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Nasir A, Rehman MU, Khan T, Husn M, Khan M, Khan A, Nuh AM, Jiang W, Farooqi HMU, Bai Q. Advances in nanotechnology-assisted photodynamic therapy for neurological disorders: a comprehensive review. ARTIFICIAL CELLS, NANOMEDICINE, AND BIOTECHNOLOGY 2024; 52:84-103. [PMID: 38235991 DOI: 10.1080/21691401.2024.2304814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024]
Abstract
Neurological disorders such as neurodegenerative diseases and nervous system tumours affect more than one billion people throughout the globe. The physiological sensitivity of the nervous tissue limits the application of invasive therapies and leads to poor treatment and prognosis. One promising solution that has generated attention is Photodynamic therapy (PDT), which can potentially revolutionise the treatment landscape for neurological disorders. PDT attracted substantial recognition for anticancer efficacy and drug conjugation for targeted drug delivery. This review thoroughly explained the basic principles of PDT, scientific interventions and advances in PDT, and their complicated mechanism in treating brain-related pathologies. Furthermore, the merits and demerits of PDT in the context of neurological disorders offer a well-rounded perspective on its feasibility and challenges. In conclusion, this review encapsulates the significant potential of PDT in transforming the treatment landscape for neurological disorders, emphasising its role as a non-invasive, targeted therapeutic approach with multifaceted applications.
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Affiliation(s)
- Abdul Nasir
- Medical Research Center, Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mujeeb Ur Rehman
- Department of Zoology, Islamia College University, Peshawar, Pakistan
| | - Tamreez Khan
- Department of Zoology, Abdul Wali Khan University, Mardan, Pakistan
| | - Mansoor Husn
- Department of Biochemistry, Abdul Wali Khan University, Mardan, Pakistan
| | - Manzar Khan
- Department of Zoology, Hazara University Mansehra, Mansehra, Pakistan
| | - Ahmad Khan
- Department of Psychology, University of Karachi, Karachi, Pakistan
| | - Abdifatah Mohamed Nuh
- Department of Obstetrics and Gynecology, Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wei Jiang
- Medical Research Center, Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | - Qain Bai
- Medical Research Center, Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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2
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Overchuk M, Weersink RA, Wilson BC, Zheng G. Photodynamic and Photothermal Therapies: Synergy Opportunities for Nanomedicine. ACS NANO 2023; 17:7979-8003. [PMID: 37129253 PMCID: PMC10173698 DOI: 10.1021/acsnano.3c00891] [Citation(s) in RCA: 87] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Tumoricidal photodynamic (PDT) and photothermal (PTT) therapies harness light to eliminate cancer cells with spatiotemporal precision by either generating reactive oxygen species or increasing temperature. Great strides have been made in understanding biological effects of PDT and PTT at the cellular, vascular and tumor microenvironmental levels, as well as translating both modalities in the clinic. Emerging evidence suggests that PDT and PTT may synergize due to their different mechanisms of action, and their nonoverlapping toxicity profiles make such combination potentially efficacious. Moreover, PDT/PTT combinations have gained momentum in recent years due to the development of multimodal nanoplatforms that simultaneously incorporate photodynamically- and photothermally active agents. In this review, we discuss how combining PDT and PTT can address the limitations of each modality alone and enhance treatment safety and efficacy. We provide an overview of recent literature featuring dual PDT/PTT nanoparticles and analyze the strengths and limitations of various nanoparticle design strategies. We also detail how treatment sequence and dose may affect cellular states, tumor pathophysiology and drug delivery, ultimately shaping the treatment response. Lastly, we analyze common experimental design pitfalls that complicate preclinical assessment of PDT/PTT combinations and propose rational guidelines to elucidate the mechanisms underlying PDT/PTT interactions.
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Affiliation(s)
- Marta Overchuk
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario M5G 1L7, Canada
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, North Carolina 27599, United States
| | - Robert A Weersink
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario M5G 1L7, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario M5G 1L7, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario M5G 1L7, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario M5G 1L7, Canada
| | - Brian C Wilson
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario M5G 1L7, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario M5G 1L7, Canada
| | - Gang Zheng
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario M5G 1L7, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario M5G 1L7, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario M5G 1L7, Canada
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Yang TS, Hsiao YC, Chiang YF, Chang CJ. Imaging and Histopathological Analysis of Microvascular Angiogenesis in Photodynamic Therapy for Oral Cancer. Cancers (Basel) 2023; 15:cancers15041110. [PMID: 36831454 PMCID: PMC9954751 DOI: 10.3390/cancers15041110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/04/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
The objective of this study is to use imaging and histopathological analysis to characterize and monitor microvascular responses to photodynamic therapy (PDT). In vivo chicken chorioallantoic membranes (CAMs) and a stimulated malignant oral lesions animal model were used to determine the blood flow and the biological activities of Photofrin® (2.5 mg/kg) exposed to different laser power densities at 630 nm. The vascular changes, the velocity of the blood flow, the speckle flow index (SFI) of fluorescence changes, and ultrastructure damage in the microvasculature before and after PDT were recorded. The subcellular localization of Photofrin® revealed satisfactory uptake throughout the cytoplasm of human red blood cells at 10 s and 20 s before PDT. The mean blood-flow velocities of the veins and arteries were 500 ± 40 and 1500 ± 100 μm/s, respectively. A significant decrease in the velocities of the blood flow in the veins and arteries was detected in the CAM model after PDT. The veins and arteries of CAMs, exposed to the power densities of 80, 100, and 120 mW/cm2, had average blood-flow velocities of 100 ± 20, 60 ± 10, and 0 μm/s and 300 ± 50, 150 ± 30, and 0 μm/s, respectively. In the stimulated malignant oral lesions animal model, the treated tumors exhibited hemorrhage and red blood cell extravasation after PDT. The oxyhemoglobin and total hemoglobin levels decreased, which resulted in a decrease in tissue oxygen saturation, while the deoxyhemoglobin levels increased. PDT using Photofrin® has the ability to cause the destruction of the targeted microvasculature under nonthermal mechanisms selectively.
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Affiliation(s)
- Tzu-Sen Yang
- Graduate Institute of Biomedical Optomechatronics, Taipei Medical University, Taipei 110, Taiwan
- International PhD Program in Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan
- School of Dental Technology, Taipei Medical University, Taipei 110, Taiwan
- Research Center of Biomedical Device, Taipei Medical University, Taipei 110, Taiwan
- TMU Research Center of Cancer Translational Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Yen-Chang Hsiao
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Yu-Fan Chiang
- Medical School, University of Queensland, Saint Lucia, QLD 4072, Australia
| | - Cheng-Jen Chang
- Graduate Institute of Biomedical Optomechatronics, Taipei Medical University, Taipei 110, Taiwan
- TMU Research Center of Cancer Translational Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City 33302, Taiwan
- Department of Plastic Surgery, Taipei Medical University Hospital, Taipei Medical University, Taipei 110, Taiwan
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Correspondence:
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4
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Carigga Gutierrez NM, Pujol-Solé N, Arifi Q, Coll JL, le Clainche T, Broekgaarden M. Increasing cancer permeability by photodynamic priming: from microenvironment to mechanotransduction signaling. Cancer Metastasis Rev 2022; 41:899-934. [PMID: 36155874 DOI: 10.1007/s10555-022-10064-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/06/2022] [Indexed: 01/25/2023]
Abstract
The dense cancer microenvironment is a significant barrier that limits the penetration of anticancer agents, thereby restraining the efficacy of molecular and nanoscale cancer therapeutics. Developing new strategies to enhance the permeability of cancer tissues is of major interest to overcome treatment resistance. Nonetheless, early strategies based on small molecule inhibitors or matrix-degrading enzymes have led to disappointing clinical outcomes by causing increased chemotherapy toxicity and promoting disease progression. In recent years, photodynamic therapy (PDT) has emerged as a novel approach to increase the permeability of cancer tissues. By producing excessive amounts of reactive oxygen species selectively in the cancer microenvironment, PDT increases the accumulation, penetration depth, and efficacy of chemotherapeutics. Importantly, the increased cancer permeability has not been associated to increased metastasis formation. In this review, we provide novel insights into the mechanisms by which this effect, called photodynamic priming, can increase cancer permeability without promoting cell migration and dissemination. This review demonstrates that PDT oxidizes and degrades extracellular matrix proteins, reduces the capacity of cancer cells to adhere to the altered matrix, and interferes with mechanotransduction pathways that promote cancer cell migration and differentiation. Significant knowledge gaps are identified regarding the involvement of critical signaling pathways, and to which extent these events are influenced by the complicated PDT dosimetry. Addressing these knowledge gaps will be vital to further develop PDT as an adjuvant approach to improve cancer permeability, demonstrate the safety and efficacy of this priming approach, and render more cancer patients eligible to receive life-extending treatments.
