Type I photodynamic therapy by organic–inorganic hybrid materials: From strategies to applications

Photoactivatable nanogenerators of reactive species for cancer therapy

In recent years, reactive species-based cancer therapies have attracted tremendous attention due to their simplicity, controllability, and effectiveness. Herein, we overviewed the state-of-art advance for photo-controlled generation of highly reactive radical species with nanomaterials for cancer therapy. First, we summarized the most widely explored reactive species, such as singlet oxygen, superoxide radical anion (O2 ●-), nitric oxide (●NO), carbon monoxide, alkyl radicals, and their corresponding secondary reactive species generated by interaction with other biological molecules. Then, we discussed the generating mechanisms of these highly reactive species stimulated by light irradiation, followed by their anticancer effect, and the synergetic principles with other therapeutic modalities. This review might unveil the advantages of reactive species-based therapeutic methodology and encourage the pre-clinical exploration of reactive species-mediated cancer treatments.

Conquering the Hypoxia Limitation for Photodynamic Therapy

Photodynamic therapy (PDT) has aroused great research interest in recent years owing to its high spatiotemporal selectivity, minimal invasiveness, and low systemic toxicity. However, due to the hypoxic nature characteristic of many solid tumors, PDT is frequently limited in therapeutic effect. Moreover, the consumption of O₂ during PDT may further aggravate the tumor hypoxic condition, which promotes tumor proliferation, metastasis, and invasion resulting in poor prognosis of treatment. Therefore, numerous efforts have been made to increase the O₂ content in tumor with the goal of enhancing PDT efficacy. Herein, these strategies developed in past decade are comprehensively reviewed to alleviate tumor hypoxia, including 1) delivering exogenous O₂ to tumor directly, 2) generating O₂ in situ, 3) reducing tumor cellular O₂ consumption by inhibiting respiration, 4) regulating the TME, (e.g., normalizing tumor vasculature or disrupting tumor extracellular matrix), and 5) inhibiting the hypoxia-inducible factor 1 (HIF-1) signaling pathway to relieve tumor hypoxia. Additionally, the O₂ -independent Type-I PDT is also discussed as an alternative strategy. By reviewing recent progress, it is hoped that this review will provide innovative perspectives in new nanomaterials designed to combat hypoxia and avoid the associated limitation of PDT.

Type I macrophage activator photosensitizer against hypoxic tumors

Photodynamic immunotherapy has emerged as a promising strategy to treat cancer. However, the hypoxic nature of most solid tumors and notoriously immunosuppressive tumor microenvironment could greatly compromise the efficacy of photodynamic immunotherapy. To address this challenge, we rationally synthesized a type I photosensitizer of TPA-DCR nanoparticles (NPs) with aggregation-enhanced reactive oxygen species generation via an oxygen-independent pathway. We demonstrated that the free radicals produced by TPA-DCR NPs could reprogram M0 and M2 macrophages into an anti-tumor state, which is not restricted by the hypoxic conditions. The activated M1 macrophages could further induce the immunogenic cell death of cancer cells by secreting pro-inflammatory cytokines and phagocytosis. In addition, in vivo anti-tumor experiments revealed that the TPA-DCR NPs could further trigger tumor immune response by re-educating tumor-associated macrophages toward M1 phenotype and promoting T cell infiltration. Overall, this work demonstrates the design of type I organic photosensitizers and mechanistic investigation of their superior anti-tumor efficacy. The results will benefit the exploration of advanced strategies to regulate the tumor microenvironment for effective photodynamic immunotherapy against hypoxic tumors.

Targeted Photodynamic Diagnosis and Therapy for Esophageal Cancer: Potential Role of Functionalized Nanomedicine

Esophageal cancer is often diagnosed at the late stage when cancer has already spread and is characterized by a poor prognosis. Therefore, early diagnosis is vital for a better and efficient treatment outcome. Upper endoscopy with biopsy is the standard diagnostic tool for esophageal cancer but is challenging to diagnose at its premalignant stage, while conventional treatments such as surgery, chemotherapy, and irradiation therapy, are challenging to eliminate the tumor. Photodynamic diagnosis (PDD) and therapy (PDT) modalities that employ photosensitizers (PSs) are emerging diagnostic and therapeutic strategies for esophageal cancer. However, some flaws associated with the classic PSs have limited their clinical applications. Functionalized nanomedicine has emerged as a potential drug delivery system to enhance PS drug biodistribution and cellular internalization. The conjugation of PSs with functionalized nanomedicine enables increased localization within esophageal cancer cells due to improved solubility and stability in blood circulation. This review highlights PS drugs used for PDD and PDT for esophageal cancer. In addition, it focuses on the various functionalized nanomedicine explored for esophageal cancer and their role in targeted PDD and PDT for diagnosis and treatment.

