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Aebisher D, Przygórzewska A, Myśliwiec A, Dynarowicz K, Krupka-Olek M, Bożek A, Kawczyk-Krupka A, Bartusik-Aebisher D. Current Photodynamic Therapy for Glioma Treatment: An Update. Biomedicines 2024; 12:375. [PMID: 38397977 PMCID: PMC10886821 DOI: 10.3390/biomedicines12020375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/02/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
Research on the development of photodynamic therapy for the treatment of brain tumors has shown promise in the treatment of this highly aggressive form of brain cancer. Analysis of both in vivo studies and clinical studies shows that photodynamic therapy can provide significant benefits, such as an improved median rate of survival. The use of photodynamic therapy is characterized by relatively few side effects, which is a significant advantage compared to conventional treatment methods such as often-used brain tumor surgery, advanced radiotherapy, and classic chemotherapy. Continued research in this area could bring significant advances, influencing future standards of treatment for this difficult and deadly disease.
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Affiliation(s)
- David Aebisher
- Department of Photomedicine and Physical Chemistry, Medical College of the Rzeszów University, 35-959 Rzeszów, Poland
| | - Agnieszka Przygórzewska
- English Division Science Club, Medical College of the Rzeszów University, 35-025 Rzeszów, Poland;
| | - Angelika Myśliwiec
- Center for Innovative Research in Medical and Natural Sciences, Medical College of the Rzeszów University, 35-310 Rzeszów, Poland; (A.M.); (K.D.)
| | - Klaudia Dynarowicz
- Center for Innovative Research in Medical and Natural Sciences, Medical College of the Rzeszów University, 35-310 Rzeszów, Poland; (A.M.); (K.D.)
| | - Magdalena Krupka-Olek
- Clinical Department of Internal Medicine, Dermatology and Allergology, Medical University of Silesia in Katowice, M. Sklodowskiej-Curie 10, 41-800 Zabrze, Poland; (M.K.-O.); (A.B.)
| | - Andrzej Bożek
- Clinical Department of Internal Medicine, Dermatology and Allergology, Medical University of Silesia in Katowice, M. Sklodowskiej-Curie 10, 41-800 Zabrze, Poland; (M.K.-O.); (A.B.)
| | - Aleksandra Kawczyk-Krupka
- Department of Internal Medicine, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Batorego 15 Street, 41-902 Bytom, Poland
| | - Dorota Bartusik-Aebisher
- Department of Biochemistry and General Chemistry, Medical College of the Rzeszów University, 35-025 Rzeszów, Poland;
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2
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Yang YC, Zhu Y, Sun SJ, Zhao CJ, Bai Y, Wang J, Ma LT. ROS regulation in gliomas: implications for treatment strategies. Front Immunol 2023; 14:1259797. [PMID: 38130720 PMCID: PMC10733468 DOI: 10.3389/fimmu.2023.1259797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/30/2023] [Indexed: 12/23/2023] Open
Abstract
Gliomas are one of the most common primary malignant tumours of the central nervous system (CNS), of which glioblastomas (GBMs) are the most common and destructive type. The glioma tumour microenvironment (TME) has unique characteristics, such as hypoxia, the blood-brain barrier (BBB), reactive oxygen species (ROS) and tumour neovascularization. Therefore, the traditional treatment effect is limited. As cellular oxidative metabolites, ROS not only promote the occurrence and development of gliomas but also affect immune cells in the immune microenvironment. In contrast, either too high or too low ROS levels are detrimental to the survival of glioma cells, which indicates the threshold of ROS. Therefore, an in-depth understanding of the mechanisms of ROS production and scavenging, the threshold of ROS, and the role of ROS in the glioma TME can provide new methods and strategies for glioma treatment. Current methods to increase ROS include photodynamic therapy (PDT), sonodynamic therapy (SDT), and chemodynamic therapy (CDT), etc., and methods to eliminate ROS include the ingestion of antioxidants. Increasing/scavenging ROS is potentially applicable treatment, and further studies will help to provide more effective strategies for glioma treatment.
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Affiliation(s)
- Yu-Chen Yang
- Department of Traditional Chinese Medicine, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, China
| | - Yu Zhu
- College of Health, Dongguan Polytechnic, Dongguan, China
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Si-Jia Sun
- Department of Postgraduate Work, Xi’an Medical University, Xi’an, China
| | - Can-Jun Zhao
- Department of Traditional Chinese Medicine, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, China
| | - Yang Bai
- Department of Neurosurgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Jin Wang
- Department of Radiation Protection Medicine, Faculty of Preventive Medicine, Air Force Medical University (Fourth Military Medical University), Xi’an, China
- Shaanxi Key Laboratory of Free Radical and Medicine, Xi’an, China
| | - Li-Tian Ma
- Department of Traditional Chinese Medicine, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, China
- Key Laboratory of Integrated Traditional Chinese and Western Medicine Tumor Diagnosis and Treatment in Shaanxi Province, Xi’an, China
- Department of Gastroenterology, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, China
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3
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Hsia T, Small JL, Yekula A, Batool SM, Escobedo AK, Ekanayake E, You DG, Lee H, Carter BS, Balaj L. Systematic Review of Photodynamic Therapy in Gliomas. Cancers (Basel) 2023; 15:3918. [PMID: 37568734 PMCID: PMC10417382 DOI: 10.3390/cancers15153918] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 08/13/2023] Open
Abstract
Over the last 20 years, gliomas have made up over 89% of malignant CNS tumor cases in the American population (NIH SEER). Within this, glioblastoma is the most common subtype, comprising 57% of all glioma cases. Being highly aggressive, this deadly disease is known for its high genetic and phenotypic heterogeneity, rendering a complicated disease course. The current standard of care consists of maximally safe tumor resection concurrent with chemoradiotherapy. However, despite advances in technology and therapeutic modalities, rates of disease recurrence are still high and survivability remains low. Given the delicate nature of the tumor location, remaining margins following resection often initiate disease recurrence. Photodynamic therapy (PDT) is a therapeutic modality that, following the administration of a non-toxic photosensitizer, induces tumor-specific anti-cancer effects after localized, wavelength-specific illumination. Its effect against malignant glioma has been studied extensively over the last 30 years, in pre-clinical and clinical trials. Here, we provide a comprehensive review of the three generations of photosensitizers alongside their mechanisms of action, limitations, and future directions.
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Affiliation(s)
- Tiffaney Hsia
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Julia L. Small
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02114, USA
- Chan Medical School, University of Massachusetts, Worcester, MA 01605, USA
| | - Anudeep Yekula
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN 554414, USA
| | - Syeda M. Batool
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Ana K. Escobedo
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Emil Ekanayake
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Dong Gil You
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Hakho Lee
- Center for Systems Biology, Massachusetts General Hospital Research Institute, Boston, MA 02114, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Bob S. Carter
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02215, USA
| | - Leonora Balaj
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02215, USA
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Lioret V, Saou S, Berrou A, Lernerman L, Arnould C, Decréau RA. Water soluble octa-imidazolium zinc phthalocyanine for nucleus/nucleolus cell fluorescence microscopy and photodynamic therapy. Photochem Photobiol Sci 2023; 22:303-309. [PMID: 36201159 DOI: 10.1007/s43630-022-00313-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 09/19/2022] [Indexed: 11/30/2022]
Abstract
A poly-cationic theranostic macrocycle was developed to perform confocal microscopy imaging and photodynamic therapy studies on a model of melanoma cancer, one of the most aggressive cancer. Hence, an octa-imidazolium zinc phthalocyanine was conveniently synthesized in large amount in three steps in a 44% overall yield: upon double nucleophilic aromatic substitution, cyclo-tetramerization and quaternization reactions. Such an octa-cationic molecule was readily soluble in physiological media, reaching concentrations beyond 1 mM. It showed fluorescence properties in aqueous medium (ΦF = 0.31) with no noticeable aggregation, spectroscopy studies showed. In vitro confocal fluorescence microscopy studies carried out on murine melanoma model (B16F10 cells) showed that the fluorophore was mainly located in the cell nucleolus, an organelle of interest for the treatment of cancer. The anticancer photodynamic potential of the octa-cationic photosensitizer could be measured (IC50 = 5.4 µM) using the MTS viability assay. Both fluorescence microscopy studies and photodynamic studies demonstrate the octa-cationic molecule is theranostic and could be further developed for future photodynamic diagnosis (PDD) and photodynamic inactivation of micro-organisms (PDI).
