically operated sensitizer for treatment of oncological diseases by photodynamic therapy.     

THE CONTRASTING MECHANISMS OF COLONIC COLLAGEN DAMAGE BETWEEN PHOTODYNAMIC THERAPY and THERMAL INJURY

Abstract The colon is protected from disruption and bursting pressures by the submucosal collagen layer. Photodynamic therapy with aluminium sulphonated phthalocyanine (AlSPc) does not cause perforation or reduction in the bursting strength of the rodent colon despite causing full thickness damage. Thermal injury also produces full thickness necrosis but causes perforation and considerably reduces the bursting strength of the colon. The differing mechanisms of damage were examined. Using transmission electron microscopy we examined collagen from undamaged normal rodent colon, colon damaged by photodynamic therapy and thermally injured colon. Following photodynamic therapy collagen maintained its architecture and periodicity. Thermally damaged collagen became grossly swollen and lost its fibrillary architecture. We have concluded that photodynamic therapy with AlSPc is collagen sparing.     

INTRATUMOR TEMPERATURE MEASUREMENTS DURING PHOTODYNAMIC THERAPY

Abstract Photodynamic therapy has been under investigation as a form of cancer treatment for a number of years. This procedure uses a light source of 630 nm to photoactivate the drug, Photofrin II. Researchers in the past have reported temperature increases during photodynamic therapy, by measuring surface temperature of the tumor or a single point temperature within the tumors. Three temperature points within the tumors have been measured in this study, to quantify the temperature distribution within the lesion. These temperatures were measured for photodynamic therapy treated mice and control mice receiving an exposure to the treatment light without the drug. The use of a filtered xenon arc lamp for the 630 nm light source produced larger temperature increases and thermal gradients within the tumors, than when an Argon dye laser was employed. This temperature increase is due in part to the broad wavelength output of this filtered lamp. When this thermal effect is present during PDT treatment, researchers have observed the development of shock proteins resulting in the induction of thermotolerance and resistance to subsequence hyperthermia treatments. Using the filtered arc lamp, mice receiving photodynamic therapy treatments displayed consistently higher temperature increases than control mice. The use of an argon dye laser, with sufficient air cooling of the tumor, can eliminate this thermal effect. It has been demonstrated that the use of filtered lamps produce thermal effects which cannot be eliminated, demonstrating that lasers should be the primary source of light used to photoirradiate animals for photodynamic therapy studies. The intratumor temperature increases should be documented at multiple positions, to determine the amount of thermotolerance which can be induced. When photodynamic therapy is followed with a subsequent hyperthermia treatment, this induced thermotolerance can then be taken into consideration.     

双重作用机制卟啉靶向给药体系的研究进展

近年来卟啉化学研究的一个新热点是,依据卟啉类化合物在肿瘤细胞优先集聚的特点,将其作为携带剂介导现有抗癌药物,实现靶向给药,同时利用卟啉的光敏性,实现分子内加和增效,合成具有化学杀伤和光动力杀伤双重活性的卟啉-抗癌药物体系。本文主要就双重作用机制卟啉靶向给药体系的研究进展进行综述。     

Specific inhibition of the ABCG2 transporter could improve the efficacy of photodynamic therapy

Photodynamic therapy is based on the selective accumulation of a photosensitizer in tumors, followed by destruction of the target tissue by a light source. Protoporphyrin IX, a well-known photosensitizer, was recently reported as an endogenous substrate for the multidrug transporter ABCG2. We investigated the role of ABCG2 protein in the porphyrin extrusion ability of keratinocytes, with regard to the impact of the specific inhibition of ABCG2 by a non-toxic fumitremorgin C analog, Ko-134, on photodynamic therapy efficacy. We studied the level of porphyrin accumulation in response to delta-aminolevulinic acid pretreatment in proliferating and highly differentiated HaCaT keratinocytes. An in vitro model of photodynamic therapy on HaCaT cells was established with a therapeutically approved narrow-bandwidth red-light source. The porphyrin extrusion ability of HaCaT cells proved to correlate with their ABCG2 expression which was higher in proliferating cells than in differentiated cells. Moreover, the specific inhibition of ABCG2 by Ko-134 enhanced the sensitivity of keratinocytes to photodynamic therapy in vitro. These results suggest that ABCG2 may serve as a target molecule via which to improve the photodynamic therapy of skin lesions: its inhibition by the non-toxic Ko-134 is a promising therapeutic modality.     