Inorganic Nanomaterials with Intrinsic Singlet Oxygen Generation for Photodynamic Therapy

Inorganic nanomaterials with intrinsic singlet oxygen (1 O2 ) generation capacity, are emerged yet dynamically developing materials as nano-photosensitizers (NPSs) for photodynamic therapy (PDT). Compared to previously reported nanomaterials that have been used as either carriers to load organic PSs or energy donors to excite the attached organic PSs through a Foster resonance energy transfer process, these NPSs possess intrinsic 1 O2 generation capacity with extremely high 1 O2 quantum yield (e.g., 1.56, 1.3, 1.26, and 1.09) than any classical organic PS reported to date, and thus are facilitating to make a revolution in PDT. In this review, the recent advances in the development of various inorganic nanomaterials as NPSs, including metal-based (gold, silver, and tungsten), metal oxide-based (titanium dioxide, tungsten oxide, and bismuth oxyhalide), metal sulfide-based (copper and molybdenum sulfide), carbon-based (graphene, fullerene, and graphitic carbon nitride), phosphorus-based, and others (hybrids and MXenes-based NPSs) are summarized, with an emphasis on the design principle and 1 O2 generation mechanism, and the photodynamic therapeutic performance against different types of cancers. Finally, the current challenges and an outlook of future research are also discussed. This review may provide a comprehensive account capable of explaining recent progress as well as future research of this emerging paradigm.

Umbelliferone Decorated Water-soluble Zinc(II) Phthalocyanines - In Vitro Phototoxic Antimicrobial Anti-cancer Agents

In this contribution we report on the synthesis, characterization and application of water-soluble zinc(II) phthalocyanines, which are decorated with four or eight umbelliferone moieties for photodynamic therapy (PDT). These compounds are linked peripherally to zinc(II) phthalocyanine by a triethylene glycol linker attached to pyridines, leading to cationic pyridinium units, able to increase the water solubility of the system. Beside their photophysical properties they were analyzed concerning their cellular distribution in human hepatocyte carcinoma (HepG2) cells as well as their phototoxicity towards HepG2 cells, Gram-positive (S. aureus strain 3150/12 and B. subtilis strain DB104) and Gram-negative bacteria (E. coli strain UTI89 and E. coli strain Nissle 1917). At low light doses and concentrations, they exhibit superb antimicrobial activity against Gram-positive bacteria as well as anti-tumor activity against HepG2. They are even capable to inactivate Gram-negative bacteria, whereas the dark toxicity remains low. These unique water-soluble compounds can be regarded as all-in-one type photosensitizers with broad applications ranges in the future.

A mitochondrion-targeted BODIPY-Ir(III) conjugate as a photoinduced ROS generator for the oxidative destruction of triple-negative breast cancer cells

Photodynamic therapy (PDT) provides an alternative option to root out localized triple-negative breast cancer (TNBC) and has been experiencing a surge of research interest over recent years. In this study, we put forward a paradigm of designing novel transition metal-based PSs with the following characteristics: favorable cell-permeability, significant light-harvesting ability and prominent ROS yield. A novel BODIPY-Ir(III) conjugate has been designed as a photoinduced ROS (¹O₂, ˙OH and ˙O₂^-) generator. BODIPY-Ir is highly photoactive in subduing cancer cells in the PDT regimen with PI values ranging from 172 to 519 and EC₅₀ in the nanomolar regime. Among various cancerous cell lines, TNBC was especially sensitive to BODIPY-Ir-mediated PDT, with a stunning EC₅₀ value of 4.32 nM (PI = 519) under a moderate flux of visible-light irradiation (500 nm, 10.5 mW cm^-2). BODIPY-Ir mainly accumulates in mitochondria and induces cell apoptosis under irradiation. Furthermore, the nanomolar antiproliferative activity of BODIPY-Ir is retained under hypoxia (2.5% O₂). This work sheds light on instilling the O₂-independent type I mechanism and conferring a red-shift absorption to metal-based PSs which fundamentally facilitate the clinical translation of PSs.

CeO2 QDs anchored on MnO2 nanoflowers with multiple synergistic effects for amplified tumour therapy

Chemodynamic therapy (CDT) is an emerging tumour-specific therapeutic technology. However, the relatively insufficient catalytic activity of CDT agents in the tumour microenvironment (TME) limits their biomedical application. In addition, severe hypoxia and glutathione (GSH) overexpression in the TME greatly limit the antitumour efficiency of monotherapy. Herein, a cancer cell membrane-camouflaged and ultrasmall CeO₂-decorated MnO₂ (mMC) composite is developed for amplified CDT, photodynamic therapy (PDT) and photothermal therapy (PTT). Due to the homotypic targeting ability of cancer cell membranes, mMC nanoparticles preferentially accumulate in tumour tissue. In the TME, CeO₂ acts as a highly efficient CDT agent to convert endogenous H₂O₂ to toxic reactive oxygen species (ROS) for killing cancer cells. Meanwhile, MnO₂ irradiated with near-infrared (NIR) light displays prominent hyperthermia and ROS generation performance to perform PTT and PDT. Moreover, MnO₂ can produce oxygen to ameliorate hypoxia and deplete GSH to relieve the antioxidant capability of tumours, which is beneficial to the simultaneous augmentation of PDT and CDT. Most importantly, the catalytic activity of CeO₂ was greatly improved by hyperthermia. Consequently, a significantly enhanced therapeutic efficiency was obtained by the above multiple synergistic effects. This work provides a proof of concept for amplified tumour therapy by synchronously self-supplying oxygen, consuming GSH, and enhancing catalytic activity.

BODIPY-Based Photodynamic Agents for Exclusively Generating Superoxide Radical over Singlet Oxygen

Developing Type-I photosensitizers is considered as an efficient approach to overcome the deficiency of traditional photodynamic therapy (PDT) for hypoxic tumors. However, it remains a challenge to design photosensitizers for generating reactive oxygen species by the Type-I process. Herein, we report a series of α,β-linked BODIPY dimers and a trimer that exclusively generate superoxide radical (O₂ ^-. ) by the Type-I process upon light irradiation. The triplet formation originates from an effective excited-state relaxation from the initially populated singlet (S₁ ) to triplet (T₁ ) states via an intermediate triplet (T₂ ) state. The low reduction potential and ultralong lifetime of the T₁ state facilitate the efficient generation of O₂ ^-. by inter-molecular charge transfer to molecular oxygen. The energy gap of T₁ -S₀ is smaller than that between ³ O₂ and ¹ O₂ thereby precluding the generation of singlet oxygen by the Type-II process. The trimer exhibits superior PDT performance under the hypoxic environment.

