Cellular and subcellular mechanisms of photodynamic action: the 1O2 hypothesis as a driving force in recent research

Photophysical and photobiological processes in the photodynamic therapy of tumours

Photodynamic therapy (PDT) is an innovative and attractive modality for the treatment of small and superficial tumours. PDT, as a multimodality treatment procedure, requires both a selective photosensitizer and a powerful light source which matches the absorption spectrum of the photosensitizer. Quadra Logic's Photofrin, a purified haematoporphyrin derivative, is so far the only sensitizer approved for phase III and IV clinical trials. The major drawbacks of this product are the lack of chemical homogeneity and stability, skin phototoxicity, unfavourable physicochemical properties and low selectivity with regard to uptake and retention by tumour vs. normal cells. Second-generation photosensitizers, including the phthalocyanines, show an increased photodynamic efficiency in the treatment of animal tumours and reduced phototoxic side effects. At the time of writing of this article, there were more than half a dozen new sensitizers in or about to start clinical trials. Most available data suggest a common mechanism of action. Following excitation of photosensitizers to long-lived excited singlet and/ or triplet states, the tumour is destroyed either by reactive singlet oxygen species (type II mechanism) and/or radical products (type I mechanism) generated in an energy transfer reaction. The major biological targets of the radicals produced and of singlet oxygen are well known today. Nucleic acids, enzymes and cellular membranes are rapidly attacked and cause the release of a wide variety of pathophysiologically highly reactive products, such as prostaglandins, thromboxanes and leukotrienes. Activation of the complement system and infiltration of immunologically active blood cells into the tumorous region enhance the damaging effect of these aggressive intermediates and ultimately initiate tumour necrosis. The purpose of this review article is to summarize the up-to-date knowledge on the mechanisms responsible for the induction of tumour necrotic reactions.

Intravital fluorescence microscopy: impact of light-induced phototoxicity on adhesion of fluorescently labeled leukocytes

Alterations in leukocyte/endothelium interaction due to phototoxic effects of the fluorescent dyes acridine orange (AO) and rhodamine 6G (Rh6G) were studied by intravital microscopy using the dorsal skinfold model in awake Syrian golden hamsters. AO (0.5 mg/kg/min; constant IV infusion) and Rh6G (0.1 micromol/kg; bolus IV) were administered via an indwelling venous catheter. Five to seven arterioles (35-55 microm) and postcapillary venules (30-65 microm) were investigated in each animal. Vessels were exposed four times for 30 sec to continuous light of the appropriate excitation wavelength with a 10-15-min time interval between exposures. Animals were randomly assigned to five experimental groups (five distinct light energy levels). AO and Rh6G induced leukocyte rolling/sticking in postcapillary venules and arterioles when exposed to high light energy levels. AO, but not Rh6G, induced arteriolar vasospasm when exposed to high light energies. The potential phototoxic effect of AO and Rh6G is demonstrated, as assessed by the stimulation of leukocyte-endothelium interaction and arteriolar vasospasm in vivo. This study underscores the necessity to optimize microscopic set-ups for intravital microscopy, to reduce the excitation light energy level significantly, and to perform stringent control experiments, ruling out an artificial phototoxicity-induced stimulation of leukocyte adhesion.

Effects of Photofrin photodynamic action on mitochondrial respiration and superoxide radical generation

Cyanide-resistant respiration increases after irradiation of isolated mitochondria in the presence of Photofrin. This suggests an enhancement of electron leakage which has been evaluated by measuring superoxide radical formation in submitochondrial particles incubated with 6 micrograms/ml Photofrin in the medium and irradiated with increasing doses of light at 365 nm. After a dose of 4.5 kJ/m2 has been delivered, superoxide generation increases by a factor of approximately 2.5 at the level of NADH dehydrogenase and by a factor approximately 1.5 in the cyt bc1 region. These effects have been compared with changes observed in NADH-, succinate- and ascorbate-driven respiration and their implications discussed.

Photodynamic action increases leakage of the mitochondrial electron transport chain

Rat liver submitochondrial particles were treated with rose bengal or flavin mononucleotide and irradiated with visible or near UV light. In both cases, oxygen consumption is impaired after irradiation while O2-. production increases significantly. This suggests that exogenous or endogenous photosensitizers can induce more electron leakage in the mitochondrial respiratory chain. Photobiological implications in dermatology are discussed.

