X射线激发发光体在光动力治疗中的应用

激发光的组织穿透能力和光敏剂的吸收波长阻碍了传统光动力治疗(photodynamic therapy,PDT)对深层肿瘤的有效治疗。近年来,基于X射线直接激发光敏剂或以X射线激发纳米闪烁体作为能量传递介质间接激发光敏剂的X射线激发的光动力治疗方法(XE-PDT)成为深层肿瘤治疗领域的研究热点。本文将重点介绍近五年来被报道的X射线激发纳米闪烁体类型、光敏剂负载策略、能量传递效果以及光动力治疗效果,同时对深层肿瘤光动力治疗中存在的主要问题、挑战以及未来的发展方向进行展望。     

上转换光动力诊疗体系的构建及抗癌研究进展

具有创伤小、毒性低、选择性好、无耐药性等优点的光动力疗法已被广泛应用于癌症治疗研究。然而，多数光敏剂存在水溶性差易聚集、肿瘤组织选择性差的问题，且其激发光都在可见或紫外光范围内，组织穿透深度较浅导致治疗深度不够，限制了光动力疗效。稀土上转换纳米粒子具有低生物毒性、高化学稳定性、强组织穿透力等优点，可作为将近红外光转换成紫外/可见光的发光材料和光敏剂载体，因此，构建上转换光动力诊疗体系为增强光动力疗效提供新思路。本文介绍了上转换光动力诊疗体系的构建方法，包括物理吸附法、物理包封法、共价偶联法，并分析了其应用于光动力抗癌研究的优缺点，最后总结并展望了其存在的挑战及未来发展方向。     

基于上转换纳米颗粒的光动力疗法研究新进展

作为一种新型治疗手段,光动力疗法近年来被广泛应用于癌症等疾病的治疗研究。然而,用于激活光敏剂的紫外或可见光具有较低的组织穿透深度,限制了光动力疗法的治疗效果。上转换纳米颗粒可以将组织穿透能力较强的近红外光转换为紫外或可见光,为实现近红外光激活的光动力疗法提供了光转换器,有望解决传统光动力疗法组织穿透深度较浅的问题。本文综述了基于上转换纳米颗粒光动力治疗体系的构建方法,重点讨论近期发展的基于金属-有机框架结构与上转换纳米颗粒相结合的新策略,并对其进行总结和展望。     

光动力肿瘤精准治疗的研究进展

光动力治疗是一种局部、温和及相对安全的治疗模式,在癌症精准治疗方面展现了良好应用前景。光敏剂、光源以及氧气是光动力治疗的三个关键要素。首先,传统小分子光敏剂的吸收光谱大多在紫外或可见光区,且缺乏肿瘤靶向性和特异性,组织穿透深度不足且存在非特异性损伤。其次,光动力治疗效率依赖于外光源连续照射,易引发光毒性和组织损伤。另外,实体肿瘤组织处乏氧等微环境限制了光动力治疗效率。因此,提高光动力治疗效率的同时降低副作用,并实现深层组织的高效特异性治疗,是亟待解决的难题。近年来,新型光动力治疗体系不断涌现,以期解决上述限制光动力治疗进一步发展与应用的瓶颈问题。本文从光动力治疗所需三要素角度,综述了近年来发展的各类新型光动力治疗体系及其在肿瘤精准治疗中的应用进展。     

基于光敏剂的纳米诊疗载体构建的研究进展

光动力疗法是一种很有前景的癌症治疗方法,光敏剂作为其核心,在被一定波长的激发光照射下产生荧光,因此光敏剂具有荧光成像诊断的潜力。然而光敏剂多是芳香共轭结构的疏水分子,存在易聚集结晶和溶解度差的问题。本文综述了近五年有关改善光敏剂缺陷,提高光敏剂对癌症的治疗和诊断的研究成果。具体从肿瘤微环境、肿瘤靶向性和改善荧光淬灭三个方面进行综述。     

