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Oskroba A, Bartusik-Aebisher D, Myśliwiec A, Dynarowicz K, Cieślar G, Kawczyk-Krupka A, Aebisher D. Photodynamic Therapy and Cardiovascular Diseases. Int J Mol Sci 2024; 25:2974. [PMID: 38474220 DOI: 10.3390/ijms25052974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/24/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
Cardiovascular diseases are the third most common cause of death in the world. The most common are heart attacks and stroke. Cardiovascular diseases are a global problem monitored by many centers, including the World Health Organization (WHO). Atherosclerosis is one aspect that significantly influences the development and management of cardiovascular diseases. Photodynamic therapy (PDT) is one of the therapeutic methods used for various types of inflammatory, cancerous and non-cancer diseases. Currently, it is not practiced very often in the field of cardiology. It is most often practiced and tested experimentally under in vitro experimental conditions. In clinical practice, the use of PDT is still rare. The aim of this review was to characterize the effectiveness of PDT in the treatment of cardiovascular diseases. Additionally, the most frequently used photosensitizers in cardiology are summarized.
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Affiliation(s)
- Aleksander Oskroba
- Science Club, Faculty of Medicine, Medical University of Lublin, 20-059 Lublin, Poland
| | - Dorota Bartusik-Aebisher
- Department of Biochemistry and General Chemistry, Medical College of The Rzeszów University, 35-959 Rzeszów, Poland
| | - Angelika Myśliwiec
- Center for Innovative Research in Medical and Natural Sciences, Medical College of the University of Rzeszów, 35-310 Rzeszów, Poland
| | - Klaudia Dynarowicz
- Center for Innovative Research in Medical and Natural Sciences, Medical College of the University of Rzeszów, 35-310 Rzeszów, Poland
| | - Grzegorz Cieślar
- Department of Internal Medicine, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Batorego 15 St., 41-902 Bytom, Poland
| | - Aleksandra Kawczyk-Krupka
- Department of Internal Medicine, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Batorego 15 St., 41-902 Bytom, Poland
| | - David Aebisher
- Department of Photomedicine and Physical Chemistry, Medical College of The Rzeszów University, 35-959 Rzeszów, Poland
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Mytych W, Bartusik-Aebisher D, Łoś A, Dynarowicz K, Myśliwiec A, Aebisher D. Photodynamic Therapy for Atherosclerosis. Int J Mol Sci 2024; 25:1958. [PMID: 38396639 PMCID: PMC10888721 DOI: 10.3390/ijms25041958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/26/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024] Open
Abstract
Atherosclerosis, which currently contributes to 31% of deaths globally, is of critical cardiovascular concern. Current diagnostic tools and biomarkers are limited, emphasizing the need for early detection. Lifestyle modifications and medications form the basis of treatment, and emerging therapies such as photodynamic therapy are being developed. Photodynamic therapy involves a photosensitizer selectively targeting components of atherosclerotic plaques. When activated by specific light wavelengths, it induces localized oxidative stress aiming to stabilize plaques and reduce inflammation. The key advantage lies in its selective targeting, sparing healthy tissues. While preclinical studies are encouraging, ongoing research and clinical trials are crucial for optimizing protocols and ensuring long-term safety and efficacy. The potential combination with other therapies makes photodynamic therapy a versatile and promising avenue for addressing atherosclerosis and associated cardiovascular disease. The investigations underscore the possibility of utilizing photodynamic therapy as a valuable treatment choice for atherosclerosis. As advancements in research continue, photodynamic therapy might become more seamlessly incorporated into clinical approaches for managing atherosclerosis, providing a blend of efficacy and limited invasiveness.
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Affiliation(s)
- Wiktoria Mytych
- Students English Division Science Club, Medical College of the University of Rzeszów, 35-959 Rzeszów, Poland; (W.M.); (A.Ł.)
| | - Dorota Bartusik-Aebisher
- Department of Biochemistry and General Chemistry, Medical College of the University of Rzeszów, 35-959 Rzeszów, Poland;
| | - Aleksandra Łoś
- Students English Division Science Club, Medical College of the University of Rzeszów, 35-959 Rzeszów, Poland; (W.M.); (A.Ł.)
| | - Klaudia Dynarowicz
- Center for Innovative Research in Medical and Natural Sciences, Medical College of the University of Rzeszów, 35-310 Rzeszów, Poland; (K.D.); (A.M.)
| | - Angelika Myśliwiec
- Center for Innovative Research in Medical and Natural Sciences, Medical College of the University of Rzeszów, 35-310 Rzeszów, Poland; (K.D.); (A.M.)
| | - David Aebisher
- Department of Photomedicine and Physical Chemistry, Medical College of the University of Rzeszów, 35-959 Rzeszów, Poland
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Wu G, Yu G, Zheng M, Peng W, Li L. Recent Advances for Dynamic-Based Therapy of Atherosclerosis. Int J Nanomedicine 2023; 18:3851-3878. [PMID: 37469455 PMCID: PMC10352141 DOI: 10.2147/ijn.s402678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 05/06/2023] [Indexed: 07/21/2023] Open
Abstract
Atherosclerosis (AS) is a chronic inflammatory disease, which may lead to high morbidity and mortality. Currently, the clinical treatment strategy for AS is administering drugs and performing surgery. However, advanced therapy strategies are urgently required because of the deficient therapeutic effects of current managements. Increased number of energy conversion-based organic or inorganic materials has been used in cancer and other major disease treatments, bringing hope to patients with the development of nanomedicine and materials. These treatment strategies employ specific nanomaterials with specific own physiochemical properties (external stimuli: light or ultrasound) to promote foam cell apoptosis and cholesterol efflux. Based on the pathological characteristics of vulnerable plaques, energy conversion-based nano-therapy has attracted increasing attention in the field of anti-atherosclerosis. Therefore, this review focuses on recent advances in energy conversion-based treatments. In addition to summarizing the therapeutic effects of various techniques, the regulated pathological processes are highlighted. Finally, the challenges and prospects for further development of dynamic treatment for AS are discussed.