Selective phototoxic destruction of rat Merkel cells abolishes responses of slowly adapting type I mechanoreceptor units

1. The fluorescent dye quinacrine which accumulates in Merkel cells in touch domes was administered to rats and the effects of excitation light irradiation on the mechanical responses of slowly adapting (SA) type I units innervating the touch domes were investigated. 2. Histological examination showed that after 10 min of irradiation degeneration was specifically localized to Merkel cells loaded with quinacrine. Nerve terminals associated with Merkel cells remained intact, even after treatment. 3. In SA type I units, responses to standard stimulation (a 100 ms ramp followed by a 2.9 s plateau of 400 microns constant displacement) decreased significantly after irradiation of the domes with quinacrine-excitation light through a 'B' filter ('B' light). With 5 min irradiation, the response decreased to 52 +/- 7% (n = 10, mean +/- S.E.M.) of the pretreated value, to 17 +/- 4% with a 10 min treatment and practically disappeared within 20 min. 4. In SA type I units with non-loaded Merkel cells, the response increased to 119 +/- 8% (n = 13) with 5 min irradiation and was 99 +/- 9% with the 10 min treatment. At around 15 min after the onset of irradiation there was a gradual decrease and within 60 min the response disappeared. 5. When responses were divided into phasic (0-120 ms after the onset of stimulation) and tonic (120-3000 ms) components, 'tonic' responses were more affected than 'phasic' ones in quinacrine-loaded SA type I units. 6. Stimulus-response curves shifted to the right and downwards in SA type I units with quinacrine-loaded Merkel cells after irradiation, but no significant change was seen in SA type I units without quinacrine. 7. Our observations are consistent with the hypothesis that Merkel cells are responsible for mechanoelectric transduction in SA type I units.

Photochemical interactions of methylene blue and analogues with DNA and other biological substrates

The light-induced reactions of methylene blue and related phenothiazinium dyes with biological substrates are described. The properties of the excited states of the dyes, their reactions with nucleic acids and their photosensitised chemical modifications of nucleic acid bases are examined. Reports on phenothiazinium dye-induced damage to proteins, lipids, biological membranes, organelles, viruses, bacteria, mammalian cells and carcinomas are reviewed.

Pharmaceutics and drug delivery aspects of heme and porphyrin therapy

The importance of porphyrins and metalloporphyrins as therapeutic drugs has increased significantly over the last decade. This review highlights some of the challenges faced by pharmaceutical scientists in formulating these drugs into stable, effective, and safe dosage forms. Most activity in the clinic has focused on three areas: photodynamic therapy of cancer (e.g., hematoporphyrin derivatives), porphyrias and hematological diseases (e.g., heme), and various forms of jaundice (e.g., tin porphyrins). The biodistribution, stability, aggregation, toxicology, and analytical methodology of porphyrin drugs are all important considerations in the pharmaceutical development of porphyrin drugs. The utility of delivery systems such as liposomes hold promise of increasing the therapeutic potential of these drugs. Future prospects for therapeutic applications of porphyrin drugs are also discussed.

Time-resolved studies of singlet-oxygen emission from L1210 leukemia cells labeled with 5-(N-hexadecanoyl)amino eosin. A comparison with a one-dimensional model of singlet-oxygen diffusion and quenching

Time-resolved measurements were made of near-infrared emission from 5-(N-hexadecanoyl)amino-eosin-labeled L1210 leukemia cells following pulsed-laser excitation. The cells were suspended in phosphate-buffered saline made with deuterium oxide solvent. A significant fraction of the emission occurring 10-80 microseconds after the laser pulse was due to singlet oxygen. This singlet-oxygen emission is believed to result from singlet oxygen generated near the cell-membrane surface, where 5-(N-hexadecanoyl)amino eosin is known to concentrate, and then diffusing out into the buffer. The intensity and the kinetics of the experimentally observed singlet-oxygen emission were in excellent agreement with the predictions of a theoretical one-dimensional model of singlet-oxygen diffusion and quenching. During the 10-80 microseconds time period studied, most of the singlet oxygen was located in the buffer. Thus, the use of water-soluble singlet-oxygen quenchers, such as histidine, provide one means of separating the singlet-oxygen emission from other sources of light during this time interval.