靶标性酞菁类光敏剂的光动力疗法研究进展

光动力治疗（Photodynamic therapy,PDT）作为一种有别于传统癌症治疗方式的新型疗法,近些年来受到了科学家们越来越多的关注.它凭借着自身创伤性小,毒性低微,适用性好,可协同手术治疗以及可重复治疗等独特优势,在许多肿瘤的治疗方面有着广泛的应用.本文简要概述了光动力疗法的原理以及光敏剂的发展历程,并对理想光敏剂的特点作了总结.目前,以酞菁类化合物为主的第三代光敏剂已经成为光动力疗法的研究热点,然而如何提高光敏剂分子的靶向性达到精准的光动力治疗仍然是亟待解决的问题.因此,主要综述了近年来靶向性酞菁类光敏剂的研究进展,并对未来光敏剂的重点研究方向做出了展望.从目前来看,如何克服癌症低氧微环境的限制,发展Type I型不依赖氧的体系以及光穿透力强的靶向光敏剂在光动力治疗方面存在着巨大的潜质,有望成为新一代十分优良的光动力疗法用光敏剂.     

肿瘤微环境刺激响应型上转换光动力诊疗体系的构建和发展

光动力治疗是一种新型的非侵入式肿瘤治疗方法,具有创伤性和毒性小、选择性好、无耐药性、可重复治疗等突出优点,在癌症的治疗上取得了显著的成效.为了增加光动力治疗的组织穿透深度,研究者提出构建基于上转换纳米颗粒（upconversion nanoparticles,UCNPs）的光动力诊疗探针（简称上转换光动力诊疗探针）.基于发光共振能量转移过程,上转换光动力诊疗探针利用UCNPs在近红外光激发下发射的荧光激活负载的光敏剂发挥光动力疗效,有助于实现深层肿瘤的治疗.新型的上转换光动力诊疗探针通过多功能一体化的结构组合设计可以实现靶向运输、成像诊断以及刺激响应的按需治疗,是未来纳米医药发展的必然趋势.目前,研究者越来越关注构建基于肿瘤微环境刺激响应型上转换光动力诊疗体系,以提高治疗体系的靶向性,改善光动力治疗效果,并减小对周围正常组织的毒性.本工作主要讨论了基于pH、酶及过氧化氢刺激响应型上转换光动力诊疗体系的构建和发展,并对其发展前景进行了展望.     

取代酞菁光敏剂的光动力疗法研究进展

酞菁类化合物作为新一代光敏剂用于光动力学治疗癌症,因表现出良好的光动力活性、靶组织选择性和低毒等优点而备受关注。本文对近几年取代酞菁光敏剂的光动力疗法研究进展作一简单介绍。     

聚集诱导发光型光敏剂用于线粒体靶向光动力治疗

光动力治疗是一种基于光敏剂和光照的安全无创性治疗方法,在癌症治疗和杀菌等方面具有广阔的应用前景。光敏剂在光照激发下与氧气作用会生成高反应活性的活性氧。在细胞中过量的活性氧会氧化损伤蛋白质、核酸和脂质等细胞组分,诱导细胞凋亡或坏死。新兴的聚集诱导发光型光敏剂在分子聚集状态下光照激发能发射强的荧光,同时高效地产生活性氧,解决了传统光敏剂在分子聚集时荧光猝灭的问题,易实现成像指导的光动力治疗,近年来备受关注。线粒体作为细胞能量工厂富含氧气,是理想的光动力治疗靶点。本文总结了靶向癌细胞线粒体的聚集诱导发光型光敏剂的分子类型和设计策略,以及其在光动力治疗肿瘤方面的应用。     

铱(Ⅲ)配合物乏氧肿瘤光动力治疗

光动力治疗因其无创、可控和不易产生耐药性等显著优点,成为一种新型的肿瘤靶向治疗模式。光敏化过程涉及光敏剂对氧分子的光激活反应,然而实体肿瘤的乏氧环境严重限制了传统有机光敏剂的疗效。金属铱配合物具有良好的光物理和光化学性质,是理想的新一代光敏剂,近些年,铱光敏剂被发现可以应用于乏氧肿瘤的光动力治疗。本文总结了近些年金属铱配合物应用于乏氧肿瘤光动力治疗的研究;同时介绍了基于铱配合物的乏氧纳米复合体系的构建和乏氧肿瘤的光动力治疗研究,为开发新型高效的乏氧肿瘤治疗光敏剂及其载体提供参考。     