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First Clinical Report of the Intraoperative Macro- and Micro-Photodiagnosis and Photodynamic Therapy Using Talaporfin Sodium for a Patient with Disseminated Lumbar Medulloblastoma. J Clin Med 2023; 12:jcm12020432. [PMID: 36675360 PMCID: PMC9867022 DOI: 10.3390/jcm12020432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/26/2022] [Accepted: 12/30/2022] [Indexed: 01/07/2023] Open
Abstract
Photodiagnosis (PD) and photodynamic therapy (PDT) using the second-generation photosensitizer talaporfin sodium together with an exciting laser for primary intracranial malignant tumors is well recognized in Japan, and many medical institutions are introducing this new therapeutic option. In particular, intraoperative PDT using talaporfin sodium for infiltrating tumor cells in the cavity walls after the resection of malignant glioma is now covered by health insurance after receiving governmental approvement, and this method has been recommended in therapeutic guidelines for primary malignant brain tumors in Japan. On the other hand, experimental and clinical studies on the development of novel therapeutic strategies for malignant spinal cord tumors have not been reported to date, although their histological features are almost identical to those of intracranial malignant tumors. Therefore, the clinical outcomes of malignant spinal cord tumors have been less favorable than those of malignant brain tumors. In this report, we performed the PD and PDT using talaporfin sodium on a patient with a metastatic lumbar lesion that was detected on magnetic resonance image (MRI) 50 months after the resection of cerebellar medulloblastoma who presented with lumbago and sciatica. We were able to detect the target lesion in the conus medullaris using a surgical microscope, and detected the disseminated medulloblastoma cells floating in the cerebrospinal fluid using a compact fluorescence microscope. Furthermore, we performed PDT to the resected lumbar lesion with the adjuvant platinum-based chemotherapy, and the patient survived a meaningful life for more than 2 years after the lumbar surgery. This report describes the first case of a human patient in whom the efficacy of PD and PDT was demonstrated for a malignant spinal cord tumor.
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Rynda AY, Olyushin VE, Rostovtsev DM, Zabrodskaya YM, Ulitin AY, Papayan GV. [Intraoperative photodynamic therapy in complex treatment of malignant gliomas]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2023; 87:25-34. [PMID: 36763550 DOI: 10.17116/neiro20238701125] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Treatment of malignant gliomas is an extremely difficult objective associated with difficult choice of correct strategy. Photodynamic therapy is still not the treatment standard in these patients although this approach significantly improves treatment outcomes in surgery of gliomas. OBJECTIVE To demonstrate the possibilities of chlorin e6-mediated photodynamic therapy for malignant glial tumors. MATERIAL AND METHODS There were 161 patients with malignant supratentorial glial tumors who were treated at the Polenov Russian Neurosurgery Institute between 2009 and 2016. Eighty patients comprised the main group (photodynamic therapy), 81 ones - control group (without photodynamic therapy). RESULTS Photodynamic therapy in complex treatment of malignant brain gliomas significantly increases overall survival in patients with Grade III gliomas up to 39.1±5.5 months (control group - 22.8±3.3 months) and Grade IV gliomas up to 20.7±4.7 months (control group - 13.5±2.3 months) (p=0.0002). This method also increases relapse-free period in patients with Grade III gliomas up to 21.7±3.4 months (control group - 15.8±3.1 months) (p=0.0002) and Grade IV gliomas up to 11.1±2.1 months (control group - 8.0±2.3 months) (p=0.0001).
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Affiliation(s)
- A Yu Rynda
- Polenov Russian Neurosurgery Institute, St. Petersburg, Russia
| | - V E Olyushin
- Polenov Russian Neurosurgery Institute, St. Petersburg, Russia
| | - D M Rostovtsev
- Polenov Russian Neurosurgery Institute, St. Petersburg, Russia
| | | | - A Yu Ulitin
- Polenov Russian Neurosurgery Institute, St. Petersburg, Russia
| | - G V Papayan
- Polenov Russian Neurosurgery Institute, St. Petersburg, Russia
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ROS-Responsive Chlorin e6 and Silk Fibroin Loaded Ultrathin Magnetic Hydroxyapatite Nanorods for T1-Magnetic Resonance Imaging Guided Photodynamic Therapy In Vitro. Colloids Surf A Physicochem Eng Asp 2022. [DOI: 10.1016/j.colsurfa.2022.130513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Correlation of Intraoperative 5-ALA-Induced Fluorescence Intensity and Preoperative 11C-Methionine PET Uptake in Glioma Surgery. Cancers (Basel) 2022; 14:cancers14061449. [PMID: 35326600 PMCID: PMC8946621 DOI: 10.3390/cancers14061449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/01/2022] [Accepted: 03/08/2022] [Indexed: 12/14/2022] Open
Abstract
Simple Summary In malignant brain tumor surgery, precise identification of the tumor is essential. 5-Aminolevulinic acid (5-ALA) labels tumor cells with red fluorescence to facilitate tumor resection. On the other hand, the nuclear medicine imaging technique, positron emission tomography with 11C-methionine (MET-PET), can delineate tumors precisely but is not widely available. This study aimed to determine the correlation between intraoperative 5-ALA-induced fluorescence and preoperative MET-PET signals of gliomas. We quantitatively measured the fluorescence intensity from tumor samples and calculated the MET-PET uptake by the tumor. Our study showed that strong tumor fluorescence correlated with high MET-PET uptake and cellular proliferation. Our findings might be valuable to rapidly provide information on tumor biology at the time of surgery in circumstances where MET-PET is inaccessible. Abstract Background: 5-Aminolevulinic acid (5-ALA) is widely employed to assist fluorescence-guided surgery for malignant brain tumors. Positron emission tomography with 11C-methionine (MET-PET) represents the activity of brain tumors with precise boundaries but is not readily available. We hypothesized that quantitative 5-ALA-induced fluorescence intensity might correlate with MET-PET uptake in gliomas. Methods: Adult patients with supratentorial astrocytic gliomas who underwent preoperative MET-PET and surgical tumor resection using 5-ALA were enrolled in this prospective study. The regional tumor uptake of MET-PET was expressed as the ratio of standardized uptake volume max to that of the normal contralateral frontal lobe. A spectrometric fluorescence detection system measured tumor specimens’ ex vivo fluorescence intensity at 635 nm. Ki-67 index and IDH mutation status were assessed by histopathological analysis. Use of an antiepileptic drug (AED) and contrast enhancement pattern on MRI were also investigated. Results: Thirty-two patients, mostly with Glioblastoma IDH wild type (46.9%) and anaplastic astrocytoma IDH mutant (21.9%), were analyzed. When the fluorescence intensity was ranked into four groups, the strongest fluorescence group exhibited the highest mean MET-PET uptake and Ki-67 index values. When rearranged into fluorescence Visible or Non-visible groups, the Visible group had significantly higher MET-PET uptake and Ki-67 index compared to the Non-visible group. Contrast enhancement on MRI and IDH wild type tumors were more frequent among the Visible group. AED use did not correlate with 5-ALA-induced fluorescence intensity. Conclusions: In astrocytic glioma surgery, visible 5-ALA-induced fluorescence correlated with high MET-PET uptake, along with a high Ki-67 index.
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The Combined Use of 5-ALA and Chlorin e6 Photosensitizers for Fluorescence-Guided Resection and Photodynamic Therapy under Neurophysiological Control for Recurrent Glioblastoma in the Functional Motor Area after Ineffective Use of 5-ALA: Preliminary Results. Bioengineering (Basel) 2022; 9:bioengineering9030104. [PMID: 35324793 PMCID: PMC8945443 DOI: 10.3390/bioengineering9030104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/25/2022] [Accepted: 03/01/2022] [Indexed: 11/17/2022] Open
Abstract
The treatment of glial brain tumors is an unresolved problem in neurooncology, and all existing methods (tumor resection, chemotherapy, radiotherapy, radiosurgery, fluorescence diagnostics, photodynamic therapy, etc.) are directed toward increasing progression-free survival for patients. Fluorescence diagnostics and photodynamic therapy are promising methods for achieving gross total resection and additional treatment of residual parts of the tumor. However, sometimes the use of one photosensitizer for photodynamic therapy does not help, and the time until tumor relapse barely increases. This translational case report describes the preliminary results of the first combined use of 5-ALA and chlorin e6 photosensitizers for fluorescence-guided resection and photodynamic therapy of glioblastoma, which allowed us to perform total resection of tumor tissue according to magnetic resonance and computed tomography images, remove additional tissue with increased fluorescence intensity without neurophysiological consequences, and perform additional therapy. Two months after surgery, no recurrent tumor and no contrast uptake in the tumor bed were detected. Additionally, the patient had ischemic changes in the access zone and along the periphery and cystic-glial changes in the left parietal lobe.