Cellular responses to hematoporphyrin-induced photooxidative damage in Fanconi anemia, xeroderma pigmentosum and normal human fibroblasts

Several observations reported in the literature suggest that singlet oxygen (1O2) might play a role in the clastogenic process in Fanconi anemia (FA) cells, and that the antioxidant status of xeroderma pigmentosum (XP) may also be altered. In order to test the ability of FA and XP cells, relative to normal cells, to cope with 1O2 damage, the effects of photosensitization by hematoporphyrin (HP) have been determined (i) on host cell reactivation (HCR) of damaged infecting herpes simplex virus (HSV) or transfecting SV40 DNA, and (ii) on DNA template capability and clonogenicity of treated cells. Results showed no significant difference among the three types of cells, either for the survival of HP-photosensitized HSV, or for the yields of SV40 virus following transfection of cultures with damaged viral DNA. The treatment of cells with HP plus 365-nm light leads to a dose-dependent, homothetic reduction of 18S and 28S ribosomal RNA (rRNA) synthesis, presumably through a mechanism other than the formation of transcription termination sites. After a 24-h post-exposure incubation, the rate of rRNA synthesis was restored to higher than normal levels in all cell lines. Finally, two FA cell lines showed a higher survival to HP photosensitization than two normal cell lines. Another FA cell line and XP-A and XP-C cells were in the range of sensitivity of the two normal strains for this treatment. These results indicate that FA cells possess an antioxidant defense system at least as efficient as that of normal cells for processing 1O2-induced damage.

Resonance Raman and surface-enhanced resonance Raman spectroscopy of hypericin

Hypericin has been found to exhibit a variety of photodynamic effects. To correlate biological activity with molecular structure, complete physical characterization of hypericin is required. The vibrational spectrum has been determined and resonance Raman and surface enhanced resonance Raman scattering spectra are reported. In addition, the Raman spectrum of a model compound has been studied to facilitate assignment of the vibrational modes of hypericin.

Photo-enhancement of the mutagenicity of 9-anilinoacridine derivatives related to the antitumour agent amsacrine

The frameshift mutagenicity of the DNA intercalating drug proflavine is known to be enhanced by photoirradiation of bacterial cultures. To determine whether this phenomenon was also present in acridine-derived antitumour drugs, cultures of Salmonella typhimurium were exposed to the antileukaemia agent amsacrine and the experimental agent N-[2-(dimethylamino)ethyl]acridine-4-carboxamide dihydrochloride (acridine carboxamide) in the presence or absence of visible light. A small increase in mutagenicity was observed with amsacrine but not with acridine carboxamide. A series of analogues of amsacrine were then tested, and a striking relationship was found between the minimum drug concentration for mutagenicity and DNA binding affinity. In each case, photoirradiation was associated with a small increase in mutagenicity. Each of the compounds showing the photo-enhancement effect was capable of reversible one-electron oxidation. It is suggested that this oxidation occurs in bacteria, and that the DNA binding constant of the resulting acridine radical species will increase because of the extra positive charge. This increased DNA binding would be sufficient to explain the photo-enhancement of mutagenicity of these drugs.

Quenching of singlet oxygen by biomolecules from L1210 leukemia cells

Singlet oxygen lifetimes for detergent-dispersed L1210 leukemia cells in deuterium oxide buffer were measured by following the decay of 1270 nm phosphorescence. Four photosensitizers and two detergents were studied. Stern-Volmer plots were linear over the cell concentration range studied (0-10(7) cells/mL). The singlet-oxygen quenching constants obtained depended somewhat upon the specific combination of detergent and photosensitizer used. Extrapolation of the singlet-oxygen lifetime data to "100%" cell concentration (1.39 +/- 0.04 x 10(9) cells/mL) and correction for the contribution of the water solvent gave a singlet-oxygen lifetime between 0.17 and 0.32 microseconds for the L1210 leukemia cell. The theoretical contributions of various types of biological molecules within the L1210 cell to the total singlet-oxygen quenching were calculated from their concentrations and their quenching constants. These calculations suggest that proteins will quench most of the singlet-oxygen. Only about 7% of the singlet-oxygen is quenched by water.

Biological consequences associated with DNA oxidation mediated by singlet oxygen

Singlet oxygen is a major oxidative species that can be generated by numerous biological processes such as photosensitization. This oxidant can react with deoxyguanosine and with guanine in deoxyribonucleic acid (DNA) leading to the induction of at least four different reaction products such as 4,8-dihydro-4-hydroxy-8-oxodeoxyguanosine and 7,8-dihydro-8-oxodeoxyguanosine. The induction of true single-stranded breaks in the oxidated DNA is still a matter of controversy and is not yet clearly established. This paper focuses mainly on several biological consequences which can be associated with the induction of DNA lesions by singlet oxygen. Oxidated DNA loses its transformation efficiency probably because unrepaired lesions can partially inhibit DNA replication. Mutagenesis is one of the main effects induced by guanine oxidation products. Molecular analysis of mutated genes reveals that G to T transversions are the most frequent mutations; these are probably introduced in DNA by misincorporation of deoxyadenosine monophosphate (dAMP) opposite to the lesion. Efficient repair of these oxidated guanine residues can take place via specific glycosylase, endonuclease or the SOS network. However, the data concerning the toxicity of singlet oxygen for eukaryotic cells are not frequent enough in the literature to draw a clear picture of the effects of this activated species in several biologically revelant phenomena.

