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Siddiqui SA, Siddiqui S, Hussain MAB, Khan S, Liu H, Akhtar K, Hasan SA, Ahmed I, Mallidi S, Khan AP, Cuckov F, Hopper C, Bown S, Celli JP, Hasan T. Clinical evaluation of a mobile, low-cost system for fluorescence guided photodynamic therapy of early oral cancer in India. Photodiagnosis Photodyn Ther 2022; 38:102843. [PMID: 35367616 DOI: 10.1016/j.pdpdt.2022.102843] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 12/18/2022]
Abstract
BACKGROUND Morbidity and mortality due to oral cancer in India are exacerbated by a lack of access to effective treatments amongst medically underserved populations. We developed a user-friendly low-cost, portable fibre-coupled LED system for photodynamic therapy (PDT) of early oral lesions, using a smartphone fluorescence imaging device for treatment guidance, and 3D printed fibreoptic attachments for ergonomic intraoral light delivery. METHODS 30 patients with T1N0M0 buccal mucosal cancer were recruited from the JN Medical College clinics, Aligarh, and rural screening camps. Tumour limits were defined by external ultrasound (US), white light photos and increased tumour fluorescence after oral administration of the photosensitising agent ALA (60 mg/kg, divided doses), monitored by a smartphone fluorescence imaging device. 100 J/cm2 LED light (635 nm peak) was delivered followed by repeat fluorescence to assess photobleaching. US and biopsy were repeated after 7-17 days. This trial is registered with ClinicalTrials.gov, NCT03638622, and the study has been completed. FINDINGS There were no significant complications or discomfort. No sedation was required. No residual disease was detected in 22 out of 30 patients who completed the study (26 of 34 lesions, 76% complete tumour response, 50 weeks median follow-up) with up to 7.2 mm depth of necrosis. Treatment failures were attributed to large tumour size and/or inadequate light delivery (documented by limited photobleaching). Moderately differentiated lesions were more responsive than well-differentiated cancers. INTERPRETATION This simple and low-cost adaptation of fluorescenceguided PDT is effective for treatment of early-stage malignant oral lesions and may have implications in global health.
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Affiliation(s)
- Shahid Ali Siddiqui
- Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Radiotherapy, Aligarh, India
| | - Shaista Siddiqui
- Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Radiodiagnosis, Aligarh, India
| | - M A Bilal Hussain
- Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Radiotherapy, Aligarh, India
| | - Shakir Khan
- Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Radiotherapy, Aligarh, India; University of Massachusetts at Boston, Boston, MA, United States; Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Hui Liu
- University of Massachusetts at Boston, Boston, MA, United States
| | - Kafil Akhtar
- Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Pathology, Aligarh, India
| | - Syed Abrar Hasan
- Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Otorhinolaryngology (E.N.T.), Aligarh, India
| | - Ibne Ahmed
- Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Radiodiagnosis, Aligarh, India
| | - Srivalleesha Mallidi
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Amjad P Khan
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Filip Cuckov
- Wentworth Institute of Technology, Boston, Massachusetts, United States
| | | | | | - Jonathan P Celli
- University of Massachusetts at Boston, Boston, MA, United States; Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Tayyaba Hasan
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States; Division of Health Sciences and Technology, Harvard University and Massachusetts Institute of Technology, Cambridge, MA, USA.
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A Warp-Knitted Light-Emitting Fabric-Based Device for In Vitro Photodynamic Therapy: Description, Characterization, and Application on Human Cancer Cell Lines. Cancers (Basel) 2021; 13:cancers13164109. [PMID: 34439263 PMCID: PMC8394325 DOI: 10.3390/cancers13164109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 12/17/2022] Open
Abstract
Simple Summary While photodynamic therapy appears to be a promising approach to treating cancers, the complexity of its parameters prevents wide acceptance. Accurate light dose measurement is one of the keys to photodynamic effect assessment, but it remains challenging when comparing different technologies. This work provides a complete demonstration of the technical performance of a homemade optical device, based on knitted light-emitting fabrics, called CELL-LEF. Thermal and optical distributions and related safeties are investigated. The results are discussed in relation to the requirements of photodynamic therapy. The usability of CELL-LEF is investigated on human cancer cell lines as a proof of concept. This study highlights that new light-emitting fabric-based technologies can be relevant light sources for in vitro photodynamic therapy studies of tomorrow. Abstract Photodynamic therapy (PDT) appears to be a promising strategy in biomedical applications. However, the complexity of its parameters prevents wide acceptance. This work presents and characterizes a novel optical device based on knitted light-emitting fabrics and dedicated to in vitro PDT involving low irradiance over a long illumination period. Technical characterization of this device, called CELL-LEF, is performed. A cytotoxic study of 5-ALA-mediated PDT on human cancer cell lines is provided as a proof of concept. The target of delivering an irradiance of 1 mW/cm2 over 750 cm2 is achieved (mean: 0.99 mW/cm2; standard deviation: 0.13 mW/cm2). The device can maintain a stable temperature with the mean thermal distribution of 35.1 °C (min: 30.7 °C; max: 38.4 °C). In vitro outcomes show that 5-ALA PDT using CELL-LEF consistently and effectively induced a decrease in tumor cell viability: Almost all the HepG2 cells died after 80 min of illumination, while less than 60% of U87 cell viability remained. CELL-LEF is suitable for in vitro PDT involving low irradiance over a long illumination period.
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Han Z, Tu X, Qiao L, Sun Y, Li Z, Sun X, Wu Z. Phototherapy and multimodal imaging of cancers based on perfluorocarbon nanomaterials. J Mater Chem B 2021; 9:6751-6769. [PMID: 34346475 DOI: 10.1039/d1tb00554e] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Phototherapy, such as photodynamic therapy (PDT) and photothermal therapy (PTT), possesses unique characteristics of non-invasiveness and minimal side effects in cancer treatment, compared with conventional therapies. However, the ubiquitous tumor hypoxia microenvironments could severely reduce the efficacy of oxygen-consuming phototherapies. Perfluorocarbon (PFC) nanomaterials have shown great practical value in carrying and transporting oxygen, which makes them promising agents to overcome tumor hypoxia and extend reactive oxygen species (ROS) lifetime to improve the efficacy of phototherapy. In this review, we summarize the latest advances in PFC-based PDT and PTT, and combined multimodal imaging technologies in various cancer types, aiming to facilitate their application-oriented clinical translation in the future.
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Affiliation(s)
- Zhaoguo Han
- NHC and CAMS Key Laboratory of Molecular Probe and Targeted Theranostics, Molecular Imaging Research Center (MIRC), Harbin Medical University, China.
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Khan S, Hussain MAB, Khan AP, Liu H, Siddiqui S, Mallidi S, Leon P, Daly L, Rudd G, Cuckov F, Hopper C, Bown SG, Akhtar K, Hasan SA, Siddiqui SA, Hasan T, Celli JP. Clinical evaluation of smartphone-based fluorescence imaging for guidance and monitoring of ALA-PDT treatment of early oral cancer. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-10. [PMID: 32279466 PMCID: PMC7148420 DOI: 10.1117/1.jbo.25.6.063813] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/10/2020] [Indexed: 05/04/2023]
Abstract
SIGNIFICANCE India has one of the highest rates of oral cancer incidence in the world, accounting for 30% of reported cancers. In rural areas, a lack of adequate medical infrastructure contributes to unchecked disease progression and dismal mortality rates. Photodynamic therapy (PDT) has emerged as an effective modality with potential for treating early stage disease in resource-limited settings, while photosensitizer fluorescence can be leveraged for treatment guidance. AIM Our aim was to assess the capability of a simple smartphone-based device for imaging 5-aminolevulinic acid (ALA)-induced protoporphyrin IX (PpIX) fluorescence for treatment guidance and monitoring as part of an ongoing clinical study evaluating low-cost technology for ALA-based PDT treatment of early oral cancer. APPROACH A total of 29 subjects with <2 cm diameter moderately/well-differentiated microinvasive ( < 5 mm depth) oral squamous cell carcinoma lesions (33 lesions total, mean area ∼1.23 cm2) were administered 60 mg / kg ALA in oral solution and imaged before and after delivery of 100 J / cm2 total light dose to the lesion surface. Smartphone-based fluorescence and white light (WL) images were analyzed and compared with ultrasound (US) imaging of the same lesions. RESULTS We present a comparative analysis of pre- and post-treatment fluorescence, WL, and US images of oral lesions. There was no significant difference in the distribution of lesion widths measured by fluorescence and US (mean widths of 14.5 and 15.3 mm, respectively) and linear regression shows good agreement (R2 = 0.91). In general, PpIX fluorescence images obtained prior to therapeutic light delivery are able to resolve lesion margins while dramatic photobleaching (∼42 % ) is visible post-treatment. Segmentation of the photobleached area confirms the boundaries of the irradiated zone. CONCLUSIONS A simple smartphone-based approach for imaging oral lesions is shown to agree in most cases with US, suggesting that this approach may be a useful tool to aid in PDT treatment guidance and monitoring photobleaching as part of a low-cost platform for intraoral PDT.
