NEW PHTHALOCYANINE PHOTOSENSITIZERS FOR PHOTODYNAMIC THERAPY

Six new aluminum and silicon phthalocyanines have been synthesized and their photocytotoxicity toward V79 cells has been studied. The compounds that have been prepared are: AIPcOSi(CH₃)₂(CH₂),N(CH₃)₂, I; AIPcOSi(CH₃)₂(CH₂)₃N(CH₃)₃⁺I^?, II; CH₃SiPcOSi(CH₃)₂(CH₂)₃N(CH₃)₂, III; HOSiPcOSi(CH₃)₂(CH₂)₃N(CH₃)₂, IV; HOSiPcOSi(CH₃)₂(CH₂)₃)₃(CH₃)₃⁺I^?, V; and SiPc[OSi(CH₃)₂(CH₂)₃N(CH₃)₃⁺I^?]₂, VI. Relative growth delay values for compounds I-VI and relative cytotoxicity values for compounds I, II, IV, V and VI have been determined. Compounds I and II have been shown to be comparable in photocytotoxicity to what is presumed to be AIPcOH.xH₂O, and compound IV has been shown to have greater activity. The classes of compounds to which these six compounds belong appear to have potential for photodynamic therapy.     

THE PHOTOPHYSICAL PROPERTIES OF PORPHYCENES: POTENTIAL PHOTODYNAMIC THERAPY AGENTS*

Porphycene and a tetra-n-propyl derivative remained unaltered on irradiation in toluene at room temperature. Quantum yields of fluorescence, S T intersystem crossing, and singlet molecular oxygen sensitization, as well as lifetimes of the singlet and triplet excited states were measured. In view of their structural relationship to porphyrin, their high absorption above 620 nm, their stability towards photooxidation, and their high quantum yields of fluorescence and singlet oxygen sensitization, these compounds qualify as potential agents for tumor marking and photodynamic therapy.     

VERDINS: NEW PHOTOSENSITIZERS FOR PHOTODYNAMIC THERAPY

The in vivo cytotoxic effect of verdins was determined by histological methods, using the FANFT-induced urothelial tumor line (AY-27). The results indicate that the verdins may be good alternatives to hematoporphyrin derivative for photodynamic therapy.     

DISTRIBUTION OF TEMOPORFIN, A NEW PHOTOSENSITIZER FOR THE PHOTODYNAMIC THERAPY OF CANCER, IN A MURINE TUMOR MODEL

Abstract— The biodistribution of temoporfin (tetra[ m -hydroxyphenyl]chlorin, m -THPC), a recently developed photosensitizer, was investigated in BALB/c mice. The drug was administered intravenously (0.35-0.75 μmol/kg) to tumor-free mice or to mice implanted with the Colo 26 colorectal carcinoma. Blood and tissue samples were collected for up to 96 h post-dose. Drug concentrations were determined by HPLC coupled to photometric detection at 423 nm. Concentrations in blood and liver fell relatively rapidly such that blood concentrations at later time points were below the limit of detection. Tumor concentrations rose at first and then remained constant from 24 h. Temoporfin concentrations in some tissues, notably heart and skeletal muscle, declined only slowly when compared to blood. The tumor: tissue ratios for those organs that showed a more rapid decline in temoporfin concentrations were higher at later times, whereas in tissues such as muscle the ratio remained relatively constant. The organs with the highest tumor: tissue ratios were small intestine (8.6), liver (6.9) and skeletal muscle (5.0).     

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.     