Direct observation of singlet oxygen phosphorescence at 1270 nm from L1210 leukemia cells exposed to polyporphyrin and light

Near-infrared emission (1170-1475 nm) was studied from L1210 leukemia cells incubated with polyporphyrin (fractionated hematoporphyrin derivative), suspended in deuterium oxide buffer, and then exposed to light. Following pulsed laser excitation, the near-infrared emission decayed in two phases. The first phase of the emission (0-2 microseconds) was principally due to polyporphyrin fluorescence. The second phase of the emission (20-90 microseconds) was due mainly to singlet oxygen. Evidence supporting the assignment of the second phase emission to singlet oxygen included a spectral analysis showing a peak near 1270 nm and reductions in the second phase emission caused by the singlet oxygen quenchers, histidine, carnosine, and water. The second phase emission decayed in a biexponential manner with lifetimes of 4.5 +/- 0.5 and 49 +/- 4 microseconds. Most of the singlet oxygen in the second phase emission was likely due to singlet oxygen that was generated near the surface of the L1210 leukemia cells and then diffused into the deuterium oxide buffer. Direct measurements of singlet oxygen phosphorescence at 1270 nm may prove to be a useful analytical technique for studying photochemical generation of singlet oxygen in cultured cells.

Quenching of singlet oxygen by human red cell ghosts

Time resolved measurements of singlet oxygen phosphorescence at 1270 nm were made from unsealed red cell ghosts, labeled with 5-(N-hexadecanoyl)aminoeosin and suspended in deuterium oxide buffer. The singlet oxygen emission lifetime was long, 23 +/- 1 microseconds. The lifetime of the singlet oxygen phosphorescence from intact unsealed ghosts was not a measure of the singlet oxygen lifetime within the red cell ghost membrane, however. The prolonged singlet oxygen emission was due to singlet oxygen escaping from the thin membrane into the buffer, since the emission lifetime was significantly shortened by adding azide ion or water to the deuterium oxide buffer. The lifetime of singlet oxygen within the red cell ghosts membrane was estimated by dispersing the ghosts with detergent and then measuring the singlet oxygen lifetime in deuterium oxide buffers containing various dilutions of the dispersed ghosts. Apparent singlet-oxygen quenching constants were measured using four different photosensitizing dyes and two different detergents. The apparent quenching constant was independent of the dye used, but varied significantly with different detergents. Extrapolation of this data to "100%" ghost concentration gave a singlet oxygen lifetime from 24 and 130 ns. A ghost concentration of "100%" was defined as that concentration of red cell ghost molecules which would be contained within a red cell ghost membrane pellet containing no buffer solutions. Most of the singlet oxygen quenching was due to proteins. Lipids extracted from red cell ghosts accounted for only 2-7% of the total singlet oxygen quenching.

Genotoxicity of singlet oxygen

Singlet oxygen, 1O2 (1 delta g), fulfills essential prerequisites for a genotoxic substance, like hydroxyl radicals and other oxygen radicals: it can react efficiently with DNA and it can be generated inside cells, e.g. by photosensitization and enzymatic oxidation. As might be anticipated from the non-radical character of singlet oxygen, the pattern of DNA modifications it produces is very different from that caused by hydroxyl radicals. While hydroxyl radicals produce DNA strand breaks and sites of base loss (AP sites) in high yield and react with all four bases of DNA, singlet oxygen generates predominantly modified guanine residues and few strand breaks and AP sites. There is now convincing evidence that a major product of base modification caused by singlet oxygen is 8-hydroxyguanine (7,8-dihydro-8-oxoguanine). Indeed, the recently reported miscoding properties of 8-hydroxyguanine can explain the predominant type of mutations observed when DNA modified by singlet oxygen is replicated in cells. There are also strong indications that singlet oxygen generated by photosensitization can act as an ultimate DNA modifying species inside cells. However, indirect genotoxic mechanisms involving other reactive oxygen species produced from singlet oxygen are also possible and appear to predominate in some cases. The cellular defense system against oxidants consists of effective singlet oxygen scavengers such as carotenoids. The observation that carotenoids can inhibit neoplastic cell transformation when administered not only together with but also after the application of chemical or physical carcinogens might indicate a role of singlet oxygen in tumor promotion that could be independent of the direct or indirect DNA damaging properties.

