Clinical and preclinical photodynamic therapy

Preliminary Insights into the Fluorescence and Oxidative Characteristics of Flavin - DNA Systems on PVP - Coated Silver Nanoparticles

Emissive features of flavins (Riboflavin/RF, Flavin MonoNucleotide/FMN and Flavin Adenine Dinucleotide/FAD) labeled native Deoxyribonucleic Acid (DNA) on Polyvinylpyrrolidone (PVP)-coated silver nanoparticles (SNPs), have been studied. The dual emission of flavins in DNA-PVP-coated SNPs systems is strongly influenced by the reaction time and temperature. Changes in the RF emissive features occur as a side effect when DNA is covalently linked hence, the RF destruction depends on DNA damage. Even if in an oxidation process, the FAD-DNA - PVP-coated SNPs system acts as a weak scavenger of reactive oxygen species, its antioxidant activity is approx. five times higher than that of RF-DNA-PVP-coated SNPs system. Destruction of RF by a riboflavin-mediated DNA photo-oxidation process that occurs on PVP-coated SNPs is suggested. Results have relevance in the redox process of riboflavin and provide valuable information for the further development of novel flavin-based SNPs systems as fluorescent antioxidant markers to solve several biological barriers in humans, such as protein-DNA interaction, cell binding.

Two Photon Absorption Properties of CBHB and DEABHB Single Crystals for Optical Limiting Applications

Novel materials of (E)-N'-(4-chlorobenzylidene)-4-hydroxybenzohydrazide (CBHB) and (E)-N'-(4-(diethylamino) benzylidene)-4-hydroxybenzohydrazide (DEABHB) were synthesized by condensation reaction process and solvent evaporation method was employed to grow CBHB and DEABHB single crystals at room temperature. Lattice parameters of CBHB and DEABHB compounds were recorded using single crystal X-ray diffraction method. The presence of functional groups of the synthesized CBHB and DEABHB compounds were confirmed by Fourier transform infrared and Fourier transform Raman spectral analyses. Various intermolecular interactions were studied using Hirshfeld surface analysis. Thermal stability of the hydrazone Schiff base compounds CBHB and DEABHB were studied by thermogravimetric and differential thermal analyses. Third order nonlinear optical properties of CBHB and DEABHB were measured using open aperature Z scan technique. Two photon absorption coefficient and optical limiting properties of the crystals were reported from the Z scan studies.

A New Insight into the Mechanisms Underlying the Discoloration, Sorption, and Photodegradation of Methylene Blue Solutions with and without BNOx Nanocatalysts

Methylene blue (MB) is widely used as a test material in photodynamic therapy and photocatalysis. These applications require an accurate determination of the MB concentration as well as the factors affecting the temporal evolution of the MB concentration. Optical absorbance is the most common method used to estimate MB concentration. This paper presents a detailed study of the dependence of the optical absorbance of aqueous methylene blue (MB) solutions in a concentration range of 0.5 to 10 mg·L^-1. The nonlinear behavior of optical absorbance as a function of MB concentration is described for the first time. A sharp change in optical absorption is observed in the range of MB concentrations from 3.33 to 4.00 mg·L^-1. Based on the analysis of the absorption spectra, it is concluded that this is due to the formation of MB dimers and trimers in the specific concentration range. For the first time, a strong, thermally induced discoloration effect of the MB solution under the influence of visible and sunlight was revealed: the simultaneous illumination and heating of MB solutions from 20 to 80 °C leads to a twofold decrease in the MB concentration in the solution. Exposure to sunlight for 120 min at a temperature of 80 °C led to the discoloration of the MB solution by more than 80%. The thermally induced discoloration of MB solutions should be considered in photocatalytic experiments when tested solutions are not thermally stabilized and heated due to irradiation. We discuss whether MB is a suitable test material for photocatalytic experiments and consider this using the example of a new photocatalytic material-boron oxynitride (BNO_x) nanoparticles-with 4.2 and 6.5 at.% of oxygen. It is shown that discoloration is a complex process and includes the following mechanisms: thermally induced MB photodegradation, MB absorption on BNO_x NPs, self-sensitizing MB photooxidation, and photocatalytic MB degradation. Careful consideration of all these processes makes it possible to determine the photocatalytic contribution to the discoloration process when using MB as a test material. The photocatalytic activity of BNO_x NPs containing 4.2 and 6.5 at.% of oxygen, estimated at ~440 μmol·g^-1·h^-1. The obtained results are discussed based on the results of DFT calculations considering the effect of MB sorption on its self-sensitizing photooxidation activity. A DFT analysis of the MB sorption capacity with BNO_x NPs shows that surface oxygen defects prevent the sorption of MB molecules due to their planar orientation over the BNO_x surface. To enhance the sorption capacity, surface oxygen defects should be eliminated.

BODIPYs in PDT: A Journey through the Most Interesting Molecules Produced in the Last 10 Years

Over the past 30 years, photodynamic therapy (PDT) has shown great development. In the clinical setting the few approved molecules belong almost exclusively to the porphyrin family; but in the scientific field, in recent years many researchers have been interested in other families of photosensitizers, among which BODIPY has shown particular interest. BODIPY is the acronym for 4,4-difluoro-4-bora-3a, 4a-diaza-s-indacene, and is a family of molecules well-known for their properties in the field of imaging. In order for these molecules to be used in PDT, a structural modification is necessary which involves the introduction of heavy atoms, such as bromine and iodine, in the beta positions of the pyrrole ring; this change favors the intersystem crossing, and increases the ¹O₂ yield. This mini review focused on a series of structural changes made to BODIPYs to further increase ¹O₂ production and bioavailability by improving cell targeting or photoactivity efficiency.