Poly(ethylene glycol) conjugated nano-graphene oxide for photodynamic therapy

A novel methoxy-poly(ethylene glycol) modified nano-graphene oxide (NGO-mPEG) was designed and synthesized as a photosensitizer (PS) carrier for photodynamic therapy of cancer. NGO with a size below 200 nm was prepared using a modified Hummers’ method. NGO was observed by AFM to exhibit a structure with single-layer graphene oxide sheets down to a few nanometers in height. Hydrophilic mPEG conjugation of NGO (NGO-mPEG) was found to enhance solubility in cell culture media. No apparent cytotoxicity of the NGO-mPEG was observed towards MCF-7 carcinoma cell line. Zinc phthalocyanine (ZnPc), a photosensitizer for photodynamic therapy, was loaded in the NGO-PEG through π-π stacking and hydrophobic interactions, with the drug loading efficiency up to 14 wt%. Hydrophobic ZnPc was internalized in MCF-7 cells, exhibiting a pronounced phototoxicity in the cells under Xe light irradiation. The results indicate a great potential of NGO-mPEG for photodynamic therapy of cancer.     

Photodynamic antimicrobial activity of hypocrellin A

Antimicrobial photodynamic therapy is a recently developed therapeutic option that combines a non-toxic photosensitizer with harmless visible light to damage the microbial cell. Hypocrellin A (HA), a natural occurring lipid-soluble perylenequinone pigment, has gained considerable interest since its anticancer and antiviral activities have been reported. Here, we examined the antimicrobial activity of HA against Gram-positive (Staphylococcus aureus, Bacillus subtilis) and Gram-negative bacteria (Escherichia coli, Salmonella typhimurium). The results indicate that HA has a photodynamic antimicrobial activity against both Gram-positive and Gram-negative bacteria when CaCl(2) or MgCl(2) was employed. A loose binding has been established between HA and the organisms. Molecular oxygen is significantly involved in the photodynamic action of HA. Furthermore, HA maintains a photodynamic activity in terms of both types I and II reactions. Our results confirm the potential of HA to be used as a photosensitizer in antimicrobial photodynamic therapy.     

OVERVIEW OF EXPERIENCES WITH PHOTODYNAMIC THERAPY FOR MALIGNANCY IN 192 PATIENTS

Abstract From April 1982 to April 1986 we used photodynamic therapy to treat 192 patients with various malignancies. In all, 172 injections of hematoporphyrin derivative and 135 injections of dihematoporphyrin ether were made intravenously to sensitize the tumors; 684 photodynamic treatments were given using a tunable dye argon laser system for the light source. The technical problems of the light source and delivery systems are presented and the efficacy of therapy is analyzed.     

PHOTODYNAMIC THERAPY WITH PHOTOFRIN II INDUCES PROGRAMMED CELL DEATH IN CARCINOMA CELL LINES

Abstract The mode of cell death following photodynamic therapy was investigated from the perspective of programmed cell death or apoptosis. Human prostate carcinoma cells (PC3), human non-small cell lung carcinoma (H322a) and rat mammary carcinoma (MTF7) were treated by photodynamic therapy. An examination of extracted cellular DNA by gel electrophoresis showed the characteristic DNA ladder indicative of internucleosomal cleavage of DNA during apoptosis. The magnitude of the response and the photodynamic therapy dosage required to induce DNA fragmentation were different in PC3 and MTF7. The MTF7 cells responded with rapid apoptosis at the dose of light and drug that yielded 50% cell death (LD₅₀). In contrast, PC3 showed only marginal response at the LD₅₀ but had a marked response at the LD₈₅. Thus, apoptosis did not ensue as quickly in PC3 as in MTF7. The H322a cells were killed by photodynamic therapy but failed to exhibit any apoptotic response. The results also suggested that apoptosis in these cell lines has a minor requirement for de novo protein synthesis and no requirement for de novo RNA synthesis. This study indicates that although apoptosis can occur during photodynamic therapy-induced cell death, this response is not universal for all cancer cell lines.     