Enzymatic recognition of DNA modifications induced by singlet oxygen and photosensitizers

DNA modifications induced either by photosensitization (illumination in the presence of methylene blue) or by chemically generated singlet oxygen (thermal decomposition of an 1,4-etheno-2,3-benzodioxin) are recognized and incised by repair endonucleases present in crude bacterial cell extracts. Only a small fraction of the incised modifications are sites of base loss (AP-sites) sensitive to exonuclease III, endonuclease IV from E. coli or to the UV-endonuclease from M. luteus. Cell extracts from E. coli strains overproducing or defective in endonuclease III recognize the modifications induced by illumination in the presence of methylene blue just as well as do those from wild-type E. coli strains. This indicates that dihydropyrimidine derivatives, which are characteristic of hydroxyl radical-induced DNA modifications, are absent. In contrast, most of the modifications induced are not recognized by a cell extract from a fpg strain defective in formamidopyrimidine-DNA glycosylase FPG protein). Furthermore, incision by a cell extract from an E. coli strain overproducing FPG protein takes place at much lower protein concentration than with the wild-type strain. Experiments with purified FPG protein confirm that this enzyme is responsible for the recognition of singlet oxygen-induced DNA base modifications.

The photokilling of bladder carcinoma cells in vitro by phenothiazine dyes

The potential photodynamic therapy photosensitizers Methylene Blue, Azure C, Methylene Violet, Thionine, Methylene Green, Haematoporphyrin, Nile Blue A, chloroaluminium phthalocyanine and bis-aluminium phthalocyanine were examined for their photoeffects and dark toxicity against a human superficial bladder carcinoma cell-line. By examination of [3H]thymidine uptake into dye-treated cells after irradiation with a copper-vapour pumped dye laser, it was found that Methylene Blue was the most phototoxic and dark toxic of all the dyes tested, suggesting that the dye might be of some use as a topically applied photodrug for use in photodynamic therapy of superficial or early-recurring carcinomas.

The induction of chromosomal aberrations and SCEs by visible light in combination with dyes. II. Cell cycle dependence, and the effect of hydroxyl radical scavengers during light exposure in cultures of Chinese hamster ovary cells sensitized with acridine orange

Chinese hamster ovary (CHO) cells were synchronized by mitotic shake-off, treated with the fluorochrome acridine orange (AO; 0.5 micrograms/ml), washed free of excess dye and subsequently exposed to visible light (2 X 40 W/8 Wm-2). The light exposure was performed on cells in the G1, G1/S, S or G2 phase of the cell cycle. AO + light induced high frequencies of aberration in the S phase and even higher in the G1 phase. The aberrations observed were all of the chromatid type. The chromosome-type aberrations (dicentrics, rings) obtained when cells in the G1 phase were exposed to X-rays were not found after corresponding treatments with AO + light. With the exception of an increased frequency of gaps, no chromosomal aberrations were induced in G2-phase cells. Sister-chromatid exchanges were efficiently produced by the photodynamic system in the G1, G1/S and S phase of the cell cycle. In other experiments, AO-treated unsynchronized CHO cells were exposed to light in the presence of the hydroxyl radical scavengers mannitol (100 mM) and 5-dimethyl thiourea (100 mM). In parallel experiments these scavengers were found to reduce markedly the chromosome breaking effects by X-rays but had no influence on the photodynamic induction of chromosomal alterations. The results presented show that the visible light-induced chromosomal alterations in CHO cells sensitized with the fluorochrome AO are obtained by an S-dependent mechanism. Furthermore, the results indicate that the hydroxyl free radical does not play a major role in the production of chromosomal alterations by AO + light.

Readily available fluorescein isothiocyanate-conjugated antibodies can be easily converted into targeted phototoxic agents for antibacterial, antiviral, and anticancer therapy

Fluorescein-labeled antibodies have little, if any, photodynamic effect because energy acquired by light absorption is rapidly dissipated in fluorescence. However, they can be easily and efficiently converted to selective photodynamic sensitizers by iodination under mild conditions. We have outlined general experimental procedures that can be used to turn a fluorescein-labeled anti-Escherichia coli antibody into a photodynamic sensitizer that selectively kills E. coli while sparing closely related Salmonella typhimurium. These results demonstrate that iodination did not destroy the specificity or activity of the antibody. This technique should be applicable to the large number of fluoresceinated antibodies that are commercially available. Thus, this strategy provides a simple way to rapidly prepare a large number of targeted phototoxic agents that can be used for the selective destruction with light of nearly any type of tissue or organism.