Type I Photosensitizers Revitalizing Photodynamic Oncotherapy

Photodynamic therapy (PDT) has shown great potential for tumor treatment with merits of non-invasiveness, high selectivity, and minimal side effects. However, conventional type II PDT relying on ¹ O₂ presents poor therapeutic efficacy for hypoxic tumors due to the oxygen-dependent manner. Alternatively, emerging researches have demonstrated that type I PDT exhibits superiority over type II PDT in tumor treatment owing to its diminished oxygen-dependence. In this review, state-of-the-art studies concerning recent progress in type I photosensitizers are scrutinized, emphasizing the strategies to construct highly effective type I photosensitizers. As the foundation, basic principles of type I PDT are presented, and up-to-date type I photosensitizers are summarized and classified based on their attributes. Then, a literature review of representative type I photosensitizers (including nanomaterials and small molecules) is presented with impetus to delineate their novel designs, action mechanisms, as well as anticancer PDT applications. Finally, the remaining challenges and development directions of type I photosensitizers are outlined, highlighting key scientific issues toward clinical translations.

Recent progress in sono-photodynamic cancer therapy: From developed new sensitizers to nanotechnology-based efficacy-enhancing strategies

Many sensitizers have not only photodynamic effects, but also sonodynamic effects. Therefore, the combination of sonodynamic therapy (SDT) and photodynamic therapy (PDT) using sensitizers for sono-photodynamic therapy (SPDT) provides alternative opportunities for clinical cancer therapy. Although significant advances have been made in synthesizing new sensitizers for SPDT, few of them are successfully applied in clinical settings. The anti-tumor effects of the sensitizers are restricted by the lack of tumor-targeting specificity, incapability in deep intratumoral delivery, and the deteriorating tumor microenvironment. The application of nanotechnology-based drug delivery systems (NDDSs) can solve the above shortcomings, thereby improving the SPDT efficacy. This review summarizes various sensitizers as sono/photosensitizers that can be further used in SPDT, and describes different strategies for enhancing tumor treatment by NDDSs, such as overcoming biological barriers, improving tumor-targeted delivery and intratumoral delivery, providing stimuli-responsive controlled-release characteristics, stimulating anti-tumor immunity, increasing oxygen supply, employing different therapeutic modalities, and combining diagnosis and treatment. The challenges and prospects for further development of intelligent sensitizers and translational NDDSs for SPDT are also discussed.

Amphiphilic tricationic Zn(II)phthalocyanine provides effective photodynamic action to eradicate broad-spectrum microorganisms

A novel tricationic Zn(II)phthalocyanine derivative, (NCH₃)₃ZnPc³⁺, was synthesized by ring expansion reaction of boron(III) [2,9(10),16(17)-trinitrosubphthalocyaninato]chloride. First, the reaction of this subphthalocyanine with 2,3-naphthalenedicarbonitrile and Zn(CH₃COO)₂ catalyzed by 8-diazabicyclo[5.4.0]undec-7-ene was used to obtain the A₃B-type nitrophthalocyanine. After reduction of nitro groups with Na₂S and exhaustive methylation of amino groups, (NCH₃)₃ZnPc³⁺ was formed in good yields. In addition, the tetracationic analog (NCH₃)₄ZnPc⁴⁺ was synthesized to compare their properties. The absorption and fluorescence spectra showed the Q-bands and the red emission, respectively, which are characteristic of the Zn(II)phthalocyanine derivatives in N,N-dimethylformamide. Furthermore, photodynamic activity sensitized by these compounds was studied in the presence of different molecular probes to sense the formation of reactive oxygen species. (NCH₃)₃ZnPc³⁺ efficiently produced singlet molecular oxygen and also it sensitized the formation of superoxide anion radical in the presence of NADH, while the photodynamic activity of (NCH₃)₄ZnPc⁴⁺ was very poor, possibly due to the partial formation of aggregates. Furthermore, the decomposition of L-tryptophan induced by (NCH₃)₃ZnPc³⁺ was mainly mediated by a type II mechanism. Antimicrobial photodynamic inactivation sensitized by these phthalocyanines was evaluated in Staphylococcus aureus, Escherichia coli, and Candida albicans, as representative microbial cells. In cell suspensions, (NCH₃)₃ZnPc³⁺ was rapidly bound to microbial cells, showing bioimages with red fluorescence emission. After 5 min of irradiation with visible light, (NCH₃)₃ZnPc³⁺ was able to completely eliminate S. aureus, E. coli and C. albicans, using 1.0, 2.5 and 5.0 μM phthalocyanine, respectively. In contrast, a low photoinactivation activity was found with (NCH₃)₄ZnPc⁴⁺ as a photosensitizer. Therefore, the amphiphilic tricationic phthalocyanine (NCH₃)₃ZnPc³⁺ is a promising photosensitizing structure for application as a broad-spectrum antimicrobial phototherapeutic agent.