Antivascular tumor eradication by hypericin-mediated photodynamic therapy

Photodynamic therapy (PDT) with hypericin has been shown to inhibit tumor growth in different tumor models, and tumor vascular damage was suggested to be mainly responsible for the antitumoral effect. Here, we demonstrate tumor vascular damage and its consequence on local tumor control after hypericin-mediated PDT by using both short and long drug-light intervals. Radiation-induced fibrosarcoma-1 tumors were exposed to laser light at either 0.5 or 6 h after a 5 mg/kg dose of hypericin. Tumor perfusion was monitored by fluorescein dye-exclusion assay and by Hoechst 33342 staining of functional blood vessels. Significant reduction in tumor perfusion was found immediately after both PDT treatments. A complete arrest of vascular perfusion was detected by 15 h after the 0.5 h-interval PDT, whereas well-perfused areas could still be found at this time in tumors after the 6 h-interval PDT. A histological study confirmed that primary vascular damage was involved in both PDT treatments. Tumor cells appeared intact shortly after light treatment, degenerated at later hours and became extensively pycnotic at 24 h after the 0.5 h-interval PDT. PDT under this condition led to complete tumor cure. In contrast, significant numbers of viable tumor cells, especially at the tumor periphery, were found histologically at 24 h after the 6 h-interval PDT. No tumor cure was obtained when PDT was performed at this time. Our results strongly suggest that targeting the tumor vasculature by applying short drug-light interval PDT with hypericin might be a promising way to eradicate solid tumors.     

Redaporfin Development for Photodynamic Therapy and its Combination with Glycolysis Inhibitors†

Photodynamic therapy (PDT) remains an underutilized treatment modality in oncology. Many efforts have been dedicated to the development of better photosensitizers, better formulations and delivery methods, rigorous planning of light dose distribution in tissues, mechanistic insight, improvement of treatment protocols and combinations with other therapeutic agents. Hopefully, progress in all these fields will eventually expand the use of PDT. Here we offer a brief review of our own contribution to the development of a photosensitizer for PDT – redaporfin – currently in Phase II clinical trials, and present data on its combination with two glycolysis inhibitors: 2-deoxyglucose and 3-bromopyruvate. We show that 3-bromopyruvate is more cytotoxic to a carcinoma cell line (CT26) than to a normal fibroblast (3T3) cell line, and that this selectivity is maintained in the in vitro combination with redaporfin-PDT. This combination was investigated in BALB/c mice with large subcutaneous CT26 tumors and it is shown that the cure rate in the combination is higher (33% cures) than in PDT (11% cures) or in 3-bromopyruvate (no cures) alone. The combination of redaporfin-PDT with 3-bromopyruvate illustrates the potential of combination therapies and how PDT benefits can be enhanced by systemic drugs with complementary targets.     

A Combination of Visudyne and a Lipid‐anchored Liposomal Formulation of Benzoporphyrin Derivative Enhances Photodynamic Therapy Efficacy in a 3D Model for Ovarian Cancer

A major objective in developing new treatment approaches for lethal tumors is to reduce toxicity to normal tissues while maintaining therapeutic efficacy. Photodynamic therapy (PDT) provides a mechanistically distinct approach to treat tumors without the systemic toxicity of chemotherapy drugs. PDT involves the light‐based activation of a small molecule, a photosensitizer (PS), to generate reactive molecular species (RMS) that are toxic to target tissue. Depending on the PS localization, various cellular and subcellular components can be targeted, causing selective photodamage. It has been shown that targeted lysosomal photodamage followed by, or simultaneous with, mitochondrial photodamage using two different PS results in a considerable enhancement in PDT efficacy. Here, two liposomal formulations of benzoporphyrin derivative (BPD): (1) Visudyne (clinically approved) and (2) an in‐house formulation entrapping a lipid conjugate of BPD are used in combination with direct PS localization to mitochondria, endoplasmic reticulum and lysosomes, enabling simultaneous photodamage to all three organelles using a single wavelength of light. Building on findings by our group, and others, this study demonstrates, for the first time in a 3D model for ovarian cancer, that BPD‐mediated photodestruction of lysosomes and mitochondria/ER significantly enhances PDT efficacy at lower light doses than treatment with either PS formulation alone.     