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Affiliation(s)
- Guanghao Wu
- School of Materials Science and Engineering, Beijing Institute of Technology, Beijing, 100081, People’s Republic of China
| | - Guanye Yu
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University, School of Medicine, Shanghai, 200072, People’s Republic of China
| | - Meiling Zheng
- Dongzhimen Hospital Beijing University of Chinese Medicine, Beijing, 101121, People’s Republic of China
| | - Wenhui Peng
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University, School of Medicine, Shanghai, 200072, People’s Republic of China
| | - Lei Li
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
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Therapeutic Strategies and Chemoprevention of Atherosclerosis: What Do We Know and Where Do We Go? Pharmaceutics 2022; 14:pharmaceutics14040722. [PMID: 35456556 PMCID: PMC9025701 DOI: 10.3390/pharmaceutics14040722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/24/2022] [Accepted: 03/26/2022] [Indexed: 12/15/2022] Open
Abstract
Despite progress in understanding the pathogenesis of atherosclerosis, the development of effective therapeutic strategies is a challenging task that requires more research to attain its full potential. This review discusses current pharmacotherapy in atherosclerosis and explores the potential of some important emerging therapies (antibody-based therapeutics, cytokine-targeting therapy, antisense oligonucleotides, photodynamic therapy and theranostics) in terms of clinical translation. A chemopreventive approach based on modern research of plant-derived products is also presented. Future perspectives on preventive and therapeutic management of atherosclerosis and the design of tailored treatments are outlined.
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Céspedes MA, Saénz DA, Calvo GH, González M, MacRobert AJ, Battah S, Casas AG, Di Venosa GM. Apoptotic cell death induced by dendritic derivatives of aminolevulinic acid in endothelial and foam cells co-cultures. Photochem Photobiol Sci 2021; 20:489-499. [PMID: 33825180 DOI: 10.1007/s43630-021-00025-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/12/2021] [Indexed: 11/27/2022]
Abstract
Photodynamic therapy (PDT) is an effective procedure for the treatment of lesions diseases based on the selectivity of a photosensitising compound with the ability to accumulate in the target cell. Atherosclerotic plaque is a suitable target for PDT because of the preferential accumulation of photosensitisers in atherosclerotic plaques. Dendrimers are hyperbranched polymers conjugated to drugs. The dendrimers of ALA hold ester bonds that inside the cells are cleaved and release ALA, yielding PpIX production. The dendrimer 6m-ALA was chosen to perform this study since in previous studies it induced the highest porphyrin macrophage: endothelial cell ratio (Rodriguez et al. in Photochem Photobiol Sci 14:1617-1627, 2015). We transformed Raw 264.7 macrophages to foam cells by exposure to oxidised LDLs, and we employed a co-culture model of HMEC-1 endothelial cells and foam cells to study the affinity of ALA dendrimers for the foam cells. In this work it was proposed an in vitro model of atheromatous plaque, the aim was to study the selectivity of an ALA dendrimer for the foam cells as compared to the endothelial cells in a co-culture system and the type of cell death triggered by the photodynamic treatment. The ALA dendrimer 6m-ALA showed selectivity PDT response for foam cells against endothelial cells. A light dose of 1 J/cm2 eliminate foam cells, whereas less than 50% of HMEC-1 is killed, and apoptosis cell death is involved in this process, and no necrosis is present. We propose the use of ALA dendrimers as pro-photosensitisers to be employed in photoangioplasty to aid in the treatment of obstructive cardiovascular diseases, and these molecules can also be employed as a theranostic agent.
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Affiliation(s)
- Mariela A Céspedes
- Centro de Investigaciones Sobre Porfirinas y Porfirias (CIPYP), Hospital de Clínicas José de San Martin, Universidad de Buenos Aires and CONICET, Avenida Córdoba 2351, 1er subsuelo, 1120 AAF, Autonomous City of Buenos Aires, Argentina
| | - Daniel A Saénz
- Centro de Investigaciones Sobre Porfirinas y Porfirias (CIPYP), Hospital de Clínicas José de San Martin, Universidad de Buenos Aires and CONICET, Avenida Córdoba 2351, 1er subsuelo, 1120 AAF, Autonomous City of Buenos Aires, Argentina
| | - Gustavo H Calvo
- Centro de Investigaciones Sobre Porfirinas y Porfirias (CIPYP), Hospital de Clínicas José de San Martin, Universidad de Buenos Aires and CONICET, Avenida Córdoba 2351, 1er subsuelo, 1120 AAF, Autonomous City of Buenos Aires, Argentina
| | - Marina González
- Facultad de Ciencias Médicas, Centro Científico Tecnológico La Plata, Instituto de Investigaciones Bioquímica de La Plata (INIBIOLP), Universidad Nacional de La Plata, Calle 60 y 120 s/n, 1900, La Plata, Argentina
| | - Alexander J MacRobert
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Sinan Battah
- The School of Life Sciences, University of Essex, Colchester, CO4 3SQ, UK
| | - Adriana G Casas
- Centro de Investigaciones Sobre Porfirinas y Porfirias (CIPYP), Hospital de Clínicas José de San Martin, Universidad de Buenos Aires and CONICET, Avenida Córdoba 2351, 1er subsuelo, 1120 AAF, Autonomous City of Buenos Aires, Argentina.
| | - Gabriela M Di Venosa
- Centro de Investigaciones Sobre Porfirinas y Porfirias (CIPYP), Hospital de Clínicas José de San Martin, Universidad de Buenos Aires and CONICET, Avenida Córdoba 2351, 1er subsuelo, 1120 AAF, Autonomous City of Buenos Aires, Argentina.