Hydrogen sulfide decreases photodynamic therapy outcome through the modulation of the cellular redox state

Photodynamic therapy (PDT) is a non-surgical treatment that has been approved for its human medical use in many cancers. PDT involves the interaction of a photosensitizer (PS) with light. The amino acid 5- aminolevulinic acid (ALA) can be used as a pro-PS, leading to the synthesis of Protoporphyrin IX. Hydrogen sulfide (H₂S) is an endogenously produced gas that belongs to the gasotransmitter family, which can diffuse through biological membranes and have relevant physiological effects such as cardiovascular functions, vasodilatation, inflammation, cell cycle and neuro-modulation. It was also proposed to have cytoprotective effects. We aimed to study the modulatory effects of H₂S on ALAPDT in the mammary adenocarcinoma cell line LM2. Exposure of the cells to NaHS (donor of H₂S) in concentrations up to 10 mM impaired the response to ALA-PDT in a dose-dependent manner. The addition of 3 doses of NaHS showed the highest effect. This decreased response to the photodynamic treatment was correlated to an increase in the GSH levels, catalase activity, a dose dependent reduction of PpIX and increased intracellular ALA, decreased levels of oxidized proteins and a decrease of PDT-induced ROS. NaHS also reduced the levels of singlet oxygen in an in vitro assay. H₂S also protected other cells of different origins against PDT mediated by ALA and other PSs. These results suggest that H₂S has a role in the modulation of the redox state of the cells, and thus impairs the response to ALA-PDT through multifactor pathways. These findings could contribute to developing new strategies to improve the effectiveness of PDT particularly mediated by ALA or other ROS-related treatments.

Fluorescent Flavin/PVP-Coated Silver Nanoparticles: Design and Biological Performance

A red-emitting fluorescent Riboflavin (RF)/Polyvinylpyrrolidone (PVP)-coated silver nanoparticles system, λ_em = 527 nm, Φ = 0.242, with a diameter of the metallic core of 27.33 nm and a zeta potential of - 25.05 mV was prepared and investigated regarding its biological activity. We found that PVP has a key role in RF adsorption around the SNPs surface leading to an enhancement of antioxidant properties (∼70%), low cytotoxicity (> 90% cell viability, at 50 µL/mL, after 48 h of incubation) as well as to an efficient process of its cellular uptake (∼ 60%, after 24 h of incubation) in L929 cells. The results are relevant concerning the involvement of RF and its coenzymes forms in SNPs - based systems, in cellular respiration as well as for future studies as antioxidant marker system on tumoral cells for viewing and monitoring them, by cellular imaging.

Posterior Capsule Opacification: A Review of Experimental Studies

Posterior capsule opacification (PCO) is the most common complication of cataract surgery. It causes a gradual deterioration of visual acuity, which would otherwise improve after a successful procedure. Despite recent advances in ophthalmology, this complication has not been eradicated, and the incidence of PCO can be as high as 10%. This article reviews the literature concerning the pathomechanism of PCO and examines the biochemical pathways involved in its formation and methods to prevent this complication. We also review the reported tests performed in cell cultures under laboratory conditions and in experimental animal models and in ex vivo human lens capsules. Finally, we describe research involving human eyes in the clinical setting and pharmacological methods that may reduce the frequency of PCO. Due to the multifactorial etiology of PCO, in vitro studies make it possible to assess the factors contributing to its complications and search for new therapeutic targets. Not all pathways involved in cell proliferation, migration, and contraction of the lens capsule are reproducible in laboratory conditions; moreover, PCO in humans and laboratory animals may be additionally stimulated by various degrees of postoperative reactions depending on the course of surgery. Therefore, further studies are necessary.

Biogenic Gold Nanoparticles Decrease Methylene Blue Photobleaching and Enhance Antimicrobial Photodynamic Therapy

Antibiotic resistance is a growing concern that is driving the exploration of alternative ways of killing bacteria. Here we show that gold nanoparticles synthesized by the mycelium of Mucor plumbeus are an effective medium for antimicrobial photodynamic therapy (PDT). These particles are spherical in shape, uniformly distributed without any significant agglomeration, and show a single plasmon band at 522–523 nm. The nanoparticle sizes range from 13 to 25 nm, and possess an average size of 17 ± 4 nm. In PDT, light (from a source consisting of nine LEDs with a peak wavelength of 640 nm and FWMH 20 nm arranged in a 3 × 3 array), a photosensitiser (methylene blue), and oxygen are used to kill undesired cells. We show that the biogenic nanoparticles enhance the effectiveness of the photosensitiser, methylene blue, and so can be used to kill both Gram-positive (Staphylococcus aureus) and Gram-negative (Escherichia coli) bacteria. The enhanced effectiveness means that we could kill these bacteria with a simple, small LED-based light source. We show that the biogenic gold nanoparticles prevent fast photobleaching, thereby enhancing the photoactivity of the methylene blue (MB) molecules and their bactericidal effect.