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Affiliation(s)
- Shakir Khan
- Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Radiotherapy, Aligarh, India
- University of Massachusetts at Boston, Boston, Massachusetts, United States
| | - M. A. Bilal Hussain
- Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Radiotherapy, Aligarh, India
| | - Amjad P. Khan
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Hui Liu
- University of Massachusetts at Boston, Boston, Massachusetts, United States
| | - Shaista Siddiqui
- Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Radiodiagnosis, Aligarh, India
| | - Srivalleesha Mallidi
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Paola Leon
- University of Massachusetts at Boston, Boston, Massachusetts, United States
| | - Liam Daly
- University of Massachusetts at Boston, Boston, Massachusetts, United States
| | - Grant Rudd
- University of Massachusetts at Boston, Boston, Massachusetts, United States
| | - Filip Cuckov
- University of Massachusetts at Boston, Boston, Massachusetts, United States
| | - Colin Hopper
- University College London, London, England, United Kingdom
| | | | - Kafil Akhtar
- Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Pathology, Aligarh, India
| | - Syed Abrar Hasan
- Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Otorhinolaryngology (E.N.T.), Aligarh, India
| | - Shahid Ali Siddiqui
- Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Radiotherapy, Aligarh, India
| | - Tayyaba Hasan
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Jonathan P. Celli
- University of Massachusetts at Boston, Boston, Massachusetts, United States
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Hu D, Pan M, Yu Y, Sun A, Shi K, Qu Y, Qian Z. Application of nanotechnology for enhancing photodynamic therapy via ameliorating, neglecting, or exploiting tumor hypoxia. VIEW 2020. [DOI: 10.1002/viw2.6] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- DanRong Hu
- State Key Laboratory of Biotherapy and Cancer CenterWest China HospitalSichuan University, Collaborative Innovation Center for Biotherapy Chengdu Sichuan P. R. China
| | - Meng Pan
- State Key Laboratory of Biotherapy and Cancer CenterWest China HospitalSichuan University, Collaborative Innovation Center for Biotherapy Chengdu Sichuan P. R. China
| | - Yan Yu
- State Key Laboratory of Biotherapy and Cancer CenterWest China HospitalSichuan University, Collaborative Innovation Center for Biotherapy Chengdu Sichuan P. R. China
| | - Ao Sun
- State Key Laboratory of Biotherapy and Cancer CenterWest China HospitalSichuan University, Collaborative Innovation Center for Biotherapy Chengdu Sichuan P. R. China
| | - Kun Shi
- State Key Laboratory of Biotherapy and Cancer CenterWest China HospitalSichuan University, Collaborative Innovation Center for Biotherapy Chengdu Sichuan P. R. China
| | - Ying Qu
- Department of Hematology and Research Laboratory of HematologyState Key Laboratory of BiotherapyWest China HospitalSichuan University, Collaborative Innovation Center for Biotherapy Chengdu Sichuan P. R. China
| | - ZhiYong Qian
- State Key Laboratory of Biotherapy and Cancer CenterWest China HospitalSichuan University, Collaborative Innovation Center for Biotherapy Chengdu Sichuan P. R. China
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Curnow A, Perry A, Wood M. Improving in vitro photodynamic therapy through the development of a novel iron chelating aminolaevulinic acid prodrug. Photodiagnosis Photodyn Ther 2018; 25:157-165. [PMID: 30553949 PMCID: PMC6456724 DOI: 10.1016/j.pdpdt.2018.12.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/12/2018] [Accepted: 12/12/2018] [Indexed: 12/16/2022]
Abstract
A new combined iron chelating prodrug (AP2-18) has been synthesised and evaluated. AP2-18 significantly increased protoporphyrin IX accumulation in human skin cells. This enhancement translated into greater cytotoxicity on irradiation. Clinical AP2-18 application may improve future dermatological photodynamic therapy.
Background Photodynamic therapy (PDT) is a light activated drug therapy that can be used to treat a number of cancers and precancers. It is particularly useful in its topical form in dermatology but improvement of efficacy is required to widen its application. Methods An ester between aminolaevulinic acid (ALA) and CP94 was synthesised (AP2-18) and experimentally evaluated to determine whether protoporphyrin IX (PpIX)-induced PDT effectiveness could be improved. A biological evaluation of AP2-18 was conducted in cultured human primary cells with both PpIX fluorescence and cell viability (as determined via the neutral red assay) being assessed in comparison to the PpIX prodrugs normally utilised in clinical practice (aminolaevulinic acid (ALA) or its methyl ester (MAL)) either administered alone or with the comparator iron chelator, CP94. Results No significant dark toxicity was observed in human lung fibroblasts but AP2-18 significantly increased PpIX accumulation above and beyond that achieved with ALA or MAL administration +/- CP94 in both human dermal fibroblasts and epithelial squamous carcinoma cells. On light exposure, the combined hydroxypyridinone iron chelating ALA prodrug AP2-18 generated significantly greater cytotoxicity than any of the other treatment parameters investigated when the lowest concentration (250 μM) was employed. Conclusions Newly synthesised AP2-18 is therefore concluded to be an efficacious prodrug for PpIX-induced PDT in these dermatologically relevant human cells, achieving enhanced effects at lower concentrations than currently possible with existing pharmaceuticals.
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Affiliation(s)
- Alison Curnow
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Environment and Sustainability Institute, Penryn Campus, Cornwall, TR10 9FE, UK.
| | - Alexis Perry
- Biosciences, College of Life and Environmental Sciences, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, Devon, EX4 4QD, UK
| | - Mark Wood
- Biosciences, College of Life and Environmental Sciences, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, Devon, EX4 4QD, UK
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Vermandel M, Quidet M, Vignion-Dewalle AS, Leroy HA, Leroux B, Mordon S, Reyns N. Comparison of different treatment schemes in 5-ALA interstitial photodynamic therapy for high-grade glioma in a preclinical model: An MRI study. Photodiagnosis Photodyn Ther 2018; 25:166-176. [PMID: 30543907 DOI: 10.1016/j.pdpdt.2018.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/14/2018] [Accepted: 12/07/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND There is currently no therapy that prevents high-grade glioma recurrence. Thus, these primary brain tumors have unfavorable outcomes. Recently, 5-ALA photodynamic therapy (PDT) has been proposed to delay relapse and is highly expected to have potential synergistic effects with the current standard of care. However, PDT treatment delivery needs to be optimized by evaluating the impact of both the number of fractions and the light power used. OBJECTIVES Previous studies have reported MRI examination-based outcomes for PDT in glioblastoma. Our study aimed to compare MRI markers across different treatment schemes that use interstitial PDT in high-grade glioma in a preclinical model. MATERIALS AND METHODS Forty-eight "nude" rats were grafted with human U87 cells into the right putamen and subsequently submitted to interstitial PDT. The rats were randomized into six groups, including two different sham groups and four different treated groups (5 fractions at 5 mW or 30 mW and 2 fractions at 5 mW or 30 mW). After photosensitizer (PS) precursor (5-ALA) intake, an optical fiber was introduced into the tumor. Treatment effects were assessed with early high-field MRI to acquire T1 and T2 diffusion and perfusion images. RESULTS There was no difference in the variation of the diffusion coefficient among the six groups (p = 0.0549, Kruskal-Wallis test). However, a significant difference was identified among the six groups in terms of variation in perfusion (p = 0.048, Kruskal-Wallis test), supporting a lesional effect in the treated groups. Additionally, the sham groups had significantly smaller edema volumes than were observed in the treated groups. Moreover, the 5-fraction group treated with 30 mW was associated with edema volumes that were significantly greater than those in the 5-fraction group treated with 5 mW (p = 0.019). CONCLUSION Based on observations of MRI data and considering treatment effects, the 5-fraction group treated at 5 mW was not significantly different from the other treated groups in terms of cell deaths, characterized by diffusion imaging, or necrosis level. However, the significantly lower level of edema observed in this group indicated that this treatment scheme had limited toxicity.
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Affiliation(s)
- Maximilien Vermandel
- Univ. Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image-Assisted Laser Therapy for Oncology, F-59000, Lille, France; Department of Neurosurgery, University Hospital, F-59000, Lille, France.
| | - Mathilde Quidet
- Department of Neurosurgery, University Hospital, F-59000, Lille, France
| | - Anne-Sophie Vignion-Dewalle
- Univ. Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image-Assisted Laser Therapy for Oncology, F-59000, Lille, France
| | - Henri-Arthur Leroy
- Univ. Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image-Assisted Laser Therapy for Oncology, F-59000, Lille, France; Department of Neurosurgery, University Hospital, F-59000, Lille, France
| | - Bertrand Leroux
- Univ. Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image-Assisted Laser Therapy for Oncology, F-59000, Lille, France
| | - Serge Mordon
- Univ. Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image-Assisted Laser Therapy for Oncology, F-59000, Lille, France
| | - Nicolas Reyns
- Univ. Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image-Assisted Laser Therapy for Oncology, F-59000, Lille, France; Department of Neurosurgery, University Hospital, F-59000, Lille, France
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Guo X, Qu J, Zhu C, Li W, Luo L, Yang J, Yin X, Li Q, Du Y, Chen D, Qiu Y, Lou Y, You J. Synchronous delivery of oxygen and photosensitizer for alleviation of hypoxia tumor microenvironment and dramatically enhanced photodynamic therapy. Drug Deliv 2018; 25:585-599. [PMID: 29461122 PMCID: PMC6058564 DOI: 10.1080/10717544.2018.1435751] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Photosensitizer, proper laser irradiation, and oxygen are essential components for effective photodynamic therapy (PDT) in clinical cancer therapy. However, native hypoxic tumoral microenvironment is a major barrier hindering photodynamic reactions in vivo. Thus, we have prepared biocompatible liposomes by loading complexes of oxygen-carrier (hemoglobin, Hb) and photosensitizer (indocyanine green, ICG) for enhanced PDT against hypoxic tumor. Ideal oxygen donor Hb, which is an oxygen-carried protein in red blood cells, makes such liposome which provide stable oxygen supply. ICG, as a photosensitizer, could transfer energy from lasers to oxygen to generate cytotoxic reactive oxygen species (ROS) for treatment. The liposomes loading ICG and Hb (LIH) exhibited efficient tumor homing upon intravenous injection. As revealed by T2-weighted magnetic resonance imaging and immunohistochemical analysis, the intratumoral hypoxia was greatly alleviated, and the level of hypoxia inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) in tumor was obviously down-regulated. A weak PDT efficiency was found in cells incubated in simulated hypoxia condition in vitro, while PDT effect was dramatically enhanced in LIH treated hypoxia cells under near-infrared (NIR) laser, which was mainly attributed to massive generation of ROS with sufficient oxygen supply. ROS trigger oxidative damage of tumors and induce complete suppression of tumor growth and 100% survival rate of mice, which were also in good health condition. Our work highlights a liposome-based nanomedicine that could effectively deliver oxygen to tumor and alleviate tumor hypoxia state, inducing greatly improved efficacy compared to conventional cancer PDT and demonstrates the promise of modulating unfavorable tumor microenvironment with nanotechnology to overcome limitations of cancer therapies.