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Affiliation(s)
| | - Núria Pujol-Solé
- Université Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Institute for Advanced Biosciences, 38000, Grenoble, France
| | - Qendresa Arifi
- Université Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Institute for Advanced Biosciences, 38000, Grenoble, France
| | - Jean-Luc Coll
- Université Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Institute for Advanced Biosciences, 38000, Grenoble, France
| | - Tristan le Clainche
- Université Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Institute for Advanced Biosciences, 38000, Grenoble, France.
| | - Mans Broekgaarden
- Université Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Institute for Advanced Biosciences, 38000, Grenoble, France.
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Sbeit W, Napoléon B, Khoury T. Endoscopic ultrasound role in pancreatic adenocarcinoma treatment: A review focusing on technical success, safety and efficacy. World J Gastroenterol 2022; 28:332-347. [PMID: 35110953 PMCID: PMC8771609 DOI: 10.3748/wjg.v28.i3.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/22/2021] [Accepted: 01/06/2022] [Indexed: 02/06/2023] Open
Abstract
The impressive technological advances in recent years have rapidly translated into the shift of endoscopic ultrasound (EUS) from diagnostic modality into an interventional and therapeutic tool. Despite the great advance in its diagnosis, the majority of pancreatic adenocarcinoma cases are inoperable when diagnosed, thus demanding alternative optional therapies. EUS has emerged as an easy, minimally invasive modality targeting this carcinoma with different interventions that have been reported recently. In this review we summarize the evolving role of interventional therapeutic EUS in pancreatic adenocarcinoma management.
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Affiliation(s)
- Wisam Sbeit
- Department of Gastroenterology, Galilee Medical Center, Faculty of Medicine in the Galilee, Bar-Ilan University, Nahariya 2221006, Israel
| | - Bertrand Napoléon
- Department of Endoscopy Unit, Private Hospital Jean Mermoz, Ramsay Generale de Sante, Lyon 69008, France
| | - Tawfik Khoury
- Department of Gastroenterology, Galilee Medical Center, Faculty of Medicine in the Galilee, Bar-Ilan University, Nahariya 2221006, Israel
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6
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Chen P, Yang T, Shi P, Shen J, Feng Q, Su J. Benefits and safety of photodynamic therapy in patients with hilar cholangiocarcinoma: A meta-analysis. Photodiagnosis Photodyn Ther 2022; 37:102712. [PMID: 34995788 DOI: 10.1016/j.pdpdt.2022.102712] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/16/2021] [Accepted: 01/03/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) is a therapy evaluated for the treatment of cancers resistant to standard oncological treatments. PDT might be beneficial for the palliation of hilar cholangiocarcinoma. AIM To evaluate the efficacy and safety of PDT for treating hilar cholangiocarcinoma. METHODS PubMed, Embase, the Cochrane Library, and Web of Science were searched for articles published up to May 2021. The patients were grouped as PDT+stent vs. stent alone. The outcomes were survival, quality of life, and adverse events (AEs). Data were summarized using hazard ratios (HRs), odds ratios (ORs), and 95% confidence intervals (CIs). RESULTS Six studies were included in this meta-analysis. There were 235 and 211 patients in the PDT+stent and stent groups, respectively. The 1-year survival rate of the PDT+stent group was 0.56, and that of the control group was 0.25. The 2-year survival rate of the PDT+stent group was 0.16, and that of the control group was 0.07. PDT significantly prolonged overall survival compared to the controls (P = 0.002). No differences were detected in the occurrence of cholangitis (P = 0.996) and all other AEs (early complications, stent malfunction, total AEs, acute pancreatitis, liver abscess, and biliary hemorrhage) between the two groups. CONCLUSION PDT in patients with hilar cholangiocarcinoma could improve survival without additional AEs. Large-scale randomized controlled trials are needed to confirm the findings.
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Affiliation(s)
- Pengcheng Chen
- Department of General Surgery, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Ting Yang
- Department of General Surgery, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Peidong Shi
- Department of General Surgery, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Jiangbo Shen
- Department of General Surgery, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Qingchun Feng
- Department of General Surgery, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Jingen Su
- Department of General Surgery, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China.
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7
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Overchuk M, Harmatys KM, Sindhwani S, Rajora MA, Koebel A, Charron DM, Syed AM, Chen J, Pomper MG, Wilson BC, Chan WCW, Zheng G. Subtherapeutic Photodynamic Treatment Facilitates Tumor Nanomedicine Delivery and Overcomes Desmoplasia. NANO LETTERS 2021; 21:344-352. [PMID: 33301689 DOI: 10.1021/acs.nanolett.0c03731] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Limited tumor nanoparticle accumulation remains one of the main challenges in cancer nanomedicine. Here, we demonstrate that subtherapeutic photodynamic priming (PDP) enhances the accumulation of nanoparticles in subcutaneous murine prostate tumors ∼3-5-times without inducing cell death, vascular destruction, or tumor growth delay. We also found that PDP resulted in an ∼2-times decrease in tumor collagen content as well as a significant reduction of extracellular matrix density in the subendothelial zone. Enhanced nanoparticle accumulation combined with the reduced extravascular barriers improved therapeutic efficacy in the absence of off-target toxicity, wherein 5 mg/kg of Doxil with PDP was equally effective in delaying tumor growth as 15 mg/kg of Doxil. Overall, this study demonstrates the potential of PDP to enhance tumor nanomedicine accumulation and alleviate tumor desmoplasia without causing cell death or vascular destruction, highlighting the utility of PDP as a minimally invasive priming strategy that can improve therapeutic outcomes in desmoplastic tumors.
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Affiliation(s)
- Marta Overchuk
- Princess Margaret Cancer Centre, University Health Network, 101 College Street, PMCRT 5-354, Toronto, Ontario M5G 1L7, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario M5G 1L7, Canada
| | - Kara M Harmatys
- Princess Margaret Cancer Centre, University Health Network, 101 College Street, PMCRT 5-354, Toronto, Ontario M5G 1L7, Canada
| | - Shrey Sindhwani
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario M5G 1L7, Canada
| | - Maneesha A Rajora
- Princess Margaret Cancer Centre, University Health Network, 101 College Street, PMCRT 5-354, Toronto, Ontario M5G 1L7, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario M5G 1L7, Canada
| | - Adam Koebel
- Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario M5S 3M2, Canada
| | - Danielle M Charron
- Princess Margaret Cancer Centre, University Health Network, 101 College Street, PMCRT 5-354, Toronto, Ontario M5G 1L7, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario M5G 1L7, Canada
| | - Abdullah M Syed
- J. David Gladstone Institutes, San Francisco, California 94158, USA
| | - Juan Chen
- Princess Margaret Cancer Centre, University Health Network, 101 College Street, PMCRT 5-354, Toronto, Ontario M5G 1L7, Canada
| | - Martin G Pomper
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland 21205, United States
| | - Brian C Wilson
- Princess Margaret Cancer Centre, University Health Network, 101 College Street, PMCRT 5-354, Toronto, Ontario M5G 1L7, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario M5G 1L7, Canada
| | - Warren C W Chan
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario M5G 1L7, Canada
| | - Gang Zheng
- Princess Margaret Cancer Centre, University Health Network, 101 College Street, PMCRT 5-354, Toronto, Ontario M5G 1L7, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario M5G 1L7, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario M5G 1L7, Canada
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De Silva P, Saad MA, Thomsen HC, Bano S, Ashraf S, Hasan T. Photodynamic therapy, priming and optical imaging: Potential co-conspirators in treatment design and optimization - a Thomas Dougherty Award for Excellence in PDT paper. J PORPHYR PHTHALOCYA 2020; 24:1320-1360. [PMID: 37425217 PMCID: PMC10327884 DOI: 10.1142/s1088424620300098] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Photodynamic therapy is a photochemistry-based approach, approved for the treatment of several malignant and non-malignant pathologies. It relies on the use of a non-toxic, light activatable chemical, photosensitizer, which preferentially accumulates in tissues/cells and, upon irradiation with the appropriate wavelength of light, confers cytotoxicity by generation of reactive molecular species. The preferential accumulation however is not universal and, depending on the anatomical site, the ratio of tumor to normal tissue may be reversed in favor of normal tissue. Under such circumstances, control of the volume of light illumination provides a second handle of selectivity. Singlet oxygen is the putative favorite reactive molecular species although other entities such as nitric oxide have been credibly implicated. Typically, most photosensitizers in current clinical use have a finite quantum yield of fluorescence which is exploited for surgery guidance and can also be incorporated for monitoring and treatment design. In addition, the photodynamic process alters the cellular, stromal, and/or vascular microenvironment transiently in a process termed photodynamic priming, making it more receptive to subsequent additional therapies including chemo- and immunotherapy. Thus, photodynamic priming may be considered as an enabling technology for the more commonly used frontline treatments. Recently, there has been an increase in the exploitation of the theranostic potential of photodynamic therapy in different preclinical and clinical settings with the use of new photosensitizer formulations and combinatorial therapeutic options. The emergence of nanomedicine has further added to the repertoire of photodynamic therapy's potential and the convergence and co-evolution of these two exciting tools is expected to push the barriers of smart therapies, where such optical approaches might have a special niche. This review provides a perspective on current status of photodynamic therapy in anti-cancer and anti-microbial therapies and it suggests how evolving technologies combined with photochemically-initiated molecular processes may be exploited to become co-conspirators in optimization of treatment outcomes. We also project, at least for the short term, the direction that this modality may be taking in the near future.