Photosensitization by selected anticancer agents

Novel anticancer anthrapyrazoles and anthracenediones are available as alternatives to the cardiotoxic clinical agents, doxorubicin and daunorubicin. Certain representatives of these new classes of compounds possess photosensitizing properties. The structural features influencing the photophysical parameters of these agents are discussed. Photosensitizing reactions involving singlet oxygen production, free radical formation, decomposition of hydrogen peroxide and organic hydroperoxides, oxidation of certain biochemical electron donors, DNA damage and killing of human leukemic cells in vitro in the presence of photoactive anthrapyrazoles, anthracenediones and anthracyclines are described.

Quenching of singlet oxygen by human plasma

Direct measurements of the decay of singlet oxygen phosphorescence at 1270 nm were made in human plasma diluted with various amounts of deuterium oxide. The Stern-Volmer plot of the singlet oxygen lifetimes was linear up to 15% plasma concentration (vol/vol). Extrapolation of these measurements to 100% plasma content gave a singlet oxygen lifetime of 1.04 +/- 0.03 microseconds in human plasma. Biological molecules accounted for 77% of the total singlet oxygen quenching while water accounted for 23% of the quenching. The contributions of various types of biological molecules to the total singlet oxygen quenching were calculated from their plasma concentrations and their quenching constants. Plasma proteins quenched most of the singlet oxygen. Uric acid also quenched a significant amount of singlet oxygen (12%). Tocopherols, carotenoids, ascorbic acid and bilirubin made only small contributions to the total singlet oxygen quenching (less than or equal to 4%).

Photooxidative damage to lysosomes of cultured macrophages by acridine orange

Cultured cells accumulate acridine orange (AO), which is a weak basic dye and a photosensitizer, in lysosomes and other acidic compartments. During exposure to blue light, AO-loaded macrophages show decreasing red granular fluorescence and increasing green diffuse fluorescence. This is hypothesized to represent peroxidative damage to lysosomal membranes resulting in an impaired proton gradient with deprotonation of the AO to its uncharged form and subsequent leakage of the dye. Further damage to the lysosomal membranes will result in release of lytic enzymes from the lysosomal compartment into the cytosol, leading to degeneration and finally cell death. The survival of AO-loaded and light-exposed macrophages is controllable by varying the exposure times to blue light. Inhibition of lysosomal proteases by E-64 results in increased cell survival after AO and blue light-mediated damage, indicating a role of proteolytic enzymes in this type of damage. Morphological analysis shows 'rounding up' with formation of retraction fibrils and pronounced plasma membrane blebbing. The formation of autophagic vacuoles is an early and pronounced event. After protease inhibition, however, all these phenomena are inhibitable to a considerable degree. We have thus directed photooxidative damage selectively to lysosomal membranes and their contents. This technique will allow further detailed studies of the role of lysosomes in degeneration-regeneration processes.

Cancer chemoprevention by supplemental carotenoids in animals and humans

Experiments were carried out in mice demonstrating that dietary carotenoids (beta-carotene or canthaxanthin), starting before cancer initiation and continuing throughout the experiment, have a protective effect against indirect skin carcinogenesis induced by benzo[a]pyrene +/- UVA and breast cancer induced by 8-methoxypsoralen + UVA. Experiments in rats demonstrated that carotenoids also prevent the direct gastric carcinogenesis induced by N-methyl-N'-nitro-nitroso-guanidine. Recently, prevention by beta-carotene against colon cancer induced in mice by dimethylhydrazine, another indirect carcinogen, was confirmed by others. The prospects for carotenoid intervention with humans were based on their antitumorigenic effect, which is quite independent of pro-vitamin A activity, their lack of toxicity even after prolonged administration, and their immunostimulating activity. These facts helped to build up a rationale predicting that any epithelial cancer, after radical surgery, can be chemoprevented with supplemental carotenoids. Thus, it is expected that the remaining initiated epithelial tissue will be protected by quenching oxygen radical formation, against the onset of a second primary malignancy. This type of prevention can be envisaged in organs like the lung, urinary bladder, breast, stomach, and colon-rectum. At present, human intervention protocols with a randomized drug/placebo method are underway under the supervision of the Centro Tumori of Pavia to chemoprevent with beta-carotene second primary lung or bladder cancer after radical surgery. Preliminary observations regarding findings in humans without randomization (1980-1988) in Pavia are also reported here. This consisted of chemoprevention with beta-carotene plus canthaxanthin against recurrence of different epithelial malignancies after radical treatment (surgery +/- chemoradiotherapy). None of the 11 cases recruited, on the basis of radical nature of treatment and patient adherence, have shown any recurrence beyond their expected disease-free intervals.