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Affiliation(s)
- Xiaomeng Guo
- a College of Pharmaceutical Sciences , Zhejiang University , Hangzhou , Zhejiang , P. R. China
| | - Jiaxin Qu
- a College of Pharmaceutical Sciences , Zhejiang University , Hangzhou , Zhejiang , P. R. China.,b Department of Pharmaceutics , School of Pharmaceutical Science, Shenyang Pharmaceutical University , Shenyang , Liaoning , P. R. China
| | - Chunqi Zhu
- a College of Pharmaceutical Sciences , Zhejiang University , Hangzhou , Zhejiang , P. R. China
| | - Wei Li
- a College of Pharmaceutical Sciences , Zhejiang University , Hangzhou , Zhejiang , P. R. China
| | - Lihua Luo
- a College of Pharmaceutical Sciences , Zhejiang University , Hangzhou , Zhejiang , P. R. China
| | - Jie Yang
- a College of Pharmaceutical Sciences , Zhejiang University , Hangzhou , Zhejiang , P. R. China
| | - Xiaoyi Yin
- b Department of Pharmaceutics , School of Pharmaceutical Science, Shenyang Pharmaceutical University , Shenyang , Liaoning , P. R. China
| | - Qingpo Li
- a College of Pharmaceutical Sciences , Zhejiang University , Hangzhou , Zhejiang , P. R. China
| | - Yongzhong Du
- a College of Pharmaceutical Sciences , Zhejiang University , Hangzhou , Zhejiang , P. R. China
| | - Dawei Chen
- b Department of Pharmaceutics , School of Pharmaceutical Science, Shenyang Pharmaceutical University , Shenyang , Liaoning , P. R. China
| | - Yunqing Qiu
- c State Key Laboratory for Diagnosis and Treatment of Infectious Diseases , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University , Hangzhou , Zhejiang , P. R. China
| | - Yan Lou
- c State Key Laboratory for Diagnosis and Treatment of Infectious Diseases , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University , Hangzhou , Zhejiang , P. R. China
| | - Jian You
- a College of Pharmaceutical Sciences , Zhejiang University , Hangzhou , Zhejiang , P. R. China
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Anayo L, Magnussen A, Perry A, Wood M, Curnow A. An experimental investigation of a novel iron chelating protoporphyrin IX prodrug for the enhancement of photodynamic therapy. Lasers Surg Med 2018; 50:552-565. [PMID: 29603761 PMCID: PMC6032951 DOI: 10.1002/lsm.22809] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2018] [Indexed: 01/04/2023]
Abstract
Objectives Non‐melanoma skin cancers are the most frequently occurring type of cancer worldwide. They can be effectively treated using topical dermatological photodynamic therapy (PDT) employing protoporphyrin IX (PpIX) as the active photosensitising agent as long as the disease remains superficial. Novel iron chelating agents are being investigated to enhance the effectiveness and extend the applications of this treatment modality, as limiting free iron increases the accumulation of PpIX available for light activation and thus cell kill. Methods Human lung fibroblasts (MRC‐5) and epithelial squamous carcinoma (A431) cells were treated with PpIX precursors (aminolaevulinic acid [ALA] or methyl‐aminolevulinate [MAL]) with or without the separate hydroxypyridinone iron chelating agent (CP94) or alternatively, the new combined iron chelator and PpIX producing agent, AP2‐18. PpIX fluorescence was monitored hourly for 6 hours prior to irradiation. PDT effectiveness was then assessed the following day using the lactate dehydrogenase and neutral red assays. Results Generally, iron chelation achieved via CP94 or AP2‐18 administration significantly increased PpIX fluorescence. ALA was more effective as a PpIX‐prodrug than MAL in A431 cells, corresponding with the lower PpIX accumulation observed with the latter congener in this cell type. Addition of either iron chelating agent consistently increased PpIX accumulation but did not always convey an extra beneficial effect on PpIX‐PDT cell kill when using the already highly effective higher dose of ALA. However, these adjuvants were highly beneficial in the skin cancer cells when compared with MAL administration alone. AP2‐18 was also at least as effective as CP94 + ALA/MAL co‐administration throughout and significantly better than CP94 supplementation at increasing PpIX fluorescence in MRC5 cells as well as at lower doses where PpIX accumulation was observed to be more limited. Conclusions PpIX fluorescence levels, as well as PDT cell kill effects on irradiation can be significantly increased by pyridinone iron chelation, either via the addition of CP94 to the administration of a PpIX precursor or alternatively via the newly synthesized combined PpIX prodrug and siderophore, AP2‐18. The effect of the latter compound appears to be at least equivalent to, if not better than, the separate administration of its constituent parts, particularly when employing MAL to destroy skin cancer cells. AP2‐18 therefore warrants further detailed analysis, as it may have the potential to improve dermatological PDT outcomes in applications currently requiring enhancement. Lasers Surg. Med. 50:552–565, 2018. © 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Lizette Anayo
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Environment and Sustainability Institute, Penryn Campus, Cornwall TR10 9FE, UK
| | - Anette Magnussen
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Environment and Sustainability Institute, Penryn Campus, Cornwall TR10 9FE, UK
| | - Alexis Perry
- Biosciences, College of Life and Environmental Sciences, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, Devon EX4 4QD, UK
| | - Mark Wood
- Biosciences, College of Life and Environmental Sciences, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, Devon EX4 4QD, UK
| | - Alison Curnow
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Environment and Sustainability Institute, Penryn Campus, Cornwall TR10 9FE, UK
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Wang Q, Li JM, Yu H, Deng K, Zhou W, Wang CX, Zhang Y, Li KH, Zhuo RX, Huang SW. Fluorinated polymeric micelles to overcome hypoxia and enhance photodynamic cancer therapy. Biomater Sci 2018; 6:3096-3107. [DOI: 10.1039/c8bm00852c] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Perfluoroalkyl groups-containing polymeric micelles were constructed to transport oxygen, overcome the hypoxia of tumours and enhance photodynamic cancer therapy.
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Leroy HA, Vermandel M, Leroux B, Duhamel A, Lejeune JP, Mordon S, Reyns N. MRI assessment of treatment delivery for interstitial photodynamic therapy of high-grade glioma in a preclinical model. Lasers Surg Med 2017; 50:460-468. [PMID: 29023876 DOI: 10.1002/lsm.22744] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND High-grade gliomas are primary brain tumors that have shown increasing incidence and unfavorable outcomes. Local control is crucial to the management of this pathology. Photodynamic therapy (PDT), based on the light-induced activation of a photosensitizer (PS), achieves local treatment by inducing selective lesions in tumor tissue. OBJECTIVES Previous studies have reported the outcomes of PDT for glioblastoma via immunohistological data. Our study aimed to evaluate MRI findings, including diffusion, and perfusion sequences, compared with immunohistological data from the same population to address the efficiency of light fractionation. MATERIALS AND METHODS Twenty-six "nude" rats grafted with human U87 cells into the right putamen underwent PDT. After PS precursor (5-ALA) intake, an optical fiber was introduced into the tumor. The rats were randomized into the following groups: those without illumination and those that received two or five fractions of light. Treatment effects were assessed with early high-field MRI to measure the volume of necrosis and edema using diffusion and perfusion sequences; the MRI results were compared with immunohistology results, including necrosis and apoptosis markers. RESULTS Elevated diffusion values were observed on MRI in the centers of the tumors of the treated animals, especially in the 5-fraction group (P < 0.01). Perfusion was decreased around the treatment site, especially in the 5-fraction group (P = 0.024). The MRI findings were consistent with previously published histological data. The median volume of necrosis was significantly different between the sham group and treated groups, 0 mm3 versus 2.67 mm3 , P < 0.001. The same trend was previously observed in histology data when grading the absence or presence of necrosis and when the presence of necrosis was significantly more predominant for the treated group than for the untreated group (P < 001). Additionally, cell death represented by apoptosis marker data (TUNEL method) was significantly higher in the 5-fraction group than in the 2-fraction group (P = 0.01). CONCLUSION Diffusion and perfusion MRI revealed histological lesions. Interstitial PDT (iPDT) induced specific lesions in the tumor tissue, which were observed with MRI and confirmed by histopathological analysis. Thus, MRI may provide a non-invasive and reliable tool to assess treatment outcomes after PDT. Lasers Surg. Med. 50:460-468, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Henri-Arthur Leroy
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, F-59000, Lille, France.,Department of Neurosurgery, University Hospital, Lille, France
| | - Maximilien Vermandel
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, F-59000, Lille, France
| | - Bertrand Leroux
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, F-59000, Lille, France
| | - Alain Duhamel
- Department of Biostatistics, EA2694, UDSL, University of Lille, University Hospital, Lille, France
| | - Jean-Paul Lejeune
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, F-59000, Lille, France.,Department of Neurosurgery, University Hospital, Lille, France
| | - Serge Mordon
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, F-59000, Lille, France
| | - Nicolas Reyns
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, F-59000, Lille, France.,Department of Neurosurgery, University Hospital, Lille, France
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12
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Overcome the limitation of hypoxia against photodynamic therapy to treat cancer cells by using perfluorocarbon nanodroplet for photosensitizer delivery. Biochem Biophys Res Commun 2017; 487:483-487. [DOI: 10.1016/j.bbrc.2017.03.142] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 03/26/2017] [Indexed: 11/17/2022]
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13