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Affiliation(s)
- Pushpamali De Silva
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Mohammad A. Saad
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Hanna C. Thomsen
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Shazia Bano
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Shoaib Ashraf
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Tayyaba Hasan
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Division of Health Sciences and Technology, Harvard University and Massachusetts Institute of Technology, Cambridge, MA 02139, USA
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9
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Peng W, de Bruijn HS, ten Hagen TLM, van Dam GM, Roodenburg JLN, Berg K, Witjes MJH, Robinson DJ. Targeted Photodynamic Therapy of Human Head and Neck Squamous Cell Carcinoma with Anti-epidermal Growth Factor Receptor Antibody Cetuximab and Photosensitizer IR700DX in the Mouse Skin-fold Window Chamber Model. Photochem Photobiol 2020; 96:708-717. [PMID: 32222965 PMCID: PMC7383977 DOI: 10.1111/php.13267] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 03/13/2020] [Indexed: 01/09/2023]
Abstract
Targeted photodynamic therapy (PDT) in head/neck cancer patients with a conjugate of the anti-epidermal growth factor receptor (EGFR) antibody, Cetuximab and a phthalocyanine photosensitizer IR700DX is under way, but the exact mechanisms of action are still not fully understood. In this study, the EGFR-overexpressing human head/neck OSC-19-luc2-cGFP tumor with transfected GFP gene was used in a skin-fold window chamber model in BALB/c nude mice. The uptake and localization of the conjugate in the tumor and its surrounding normal tissues were studied by an intravital confocal laser scanning microscopy with image analyses. The tumor was also irradiated with 690 nm laser light 24 h after conjugate administration. The vascular and tumor responses were examined by morphological evaluation and immunohistochemistry (IHC). The amount of conjugate in the tumor peaked at 24-48 h after injection. Image analyses of colocalization correlation parameters demonstrated a high fraction of the conjugate IR700DX colocalized in the GFP-expressing tumor cells. PDT-treated tumors showed extensive necrotic/apoptotic destruction with little vascular damage, while IHC showed no HIF-1α expression and decreased EGFR and Ki67 expression with activated caspase-3 overexpression, indicating a direct killing of tumor cells through both necrotic and apoptotic cell death.
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Affiliation(s)
- Wei Peng
- Department of Oral and Maxillofacial SurgeryUniversity Medical Center GroningenGroningenThe Netherlands
- Centre for Optical Diagnostics and TherapyDepartment of Otorhinolaryngology and Head & Neck SurgeryErasmus University Medical Center RotterdamRotterdamThe Netherlands
- Department of Radiation BiologyInstitute for Cancer ResearchNorwegian Radium HospitalOslo University HospitalOsloNorway
| | - Henriette S. de Bruijn
- Centre for Optical Diagnostics and TherapyDepartment of Otorhinolaryngology and Head & Neck SurgeryErasmus University Medical Center RotterdamRotterdamThe Netherlands
| | - Timo L. M. ten Hagen
- Laboratory of Experimental Oncology Department of PathologyErasmus University Medical Center RotterdamRotterdamThe Netherlands
| | - Go M. van Dam
- Department of SurgeryUniversity Medical Center GroningenGroningenThe Netherlands
| | - Jan L. N. Roodenburg
- Department of Oral and Maxillofacial SurgeryUniversity Medical Center GroningenGroningenThe Netherlands
| | - Kristian Berg
- Department of Radiation BiologyInstitute for Cancer ResearchNorwegian Radium HospitalOslo University HospitalOsloNorway
| | - Max J. H. Witjes
- Department of Oral and Maxillofacial SurgeryUniversity Medical Center GroningenGroningenThe Netherlands
| | - Dominic J. Robinson
- Centre for Optical Diagnostics and TherapyDepartment of Otorhinolaryngology and Head & Neck SurgeryErasmus University Medical Center RotterdamRotterdamThe Netherlands
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10
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Mousavi M, Moriyama LT, Grecco C, Nogueira MS, Svanberg K, Kurachi C, Andersson-Engels S. Photodynamic therapy dosimetry using multiexcitation multiemission wavelength: toward real-time prediction of treatment outcome. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-14. [PMID: 32246614 PMCID: PMC7118359 DOI: 10.1117/1.jbo.25.6.063812] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 01/27/2020] [Indexed: 05/28/2023]
Abstract
Evaluating the optical properties of biological tissues is needed to achieve accurate dosimetry during photodynamic therapy (PDT). Currently, accurate assessment of the photosensitizer (PS) concentration by fluorescence measurements during PDT is typically hindered by the lack of information about tissue optical properties. In the present work, a hand-held fiber-optic probe instrument monitoring fluorescence and reflectance is used for assessing blood volume, reduced scattering coefficient, and PS concentration facilitating accurate dosimetry for PDT. System validation was carried out on tissue phantoms using nonlinear least squares support machine regression analysis. It showed a high correlation coefficient (>0.99) in the prediction of the PS concentration upon a large variety of phantom optical properties. In vivo measurements were conducted in a PDT chlorine e6 dose escalating trial involving 36 male Swiss mice with Ehrlich solid tumors in which fluences of 5, 15, and 40 J cm - 2 were delivered at two fluence rates (100 and 40 mW cm - 2). Remarkably, quantitative measurement of fluorophore concentration was achieved in the in vivo experiment. Diffuse reflectance spectroscopy (DRS) system was also used to independently measure the physiological properties of the target tissues for result comparisons. Then, blood volume and scattering coefficient measured by the fiber-optic probe system were compared with the corresponding result measured by DRS and showed agreement. Additionally, tumor hemoglobin oxygen saturation was measured using the DRS system. Overall, the system is capable of assessing the implicit photodynamic dose to predict the PDT outcome.
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Affiliation(s)
| | - Lilian Tan Moriyama
- University of São Paulo, São Carlos Institute of Physics, Optics Group, São Carlos/SP, Brazil
| | - Clovis Grecco
- University of São Paulo, São Carlos Institute of Physics, Optics Group, São Carlos/SP, Brazil
| | - Marcelo Saito Nogueira
- Tyndall National Institute, IPIC, Biophotonics@Tyndall, Lee Maltings, Cork, Ireland
- University College Cork, Department of Physics, Cork, Ireland
| | - Katarina Svanberg
- Lund University, Department of Physics, Biophotonics Group, Lund, Sweden
| | - Cristina Kurachi
- University of São Paulo, São Carlos Institute of Physics, Optics Group, São Carlos/SP, Brazil
| | - Stefan Andersson-Engels
- Lund University, Department of Physics, Biophotonics Group, Lund, Sweden
- Tyndall National Institute, IPIC, Biophotonics@Tyndall, Lee Maltings, Cork, Ireland
- University College Cork, Department of Physics, Cork, Ireland
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11
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Akimoto J, Fukami S, Ichikawa M, Mohamed A, Kohno M. Intraoperative Photodiagnosis for Malignant Glioma Using Photosensitizer Talaporfin Sodium. Front Surg 2019; 6:12. [PMID: 30949484 PMCID: PMC6438081 DOI: 10.3389/fsurg.2019.00012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 02/19/2019] [Indexed: 11/13/2022] Open
Abstract
Objective: The aim of this study was to demonstrate the clinical feasibility of intraoperative photodiagnosis (PD) of malignant brain tumor using talaporfin sodium (TPS), which is an agent used in photodynamic therapy (PDT) for cancers. Methods: Forty-seven patients diagnosed with malignant gliomas by preoperative imaging (42 patients with gliomas and 5 patients with other brain tumors) received an intravenous injection of TPS at 40 mg/m2 24 h before resection. During surgery, these patients were irradiated with diode laser light at 664 nm, and tumor fluorescence was observed. The fluorescence intensity was visually rated on a 3-point rating scale [strong fluorescence, weak fluorescence and no fluorescence]. TPS concentrations in 124 samples from 47 cases were measured by HPLC (High performance liquid chromatography). Results: The fluorescence intensity was confirmed to be weak in all patients with Grade II gliomas and strong in almost all patients with Grade III or IV gliomas, reflecting the histological grade of malignancy. In patients with non-glioma brain tumors except for 1 patient with a metastatic brain tumor, the fluorescence intensity was strong. The mean TPS concentration in tissues was 1.62 μg/g for strong fluorescence areas, 0.67 μg/g for weak fluorescence areas and 0.19 μg/g for no fluorescence areas. Conclusions: Establishment of an appropriate fluorescence observation system enabled fluorescence-guided resection of malignant brain tumors using TPS, and the fluorescence intensity of tumors correlated with the TPS concentrations in tissues. These results suggest that TPS is a useful photosensitizer for both intraoperative fluorescence diagnosis and photodynamic therapy.