THE MICROVASCULAR EFFECTS OF PHOTODYNAMIC THERAPY: EVIDENCE FOR A POSSIBLE ROLE OF CYCLOOXYGENASE PRODUCTS

Photodynamic therapy (PDT) of malignant tumours may involve the interruption of tumor and peritumor microcirculation. We have studied the effect of light activation of the photosensitizing drug dihematoporphyrin ether (DHE) on rat subcutaneous arterioles and the modulation of these effects by cyclooxygenase inhibitors indomethacin and acetyl salicylic acid (ASA). Animals received DHE 48 h prior to light activation and additionally either indomethacin, ASA or saline 3 h prior to treatment. Light activation (630 nm, 60 J/cm2) resulted in a significant reduction to 62 +/- 2% SEM of initial blood flow. This effect was inhibited by ASA (98 +/- 8% SEM) and indomethacin (87 +/- 8% SEM). Results from the administration of various doses of both compounds indicate that this inhibition is dose related. The data presented here show that PDT causes a significant reduction in blood flow in normal arterioles and that this effect was inhibited by ASA and indomethacin indicating that prostaglandins or thromboxane A2 may play an important role in the microvascular response to PDT.     

EVALUATION OF PORPHYRIN CHARACTERISTICS REQUIRED FOR PHOTODYNAMIC THERAPY

The cytotoxicity (in the dark), phototoxicity (red light) and subcellular localization (using confocal laser scanning microscopy) were determined for 15 porphyrins (1-15) in C6 glioma cells. The partition coefficient in 2-octanol was also determined for each porphyrin at pH 7.4. The cytotoxicity increased with pi (log of partition coefficient) up to pi values of +2. The 7 porphyrins with cationic side chains exhibited a classical parabolic correlation between phototoxicity and pi, with maximal activity at a pi value of approximately 1.0. There was also a significant correlation between subcellular localization and degree of phototoxicity, with the three most photosensitive porphyrins all possessing cationic side chains, and all three localizing in mitochondria.     

PHOTOBLEACHING OF PORPHYRINS USED IN PHOTODYNAMIC THERAPY AND IMPLICATIONS FOR THERAPY

Abstract— The development of an extraction procedure to quantitate dihematoporphyrin ether (DHE) concentration in tissues correlated to fluorescence measurements from instrumentation developed for in vivo fluorimetry was examined. In vivo fluorometric results from mouse mammary carcinoma (SMT-F) were calibrated against results of the chemical extraction assay quantitated spectrophotometrically. Fluorescence and drug extractable levels increase in a linear fashion with injected dose. Loss of porphyrin fluorescence (photobleaching) and intra-tumoral porphyrin level has been demonstrated both in vitro (NHIK cells) and in vivo (SMT-F tumor) during illumination with light following exposure to Hpd or DHE. This process is essentially independent of porphyrin tumor level in vivo and could lead to tumor protection at very low porphyrin levels. On the other hand, this photobleaching process which occurs concurrent with cellular inactivation and tissue damage due to the photodynamic process can be exploited to protect normal tissue during photodynamic therapy (PDT) and thus greatly enhance the therapeutic ratio. This has been demonstrated in patients undergoing PDT.     

OPTIMIZATION OF MULTIFIBER LIGHT DELIVERY FOR THE PHOTODYNAMIC THERAPY OF LOCALIZED PROSTATE CANCER

The understanding of light distribution within the target organ is essential in ensuring efficacy and safety in photodynamic therapy (PDT). A computer simulator of light distribution in prostatic tissue was employed for optimizing dosimetry for PDT in localized prostatic cancer. The program was based on empirically determined light distributions and optical constants and an assumed Ruence rate differential from fiber source to necrosis periphery. The diffusion theory approximation to the Boltzmann transport equation was the applicable formulation relevant to prostatic tissue, which has a high albedo with forward-scattering characteristics. Solving this equation of diffusive transfer for the appropriate fiber geometry yielded the energy fluence distributions for cleaved fiber and cylindrical diffuser light delivery. These distributions, confirmed by our measurements, show a l/r and l/r dependency (r = distance from light source) of the fluence ø(r) for the cleaved fiber and diffuser, respectively. This manifests itself by the tighter spacing of energy fluence isodoses in the case of the cleaved fiber. It was predicted that for a typical PDT regime a single interstitially placed cleaved fiber would treat 0.05–0.72 cm³, Four parallel fibers improve the uniformity of light distribution and treatment volume, and an interfiber separation of 12 mm would be necessary to provide optimal overlap of PDT necrosis, treating 0.26–3.6 cm³. The cylindrical diffuser, however, could treat larger volumes, and it was predicted that four 3 cm long diffusers at an optimal separation of 25 mm would treat 25–88 cm³ of prostatic tissue.     