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Matsumae M, Nishiyama J, Kuroda K. Intraoperative MR Imaging during Glioma Resection. Magn Reson Med Sci 2022; 21:148-167. [PMID: 34880193 PMCID: PMC9199972 DOI: 10.2463/mrms.rev.2021-0116] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/11/2021] [Indexed: 11/09/2022] Open
Abstract
One of the major issues in the surgical treatment of gliomas is the concern about maximizing the extent of resection while minimizing neurological impairment. Thus, surgical planning by carefully observing the relationship between the glioma infiltration area and eloquent area of the connecting fibers is crucial. Neurosurgeons usually detect an eloquent area by functional MRI and identify a connecting fiber by diffusion tensor imaging. However, during surgery, the accuracy of neuronavigation can be decreased due to brain shift, but the positional information may be updated by intraoperative MRI and the next steps can be planned accordingly. In addition, various intraoperative modalities may be used to guide surgery, including neurophysiological monitoring that provides real-time information (e.g., awake surgery, motor-evoked potentials, and sensory evoked potential); photodynamic diagnosis, which can identify high-grade glioma cells; and other imaging techniques that provide anatomical information during the surgery. In this review, we present the historical and current context of the intraoperative MRI and some related approaches for an audience active in the technical, clinical, and research areas of radiology, as well as mention important aspects regarding safety and types of devices.
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Affiliation(s)
- Mitsunori Matsumae
- Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Jun Nishiyama
- Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Kagayaki Kuroda
- Department of Human and Information Sciences, School of Information Science and Technology, Tokai University, Hiratsuka, Kanagawa, Japan
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Kobayashi T, Nitta M, Shimizu K, Saito T, Tsuzuki S, Fukui A, Koriyama S, Kuwano A, Komori T, Masui K, Maehara T, Kawamata T, Muragaki Y. Therapeutic Options for Recurrent Glioblastoma—Efficacy of Talaporfin Sodium Mediated Photodynamic Therapy. Pharmaceutics 2022; 14:pharmaceutics14020353. [PMID: 35214085 PMCID: PMC8879869 DOI: 10.3390/pharmaceutics14020353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/28/2022] [Accepted: 02/01/2022] [Indexed: 11/16/2022] Open
Abstract
Recurrent glioblastoma (GBM) remains one of the most challenging clinical issues, with no standard treatment and effective treatment options. To evaluate the efficacy of talaporfin sodium (TS) mediated photodynamic therapy (PDT) as a new treatment for this condition, we retrospectively analyzed 70 patients who underwent surgery with PDT (PDT group) for recurrent GBM and 38 patients who underwent surgery alone (control group). The median progression-free survival (PFS) in the PDT and control groups after second surgery was 5.7 and 2.2 months, respectively (p = 0.0043). The median overall survival (OS) after the second surgery was 16.0 and 12.8 months, respectively (p = 0.031). Both univariate and multivariate analyses indicated that surgery with PDT and a preoperative Karnofsky Performance Scale were significant independent prognostic factors for PFS and OS. In the PDT group, there was no significant difference regarding PFS and OS between patients whose previous pathology before recurrence was already GBM and those who had malignant transformation to GBM from lower grade glioma. There was also no significant difference in TS accumulation in the tumor between these two groups. According to these results, additional PDT treatment for recurrent GBM could have potential survival benefits and its efficacy is independent of the pre-recurrence pathology.
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Affiliation(s)
- Tatsuya Kobayashi
- Department of Neurosurgery, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan; (T.K.); (T.S.); (S.T.); (A.F.); (S.K.); (A.K.); (T.K.); (Y.M.)
| | - Masayuki Nitta
- Department of Neurosurgery, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan; (T.K.); (T.S.); (S.T.); (A.F.); (S.K.); (A.K.); (T.K.); (Y.M.)
- Faculty of Advanced Techno-Surgery, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan
- Correspondence:
| | - Kazuhide Shimizu
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge Street, Boston, MA 02114, USA;
- Department of Neurosurgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan;
| | - Taiichi Saito
- Department of Neurosurgery, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan; (T.K.); (T.S.); (S.T.); (A.F.); (S.K.); (A.K.); (T.K.); (Y.M.)
- Faculty of Advanced Techno-Surgery, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Shunsuke Tsuzuki
- Department of Neurosurgery, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan; (T.K.); (T.S.); (S.T.); (A.F.); (S.K.); (A.K.); (T.K.); (Y.M.)
| | - Atsushi Fukui
- Department of Neurosurgery, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan; (T.K.); (T.S.); (S.T.); (A.F.); (S.K.); (A.K.); (T.K.); (Y.M.)
| | - Shunichi Koriyama
- Department of Neurosurgery, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan; (T.K.); (T.S.); (S.T.); (A.F.); (S.K.); (A.K.); (T.K.); (Y.M.)
| | - Atsushi Kuwano
- Department of Neurosurgery, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan; (T.K.); (T.S.); (S.T.); (A.F.); (S.K.); (A.K.); (T.K.); (Y.M.)
| | - Takashi Komori
- Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu-shi, Tokyo 183-0042, Japan;
| | - Kenta Masui
- Department of Pathology, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan;
| | - Taketoshi Maehara
- Department of Neurosurgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan;
| | - Takakazu Kawamata
- Department of Neurosurgery, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan; (T.K.); (T.S.); (S.T.); (A.F.); (S.K.); (A.K.); (T.K.); (Y.M.)
| | - Yoshihiro Muragaki
- Department of Neurosurgery, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan; (T.K.); (T.S.); (S.T.); (A.F.); (S.K.); (A.K.); (T.K.); (Y.M.)
- Faculty of Advanced Techno-Surgery, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan
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12
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Kozlikina EI, Efendiev KT, Grigoriev AY, Bogdanova OY, Trifonov IS, Krylov VV, Loschenov VB. A Pilot Study of Fluorescence-Guided Resection of Pituitary Adenomas with Chlorin e6 Photosensitizer. Bioengineering (Basel) 2022; 9:bioengineering9020052. [PMID: 35200407 PMCID: PMC8869665 DOI: 10.3390/bioengineering9020052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 12/13/2022] Open
Abstract
Fluorescence diagnostics is one of the promising methods for intraoperative detection of brain tumor boundaries and helps in maximizing the extent of resection. This paper presents the results of a pilot study on the first use of the chlorin e6 photosensitizer and a two-channel video system for fluorescence-guided resection of pituitary adenomas. The study’s clinical part involved two patients diagnosed with hormonally inactive pituitary macroadenomas and one patient with a hormonally active one. All neoplasms had different sizes and growth patterns. The data showed accumulation of chlorin e6 in tumor tissues in high concentrations: Patient 1: 2 mg/kg, Patient 2: 5 mg/kg, and Patient 3: 4 mg/kg. For Patient 1, the residual part of the tumor was not resected since it was intimately attached to the anterior genu of the internal carotid artery. For Patients 2 and 3, no regions of increased Ce6 accumulation were detected in the tumor foci after resection. Therefore, the use of the Ce6 and a two-channel video system helped to achieve a high degree of tumor resection in each case.
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Affiliation(s)
- Elizaveta I. Kozlikina
- Prokhorov General Physics Institute of the Russian Academy of Sciences, 119991 Moscow, Russia; (K.T.E.); (V.B.L.)
- Institute for Physics and Engineering in Biomedicine, National Research Nuclear University MEPhI, 115409 Moscow, Russia
- Correspondence:
| | - Kanamat T. Efendiev
- Prokhorov General Physics Institute of the Russian Academy of Sciences, 119991 Moscow, Russia; (K.T.E.); (V.B.L.)
- Institute for Physics and Engineering in Biomedicine, National Research Nuclear University MEPhI, 115409 Moscow, Russia
| | - Andrey Yu. Grigoriev
- Federal State Budgetary Educational Institution of Higher Education “A.I. Evdokimov Moscow State University of Medicine and Dentistry”, The Ministry of Healthcare of the Russian Federation, 127473 Moscow, Russia; (A.Y.G.); (O.Y.B.); (I.S.T.); (V.V.K.)