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Affiliation(s)
- Jiro Akimoto
- Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan.,Department of Neurosurgery, Kohsei Chuo General Hospital, Tokyo, Japan
| | - Shinjiro Fukami
- Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan
| | - Megumi Ichikawa
- Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan
| | - Awad Mohamed
- Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan.,Department of Neurosurgery, Sohag University, Sohag, Egypt
| | - Michihiro Kohno
- Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan
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Chen B. 14 Vascular imaging in photodynamic therapy. IMAGING IN PHOTODYNAMIC THERAPY 2017:275-292. [DOI: 10.1201/9781315278179-15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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13
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Abramczyk H, Brozek-Pluska B, Surmacki J, Tondusson M, Freysz E. Photostability of biological systems—Femtosecond dynamics of zinc tetrasulfonated phthalocyanine at cancerous and noncancerous human Breast tissues. J Photochem Photobiol A Chem 2017. [DOI: 10.1016/j.jphotochem.2016.08.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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14
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15
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Milla Sanabria L, Rodríguez ME, Cogno IS, Rumie Vittar NB, Pansa MF, Lamberti MJ, Rivarola VA. Direct and indirect photodynamic therapy effects on the cellular and molecular components of the tumor microenvironment. Biochim Biophys Acta Rev Cancer 2012; 1835:36-45. [PMID: 23046998 DOI: 10.1016/j.bbcan.2012.10.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 09/28/2012] [Accepted: 10/01/2012] [Indexed: 12/31/2022]
Abstract
Photodynamic therapy (PDT) is a novel cancer treatment. It involves the activation of a photosensitizer (PS) with light of specific wavelength, which interacts with molecular oxygen to generate singlet oxygen and other reactive oxygen species (ROS) that lead to tumor cell death. When a tumor is treated with PDT, in addition to affect cancer cells, the extracellular matrix and the other cellular components of the microenvironment are altered and finally this had effects on the tumor cells survival. Furthermore, the heterogeneity in the availability of nutrients and oxygen in the different regions of a tridimensional tumor has a strong impact on the sensitivity of cells to PDT. In this review, we summarize how PDT affects indirectly to the tumor cells, by the alterations on the extracellular matrix, the cell adhesion and the effects over the immune response. Also, we describe direct PDT effects on cancer cells, considering the intratumoral role that autophagy mediated by hypoxia-inducible factor 1 (HIF-1) has on the efficiency of the treatment.
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Affiliation(s)
- Laura Milla Sanabria
- Department of Molecular Biology, National University of Río Cuarto, Río Cuarto (5800), Córdoba, Argentina
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Kawakubo M, Eguchi K, Arai T, Kobayashi K, Hamblin MR. Surface layer-preserving photodynamic therapy (SPPDT) in a subcutaneous mouse model of lung cancer. Lasers Surg Med 2012; 44:500-7. [PMID: 22752880 DOI: 10.1002/lsm.22046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Photodynamic therapy (PDT) may be a less invasive treatment for lung cancer. Our newly developed surface layer-preserving PDT (SPPDT) technique enables us to irradiate deep tumor while preserving the overlying tissue. The aim of this basic study was to verify that the SPPDT technique might be applied to lung cancer. STUDY DESIGN/MATERIALS AND METHODS PDT with talaporfin sodium was performed using a pulsed laser with different pulse dose rates (PDRs, 2.5-20.0 mJ/cm(2) /pulse) in a mouse model of subcutaneous tumor. To mimic the tracheal wall structure and a thoracic tumor in the tracheobronchus, we also made a mouse model in which a piece of swine cartilage was placed between the dermis and the tumor, and PDT was carried out 2 weeks after implantation. In both experiments, the tissue samples were collected 48 hours after PDT and evaluated microscopically. RESULTS SPPDT using a high-PDR laser damaged the underlying tissue but left the superficial tissue intact in the mouse subcutaneous tumor model. In SPPDT, a higher PDR produced a thicker layer of intact superficial tissue than a lower PDR, while a lower PDR produced a deeper layer of damaged tissue than a higher PDR. SPPDT was also able to preserve the superficial tissue and to damage the tumor tissue beneath the cartilage implant. CONCLUSION SPPDT was able to damage tumor beneath the superficial normal tissue layer, which included tracheal cartilage in the mouse model. The thickness control of SPPDT was provided by controlling laser pulse intensity. SPPDT is a new technology, whose future potential is unknown. The initial clinical application of this technology could be endoscopic treatment (e.g., palliative therapy of thoracic malignancies via bronchoscopy).
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Affiliation(s)
- Masayoshi Kawakubo
- Department of Thoracic Surgery, School of Medicine, Keio University, Tokyo, Japan.
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Senge MO, Brandt JC. Temoporfin (Foscan®, 5,10,15,20-tetra(m-hydroxyphenyl)chlorin)--a second-generation photosensitizer. Photochem Photobiol 2011; 87:1240-96. [PMID: 21848905 DOI: 10.1111/j.1751-1097.2011.00986.x] [Citation(s) in RCA: 212] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This review traces the development and study of the second-generation photosensitizer 5,10,15,20-tetra(m-hydroxyphenyl)chlorin through to its acceptance and clinical use in modern photodynamic (cancer) therapy. The literature has been covered up to early 2011.
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Affiliation(s)
- Mathias O Senge
- Medicinal Chemistry, Institute of Molecular Medicine, Trinity Centre for Health Sciences, Trinity College Dublin, St. James's Hospital, Dublin 8, Ireland.
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Predictive factor for photodynamic therapy effects on oral squamous cell carcinoma and oral epithelial dysplasia. Arch Oral Biol 2011; 56:1366-72. [PMID: 21596370 DOI: 10.1016/j.archoralbio.2011.04.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Revised: 04/03/2011] [Accepted: 04/18/2011] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the correlation between the immunohistochemical expression of proliferating cell nuclear antigen (PCNA), factor VIII, and CD34 (markers of endothelial cells), and vascular endothelial growth factor (VEGF) and the recurrence of oral squamous cell carcinoma (OSCC) and oral epithelial dysplasia (OED) subjected to photodynamic therapy (PDT). DESIGN Twenty-one biopsy specimens (14 cases of OSCC and 7 cases of OED) before PDT were immunohistochemically investigated in terms of their expressions of PCNA, factor VIII, CD34 and VEGF. The percentages of the total sample area that were immunopositive for factor VIII (percentage factor VIII immunopositive area: PFIA) CD34 (PCIA) and VEGF (PVIA) were calculated using computer-assisted image analysis for quantitative assessment of endothelial cells or VEGF expression in the lesions. The PCNA labelling index (LI) was evaluated as a proliferation marker. RESULTS Five cases of OSCC and one case of OED recurred 4 to 30 months after PDT. We found that the average PVIA was 14.5% in the no-recurrence group and 1.7% in the recurrence group. The difference between these values was statistically significant (P=0.0483). On the other hand, the average PCNA LI was 30.3% in the no-recurrence group and 24.3% in the recurrence group; the average PFIA was 3.7% in the no-recurrence group and 1.6% in the recurrence group; and the average PCIA was 2.0% in the no-recurrence group and 1.4% in the recurrence group. There were no significant differences between the two groups for any of these markers (P=0.3379, P=0.1195, P=0.4835, respectively). CONCLUSIONS These results provide clinical data indicating that VEGF expression may be a useful predictive marker for the effects of PDT in OSCC and OED.
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Honda N, Ishii K, Terada T, Nanjo T, Awazu K. Determination of the tumor tissue optical properties during and after photodynamic therapy using inverse Monte Carlo method and double integrating sphere between 350 and 1000 nm. JOURNAL OF BIOMEDICAL OPTICS 2011; 16:058003. [PMID: 21639587 DOI: 10.1117/1.3581111] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Photodynamic therapy (PDT) efficacy depends on the amount of light distribution within the tissue. However, conventional PDT does not consider the laser irradiation dose during PDT. The optical properties of biological tissues (absorption coefficient μ(a), reduced scattering coefficient μ's), anisotropy factor g, refractive index, etc.) help us to recognize light propagation through the tissue. The goal of this paper is to acquire the knowledge of the light propagation within tissue during and after PDT with the optical property of PDT-performed mouse tumor tissue. The optical properties of mouse tumor tissues were evaluated using a double integrating sphere setup and the algorithm based on the inverse Monte Carlo method in the wavelength range from 350 to 1000 nm. During PDT, the μ(a) and μ's were not changed after 1 and 5 min of irradiation. After PDT, the μ's in the wavelength range from 600 to 1000 nm increased with the passage of time. For seven days after PDT, the μ's increased by 1.7 to 2.0 times, which results in the optical penetration depth decreased by 1.4 to 1.8 times. To ensure an effective procedure, the adjustment of laser parameters for the decreasing penetration depth is recommended for the re-irradiation of PDT.