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Photodynamic therapy for atherosclerosis. The potential of indocyanine green. Photodiagnosis Photodyn Ther 2020; 29:101568. [DOI: 10.1016/j.pdpdt.2019.10.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 10/01/2019] [Accepted: 10/04/2019] [Indexed: 12/29/2022]
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Lin JS, Wang CJ, Li WT. Photodynamic therapy of balloon-injured rat carotid arteries using indocyanine green. Lasers Med Sci 2018; 33:1123-1130. [PMID: 29594740 DOI: 10.1007/s10103-018-2488-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 03/19/2018] [Indexed: 12/11/2022]
Abstract
Photodynamic therapy (PDT) has been used to inhibit intimal hyperplasia in injured arteries. Because of the limited tissue penetration of visible light, an endovascular light source with a guided wire is often required for effective treatment. Indocyanine green (ICG), a near-infrared (NIR) photosensitizer, has been used in PDT for cancers. An extracorporeal light source may be used for shallow tissue because of the better tissue penetration of NIR light. The aim of this study was to evaluate the effect of ICG-PDT using extracorporeal NIR light on the inhibition of intimal hyperplasia in balloon-injured carotid arteries. A balloon injury (BI) model was used to induce intimal hyperplasia of carotid artery. Sprague-Dawley rats were divided into control, BI, BI + 1 × PDT, and BI + 2 × PDT groups. The control group underwent a sham procedure. PDT was performed 7 days after BI. In the BI + 1 × PDT group, ICG was administered 1 h before light irradiation. External illumination with 780-nm light-emitting diode light at a fluence of 4 J/cm2 was applied. For the BI + 2 × PDT group, PDT was performed again at day 7, following the first PDT. Hematoxylin and eosin (H & E) staining was performed to assess vessel morphology. Arterial wall thickness was significantly larger in the BI group compared with the control group. ICG-PDT significantly reduced arterial wall thickness compared with the BI group. Repeated PDT further decreased arterial wall thickness to the level of the control group. These findings indicate a promising approach for the treatment of restenosis of carotid arteries.
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Affiliation(s)
- Jih-Shyong Lin
- Division of Cardiology, Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, 330, Taiwan, Republic of China
- Department of Biomedical Engineering, Chung Yuan Christian University, 200 Chung Pei Road, Taoyuan, 320, Taiwan, Republic of China
| | - Chia-Jung Wang
- Department of Biomedical Engineering, Chung Yuan Christian University, 200 Chung Pei Road, Taoyuan, 320, Taiwan, Republic of China
| | - Wen-Tyng Li
- Department of Biomedical Engineering, Chung Yuan Christian University, 200 Chung Pei Road, Taoyuan, 320, Taiwan, Republic of China.
- Center for Biomedical Technology and Center for Nanotechnology, Chung Yuan Christian University, Taoyuan, 320, Taiwan, Republic of China.
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8
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Jain M, Zellweger M, Wagnières G, van den Bergh H, Cook S, Giraud MN. Photodynamic therapy for the treatment of atherosclerotic plaque: Lost in translation? Cardiovasc Ther 2017; 35. [PMID: 27893195 DOI: 10.1111/1755-5922.12238] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Acute coronary syndrome is a life-threatening condition of utmost clinical importance, which, despite recent progress in the field, is still associated with high morbidity and mortality. Acute coronary syndrome results from a rupture or erosion of vulnerable atherosclerotic plaque with secondary platelet activation and thrombus formation, which leads to partial or complete luminal obstruction of a coronary artery. During the last decade, scientific evidence demonstrated that when an acute coronary event occurs, several nonculprit plaques are in a "vulnerable" state. Among the promising approaches, several investigations provided evidence of photodynamic therapy (PDT)-induced stabilization and regression of atherosclerotic plaque. Significant development of PDT strategies improved its therapeutic outcome. This review addresses PDT's pertinence and major problems/challenges toward its translation to a clinical reality.
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Affiliation(s)
- Manish Jain
- Cardiology, Department of Medicine, University and Hospital of Fribourg, Fribourg, Switzerland
| | - Matthieu Zellweger
- Medical Photonics Group, LCOM-ISIC, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
| | - Georges Wagnières
- Medical Photonics Group, LCOM-ISIC, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
| | - Hubert van den Bergh
- Medical Photonics Group, LCOM-ISIC, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
| | - Stéphane Cook
- Cardiology, Department of Medicine, University and Hospital of Fribourg, Fribourg, Switzerland
| | - Marie-Noelle Giraud
- Cardiology, Department of Medicine, University and Hospital of Fribourg, Fribourg, Switzerland
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Evaluation of the effects of systemic photodynamic therapy in a rat model of acute myeloid leukemia. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2015; 153:13-9. [PMID: 26386623 DOI: 10.1016/j.jphotobiol.2015.08.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 08/24/2015] [Accepted: 08/26/2015] [Indexed: 11/21/2022]
Abstract
Systemic PDT (SPDT) approach is developed to treat a variety of hematological diseases, including cancers and blood-borne infections. We evaluated the efficacy of an SPDT method for treating leukemia using a Brown Norway myeloid leukemia (BNML) rat model with the LT12 cells engineered to express GFP. The survival times of animals receiving SPDT at 5 (early-SPDT) and 10 (mid-SPDT) days post-LT12 injection were prolonged by 2 days, the rats in the late-SPDT group (15 days) exhibited a 6-day increase in life span (p<0.05). The percentages of GFP-LT12 cells in the bone marrow of the late-SPDT rats decreased from 61.6% to 56.5% on day 17. Likewise, there was a decrease in the serum expression levels of IL-1β, IL-10, TNF-α, and IFN-γ in the late-SPDT rats (p<0.05). Our findings indicate that SPDT could be an effective method for the treatment of leukemia, and that antitumor immunity may play a key role in this process.