- The National Medical Research Centre for Endocrinology, 117292 Moscow, Russia
| | - Olesia Y. Bogdanova
- Federal State Budgetary Educational Institution of Higher Education “A.I. Evdokimov Moscow State University of Medicine and Dentistry”, The Ministry of Healthcare of the Russian Federation, 127473 Moscow, Russia; (A.Y.G.); (O.Y.B.); (I.S.T.); (V.V.K.)
| | - Igor S. Trifonov
- Federal State Budgetary Educational Institution of Higher Education “A.I. Evdokimov Moscow State University of Medicine and Dentistry”, The Ministry of Healthcare of the Russian Federation, 127473 Moscow, Russia; (A.Y.G.); (O.Y.B.); (I.S.T.); (V.V.K.)
| | - Vladimir V. Krylov
- Federal State Budgetary Educational Institution of Higher Education “A.I. Evdokimov Moscow State University of Medicine and Dentistry”, The Ministry of Healthcare of the Russian Federation, 127473 Moscow, Russia; (A.Y.G.); (O.Y.B.); (I.S.T.); (V.V.K.)
| | - Victor B. Loschenov
- Prokhorov General Physics Institute of the Russian Academy of Sciences, 119991 Moscow, Russia; (K.T.E.); (V.B.L.)
- Institute for Physics and Engineering in Biomedicine, National Research Nuclear University MEPhI, 115409 Moscow, Russia
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13
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Rynda AY, Olyushin VE, Rostovtsev DM, Zabrodskaya YM, Papayan GV. [Comparative analysis of 5-ALA and chlorin E6 fluorescence-guided navigation in malignant glioma surgery]. Khirurgiia (Mosk) 2022:5-14. [PMID: 35080821 DOI: 10.17116/hirurgia20220115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To analyze specificity and sensitivity of 5-ALA and chlorin E6 fluorescence-guided navigation in malignant glioma surgery. MATERIAL AND METHODS Fluorescence-guided navigation was analyzed in 50 patients (2 groups) with high-grade glioma. All patients were treated at the Polenov Russian Neurosurgery Institute. Chlorin E6 1 mg/kg intravenously (Photoditazin) was used as a fluorescence inducer in 25 patients (the 1st group), 5-ALA 20 mg/kg orally (Alasens) - in other 25 patients (the 2nd group). Each group included 10 patients with glioma grade III and 15 patients with glioma grade IV. Both groups were statistically representative (p>0.05). RESULTS In patients with glioma grade III, sensitivity of chlorin E6 fluorescence-guided navigation was 83.8%, 5-ALA fluorescence - 82.5%. Specificity was 66.7% and 64.1%, respectively. In patients with glioma grade IV, sensitivity was 87.7% for chlorin E6 and 88.3% for 5-ALA. Specificity was 85.2% and 88.1%, respectively. CONCLUSION Statistical analysis confirmed comparable high efficacy of both agents in surgery of malignant gliomas. Sensitivity and specificity of fluorescence-guided navigation with chlorin E6 and 5-ALA were similar (p>0.05).
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Affiliation(s)
- A Yu Rynda
- Polenov Russian Neurosurgery Institute of the Branch of the Almazov National Medical Research Center, St. Petersburg, Russia
| | - V E Olyushin
- Polenov Russian Neurosurgery Institute of the Branch of the Almazov National Medical Research Center, St. Petersburg, Russia
| | - D M Rostovtsev
- Polenov Russian Neurosurgery Institute of the Branch of the Almazov National Medical Research Center, St. Petersburg, Russia
| | - Yu M Zabrodskaya
- Polenov Russian Neurosurgery Institute of the Branch of the Almazov National Medical Research Center, St. Petersburg, Russia
| | - G V Papayan
- Polenov Russian Neurosurgery Institute of the Branch of the Almazov National Medical Research Center, St. Petersburg, Russia
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14
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Dubey T, Chinnathambi S. Photodynamic treatment modulates various GTPase and cellular signalling pathways in Tauopathy. Small GTPases 2022; 13:183-195. [PMID: 34138681 PMCID: PMC9707546 DOI: 10.1080/21541248.2021.1940722] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
The application of photo-excited dyes for treatment is known as photodynamic therapy (PDT). PDT is known to target GTPase proteins in cells, which are the key proteins of diverse signalling cascades which ultimately modulate cell proliferation and death. Cytoskeletal proteins play critical roles in maintaining cell integrity and cell division. Whereas, it was also observed that in neuronal cells PDT modulated actin and tubulin resulting in increased neurite growth and filopodia. Recent studies supported the role of PDT in dissolving the extracellular amyloid beta aggregates and intracellular Tau aggregates, which indicated the potential role of PDT in neurodegeneration. The advancement in the field of PDT led to its clinical approval in treatment of cancers, brain tumour, and dermatological acne. Although several question need to be answered for application of PDT in neuronal cells, but the primary studies gave a hint that it can emerge as potential therapy in neural cells.
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Affiliation(s)
- Tushar Dubey
- Neurobiology Group, Division of Biochemical Sciences, CSIR-National Chemical Laboratory, Pune, India.,Academy of Scientific and Innovative Research (Acsir), Ghaziabad, India
| | - Subashchandrabose Chinnathambi
- Neurobiology Group, Division of Biochemical Sciences, CSIR-National Chemical Laboratory, Pune, India.,Academy of Scientific and Innovative Research (Acsir), Ghaziabad, India
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15
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Akimoto J, Fukami S, Ichikawa M, Nagai K, Kohno M. Preliminary Report: Rapid Intraoperative Detection of Residual Glioma Cell in Resection Cavity Walls Using a Compact Fluorescence Microscope. J Clin Med 2021; 10:jcm10225375. [PMID: 34830662 PMCID: PMC8620805 DOI: 10.3390/jcm10225375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 11/21/2022] Open
Abstract
Objective: The surgical eradication of malignant glioma cells is theoretically impossible. Therefore, reducing the number of remaining tumor cells around the brain–tumor interface (BTI) is crucial for achieving satisfactory clinical results. The usefulness of fluorescence–guided resection for the treatment of malignant glioma was recently reported, but the detection of infiltrating tumor cells in the BTI using a surgical microscope is not realistic. Therefore, we have developed an intraoperative rapid fluorescence cytology system, and exploratorily evaluated its clinical feasibility for the management of malignant glioma. Materials and methods: A total of 25 selected patients with malignant glioma (newly diagnosed: 17; recurrent: 8) underwent surgical resection under photodiagnosis using photosensitizer Talaporfin sodium and a semiconductor laser. Intraoperatively, a crush smear preparation was made from a tiny amount of tumor tissue, and the fluorescence emitted upon 620/660 nm excitation was evaluated rapidly using a compact fluorescence microscope in the operating theater. Results: Fluorescence intensities of tumor tissues measured using a surgical microscope correlated with the tumor cell densities of tissues evaluated by measuring the red fluorescence emitted from the cytoplasm of tumor cells using a fluorescence microscope. A “weak fluorescence” indicated a reduction in the tumor cell density, whereas “no fluorescence” did not indicate the complete eradication of the tumor cells, but indicated that few tumor cells were emitting fluorescence. Conclusion: The rapid intraoperative detection of fluorescence from glioma cells using a compact fluorescence microscope was probably useful to evaluate the presence of tumor cells in the resection cavity walls, and could provide surgical implications for the more complete resection of malignant gliomas.
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Affiliation(s)
- Jiro Akimoto
- Department of Neurosurgery, Kohsei Chuo General Hospital, Tokyo 153-0062, Japan
- Department of Neurosurgery, Tokyo Medical University, Tokyo 160-8402, Japan; (S.F.); (M.I.); (K.N.); (M.K.)
- Correspondence:
| | - Shinjiro Fukami
- Department of Neurosurgery, Tokyo Medical University, Tokyo 160-8402, Japan; (S.F.); (M.I.); (K.N.); (M.K.)
| | - Megumi Ichikawa
- Department of Neurosurgery, Tokyo Medical University, Tokyo 160-8402, Japan; (S.F.); (M.I.); (K.N.); (M.K.)
| | - Kenta Nagai
- Department of Neurosurgery, Tokyo Medical University, Tokyo 160-8402, Japan; (S.F.); (M.I.); (K.N.); (M.K.)
| | - Michihiro Kohno
- Department of Neurosurgery, Tokyo Medical University, Tokyo 160-8402, Japan; (S.F.); (M.I.); (K.N.); (M.K.)