Overcoming barriers in photodynamic therapy harnessing nano-formulation strategies

Photodynamic therapy (PDT) has been extensively investigated for decades for tumor treatment because of its non-invasiveness, spatiotemporal selectivity, lower side-effects, and immune activation ability. It can be a promising treatment modality in several medical fields, including oncology, immunology, urology, dermatology, ophthalmology, cardiology, pneumology, and dentistry. Nevertheless, the clinical application of PDT is largely restricted by the drawbacks of traditional photosensitizers, limited tissue penetrability of light, inefficient induction of tumor cell death, tumor resistance to the therapy, and the severe pain induced by the therapy. Recently, various photosensitizer formulations and therapy strategies have been developed to overcome these barriers. Significantly, the introduction of nanomaterials in PDT, as carriers or photosensitizers, may overcome the drawbacks of traditional photosensitizers. Based on this, nanocomposites excited by various light sources are applied in the PDT of deep-seated tumors. Modulation of cell death pathways with co-delivered reagents promotes PDT induced tumor cell death. Relief of tumor resistance to PDT with combined therapy strategies further promotes tumor inhibition. Also, the optimization of photosensitizer formulations and therapy procedures reduces pain in PDT. Here, a systematic summary of recent advances in the fabrication of photosensitizers and the design of therapy strategies to overcome barriers in PDT is presented. Several aspects important for the clinical application of PDT in cancer treatment are also discussed.

Photosensitizing nanoclays for efficient cell uptake and in vitro photodynamic therapy

In this study a straightforward strategy to deliver photosensitizing molecules into cancer cells by using Laponite RD® (LAP) nanodisks as carrier is presented. We report the application of LAP functionalized with a highly hydrophobic Silicon phthalocyanine photosensitizer (SiPc) for efficient cell uptake and photodynamic therapy (PDT) of MCF-7 breast cancer cells in vitro. This inorganic-organic hybrid nanomaterial caused a threefold increase in intracellular ROS levels and 99.7% of cancer cell inactivation after light treatment (630 nm; fluency of 108 J/cm²). With its theranostic capabilities (simultaneous fluorescence and singlet oxygen generation), uptake into cancer cells was monitored to control the photo-inactivation. The functionalized nanodisks already proved to be an efficient photo-inactivator of pathogenic Gram-(+) bacteria and were previously reported as LS10. By extending the use of LS10 to PDT of cancer cells, it is an example of a photosensitizer functionalized nanoclay with multipurpose drug characteristics, demonstrating an intriguing potential for future phototherapeutic studies and applications.

Recent Advances in Activatable Organic Photosensitizers for Specific Photodynamic Therapy

Photodynamic therapy is an alternative modality for the therapy of diseases such as cancer in a minimally invasive manner. The essential photosensitizer, which acts as a catalyst when absorbing light, converts oxygen into cytotoxic reactive oxygen species that ablate malignant cells through apoptosis and/or necrosis, destroy tumor microvasculature, and stimulate immunity. An activatable photosensitizer whose photoactivity could be turned on by a specific disease biomarker is capable of distinguishing healthy cells from diseased cells, thereby reducing off-target photodamage. In this Minireview, we highlight progress in activatable organic photosensitizers over the past five years, including: (i) biorthogonal activatable BODIPYs; (ii) activatable Se-rhodamine with single-cell resolution; (iii) silicon phthalocyanine targeting oxygen tension; (iv) general D-π-A scaffolds; and (v) AIEgens. The potential challenges and opportunities for developing new types of activatable organic photosensitizers to overcome the hypoxia dilemmas of photodynamic therapy are discussed.

Recent Progress of Alkyl Radicals Generation-Based Agents for Biomedical Applications

Photodynamic therapy (PDT) is extensively explored for anticancer and antibacterial applications. It typically relies on oxygen-dependent generation of reactive oxygen species (ROS) to realize its killing effect. This type of therapy modality shows compromised therapeutic results for treating hypoxic tumors or bacteria-infected wounds. Recently, alkyl radicals attracted much attention as they can be generated from some azo-based initiators only under mild heat stimulus without oxygen participation. Many nanocarriers or hydrogel systems have been developed to load and deliver these radical initiators to lesion sites for theranostics. These systems show good anticancer or antimicrobial effect in hypoxic environment and some of them possess specific imaging abilities providing precise guidance for treatment. This review summarizes the developed materials that aim at treating hypoxic cancer and bacteria-infected wound by using this kind of oxygen-irrelevant alkyl radicals. Based on the carrier components, these agents are divided into three groups: inorganic, organic, as well as inorganic and organic hybrid carrier-based therapeutic systems. The construction of these agents and their specific advantages in biomedical field are highlighted. Finally, the existing problems and future promising development directions are discussed.

Organic/inorganic nanohybrids rejuvenate photodynamic cancer therapy

The development of nanotechnology has changed the 100-year-old paradigm of photodynamic therapy (PDT), in which organic/inorganic hybrid nanomaterials have made great contributions. In this review, we first describe the mechanisms of PDT and discuss the limitations of conventional PDT. On this basis, we summarize recent progress in organic/inorganic nanohybrids-based photodynamic agents, highlighting how these nanohybrids can be programmed to overcome challenges in photodynamic cancer therapy.