Hypoxia Induced by Upconversion‐Based Photodynamic Therapy: Towards Highly Effective Synergistic Bioreductive Therapy in Tumors

Local hypoxia in tumors is an undesirable consequence of photodynamic therapy (PDT), which will lead to greatly reduced effectiveness of this therapy. Bioreductive pro‐drugs that can be activated at low‐oxygen conditions will be highly cytotoxic under hypoxia in tumors. Based on this principle, double silica‐shelled upconversion nanoparticles (UCNPs) nanostructure capable of co‐delivering photosensitizer (PS) molecules and a bioreductive pro‐drug (tirapazamine, TPZ) were designed (TPZ‐UC/PS), with which a synergetic tumor therapeutic effect has been achieved first by UC‐based (UC‐) PDT under normal oxygen environment, immediately followed by the induced cytotoxicity of activated TPZ when oxygen is depleted by UC‐PDT. Treatment with TPZ‐UC/PS plus NIR laser resulted in a remarkably suppressed tumor growth as compared to UC‐PDT alone, implying that the delivered TPZ has a profound effect on treatment outcomes for the much‐enhanced cytotoxicity of TPZ under PDT‐induced hypoxia.     

肿瘤光动力治疗临床应用的光敏剂及其研究概况

光动力治疗是一种非侵蚀性并具有一定靶向性的肿瘤治疗新方法。 光动力治疗需要光敏剂、光和氧结合产生光动力反应。 光敏剂是光动力治疗的关键和物质基础。 本文概括介绍了已上市的和已被批准进入临床试验中的光敏剂,并根据其分子的骨架结构,将其分为分卟啉类、二氢卟吩（叶绿素）类和菌绿素/酞菁三类。 同时从理想光敏剂应具备特点出发,探讨了研究中的光敏剂和光动力治疗的发展前景。     

Simultaneous two-photon excitation of photofrin in relation to photodynamic therapy

Photodynamic therapy (PDT), the use of light-activated drugs (photosensitizers), is an emerging treatment modality for tumors as well as various nononcologic conditions. Single-photon (1-gamma) PDT is limited by low specificity of the photosensitizer, leading to damage to healthy tissue adjacent to the diseased target tissue. One solution is to use simultaneous two-photon (2-gamma) excitation with ultrafast pulses of near-IR light. Due to the nonlinear interaction mechanism, 2-gamma excitation with a focused beam is localized in three dimensions, allowing treatment volumes on the order of femtoliters. We propose that this will be valuable in PDT of age-related macular degeneration (AMD), which causes blindness due to abnormal choroidal neovasculature and which is currently treated by 1-gamma PDT. Here, Photofrin has been used as the photosensitizer to demonstrate proof-of-principle of 2-gamma killing of vascular endothelial cells in vitro. The 2-gamma absorption properties of Photofrin were investigated in the 750-900 nm excitation wavelength range. It was shown that 2-gamma excitation dominates over 1-gamma excitation above 800 nm. The 2-gamma absorption spectrum of Photofrin in the 800-900 nm excitation wavelength range was measured. The 2-gamma cross section decreased from about 10 GM (1 GM = 10(-50) cm4 s/photon) at 800 nm to 5 GM at 900 nm. Adherent YPEN-1 endothelial cells were then incubated with Photofrin for 24 h and then treated by PDT at 850 nm where the 1-gamma contribution was negligible. Cell death was monitored with the use of 2-gamma scanning laser microscopy. The light doses required for killing were high (6300 J cm(-2) for approximately 50% killing), but 2-gamma cytotoxicity was unequivocally demonstrated. Although Photofrin is, per se, not a good choice for 2-gamma PDT due to its low 2-gamma cross section, this work provides baseline data to guide the development of novel photosensitizers with much higher 2-gamma cross sections (>100 GM), which will be required for 2-gamma PDT of AMD (and other conditions) to be clinically practical.     