Singlet oxygen production by biological systems

Singlet oxygen (1 delta g) is a highly reactive, short-lived intermediate which readily oxidizes a variety of biological molecules. The biochemical production of singlet oxygen has been proposed to contribute to the destructive effects seen in a number of biological processes. Several model biochemical systems have been shown to produce singlet oxygen. These systems include the peroxidase-catalyzed oxidations of halide ions, the peroxidase-catalyzed oxidations of indole-3-acetic acid, the lipoxygenase-catalyzed oxidation of unsaturated long chain fatty acids and the bleomycin-catalyzed decomposition of hydroperoxides. Results from these model systems should not be uncritically extrapolated to living systems. Recently, however, an intact cell, the human eosinophil, was shown to generate detectable amounts of singlet oxygen. This result suggests that singlet oxygen may be shown to be a significant biochemical intermediate in a few biological processes.

Acridine orange-mediated photodamage of microsomal- and lysosomal fractions

Irradiation of microsomes with visible light in the presence of externally-added acridine orange results in O2 uptake, malondialdehyde accumulation, and inactivation of the microsomal drug-metabolizing system. The latter effect is reflected by a decrease in NADPH-cytochrome P450- and NADH-cytochrome b5 reductase activities and cytochromes P450 and b5 content by 88-, 85-, 60-, and 34%, respectively, after 5-min irradiation. Anoxia prevented inactivation of both reductases by 70-90%, whereas it prevented completely cytochrome b5 destruction. The presence of reducing equivalents, at the expense of NADPH and NADH, exert a partial protection (40-54% residual activities) against photosensitization damage on both reductase activities, whereas it almost fully protected cytochrome b5. Photosensitization of lipid peroxidation, as well as inactivation of the microsomal drug-metabolizing system, appears to involve both a type I and type II process. Products of lipid peroxidation might also play a role in enzyme inactivation and cytochrome destruction, as suggested by kinetic and time course studies and the redox state of microsomes. The uptake of acridine orange by isolated lysosomes is linearly dependent on the concentration of added dye and the distribution between extra- and intralysosomal acridine orange is strongly dependent on the amount of lysosomes. Irradiation of acridine orange-loaded lysosomes (light intensity at the sample position approximately 320 mW/cm2) produces an impairment of the membrane which leads to a rapid release of enzyme (N-acetyl-beta-glucosaminidase activity) into the medium, accompanied by a loss of activity in the lysosome-containing pellet and a partial photodamage of the enzyme. Concomitantly, thiobarbituric acid-reactive material accumulation increases in the reaction mixture with increasing irradiation time. When light intensity at the position was reduced to approximately 3.6 mW/cm2, photodamage of lysosomes was of a lesser magnitude, allowing the demonstration of a lag phase, which decreased with irradiation time, probably reflecting the so-called first-stage activation of lysosomes, preceding the release of lysosomal enzymes.

Evaluation of lysosomal stability in living cultured macrophages by cytofluorometry. Effect of silver lactate and hypotonic conditions

The ability of living mouse peritoneal macrophages to retain the lysosomotropic photosensitizer acridine orange (AO) within their secondary lysosomes was studied with a novel cytofluorometric method. During exposure to blue light, cellular AO fluorescence turned from a red granular pattern to that of diffuse green. The resulting change in total fluorescence intensity versus time - a primary decline due to red fluorescence bleaching and a secondary recovery due to the spectral shift - was interpreted as the result of leakage of AO from the lysosomal vacuome. The hypothesis that this time course should be affected by changes in lysosomal membrane stability was tested by labilizing the lysosomes by exposure of cultured macrophages to either hypotonic medium or silver lactate. In hypotonic medium, the ability to retain AO decreased continuously. Exposure to low concentrations of silver lactate (10 microM) also decreased AO retention time. We suggest that this method could be used, within appropriate experimental conditions, to evaluate lysosomal membrane stability in living cells.