In-vitro and In-vivo Photocatalytic Cancer Therapy with Biocompatible Iridium(III) Photocatalysts

Photocatalytic anticancer profile of a Ir^III photocatalyst (Ir3) with strong light absorption, high turnover frequency, and excellent biocompatibility is reported. Ir3 showed selective photo-cytotoxicity against cisplatin- and sorafenib-resistant cell lines while remaining dormant to normal cell lines in the dark. Ir3 exhibited excellent photo-catalytic oxidation of cellular co-enzyme, the reduced nicotinamide adenine dinucleotide phosphate (NADPH), and amino acids via a single electron transfer mechanism. The photo-induced intracellular redox imbalance and change in mitochondrial membrane potential resulted in necrosis and apoptosis of cancer cells. Importantly, Ir3 exhibited high biocompatibility and photo-catalytic anticancer efficiency as evident from in vivo zebrafish and mouse cancer models. To the best of our knowledge, Ir3 is the first Ir^III based photocatalyst with such a high biocompatibility and photocatalytic anticancer therapeutic effect.

A novel tricationic fullerene C60 as broad-spectrum antimicrobial photosensitizer: mechanisms of action and potentiation with potassium iodide

A novel amphiphilic photosensitizing agent based on a tricationic fullerene C₆₀ (DMC₆₀³⁺) was efficiently synthesized from its non-charged analogue MMC₆₀. These fullerenes presented strong UV absorptions, with a broad range of less intense absorption up to 710 nm. Both compounds showed low fluorescence emission and were able to photosensitize the production of reactive oxygen species. Furthermore, photodecomposition of L-tryptophan sensitized by both fullerenes indicated an involvement of type II pathway. DMC₆₀³⁺ was an effective agent to produce the photodynamic inactivation (PDI) of Staphylococcus aureus, Escherichia coli and Candida albicans. Mechanistic insight indicated that the photodynamic action sensitized by DMC₆₀³⁺ was mainly mediated by both photoprocesses in bacteria, while a greater preponderance of the type II pathway was found in C. albicans. In presence of potassium iodide, a potentiation of PDI was observed due to the formation of reactive iodine species. Therefore, the amphiphilic DMC₆₀³⁺ can be used as an effective potential broad-spectrum antimicrobial photosensitizer.

Phthalocyanine-DNA origami complexes with enhanced stability and optical properties

In this communication, electrostatically assembled phthalocyanine (Pc)-DNA origami (DO) complexes are formed and their optical properties are demonstrated. The formation of the complex prevents the Pc aggregation, thus yielding an enhanced optical response and photooxidative resilience towards aggregation in biologically relevant media. Simultaneously, the Pc protects the DO against enzymatic digestion. Both features solve previous drawbacks associated with phthalocyanine photosensitizers and DNA nanocarriers. The studied complexes may find use in technologies related to the photogeneration of singlet oxygen, e.g., photocatalysis, diagnositic arrays and photodynamic therapy.

Recent progress in photosensitizers for overcoming the challenges of photodynamic therapy: from molecular design to application

Photodynamic therapy (PDT), a therapeutic mode involving light triggering, has been recognized as an attractive oncotherapy treatment. However, nonnegligible challenges remain for its further clinical use, including finite tumor suppression, poor tumor targeting, and limited therapeutic depth. The photosensitizer (PS), being the most important element of PDT, plays a decisive role in PDT treatment. This review summarizes recent progress made in the development of PSs for overcoming the above challenges. This progress has included PSs developed to display enhanced tolerance of the tumor microenvironment, improved tumor-specific selectivity, and feasibility of use in deep tissue. Based on their molecular photophysical properties and design directions, the PSs are classified by parent structures, which are discussed in detail from the molecular design to application. Finally, a brief summary of current strategies for designing PSs and future perspectives are also presented. We expect the information provided in this review to spur the further design of PSs and the clinical development of PDT-mediated cancer treatments.

Small Molecular NIR-II Fluorophores for Cancer Phototheranostics

Phototheranostics integrates deep-tissue imaging with phototherapy (containing photothermal therapy and photodynamic therapy), holding great promise in early diagnosis and precision treatment of cancers. Recently, second near-infrared (NIR-II) fluorescence imaging exhibits the merits of high accuracy and specificity, as well as real-time detection. Among the NIR-II fluorophores, organic small molecular fluorophores have shown superior properties in the biocompatibility, variable structure, and tunable emission wavelength than the inorganic NIR-II materials. What's more, some small molecular fluorophores also display excellent cytotoxicity when illuminated with the NIR laser. This review summarizes the progress of small molecular NIR-II fluorophores with different central cores for cancer phototheranostics in the past few years, focusing on the molecular structures and phototheranostic performances. Furthermore, challenges and prospects of future development toward clinical translation are discussed.

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Phototheranostics combines diagnostic imaging with phototherapy, showing broad applications in the early diagnosis and precise treatment of tumors

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Small molecular NIR-II fluorophores with good biocompatibility, tunable structure, high imaging quality, and excellent phototoxicity, have shown great potential for cancer phototheranostics

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Small molecular NIR-II fluorophores with different central cores for cancer phototheranostics are summarized, highlighting the design strategies and phototheranostic performances

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Challenges and prospects of future development toward clinical translation are discussed

Cascade Reactions by Nitric Oxide and Hydrogen Radical for Anti-Hypoxia Photodynamic Therapy Using an Activatable Photosensitizer