Injectable Single-Component Peptide Depot: Autonomously Rechargeable Tumor Photosensitization for Repeated Photodynamic Therapy

The general practice of photodynamic therapy (PDT) comprises repeated multiple sessions, where photosensitizers are repeatedly administered prior to each operation of light irradiation. To address potential problems arising from the total overdose of photosensitizer by such repeated injections, we here introduce an internalizing RGD peptide (iRGD) derivative (Ppa-iRGDC-BK01) that self-aggregates into an injectable single-component supramolecular depot. Ppa-iRGDC-BK01 is designed as an in situ self-implantable photosensitizer so that it forms a depot by itself upon injection, and its molecular functions (cancer cell internalization and photosensitization) are activated by sustained release, tumor targeting, and tumor-selective proteolytic/reductive cleavage of the iRGD segment. The experimental and theoretical studies revealed that when exposed to body temperature, Ppa-iRGDC-BK01 undergoes thermally accelerated self-assembly to form a supramolecular depot through the hydrophobic interaction of the Ppa pendants and the reorganization of the interpeptide hydrogen bonding. It turned out that the self-aggregation of Ppa-iRGDC-BK01 into a depot exerts a multiple-quenching effect on the photosensitivity to effectively prevent nonspecific phototoxicity and protect it from photobleaching outside the tumor, while enabling autonomous tumor rephotosensitization by long sustained release, tumor accumulation, and intratumoral activation over time. We demonstrate that depot formation through a single peritumoral injection and subsequent quintuple laser irradiations at intervals resulted in complete eradication of the tumor. During the repeated PDT, depot-implanted normal tissues around the tumor exhibited no phototoxic damage under laser exposure. Our approach of single-component photosensitizing supramolecular depot, combined with a strategy of tumor-targeted therapeutic activation, would be a safer and more precise operation of PDT through a nonconventional protocol composed of one-time photosensitizer injection and multiple laser irradiations.

In vivo assessment of functional and morphological alterations in tumors under treatment using OCT-angiography combined with OCT-elastography

Emerging methods of anti-tumor therapies require new approaches to tumor response evaluation, especially enabling label-free diagnostics and in vivo utilization. Here, to assess the tumor early reaction and predict its long-term response, for the first time we apply in combination the recently developed OCT extensions - optical coherence angiography (OCA) and compressional optical coherence elastography (OCE), thus enabling complementary functional/microstructural tumor characterization. We study two vascular-targeted therapies of different types, (1) anti-angiogenic chemotherapy (ChT) and (2) photodynamic therapy (PDT), aimed to indirectly kill tumor cells through blood supply injury. Despite different mechanisms of anti-angiogenic action for ChT and PDT, in both cases OCA demonstrated high sensitivity to blood perfusion cessation. The new method of OCE-based morphological segmentation revealed very similar histological structure alterations. The OCE results showed high correlation with conventional histology in evaluating percentages of necrotic and viable tumor zones. Such possibilities make OCE an attractive tool enabling previously inaccessible in vivo monitoring of individual tumor response to therapies without taking multiple biopsies.

Revealing structural modifications in thermomechanical reshaping of collagenous tissues using optical coherence elastography

Moderate heating of such collagenous tissues as cornea and cartilages by infra-red laser (IR laser) irradiation is an emerging technology for nondestructive modification of the tissue shape and microstructure for a variety of applications in ophthalmology, otolaryngology and so on. Postirradiation high-resolution microscopic examination indicates the appearance of microscopic either spheroidal or crack-like narrow pores depending on the tissue type and irradiation regime. Such examinations usually require special tissue preparation (eg, staining, drying that affect microstructure themselves) and are mostly suitable for studying individual pores, whereas evaluation of their averaged parameters, especially in situ, is challenging. Here, we demonstrate the ability of optical coherence tomography (OCT) to visualize areas of pore initiation and evaluate their averaged properties by combining visualization of residual irradiation-induced tissue dilatation and evaluation of the accompanying Young-modulus reduction by OCT-based compressional elastography. We show that the averaged OCT-based data obtained in situ fairly well agree with the microscopic examination results. The results obtained develop the basis for effective and safe applications of novel nondestructive laser technologies of tissue modification in clinical practice. PICTURE: Elastographic OCT-based images of an excised rabbit eye cornea subjected to thermomechanical laser-assisted reshaping. Central panel shows resultant cumulative dilatation in cornea after moderate (~45-50°C) pulse-periodic heating by an IR laser together with distribution of the inverse Young modulus 1/E before (left) and after (right) IR irradiation. Significant modulus decrease in the center of irradiated region is caused by initiated micropores. Their parameters can be extracted by analyzing the elastographic images.

Radiation-responsive scintillating nanotheranostics for reduced hypoxic radioresistance under ROS/NO-mediated tumor microenvironment regulation

Abstract: Hypoxia-induced radioresistance is the primary reason for failure of tumor radiotherapy (RT). Changes within the irradiated tumor microenvironment (TME) including oxygen, reactive oxygen species (ROS) and nitric oxide (NO) are closely related to radioresistance. Therefore, there is an urgent need to develop new approaches for overcoming hypoxic radioresistance by incorporating TME regulation into current radiotherapeutic strategies.

Methods: Herein, we explored a radiation-responsive nanotheranostic system to enhance RT effects on hypoxic tumors by multi-way therapeutic effects. This system was developed by loading S-nitrosothiol groups (SNO, a NO donor) and indocyanine green (ICG, a photosensitizer) onto mesoporous silica shells of Eu³⁺-doped NaGdF₄ scintillating nanocrystals (NSC).

Results: Under X-ray radiation, this system can increase the local dosage by high-Z elements, promote ROS generation by X-ray-induced photodynamic therapy, and produce high levels of NO to enhance tumor-killing effects and improve hypoxia via NO-induced vasodilation. In vitro and in vivo studies revealed that this combined strategy can greatly reinforce DNA damage and apoptosis of hypoxic tumor cells, while significantly suppressing tumor growth, improving tumor hypoxia and promoting p53 up-regulation and HIF1α down-regulation. In addition, this system showed pronounced tumor contrast performance in T₁-weighted magnetic resonance imaging and computed tomography.

Conclusion: This work demonstrates the great potential of scintillating nanotheranostics for multimodal imaging-guided X-ray radiation-triggered tumor combined therapy to overcome radioresistance.