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16
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Rynda AY, Zabrodskaya YM, Olyushin VE, Rostovtsev DM, Sokolova TV, Papayan GV. [Morphological evaluation of the effectiveness of fluorescence navigation with chlorin e6 in surgery for malignant gliomas]. Arkh Patol 2021; 83:13-20. [PMID: 34609799 DOI: 10.17116/patol20218305113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of fluorescence navigation with chlorin e6 in surgery for malignant gliomas based on surgical material morphological and immunohistochemical data. MATERIAL AND METHODS The surgical material obtained from patients with high-grade (Grade III-IV) anaplastic glioma was examined. Along with histological examination, the proliferation marker Ki-67, the cell cycle transcription factor protein p53, and vascular endothelial growth factor (VEGF) were determined. RESULTS A significant direct correlation was found between the expression of Ki-67, p53, and VEGF and the fluorescence intensity of tumor tissues (p<0.05). CONCLUSION The technique of fluorescence navigation using chlorin e6 in comparative morphopathological analysis has confirmed its effectiveness in surgery for malignant gliomas.
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Affiliation(s)
- A Yu Rynda
- Prof. A.L. Polenov Russian Neurosurgical Institute - Branch V.A. Almazov National Medical Research Center of the Ministry of Health of Russia, Saint Petersburg, Russia
| | - Yu M Zabrodskaya
- Prof. A.L. Polenov Russian Neurosurgical Institute - Branch V.A. Almazov National Medical Research Center of the Ministry of Health of Russia, Saint Petersburg, Russia
| | - V E Olyushin
- Prof. A.L. Polenov Russian Neurosurgical Institute - Branch V.A. Almazov National Medical Research Center of the Ministry of Health of Russia, Saint Petersburg, Russia
| | - D M Rostovtsev
- Prof. A.L. Polenov Russian Neurosurgical Institute - Branch V.A. Almazov National Medical Research Center of the Ministry of Health of Russia, Saint Petersburg, Russia
| | - T V Sokolova
- Prof. A.L. Polenov Russian Neurosurgical Institute - Branch V.A. Almazov National Medical Research Center of the Ministry of Health of Russia, Saint Petersburg, Russia
| | - G V Papayan
- Prof. A.L. Polenov Russian Neurosurgical Institute - Branch V.A. Almazov National Medical Research Center of the Ministry of Health of Russia, Saint Petersburg, Russia
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17
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Rynda AY, Olyushin VE, Rostovtsev DM, Zabrodskaya YM, Tastanbekov MM, Papayan GV. [Intraoperative fluorescence control with chlorin E6 in resection of glial brain tumors]. ZHURNAL VOPROSY NEĬROKHIRURGII IMENI N. N. BURDENKO 2021; 85:20-28. [PMID: 34463447 DOI: 10.17116/neiro20218504120] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In recent years, fluorescence navigation has been increasingly used in surgery for gliomas. In most studies, 5-ALA derivatives are used as fluorescence inducers. However, there are few data regarding E6 chlorin for these purposes. OBJECTIVE To evaluate an effectiveness and feasibility of fluorescence navigation with chlorin E6 in surgery of brain gliomas. MATERIAL AND METHODS The study included 30 patients with glial brain tumors grade II-IV. All patients were operated at the Polenov Russian Neurosurgical Institute. We used surgical microscope (Leica OHS-1), D-Light AF System (Karl Storz, Germany), original fluorescence module (St. Petersburg LOMO, developed by G.V. Papayan) and special software RSS Cam - Endo 1.4.313 for visual analysis of fluorescence. Histological examination included hematoxylin-eosin staining of specimens and immunohistochemical studies. RESULTS Fluorescence was weak in all patients with Grade II gliomas and strong in almost all patients with Grade III-IV gliomas. Sensitivity of fluorescence diagnosis with chlorin E6 was 72.2% for Grade II gliomas, 83.8% for Grade III gliomas and 87.7% for Grade IV. Specificity of this method was 60% for Grade II gliomas, 66.7% for Grade III gliomas and 85.2% for Grade IV. CONCLUSION Certain method of fluorescence imaging ensured resection of glial brain tumors using chlorin E6. Intensity of tumor fluorescence correlated with glioma malignancy grade. These results indicate that chlorin E6 is an effective photosensitizer for intraoperative fluorescence diagnosis in surgery for glioma.
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Affiliation(s)
- A Yu Rynda
- Polenov Russian Neurosurgical Institute, St. Petersburg, Russia
| | - V E Olyushin
- Polenov Russian Neurosurgical Institute, St. Petersburg, Russia
| | - D M Rostovtsev
- Polenov Russian Neurosurgical Institute, St. Petersburg, Russia
| | | | - M M Tastanbekov
- Polenov Russian Neurosurgical Institute, St. Petersburg, Russia
| | - G V Papayan
- Polenov Russian Neurosurgical Institute, St. Petersburg, Russia
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18
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Ibarra LE, Vilchez ML, Caverzán MD, Milla Sanabria LN. Understanding the glioblastoma tumor biology to optimize photodynamic therapy: From molecular to cellular events. J Neurosci Res 2020; 99:1024-1047. [PMID: 33370846 DOI: 10.1002/jnr.24776] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 11/29/2020] [Indexed: 12/19/2022]
Abstract
Photodynamic therapy (PDT) has recently gained attention as an alternative treatment of malignant gliomas. Glioblastoma (GBM) is the most prevalent within tumors of the central nervous system (CNS). Conventional treatments for this CNS tumor include surgery, radiation, and chemotherapy. Surgery is still being considered as the treatment of choice. Even so, the poor prognosis and/or recurrence of the disease after applying any of these treatments highlight the urgency of exploring new therapies and/or improving existing ones to achieve the definitive eradication of tumor masses and remaining cells. PDT is a therapeutic modality that involves the destruction of tumor cells by reactive oxygen species induced by light, which were previously treated with a photosensitizing agent. However, in recent years, its experimental application has expanded to other effects that could improve overall performance against GBM. In the current review, we revisit the main advances of PDT for GBM management and also, the recent mechanistic insights about cellular and molecular aspects related to tumoral resistance to PDT of GBM.
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Affiliation(s)
- Luis Exequiel Ibarra
- Instituto de Biotecnología Ambiental y Salud (INBIAS), Universidad Nacional de Río Cuarto (UNRC) y Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Río Cuarto, Argentina.,Departamento de Biología Molecular, Facultad de Ciencias Exactas Físico-Químicas y Naturales, UNRC, Río Cuarto, Argentina
| | - María Laura Vilchez
- Instituto de Biotecnología Ambiental y Salud (INBIAS), Universidad Nacional de Río Cuarto (UNRC) y Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Río Cuarto, Argentina.,Departamento de Biología Molecular, Facultad de Ciencias Exactas Físico-Químicas y Naturales, UNRC, Río Cuarto, Argentina
| | - Matías Daniel Caverzán
- Departamento de Biología Molecular, Facultad de Ciencias Exactas Físico-Químicas y Naturales, UNRC, Río Cuarto, Argentina
| | - Laura Natalia Milla Sanabria
- Instituto de Biotecnología Ambiental y Salud (INBIAS), Universidad Nacional de Río Cuarto (UNRC) y Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Río Cuarto, Argentina.,Departamento de Biología Molecular, Facultad de Ciencias Exactas Físico-Químicas y Naturales, UNRC, Río Cuarto, Argentina
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19
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Gries M, Thomas N, Daouk J, Rocchi P, Choulier L, Jubréaux J, Pierson J, Reinhard A, Jouan-Hureaux V, Chateau A, Acherar S, Frochot C, Lux F, Tillement O, Barberi-Heyob M. Multiscale Selectivity and in vivo Biodistribution of NRP-1 -Targeted Theranostic AGuIX Nanoparticles for PDT of Glioblastoma. Int J Nanomedicine 2020; 15:8739-8758. [PMID: 33223826 PMCID: PMC7673487 DOI: 10.2147/ijn.s261352] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/27/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Local recurrences of glioblastoma (GBM) after heavy standard treatments remain frequent and lead to a poor prognostic. Major challenges are the infiltrative part of the tumor tissue which is the ultimate cause of recurrence. The therapeutic arsenal faces the difficulty of eradicating this infiltrating part of the tumor tissue while increasing the targeting of tumor and endogenous stromal cells such as angiogenic endothelial cells. In this aim, neuropilin-1 (NRP-1), a transmembrane receptor mainly overexpressed by endothelial cells of the tumor vascular system and associated with malignancy, proliferation and migration of GBM, highlighted to be a relevant molecular target to promote the anti-vascular effect of photodynamic therapy (VTP). METHODS The multiscale selectivity was investigated for KDKPPR peptide moiety targeting NRP-1 and a porphyrin molecule as photosensitizer (PS), both grafted onto original AGuIX design nanoparticle. AGuIX nanoparticle, currently in Phase II clinical trials for the treatment of brain metastases with radiotherapy, allows to achieve a real-time magnetic resonance imaging (MRI) and an accumulation in the tumor area by EPR (enhanced permeability and retention) effect. Using surface-plasmon resonance (SPR), we evaluated the affinities of KDKPPR and scramble free peptides, and also peptides-conjugated AGuIX nanoparticles to recombinant rat and human NRP-1 proteins. For in vivo selectivity, we used a cranial window model and parametric maps obtained from T2*-weighted perfusion MRI analysis. RESULTS The photophysical characteristics of the PS and KDKPPR molecular affinity for recombinant human NRP-1 proteins were maintained after the functionalization of AGuIX nanoparticle with a dissociation constant of 4.7 μM determined by SPR assays. Cranial window model and parametric maps, both revealed a prolonged retention in the vascular system of human xenotransplanted GBM. Thanks to the fluorescence of porphyrin by non-invasive imaging and the concentration of gadolinium evaluated after extraction of organs, we checked the absence of nanoparticle in the brains of tumor-free animals and highlighted elimination by renal excretion and hepatic metabolism. CONCLUSION Post-VTP follow-ups demonstrated promising tumor responses with a prolonged delay in tumor growth accompanied by a decrease in tumor metabolism.