Organelle-targeted activatable photosensitizers are attractive to improve the specificity and controllability of photodynamic therapy (PDT), however, they suffer from a big problem in the photoactivity under both normoxia and hypoxia due to the limited diversity of phototoxic species (mainly reactive oxygen species). Herein, by effectively photocaging a π-conjugated donor-acceptor (D-A) structure with an N-nitrosamine substituent, we established a unimolecular glutathione and light coactivatable photosensitizer, which achieved its high performance PDT effect by targeting mitochondria through both type I and type II (dual type) reactions as well as secondary radicals-participating reactions. Of peculiar interest, hydrogen radical (H^•) was detected by electron spin resonance technique. The generation pathway of H^• via reduction of proton and its role in type I reaction were discussed. We demonstrated that the synergistic effect of multiple reactive species originated from tandem cascade reactions comprising reduction of O₂ by H^• to form O₂^•-/HO₂^• and downstream reaction of O₂^•- with ^•NO to yield ONOO^-. With a relatively large two-photon absorption cross section for photoexcitation in the near-infrared region (166 ± 22 GM at 800 nm) and fluorogenic property, the new photosensitizing system is very promising for broad biomedical applications, particularly low-light dose PDT, in both normoxic and hypoxic environments.

Theoretical insights on type I/II photoreactions of potential Zn(II) polypyridyl photosensitizers for two-photon photodynamic therapy

Large two-photon absorption cross-sections are vital to photosensitizers (PSs) in TP-PDT, which can be used to develop in-depth treatment for diseased cells and minimize the harm to surrounding cells. Here, we conduct a study about photophysical properties of one Ru(II) polypyridyl complex and two designed Zn(II) polypyridyl complexes by means of DFT and TD-DFT methods. The main results are as follows: firstly, the two-photon absorption spectrum of two designed complexes Zn-OMe and Zn-OCOOCH₃ are all within the phototherapeutic window (550-900 nm). Secondly, large SOC values and small energy gaps ΔE_S-T of these complexes guarantee the efficiency of ISC process. Thirdly, their T₁ energy is greater than that required for generating ¹O₂ (0.98 eV) via Type II photoreaction. In addition, the calculated results of vertical electron affinities (VEA) and vertical ionization potentials (VIP) show that these complexes are able to form superoxide ions O₂^(-) via Type I photoreaction. Specifically, both of two designed Zn-centric complexes have larger TPA cross-sections than that of Ru-centric complex. In a word, we are pleased to report two potential photosensitizers with excellent performance and reasonable price for Type I/II photoreactions. We expect our study will offer some theoretical guidance and help in TP-PDT.

GSH-Depleted Nanozymes with Hyperthermia-Enhanced Dual Enzyme-Mimic Activities for Tumor Nanocatalytic Therapy

Nanocatalytic therapy, using artificial nanoscale enzyme mimics (nanozymes), is an emerging technology for therapeutic treatment of various malignant tumors. However, the relatively deficient catalytic activity of nanozymes in the tumor microenvironment (TME) restrains their biomedical applications. Here, a versatile and bacteria-like PEG/Ce-Bi@DMSN nanozyme is developed by coating uniform Bi₂ S₃ nanorods (NRs) with dendritic mesoporous silica (Bi₂ S₃ @DMSN) and then decorating ultrasmall ceria nanozymes into the large mesopores of Bi₂ S₃ @DMSN. The nanozymes exhibit dual enzyme-mimic catalytic activities (peroxidase-mimic and catalase-mimic) under acidic conditions that can regulate the TME, that is, simultaneously elevate oxidative stress and relieve hypoxia. In addition, the nanozymes can effectively consume the overexpressed glutathione (GSH) through redox reaction. Photothermal therapy (PTT) is introduced to synergistically improve the dual enzyme-mimicking catalytic activities and depletion of the overexpressed GSH in the tumors by photonic hyperthermia. This is achieved by taking advantage of the desirable light absorbance in the second near-infrared (NIR-II) window of the PEG/Ce-Bi@DMSN nanozymes. Subsequently the reactive oxygen species (ROS)-mediated therapeutic efficiency is significantly improved. Therefore, this study provides a proof of concept of hyperthermia-augmented multi-enzymatic activities of nanozymes for tumor ablation.

Avoiding ventilator-associated pneumonia: Curcumin-functionalized endotracheal tube and photodynamic action

Hospital-acquired infections are a global health problem that threatens patients' treatment in intensive care units, causing thousands of deaths and a considerable increase in hospitalization costs. The endotracheal tube (ETT) is a medical device placed in the patient's trachea to assist breathing and delivering oxygen into the lungs. However, bacterial biofilms forming at the surface of the ETT and the development of multidrug-resistant bacteria are considered the primary causes of ventilator-associated pneumonia (VAP), a severe hospital-acquired infection for significant mortality. Under these circumstances, there has been a need to administrate antibiotics together. Although necessary, it has led to a rapid increase in bacterial resistance to antibiotics. Therefore, it becomes necessary to develop alternatives to prevent and combat these bacterial infections. One possibility is to turn the ETT itself into a bactericide. Some examples reported in the literature present drawbacks. To overcome those issues, we have designed a photosensitizer-containing ETT to be used in photodynamic inactivation (PDI) to avoid bacteria biofilm formation and prevent VAP occurrence during tracheal intubation. This work describes ETT's functionalization with curcumin photosensitizer, as well as its evaluation in PDI against Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli A significant photoinactivation (up to 95%) against Gram-negative and Gram-positive bacteria was observed when curcumin-functionalized endotracheal (ETT-curc) was used. These remarkable results demonstrate this strategy's potential to combat hospital-acquired infections and contribute to fighting antimicrobial resistance.