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Leroy HA, Vermandel M, Vignion-Dewalle AS, Leroux B, Maurage CA, Duhamel A, Mordon S, Reyns N. Interstitial photodynamic therapy and glioblastoma: Light fractionation in a preclinical model. Lasers Surg Med 2016; 49:506-515. [PMID: 28012197 DOI: 10.1002/lsm.22620] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND Glioblastoma is a high-grade cerebral tumor with local recurrence and poor outcome. Photodynamic therapy (PDT) is a localized treatment based on the light activation of a photosensitizer (PS) in the presence of oxygen, which results in the formation of cytotoxic species. The delivery of fractionated light may enhance treatment efficacy by reoxygenating tissues. OBJECTIVE To evaluate the efficiency of two light-fractionation schemes using immunohistological data. MATERIALS AND METHODS Human U87 cells were grafted into the right putamen of 39 nude rats. After PS precursor intake (5-ALA), an optic fiber was introduced into the tumor. The rats were randomly divided into three groups: without light, with light split into 2 fractions and with light split into 5 fractions. Treatment effects were assessed using brain immunohistology. RESULTS Fractionated treatments induced intratumoral necrosis (P < 0.001) and peritumoral edema (P = 0.009) associated with a macrophagic infiltration (P = 0.006). The ratio of apoptotic cells was higher in the 5-fraction group than in either the sham (P = 0.024) or 2-fraction group (P = 0.01). Peripheral vascularization increased after treatment (P = 0.017), and these likely new vessels were more frequently observed in the 5-fraction group (P = 0.028). CONCLUSION Interstitial PDT with fractionated light resulted in specific tumoral lesions. The 5-fraction scheme induced more apoptosis but led to greater peripheral neovascularization. Lasers Surg. Med. 49:506-515, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Henri-Arthur Leroy
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000, Lille, France.,Department of Neurosurgery, CHU Lille, F-59000, Lille, France
| | - Maximilien Vermandel
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000, Lille, France.,Department of Neurosurgery, CHU Lille, F-59000, Lille, France
| | - Anne-Sophie Vignion-Dewalle
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000, Lille, France
| | - Bertrand Leroux
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000, Lille, France
| | | | - Alain Duhamel
- Department of Biostatistics, CHU Lille, EA2694, Université de Lille, F-59000, Lille, France
| | - Serge Mordon
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000, Lille, France
| | - Nicolas Reyns
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000, Lille, France.,Department of Neurosurgery, CHU Lille, F-59000, Lille, France
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14
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Interstitial 5-ALA photodynamic therapy and glioblastoma: Preclinical model development and preliminary results. Photodiagnosis Photodyn Ther 2016. [DOI: 10.1016/j.pdpdt.2015.07.169] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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15
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Shen Y, Shuhendler AJ, Ye D, Xu JJ, Chen HY. Two-photon excitation nanoparticles for photodynamic therapy. Chem Soc Rev 2016; 45:6725-6741. [DOI: 10.1039/c6cs00442c] [Citation(s) in RCA: 365] [Impact Index Per Article: 45.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Integration of the two-photon excitation (TPE) technique and nanomaterials to construct TPE nanoparticle-based photosensitizers for PDT is summarized and reviewed.
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Affiliation(s)
- Yizhong Shen
- State Key Laboratory of Analytical Chemistry for Life Science and Collaborative Innovation Center of Chemistry for Life Sciences
- School of Chemistry and Chemical Engineering
- Nanjing University
- Nanjing 210093
- P. R. China
| | - Adam J. Shuhendler
- Department of Chemistry and Biomolecular Sciences
- University of Ottawa
- Ottawa
- Canada
| | - Deju Ye
- State Key Laboratory of Analytical Chemistry for Life Science and Collaborative Innovation Center of Chemistry for Life Sciences
- School of Chemistry and Chemical Engineering
- Nanjing University
- Nanjing 210093
- P. R. China
| | - Jing-Juan Xu
- State Key Laboratory of Analytical Chemistry for Life Science and Collaborative Innovation Center of Chemistry for Life Sciences
- School of Chemistry and Chemical Engineering
- Nanjing University
- Nanjing 210093
- P. R. China
| | - Hong-Yuan Chen
- State Key Laboratory of Analytical Chemistry for Life Science and Collaborative Innovation Center of Chemistry for Life Sciences
- School of Chemistry and Chemical Engineering
- Nanjing University
- Nanjing 210093
- P. R. China
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16
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Perfluorocarbon nanoparticles enhance reactive oxygen levels and tumour growth inhibition in photodynamic therapy. Nat Commun 2015; 6:8785. [PMID: 26525216 PMCID: PMC4659941 DOI: 10.1038/ncomms9785] [Citation(s) in RCA: 628] [Impact Index Per Article: 69.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 10/05/2015] [Indexed: 02/06/2023] Open
Abstract
Photodynamic therapy (PDT) kills cancer cells by converting tumour oxygen into reactive singlet oxygen (1O2) using a photosensitizer. However, pre-existing hypoxia in tumours and oxygen consumption during PDT can result in an inadequate oxygen supply, which in turn hampers photodynamic efficacy. Here to overcome this problem, we create oxygen self-enriching photodynamic therapy (Oxy-PDT) by loading a photosensitizer into perfluorocarbon nanodroplets. Because of the higher oxygen capacity and longer 1O2 lifetime of perfluorocarbon, the photodynamic effect of the loaded photosensitizer is significantly enhanced, as demonstrated by the accelerated generation of 1O2 and elevated cytotoxicity. Following direct injection into tumours, in vivo studies reveal tumour growth inhibition in the Oxy-PDT-treated mice. In addition, a single-dose intravenous injection of Oxy-PDT into tumour-bearing mice significantly inhibits tumour growth, whereas traditional PDT has no effect. Oxy-PDT may enable the enhancement of existing clinical PDT and future PDT design. Photodynamic therapy is used in cancer treatment and generates reactive oxygen species to kill tumour cells but is limited by the availability of oxygen. Here, the authors modify a photodynamic sensitiser so that it produces excess oxygen species and show enhanced tumour cell killing in vitro and in vivo.
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17
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Gallagher-Colombo SM, Quon H, Malloy KM, Ahn PH, Cengel KA, Simone CB, Chalian AA, O'Malley BW, Weinstein GS, Zhu TC, Putt ME, Finlay JC, Busch TM. Measuring the Physiologic Properties of Oral Lesions Receiving Fractionated Photodynamic Therapy. Photochem Photobiol 2015; 91:1210-8. [PMID: 26037487 DOI: 10.1111/php.12475] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 05/26/2015] [Indexed: 11/28/2022]
Abstract
Photodynamic therapy (PDT) can treat superficial, early-stage disease with minimal damage to underlying tissues and without cumulative dose-limiting toxicity. Treatment efficacy is affected by disease physiologic properties, but these properties are not routinely measured. We assessed diffuse reflectance spectroscopy (DRS) for the noninvasive, contact measurement of tissue hemoglobin oxygen saturation (St O2 ) and total hemoglobin concentration ([tHb]) in the premalignant or superficial microinvasive oral lesions of patients treated with 5-aminolevulinic acid (ALA)-PDT. Patients were enrolled on a Phase 1 study of ALA-PDT that evaluated fluences of 50, 100, 150 or 200 J cm(-2) delivered at 100 mW cm(-2) . To test the feasibility of incorporating DRS measurements within the illumination period, studies were performed in patients who received fractionated (two-part) illumination that included a dark interval of 90-180 s. Using DRS, tissue oxygenation at different depths within the lesion could also be assessed. DRS could be performed concurrently with contact measurements of photosensitizer levels by fluorescence spectroscopy, but a separate noncontact fluorescence spectroscopy system provided continuous assessment of photobleaching during illumination to greater tissue depths. Results establish that the integration of DRS into PDT of early-stage oral disease is feasible, and motivates further studies to evaluate its predictive and dosimetric value.
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Affiliation(s)
| | - Harry Quon
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Kelly M Malloy
- Department of Otorhinolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Peter H Ahn
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Keith A Cengel
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Charles B Simone
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ara A Chalian
- Department of Otorhinolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Bert W O'Malley
- Department of Otorhinolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Gregory S Weinstein
- Department of Otorhinolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Timothy C Zhu
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Mary E Putt
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jarod C Finlay
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Theresa M Busch
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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18
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Low-cost photodynamic therapy devices for global health settings: Characterization of battery-powered LED performance and smartphone imaging in 3D tumor models. Sci Rep 2015; 5:10093. [PMID: 25965295 PMCID: PMC4428052 DOI: 10.1038/srep10093] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 03/27/2015] [Indexed: 12/24/2022] Open
Abstract
A lack of access to effective cancer therapeutics in resource-limited settings is implicated in global cancer health disparities between developed and developing countries. Photodynamic therapy (PDT) is a light-based treatment modality that has exhibited safety and efficacy in the clinic using wavelengths and irradiances achievable with light-emitting diodes (LEDs) operated on battery power. Here we assess low-cost enabling technology to extend the clinical benefit of PDT to regions with little or no access to electricity or medical infrastructure. We demonstrate the efficacy of a device based on a 635 nm high-output LED powered by three AA disposable alkaline batteries, to achieve strong cytotoxic response in monolayer and 3D cultures of A431 squamous carcinoma cells following photosensitization by administering aminolevulinic acid (ALA) to induce the accumulation of protoporphyrin IX (PpIX). Here we characterize challenges of battery-operated device performance, including battery drain and voltage stability specifically over relevant PDT dose parameters. Further motivated by the well-established capacity of PDT photosensitizers to serve as tumour-selective fluorescence contrast agents, we demonstrate the capability of a consumer smartphone with low-cost add-ons to measure concentration-dependent PpIX fluorescence. This study lays the groundwork for the on-going development of image-guided ALA-PDT treatment technologies for global health applications.