Role of cloned carotenoid genes expressed in Escherichia coli in protecting against inactivation by near-UV light and specific phototoxic molecules

Genes controlling carotenoid synthesis were cloned from Erwinia herbicola and expressed in an Escherichia coli strain. Carotenoids protect against high fluences of near-UV (NUV; 320 to 400 nm) but not against far-UV (200-300 nm). Protection of E. coli cells was not observed following treatment with either psoralen or 8-methoxypsoralen plus NUV. However, significant protection of cells producing carotenoids was observed with three photosensitizing molecules activated by NUV (alpha-terthienyl, harmine, and phenylheptatriyne) which are thought to have the membrane as an important lethal target. Protection of carotenoid-producing cells against inactivation was not observed with acridine orange plus visible light but was seen with toluidine blue O plus visible light.

The induction of chromosomal aberrations and SCE by visible light in combination with dyes. I. The effect of hypoxia during light exposure in unsynchronized Chinese hamster ovary cells, sensitized with acridines

A comparison has been made between the ability of different acridine compounds to act as sensitizers for visible light (400-700 nm) induced chromosomal aberrations and sister-chromatid exchanges (SCE) in unsynchronized Chinese hamster ovary (CHO) cells. Cells were treated for 20 min with acridines (0.1-5.0 microgram/ml), washed free of excess dye and subsequently exposed to visible light (2 x 40 W/8 W m-2) either in air or in nitrogen for 5-15 min. The 4 acridines tested, proved to be effective sensitizers for the induction of both chromosomal aberrations and SCE by visible light. The most pronounced effect was observed when the light exposure of the fluorochrome-pretreated cells was performed in air. Hypoxic conditions during light exposure reduced the effect dramatically, especially in the case of induced chromosomal aberrations. The order of efficiency for the induction of both chromosomal aberrations and SCE was acridine orange greater than acridine yellow greater than proflavine greater than 3,6-diamino-10-methylacridine. The results are discussed in terms of S-independent versus S-dependent mechanisms for inducing chromosomal alterations and the potential involvement of oxygen-derived free radicals in this process.

Conformational changes of beta H-crystallin in riboflavin-sensitized photooxidation

The effect of riboflavin-sensitized photooxidation on calf lens beta H-crystallin has been investigated by using fluorescence and circular dichroism techniques. beta H-Crystallin showed a pronounced change in its tertiary structure (conformation) as manifested in the near-u.v. circular dichroism spectra and fluorescence yield of tryptophan residues. The rate of tryptophan photolysis was significantly diminished under anaerobic conditions, but was not affected appreciably when D2O was used in the reaction mixture instead of H2O. Ferricyanide and ferricytochrome c added to the solution prior to irradiation inhibited the rate of photolysis of tryptophan, suggesting the involvement of O2- anion in the photoreactions. Quantitative assays of O2- and H2O2 in the irradiated protein solution strongly suggest that the Type I photosensitization pathway is involved in the RF-sensitized photooxidation of beta H-crystallin. The effect of photolysis on the cysteine residues of the protein was also studied. The sulfhydryl specific fluorophore N-iodoacetyl-N'-(5-sulfonaphthyl) ethylenediamine (1,5-IAEDANS) was used to study the change in the microenvironment of the cysteine (sulfhydryl) residues of the protein by photolysis. The results indicate that there is a quantitative loss of IAEDANS labeling sites due to photooxidation as well as structural changes of the protein. Fluorescence lifetime measurements indicate that the probe is bound in two environments--the major one (95%) is exposed and the minor one (5%) hydrophobic. A decrease in the lifetimes of the bound label occurs after photooxidation. However, the relative proportion of the hydrophobic IAEDANS-labeling sites increases in the photooxidized beta H-crystallin, probably due to the formation of supra-aggregated protein by photolysis.

Ocular fluorescein phototoxicity

Fluorescein angiography is one of the most commonly used diagnostic techniques in modern ophthalmology. Prior to this study, recommendations on the phototoxicity of this technique were based on light levels alone (i.e., without fluorescein present). Using a rabbit model to demonstrate retinal damage, intravenous sodium fluorescein was found to reduce the amount of blue light needed to cause a phototoxic retinal lesion almost a log unit (from 1.6 to 0.2 W/cm(2)). Intravenous fluorescein also reduced the threshold for light damage to iris and cornea in the rabbit. The results suggest that blue light exposure should be minimized when sodium fluorescein is present in ocular tissue.