Improvement in dissolution rate and photodynamic efficacy of chlorin e6 by sucrose esters as drug carrier in nanosuspension formulation: optimisation and in vitro characterisation

OBJECTIVES

Chlorin e6 is a poorly water-soluble photoactive drug. Its monomers form aggregates at the tumour physiological pH, which drastically reduces its photodynamic efficacy. This study aimed to improve the dissolution rate and photodynamic efficacy of chlorin e6 by nanosuspension formulation using biodegradable sucrose esters as drug carrier.

METHODS

A modified emulsion-solvent diffusion method was used to prepare the nanosuspension, where amount of Ce6, ratio of sucrose monopalmitate to sucrose monolaurate as carrier and ratio of dichloromethane to acetone as solvent, were varied using central composite design. Particle size, zeta potential, encapsulation efficiency and in vitro drug release characteristics of the nanosuspensions were evaluated. The formulation was optimised by response surface methodology and its photodynamic efficacy evaluated.

KEY FINDINGS

The optimised nanosuspension had mean particle size of ~200 nm, 88% drug encapsulation efficiency and faster drug release compared to pure Ce6. Spectroscopic studies showed that Ce6 exists in monomeric form in the carrier, which facilitated a remarkable increase in cellular uptake, in vitro singlet oxygen generation and cytotoxicity to oral squamous carcinoma cells.

CONCLUSIONS

The dissolution rate and photodynamic efficacy of Ce6 were markedly improved by formulating the drug as a nanosuspension with sucrose esters as drug carrier.

Photodynamic therapy versus endoscopic submucosal dissection for management of patients with early esophageal neoplasia: a retrospective study

Background

Photodynamic therapy (PDT) and endoscopic submucosal dissection (ESD) have been proposed as a treatment for early esophageal neoplasia. The objective of this study is to compare between the clinical outcome after ESD and PDT to reach the best management for early esophageal neoplasia.

Methods

All patients undergoing ESD or PDT for early esophageal neoplasia between 2014 and 2015 were eligible for the study. A retrospective analysis for comparison between the results of ESD and PDT was done.

Results

36 patients underwent ESD and Thirty PDT. No significant difference was found between the two groups regarding the demographic or pathologic data. Also, there was no significant difference regarding the length of hospital stay, presence of hydrothorax, fever, and pain. Operative time was significantly longer in ESD than in PDT (72 vs. 8 minutes, P<0.001). In addition, bleeding was significantly lower in ESD than PDT (12 vs. 2, P<0.05). There was a significant difference regarding stricture and cost which were less in ESD (6 vs. 15, P<0.05). However, perforation was much more in ESD (6 vs. 0, P<0.05). There was no significant difference between the two groups regarding the disease free survival (DFS), but it was observed that patients who underwent PDT had more favorable 2-year DFS rates than patients received ESD.

Conclusions

The PDT may be comparable to the ESD. With the exception of esophageal stenosis, PDT could reduce many complications and have longer DFS in comparison with ESD. PDT is feasible for patients with early esophageal neoplasia confined to the mucosal layer without regional lymph nodal or distant metastasis.

ALA-Photodynamic treatment in Lichen sclerosus-clinical and immunological outcome focusing on the assesment of antinuclear antibodies

BACKGROUND

Lichen sclerosus (LS) is a difficult to treat, often relapsing disease with unknown background. Autoimmune diseases also coexist with LS. Over recent years photodynamic therapy (PDT) has been shown to be a noninvasive and successful therapeutic approach for the effective treatment of many conditions. However, the change of immune status of the patients based on ANA antibodies has not been yet reported. Our aim was to observe the clinical response followed by possible changes in autoimmune antibodies levels before and after PDT for LS.

MATERIAL AND METHODS

We enrolled 100 women with Lichen sclerosus with or without a concomitant autoimmune disease. All patients received 10 cycles of PDT (65 treated with DIOMED Light, 35 with PhotoDYN Light). We assessed autoimmune antibodies before and after PDT in addition to the clinical response evaluation.Two-year prospective controlled before-and-after study.

RESULTS

Following PDT, patients showed a significant attenuation in symptoms' intensity (itching, pruritus, vulvar discomfort). After therapy 41% of patients had partial response, 51% of patients had no symptoms and 8% had persistent or worsened symptoms. The most frequent autoimmune disease were thyroid disorders, followed by vitiligo and arthritis. 57% patients with an additional autoimmune disease before PDT had ANA antibodies. The mean level of ANA in this group diminished significantly after PDT treatment (261.74 IU/ml before vs. 123.20 IU/ml after treatment).

CONCLUSION

Based on our results, we assume that PDT may influence the immune status of patients with Lichen sclerosus.

Photodynamic therapy monitoring with optical coherence angiography

Photodynamic therapy (PDT) is a promising modern approach for cancer therapy with low normal tissue toxicity. This study was focused on a vascular-targeting Chlorine E6 mediated PDT. A new angiographic imaging approach known as M-mode-like optical coherence angiography (MML-OCA) was able to sensitively detect PDT-induced microvascular alterations in the mouse ear tumour model CT26. Histological analysis showed that the main mechanisms of vascular PDT was thrombosis of blood vessels and hemorrhage, which agrees with angiographic imaging by MML-OCA. Relationship between MML-OCA-detected early microvascular damage post PDT (within 24 hours) and tumour regression/regrowth was confirmed by histology. The advantages of MML-OCA such as direct image acquisition, fast processing, robust and affordable system opto-electronics, and label-free high contrast 3D visualization of the microvasculature suggest attractive possibilities of this method in practical clinical monitoring of cancer therapies with microvascular involvement.