光动力治疗用酞菁类光敏剂的合成研究进展

本文介绍了光动力治疗原理、酞菁类光敏剂的合成方法及其近年来得到的研究进展,并介绍了酞菁在光动力治疗中的光化学生物过程和光漂白现象,还对其存在的缺点和今后的研究方向进行了讨论.     

In vivo TUMOR OXYGEN TENSION MEASUREMENTS FOR THE EVALUATION OF THE EFFICIENCY OF PHOTODYNAMIC THERAPY

Among the sequence of events which occur during photodynamic therapy (PDT) are depletion of oxygen and disruption of tumor blood flow. In order to more clearly understand these phenomena we have utilized transcutaneous oxygen electrodes to monitor tissue oxygen disappearance. These results provide, for the first time, non-invasive real-time information regarding the influence of light dose on tissue oxygenation during irradiation. Measurements were conducted on transplanted VX-2 skin carcinomas grown in the ears of New Zealand white rabbits. Rabbits were treated with Photofrin II and tumors were irradiated with up to 200 kJ/m2 (500 W/m2) of 630-nm light. Substantial reductions in tumor oxygen tension were observed upon administration of as little as 20 kJ/m2. For a series of brief irradiations, oxygen tension was modulated by the appearance of laser light. Tissue oxygen reversibility appeared to be dependent upon PDT dose. Long-term, irreversible tissue hypoxia was recorded in tumors for large (200 kJ/m2) fluences. These results suggest that transcutaneous oxygen tension may be useful as a general indicator of the effectiveness of PDT and as an in situ predictor of the energy required to elicit tumor damage.     

ULTRASTRUCTURAL STUDIES ON THE MECHANISM OF THE PHOTODYNAMIC THERAPY OF TUMORS

Abstract Balb/c mice bearing a transplanted MS-2 fibrosarcoma were injected with 2.5 mg kg ¹ of either tetra(4-sulfonatophenyl/porphine (TPPS) in phosphate-buffered saline or 0.5 mg kg⁻¹ of Zn²⁺-phthalocyanine (Zn-Pc) incorporated into unilamellar liposomes of dipalmitoyl-phosphatidylcholine. Chromatographic studies showed that TPPS is mainly transported in the serum by globulins and albumin, while Zn-Pc is specifically bound by lipoproteins. Exposure of the injected mice to red light (300 J cm⁻²) caused extensive tumor necrosis. The ultrastructural analysis of tumor specimens taken from mice at 15 h after PDT showed that TPPS photoinduces a preferential necrosis of the neoplastic cells, while Zn-Pc causes severe photodamage to both the vascular system and the neoplastic cells. The different modes of tumor photosensitization by TPPS and Zn-Pc are discussed on the basis of the transport mechanism of the two dyes.     

