Photodynamic Therapy for Gastrointestinal Cancer

The clinical application of photodynamic therapy (PDT) for gastrointestinal (GI) neoplastic lesions has been developed with appreciation for the great efforts and kind support of Dr. Tom Dougherty and his followers’ contributions. There are several published studies on clinical PDT in the field of GI oncology. Esophageal cancer was one of the first clinical indications for PDT that was approved as an endoscopic procedure in both the United States and Japan. PDT was initially used as a palliative local treatment for patients with obstructive esophageal cancer. PDT is also indicated for eradicative therapy for dysplastic Barret’s esophagus, which is the precursor state of esophageal adenocarcinoma, with the support of level one evidence. In Japan, PDT was approved as a curative treatment for superficial esophageal carcinoma lesions, which are difficult to treat with endoscopic resection. Further, PDT using second-generation photosensitizers is approved for early local failure after radiotherapy, for which treatment with other modalities is difficult. PDT has also been assessed in other GI cancers, including gastric cancer, biliary cancer and pancreatic cancer. In this review, we overview the history and state of PDT for GI cancer.     

基于光敏剂的光动力疗法

光动力治疗日益受到关注。本文综述了光敏剂在光动力疗法领域中的研究进展,包括它的性能改进、作用机理和靶点。并对光动力疗法的发展前景进行了展望。     

A Tumor-Targeting Dual-Stimuli-Activatable Photodynamic Molecular Beacon for Precise Photodynamic Therapy

A multifunctional photodynamic molecular beacon (PMB) has been designed and synthesized which contains an epidermal growth factor receptor (EGFR)-targeting cyclic peptide and a trimeric phthalocyanine skeleton in which the three zinc(II) phthalocyanine units are each substituted with a glutathione (GSH)-responsive 2,4-dinitrobenzenesulfonate (DNBS) quencher and are linked via two cathepsin B-cleavable GFLG peptide chains. This tailor-made conjugate is fully quenched in the native form due to the photoinduced electron transfer effect of the DNBS moieties and the self-quenching of the phthalocyanine units. It can target the EGFR overexpressed in cancer cells, and after receptor-mediated endocytosis, it can be activated selectively by the co-existence of intracellular GSH and cathepsin B, both of which are also overproduced in cancer cells, in terms of fluorescence emission and singlet oxygen generation. The cell-selective behavior of this PMB has been demonstrated using a range of cancer cells with different expression levels of EGFR, while the stimuli-responsive properties have been studied both in vitro and in various aqueous media. The overall results show that this advanced PMB, which exhibits several levels of control of the tumor specificity, is a promising photosensitizer for precise antitumoral photodynamic therapy.     

酞菁在光动力治疗中的应用

光动力治疗因具有低毒、副作用小、抗癌广谱、高选择性等优势, 正吸引着人们越来越多的关注。提高光敏剂的选择性和光毒性已经成为研究的热点。本文简单介绍了光敏剂的发展历程, 并对酞菁类第三代光动力治疗光敏剂的最新研究进展进行了论述。     

酞菁在光动力治疗中的应用

光动力治疗因具有低毒、副作用小、抗癌广谱、高选择性等优势,正吸引着人们越来越多的关注。提高光敏剂的选择性和光毒性已经成为研究的热点。本文简单介绍了光敏剂的发展历程,并对酞菁类第三代光动力治疗光敏剂的最新研究进展进行了论述。     

Nanobody-Ferritin Conjugate for Targeted Photodynamic Therapy

Ferritin is an iron-storage protein nanocage that is assembled from 24 subunits. The hollow cavity of ferritin enables its encapsulation of various therapeutic agents; therefore, ferritin has been intensively investigated for drug delivery. The use of antibody-ferritin conjugates provides an effective approach for targeted drug delivery. However, the complicated preparation and limited protein stability hamper wide applications of this system. Herein, we designed a novel nanobody-ferritin platform (Nb-Ftn) for targeted drug delivery. The site-specific conjugation between nanobody and ferritin is achieved by transglutaminase-catalyzed protein ligation. This ligation strategy allows the Nb conjugation after drug loading in ferritin, which avoids deactivation of the nanobody under the harsh pH environment required for drug encapsulation. To verify the tumor targeting of this Nb-Ftn platform, a photodynamic reagent, manganese phthalocyanine (MnPc), was loaded into the ferritin cavity, and an anti-EGFR nanobody was conjugated to the surface of the ferritin. The ferritin nanocage can encapsulate about 82 MnPc molecules. This MnPc@Nb-Ftn conjugate can be efficiently internalized by EGFR positive A431 cancer cells, but not by EGFR negative MCF-7 cells. Upon 730 nm laser irradiation, MnPc@Nb-Ftn selectively killed EGFR positive A431 cells by generating reactive oxygen species (ROS), whereas no obvious damage was observed on MCF-7 cells. Given that ferritin can be used for encapsulation of various therapeutic agents, this work provides a strategy for facile construction of nanobody-ferritin for targeted drug delivery.     