Lipase-Sensitive Transfersomes Based on Photosensitizer/Polymerizable Lipid Conjugate for Selective Antimicrobial Photodynamic Therapy of Acne

Acne vulgaris is a common skin problem affecting nearly 90% of adolescents and its development is associated with a colonization of Propionibacterium acnes (P. acnes). Although antibiotics have commonly been used to treat acne, antibiotic resistance of P. acnes is an emerging issue to be solved. In this study, a new way of photodynamic acne therapy is developed using P. acnes lipase-sensitive transfersome (DSPE-PEG-Pheo A (DPP) transfersome). For enhanced selectivity and skin penetration efficiency, DPP transfersomes are prepared from 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[amino(polyethylene glycol)-2000], pheophorbide A (Pheo A), cholesterol, and Tween-80. Incorporation of Tween-80 as an edge activator increases the deformability of DPP transfersomes, enhancing skin penetration efficiency to four times that of free Pheo A. The photoactivity of Pheo A quenched by DPP transfersomes is gradually recovered by selective cleavage of the ester linkage in DPP transfersomes by P. acnes lipases. In vitro P. acnes-specific photoactivity and subsequent selective antimicrobial effect exhibit a greater than 99% loss of P. acnes viability. In vivo antiacne therapeutic effect is confirmed by reduction of swelling volume and thickness of P. acnes-induced nude mice skin. These results demonstrate that DPP transfersome-mediated photodynamic therapy can be used as an alternative method to treat bacterial skin infections.

Red Blood Cell-Facilitated Photodynamic Therapy for Cancer Treatment

Photodynamic therapy (PDT) is a promising treatment modality for cancer management. So far, most PDT studies have focused on delivery of photosensitizers to tumors. O₂, another essential component of PDT, is not artificially delivered but taken from the biological milieu. However, cancer cells demand a large amount of O₂ to sustain their growth and that often leads to low O₂ levels in tumors. The PDT process may further potentiate the oxygen deficiency, and in turn, adversely affect the PDT efficiency. In the present study, a new technology called red blood cell (RBC)-facilitated PDT, or RBC-PDT, is introduced that can potentially solve the issue. As the name tells, RBC-PDT harnesses erythrocytes, an O₂ transporter, as a carrier for photosensitizers. Because photosensitizers are adjacent to a carry-on O₂ source, RBC-PDT can efficiently produce ¹O₂ even under low oxygen conditions. The treatment also benefits from the long circulation of RBCs, which ensures a high intraluminal concentration of photosensitizers during PDT and hence maximizes damage to tumor blood vessels. When tested in U87MG subcutaneous tumor models, RBC-PDT shows impressive tumor suppression (76.7%) that is attributable to the codelivery of O₂ and photosensitizers. Overall, RBC-PDT is expected to find wide applications in modern oncology.

Upconverting NIR Photons for Bioimaging

Lanthanide-doped upconverting nanoparticles (UCNPs) possess uniqueanti-Stokes optical properties, in which low energy near-infrared (NIR) photons can beconverted into high energy UV, visible, shorter NIR emission via multiphoton upconversionprocesses. Due to the rapid development of synthesis chemistry, lanthanide-doped UCNPscan be fabricated with narrow distribution and tunable multi-color optical properties. Theseunique attributes grant them unique NIR-driven imaging/drug delivery/therapeuticapplications, especially in the cases of deep tissue environments. In this brief review, weintroduce both the basic concepts of and recent progress with UCNPs in material engineeringand theranostic applications in imaging, molecular delivery, and tumor therapeutics. The aimof this brief review is to address the most typical progress in basic mechanism, materialdesign as bioimaging tools.

Phototoxic Activity and DNA Interactions of Water-Soluble Porphyrins and Their Rhenium(I) Conjugates

In the search for alternative photosensitizers for use in photodynamic therapy (PDT), herein we describe two new water-soluble porphyrins, a neutral fourfold-symmetric compound and a +3-charged tris-methylpyridinium derivative, in which either four or one [1,4,7]-triazacyclononane (TACN) units are connected to the porphyrin macrocycle through a hydrophilic linker; we also report their corresponding tetracationic Re(I) conjugates. The in vitro (photo)toxic effects of the compounds toward the human cell lines HeLa (cervical cancer), H460M2 (non-small-cell lung carcinoma), and HBL-100 (non-tumorigenic epithelial cells) are reported. Three of the compounds are not cytotoxic in the dark up to 100 μm, and the fourfold-symmetric couple revealed very good phototoxic indexes (PIs). The intracellular localization of all derivatives was studied in HeLa cells by confocal fluorescence microscopy. Although low nuclear localization was observed for some of them, it still prompted us to investigate their capacity to bind both quadruplex and duplex DNA; we observed significant selectivity in the tris-methylpyridinium derivatives for G-quadruplex interactions.

Erythrocyte membrane-coated NIR-triggered biomimetic nanovectors with programmed delivery for photodynamic therapy of cancer

A new type of photodynamic therapy (PDT) agents using upconversion nanoparticles (UCNPs) with incorporated photosensitizers as the inner core and an erythrocyte membrane (RM) decorated with dual targeting moieties as the cloak is developed. Owing to the endogenous nature of RM, the RM-coating endows the PDT agents with perfect biocompatibility and stealth ability to escape from the entrapment by the reticulo-endothelial system (RES). More importantly, owing to the unique nature of erythrocyte as an oxygen carrier in the blood, the RM outer layer of the agents unequivocally facilitates the permeation of ground-state molecular oxygen ((3)O2) and the singlet oxygen ((1)O2) as compared to the previously developed PDT agents with other types of coating. Another salient feature of the as-prepared PDT platform is the decoration of RM with dual targeting moieties for selective recognition of cancer cells and mitochondrial targeting, respectively. The synergistic effect of RM coating and dual-targeting of such feature-packed agents are investigated in tumor-bearing mice and the improved PDT therapeutic efficacy is confirmed, which is the first paradigm where RM-coated NIR-triggered nanovectors with programmed delivery ability is applied in PDT of tumor in vivo.