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19
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Bovis MJ, Noimark S, Woodhams JH, Kay CWM, Weiner J, Peveler WJ, Correia A, Wilson M, Allan E, Parkin IP, MacRobert AJ. Photosensitisation studies of silicone polymer doped with methylene blue and nanogold for antimicrobial applications. RSC Adv 2015. [DOI: 10.1039/c5ra09045h] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
2 nm gold nanoparticle (AuNP) and methylene blue (MB) incorporated into medical-grade silicone polymer for antimicrobial applications.
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20
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Tetard MC, Vermandel M, Mordon S, Lejeune JP, Reyns N. Experimental use of photodynamic therapy in high grade gliomas: a review focused on 5-aminolevulinic acid. Photodiagnosis Photodyn Ther 2014; 11:319-30. [PMID: 24905843 DOI: 10.1016/j.pdpdt.2014.04.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 04/14/2014] [Accepted: 04/18/2014] [Indexed: 11/16/2022]
Abstract
Photodynamic therapy (PDT) consists of a laser light exposure of tumor cells photosensitized by general or local administration of a pharmacological agent. Nowadays, PDT is a clinically established modality for treatment of many cancers. 5-Aminolevulinic acid (ALA) induced protoporphyrin IX (PpIX) has proven its rational in fluoro-guided resection of malignant gliomas due to a selective tumor uptake and minimal skin sensitization. Moreover, the relatively specific accumulation of photosensitizing PPIX within the tumor cells has gained interest in the PDT of malignant gliomas. Several experimental and clinical studies have then established ALA-PDT as a valuable adjuvant therapy in the management of malignant gliomas. However, the procedure still requires optimizations in the fields of tissue oxygenation status, photosensitizer concentration or scheme of laser light illumination. In this extensive review, we focused on the methods and results of ALA-PDT for treating malignant gliomas in experimental conditions. The biological mechanisms, the effects on tumor and normal brain tissue, and finally the critical issues to optimize the efficacy of ALA-PDT were discussed.
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Affiliation(s)
- Marie-Charlotte Tetard
- University Hospital of Lille - CHRU, Lille F59000, France; Université de Lille 2, Lille F59000, France; Inserm, U703 - ThIAIS, Loos F59120, France
| | - Maximilien Vermandel
- University Hospital of Lille - CHRU, Lille F59000, France; Université de Lille 2, Lille F59000, France; Inserm, U703 - ThIAIS, Loos F59120, France.
| | | | - Jean-Paul Lejeune
- University Hospital of Lille - CHRU, Lille F59000, France; Université de Lille 2, Lille F59000, France; Inserm, U703 - ThIAIS, Loos F59120, France
| | - Nicolas Reyns
- University Hospital of Lille - CHRU, Lille F59000, France; Université de Lille 2, Lille F59000, France; Inserm, U703 - ThIAIS, Loos F59120, France
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21
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Photodynamic therapy of malignant brain tumours: A complementary approach to conventional therapies. Cancer Treat Rev 2014; 40:229-41. [DOI: 10.1016/j.ctrv.2012.07.004] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Revised: 07/06/2012] [Accepted: 07/09/2012] [Indexed: 11/19/2022]
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22
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Antonina CM, Romeo CM, Emil P, Monica N. Increased number of fractionated irradiation sessions does not improve the cellular response to methyl aminolevulinate-mediated photodynamic therapy. Photodiagnosis Photodyn Ther 2013; 10:526-34. [DOI: 10.1016/j.pdpdt.2013.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 04/17/2013] [Accepted: 04/19/2013] [Indexed: 10/26/2022]
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23
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Blake E, Allen J, Curnow A. The effects of protoporphyrin IX-induced photodynamic therapy with and without iron chelation on human squamous carcinoma cells cultured under normoxic, hypoxic and hyperoxic conditions. Photodiagnosis Photodyn Ther 2013; 10:575-82. [PMID: 24284114 DOI: 10.1016/j.pdpdt.2013.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 06/13/2013] [Accepted: 06/16/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Photodynamic therapy requires the combined interaction of a photosensitiser, light and oxygen to ablate target tissue. In this study we examined the effect of iron chelation and oxygen environment manipulation on the accumulation of the clinically useful photosensitiser protoporphyrin IX (PpIX) within human squamous epithelial carcinoma cells and the subsequent ablation of these cells on irradiation. METHODS Cells were incubated at concentrations of 5%, 20% or 40% oxygen for 24h prior to and for 3h following the administration of the PpIX precursors aminolevulinic acid (ALA), methyl aminolevulinate (MAL) or hexylaminolevulinate (HAL) with or without the iron chelator 1,2-diethyl-3-hydroxypyridin-4-one hydrochloride (CP94). PpIX accumulation was monitored using a fluorescence plate reader, cells were irradiated with 37 J/cm(2) red light and cell viability measured using the neutral red uptake assay. RESULTS Manipulation of the oxygen environment and/or co-administration of CP94 with PpIX precursors resulted in significant changes in both PpIX accumulation and photobleaching. Incubation with 5% or 40% oxygen produced the greatest levels of PpIX and photobleaching in cells incubated with ALA/MAL. Incorporation of CP94 also resulted in significant decreases in cell viability following administration of ALA/MAL/HAL, with oxygen concentration predominantly having a significant effect in cells incubated with HAL. CONCLUSIONS Experimentation with human squamous epithelial carcinoma cells has indicated that the iron chelator CP94 significantly increased PpIX accumulation induced by each PpIX congener investigated (ALA/MAL/HAL) at all oxygen concentrations employed (5%/20%/40%) resulting in increased levels of photobleaching and reduced cell viability on irradiation. Further detailed investigation of the complex relationship of PDT cytotoxicity at various oxygen concentrations is required. It is therefore concluded that iron chelation with CP94 is a simple protocol modification with which it may be much easier to enhance clinical PDT efficacy than the complex and less well understood process of oxygen manipulation.
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Affiliation(s)
- Emma Blake
- Clinical Photobiology, European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, UK
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Quon H, Grossman CE, Finlay JC, Zhu TC, Clemmens CS, Malloy KM, Busch TM. Photodynamic therapy in the management of pre-malignant head and neck mucosal dysplasia and microinvasive carcinoma. Photodiagnosis Photodyn Ther 2011; 8:75-85. [PMID: 21497298 DOI: 10.1016/j.pdpdt.2011.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 12/24/2010] [Accepted: 01/06/2011] [Indexed: 12/25/2022]
Abstract
The management of head and neck mucosal dysplasia and microinvasive carcinoma is an appealing strategy to prevent the development of invasive carcinomas. While surgery remains the standard of care, photodynamic therapy (PDT) offers several advantages including the ability to provide superficial yet wide field mucosal ablative treatment. This is particularly attractive where defining the extent of the dysplasia can be difficult. PDT can also retreat the mucosa without any cumulative fibrotic complications affecting function. To date, clinical experience suggests that this treatment approach can be effective in obtaining a complete response for the treated lesion but long term follow-up is limited. Further research efforts are needed to define not only the risk of malignant transformation with PDT but also to develop site specific treatment recommendations that include the fluence, fluence rate and light delivery technique.
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Affiliation(s)
- Harry Quon
- Department of Radiation Oncology, United States.
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Blake E, Curnow A. The hydroxypyridinone iron chelator CP94 can enhance PpIX-induced PDT of cultured human glioma cells. Photochem Photobiol 2011; 86:1154-60. [PMID: 20573043 DOI: 10.1111/j.1751-1097.2010.00770.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Photodynamic therapy (PDT) with the pro-drugs 5-aminolevulinic acid (ALA) or methyl aminolevulinate (MAL) utilizes the combined interaction of a photosensitizer, light and molecular oxygen to ablate tumor tissue. To potentially increase accumulation of the photosensitizer, protoporphyrin IX (PpIX), within tumor cells an iron chelator can be employed. This study analyzed the effects of ALA/MAL-induced PDT combined with the iron chelator 1, 2-diethyl-3-hydroxypyridin-4-one hydrochloride (CP94) on the accumulation of PpIX in human glioma cells in vitro. Cells were incubated for 0, 3 and 6h with various concentrations of ALA/MAL with or without CP94 and the resulting accumulations of PpIX, which naturally fluoresces, were quantified prior to and following light irradiation. In addition, counts of viable cells were recorded. The use of CP94 in combination with ALA/MAL produced significant enhancements of PpIX fluorescence in human glioma cells. At the highest concentrations of each prodrug, CP94 enhanced PpIX fluorescence significantly at 3h for ALA and by more than 50% at 6h for MAL. Cells subsequently treated with ALA/MAL-induced PDT in combination with CP94 produced the greatest cytotoxicity. It is therefore concluded that with further study CP94 may be a useful adjuvant to photodiagnosis and/or PpIX-induced PDT treatment of glioma.
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Affiliation(s)
- Emma Blake
- Clinical Photobiology, Peninsula Medical School, University of Exeter, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, UK.