Optical properties of photodynamic therapy drugs in different environments: the paradigmatic case of temoporfin

Computational tools have been used to study the photophysical and photochemical features of photosensitizers in photodynamic therapy (PDT) - a minimally invasive, less aggressive alternative for cancer treatment. PDT is mainly based on the activation of molecular oxygen through the action of a photoexcited sensitizer (photosensitizer). Temoporfin, widely known as mTHPC, is a second-generation photosensitizer, which produces the cytotoxic singlet oxygen when irradiated with visible light and hence destroys tumor cells. However, the bioavailability of the mostly hydrophobic photosensitizer, and hence its incorporation into cells, is fundamental to achieve the desired effect on malignant tissues via PDT. In this study, we focus on the optical properties of the temoporfin chromophore in different environments -in vacuo, in solution, encapsulated in drug delivery agents, namely cyclodextrin, and interacting with a lipid bilayer.

A Cu9S5 nanoparticle-based CpG delivery system for synergistic photothermal-, photodynamic- and immunotherapy

Despite its great potential in cancer therapy, phototherapy, including photothermal therapy (PTT) and photodynamic therapy (PDT), often cause metastasis of tumors. Immunotherapy has revolutionized the cancer treatment owing to the capability of activating immune system to eliminate tumors. However, the integration of phototherapy and immunotherapy in a single nanoagent for cancer therapy is still a challenging task. Here, we fabricated (Cu₉S₅@mSiO₂-PpIX@MnO₂@CpG (CSPM@CpG)) as a synergistic therapeutic model for phototherapy enhanced immunotherapy. The intracellular uptake of cytosine-phosphate-guanine (CpG) promoted the infiltration of cytotoxic T lymphocytes (CTLs) in tumor tissue, further stimulating the production of interferon gamma (IFN-γ) and remarkably elevating the immune response level. Excellent anti-tumor effects have been achieved by synergistic PTT/PDT/immunotherapy. The metastasis of tumors was effectively inhibited by the immune response of CpG. Thus, our proposed work provides a strategy to combine phototherapy with immunotherapy to enhance the therapeutic efficiency and further inhibit metastasis of tumors.

CpG oligonucleotides can stimulate an anticancer immune response. Zhou et al. now develop nanoparticles that can deliver CpG, which promotes cancer cell death after photothermal and photodynamic therapy in vitro and in vivo, concomitant with an immunological response.

Host-guest complexes - Boosting the performance of photosensitizers

In this review, we will show the diversity of supramolecular host-guest complexes of cyclodextrins, cucurbit[n]urils, calix[n]- and pillar[n]arenes with photosensitizers, like porphyrins and phthalocyanines. Host-guest complexes are one of the main building blocks in supramolecular chemistry. For example, they have been widely used to encapsulate hydrophobic drug molecules to enhance the bioavailability in the human body. In these days of multiresistant bacteria and difficulties in cancer therapy, supramolecular host-guest systems with photosensitizers for the photodynamic therapy(PDT) gain more and more interest. In general, photosensitizers with a (large) conjugated aromatic π-system are used, which tend to π-πstacking in aqueous media suppressing the cell toxicity by singletoxygen production quenching. This can be overcome by the formation of host-guest complexes. Besides that, encapsulation of the photosensitizers in host molecules can enhance the solubility, increase cellular uptake, lead to hydrogels, rotaxanes, and switchable systems.

New nitroindazole-porphyrin conjugates: Synthesis, characterization and antibacterial properties

The synthesis of new porphyrin-indazole hybrids by a Knoevenagel condensation of 2-formyl-5,10,15,20-tetraphenylporphyrin and N-methyl-nitroindazolylacetonitrile derivatives is reported. The target compounds were isolated in moderate to good yields (32-57%) and some of the isolated porphyrin-indazole conjugates showed good performance in the generation of singlet oxygen when irradiated with visible light. Their efficiency as photosensitizers in the photoinactivation of methicillin resistant Staphylococcus aureus-MRSA was evaluated. All derivatives showed to be able to photoinactivate the MRSA bacteria. Compound 3a appears to be the most promising photosensitiser (PS) in the photoinactivation of these bacteria, despite being the least efficient in singlet oxygen generation. The addition of potassium iodide (KI) significantly potentiated the antimicrobial Photodynamic Therapy (aPDT) process mediated by all the analysed porphyrin-indazole conjugates. The combined action of nitroindazole-porphyrins with potassium iodide (KI) action appears to be promising in the photoinactivation of MRSA.

Aza-BODIPY-Based Nanomedicines in Cancer Phototheranostics

Cancer phototheranostics, composed of optical diagnosis and phototherapy (including photodynamic therapy and photothermal therapy), is a promising strategy for precise tumor treatment. Due to the unique properties of near-infrared absorption/emission, high reactive oxygen species generation, and photothermal conversion efficiency, aza-boron-dipyrromethene (aza-BODIPY), as an emerging organic photosensitizer, has shown great potential for tumor phototheranostics. By encapsulating aza-BODIPY photosensitizers within functional amphiphilic polymers, we can afford hydrophilic nanomedicines that selectively target tumor sites via an enhanced permeability and retention effect, thereby efficiently improving diagnosis and therapeutic efficacy. Herein, in this spotlight article, we attempt to highlight our recent contributions in the development of aza-BODIPY-based nanomedicines, which comprises three main sections: (1) to elucidate the design strategy of aza-BODIPY photosensitizers and corresponding nanomedicines; (2) to overview their photophysical properties and biomedical applications in phototheranostics, including fluorescence imaging, photoacoustic imaging, photodynamic therapy, photothermal therapy, and synergistic therapy; and (3) to depict the challenges and future perspectives of aza-BODIPY nanomedicines. It is believed that this Spotlight on Applications article would illuminate the way of developing new aza-BODIPY nanomedicines as well as other organic photosensitizer-based nanomedicines for future clinical translation.