Topical ALA-PDT modifies neutrophils' chemiluminescence, lymphocytes' interleukin-1beta secretion and serum level of transforming growth factor beta1 in patients with nonmelanoma skin malignancies A clinical study

BACKGROUND

Photodynamic therapy (PDT) has been recognized as a noninvasive therapeutic approach for the effective treatment of tumors. It has been shown in studies conducted on malignant cell lines and various animal tumor models, that the interaction of photosensitizing substances with light leads to the release of cytotoxic substances and stimulates the immune response.

PURPOSE

The aim of our study was to analyze the immune system response in patients undergoing photodynamic therapy due to basal cell carcinoma (BCC).

METHODS

Patients with skin malignancies have been treated by 10% delta-aminolevulinic acid (ALA) (Medac GmbH, Wedel, Germany) topically and light from a diode laser. Blood samples were obtained from each patient twice in the same day: before and 4h after photodynamic treatment procedure. In patients' serum the concentration of transforming growth factor beta1 (TGF-β1) was determined. Additionally the study has been conducted on lymphocytes and granulocytes from peripheral blood. In cell culture supernatants the concentration of interleukin 1beta (IL-1β), interleukin 2 (IL-2), interleukin 6 (IL-6), tumor necrosis factor alpha (TNFα), the percentile composition of patients' lymphocytes and the chemiluminescence of neutrophils have been measured.

RESULTS

We have observed a significant increase (p=0.015) in the intensity of the neutrophil chemiluminescence and significant diminution (p=0.006) of IL-1β concentration in supernatants. Similarly the serum level of TGF-β1 has been significantly decreased (p<0.001).

CONCLUSION

It is very likely that human immune system activity is modified by topical ALA-PDT and may potentially contribute to its final outcome.

Tumor vasculature targeted photodynamic therapy for enhanced delivery of nanoparticles

Delivery of nanoparticle drugs to tumors relies heavily on the enhanced permeability and retention (EPR) effect. While many consider the effect to be equally effective on all tumors, it varies drastically among the tumors' origins, stages, and organs, owing much to differences in vessel leakiness. Suboptimal EPR effect represents a major problem in the translation of nanomedicine to the clinic. In the present study, we introduce a photodynamic therapy (PDT)-based EPR enhancement technology. The method uses RGD-modified ferritin (RFRT) as "smart" carriers that site-specifically deliver (1)O2 to the tumor endothelium. The photodynamic stimulus can cause permeabilized tumor vessels that facilitate extravasation of nanoparticles at the sites. The method has proven to be safe, selective, and effective. Increased tumor uptake was observed with a wide range of nanoparticles by as much as 20.08-fold. It is expected that the methodology can find wide applications in the area of nanomedicine.

25th anniversary article: Design of polymethine dyes for all-optical switching applications: guidance from theoretical and computational studies

All-optical switching--controlling light with light--has the potential to meet the ever-increasing demand for data transmission bandwidth. The development of organic π-conjugated molecular materials with the requisite properties for all-optical switching applications has long proven to be a significant challenge. However, recent advances demonstrate that polymethine dyes have the potential to meet the necessary requirements. In this review, we explore the theoretical underpinnings that guide the design of π-conjugated materials for all-optical switching applications. We underline, from a computational chemistry standpoint, the relationships among chemical structure, electronic structure, and optical properties that make polymethines such promising materials.

Rationale and mechanism for the low photoinactivation rate of bacteria in plasma

The rate of bacterial photoinactivation in plasma by methylene blue (MB), especially for Gram-negative bacteria, has been reported to be lower, by about an order of magnitude, than the rate of inactivation in PBS and water solutions. This low inactivation rate we attribute to the bleaching of the 660-nm absorption band of MB in plasma that results in low yields of MB triplet states and consequently low singlet oxygen generation. We have recorded the change of the MB 660-nm-band optical density in plasma, albumin, and cysteine solutions, as a function of time, after 661-nm excitation. The transient triplet spectra were recorded and the singlet oxygen generated in these solutions was determined by the rate of decrease in the intensity of the 399-nm absorption band of 9, 10-anthracene dipropionic acid. We attribute the bleaching of MB, low singlet oxygen yield, and consequently the low inactivation rate of bacteria in plasma to the attachment of a hydrogen atom, from the S-H group of cysteine, to the central nitrogen atom of MB and formation of cysteine dimer.

Molecular characterization of photosensitizer-mediated photodynamic therapy by gene expression profiling

Photodynamic therapy (PDT) is a novel cancer treatment based on the tumor-specific accumulation of a photosensitizer followed by irradiation with visible light, which induces selective tumor cell death via production of reactive oxygen species. To elucidate the underlying mechanisms, microarray analysis was used to analyze the changes in gene expression patterns during PDT induced by various photosensitizers. Cancer cells were subjected to four different photosensitizer-mediated PDT and the resulting gene expression profiles were compared. We identified many differentially expressed genes reported previously as well as new genes for which the functionfunctions in PDT are still unclear. Our current results not only advance the general understanding of PDT but also suggest that distinct molecular mechanisms are involved in different photosensitizer-mediated PDT. Elucidating the signaling mechanisms in PDT will provide information to modulate the antitumor effectiveness of PDT using various photosensitizers.