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Affiliation(s)
- Mickaël Gries
- Université de Lorraine, Centre National de la Recherche Scientifique (CNRS), Research Center for Automatic Control of Nancy (CRAN), Nancy, France
| | - Noémie Thomas
- Université de Lorraine, Centre National de la Recherche Scientifique (CNRS), Research Center for Automatic Control of Nancy (CRAN), Nancy, France
| | - Joël Daouk
- Université de Lorraine, Centre National de la Recherche Scientifique (CNRS), Research Center for Automatic Control of Nancy (CRAN), Nancy, France
| | - Paul Rocchi
- Université de Lyon, CNRS, Institut Lumière Matière, Lyon, France
| | - Laurence Choulier
- Université de Strasbourg, CNRS, Laboratory of Bioimaging and Pathologies, Illkirch, France
| | - Justine Jubréaux
- Université de Lorraine, Centre National de la Recherche Scientifique (CNRS), Research Center for Automatic Control of Nancy (CRAN), Nancy, France
| | - Julien Pierson
- Université de Lorraine, Centre National de la Recherche Scientifique (CNRS), Research Center for Automatic Control of Nancy (CRAN), Nancy, France
| | - Aurélie Reinhard
- Université de Lorraine, Centre National de la Recherche Scientifique (CNRS), Research Center for Automatic Control of Nancy (CRAN), Nancy, France
| | - Valérie Jouan-Hureaux
- Université de Lorraine, Centre National de la Recherche Scientifique (CNRS), Research Center for Automatic Control of Nancy (CRAN), Nancy, France
| | - Alicia Chateau
- Université de Lorraine, Centre National de la Recherche Scientifique (CNRS), Research Center for Automatic Control of Nancy (CRAN), Nancy, France
| | - Samir Acherar
- Université de Lorraine, CNRS, Laboratoire de Chimie-Physique Macromoléculaire, Nancy, France
| | - Céline Frochot
- Université de Lorraine, CNRS, Laboratoire Réactions et Génie des Procédés, Nancy, France
| | - François Lux
- Université de Lyon, CNRS, Institut Lumière Matière, Lyon, France
- Université de Strasbourg, CNRS, Laboratory of Bioimaging and Pathologies, Illkirch, France
- Université de Lorraine, CNRS, Laboratoire de Chimie-Physique Macromoléculaire, Nancy, France
- Université de Lorraine, CNRS, Laboratoire Réactions et Génie des Procédés, Nancy, France
- Institut Universitaire de France, Paris, France
| | | | - Muriel Barberi-Heyob
- Université de Lorraine, Centre National de la Recherche Scientifique (CNRS), Research Center for Automatic Control of Nancy (CRAN), Nancy, France
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20
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Therapeutic pathomorphosis in malignant glioma tissues after photodynamic therapy with сhlorin e6 (reports of two clinical cases). BIOMEDICAL PHOTONICS 2020. [DOI: 10.24931/2413-9432-2020-9-2-45-54] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In recent years, photodynamic therapy (PDT) has been increasingly introduced into the surgical practice of treating malignant neoplasms. In this publication, the authors show the appearance of therapeutic pathomorphosis in vivo in human malignant glioma cells after intraoperative photodynamic therapy. Tissue samples obtained 10–14 days after PDT revealed nuclear and cytoplasmic signs indicating apoptosis, necrosis, and autophagy. A decrease in the proliferative activity of glial tumor cells and their higher death count were detected.. Immunohistochemical analysis shows decreases expression of Ki-67 cell proliferation marker and decreased amount of transcription factor protein p53.
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21
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Ibarra LE, Beaugé L, Arias-Ramos N, Rivarola VA, Chesta CA, López-Larrubia P, Palacios RE. Trojan horse monocyte-mediated delivery of conjugated polymer nanoparticles for improved photodynamic therapy of glioblastoma. Nanomedicine (Lond) 2020; 15:1687-1707. [DOI: 10.2217/nnm-2020-0106] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Aim: To assess monocyte-based delivery of conjugated polymer nanoparticles (CPNs) for improved photodynamic therapy (PDT) in glioblastoma (GBM). Materials & methods: Human monocyte cells (THP-1) and murine monocytes isolated from bone marrow (mBMDMs) were employed as stealth CPN carriers to penetrate into GBM spheroids and an orthotopic model of the tumor. The success of PDT, using this cell-mediated targeting strategy, was determined by its effect on the spheroids. Results: CPNs did not affect monocyte viability in the absence of light and did not show nonspecific release after cell loading. Activated monocytes incorporated CPNs in a higher proportion than monocytes in their naive state, without a loss of cellular functionality. In vitro PDT efficacy using cell-mediated delivery was superior to that using non vehiculized CPNs. Conclusion: CPN-loaded monocytes could efficiently deliver CPNs into GBM spheroids and the orthotopic model. Improved PDT in spheroids was confirmed using this delivery strategy.
