Topical Administration of Tetrasodium-Mesotetraphenyl-Porphinesulfonate (TPPS) and Red Light Irradiation for the Treatment of Superficial Neoplastic Lesions

On the dynamics of the TPPS4 aggregation in aqueous solutions: successive formation of H and J aggregates

The dynamics of aggregation of meso-tetrakis (p-sulfonatofenyl) porphyrin (TPPS4) in function of its concentration, pH and ionic strength was studied by optical absorption, fluorescence and resonance light scattering (RLS) techniques. In the region of pH, where TPPS4 exists in biprotonated form, the addition of NaCl induces the TPPS4 aggregation due to the formation of the "cloud" of counter ions around the TPPS4 molecule thus reducing electrostatic repulsion between the porphyrin molecules. The formation of this "cloud" shifts the pKa value to acid region (from 5.0 in the absence of salt to 4.5 at [NaCl] = 0.4 M), reduces the TPPS4 absorption in all spectral range and quantum yield and lifetime of fluorescence (from 0.27 to 0.17 and from 4.00+/-0.04 to 3.00+/-0.03 ns in the absence of salt and in the presence of NaCl, respectively). The aggregation process involves two successive stages: initially H aggregates are formed, which in time are transformed in J ones. The existence of these two stages was confirmed by the fluorescence and RLS data. The kinetics of the formation of J aggregates is characterized by the induction time t1 and the average growth time t2, which depend on both TPPS4 and salt concentrations. The induction period t1 appears as a result of initial formation of H aggregates and their successive transformation in J ones. At very high TPPS4 concentrations, the J aggregates are united in more complex structures such as hollow cylinders or helixes.

Topical photodynamic therapy in dermatology

Although photodynamic therapy (PDT) was first used in the treatment of skin diseases, phase-III-clinical trials were primarily conducted for the treatment of bladder cancer, endobronchial and oesophageal carcinoma. In dermatology PDT has most extensively been used for the treatment of malignant cutaneous lesions. Up to now those patients have been treated systemically with first-generation photosensitizers. However, prolonged skin photosensitivity is a major disadvantage of this form of therapy. Topical PDT utilizing a variety of sensitizers bypass this unwanted effect. Of strong interest is 5-aminolevulinic acid (ALA), first introduced in the topical PDT of skin disorders in 1990 by Kennedy and co-workers. ALA serves as a pro-drug, i.e. the active photosensitizing compound is protoporphyrin IX which is synthesized in vivo after exogenous application of ALA. In several oncologic and non-oncologic skin conditions including non-melanoma skin cancer, premalignant conditions like actinic keratoses and in psoriasis, topical ALA-PDT showed it's effectiveness. Besides ALA, new sensitizers like benzoporphyrines and porphycenes may play a role in topical PDT. However, at the moment, there is still a need for comparative studies and standardized therapeutic protocols to define the place of topical PDT in Dermatology.

Intracellular fluorescence behaviour of meso-tetra(4-sulphonatophenyl)porphyrin during photodynamic treatment at various growth phases of cultured cells

Meso-tetra(4-sulphonatophenyl)porphyrin (TPPS4) taken up by cells is mainly localized in lysosomes as previously shown by fluorescence microscopical and fluorescence spectroscopical investigations. In the present study the intracellular fluorescence behaviour and the intracellular amount of this dye at various growth periods of cells were examined. For cells irradiated in the growth phase a relocalization of TPPS4 from the lysosomes into the cytoplasm and finally into the nucleus was observed. In contrast, for cells irradiated in the stationary phase no redistribution could be detected and therefore no evidence for severe damage of the lysosomal membranes and subsequently for the release of lytical enzymes is given. In both cases lethal damage of the cells was achieved as examined using the trypan blue exclusion test. This indicates that damage of the lysosomes is less important in the photodynamic inactivation of cells sensitized by TPPS4.

Penetration potency of topical applied delta-aminolevulinic acid for photodynamic therapy of basal cell carcinoma

Penetration potency of delta-aminolevulinic acid (ALA) was studied by examining fluorescence of endogenous protoporphyrin IX in different histological types of basal cell carcinoma. Ten basal cell carcinomas were coated with an ointment containing 10% ALA prior to excision; five served as controls. Tumors were excised either 4 h or 12 h after application of ALA using a modified Mohs' micrographic surgical technique. Horizontal sections were cut from deep dermis to tumor surface and examined under a fluorescence microscope. After 4 h of application, only skin appendages demonstrated fluorescence typical of protoporphyrin IX. After 12 h, fluorescence was detectable in tumor cells in deep dermis. The five controls revealed no fluorescence at any site. These results may confirm the high penetration potential of topically applied ALA and its usefulness in photodynamic therapy. For tumors penetrating to deep dermis, an application time of more than 4 h seems necessary, at least when hydrophilic solvents for ALA are used.