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Affiliation(s)
- Norihiro Honda
- Osaka University, Medical Beam Physics Laboratory, Graduate School of Engineering, 2-1-A14 Yamadaoka, Suita, Osaka 565-0871, Japan
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Shenoy R, Bowman CN. Mechanism and Implementation of Oxygen Inhibition Suppression in Photopolymerizations by Competitive Photoactivation of a Singlet Oxygen Sensitizer. Macromolecules 2010. [DOI: 10.1021/ma1012682] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Raveesh Shenoy
- Department of Chemical Engineering, University of Colorado, Boulder, Colorado 80309-0424
| | - Christopher N. Bowman
- Department of Chemical Engineering, University of Colorado, Boulder, Colorado 80309-0424
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Fan S, Qiu H, Huang H, Gu Y, Zeng J. Effects of photodynamic therapy using hematoporphyrin monomethyl ether on experimental choroidal neovascularization. Photochem Photobiol 2010; 86:972-80. [PMID: 20553408 DOI: 10.1111/j.1751-1097.2010.00757.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Hematoporphyrin monomethyl ether (HMME) is a novel and promising second-generation porphyrin-related photosensitizer for photodynamic therapy (PDT). To study the effects of HMME PDT on choroidal neovascularization (CNV) in rats, the PDT was performed 20 min after HMME bolus injection, which was investigated prior to the PDT by fluorescence microscopy with laser-induced CNV, and delivered at an irradiance of 400, 600 and 1000 mW cm(-2) corresponding to a fluence of 36, 54, 90 J cm(-2) in PDT plan I (15 mg kg(-1) HMME). In PDT plan II (30 mg kg(-1) HMME), the laser had a constant irradiance of 600 mW cm(-2), which was delivered for 60, 90 or 150 s, to also achieve total energy doses of 36, 54 or 90 J cm(-2). CNV closure rates assessed by fluorescein angiography and histologic damage to treated areas of choroid and retina varied as a function of the dose of HMME and of the activating light energy fluence. Endothelial cell labeled by platelet/endothelial cell adhesion molecule-1 presented treated CNV lesions that were significantly reduced in size (P < 0.01). It can be concluded that PDT using HMME can effectively occlude CNV. HMME is a potentially useful photosensitizer for the reduction in CNV size of irradiated areas.
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Affiliation(s)
- Sijun Fan
- Department of Laser Medicine, Chinese PLA General Hospital, Beijing, China
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Kudinova NV, Berezov TT. Photodynamic therapy of cancer: Search for ideal photosensitizer. BIOCHEMISTRY MOSCOW-SUPPLEMENT SERIES B-BIOMEDICAL CHEMISTRY 2010. [DOI: 10.1134/s1990750810010129] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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23
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Odabaş Z, Dumludağ F, Özkaya AR, Yamauchi S, Kobayashi N, Bekaroğlu Ö. Novel homo- and heterobinuclear ball-type phthalocyanines: synthesis and electrochemical, electrical, EPR and MCD spectral properties. Dalton Trans 2010; 39:8143-52. [DOI: 10.1039/c0dt00398k] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Histological Responses of Cutaneous Vascular Lesions Following Photodynamic Therapy with Talaporfin Sodium: A Chicken Comb Model. Keio J Med 2009; 58:176-84. [DOI: 10.2302/kjm.58.176] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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25
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Namatame H, Akimoto J, Matsumura H, Haraoka J, Aizawa K. Photodynamic therapy of C6-implanted glioma cells in the rat brain employing second-generation photosensitizer talaporfin sodium. Photodiagnosis Photodyn Ther 2008; 5:198-209. [DOI: 10.1016/j.pdpdt.2008.08.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2008] [Revised: 08/04/2008] [Accepted: 08/07/2008] [Indexed: 11/15/2022]
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Kahaleh M, Mishra R, Shami VM, Northup PG, Berg CL, Bashlor P, Jones P, Ellen K, Weiss GR, Brenin CM, Kurth BE, Rich TA, Adams RB, Yeaton P. Unresectable cholangiocarcinoma: comparison of survival in biliary stenting alone versus stenting with photodynamic therapy. Clin Gastroenterol Hepatol 2008; 6:290-7. [PMID: 18255347 DOI: 10.1016/j.cgh.2007.12.004] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Photodynamic therapy (PDT) for unresectable cholangiocarcinoma is associated with improvement in cholestasis, quality of life, and potentially survival. We compared survival in patients with unresectable cholangiocarcinoma undergoing endoscopic retrograde cholangiopancreatography (ERCP) with PDT and stent placement with a group undergoing ERCP with stent placement alone. METHODS Forty-eight patients were palliated for unresectable cholangiocarcinoma during a 5-year period. Nineteen were treated with PDT and stents; 29 patients treated with biliary stents alone served as a control group. Multivariate analysis was performed by using Model for End-Stage Liver Disease score, age, treatment by chemotherapy or radiation, and number of ERCP procedures and PDT sessions to detect predictors of survival. RESULTS Kaplan-Meier analysis demonstrated improved survival in the PDT group compared with the stent only group (16.2 vs 7.4 months, P<.004). Mortality in the PDT group at 3, 6, and 12 months was 0%, 16%, and 56%, respectively. The corresponding mortality in the stent group was 28%, 52%, and 82%, respectively. The difference between the 2 groups was significant at 3 months and 6 months but not at 12 months. Only the number of ERCP procedures and number of PDT sessions were significant on multivariate analysis. Adverse events specific to PDT included 3 patients with skin phototoxicity requiring topical therapy only. CONCLUSIONS ERCP with PDT seems to increase survival in patients with unresectable cholangiocarcinoma when compared with ERCP alone. It remains to be proved whether this effect is attributable to PDT or the number of ERCP sessions. A prospective randomized multicenter study is required to confirm these data.
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Affiliation(s)
- Michel Kahaleh
- Digestive Health Center, University of Virginia Health System, Charlottesville, Virginia 22908-0708, USA.
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Giuliano EA, Ota J, Tucker SA. Photodynamic therapy: basic principles and potential uses for the veterinary ophthalmologist. Vet Ophthalmol 2007; 10:337-43. [PMID: 17970993 DOI: 10.1111/j.1463-5224.2007.00578.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Photodynamic therapy (PDT) involves the use of photochemical reactions mediated through the interaction of photosensitizing agents, light and oxygen. PDT, while now commonly used in physician ophthalmology and oncology, is uncommonly used for the veterinary ophthalmic patient. It is an emerging new therapy in veterinary ophthalmology for the treatment of periocular tumors. This article reviews the basic principles of PDT to provide the veterinary ophthalmologic community with a succinct reference for this emerging treatment modality in our field.
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Affiliation(s)
- Elizabeth A Giuliano
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri-Columbia, Columbia, MO 65211, USA.
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Ramírez Backhaus M, Trassierra Villa M, Vera Donoso CD, Jiménez Cruz JF. [Photodynamic therapy in localised prostate cancer]. Actas Urol Esp 2007; 31:633-41. [PMID: 17896560 DOI: 10.1016/s0210-4806(07)73700-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Photodynamic therapy is based on the administration of an energy source in form of light of a specific wavelength, on a previously photosensitized tissue by a chemical compound, in the presence of oxygen, so that the great deal of free radicals and oxygen derivatives generated (hydroxyl compounds) produces necrosis of the treated tissue. Technique improvement during the last years has allowed its recent development as a therapeutic method for localised prostate cancer. At present, several clinical trials are ongoing in patients with organ-confined prostate cancer both as a first line and salvage treatment. There is no risk either of cancer dissemination in surrounding tissues or accumulative pharmaco-toxicity. Therefore, the technique can be repeated as often as needed and can be administered on a previously irradiated tissue. The literature review shows that photodynamic treatment will become a therapeutic option for patients with prostate cancer in the very near future.
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Ullrich SE, Alcalay J, Applegate LA, Kripke ML. Immunosuppression in phototherapy. CIBA FOUNDATION SYMPOSIUM 2007; 146:131-9; discussion 139-47. [PMID: 2697529 DOI: 10.1002/9780470513842.ch9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The successful use of phototherapy, especially psoralen plus UVA (PUVA) therapy, in the treatment of a variety of skin diseases is well known. Because the pathology of diseases such as vitiligo, alopecia and lichen planus is thought to involve immune mechanisms, the beneficial effect of PUVA may be due to immunosuppression. PUVA treatment can induce suppression in two ways. In the first (local suppression) psoralen is applied topically, the skin is irradiated with UVA and the contact allergen is applied directly to the irradiated skin. The induction of contact hypersensitivity (CHS) is suppressed and suppressor cells are found in the spleens of treated animals. Systemic suppression results from the injection of psoralen followed by exposure to UVA. The contact allergen is then applied at a distant non-irradiated site. CHS is suppressed and antigen-specific suppressor cells are found in the spleens of treated mice. The ability to induce specific immunosuppression may provide novel methods of inhibiting unwanted immune responses. We have demonstrated that graft rejection and the induction of graft-versus-host disease can be suppressed in an antigen-specific manner by UV radiation. Thus phototherapy may provide promising new treatments for suppressing graft rejection and perhaps may be beneficial in the treatment of autoimmune disease and allergic reactions.