Acid-Activatable Transmorphic Peptide-Based Nanomaterials for Photodynamic Therapy

Inspired by the dynamic morphology control of molecular assemblies in biological systems, we have developed pH-responsive transformable peptide-based nanoparticles for photodynamic therapy (PDT) with prolonged tumor retention times. The self-assembled peptide–porphyrin nanoparticles transformed into nanofibers when exposed to the acidic tumor microenvironment, which was mainly driven by enhanced intermolecular hydrogen bond formation between the protonated molecules. The nanoparticle transformation into fibrils improved their singlet oxygen generation ability and enabled high accumulation and long-term retention at tumor sites. Strong fluorescent signals of these nanomaterials were detected in tumor tissue up to 7 days after administration. Moreover, the peptide assemblies exhibited excellent anti-tumor efficacy via PDT in vivo. This in situ fibrillar transformation strategy could be utilized to design effective stimuli-responsive biomaterials for long-term imaging and therapy.     

纳米材料在肿瘤光动力治疗中的研究进展

光动力治疗是新兴的非侵入性癌症治疗方法。纳米材料以其独特的结构以及光物理、光化学性质成为可用于光动力治疗的光敏剂。根据纳米材料的不同种类,分别对无机非金属纳米材料、无机金属纳米材料、有机小分子纳米材料以及有机聚合物纳米材料等的构建策略及其在光动力治疗肿瘤中的应用进行综述。展望了纳米材料在未来肿瘤光动力治疗中的挑战和发展方向。为新一代纳米光敏剂的构建提供创新思路,并扩展其在癌症治疗中的潜力。     

Programming DNA Nanoassembly for Enhanced Photodynamic Therapy

Photodynamic therapy (PDT) has extraordinary promise for the treatment of many cancers. However, its clinical progress is impaired by the intrinsic hypoxic tumor microenvironment that limits PDT efficacy and the safety concern associated with biological specificity of photosensitizers or vehicles. Now it is demonstrated that rationally designed DNA nanosponges can load and delivery photosensitizer effectively, target tumor precisely, and relieve hypoxia‐associated resistance remarkably to enhance the efficacy of PDT. Specifically, the approach exhibits a facile assembly process, provides programmable and versatile nanocarriers, and enables robust in vitro and in vivo anti‐cancer efficacy with excellent biosafety. These findings represent a practical and safe approach by designer DNA nanoassemblies to combat cancer effectively and suggest a powerful strategy for broad biomedical application of PDT.     

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.     

Organic Photodynamic Nanoinhibitor for Synergistic Cancer Therapy

Despite its great potential in cancer treatment, photodynamic therapy (PDT) often exacerbates hypoxia and subsequently compromises its therapeutic efficacy. To overcome this issue, an organic photodynamic nanoinhibitor (OPNi) has been synthesized that has the additional ability to counteract carbonic anhydrase IX (CA‐IX), a molecular target in the hypoxia‐mediated signalling cascade. OPNi is composed of a metabolizable semiconducting polymer as the photosensitizer and a CA‐IX antagonist conjugated amphiphilic polymer as the matrix. This molecular structure allows OPNi not only to selectively bind CA‐IX positive cancer cells to facilitate its tumor accumulation but also to regulate the CA‐IX‐related pathway. The integration of CA‐IX inhibition into the targeted PDT process eventually has a synergistic effect, leading to superior antitumor efficacy over that of PDT alone, as well as the reduced probability of hypoxia‐induced cancer metastasis. This study thus proposes a molecular strategy to devise simple yet amplified photosensitizers to conquer the pitfalls of traditional PDT.     

Developments in Vascular-Targeted Photodynamic Therapy for Urologic Malignancies

With improved understanding of cancer biology and technical advancements in non-invasive management of urological malignancies, there is renewed interest in photodynamic therapy (PDT) as a means of focal cancer treatment. The application of PDT has also broadened as a result of development of better-tolerated and more effective photosensitizers. Vascular-targeted PDT (VTP) using padeliporfin, which is a water-soluble chlorophyll derivative, allows for tumor-specific cytotoxicity and has demonstrated efficacy in the management of urologic malignancies. Herein, we describe the evolution of photodynamic therapy in urologic oncology and the role of VTP in emerging treatment paradigms.     