Ferritin nanocages to encapsulate and deliver photosensitizers for efficient photodynamic therapy against cancer

Photodynamic therapy is an emerging treatment modality that is under intensive preclinical and clinical investigations for many types of disease including cancer. Despite the promise, there is a lack of a reliable drug delivery vehicle that can transport photosensitizers (PSs) to tumors in a site-specific manner. Previous efforts have been focused on polymer- or liposome-based nanocarriers, which are usually associated with a suboptimal PS loading rate and a large particle size. We report herein that a RGD4C-modified ferritin (RFRT), a protein-based nanoparticle, can serve as a safe and efficient PS vehicle. Zinc hexadecafluorophthalocyanine (ZnF16Pc), a potent PS with a high (1)O2 quantum yield but poor water solubility, can be encapsulated into RFRTs with a loading rate as high as ~60 wt % (i.e., 1.5 mg of ZnF16Pc can be loaded on 1 mg of RFRTs), which far exceeds those reported previously. Despite the high loading, the ZnF16Pc-loaded RFRTs (P-RFRTs) show an overall particle size of 18.6 ± 2.6 nm, which is significantly smaller than other PS-nanocarrier conjugates. When tested on U87MG subcutaneous tumor models, P-RFRTs showed a high tumor accumulation rate (tumor-to-normal tissue ratio of 26.82 ± 4.07 at 24 h), a good tumor inhibition rate (83.64% on day 12), as well as minimal toxicity to the skin and other major organs. This technology can be extended to deliver other metal-containing PSs and holds great clinical translation potential.

Lanthanide-doped upconverting luminescent nanoparticle platforms for optical imaging-guided drug delivery and therapy

Lanthanide-doped upconverting luminescent nanoparticles (UCNPs) are promising materials for optical imaging-guided drug delivery and therapy due to their unique optical and chemical properties. UCNPs absorb low energy near-infrared (NIR) light and emit high-energy shorter wavelength photons. Their special features allow them to overcome various problems associated with conventional imaging probes and to provide versatility for creating nanoplatforms with both imaging and therapeutic modalities. Here, we discuss several approaches to fabricate and utilize UCNPs for traceable drug delivery and therapy.

The conjugates of gold nanorods and chlorin e6 for enhancing the fluorescence detection and photodynamic therapy of cancers

Gold nanorods (AuNRs) were conjugated with chlorin e6 (Ce6), a commonly used photosensitizer, to form AuNRs-Ce6 by electrostatic binding. Due to the strong surface plasmon resonance coupling, the fluorescence of conjugated Ce6 was enhanced 3-fold and the production of singlet oxygen was increased 1.4-fold. AuNRs-Ce6 were taken up by the HeLa and KB cell lines more easily than free Ce6, enhancing the intracellular delivery of Ce6. The increased cellular amount of Ce6 leads to a 3-fold more efficient photodynamic killing of these two cell lines. This demonstrates the potential of this approach to improve photodynamic detection and therapy of cancers.

Nanotechnology-based photodynamic therapy

According to recent advances in nanotechnology, various nano-sized formulations have been designed for the application in biomedical fields, including diagnosis, drug delivery, and therapeutics. The nanotechnology-based formulations have a great merit in the design of multifunctional platform for the biomedical applications. Therefore, recent trends in nanotechnology are moving onto the combination of nanotechnology and conventional therapeutic. Typically, photodynamic therapy (PDT) is one of promising techniques for the combination with nanotechnology owing to its less invasiveness. In this paper, we are going to briefly review recent advances in nanotechnology-based PDT, including selective delivery and excitation of photosensitizers, combination therapy, and multifunctional PDT.

Efficacy and safety of photodynamic therapy with temoporfin in curative treatment of recurrent carcinoma of the oral cavity and oropharynx

Therapeutic options for recurrent carcinoma of the upper aérodigestive tract (UADT) are limited. The prognosis of these tumours remains poor with significant rate of recurrence and a lower median survival time. Photodynamic therapy (PDT) is a relatively new therapeutic alternative which combines the use of a photosensitising agent and light to induce a cytotoxic effect on the tissues. This is a retrospective single-centre study carried out in patients with a recurrence of an oral cavity or oropharyngeal carcinoma or a second appearance of tumour in a previously irradiated area. There were no metastases in lymph nodes or other organs. Laser treatment was carried out 96 h after temoporfin (Foscan(®)) injection. In our series we had 14 cases with a complete response, 1 partial response. Overall survival at 1 year was 72 % and 36 % at 5 years. Disease-specific survival at 1 year was 82 % and 45 % at 5 years. Recurrence-free survival at 1 year was 52 % and 34 % at 5 years. Side effects mainly described are pain in the area of illumination, well controlled. PDT with Foscan(®) gives useful results in terms of survival and improvement in quality of life with few adverse events or severe complications. The fact that it has low toxicity and that treatment sessions can be repeated mean it should be considered in the therapeutic armamentarium for recurrent carcinoma of the UADT.

Constitutive overexpression of HSP-70 in thermal resistant tumor cells does not alter sensitivity to porphyrin-, chlorin-, or purpurin-mediated PDT

Cellular expression of the 70 kDa heat shock protein (HSP-70) is observed following hyperthermia and is correlated with transient resistance to subsequent heating. Photodynamic therapy (PDT) mediated oxidative stress can also induce transcriptional and translational expression of a variety of genes including HSP-70. However, PDT-mediated HSP-70 expression can vary as a function of photosensitizer type and incubation conditions. In the current study we used three clinically relevant photosensitizers, a porphyrin (Photofrin), a purpurin (SnET2), and a chlorin (NPe6), to examine PDT-mediated HSP-70 expression profiles and photosensitivity characteristics in parental radiation-induced fibrosarcoma cells (RIF-1) and in thermal resistant RIF-1 clones. We observed that in vitro PDT treatments using either SnET2 or NPe6 induced HSP-70 expression but that comparable PDT treatments using Photofrin did not result in increased HSP-70 levels. We also observed that PDT sensitivity in parental and heat-resistant cell clones were similar for each photosensitizer while thermal sensitivity was significantly reduced in the RIF clones which constitutively overexpressed HSP-70. These results indicate that definable differences can exist in the molecular pathways induced by PDT for different photosensitizers. Our results also demonstrate that constitutive overexpression of HSP-70 does not modulate PDT photosensitivity regardless of whether PDT treatments induce HSP-70 expression. We conclude that HSP-70 expression does not play a significant role in cellular PDT photosensitivity.