PHOTODYNAMIC THERAPY OF NORMAL CEREBRAL TISSUE IN THE CAT: A NONINVASIVE MODEL FOR CEREBROVASCULAR THROMBOSIS

The early neuropathological response of normal cat brain to photodynamic therapy was investigated. Photofrin II was injected (IV) into a cat and photoactivated with red light from a filtered incandescent lamp. Animals were subjected to phototherapy either through the intact skull or with energy deposition onto the intact dura. Following photoactivation the animals were maintained for 6 h after which time the brain was removed and sections submitted for electron microscopic and or light microscopic study. Gross anatomical analysis of the photoactivated brain revealed hemorrhagic dusky discoloration limited to the area of the tissue illuminated. Animals that failed to show a lesion were cats characterized by low Photofrin II dosage and low photoactivation intensity. The microscopic cortical features of cats with lesions included prominent capillary congestion and regions of marked vacuolization and rarefaction. Blood vessels were structurally altered and the lumen of many vessels was completely filled with tightly packed erythrocytes. Our study suggests that the acute neuropathological response of cerebral tissue to photoactivation resembles that of microvascular thrombosis. It is thus reasonable to explore PDT of normal tissue as a non invasive model of cerebrovascular thrombosis in the cat.     

SPECTROSCOPIC PROPERTIES OF POTENTIAL SENSITIZERS FOR NEW PHOTODYNAMIC THERAPY START MECHANISMS via TWO-STEP EXCITED ELECTRONIC STATES

Three substituted tetraazaporphyrins, octa-(4-tert-butylphenyl)-tetrapyrazinoporphyrazine, tetra-(4-tert-butyl)phthalocyanine and tetra-(4-tert-butyi)phthalocyanatomagnesium (t₄-PcMg), were spectroscopically checked in solutions and liposomes with respect to suitability as potential sensitizers of a possible new start mechanism for photodynamic therapy (PDT) from a stepwise excited higher singlet state. This PDT start mechanism was recently proposed to overcome the problem of O₂ (¹δ₂)-caused cutaneous phototoxicity in PDT. By means of absorption and fluorescence measurements as well as nonlinear absorption investigation, transient spectroscopy and lasing experiments, compound t₄-PcMg was found to have the most appropriate properties: Based on a high fluorescence quantum yield (φ_fi= 0.84) and a very low crossing to the triplet (φ_isc= 0.05), two higher excited states can be effectively populated both by two stepwise absorption transitions at 674 nm and consecutive absorption transitions at 674 and 710 nm. Moreover, t₄-PcMg incorporates into liposomes very well with spectroscopic properties similar to those in solution.     

OCTA-ALKYL ZINC PHTHALOCYANINES: POTENTIAL PHOTOSENSITIZERS FOR USE IN THE PHOTODYNAMIC THERAPY OF CANCER

The synthesis, characterization and electronic spectra of a series of nine 1,4,8,11,15,18,22,25-octa-alkyl zinc phthalocyanines (ZnPc), potential photosensitizers for the photodynamic therapy of cancer, are described. The substituents on the phthalocyanine (Pc) macrocycle “red-shift” the absorbance maximum, in cyclohexane, of all nine members of this series to a value of 703 ± 2 nm, with a corrected fluorescence emission maximum for the octadecyl derivative of 715 nm. The solubilities and degree of aggregation of six examples in cyclohexane have been measured. The highest homologue, the octadecyl derivative, remains essentially unaggregated to a concentration of 1.5 ± 10^?4 mol dm^?3. The photostability of this Pc has been examined and the compound shown to be sensitive to photooxidation processes, which lead to its decomposition to 3,6-fcw-decylphthalimide. Known singlet oxygen quenchers inhibit the photodecomposition. In a comparative study, the octadecyl ZnPc underwent a more rapid photodecomposition than the corresponding metal-free derivative.     