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Affiliation(s)
- S E Ullrich
- Department of Immunology, University of Texas, M. D. Anderson Cancer Center, Houston 77030
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Thelen A, Neuhaus P. Liver transplantation for hilar cholangiocarcinoma. ACTA ACUST UNITED AC 2007; 14:469-75. [PMID: 17909715 DOI: 10.1007/s00534-006-1196-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2006] [Accepted: 10/16/2006] [Indexed: 12/19/2022]
Abstract
Hilar cholangiocarcinoma was accepted as an indication for liver transplantation at the beginning of the transplantation era. Owing to disappointing long-term results for this indication, and in parallel, encouraging results in patients with benign disease, hilar cholangiocarcinoma has generally not been accepted as an indication for liver transplantation in recent years. To improve results, more aggressive approaches have been used: "abdominal organ cluster transplantation" and "extended bile duct resection", which lead to increased long-term survival rates. However, with improving results after conventional extrahepatic bile duct resection in combination with partial hepatectomy, extended procedures in combination with liver transplantation never became a real option in the treatment of hilar cholangiocarcinoma. However, new awareness of liver transplantation in the treatment of this cancer has been raised for patients with hilar cholangiocarcinoma in the context of underlying liver diseases such as primary sclerosing cholangitis, which preclude liver resection. Current results show increased survival figures, in particular in well-selected patients with early tumor stages. Further improvements in long-term survival may be reached with new adjuvant and neoadjuvant protocols. Patients with neoadjuvant radiochemotherapy show long-term results similar to those for liver transplantation for other indications. Also, photodynamic therapy and the use of new antiproliferative immunosuppressive agents may be an approach for further improvement of the long-term results. Currently, liver transplantation for the treatment of hilar cholangiocarcinoma should be restricted to centers with experience in the treatment of this cancer and should be taken into consideration in patients with contraindications to liver resection.
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Affiliation(s)
- Armin Thelen
- Department of General, Visceral and Transplantation Surgery, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Berlin, Germany
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Henderson BW, Bellnier DA. Tissue localization of photosensitizers and the mechanism of photodynamic tissue destruction. CIBA FOUNDATION SYMPOSIUM 2007; 146:112-25; discussion 125-30. [PMID: 2697528 DOI: 10.1002/9780470513842.ch8] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This paper outlines our present knowledge of photosensitizer tissue distribution, derived from preclinical animal studies, and relates it to the observed biological response to photodynamic therapy (PDT). Emphasis is placed on porphyrins (haematoporphyrin derivative (HpD), Photofrin II) and phthalocyanines (aluminum phthalocyanine sulphonate AlPcS). In mice, both groups of sensitizers show multiphasic plasma clearance kinetics with an initial rapid decline followed by further slow reduction. Residual amounts of Photofrin II are detectable 75 days after injection. Drug elimination occurs through urine and faeces, but faecal elimination predominates for Photofrin II. Circulating sensitizer greatly influences the mouse ear-swelling response, but not the foot response. Tumours and normal skin can be destroyed by vascular damage, if illumination occurs at times of maximal plasma sensitizer concentration, with no detectable sensitizer accumulation in tumour cells. Organ retention for both photosensitizer groups is similar and persistent. Organs rich in reticuloendothelial elements (liver, kidney, spleen) accumulate and retain the highest levels, skin and muscle the lowest, while normal brain tissue excludes sensitizer. The adrenal and pancreatic glands, as well as urinary bladder, also retain high amounts of Photofrin II. Tumour/skin ratios of 1 to 3:1 and 2 to 7:1 have been reported for porphyrins and sulphonated phthalocyanines respectively. Tissue destruction upon light exposure is not always correlated with photosensitizer levels, as is exemplified by liver and pancreas. Stromal sensitizer localization usually predominates in tumour and normal tissue, and often determines tumour response. Certain compounds, such as monosulphonated tetraphenylporphyrin and AlPcS, may favour parenchymal localization. The formed blood elements remain free of photosensitizer, while mast cells and macrophages accumulate especially large amounts and, upon illumination, release an array of vasoactive inflammatory and immune mediators.
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Affiliation(s)
- B W Henderson
- Division of Radiation Biology, Roswell Park Memorial Institute, Buffalo, NY 14263
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Matsumura H, Akimoto J, Haraoka J, Aizawa K. Uptake and retention of the photosensitizer mono-l-asparthyl chlorine e6 in experimental malignant glioma. Lasers Med Sci 2007; 23:237-45. [PMID: 17703335 DOI: 10.1007/s10103-007-0469-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2006] [Accepted: 04/27/2007] [Indexed: 10/22/2022]
Abstract
The objective of the study was to investigate the potential of mono-L-aspartyl chlorine e6 (NPe6), a water-soluble photosensitizer derived from chlorophyll, for use in photodynamic diagnosis (PDD) of malignant brain tumor. A C6 glioma cell line was transplanted in the SD rat brain to create a brain tumor model. Five days after transplantation, NPe6 was administrated via the tail vein at concentrations ranging from 1.25 to 10 mg/kg; then the skull was opened in the rat brain, the site of tumor transplant was irradiated with a diode laser beam at 664 nm, and the time-course intensity and distribution of emerging fluorescence were observed. Furthermore, the correlation between fluorescence distribution and histopathological findings was investigated in the removed brain. Fluorescence was observed in the site of brain tumor transplant from 5 min after injection, and stable fluorescence was recognized at the site until 4 h after administration. No differences were noted in fluorescence intensity at NPe6 doses of 2.5 mg/kg or more; therefore, it was possible to estimate the optimal dose range. Fluorescence distribution had a clear correlation with tumor cell density, and it was possible to capture the margin of tumor cell invasion with fluorescence. The photosensitizer NPe6 is capable of assessing tumor cell density in malignant glioma tissue in terms of differences in fluorescence intensity. The usefulness of PDD using 5-aminoleveulinic acid during surgery for malignant glioma has been recognized in recent years. The results of the present study suggested the potential of NPe6 as a promising photosensitizer for use in PDD for accurate grasp of the extent of removal during the course of malignant glioma surgery.
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Affiliation(s)
- Hiroyuki Matsumura
- Department of Neurosurgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku, Tokyo 160-0023, Japan
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Microvascular effects of Photofrin®-induced photodynamic therapy. Photodiagnosis Photodyn Ther 2007; 4:95-9. [DOI: 10.1016/j.pdpdt.2007.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2006] [Revised: 02/20/2007] [Accepted: 03/22/2007] [Indexed: 11/23/2022]
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Blank M, Kostenich G, Lavie G, Kimel S, Keisari Y, Orenstein A. Wavelength-dependent Properties of Photodynamic Therapy Using Hypericin in vitro and in an Animal Model¶. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2002)0760335wdpopt2.0.co2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Tong Z, Singh G, Rainbow AJ. The Role of the p53 Tumor Suppressor in the Response of Human Cells to Photofrin-mediated Photodynamic Therapy. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2000)0710201trotpt2.0.co2] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Cauchon N, Nader M, Bkaily G, van Lier JE, Hunting D. Photodynamic activity of substituted zinc trisulfophthalocyanines: role of plasma membrane damage. Photochem Photobiol 2007; 82:1712-20. [PMID: 16906790 DOI: 10.1562/2005-12-13-ra-752] [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: 12/29/2022]
Abstract
We recently reported that variations in cellular phototoxicity among a series of alkynyl-substituted zinc trisulfophthalocyanines (ZnPcS3Cn) correlates with their hydrophobicity, with the most amphiphilic derivatives showing the highest cell uptake and phototoxicity. In this study we address the role of the plasma membrane in the photodynamic response as it relates to the overall hydrophobicity of the photosensitizer. The membrane tracker dye 1-[4(trimethylamino)phenyl]-6-phenylhexa-1,3,5-triene (TMA-DPH), which is incorporated into plasma membranes by endocytosis, was used to establish plasma membrane uptake by EMT-6 cells of the ZnPcS3C, by colocalization, and TMA-DPH membrane uptake rates after photodynamic therapy were used to quantify membrane damage. TMA-DPH colocalization patterns show plasma membrane uptake of the photosensitizers after short 1 h incubation periods. TMA-DPH plasma membrane uptake rates after illumination of the photosensitizer-treated cells show a parabolic relationship with photosensitizer hydrophobicity that correlates well with the phototoxicity of the ZnPcS3C,. After a 1 h incubation period, overall phototoxicity correlates closely with the postillumination rate of TMA-DPH incorporation into the cell membrane, suggesting a major role of plasma membrane damage in the overall PDT effect. In contrast, after a 24 h incubation, phototoxicity shows a stronger but imperfect correlation with total cellular photosensitizer uptake rather than TMA-DPH membrane uptake, suggesting a partial shift in the cellular damage responsible for photosensitization from the plasma membrane to intracellular targets. We conclude that plasma membrane localization of the amphiphilic ZnPcS3C6-C9 is a major factor in their overall photodynamic activity.