Texaphyrins: a new approach to drug development

The texaphyrins are prototypical metal-coordinating expanded porphyrins. They represent a burgeoning class of pharmacological agents that show promise for an array of medical applications. Currently, two different water-soluble lanthanide texaphyrins, namely motexafin gadolinium ( Gd-Tex , 1) and motexafin lutetium ( Lu-Tex , 2), are involved in multi-center clinical trials for a variety of indications. The first of these agents, XCYTRIN® (motexafin gadolinium) Injection, is being evaluated as a potential X-ray radiation enhancer in a randomized Phase III clinical trial in patients with brain metastases. The second, in various formulations, is being evaluated as a photosensitizer for use in: (i) the photodynamic treatment of recurrent breast cancer (LUTRIN® Injection; now in Phase IIb clinical trials); (ii) photoangioplastic reduction of atherosclerosis involving peripheral and coronary arteries (ANTRIN® Injection; now in Phase II and Phase I clinical trials, respectively); and (iii) light-based age-related macular degeneration (OPTRIN™ Injection; currently under Phase II clinical evaluation), a vision-threatening disease of the retina. In this article, these developments, along with fundamental aspects of the underlying chemistry are reviewed.

Pharmaceutical development and medical applications of porphyrin-type macrocycles

The current state of pharmaceutical development of porphyrin-type macrocycles in medicine is highlighted. Currently, several porphyrinoid-based drugs are under various stages of development as phototherapeutic agents, X-ray radiation enhancers and boron neutron capture agents. These compounds represent a burgeoning class of pharmacological agents that are potentially useful in an array of treatment areas.

A non-tetradecarboxylative synthesis of 2,7,12,17-tetraphenylporphycene

A new synthetic method for 2,7,12,17-tetraphenylporphycene (2e, TPPo) which avoids tetradecarboxylation by sublimation of the intermediate tetracarboxylic acid 8 is reported. Thus, the use of a pyrrol 13a bearing two orthogonal ester groups allows the synthesis of bipyrrol 12a, from which the benzyl ester groups are selectively removed to afford diester 11. The latter is transformed to dialdehyde 10 by using the McFayden–Stevens reaction, thus avoiding the unstable bipyrrol 9 formed during the tetradecarboxylation of 8.

Spectrometry researches on interaction and sonodynamic damage of riboflavin (RF) to bovine serum albumin (BSA)

In this paper, the riboflavin (RF) was used to study the interaction and sonodynamic damage to bovine serum albumin (BSA) by fluorescence and UV-vis spectroscopy. The results showed that the RF could efficiently bind to BSA in aqueous solution. Under ultrasonic irradiation, the RF could obviously damage the BSA. In addition, synchronous fluorescence spectroscopy revealed that the RF showed more accessible to tryptophan (Trp) residues than to tyrosine (Tyr) residues. Also, it damaged Trp residues more seriously than Tyr residues under ultrasonic irradiation. At last, the generation of reactive oxygen species (ROS) in sonodynamic process was estimated by the method of Oxidation-Extraction Spectrometry (OES). And then, several radical scavengers were used to determine the kind of ROS. It was found that at least the singlet oxygen ((1)O(2)) and hydroxyl radicals (*OH) were generated.

Enhanced photodynamic efficacy and efficient delivery of Rose Bengal using nanostructured poly(amidoamine) dendrimers: potential application in photodynamic therapy of cancer

Photodynamic therapy (PDT) is a promising treatment methodology whereby diseased cells and tissues are destroyed by reactive oxygen species (ROS) by using a combination of light and photosensitizers (PS). The medical application of Rose Bengal (RB), photosensitizer with very good ROS generation capability, is limited due to its intrinsic toxicity and insufficient lipophilicity. In this report, we evaluate the potential of polyamidoamine (PAMAM) dendrimers in delivering RB and its phototoxic efficiency towards a model cancer cell line. The spherical, nanoscaled dendrimers could efficiently encapsulate RB and showed characteristic spectral responses. The controlled release property of dendrimer-RB formulation was clearly evident from the in vitro drug release study. ROS generation was confirmed in dendrimer-RB system upon white light illumination. Photosensitization of Dalton's Lymphoma Ascite (DLA) cells incubated with dendrimer-RB formulation caused remarkable photocytotoxicity. Importantly, the use of dendrimer-based delivery system reduced the dark toxicity of RB.

Temoporfin-mediated photodynamic therapy in patients with advanced, incurable head and neck cancer: A multicenter study

BACKGROUND

The aim of this study was to confirm the efficacy of temoporfin (Foscan)-mediated photodynamic therapy (PDT) in patients with end-stage head and neck squamous cell carcinoma (HNSCC).

METHODS

Thirty-nine patients with recurring HNSCC lesions ≤10 mm in depth were injected with temoporfin, followed by illumination of the tumor surface.

RESULTS

Of 39 treated patients, 19 achieved complete response, 2 partial response, 5 stable disease, 5 had progressive disease, and 8 patients were nonevaluable. Thus, in the per-protocol analysis, the response rate was 68%. Of the treated patients 54% had a response. Median survival was significantly longer for responders (37 months) than for nonresponders (7.4 months). Nine patients were alive at 3.7 to 6.5 years (median, 4.8 years) post-treatment, 7 free of disease. No major toxicities were observed.

CONCLUSIONS

Patients with advanced HNSCC with lesions ≤10 mm in depth, who have exhausted other treatment options, can achieve significant local control and survival benefit from temoporfin-mediated PDT.