酞菁配合物的结构与其光动力抗癌活性

光动力治疗是一种正在发展中的治疗癌症的新方法.主要是利用抗癌光敏剂可优先在 肿瘤组织中富集的特性和随后在适当波长的光照下所引发的光敏化反应来杀死癌肿瘤.自198 5年以来,酞菁配合物作为抗癌光敏剂的研究越来越引人注目. 此文在总结51篇参考文献的 基础上,提出了酞菁配合物的结构与其光动力抗癌活性的某些相关性,着重讨论了中心离子 、环取代基、轴向配体对光动力活性和相关物化性质的影响.得出的一个主要的结论是两亲 性酞菁是极具潜力的光敏剂.     

An Assembled Nanocomplex for Improving both Therapeutic Efficiency and Treatment Depth in Photodynamic Therapy

Photodynamic therapy (PDT) shows unique selectivity and irreversible destruction toward treated tissues or cells, but still has several problems in clinical practice. One is limited therapeutic efficiency, which is attributed to hypoxia in tumor sites. Another is the limited treatment depth because traditional photosensitizes are excited by short wavelength light (<700 nm). An assembled nano‐complex system composed of oxygen donor, two‐photon absorption (TPA) species, and photosensitizer (PS) was synthesized to address both problems. The photosensitizer is excited indirectly by two‐photon laser through intraparticle FRET mechanism for improving treatment depth. The oxygen donor, hemoglobin, can supply extra oxygen into tumor location through targeting effect for enhanced PDT efficiency. The mechanism and PDT effect were verified through both in vitro and in vivo experiments. The simple system is promising to promote two‐photon PDT for clinical applications.     

A Bifunctional Photosensitizer for Enhanced Fractional Photodynamic Therapy: Singlet Oxygen Generation in the Presence and Absence of Light

The photosensitized generation of singlet oxygen within tumor tissues during photodynamic therapy (PDT) is self‐limiting, as the already low oxygen concentrations within tumors is further diminished during the process. In certain applications, to minimize photoinduced hypoxia the light is introduced intermittently (fractional PDT) to allow time for the replenishment of cellular oxygen. This condition extends the time required for effective therapy. Herein, we demonstrated that a photosensitizer with an additional 2‐pyridone module for trapping singlet oxygen would be useful in fractional PDT. Thus, in the light cycle, the endoperoxide of 2‐pyridone is generated along with singlet oxygen. In the dark cycle, the endoperoxide undergoes thermal cycloreversion to produce singlet oxygen, regenerating the 2‐pyridone module. As a result, the photodynamic process can continue in the dark as well as in the light cycles. Cell‐culture studies validated this working principle in vitro.     

Chlorins as photosensitizers in biology and medicine

The photodynamic therapy (PDT) of tumors involves illumination of the tumorous area following the administration of a tumor-localizing photodynamic sensitizer. Hematoporphyrin derivative (HPD) and Photofrin II (a purified form of HPD), the main sensitizers used clinically for PDT to date, are complex mixtures of porphyrins; furthermore, these preparations absorb light very poorly in the red region of the spectrum (wavelengths greater than 600 nm) where light penetration into mammalian tissues is greatest. Thus there is considerable interest in identifying new sensitizers that localize more effectively in tumors, absorb more strongly at longer wavelengths and can be prepared in high purity. Much of this interest has been directed towards chlorins (reduced porphyrins), which typically absorb strongly in the red. This review summarizes research that has been carried out on selected types of chlorins, some of which may have important applications as sensitizers for PDT.