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Affiliation(s)
- Luis E Ibarra
- Instituto de Biotecnología Ambiental y Salud (INBIAS), Universidad Nacional de Río Cuarto (UNRC) y Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Río Cuarto, 5800, Córdoba, Argentina
- Departamento de Biología Molecular, Facultad de Ciencias Exactas Fisicoquímicas y Naturales, UNRC, Río Cuarto, 5800, Córdoba, Argentina
| | - Lucía Beaugé
- Departamento de Biología Molecular, Facultad de Ciencias Exactas Fisicoquímicas y Naturales, UNRC, Río Cuarto, 5800, Córdoba, Argentina
| | - Nuria Arias-Ramos
- Instituto de Investigaciones Biomédicas “Alberto Sols”, CSIC/UAM, Madrid, 28029, España
| | - Viviana A Rivarola
- Instituto de Biotecnología Ambiental y Salud (INBIAS), Universidad Nacional de Río Cuarto (UNRC) y Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Río Cuarto, 5800, Córdoba, Argentina
- Departamento de Biología Molecular, Facultad de Ciencias Exactas Fisicoquímicas y Naturales, UNRC, Río Cuarto, 5800, Córdoba, Argentina
| | - Carlos A Chesta
- Instituto de Investigaciones en Tecnologías Energéticas y Materiales Avanzados (IITEMA), Universidad Nacional de Río Cuarto (UNRC) y CONICET, Río Cuarto, 5800, Córdoba, Argentina
- Departamento de Química, Facultad de Ciencias Exactas Fisicoquímicas y Naturales, UNRC, Río Cuarto, 5800, Córdoba, Argentina
| | - Pilar López-Larrubia
- Instituto de Investigaciones Biomédicas “Alberto Sols”, CSIC/UAM, Madrid, 28029, España
| | - Rodrigo E Palacios
- Instituto de Investigaciones en Tecnologías Energéticas y Materiales Avanzados (IITEMA), Universidad Nacional de Río Cuarto (UNRC) y CONICET, Río Cuarto, 5800, Córdoba, Argentina
- Departamento de Química, Facultad de Ciencias Exactas Fisicoquímicas y Naturales, UNRC, Río Cuarto, 5800, Córdoba, Argentina
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22
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Using Light for Therapy of Glioblastoma Multiforme (GBM). Brain Sci 2020; 10:brainsci10020075. [PMID: 32024010 PMCID: PMC7071600 DOI: 10.3390/brainsci10020075] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/16/2020] [Accepted: 01/27/2020] [Indexed: 12/22/2022] Open
Abstract
: Glioblastoma multiforme (GBM) is the most malignant form of primary brain tumour with extremely poor prognosis. The current standard of care for newly diagnosed GBM includes maximal surgical resection followed by radiotherapy and adjuvant chemotherapy. The introduction of this protocol has improved overall survival, however recurrence is essentially inevitable. The key reason for that is that the surgical treatment fails to eradicate GBM cells completely, and adjacent parenchyma remains infiltrated by scattered GBM cells which become the source of recurrence. This stimulates interest to any supplementary methods which could help to destroy residual GBM cells and fight the infiltration. Photodynamic therapy (PDT) relies on photo-toxic effects induced by specific molecules (photosensitisers) upon absorption of photons from a light source. Such toxic effects are not specific to a particular molecular fingerprint of GBM, but rather depend on selective accumulation of the photosensitiser inside tumour cells or, perhaps their greater sensitivity to the effects, triggered by light. This gives hope that it might be possible to preferentially damage infiltrating GBM cells within the areas which cannot be surgically removed and further improve the chances of survival if an efficient photosensitiser and hardware for light delivery into the brain tissue are developed. So far, clinical trials with PDT were performed with one specific type of photosensitiser, protoporphyrin IX, which tends to accumulate in the cytoplasm of the GBM cells. In this review we discuss the idea that other types of molecules which build up in mitochondria could be explored as photosensitisers and used for PDT of these aggressive brain tumours.
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23
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Nompumelelo Simelane NW, Kruger CA, Abrahamse H. Photodynamic diagnosis and photodynamic therapy of colorectal cancer in vitro and in vivo. RSC Adv 2020; 10:41560-41576. [PMID: 35516575 PMCID: PMC9058000 DOI: 10.1039/d0ra08617g] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/08/2020] [Indexed: 02/06/2023] Open
Abstract
This review highlights the various photo diagnostic and treatment methods utilized for CRC, over the last seven years.
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Affiliation(s)
| | - Cherie Ann Kruger
- Laser Research Centre
- Faculty of Health Sciences
- University of Johannesburg
- Johannesburg 2028
- South Africa
| | - Heidi Abrahamse
- Laser Research Centre
- Faculty of Health Sciences
- University of Johannesburg
- Johannesburg 2028
- South Africa
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Valli D, Belykh E, Zhao X, Gandhi S, Cavallo C, Martirosyan NL, Nakaji P, Lawton MT, Preul MC. Development of a Simulation Model for Fluorescence-Guided Brain Tumor Surgery. Front Oncol 2019; 9:748. [PMID: 31475107 PMCID: PMC6706957 DOI: 10.3389/fonc.2019.00748] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/25/2019] [Indexed: 12/11/2022] Open
Abstract
Objective: Fluorescence dyes are increasingly used in brain tumor surgeries, and thus the development of simulation models is important for teaching neurosurgery trainees how to perform fluorescence-guided operations. We aimed to create a tumor model for fluorescence-guided surgery in high-grade glioma (HGG). Methods: The tumor model was generated by the following steps: creating a tumor gel with a similar consistency to HGG, selecting fluorophores at optimal concentrations with realistic color, mixing the fluorophores with tumor gel, injecting the gel into fresh pig/sheep brain, and testing resection of the tumor model under a fluorescence microscope. The optimal tumor gel was selected among different combinations of agar and gelatin. The fluorophores included fluorescein, indocyanine green (ICG), europium, chlorin e6 (Ce6), and protoporphyrin IX (PpIX). The tumor model was tested by neurosurgeons and neurosurgery trainees, and a survey was used to assess the validity of the model. In addition, the photobleaching phenomenon was studied to evaluate its influence on fluorescence detection. Results: The best tumor gel formula in terms of consistency and tactile response was created using 100 mL water at 100°C, 0.5 g of agar, and 3 g of gelatin mixed thoroughly for 3 min. An additional 1 g of agar was added when the tumor gel cooled to 50°C. The optimal fluorophore concentration ranges were fluorescein 1.9 × 10−4 to 3.8 × 10−4 mg/mL, ICG 4.9 × 10−3 to 9.8 × 10−3 mg/mL, europium 7.0 × 10−2 to 1.4 × 10−1 mg/mL, Ce6 2.2 × 10−3 to 4.4 × 10−3 mg/mL, and PpIX 1.8 × 10−2 to 3.5 × 10−2 mg/mL. No statistical differences among fluorophores were found for face validity, content validity, and fluorophore preference. Europium, ICG, and fluorescein were shown to be relatively stable during photobleaching experiments, while chlorin e6 and PpIX had lower stability. Conclusions: The model can efficiently highlight the “tumor” with 3 different colors—green, yellow, or infrared green with color overlay. These models showed high face and content validity, although there was no significant difference among the models regarding the degree of simulation and training effectiveness. They are useful educational tools for teaching the key concepts of intra-axial tumor resection techniques, such as subpial dissection and nuances of fluorescence-guided surgery.
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Affiliation(s)
- Daniel Valli
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | - Evgenii Belykh
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | - Xiaochun Zhao
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | - Sirin Gandhi
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | - Claudio Cavallo
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | | | - Peter Nakaji
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | - Michael T Lawton
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | - Mark C Preul
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
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Gandhi S, Tayebi Meybodi A, Belykh E, Cavallo C, Zhao X, Syed MP, Borba Moreira L, Lawton MT, Nakaji P, Preul MC. Survival Outcomes Among Patients With High-Grade Glioma Treated With 5-Aminolevulinic Acid-Guided Surgery: A Systematic Review and Meta-Analysis. Front Oncol 2019; 9:620. [PMID: 31380272 PMCID: PMC6652805 DOI: 10.3389/fonc.2019.00620] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 06/24/2019] [Indexed: 01/08/2023] Open
Abstract
Background: High-grade glioma (HGG) is associated with a dismal prognosis despite significant advances in adjuvant therapies, including chemotherapy, immunotherapy, and radiotherapy. Extent of resection continues to be the most important independent prognosticator of survival. This underlines the significance of increasing gross total resection (GTR) rates by using adjunctive intraoperative modalities to maximize resection with minimal neurological morbidity. 5-aminolevulinic acid (5-ALA) is the only US Food and Drug Administration–approved intraoperative optical agent used for fluorescence-guided surgical resection of gliomas. Despite several studies on the impact of intra-operative 5-ALA use on the extent of HGG resection, a clear picture of how such usage affects patient survival is still unavailable. Methods: A systematic review was conducted of all relevant studies assessing the GTR rate and survival outcomes [overall survival (OS) and progression-free survival (PFS)] in HGG. A meta-analysis of eligible studies was performed to assess the influence of 5-ALA-guided resection on improving GTR, OS, and PFS. GTR was defined as >95% resection. Results: Of 23 eligible studies, 19 reporting GTR rates were included in the meta-analysis. The pooled cohort had 998 patients with HGG, including 796 with newly diagnosed cases. The pooled GTR rate among patients with 5-ALA–guided resection was 76.8% (95% confidence interval, 69.1–82.9%). A comparative subgroup analysis of 5-ALA–guided vs. conventional surgery (controlling for within-study covariates) showed a 26% higher GTR rate in the 5-ALA subgroup (odds ratio, 3.8; P < 0.001). There were 11 studies eligible for survival outcome analysis, 4 of which reported PFS. The pooled mean difference in OS and PFS was 3 and 1 months, respectively, favoring 5-ALA vs. control (P < 0.001). Conclusions: This meta-analysis shows a significant increase in GTR rate with 5-ALA–guided surgical resection, with a higher weighted GTR rate (~76%) than the pivotal phase III study (~65%). Pooled analysis showed a small yet significant increase in survival measures associated with the use of 5-ALA. Despite the statistically significant results, the low level of evidence and heterogeneity across these studies make it difficult to conclusively report an independent association between 5-ALA use and survival outcomes in HGG. Additional randomized control studies are required to delineate the role of 5-ALA in survival outcomes in HGG.