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Naghavi N, Miranbaygi MH, Sazgarnia A. Simulation of fractionated and continuous irradiation in photodynamic therapy: study the differences between photobleaching and singlet oxygen dose deposition. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2011; 34:203-11. [DOI: 10.1007/s13246-011-0064-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 03/08/2011] [Indexed: 11/24/2022]
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Ekroll IK, Gederaas OA, Helander L, Hjelde A, Melø TB, Johnsson A. Photo induced hexylaminolevulinate destruction of rat bladder cells AY-27. Photochem Photobiol Sci 2011; 10:1072-9. [DOI: 10.1039/c0pp00393j] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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28
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Estevez JP, Ascencio M, Colin P, Farine MO, Collinet P, Mordon S. Continuous or fractionated photodynamic therapy? Comparison of three PDT schemes for ovarian peritoneal micrometastasis treatment in a rat model. Photodiagnosis Photodyn Ther 2010; 7:251-7. [PMID: 21112548 DOI: 10.1016/j.pdpdt.2010.07.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Revised: 07/19/2010] [Accepted: 07/21/2010] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This experimental study aimed to compare three illumination schemes to optimize hexaminolaevulinate (HAL)-PDT in a rat tumor model with advanced ovarian cancer. MATERIALS AND METHODS Peritoneal carcinomatosis was induced by intraperitoneal 5×10(6)NuTu-19 cells injection in 60 female rats Fisher 344. Carcinomatosis was obtained 50 days post-tumor induction. Four hours post-intraperitoneal HAL (Photocure ASA, Oslo, Norway) injection, three different schemes of PDT were performed during 25 min on a 1cm(2) area. (A) Fractionated illumination (n=20) with an on-off cycle ("on": 2 min and "off": 1 min) at 30mW cm(-2) until a fluence of 30J cm(-2), (B) continuous illumination (n=20) at 30mW cm(-2) with a fluence of (45J cm(-2)C) continuous illumination (n=20) at 20mW cm(-2) with a fluence of 30J cm(-2). Laser light was generated using a 532nm KTP laser (Laser Quantum, Stockport, UK). Biopsies were taken 24h after treatment. Quantitative histology was performed. Necrosis value was determined: 0-no necrosis to 4-full necrosis. Depth of necrosis was then measured for each sample and correlated to Necrosis value. RESULTS HAL-PDT was efficient in producing necrosis irrespective of the scheme. Tumor destruction was superior with fractionated illumination compared to both continuous illumination schemes regarding to the depth of necrosis (213±113μm vs 154±133μm vs 171±155μm) (p<0.05) or to the full necrosis rate (50% vs 30% vs 10%) (p<0.0001). CONCLUSION Fractionated illumination during photodynamic therapy (PDT) was shown to improve tumor response. Fractionated illumination with short intervals should be considered for an effective PDT of advanced ovarian cancer.
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Affiliation(s)
- Juan Pablo Estevez
- INSERM, U 703 - Univ. de Lille Nord de France - Lille University Hospital - CHRU, Lille, France
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Kuliková L, Mikeš J, Hýžďalová M, Palumbo G, Fedoročko P. NF-κB is Not Directly Responsible for Photoresistance Induced by Fractionated Light Delivery in HT-29 Colon Adenocarcinoma Cells. Photochem Photobiol 2010; 86:1285-93. [DOI: 10.1111/j.1751-1097.2010.00788.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ascencio M, Estevez JP, Delemer M, Farine MO, Collinet P, Mordon S. Comparison of continuous and fractionated illumination during hexaminolaevulinate-photodynamic therapy. Photodiagnosis Photodyn Ther 2008; 5:210-6. [DOI: 10.1016/j.pdpdt.2008.09.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2008] [Revised: 09/23/2008] [Accepted: 09/24/2008] [Indexed: 11/27/2022]
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Enhancement of methyl-aminolevulinate photodynamic therapy by iron chelation with CP94: an in vitro investigation and clinical dose-escalating safety study for the treatment of nodular basal cell carcinoma. J Cancer Res Clin Oncol 2008; 134:841-9. [PMID: 18239941 DOI: 10.1007/s00432-008-0358-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2007] [Accepted: 12/28/2007] [Indexed: 12/29/2022]
Abstract
PURPOSE Methyl-aminolevulinate (MAL) photodynamic therapy (PDT) is a cancer therapy that combines the selective accumulation of a photosensitizer in tumor tissue with visible light (and tissue oxygen) to produce reactive oxygen species. This results in cellular damage and ablation of tumor tissue. Combining iron chelators with MAL has the potential to increase the accumulation of the photosensitizer protoporphyrin IX (PpIX) by reducing its bioconversion to heme. This paper investigates this method of enhancement both in vitro and for the first time clinically for the treatment of nodular basal cell carcinoma (BCC). METHODS Enhancement of MAL-induced PpIX accumulation by the iron chelator CP94 was quantified fluorometrically in human cultured cells (including three dermatological cell types). An open, dose-escalating, pilot study was then conducted in patients with nodular BCC, to determine the safety of this pharmacological modification. RESULTS Large enhancements in PpIX accumulation were observed in the cultured cells when co-incubated with the iron chelator CP94. Clinically the addition of CP94 was found to be feasible and safe. In addition greater reductions in tumor depth were observed in the CP94 co-incubated tumors. CONCLUSION Iron chelation by CP94 is an effective enhancer of MAL-induced PpIX accumulation in vitro. This method of enhancement was safely applied to a clinical PDT protocol with no unexpected adverse effects reported. Although the clinical investigation was only intended to be a small pilot to assess safety, enhancements in tumor clearance were observed both clinically and histologically when CP94 was included in the photosensitizing cream.
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Woodhams JH, Macrobert AJ, Bown SG. The role of oxygen monitoring during photodynamic therapy and its potential for treatment dosimetry. Photochem Photobiol Sci 2007; 6:1246-56. [PMID: 18046479 DOI: 10.1039/b709644e] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Understanding of the biology of photodynamic therapy (PDT) has expanded tremendously over the past few years. However, in the clinical situation, it is still a challenge to match the extent of PDT effects to the extent of the disease process being treated. PDT requires drug, light and oxygen, any of which can be the limiting factor in determining efficacy at each point in a target organ. This article reviews techniques available for monitoring tissue oxygenation during PDT. Point measurements can be made using oxygen electrodes or luminescence-based optodes for direct measurements of tissue pO2, or using optical spectroscopy for measuring the oxygen saturation of haemoglobin. Imaging is considerably more complex, but may become feasible with techniques like BOLD MRI. Pre-clinical studies have shown dramatic changes in oxygenation during PDT, which vary with the photosensitizer used and the light delivery regimen. Better oxygenation throughout treatment is achieved if the light fluence rate is kept low as this reduces the rate of oxygen consumption. The relationship between tissue oxygenation and PDT effect is complex and remarkably few studies have directly correlated oxygenation changes during PDT with the final biological effect, although those that have confirm the value of maintaining good oxygenation. Real time monitoring to ensure adequate oxygenation at strategic points in target tissues during PDT is likely to be important, particularly in the image guided treatment of tumours of solid organs.
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Affiliation(s)
- Josephine H Woodhams
- National Medical Laser Centre, Royal Free and University College Medical School, University College London, Charles Bell House, 67-73 Riding House Street, London, UKW1W 7EJ
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Mackenzie GD, Jamieson NF, Novelli MR, Mosse CA, Clark BR, Thorpe SM, Bown SG, Lovat LB. How light dosimetry influences the efficacy of photodynamic therapy with 5-aminolaevulinic acid for ablation of high-grade dysplasia in Barrett's esophagus. Lasers Med Sci 2007; 23:203-10. [PMID: 17610005 DOI: 10.1007/s10103-007-0473-7] [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: 10/17/2006] [Accepted: 05/03/2007] [Indexed: 12/21/2022]
Abstract
Photodynamic therapy (PDT) with 5-aminolaevulinic acid (ALA) is a novel treatment for high-grade dysplasia (HGD) in Barrett's esophagus (BE). Our aim was to evaluate the effectiveness of differing light doses. Patients with HGD in BE received oral ALA (60 mg/kg) activated by low (500 J/cm), medium (750 J/cm), high (1,000 J/cm), or highest (1,000 J/cm x2) light dose at 635 nm. Follow-up was by regular endoscopy with quadrantic biopsies. Twenty-four patients were treated. Successful eradication of HGD was significantly correlated with light dose (log rank, p < 0.01). Six of eight patients (75%) treated with the highest light dose, one of two treated with high dose (50%), two of nine (22%) receiving medium light dose, and zero of five receiving low light dose had successful eradication of HGD (median follow-up 45 months, range 1-78 months). No skin photosensitivity or esophageal strictures occurred. The efficacy of ALA-PDT for eradication of HGD in BE is closely related to the light dose used. With a drug dose of 60 mg/kg and light at 635 nm, we recommend a minimum light dose of 1,000 J/cm of esophagus. This dose appears safe.