适体功能化的金纳米棒用于癌症靶向治疗的研究进展

金纳米棒(gold nanorods,GNRs)具有特殊的光学性质、较大的比表面积、出色的光热转换性能、表面易修饰等特点,在药物递送、光疗、生物成像和化学传感等领域应用十分广泛。适体是短的单链DNA或RNA片段,可特异性识别癌细胞或其表面的膜蛋白。近年来,适体功能化的GNRs在癌症靶向治疗领域显示出良好的应用前景。根据GNRs对癌症作用机制的差异,本文从光热疗法、光动力疗法、化疗和联合疗法4个方面总结了适体功能化的GNRs在癌症靶向治疗中的最新进展,并对该领域面临的主要挑战和发展趋势进行了探讨与展望。     

Long-Circulating Prostate-Specific Membrane Antigen-Targeted NIR Phototheranostic Agent

Targeted photodynamic therapy (PDT) combined with image-guided surgical resection is a promising strategy for precision cancer treatment. Prostate-specific membrane antigen (PSMA) is an attractive target due to its pronounced overexpression in a variety of tumors, most notably in prostate cancer. Recently, we reported a pyropheophorbide-based PSMA-targeted agent, which exhibited long plasma circulation time and effective tumor accumulation. To further advance PSMA-targeted photodynamic therapy by harvesting tissue-penetrating properties of the NIR light, we developed a bacteriochlorophyll-based PSMA-targeted photosensitizer (BPP), consisting of three building blocks: (1) a PSMA-affinity ligand, (2) a peptide linker to prolong plasma circulation time and (3) a bacteriochlorophyll photosensitizer for NIR fluorescence imaging and photodynamic therapy (Qy absorption maximum at 750 nm). BPP exhibited excellent PSMA-targeting selectivity in both subcutaneous and orthotopic mouse models. The nine D-peptide linker in BPP structure prolonged its plasma circulation time (12.65 h). Favorable pharmacokinetic properties combined with excellent targeting selectivity enabled effective BPP tumor accumulation, which led to effective PDT in a subcutaneous prostate adenocarcinoma mouse model. Overall, bright NIR fluorescence of BPP enables effective image guidance for surgical resection, while the combination of its targeting capabilities and PDT activity allows for potent and precise image-guided photodynamic treatment of PSMA-expressing tumors.     

Specific Light‐Up Bioprobe with Aggregation‐Induced Emission and Activatable Photoactivity for the Targeted and Image‐Guided Photodynamic Ablation of Cancer Cells

Activatable photosensitizers (PSs) have been widely used for the simultaneous fluorescence imaging and photodynamic ablation of cancer cells. However, the ready aggregation of traditional PSs in aqueous media can lead to fluorescence quenching as well as reduced phototoxicity even in the activated form. We have developed a series of PSs that show aggregation‐enhanced emission and phototoxicity and thus the exact opposite behavior to that of previously reported PSs. We further developed a dual‐targeted enzyme‐activatable bioprobe based on the optimized photosensitizer and describe simultaneous light‐up fluorescence imaging and activated photodynamic therapy for specific cancer cells. The design of smart probes should thus open new opportunities for targeted and image‐guided photodynamic therapy.     

Red blood cell ghosts and intact red blood cells as complementary models in photodynamic cell research

Recent research on erythrocytes as model cells for photodynamic therapy showed differing behaviour of certain photosensitisers in erythrocytes compared to other cells. Differences of dye accumulation in the cell membrane were proposed to be the reason for the distinct photodynamic effects. Using pheophorbide a as an example, the combination of erythrocyte ghosts as models to follow the dye accumulation in the cell membrane and intact erythrocytes as model cells to show the photodynamic damage is provided. Evidence for the correctness of the combination of erythrocyte ghosts and intact erythrocytes as a functioning model system in photodynamic cell research is provided using the confocal laser scanning microscopy on intact, pheophorbide a loaded erythrocytes.