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Rodriguez L, Vallecorsa P, Battah S, Di Venosa G, Calvo G, Mamone L, Sáenz D, Gonzalez MC, Batlle A, MacRobert AJ, Casas A. Aminolevulinic acid dendrimers in photodynamic treatment of cancer and atheromatous disease. Photochem Photobiol Sci 2015; 14:1617-27. [DOI: 10.1039/c5pp00126a] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ALA dendrimers are taken up by caveolae-mediated endocytosis in macrophages. Intracellular ALA release gives rise to PpIX synthesis and subsequent photosensitization of key cells in atheromas and tumour diseases.
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Affiliation(s)
- L. Rodriguez
- Centro de Investigaciones sobre Porfirinas y Porfirias (CIPYP). CONICET-Htal de Clínicas Gral. José de San Martín
- Ciudad de Buenos Aires
- Argentina
| | - P. Vallecorsa
- Centro de Investigaciones sobre Porfirinas y Porfirias (CIPYP). CONICET-Htal de Clínicas Gral. José de San Martín
- Ciudad de Buenos Aires
- Argentina
| | - S. Battah
- School of Biological Sciences
- University of Essex
- Wivenhoe Park CO4 3SQ
- UK
- Division of Surgery and Interventional Sciences and UCL Institute of Biomedical Engineering
| | - G. Di Venosa
- Centro de Investigaciones sobre Porfirinas y Porfirias (CIPYP). CONICET-Htal de Clínicas Gral. José de San Martín
- Ciudad de Buenos Aires
- Argentina
| | - G. Calvo
- Centro de Investigaciones sobre Porfirinas y Porfirias (CIPYP). CONICET-Htal de Clínicas Gral. José de San Martín
- Ciudad de Buenos Aires
- Argentina
| | - L. Mamone
- Centro de Investigaciones sobre Porfirinas y Porfirias (CIPYP). CONICET-Htal de Clínicas Gral. José de San Martín
- Ciudad de Buenos Aires
- Argentina
| | - D. Sáenz
- Centro de Investigaciones sobre Porfirinas y Porfirias (CIPYP). CONICET-Htal de Clínicas Gral. José de San Martín
- Ciudad de Buenos Aires
- Argentina
| | - M. C. Gonzalez
- Facultad de Ciencias Médicas
- Instituto de Investigaciones Bioquímicas de La Plata (INIBIOLP)
- CONICET-UNLP
- Argentina
| | - A. Batlle
- Centro de Investigaciones sobre Porfirinas y Porfirias (CIPYP). CONICET-Htal de Clínicas Gral. José de San Martín
- Ciudad de Buenos Aires
- Argentina
| | - A. J. MacRobert
- Division of Surgery and Interventional Sciences and UCL Institute of Biomedical Engineering
- University College London
- London W1W 7EJ
- UK
| | - A. Casas
- Centro de Investigaciones sobre Porfirinas y Porfirias (CIPYP). CONICET-Htal de Clínicas Gral. José de San Martín
- Ciudad de Buenos Aires
- Argentina
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Liu S, Zhang G, Li X, Zhang J. Microbial production and applications of 5-aminolevulinic acid. Appl Microbiol Biotechnol 2014; 98:7349-57. [DOI: 10.1007/s00253-014-5925-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Revised: 06/27/2014] [Accepted: 06/30/2014] [Indexed: 10/25/2022]
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Therapeutic effects of systemic photodynamic therapy in a leukemia animal model using A20 cells. Lasers Med Sci 2011; 27:445-52. [DOI: 10.1007/s10103-011-0950-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Accepted: 06/13/2011] [Indexed: 10/18/2022]
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13
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Lee DK, Choi Y, Shon SM, Schellingerhout D, Park JE, Kim DE. Atorvastatin and clopidogrel interfere with photosensitization in vitro. Photochem Photobiol Sci 2011; 10:1587-92. [PMID: 21748161 DOI: 10.1039/c0pp00363h] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Photodynamic therapy (PDT) has been used to eliminate undesired cells by using a combination of photosensitizers and light illumination to generate reactive oxygen species. There is great interest in applying PDT to atherosclerosis; preferential destruction of pro-inflammatory macrophages in atheromata might attenuate plaque growth or rupture-prone vulnerability. Here, we report on a previously unknown interaction between cardiovascular drugs that are commonly prescribed for atherosclerosis patients and the cytolytic effects of photodynamic therapy using Cathepsin B activatable photosensitizer L-SR15 on murine macrophage Raw 264.7 cells in culture. Atorvastatin and clopidogrel significantly interfered with in vitro photosensitization effect while aspirin did this to a lesser extent; these drugs did not change the efficiency of cellular uptake of L-SR15 after in vitro photosensitization. A photosensitization interference effect of atorvastatin and clopidogrel was also observed when using a conventional photosensitizer free Ce6 or NCI-H1299 cancer cells. Considering the clinical implications of PDT, our study merits further investigation in clinical settings as well as in animal models.