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Affiliation(s)
- Sirin Gandhi
- Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Ali Tayebi Meybodi
- Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Evgenii Belykh
- Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, United States.,Department of Neurosurgery, Irkutsk State Medical University, Irkutsk, Russia
| | - Claudio Cavallo
- Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Xiaochun Zhao
- Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Masood Pasha Syed
- Department of Medicine, Saint Vincent Hospital, Worcester, MA, United States
| | - Leandro Borba Moreira
- Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Michael T Lawton
- Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Peter Nakaji
- Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Mark C Preul
- Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, United States
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Shi S, Cho H, Sun Q, He Y, Ma G, Kim Y, Kim B, Kim O. Acanthopanacis Cortex extract: A novel photosensitizer for head and neck squamous cell carcinoma therapy. Photodiagnosis Photodyn Ther 2019; 26:142-149. [PMID: 30836210 DOI: 10.1016/j.pdpdt.2019.02.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/28/2019] [Accepted: 02/22/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The aim of this study was to develop a novel photosensitizer from traditional plant extracts and to investigate the photodynamic therapy (PDT) effect and mechanism of action of the novel photosensitizer on KB and Hep-2 cells. METHODS Fluorescence emission, cell viability, and intracellular distribution of candidates were analyzed to screen potential photosensitizers from traditional plant extracts. Cellular reactive oxygen species (ROS) quantification, Annexin V-FITC/PI staining, and western blotting were performed to explore the mechanism of cell death in KB and Hep-2 cells. RESULT Of 289 traditional plant extracts, 13 plant extracts with strong fluorescence were initially screened by fluorescence emission analysis. The cell viability assay and intracellular distribution of candidates showed that Acanthopanacis Cortex (AC) extract is a potential photosensitizer. Under optimal PDT conditions, high levels of ROS were produced in KB and Hep-2 cells, followed by cell death. However, there was no significant damage to HaCaT cells. Moreover, apoptosis induced by AC extract with 625 nm irradiation (IR) down-regulated the expression of Bcl-2 protein and up-regulated the expression of Bax protein, as well as that of cleaved PARP-1 protein in both KB and Hep-2 cells. CONCLUSION The fluorescence intensity of AC extract at 420 nm is similar to that of the commercial Hematoporphyrin (HP). AC extract with 625 nm IR could enhance the PDT effect, induce ROS generation, and trigger apoptotic pathways in KB and Hep-2 cells. Therefore, we suggest that AC is a potential novel photosensitizer for PDT in head and neck squamous cell carcinoma.
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Affiliation(s)
- Shuhan Shi
- Department of Oral Pathology, Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, 61186, Republic of Korea; Department of Oral Maxillofacial Surgery, College of Stomatology, Dalian Medical University, Dalian 116044, China
| | - Hyejoung Cho
- Department of Oral Pathology, Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Qiaochu Sun
- Department of Oral Pathology, Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Yuzhu He
- Department of Oral Pathology, Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Guowu Ma
- Department of Oral Maxillofacial Surgery, College of Stomatology, Dalian Medical University, Dalian 116044, China
| | - Young Kim
- Department of Oral Pathology, Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Byunggook Kim
- Department of Oral Medicines, School of Dentistry, Chonnam National University, Gwangju 61189, Republic of Korea
| | - Okjoon Kim
- Department of Oral Pathology, Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, 61186, Republic of Korea.
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Jain KK. A Critical Overview of Targeted Therapies for Glioblastoma. Front Oncol 2018; 8:419. [PMID: 30374421 PMCID: PMC6196260 DOI: 10.3389/fonc.2018.00419] [Citation(s) in RCA: 134] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 09/10/2018] [Indexed: 01/07/2023] Open
Abstract
Over the past century, treatment of malignant tumors of the brain has remained a challenge. Refinements in neurosurgical techniques, discovery of powerful chemotherapeutic agents, advances in radiotherapy, applications of biotechnology, and improvements in methods of targeted delivery have led to some extension of length of survival of glioblastoma patients. Refinements in surgery are mentioned because most of the patients with glioblastoma undergo surgery and many of the other innovative therapies are combined with surgery. However, cure of glioblastoma has remained elusive because it requires complete destruction of the tumor. Radical surgical ablation is not possible in the brain and even a small residual tumor leads to rapid recurrence that eventually kills the patient. Blood-brain barrier (BBB) comprising brain endothelial cells lining the cerebral microvasculature, limits delivery of drugs to the brain. Even though opening of the BBB in tumor core occurs locally, BBB limits systemic chemotherapy especially at the tumor periphery, where tumor cells invade normal brain structure comprising intact BBB. Comprehensive approaches are necessary to gain maximally from promising targeted therapies. Common methods used for critical evaluation of targeted therapies for glioblastoma include: (1) novel methods for targeted delivery of chemotherapy; (2) strategies for delivery through BBB and blood-tumor barriers; (3) innovations in radiotherapy for selective destruction of tumor; (4) techniques for local destruction of tumor; (5) tumor growth inhibitors; (6) immunotherapy; and (7) cell/gene therapies. Suggestions for improvements in glioblastoma therapy include: (1) controlled targeted delivery of anticancer therapy to glioblastoma through the BBB using nanoparticles and monoclonal antibodies; (2) direct introduction of genetically modified bacteria that selectively destroy cancer cells but spare the normal brain into the remaining tumor after resection; (3) use of better animal models for preclinical testing; and (4) personalized/precision medicine approaches to therapy in clinical trials and translation into practice of neurosurgery and neurooncology. Advances in these techniques suggest optimism for the future management of glioblastoma.
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Baskaran R, Lee J, Yang SG. Clinical development of photodynamic agents and therapeutic applications. Biomater Res 2018; 22:25. [PMID: 30275968 PMCID: PMC6158913 DOI: 10.1186/s40824-018-0140-z] [Citation(s) in RCA: 271] [Impact Index Per Article: 45.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 09/11/2018] [Indexed: 12/20/2022] Open
Abstract
Background Photodynamic therapy (PDT) is photo-treatment of malignant or benign diseases using photosensitizing agents, light, and oxygen which generates cytotoxic reactive oxygens and induces tumour regressions. Several photodynamic treatments have been extensively studied and the photosensitizers (PS) are key to their biological efficacy, while laser and oxygen allow to appropriate and flexible delivery for treatment of diseases. Introduction In presence of oxygen and the specific light triggering, PS is activated from its ground state into an excited singlet state, generates reactive oxygen species (ROS) and induces apoptosis of cancer tissues. Those PS can be divided by its specific efficiency of ROS generation, absorption wavelength and chemical structure. Main body Up to dates, several PS were approved for clinical applications or under clinical trials. Photofrin® is the first clinically approved photosensitizer for the treatment of cancer. The second generation of PS, Porfimer sodium (Photofrin®), Temoporfin (Foscan®), Motexafin lutetium, Palladium bacteriopheophorbide, Purlytin®, Verteporfin (Visudyne®), Talaporfin (Laserphyrin®) are clinically approved or under-clinical trials. Now, third generation of PS, which can dramatically improve cancer-targeting efficiency by chemical modification, nano-delivery system or antibody conjugation, are extensively studied for clinical development. Conclusion Here, we discuss up-to-date information on FDA-approved photodynamic agents, the clinical benefits of these agents. However, PDT is still dearth for the treatment of diseases in specifically deep tissue cancer. Next generation PS will be addressed in the future for PDT. We also provide clinical unmet need for the design of new photosensitizers.
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Affiliation(s)
- Rengarajan Baskaran
- World Class Smart Lab, Department of New Drug Development, Inha University College of Medicine, 366, Seohae-daero, Jung-gu, Incheon, 22332 Republic of Korea
| | - Junghan Lee
- World Class Smart Lab, Department of New Drug Development, Inha University College of Medicine, 366, Seohae-daero, Jung-gu, Incheon, 22332 Republic of Korea
| | - Su-Geun Yang
- World Class Smart Lab, Department of New Drug Development, Inha University College of Medicine, 366, Seohae-daero, Jung-gu, Incheon, 22332 Republic of Korea
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