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Affiliation(s)
- Nicole Cauchon
- Department of Nuclear Medicine and Radiobiology, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
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Smith TK, Choi B, Ramirez-San-Juan JC, Nelson JS, Osann K, Kelly KM. Microvascular blood flow dynamics associated with photodynamic therapy, pulsed dye laser irradiation and combined regimens. Lasers Surg Med 2007; 38:532-9. [PMID: 16615132 DOI: 10.1002/lsm.20335] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Previous in vitro studies demonstrated the potential utility of benzoporphyrin derivative monoacid ring A (BPD) photodynamic therapy (PDT) for vascular destruction. Moreover, the effects of PDT were enhanced when this intervention was followed immediately by pulsed dye laser (PDL) irradiation (PDT/PDL). We further evaluate vascular effects of PDT alone, PDL alone and PDT/PDL in an in vivo rodent dorsal skinfold model. STUDY DESIGN/MATERIALS AND METHODS A dorsal skinfold window chamber was installed surgically on female Sprague-Dawley rats. One milligram per kilogram of BPD solution was administered intravenously via a jugular venous catheter. Evaluated interventions were: control (no BPD, no light), PDT alone (576 nm, 16 minutes exposure time, 15 minutes post-BPD injection, 10 mm spot), PDL alone at 7 J/cm2 (585 nm, 1.5 ms pulse duration, 7 mm spot), PDL alone at 10 J/cm2, PDT/PDL (PDL at 7 J/cm2), and PDT/PDL (PDL at 10 J/cm2). To assess changes in microvascular blood flow, laser speckle imaging was performed before, immediately after, and 18 hours post-intervention. RESULTS Epidermal irradiation was accomplished without blistering, scabbing or ulceration. A reduction in perfusion was achieved in all intervention groups. PDT/PDL at 7 J/cm2 resulted in the greatest reduction in vascular perfusion (56%). CONCLUSIONS BPD PDT can achieve safe and selective vascular flow reduction. PDT/PDL can enhance diminution of microvascular blood flow. Our results suggest that PDT and PDT/PDL should be evaluated as alternative therapeutic options for treatment of hypervascular skin lesions including port wine stain birthmarks.
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Affiliation(s)
- Tia K Smith
- Beckman Laser Institute, University of California, Irvine, California 92612, USA
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OHMORI S, HAKOMORI S, TSUKAHARA T, ARAI T. A Comparative Study between Pulsed and Continuous Wave Irradiation for Talaporfin Sodium Mediated Photosensitization in Solution, In-Vitro and In-Vivo. ACTA ACUST UNITED AC 2007. [DOI: 10.2184/lsj.35.3_180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Sayaka OHMORI
- School of Fundamental Science and Technology, Graduate School of Science and Technology, Keio University
| | - Shiho HAKOMORI
- School of Fundamental Science and Technology, Graduate School of Science and Technology, Keio University
| | - Tsubasa TSUKAHARA
- School of Fundamental Science and Technology, Graduate School of Science and Technology, Keio University
| | - Tsunenori ARAI
- School of Fundamental Science and Technology, Graduate School of Science and Technology, Keio University
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Cauchon N, Nader M, Bkaily G, Lier JE, Hunting D. Photodynamic Activity of Substituted Zinc Trisulfophthalocyanines: Role of Plasma Membrane Damage. Photochem Photobiol 2006. [DOI: 10.1111/j.1751-1097.2006.tb09835.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Uehara M, Inokuchi T, Ikeda H. Enhanced Susceptibility of Mouse Squamous Cell Carcinoma to Photodynamic Therapy Combined With Low-Dose Administration of Cisplatin. J Oral Maxillofac Surg 2006; 64:390-6. [PMID: 16487799 DOI: 10.1016/j.joms.2005.11.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2004] [Indexed: 11/16/2022]
Abstract
PURPOSE We have investigated the antitumor effect of photodynamic therapy (PDT), using Photofrin as the photosensitizer, combined with low-dose cisplatin (CDDP) on NR-S1 mouse squamous cell carcinoma. MATERIALS AND METHODS CDDP (5 mg/kg body weight) was injected intraperitoneally either 1 hour or 3 hours prior to PDT or immediately afterward. Twenty-four hours after each protocol, the antitumor effects were evaluated by percentage area of the tumor necrosis in hematoxylin-eosin stained specimens as well as terminal deoxynucleotidyl transferase-mediated d-UTP nick-end labeling indices. Furthermore, the tumor sizes were evaluated at 3, 7, and 10 days after each protocol. RESULTS The antitumor effect of PDT was enhanced by administration of CDDP 3 hours before PDT, whereas the administration of CDDP 1 hour before PDT or immediately after PDT did not potentiate a PDT antitumor effect. CONCLUSION Administration of low-dose CDDP 3 hours before PDT appears to be a useful treatment modality.
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Affiliation(s)
- Masataka Uehara
- Division of Oral and Maxillofacial Surgical Reconstruction and Restoration, Department of Developmental and Reconstructive Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan.
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Abstract
BACKGROUND AND OBJECTIVES Photodynamic therapy (PDT) is an emerging modality for the treatment of various neoplastic and non-neoplastic pathologies. STUDY DESIGN/MATERIALS AND METHODS PDT usually occurs when reactive oxygen species (ROS) generated from light-activated chemicals (photosensitizer, PS) destroy the target. For non-dermatologic applications the PS are delivered systemically and accumulate, at different concentrations, in most organs. RESULTS AND CONCLUSION Typically there is a modest enhanced accumulation of the PS in tumor tissues, providing a first level of selectivity. Additional selectivity is provided by the confined illumination of the target area with the appropriate wavelength of light. For the treatment of pathologies in complex anatomical sites, such as in the peritoneal cavity, where restricted illumination is difficult; improved targeting of the PS is necessary to prevent damage to the surrounding healthy tissue. This article will focus on targeted PDT.
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Affiliation(s)
- Nicolas Solban
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
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Tamosiūnas M, Bagdonas S, Didziapetriene J, Rotomskis R. Electroporation of transplantable tumour for the enhanced accumulation of photosensitizers. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2005; 81:67-75. [PMID: 16112584 DOI: 10.1016/j.jphotobiol.2005.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2005] [Revised: 05/17/2005] [Accepted: 05/17/2005] [Indexed: 10/25/2022]
Abstract
The aim of this study was to verify whether electroporation could increase the accumulation of the hydrophilic photosensitizers: aluminium phthalocyanine tetrasulphonate (AlPcS(4)) and chlorin e(6) (C e(6)) in tumour tissue. The experiment was performed in vivo using hybrid mice (C57Bl/CBA) bearing hepatoma A22 (MH-A22) tumours transplanted in the right haunch. The time dependence of the fluorescence intensity of administered photosensitizers was measured after the ordinary and electrically stimulated delivery. The obtained fluorescence spectroscopy results implied the tumour being affected by an electrical field in a way, which led to a higher accumulation of both photosensitizers (AlPcS(4) and C e(6)) in the periphery of the tumour and it superficial layer. Our pilot study suggests that electroporation could be considered as a useful procedure seeking for the more effective application of photodynamic tumour treatment.
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Affiliation(s)
- M Tamosiūnas
- Vilnius University, Laser Research Center, 10222 Vilnius, Lithuania
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Ayaru L, Bown SG, Pereira SP. Photodynamic therapy for pancreatic and biliary tract carcinoma. ACTA ACUST UNITED AC 2005; 35:1-13. [PMID: 15722569 DOI: 10.1385/ijgc:35:1:001] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The prognosis of patients with pancreatic and biliary tract cancer treated with conventional therapies such as stent insertion or chemotherapy is often poor, and new approaches are urgently needed. Surgery is the only curative treatment but is appropriate in less than 20% of cases, and even then it is associated with a 5-yr survival of less than 30% in selected series. Photodynamic therapy represents a novel treatment for pancreaticobiliary malignancy. It is a way of producing localized tissue necrosis with light, most conveniently from a low-power, red laser, after prior administration of a photosensitizing agent, thereby initiating a non-thermal cytotoxic effect and tissue necrosis. This review outlines the mechanisms of action of photodynamic therapy including direct cell death, vascular injury, and immune system activation, and summarizes the results of preclinical and clinical studies of photodynamic therapy for pancreaticobiliary malignancy.