Engineered Metallacycle-Based Supramolecular Photosensitizers for Effective Photodynamic Therapy

Although metallacycle-based supramolecular photosensitizers (PSs) have attracted increasing attention in biomedicine, their clinical translation is still hindered by their inherent dark toxicity. Herein, we report what to our knowledge is the first example of a molecular engineering approach to building blocks of metallacycles for constructing a series of supramolecular PSs ( RuA–RuD ), with the aim of simultaneously reducing dark toxicity and enhancing phototoxicity, and consequently obtaining high phototoxicity indexes (PI). Detailed in vitro investigations demonstrate that RuA–RuD display high cancer cellular uptake and remarkable antitumor activity even under hypoxic conditions. Notably, RuD exhibited no dark toxicity and displayed the highest PI value (≈406). Theoretical calculations verified that RuD has the largest steric hindrance and the lowest singlet-triplet energy gap (ΔE_ST, 0.61 eV). Further in vivo studies confirmed that RuD allows safe and effective phototherapy against A549 tumors.     

Corrole光敏剂在光动力治疗中的重原子效应

最近, 我们合成了一系列Corrole衍生物, 经过鼻咽癌(Nasopharyngeal carcinoma,NPC) 细胞的体外PDT试验后, 筛选出了一个具有优良PDT活性的Corrole光敏剂. 本文报道该类Corrole光敏剂在PDT中的重原子效应.     

Prodrugs of 5-Aminolevullinic Acid for Photodynamic Therapy

Abstract— The use of 5-aminolevulinic acid (ALA) as a protoporphyrin IX (PpIX) precursor for photodynamic therapy (PDT) became very popular in a short time. However, despite its advantages, ALA also has a drawback; it shows a poor ability to diffuse through biological membranes because of its low Iipophilicity. As a consequence, a high dose of ALA must be administered in order to increase PpIX in the afflicted tissue at a level sufficient for PDT. A possible solution to this problem is the use of derivatives of ALA. ALA prodrugs are expected to have better diffusing properties as a result of their enhanced Jipophilicity and are converted into the parent ALA after enzymatic hydrolysis. In this report, results are presented of the synthesis of a number of ALA derivatives. The ALA prodmgs were investigated regarding the optimum conditions for cell penetration and PPIX formation in an in vitro cellular test system. It is shown that several prod· rugs do indeed enhance the amount of accumulated PPIX considerably as compared to ALA. Finally, the most promising prodrugs were tested in an animal model and showed increased PPIX formation under these conditionsas well.     

Techniques to Improve Photodynamic Therapy

Photodynamic therapy [dye-light therapy] is an excellent technique for use in detection and treatment of cancerous tissues. While this therapy is effective, it is limited by the phototoxic reactions that can occur in the surrounding normal tissues. These damaging side effects are of particular importance when treating neurosensory organs, such as the human eye. We report here new treatment strategies to enhance photodynamic effectiveness while limiting side effects to normal tissues.     

Light Sources and Dosimetry Techniques for Photodynamic Therapy

Effective treatment delivery in photodynamic therapy (PDT) requires coordination of the light source, the photosensitizer, and the delivery device appropriate to the target tissue. Lasers, light-emitting diodes (LEDs), and lamps are the main types of light sources utilized for PDT applications. The choice of light source depends on the target location, photosensitizer used, and light dose to be delivered. Geometry of minimally accessible areas also plays a role in deciding light applicator type. Typically, optical fiber-based devices are used to deliver the treatment light close to the target. The optical properties of tissue also affect the distribution of the treatment light. Treatment light undergoes scattering and absorption in tissue. Most tissue will scatter light, but highly pigmented areas will absorb light, especially at short wavelengths. This review will summarize the basic physics of light sources, and describe methods for determining the dose delivered to the patient.     

Bioorthogonal Turn-On BODIPY-Peptide Photosensitizers for Tailored Photodynamic Therapy

Photodynamic therapy (PDT) leads to cancer remission via the production of cytotoxic species under photosensitizer (PS) irradiation. However, concomitant damage and dark toxicity can both hinder its use. With this in mind, we have implemented a versatile peptide-based platform of bioorthogonally activatable BODIPY-tetrazine PSs. Confocal microscopy and phototoxicity studies demonstrated that the incorporation of the PS, as a bifunctional module, into a peptide enabled spatial and conditional control of singlet oxygen (¹O₂) generation. Comparing subcellular distribution, PS confined in the cytoplasmic membrane achieved the highest toxicities (IC₅₀=0.096±0.003 μm ) after activation and without apparent dark toxicity. Our tunable approach will inspire novel probes towards smart PDT.     

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。