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Affiliation(s)
- Dong Kun Lee
- Molecular Imaging and Neurovascular Research (MINER) Laboratory, Department of Neurology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, 814 Siksa-dong, Goyang, Korea
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Cheng J, Liang H, Li Q, Peng C, Li Z, Shi S, Yang L, Tian Z, Tian Y, Zhang Z, Cao W. Hematoporphyrin monomethyl ether-mediated photodynamic effects on THP-1 cell-derived macrophages. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2010; 101:9-15. [DOI: 10.1016/j.jphotobiol.2010.06.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Revised: 06/13/2010] [Accepted: 06/19/2010] [Indexed: 01/07/2023]
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Shammas NW. Restenosis after lower extremity interventions: current status and future directions. J Endovasc Ther 2009; 16 Suppl 1:I170-82. [PMID: 19317571 DOI: 10.1583/08-2564.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The incidence of restenosis after percutaneous peripheral interventions (PPI) varies considerably depending upon the vascular bed but appears to be highest in the femoropopliteal and tibioperoneal arteries. The restenosis process in the periphery does not appear to stop at the 6-month mark, as seen with bare metal stents in the coronary arteries, but continues for a longer time, possibly years, after the intervention. This review evaluates the incidence of restenosis following lower extremity arterial interventions and potential drugs or devices that could alter this process, including nonpharmacological (stents, cryoplasty, Cutting Balloon angioplasty, atherectomy, brachytherapy, and photodynamic therapy) and pharmacological (systemic and direct drug delivery) approaches. A global strategy to achieve optimal outcome with PPI is offered: (1) obtain excellent acute angiographic results with less dissection and recoil, (2) protect the distal tibial vascular bed, and (3) reduce smooth muscle cell proliferation with pharmacological intervention.
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Affiliation(s)
- Nicolas W Shammas
- Midwest Cardiovascular Research Foundation, Cardiovascular Medicine, Davenport, Iowa 52803, USA.
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Kwon OC, Yoon HJ, Kim KH, Kim HT, Yoon YH, Kim JK. Fluorescence kinetics of protoporphyrin-IX induced from 5-ALA compounds in rabbit postballoon injury model for ALA-photoangioplasty. Photochem Photobiol 2008; 84:1209-14. [PMID: 18363621 DOI: 10.1111/j.1751-1097.2008.00325.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Protoporphyrin IX (PpIX) is one of the photodynamically active substances that are endogenously synthesized in the metabolic pathway for heme as a precursor. Aminolevulinic acid-esters are more lipophilic than conventional 5-aminolevulinic acid (ALA) and some of them are currently being approved as new drugs for photodynamic diagnosis (PDD) and photodynamic therapy (PDT). In order to investigate the pharmacokinetics of ALA and ALA-ethyl ester (ALA-ethyl) in the atheromatous plaque and normal aortic wall of rabbit postballoon injured artery, each 60 mg kg(-1) of ALA or ALA-ethyl was injected intravenously followed by serial detection of PpIX fluorescence of harvested arteries at 0-48 h post-injection. Maximum PpIX build-up in the atheromatous plaque was seen at 2 h after injecting ALA. In contrast, it occurred at 9 h after injecting ALA-ethyl. In addition, the selective build-up of ALA in the atheromatous plaque compared to normal vessel wall was much higher (10 times) than that of ALA-ethyl. The time of maximum fluorescence intensity of PpIX was employed as drug-light-interval for subsequent PDT treatment of the atheromatous plaque with 50-150 J cm(-1) of light dose. Significant reduction in plaque was observed without damage of the medial wall at both groups, but smooth muscle cell (SMC) was still present in the media region below the PDT-treated atheromatous plaque. In conclusion, ALA may be a more effective compound for endovascular PDT treatment of the atheromatous plaque compared with ALA-ethyl based on their pharmacokinetics, but further optimization of PDT methodology remains to remove completely residual SMC in the media for preventing potential restenosis.
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Affiliation(s)
- Oh-Choon Kwon
- Department of Thoracic Surgery, Catholic University of Taegu, Korea
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Perrée J, Leeuwen TG, Velema E, Smeets M, Kleijn D, Borst C. UVB-activated Psoralen Reduces Luminal Narrowing After Balloon Dilation Because of Inhibition of Constrictive Remodeling¶. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2002)0750068uaprln2.0.co2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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18
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Fungaloi P, Waterman P, Nigri G, Statius-van Eps R, Sluiter W, Van Urk H, LaMuraglia G. Photochemically Modulated Endothelial Cell Thrombogenicity via the Thrombomodulin-Tissue Factor Pathway¶. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2003)0780475pmectv2.0.co2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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19
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Roy-Chaudhury P, Sukhatme VP, Cheung AK. Hemodialysis vascular access dysfunction: a cellular and molecular viewpoint. J Am Soc Nephrol 2006; 17:1112-27. [PMID: 16565259 DOI: 10.1681/asn.2005050615] [Citation(s) in RCA: 408] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Hemodialysis vascular access dysfunction is a major cause of morbidity and hospitalization in the hemodialysis population. The major cause of hemodialysis vascular access dysfunction is venous stenosis as a result of neointimal hyperplasia. Despite the magnitude of the clinical problem, however, there has been a paucity of novel therapeutic interventions in this field. This is in marked contrast to a recent plethora of targeted interventions for the treatment of arterial neointimal hyperplasia after coronary angioplasty. The reasons for this are two-fold. First there has been a relative lack of cellular and molecular research that focuses on venous neointimal hyperplasia in the specific setting of hemodialysis vascular access. Second, there have been inadequate efforts by the nephrology community to translate the recent advances in molecular and interventional cardiology into therapies for hemodialysis vascular access. This review therefore (1) briefly examines the different forms of hemodialysis vascular access that are available, (2) describes the pathology and pathogenesis of hemodialysis vascular access dysfunction in both polytetrafluoroethylene grafts and native arteriovenous fistulae, (3) reviews recent concepts about the pathogenesis of vascular stenosis that could potentially be applied in the setting of hemodialysis vascular access dysfunction, (4) summarizes novel experimental and clinical therapies that could potentially be used in the setting of hemodialysis vascular access dysfunction, and, finally, (5) offers some broad guidelines for future innovative translational and clinical research in this area that hopefully will reduce the huge clinical morbidity and economic costs that are associated with this condition.