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Affiliation(s)
- Gary D Mackenzie
- National Medical Laser Centre, Department of Surgery, Royal Free and University College Medical School, University College London, UK
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Akker JTHM, Bruijn HS, Beijersbergen van Henegouwen GMJ, Star WM, Sterenborg HJCM. Protoporphyrin IX Fluorescence Kinetics and Localization after Topical Application of ALA Pentyl Ester and ALA on Hairless Mouse Skin with UVB-Induced Early Skin Cancer. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2000)0720399pifkal2.0.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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Chen Q, Huang Z, Chen H, Shapiro H, Beckers J, Hetzel FW. Improvement of Tumor Response by Manipulation of Tumor Oxygenation During Photodynamic Therapy¶. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2002)0760197iotrbm2.0.co2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Diagaradjane P, Madhuri S, Aruna P, Gupta PK, Ganesan S. In Vivo Pharmacokinetics of δ-Aminolevulinic Acid-Induced Protoporphyrin IX During Pre- and Post-Photodynamic Therapy in 7,12-Dimethylbenz(a)nthracene-Treated Skin Carcinogenesis in Swiss Mice: A Comparison by Three-Compartment Model†¶. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2002)0760081ivpoaa2.0.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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Robinson DJ, Bruijn HS, Star WM, Sterenborg HJCM. Dose and Timing of the First Light Fraction in Two-fold Illumination Schemes for Topical ALA-mediated Photodynamic Therapy of Hairless Mouse Skin¶. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2003)0770319datotf2.0.co2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Huang Z, Chen Q, Shakil A, Chen H, Beckers J, Shapiro H, Hetzel FW. Hyperoxygenation Enhances the Tumor Cell Killing of Photofrin-mediated Photodynamic Therapy¶. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2003)0780496hettck2.0.co2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Robinson DJ, Bruijn HS, Johannes de Wolf W, Sterenborg HJCM, Star WM. Topical 5-Aminolevulinic Acid-photodynamic Therapy of Hairless Mouse Skin Using Two-fold Illumination Schemes: PpIX Fluorescence Kinetics, Photobleaching and Biological Effect†¶. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2000)0720794taapto2.0.co2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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de Bruijn HS, van der Ploeg-van den Heuvel A, Sterenborg HJCM, Robinson DJ. Fractionated illumination after topical application of 5-aminolevulinic acid on normal skin of hairless mice: The influence of the dark interval. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2006; 85:184-90. [PMID: 16945548 DOI: 10.1016/j.jphotobiol.2006.07.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2006] [Revised: 07/03/2006] [Accepted: 07/25/2006] [Indexed: 10/24/2022]
Abstract
We have previously shown that light fractionation during topical aminolevulinic acid based photodynamic therapy (ALA-PDT) with a dark interval of 2h leads to a significant increase in efficacy in both pre-clinical and clinical PDT. However this fractionated illumination scheme required an extended overall treatment time. Therefore we investigated the relationship between the dark interval and PDT response with the aim of reducing the overall treatment time without reducing the efficacy. Five groups of mice were treated with ALA-PDT using a single light fraction or the two-fold illumination scheme with a dark interval of 30 min, 1, 1.5 and 2h. Protoporphyrin IX fluorescence kinetics were monitored during illumination. Visual skin response was monitored in the first seven days after PDT and assessed as PDT response. The PDT response decreases with decreasing length of the dark interval. Only the dark interval of 2h showed significantly more damage compared to all the other dark intervals investigated (P<0.05 compared to 1.5h and P<0.01 compared to 1h, 30 min and a single illumination). No relationship could be shown between the utilized PpIX fluorescence during the two-fold illumination and the PDT response. The rate of photobleaching was comparable for the first and the second light fraction and not dependent of the length of dark interval used. We conclude that in the skin of the hairless mouse the dark interval cannot be reduced below 2h without a significant reduction in PDT efficacy.
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Affiliation(s)
- H S de Bruijn
- Center for Optical Diagnostics and Therapy, Department of Radiation Oncology, Room Wk-319, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
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Curnow A, MacRobert AJ, Bown SG. Comparing and combining light dose fractionation and iron chelation to enhance experimental photodynamic therapy with aminolevulinic acid. Lasers Surg Med 2006; 38:325-31. [PMID: 16596660 DOI: 10.1002/lsm.20328] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES Enhancement of photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) has been demonstrated experimentally using light dose fractionation or CP94 iron chelation. This study extends this research. STUDY DESIGN/MATERIALS AND METHODS In normal rat colon, CP94 administration and light dose fractionation were independently and concurrently employed to enhance ALA-PDT. In colonic rat tumors, the most successful enhancement regimes were employed separately. RESULTS Independent use of light dose fractionation and iron chelation produced similar results in normal colon (2.4- and 2.9-fold more necrosis than controls, respectively). Using both techniques simultaneously produced fivefold enhancement. In the colonic tumors, light dose fractionation and iron chelation (using different parameters) produced two and five times the volume of necrosis, respectively. CONCLUSIONS Both techniques significantly enhanced ALA-PDT in the normal and neoplastic tissues investigated and produced similar levels of enhancement when comparable parameters were employed. Concurrent use of light dose fractionation and iron chelation in normal colon produced considerably more enhancement than either technique could achieve independently.
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Affiliation(s)
- Alison Curnow
- Cornwall Dermatology Research, Peninsula Medical School, Truro, Cornwall TR1 3HD, UK.
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Angell-Petersen E, Spetalen S, Madsen SJ, Sun CH, Peng Q, Carper SW, Sioud M, Hirschberg H. Influence of light fluence rate on the effects of photodynamic therapy in an orthotopic rat glioma model. J Neurosurg 2006; 104:109-17. [PMID: 16509154 DOI: 10.3171/jns.2006.104.1.109] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Failure of treatment for high-grade gliomas is usually due to local recurrence at the site of resection, indicating that a more aggressive local therapy could be beneficial. Photodynamic therapy (PDT) is a local treatment involving the administration of a tumor-localizing photosensitizing drug, in this case aminolevulinic acid (ALA). The effect depends on the total light energy delivered to the target tissue, but may also be influenced by the rate of light delivery. METHODS In vitro experiments showed that the sensitivity to ALA PDT of BT4C multicellular tumor spheroids depended on the rate of light delivery (fluence rate). The BT4C tumors were established intracranially in BD-IX rats. Microfluorometry of frozen tissue sections showed that photosensitization is produced with better than 200:1 tumor/normal tissue selectivity after ALA injection. Four hours after intraperitoneal ALA injection (125 mg/kg), 26 J of 632 nm light was delivered interstitially over 15 (high fluence rate) or 90 (low fluence rate) minutes. Histological examination of animals treated 14 days after tumor induction demonstrated extensive tumor necrosis after low-fluence-rate PDT, but hardly any necrosis after high-fluence-rate treatment. Neutrophil infiltration in tumor tissue was increased by PDT, but was similar for both treatment regimens. Low-fluence-rate PDT administered 9 days after tumor induction resulted in statistically significant prolongation of survival for treated rats compared with nontreated control animals. CONCLUSIONS Treatment with ALA PDT induced pronounced necrosis in tumors only if the light was delivered at a low rate. The treatment prolonged the survival for tumor-bearing animals.
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Thompson MS, Johansson A, Johansson T, Andersson-Engels S, Svanberg S, Bendsoe N, Svanberg K. Clinical system for interstitial photodynamic therapy with combined on-line dosimetry measurements. APPLIED OPTICS 2005; 44:4023-31. [PMID: 16004049 DOI: 10.1364/ao.44.004023] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
A system for interstitial photodynamic therapy with delta-aminolaevulinic acid and multiple optical fibers has been developed. The system enables photodynamic treatment of large embedded tumor volumes and utilizes real-time measurements to allow on-line dosimetry. Important parameters such as light fluence rate, sensitizer fluorescence intensity, and changes in local blood oxygen saturation are measured with the same fibers that deliver the therapeutic light. Data from the first clinical treatments on nodular basal cell carcinomas indicate a major treatment-induced light absorption increase, rapid sensitizer photobleaching, and a relatively constant global tissue oxygen saturation level during the treatment.
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Affiliation(s)
- Marcelo Soto Thompson
- Department of Physics, Lund Institute of Technology, PO Box 118, SE-221 00 Lund, Sweden.
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Harada M, Woodhams J, MacRobert AJ, Feneley MR, Kato H, Bown SG. The vascular response to photodynamic therapy with ATX-S10Na(II) in the normal rat colon. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2005; 79:223-30. [PMID: 15896649 DOI: 10.1016/j.jphotobiol.2004.08.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2004] [Revised: 08/12/2004] [Accepted: 08/30/2004] [Indexed: 11/15/2022]
Abstract
The mechanism of tissue damage from photodynamic therapy (PDT) may be cellular, vascular or both, depending on the photosensitising agent and the treatment conditions. Well established photosensitisers like porfimer sodium have an optimum drug light interval of two days and may cause skin photosensitivity lasting several weeks. ATX-S10Na(II) is a new photosensitiser that remains largely in the vasculature after systemic administration and clears from the body within a few hours. The present study looks at the factors controlling the extent of PDT necrosis using ATX-S10Na(II) and correlates these with changes in the circulation after PDT. Normal Wistar rats were sensitised with ATX-S10Na(II), 2 mg/kg. At laparotomy, a laser fibre was positioned just touching the colonic mucosa and 50 J light at 670 nm delivered varying the drug light interval (0.5-24 h) and light delivery regime (100 mW continuous, 20 mW continuous or 100 mW in five fractions). Some animals were killed at three days to document the area of necrosis, others received fluorescein shortly prior to death (from a few minutes to three days after PDT) to outline the zone of PDT induced vascular shutdown. Maximum necrosis was seen with the shortest drug light interval (0.5 h), with no effect by 6 h. Fractionating the light or lowering the power did not increase the necrosis. The area of fluorescein exclusion increased over the first 2 h after PDT (in contrast to the re-perfusion seen with other photosensitisers) and correlated with the area of necrosis. PDT with ATX-S10Na(II) is most effective with a drug light interval of less than one hour. It induces irreversible vascular shutdown that extends after completion of light delivery and which is largely independent of the light delivery regime.