THE EFFECTS OF ASPIRIN ON MICROVASCULATURE AFTER PHOTODYNAMIC THERAPY

Abstract— The effects of aspirin (acetylsalicylic acid: ASA) on vessel behavior and tumor response were measured during and after photodynamic therapy (PDT). Changes to vessel constriction, macromolecular leakage, tumor interstitial pressure, and tumor response were examined. Animals were randomly placed into treatment groups and injected with 0–25 mg/kg Photofrin® and given 0 or 135 J/cm² light treatment. The light treatment was standardized to 75 mW/cm² at 630 nm over a 30 min treatment interval (135 J/cm²). The treatment groups were further subdivided to receive Photofrin® alone or Photofrin® plus 100 mg/kg ASA. A cremaster muscle model in Sprague-Dawley rats was used to directly observe microvascular response and changes in vessel permeability to macromolecules. A tumor interstitial pressure model was designed to measure pressure changes in a chondrosarcoma tumor over time. This model indirectly measures macromolecular leakage, among other factors, in the tumor tissue. Groups of 10–20 rats were implanted subcutaneously with chondrosarcoma and were subjected to PDT to assess tumor response to the various treatments. Statistically significant differences in vessel leakage and changes in interstitial pressure were observed between animals given ASA plus PDT as compared to animals given PDT alone. The administration of ASA significantly inhibited venule leakage of albumin and reduced increases in interstitial pressure after treatment. The use of ASA had no effect on vessel constriction or tumor response after PDT. These findings suggest that the increases in vessel permeability observed during and after PDT, using Photofrin®, do not significantly contribute to tumor response.     

THE EVOLUTION OF PHOTODYNAMIC THERAPY TECHNIQUES IN THE TREATMENT OF INTRAOCULAR TUMORS

Abstract The techniques of photodynamic therapy (PDT) and the indications for its use in the treatment of intraocular tumors have evolved during the years in which it has been assessed in patients at our institution. It is now clear that transcorneal PDT delivered at a subthermal dose-rate to the surface of a pigmented lesion such as choroidal melanoma has little effect. In the absence of pigment, however, as in the case of retinoblastoma or amelanotic melanoma of the iris or choroid, the tumor kill attributed to PDT alone is significant. Data from animal tumor models in our institution and from patient studies elsewhere suggest that the addition of heat with the light delivery will predictably improve the outcome of the treatment of pigmented lesions. Ocular PDT delivered in conjunction with heat will be useful clinically as an adjunct to scleral plaque therapy by reducing the height of a lesion and concurrently the dose of radiation necessary at the base of the tumor for sterilization. Since the clinical tumoricidal effect of PDT is now known to be due at least in part to vascular damage, trans-scleral application of light to the base of melanomas and occlusion of its blood supply holds significant promise of efficacy with continued improvement of the light delivery system. Finally, a transpupillary approach to occlusion of the choroidal vascular supply to a melanoma by surrounding the tumor with photodynamic lesions may provide the best approach for ocular PDT as a primary 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.     

PHEOPHORBIDE a-INDUCED PHOTO-OXIDATION OF CYTOCHROME c: IMPLICATION FOR PHOTODYNAMIC THERAPY

Pheophorbide a-induced photo-oxidation, in vitro, of cytochrome c oxidase and cytochrome c results in irreversible modifications to both protein components. Photo-oxidation of cytochrome c, as exhibited by change in its heme oxidation state, displays exponential kinetics and is detected with a lag period. Both the photo-induced inactivation of the enzyme, and destruction of the substrate ability of cytochrome c occur as complex multi-process events. Under similar experimental conditions, the loss of the substrate capability of cytochrome c develops approximately three times faster than inactivation of the enzyme. The slight lag in the photo-oxidation of cytochrome c is due to pheophorbide a-induced superoxide production. However, the relative amount of photo-oxidant produced is considerably more effective than the cytochrome c reducing capacity of the superoxide. Neither hydroxyl radical nor hydrogen peroxide are involved in the photo-oxidation of the heme function. The possibilities of heme oxidation by a singlet oxygen mediated pathway or direct electron abstraction involving the heme or apoprotein are not excluded. It is proposed that a multi-site oxidation of numerous reduced energy cofactors within cells may augment collateral enzyme inactivation in maximizing photosensitizer-induced cytotoxicity. Accordingly, amphipathic photosensitizers, capable of accessing both lipid and aqueous compartments containing reduced cofactors, may be more effective agents for photodynamic therapy than those which exhibit a high specificity of subcellular localization.