Endogenous protoporphyrin IX, a clinically useful photosensitizer for photodynamic therapy

The tissue photosensitizer protoporphyrin IX (PpIX) is an immediate precursor of heme in the biosynthetic pathway for heme. In certain types of cells and tissues, the rate of synthesis of PpIX is determined by the rate of synthesis of 5-aminolevulinic acid (ALA), which in turn is regulated via a feedback control mechanism governed by the concentration of free heme. The presence of exogenous ALA bypasses the feedback control, and thus may induce the intracellular accumulation of photosensitizing concentrations of PpIX. However, this occurs only in certain types of cells and tissues. The resulting tissue-specific photosensitization provides a basis for using ALA-induced PpIX for photodynamic therapy. The topical application of ALA to certain malignant and non-malignant lesions of the skin can induce a clinically useful degree of lesion-specific photosensitization. Superficial basal cell carcinomas showed a complete response rate of approximately 79% following a single exposure to light. Recent preclinical studies in experimental animals and human volunteers indicate that ALA can induce a localized tissue-specific photosensitization if administered by intradermal injection. A generalized but still quite tissue-specific photosensitization may be induced if ALA is administered by either subcutaneous or intraperitoneal injection or by mouth. This opens the possibility of using ALA-induced PpIX to treat tumors that are too thick or that lie too deep to be accessible to either topical or locally injected ALA.

Singlet oxygen generation of porphyrins, chlorins, and phthalocyanines

The production of singlet oxygen was measured indirectly for three classes of photosensitizers: porphyrins (Photofrin II, TPPS4), chlorins (MACE, DACE), and a phthalocyanine (CASPc). Buffered solutions of sensitizers and singlet oxygen acceptors were irradiated with a CW dye laser and the oxygen depletion was monitored electrochemically with a Clark-type microelectrode. A comparison of oxygen-depletion rate constants and quantum efficiencies yields the order of efficiency of the sensitizers: TPPS4 greater than MACE greater than PII greater than DACE greater than CASPc. For singlet oxygen acceptors the order was: furfuryl alcohol greater than imidazole greater than tryptophan. CHO cell suspensions were also used as acceptors. Here the order of efficiency (per absorbed photon) was PII greater than MACE approximately CASPc. Expressed in terms of oxygen depletion per cell the order was CASPc approximately PII greater than MACE. When performing cell clonogenicity studies the order of efficiencies, expressed as percentage cell kill per unit weight of sensitizer, was CASPc greater than PII greater than MACE approximately DACE. The discrepancy between the efficiencies of sensitizers to generate singlet oxygen and their cytotoxicity was explained in terms of photodegradation (for the chlorins), intracellular localization (for PII), and contributions from a Type I mechanism (for CASPc).

Cell survival characteristics of a human colon adenocarcinoma cell line after photodynamic treatment: a comparison of Photofrin II and TPPS

A comparison has been made of the in vitro light-activated drug cytotoxicities of two different porphyrin compounds, Photofrin II and TPPS4. An early passage human colon adenocarcinoma cell line, WiDr, has been exposed to either drug for 24 h, the excess drug washed from the cells and the cells irradiated with light using quartz-tungsten-halogen lamps. Neither light nor drug alone under the experimental conditions employed was toxic to WiDr cells. Together, considerable cytotoxicity could be seen and the shapes of the cell survival curves following exposure to either drug then irradiation with light, were similar. For equal amounts of drug in the medium, Photofrin II was a more efficient photosensitizer of WiDr cells than TPPS4, and differences in cellular uptake could only partly explain this. When the experimental procedure was changed by reducing the temperature of irradiation, a reduction in photosensitizing efficiency could be demonstrated. This was more pronounced for Photofrin II, and was seen as a change in the slope of the final portion of the survival curve; and as a change in the shoulder for TPPS4. Two different batches of the two drugs were compared and shown to give slightly different results for Photofrin II (change in shoulder) but not to differ for TPPS4.