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Affiliation(s)
- Prabir Roy-Chaudhury
- Division of Nephrology, MSB G-251, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267-0585.
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20
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Waksman R, Leitch IM, Roessler J, Yazdi H, Seabron R, Tio F, Scott RW, Grove RI, Rychnovsky S, Robinson B, Pakala R, Cheneau E. Intracoronary photodynamic therapy reduces neointimal growth without suppressing re-endothelialisation in a porcine model. Heart 2006; 92:1138-44. [PMID: 16399853 PMCID: PMC1861129 DOI: 10.1136/hrt.2005.073486] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/20/2005] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To examine the effects of intracoronary PhotoPoint photodynamic therapy (PDT) with a new photosensitiser, MV0611, in the overstretch balloon and stent porcine models of restenosis. METHODS 28 pigs were injected with 3 mg/kg of MV0611 systemically 4 h before the procedure. Animals were divided into either the balloon overstretch injury (BI) group (n = 19) or the stented group (n = 9). After BI, a centred delivery catheter was positioned in the artery to cover the injured area, and light (532 nm, 125 J/cm(2)) was applied to activate the drug (n = 10). Control arteries (n = 9) were not activated by light. In the stented group, the drug was light activated before stent deployment. Serial sections of vessels were processed 14 days after treatment in the BI group and 30 days after treatment in the stented group for histomorphometric or immunohistochemical analysis. RESULTS Intracoronary PDT significantly reduced intimal thickness in both BI and stented arteries (about 65%: 0.22 (SEM 0.05) mm v 0.62 (0.05) mm, p < 0.01; and about 26%: 0.40 (0.04) mm v 0.54 (0.04) mm, p < 0.01, respectively). PDT increased luminal area by CONCLUSION Intracoronary PhotoPoint PDT with MV0611 reduces intimal proliferation without suppressing re-endothelialisation in a porcine model of restenosis.
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Affiliation(s)
- R Waksman
- Division of Cardiology, Washington Hospital Center, Washington, DC, USA.
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21
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Wakamatsu T, Saito T, Hayashi J, Takeichi T, Kitamoto K, Aizawa K. Long-term inhibition of intimal hyperplasia using vascular photodynamic therapy in balloon-injured carotid arteries. Med Mol Morphol 2006; 38:225-32. [PMID: 16378231 DOI: 10.1007/s00795-005-0301-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2005] [Accepted: 09/20/2005] [Indexed: 12/29/2022]
Abstract
Flexible treatments for intimal hyperplasia after angioplasty are still needed. The aim of this study was to demonstrate the long-term effects of vascular photodynamic therapy with talaporfin sodium on intimal hyperplasia following interventional injury. Intimal hyperplasia was induced by balloon distension injury to the carotid artery in 31 rabbits. Talaporfin, 5.0 mg/kg, was delivered systemically immediately after balloon injury. The injury site was irradiated with a diode laser light of wavelength 664 nm using a fluence of 50 J/cm2 after 30 min. At day 3 and weeks 3, 6, 9, 15, and 25 after photodynamic therapy, the treated artery of each rabbit was excised and examined immunohistochemically. Thirty minutes after talaporfin administration, drug fluorescence was found only in the balloon-injured carotid artery wall. At 3 days, no smooth muscle cells were seen in the media of the photodynamic therapy-treated arterial segments. Intimal hyperplasia developed progressively in the balloon-injured and untreated segments; however, in the segments treated with photodynamic therapy, intimal hyperplasia was markedly suppressed until 25 weeks and the media was repopulated by smooth muscle cells without macrophages. Vascular photodynamic therapy with talaporfin may be used to inhibit restenosis after vascular intervention.
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22
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Sasaki K, Watanabe M, Suda Y, Ishizuka A, Noparatnaraporn N. Applications of photosynthetic bacteria for medical fields. J Biosci Bioeng 2005; 100:481-8. [PMID: 16384785 DOI: 10.1263/jbb.100.481] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2005] [Accepted: 07/19/2005] [Indexed: 11/17/2022]
Abstract
The medical applications of photosynthetic bacteria are summarized. Photosynthetic bacteria can produce various types of physiological active substance such as vitamin B(12), ubiquinone (coenzyme Q10), 5-aminolevulinic acid (ALA), porphyrins and RNA. In particular, photosynthetic bacterial ALA was commercially applied to cancer diagnosis and treatment. Recently, ALA has been applied to the treatment of acne vulgaris and the suppression of the inflammatory response to coronary and iliac injuries. In addition, the recent applications of RNA from a marine photosynthetic bacterium as a medical supplement for immune improvement and suppression of infection are described. Furthermore, the feasible application of a biopolymer consisting of RNA from a photosynthetic bacterium as a drug delivery system (DDS) to cancer treatment is described.
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Affiliation(s)
- Ken Sasaki
- Materials Science and Engineering, Graduate School of Engineering, Hiroshima Kokusai Gakuin University, 6-20-1 Nakano, Akiku, Hiroshima 739-0321, Japan.