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Affiliation(s)
- Lakshmana Ayaru
- Institute of Hepatology, Department of Medicine, Royal Free & University College London Medical School, London, United Kingdom
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Zhou Q, Olivo M, Lye KYK, Moore S, Sharma A, Chowbay B. Enhancing the therapeutic responsiveness of photodynamic therapy with the antiangiogenic agents SU5416 and SU6668 in murine nasopharyngeal carcinoma models. Cancer Chemother Pharmacol 2005; 56:569-77. [PMID: 16001166 DOI: 10.1007/s00280-005-1017-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2004] [Accepted: 12/08/2004] [Indexed: 12/27/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) is a promising therapeutic modality using a tumor localizing photosensitizer and light to destroy tumor cells. A major limitation of PDT is tumor recurrence, which is partly due to neovascularization. PURPOSE The objective of the present study was to determine whether combination therapy with PDT and antiangiogenic agents (i.e. SU5416 and SU6668) would be more effective in controlling tumor recurrence in a mouse model of human CNE2 poorly differentiated nasopharyngeal carcinoma compared with PDT or antiangiogenic agents administered alone. METHODS Athymic mice bearing CNE2 tumor xenografts received daily i.p. injections of 20 mg/kg SU5416 or 100 mg/kg SU6668 for 28 consecutive days either alone or following a single hypericin-PDT treatment. RESULTS Significant inhibition of CNE2 tumor growth was observed in all treatment groups. Differences in 4x tumor growth time, the number of mice with 4x tumor growth, tumor growth inhibition as well as the percent of mice surviving were not statistically significant among individual treatment groups. However, the number of mice with 4x tumor growth observed in SU6668 monotherapy and combined PDT and SU6668 treatment groups was significantly less than that in the control group (P<0.05 and 0.01, respectively). Moreover, compared with the control group, only the combined PDT and SU6668 treatment significantly extended survival of tumor-bearing host mice (P<0.05). The semiquantitative RT-PCR results showed that the expression of HIF-1alpha, VEGF, COX-2 and bFGF were increased in PDT-treated tumor samples collected 24 h post-PDT, suggesting that PDT-induced damage to tumor microvasculature and the resultant hypoxia upregulate the expression of certain proangiogenic factors. CONCLUSIONS The effectiveness of PDT can be enhanced by antiangiogenic treatment with the synthetic RTK inhibitors. Of the two synthetic RTK inhibitors tested, SU6668 was more effective than SU5416 in enhancing tumor responsiveness to PDT.
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Affiliation(s)
- Qingyu Zhou
- Laboratory of Clinical Pharmacology Division of Clinical Trials & Epidemiological Sciences, National Cancer Centre, 11, Hospital Drive, 169610, Singapore
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Abstract
Photodynamic therapy (PDT) is a treatment that combines a photosensitizer with light to generate oxygen-dependent photochemical destruction of diseased tissue. This modality has been approved worldwide since 1993 for the treatment of several oncological and nononcological disorders. PDT continues to be interested in both preclinical and clinical research, with more than 500 publications each year during the past 5 years. This minireview focuses on the effects of PDT on tumor stroma. A tumor consists of two fundamental elements: parenchyma (neoplastic cells) and stroma. The stroma is composed of vasculature, cellular components, and intercellular matrix and is necessary for tumor growth. All the stromal components can be targeted by PDT. Although the exact mechanism of PDT is unknown, emerging evidence has indicated that effective PDT of tumor requires destruction of both parenchyma and stroma. Further, damage to subendothelial zone of vasculature, in addition to endothelium, also appears to be a crucial factor. The PDT-generated immune response as a way of vaccination for treatment and prevention of metastatic tumors remains to be exploited.
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Affiliation(s)
- Qian Peng
- Department of Pathology, The Norwegian Radium Hospital, University of Oslo, Oslo, Norway.
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Webber J, Leeson B, Fromm D, Kessel D. Effects of photodynamic therapy using a fractionated dosing of mono-l-aspartyl chlorin e6 in a murine tumor. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2005; 78:135-40. [PMID: 15664500 DOI: 10.1016/j.jphotobiol.2004.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2004] [Accepted: 11/01/2004] [Indexed: 10/26/2022]
Abstract
One of the 'second generation' photosensitizing agents is N-acetyl chlorin e6 (NPe6). This product has a strong absorbance band at 665 nm, permitting treatment at a greater depth of tumor than earlier agents based on porphyrin structures. We examined the effects of fractionated drug administration on photodynamic efficacy. Prior studies had shown that it is the level of NPe6 in the circulation that predicts for photodynamic efficacy, indicating vascular shut-down to be the predominant mode of tumor control. Although pharmacokinetic studies revealed that >99% of NPe6 was lost from the circulation, it appears that a fractionated dosage protocol can promote photodamage to neoplastic tissue in vivo. This study also indicated the potential utility of an implantable micro array for tumor irradiation.
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Affiliation(s)
- John Webber
- Department of Surgery, Wayne State University School of Medicine, Detroit, MI 48201, USA
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Solban N, Ortel B, Pogue B, Hasan T. Targeted optical imaging and photodynamic therapy. ERNST SCHERING RESEARCH FOUNDATION WORKSHOP 2005:229-58. [PMID: 15524219 DOI: 10.1007/3-540-26809-x_12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- N Solban
- Wellman Laboratories of Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
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48
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Photodynamic therapy for pancreatic carcinoma: experimental and clinical studies. Photodiagnosis Photodyn Ther 2004; 1:145-55. [DOI: 10.1016/s1572-1000(04)00038-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2004] [Revised: 07/28/2004] [Accepted: 07/28/2004] [Indexed: 01/03/2023]
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Krause MHJ, Kwong KK, Gragoudas ES, Young LHY. MRI of blood volume with superparamagnetic iron in choroidal melanoma treated with thermotherapy. Magn Reson Imaging 2004; 22:779-87. [PMID: 15234446 DOI: 10.1016/j.mri.2004.01.052] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2003] [Accepted: 01/27/2004] [Indexed: 11/26/2022]
Abstract
Functional magnetic resonance imaging (MRI) with a new intravascular contrast agent, monocrystalline iron oxide nanoparticles (MION), was applied to assess the effect of transpupillary thermotherapy in a rabbit model of choroidal melanoma. 3D-spoiled gradient recalled sequences were used for quantitative assessment of blood volume. The MRI-parameters were 5/22/35 degrees (time of repetition (TR)/echo delay (TE)/flip angle (FA)) for T(1)- and 50/61/10 degrees for T(2)-weighted sequences. Images were collected before and at different times after MION injection. In all untreated tissues studied, MION reduced the T(2)-weighted signal intensity within 0.5 h and at 24 h (all p <== 0.012), whereas no significant changes were detected in treated tumors. T(1)-weighted images also revealed differences of MION-related signal changes between treated tumors and other tissues, yet at lower sensitivity and specificity than T(2). The change of T(2)-weighted MRI signal caused by intravascular MION allows early distinction of laser-treated experimental melanomas from untreated tissues. Further study is necessary to determine whether MRI can localize areas of tumor regrowth within tumors treated incompletely.
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Affiliation(s)
- Matthias H J Krause
- Massachusetts General Hospital-Nuclear Magnetic Resonance (MGH-NMR) Center, Harvard Medical School, Charlestown, MA, USA
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Wiedmann M, Berr F, Schiefke I, Witzigmann H, Kohlhaw K, Mössner J, Caca K. Photodynamic therapy in patients with non-resectable hilar cholangiocarcinoma: 5-year follow-up of a prospective phase II study. Gastrointest Endosc 2004; 60:68-75. [PMID: 15229428 DOI: 10.1016/s0016-5107(04)01288-x] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Median survival of patients with non-resectable hilar cholangiocarcinoma is 3 to 6 months, even after biliary drainage. Therefore, a single-arm phase II study was conducted (July 1996 to October 1998) to investigate the effect of local photodynamic therapy; a significant improvement in survival (74%) was noted at 6 months. The present study is an analysis of the long-term follow-up for patients enrolled in that phase II study. METHODS Five-year follow-up data for the 23 patients enrolled in the original prospective study were analyzed by using Kaplan-Meier log-rank analysis. RESULTS Median survival after treatment was 11.2 months for patients without distant metastases (M0) and 9.3 months for all patients (M0+M1). The 1-year, 2-year, 3-year, and 4-year survival rates were estimated to be 47%, 21%, 11% and 5%, respectively, for patients with stage M0 cholangiocarcinoma, and 39%, 17%, 9%, and 4%, respectively, for patients with stages M0 and M1. Of the patients who died, 73.9% (n=17) were because of tumor progression; 26.1% (n=6) died as a result of cholangitis (n=4), septic shock (n=1), or appendicitis/peritonitis (n=1). For all patients, except one with diffuse liver metastases, there was improvement in cholestasis, performance, and quality of life, which was maintained for an extended period. CONCLUSIONS This 5-year follow-up study confirms that photodynamic therapy is safe and effective for non-resectable hilar cholangiocarcinoma, although it does not prevent progression of the disease.
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Affiliation(s)
- Marcus Wiedmann
- Department of Internal Medicine II, University of Leipzig, Germany
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