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Affiliation(s)
- Masahiko Harada
- National Medical Laser Centre, Academic Division of Surgical Specialties, Royal Free and University College Medical School, 1st Floor, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ, UK
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Huang Z, Chen Q, Shakil A, Chen H, Beckers J, Shapiro H, Hetzel FW. Hyperoxygenation enhances the tumor cell killing of photofrin-mediated photodynamic therapy. Photochem Photobiol 2004; 78:496-502. [PMID: 14653582 DOI: 10.1562/0031-8655(2003)078<0496:hettck>2.0.co;2] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Tumor hypoxia, either preexisting or as a result of oxygen depletion during photodynamic therapy (PDT) light irradiation, can significantly reduce the effectiveness of PDT-induced cell killing. To overcome tumor hypoxia and improve tumor cell killing, we propose using supplemental hyperoxygenation during Photofrin-PDT. The mechanism for the tumor cure enhancement of the hyperoxygenation-PDT combination is investigated using an in vivo-in vitro technique. A hypoxic tumor model was established by implanting mammary adenocarcinoma in the hind legs of mice. Light irradiation (200 J/cm2 at either 75 or 150 mW/cm2), under various oxygen supplemental conditions (room air, carbogen, 100% normobaric or hyperbaric oxygen), was delivered to animals that received 12.5 mg/kg Photofrin 24 h before light irradiation. Tumors were harvested at various time points after PDT and grown in vitro for colony formation analysis. Treated tumors were also analyzed histologically. The results show that when PDT is combined with hyperoxygenation, the hypoxic condition could be improved and the cell killing rate at various time points after PDT could be significantly enhanced over that without hyperoxygenation, suggesting an enhanced direct and indirect cell killing associated with high-concentration oxygen breathing. This study further confirms our earlier observation that when a PDT treatment is combined with hyperoxygenation it can be more effective in controlling hypoxic tumors.
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Affiliation(s)
- Zheng Huang
- Research and Development, HealthONE Alliance, Denver, CO 80203, USA.
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Robinson DJ, de Bruijn HS, Star WM, Sterenborg HJCM. Dose and timing of the first light fraction in two-fold illumination schemes for topical ALA-mediated photodynamic therapy of hairless mouse skin. Photochem Photobiol 2003; 77:319-23. [PMID: 12685661 DOI: 10.1562/0031-8655(2003)077<0319:datotf>2.0.co;2] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A fractionated illumination scheme in which a cumulative fluence of 100 J cm(-2) is delivered in two equal light fractions separated by a dark interval of 2 h has been shown to considerably increase the efficacy of 5-aminolevulinic acid (ALA)-photodynamic therapy (PDT). The efficacy of such a scheme is further increased if the fluence of the first light fraction is reduced to 5 J cm(-2). We have investigated the relationship between the PDT response and the kinetics of protoporphyrin IX (PpIX) fluorescence in the SKH1 HR hairless mouse for first fraction fluences below 5 J cm(-2) delivered 4 h after the application of ALA and 10 J cm(-2) delivered 2 h after the application of ALA. Illumination is performed using 514 nm at a fluence rate of 50 mW cm(-2). Reducing the fluence of the first fraction to 2.5 J cm(-2) does not result in significantly different visual skin damage. The PDT response, however, is significantly reduced if the fluence is lowered to 1 J cm(-2), but this illumination scheme (1 + 99 J cm(-2)) remains significantly more effective than a single illumination of 100 J cm(-2). A first light fraction of 10 J cm(-2) can be delivered 2 h earlier, 2 h after the application of ALA, without significant reduction in the PDT response compared with 5 + 95 J cm(-2) delivered 4 and 6 h after the application of ALA. The kinetics of PpIX fluorescence are consistent with those reported previously by us and do not explain the significant increase in PDT response with a two-fold illumination scheme. Histological sections of the illuminated volume showed a trend toward increasing extent and depth of necrosis for the two-fold illumination scheme in which the first light fraction is 5 J cm(-2), compared with a single illumination scheme.
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Affiliation(s)
- Dominic J Robinson
- Photodynamic Therapy and Optical Spectroscopy Research Program, Department of Radiation Oncology, Erasmus MC: Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
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Keefe KA, Tadir Y, Tromberg B, Berns M, Osann K, Hashad R, Monk BJ. Photodynamic therapy of high-grade cervical intraepithelial neoplasia with 5-aminolevulinic acid. Lasers Surg Med 2003; 31:289-93. [PMID: 12355576 DOI: 10.1002/lsm.10111] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVES To determine the safety and efficacy of 5-aminolevulinic acid (ALA) as a topically applied photosensitizer for photodynamic therapy (PDT) of cervical intraepithelial neoplasia (CIN). STUDY DESIGNS/MATERIALS AND METHODS Forty women, who were at least 18 years old with persistent biopsy-proven CIN 2 and CIN 3 within the previous 3 months of enrollment, underwent PDT in a phase I and II design. Five escalating radiant energies (increments of 25 J/cm(2), beginning at 50-150 J/cm(2)) using a Coherent Dye Model 920 argon pumped dye laser providing light at 630 nm (maximum output 0.8 W) were used to perform PDT with a fixed dose of ALA (200 mg/ml). ALA was placed in a cervical cap fitted to the cervix. After 90 minutes, the cap was removed and the ectocervix was illuminated for 5-16 minutes, depending on the irradiance. Success was defined as the absence of CIN on Pap smear or colposcopic examination at 12-months. Patients were monitored for toxicity. RESULTS Thirty-two women (80%) completed the study with 1 year of follow-up. Sixty percent had CIN 3 and 40% CIN 2. Success rates at 4, 8, and 12 months were 51, 46, and 31%, respectively, and were not light-dose dependent. Three patients progressed from CIN 2 to CIN 3. Toxicity was tolerable and only consisted of spotting, vaginal discharge, mild cramping, and vaginal warmth. There was no apparent dose relationship to toxicity. CONCLUSIONS PDT at this light and ALA dose is well tolerated but has minimal activity in the treatment of CIN 2 and CIN 3. Other doses and schedules of light and ALA or novel photosensitizers may improve efficacy.
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Affiliation(s)
- Kristin A Keefe
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology at the Chao Family Compressive Cancer Center, Orange, California, USA
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Chen Q, Huang Z, Chen H, Shapiro H, Beckers J, Hetzel FW. Improvement of tumor response by manipulation of tumor oxygenation during photodynamic therapy. Photochem Photobiol 2002; 76:197-203. [PMID: 12194217 DOI: 10.1562/0031-8655(2002)076<0197:iotrbm>2.0.co;2] [Citation(s) in RCA: 100] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Photodynamic therapy (PDT) requires molecular oxygen during light irradiation to generate reactive oxygen species. Tumor hypoxia, either preexisting or induced by PDT, can severely hamper the effectiveness of PDT. Lowering the light irradiation dose rate or fractionating a light dose may improve cell kill of PDT-induced hypoxic cells but will have no effect on preexisting hypoxic cells. In this study hyperoxygenation technique was used during PDT to overcome hypoxia. C3H mice with transplanted mammary carcinoma tumors were injected with 12.5 mg/kg Photofrin and irradiated with 630 nm laser light 24 h later. Tumor oxygenation was manipulated by subjecting the animals to 3 atp (atmospheric pressure) hyperbaric oxygen or normobaric oxygen during PDT light irradiation. The results show a significant improvement in tumor response when PDT was delivered during hyperoxygenation. With hyperoxygenation up to 80% of treated tumors showed no regrowth after 60 days. In comparison, when animals breathed room air, only 20% of treated tumors did not regrow. To explore the effect of hyperoxygenation on tumor oxygenation, tumor partial oxygen pressure was measured with microelectrodes positioned in preexisting hypoxic regions before and during the PDT. The results show that hyperoxygenation may oxygenate preexisting hypoxic cells and compensate for oxygen depletion induced by PDT light irradiation. In conclusion, hyperoxygenation may provide effective ways to improve PDT efficiency by oxygenating both preexisting and treatment-induced cell hypoxia.
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Affiliation(s)
- Qun Chen
- Research and Development, HealthONE Alliance, Denver, CO, USA
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Diagaradjane P, Madhuri S, Aruna P, Gupta PK, Ganesan S. In vivo pharmacokinetics of 8-aminolevulinic acid-induced protoporphyrin IX during pre- and post-photodynamic therapy in 7,12-dimethylbenz(a)nthracene-treated skin carcinogenesis in Swiss mice: a comparison by three-compartment model. Photochem Photobiol 2002; 76:81-90. [PMID: 12126311 DOI: 10.1562/0031-8655(2002)076<0081:ivpoaa>2.0.co;2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Delta-aminolevulinic acid-photodynamic therapy (ALA-PDT) has emerged as a useful technique in the treatment of superficial basal cell carcinoma, actinic keratosis, squamous cell carcinoma and tumors of other organs. Earlier reports mention that there is reappearance of protoporphyrin IX (PpIX) after photoirradiation of tumors. This property of reappearance of PpIX is being utilized to treat nodular tumors by fractionated light dose delivery. However, there is still no unanimously accepted reason for this reappearance phenomenon and the rate of resynthesis after PDT. On account of this, studies are carried out on the estimation of the pharmacokinetics of the ALA-induced PpIX in mice tumor models and the surrounding normal tissues before and after PDT. Further, a mathematical model based on a multiple compartment system is proposed to estimate the rate parameter for the diffusion of PpIX from the surrounding normal tissues into the tumor tissue (km) caused by photobleaching during PDT with irradiating fluences of 36.0 and 57.6 J/cm2. The km value at two different fluences, 36.0 and 57.6 J/cm2, are estimated as 3.0636+/-0.7083 h(-1) and 6.9231+/-2.17651 h(-1), respectively. Further, the rate parameter for the cleavage and efflux of ALA (k1) and the rate parameter for the evasion of PpIX from the tumor tissues after PDT (kt) were also estimated by fitting the experimental data to the developed mathematical model. The statistical significance of the estimated parameters was determined using Student's t-test. The experimental results and the rate parameters obtained using the proposed compartment model suggest that in addition to the earlier reported reasons, the invasion or diffusion of PpIX from the surrounding tissues to the tumor tissues after photoirradiation might also contribute to the reappearance of PpIX after PDT.
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