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23
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Pai M, Jamal W, Mosse A, Bishop C, Bown S, McEwan J. Inhibition of in-stent restenosis in rabbit iliac arteries with photodynamic therapy. Eur J Vasc Endovasc Surg 2005; 30:573-81. [PMID: 16125418 DOI: 10.1016/j.ejvs.2005.07.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2005] [Accepted: 07/05/2005] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Photodynamic therapy (PDT, the combination of light with a photosensitising drug in the presence of oxygen) inhibits restenosis after angioplasty without stenting. This study assesses the potential of PDT for prevention of in-stent re-stenosis. DESIGN AND METHODS Normal rabbits were given the photosensitising agent 5-aminolaevulinic acid (ALA) 60 mg/kg, 3 h prior to endovascular illumination of the iliac artery (635 nm at 50 J/cm(2)) either immediately before or after deployment of an oversized (3 mm diameter) stent. PDT treated arteries were retrieved 3 or 28 days later and assessed for cell counts and vascular morphometry. Control arteries (stent but no PDT) were examined at 28 days. RESULTS There were no adverse events and all vessels were patent at the end of the study. At 3 days there was almost complete medial cell ablation when light was delivered before stent deployment (17+/-1 cells/hpf), with little effect when illumination followed stent deployment (184+/-17 cells/hpf, p<0.0001). Twenty-eight days after PDT, the neointimal areas were 1.41+/-0.52 mm(2) (stent with no PDT), 1.24+/-0.54 mm(2) (light after stent) and 0.60+/-0.21 mm(2) (light before stent) (p=0.004). CONCLUSIONS PDT before stent deployment caused almost complete medial cell ablation at 3 days with inhibition of in-stent restenosis at 28 days. PDT is worthy of further study as an adjuvant to percutaneous intervention in patients with vascular disease.
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MESH Headings
- Aminolevulinic Acid/administration & dosage
- Aminolevulinic Acid/therapeutic use
- Animals
- Arterial Occlusive Diseases/surgery
- Blood Vessel Prosthesis Implantation/instrumentation
- Disease Models, Animal
- Endothelium, Vascular/drug effects
- Endothelium, Vascular/pathology
- Graft Occlusion, Vascular/drug therapy
- Graft Occlusion, Vascular/pathology
- Iliac Artery
- Injections, Intra-Arterial
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/pathology
- Photochemotherapy/methods
- Photosensitizing Agents/administration & dosage
- Photosensitizing Agents/therapeutic use
- Prosthesis Failure
- Rabbits
- Stents
- Treatment Outcome
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Affiliation(s)
- M Pai
- The Royal Free and University College London Medical School, London, UK
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Nigri GR, Kossodo S, Waterman P, Fungaloi P, LaMuraglia GM. Free radical attenuation prevents thrombosis and enables photochemical inhibition of vein graft intimal hyperplasia. J Vasc Surg 2004; 39:843-9. [PMID: 15071453 DOI: 10.1016/j.jvs.2003.11.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Photodynamic therapy (PDT) inhibits post-interventional stenosis in balloon-injured arteries, but causes thrombosis when applied to vein grafts. This may result from added free radicals produced during the hypoxia-reperfusion injury of vein graft implantation. The purposes of this study were to determine whether a free radical scavenger could inhibit vein graft thrombosis, enabling PDT to inhibit intimal hyperplasia; and to investigate the role of neutrophils, also a source of radicals, in this setting. METHODS Jugular vein bypass grafts of the common carotid artery were performed in rats. PDT was administered in situ to the vein graft and artery in the presence or absence of deferoxamine (DFX), an OH- scavenger. RESULTS PDT alone induced thrombosis in all untreated vein grafts. DFX administration or inhibition of neutrophil adhesion to the graft prevented PDT-induced vein graft thrombosis. Moreover, DFX given together with PDT significantly decreased vein graft intimal hyperplasia (0.010 mm2 +/- 0.005 mm2; P<.002) as compared with DFX alone (0.113 mm2 +/- 0.009 mm2) or untreated control animals (0.112 +/- 0.007 mm2). CONCLUSIONS OH- radicals and neutrophils both have key roles in PDT-induced vein graft thrombosis. By inhibiting free radical production or neutrophil adhesion to the graft, adequate PDT can be administered for successful inhibition of vein graft intimal hyperplasia.
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Affiliation(s)
- Giuseppe R Nigri
- Division of Vascular Surgery of General Surgical Servies, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
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25
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Usui M, Miyagi M, Fukasawa S, Hara T, Ueyama N, Nakajima H, Takata R, Sasame A, Tamura K, Naitou Y, Yamashina A. A first trial in the clinical application of photodynamic therapy for the prevention of restenosis after coronary-stent placement. Lasers Surg Med 2004; 34:235-41. [PMID: 15022250 DOI: 10.1002/lsm.20018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES The aim of this clinical study was to evaluate the safety of local delivery of a photosensitizer followed by photodynamic therapy (PDT), to determine its effectiveness in reducing in-stent restenosis. STUDY DESIGN/PATIENTS AND METHODS Porfimer sodium was administered via a local delivery catheter to five coronary-stent implanted lesions followed by irradiation with a pulse laser. Coronary angiography (CAG) was performed at the baseline, after the procedure and at a 6-month follow-up. RESULTS By the 18-month clinical follow-up, no adverse events such as photodermatosis, or myocardial ischemia had occurred. At the follow-up, no coronary embolization, dissection, or aneurysmal dilatation was observed in the CAG. In-stent diameter stenosis, late loss, and loss index were 19.16+/-8.20%, 0.37+/-0.18 mm, and 0.19+/-0.12, respectively. No in-stent restenosis was observed. CONCLUSIONS This study suggests that PDT, with local delivery of Porfimer sodium, is safe and may be a feasible technique in preventing in-stent restenosis.
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Affiliation(s)
- Mikio Usui
- Second Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan.