Alkyne Functionalization of a Photoactivated Ruthenium Polypyridyl Complex for Click-Enabled Serum Albumin Interaction Studies

Studying metal-protein interactions is key for understanding the fate of metallodrugs in biological systems. When a metal complex is not emissive and too weakly bound for mass spectrometry analysis, however, it may become challenging to study such interactions. In this work a synthetic procedure was developed for the alkyne functionalization of a photolabile ruthenium polypyridyl complex, [Ru(tpy)(bpy)(Hmte)](PF₆)₂, where tpy = 2,2′:6′,2′′-terpyridine, bpy = 2,2′-bipyridine, and Hmte = 2-(methylthio)ethanol. In the functionalized complex [Ru(HCC-tpy)(bpy)(Hmte)](PF₆)₂, where HCC-tpy = 4′-ethynyl-2,2′:6′,2′′-terpyridine, the alkyne group can be used for bioorthogonal ligation to an azide-labeled fluorophore using copper-catalyzed “click” chemistry. We developed a gel-based click chemistry method to study the interaction between this ruthenium complex and bovine serum albumin (BSA). Our results demonstrate that visualization of the interaction between the metal complex and the protein is possible, even when this interaction is too weak to be studied by conventional means such as UV–vis spectroscopy or ESI mass spectrometry. In addition, the weak metal complex-protein interaction is controlled by visible light irradiation, i.e., the complex and the protein do not interact in the dark, but they do interact via weak van der Waals interactions after light activation of the complex, which triggers photosubstitution of the Hmte ligand.

A “clickable” and photosubstitutionally active ruthenium complex has been prepared that bears a terminal alkyne group. In the dark, the saturated coordination sphere of the complex prevents it from interacting with serum albumin. Upon photosubstitution of one ligand, the complex interacts with the protein via weak interactions that were visualized using copper-catalyzed “click” chemistry postfunctionalization with an azide fluorophore on polyacrylamide gel electrophoresis. These studies demonstrate that the metal-protein interaction is triggered by light irradiation.

Photo/electrocatalysis and photosensitization using metal nanoclusters for green energy and medical applications

Owing to the rapidly increasing demand for sustainable technologies in fields such as energy, environmental science, and medicine, nanomaterial-based photo/electrocatalysis has received increasing attention. Recently, synthetic innovations have allowed the fabrication of atomically precise metal nanoclusters (NCs). These NCs show potential for green energy and medical applications. The present article primarily focuses on evaluation of the recent developments in the photo/electrocatalytic and photosensitizing characteristics of metal and alloy NCs. The review comprises two sections: (i) photo/electrocatalysis for green energy and (ii) photosensitization for biomedical therapy applications. Finally, the challenges associated with the use of metal NCs are presented on the basis of current developments.

Nanoparticle-based drug delivery systems for controllable photodynamic cancer therapy

Compared with the traditional treatment, photodynamic therapy (PDT) in the treatment of malignant tumors has the advantages of less damage to normal tissues, quick therapeutic effect, and ability to repeat treatments to the same site. However, most of the traditional photosensitizers (PSs) have severe skin photosensitization, poor tumor targeting, and low therapeutic effect in hypoxic tumor environment, which limit the application of PDT. Nanoparticle-based drug delivery systems can improve the targeting of PSs and release drugs with controllable photoactivity at predetermined locations, so as to achieve desired therapeutic effects with minimal side-effects. The present review summarizes the current nanoparticle platforms for PDT, and offers the description of different strategies including tumor-targeted delivery, controlled-release of PSs and the triggered photoactivity to achieve controllable PDT by nanoparticle-based drug delivery systems. The challenges and prospects for further development of intelligent PSs for PDT are also discussed.

Dancing with reactive oxygen species generation and elimination in nanotheranostics for disease treatment

Reactive oxygen species (ROS) play important roles in cell signaling and tissue homeostasis, in which the level of ROS is critical through the equilibrium between ROS generating and eliminating events. A disruption of the balance leads to disease development either by a surplus or a dearth of ROS, which requires ROS-modulating strategies to overturn the defect for disease treatment. Over the past decade, there have been tremendous advances in nanomedicine centering ROS generation and/or elimination as major mechanisms to treat a variety of diseases. In this review, we will discuss the research achievements on two opposite approaches of ROS-generating and ROS-eliminating strategies for treating cancer and other related diseases. Importantly, we will highlight the conceptual and strategic advances of ROS-mediated immunomodulation, including macrophage polarization, immunogenic cell death and T cell activation, which are currently rising as one of the mainstreams of cancer therapy. At the end, the future challenges and opportunities of mediating ROS-based mechanisms are envisioned. In light of the pleiotropic roles of ROS in different diseases, we hope this review is timely to deliver a clear logic of designing principles on ROS generation and elimination for different disease treatments.

Singlet oxygen partition between the outer-, inner- and membrane-phases of photo/chemotherapeutic liposomes

Herein, we developed a strategy to quantify the fraction of singlet oxygen lifetime spent in the three distinct local liposomal environments through the combination of direct and indirect singlet oxygen detection approaches.