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26
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Fungaloi P, Waterman P, Nigri G, Statius-van Eps R, Sluiter W, van Urk H, LaMuraglia G. Photochemically Modulated Endothelial Cell Thrombogenicity via the Thrombomodulin–Tissue Factor Pathway¶. Photochem Photobiol 2003; 78:475-80. [PMID: 14653579 DOI: 10.1562/0031-8655(2003)078<0475:pmectv>2.0.co;2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Photodynamic therapy (PDT) is based on a photochemical reaction using a photosensitizer and light to produce reactive oxygen species that have biological effects. Although its application in some fields is largely based on thrombosis, in the vascular setting thrombosis must be prevented. In this study we examined the effects of PDT on the changes in activity of thrombomodulin (TM) and tissue factor (TF) as important regulators of the coagulation process of endothelial cells. Human umbilical vein endothelial cells were treated with PDT (chloro-aluminum-sulfonated phthalocyanine, lambda = 630 nm) at different light-energy doses, and TM and TF levels were measured using fluorescence spectroscopy. Microparticles (MP) were analyzed using flow cytometry analysis. PDT alters the thrombogenic state of endothelial cells by causing decreased expression of TM and increased expression of functional TF in a light-energy dose-dependent way. PDT-treated endothelial cells shed large numbers of MP containing high levels of TF. TF functionality of PDT-treated cells, measured by a Factor Xa-generating assay, was high. TF was located mostly intracellularly and in MP. The disturbed anticoagulant balance described in this study may explain the occurrence of thrombosis induced by PDT and, if not contained, dispute the suitability of PDT as an adjuvant modality to treat vascular restenosis.
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Affiliation(s)
- Patrick Fungaloi
- Division of Vascular Surgery, Atrium Medical Center, Heerlen, The Netherlands.
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27
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Mansfield RJR, Jenkins MP, Pai ML, Bishop CCR, Bown SG, McEwan JR. Long-term safety and efficacy of superficial femoral artery angioplasty with adjuvant photodynamic therapy to prevent restenosis. Br J Surg 2002; 89:1538-9. [PMID: 12445062 DOI: 10.1046/j.1365-2168.2002.02269.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- R J R Mansfield
- Division of Cardiology and Department of Vascular Surgery, Middlesex Hospital and National Medical Laser Centre, Royal Free and University College Medical School, London, UK
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28
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Chou TM, Woodburn KW, Cheong WF, Lacy SA, Sudhir K, Adelman DC, Wahr D. Photodynamic therapy: applications in atherosclerotic vascular disease with motexafin lutetium. Catheter Cardiovasc Interv 2002; 57:387-94. [PMID: 12410519 DOI: 10.1002/ccd.10336] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Photodynamic therapy (PDT) has been approved as a tissue-specific light-activated cytotoxic therapy for many diseases. The ability of PDT to destroy target tissues selectively is especially appealing for atherosclerotic plaque. Biotechnology has developed a new generation of selective photosensitizers and catheter-based technological advances in light delivery have allowed the introduction of PDT into the vasculature. The largest experience to date is with motexafin lutetium (MLu, Antrin), an expanded porphyrin (texaphyrin) that accumulates in plaque. The combination of the motexafin lutetium and endovascular illumination, or Antrin phototherapy, has been shown to reduce plaque in animal models. Antrin phototherapy generates cytotoxic singlet oxygen that has been shown to induce apoptosis in macrophages and smooth muscle cells. The safety, tolerability, and preliminary efficacy of Antrin phototherapy has been assessed in a phase 1 dose-ranging clinical trial in subjects with peripheral artery disease and is currently being examined in a phase 1 study in subjects with lesions of the native coronary arteries undergoing stent implantation. The preliminary results suggest that Antrin phototherapy is safe, well tolerated, and nontraumatic.
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Affiliation(s)
- Tony M Chou
- Adult Cardiac Catheterization Laboratories, University of California, San Francisco, UCSF Moffitt-Long Hospitals, San Francisco, California 94143, USA.
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29
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Perrée J, van Leeuwen TG, Velema E, Smeets M, de Kleijn D, Borst C. UVB-activated psoralen reduces luminal narrowing after balloon dilation because of inhibition of constrictive remodeling. Photochem Photobiol 2002; 75:68-75. [PMID: 11837329 DOI: 10.1562/0031-8655(2002)075<0068:uaprln>2.0.co;2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In this study we have explored the potential of PUVB (8-MOP + UVB) therapy for the reduction of luminal narrowing after arterial injury. In 15 rabbits, balloon dilation of iliac arteries was performed. In 20 arteries, dilation was combined with the delivery of pulsed ultraviolet light B (UVB) irradiation with 10 arteries being previously subjected to sensitizer infusion. Changes in vessel diameter, proliferation and extracellular matrix protein content at 6 weeks were evaluated by means of angiography and histomorphometry-immunohistochemistry. We found that PUVB, applied at the time of dilation, induced reduction in late loss (LL) at 6 weeks (percutaneous transluminal angioplasty vs UVB vs PUVB: 0.64 +/- 0.15 mm vs 0.61 +/- 0.05 mm vs 0.29 +/- 0.05 mm; p = 0.018). The same holds true for constrictive remodeling (0.53 +/- 0.15 mm vs 0.45 +/- 0.06 mm vs 0.15 +/- 0.05 mm; p = 0.016). In the irradiation groups, LL was independent of acute gain (AG), as opposed to the control. Collagen content increased significantly after PUVB in media and adventitia, without increased cellular proliferation in all vessel layers. Thus, PUVB at the time of dilation reduced luminal narrowing at follow-up without effecting proliferation. This effect was independent of AG and was associated with increased collagen content in media and adventitia.
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Affiliation(s)
- Jop Perrée
- Department of Cardiology, Heart-Lung Institute, University Medical Center Utrecht, The Netherlands
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30
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Affiliation(s)
- R Mansfield
- Cardiovascular Repair and Remodelling Group, The Hatter Institute, Royal Free and UCL Medical School, Middlesex Hospital, Mortimer Street, London W1N 8AA, UK.
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