A look at clinical applications and developments of photodynamic therapy

Three-dimensional printing of the human lung pleural cavity model for PDT malignant mesothelioma

OBJECTIVE

The primary aim was to investigate emerging 3D printing and optical acquisition technologies to refine and enhance photodynamic therapy (PDT) dosimetry in the management of malignant pleural mesothelioma (MPM).

MATERIALS AND METHODS

A rigorous digital reconstruction of the pleural lung cavity was conducted utilizing 3D printing and optical scanning methodologies. These reconstructions were systematically assessed against CT-derived data to ascertain their accuracy in representing critical anatomic features and post-resection topographical variations.

RESULTS

The resulting reconstructions excelled in their anatomical precision, proving instrumental translation for precise dosimetry calculations for PDT. Validation against CT data confirmed the utility of these models not only for enhancing therapeutic planning but also as critical tools for educational and calibration purposes.

CONCLUSION

The research outlined a successful protocol for the precise calculation of light distribution within the complex environment of the pleural cavity, marking a substantive advance in the application of PDT for MPM. This work holds significant promise for individualizing patient care, minimizing collateral radiation exposure, and improving the overall efficiency of MPM treatments.

Polyelectrolytic BSA nanoparticles containing silicon dihydroxide phthalocyanine as a promising candidate for drug delivery systems for anticancer photodynamic therapy

Recently several scientific-technological advances in the health area have developed. Among them, we can highlight research addressing nanoscience and nanotechnology focusing on the development of formulations for the cancer treatment. This work describes the synthesis and characterization of bovine serum albumin (BSA) polyelectrolytic nanoparticles for controlled release using silicon dihydroxide phthalocyanine [SiPc (OH)₂] as a photosensitizer model for application in Photodynamic Therapy (PDT). BSA nanoparticles were prepared by the one-step desolvation process and the nanoparticulate system was coated with polyelectrolytes using poly-(4-styrene sulfonate - PSS) as a strong polyanion and polyallylamine hydrochloride (PAH) as a weak polycation by the technique self-assembling layer-by-layer (LbL). The formulation was characterized and available in cellular culture. The profile of drug release was investigated and compared to that of free [SiPc (OH)₂]. The nanoparticles have a mean diameter of 226.9 nm, a narrow size distribution with polydispersive index of 0.153, smooth surface and spherical shape. [SiPc(OH)₂] loaded nanoparticles maintain its photophysical behaviour after encapsulation. The polyelectrolytic nanoparticles improved efficiency in release and photocytotoxicity assay when compared to pure drug. The results demonstrate that photosensitizer adsorption on BSA nanoparticles together with biopolymer layer-by-layer assembly provides a way to manufacture biocompatible nanostructured materials that are intended for use as biomaterials for Photodynamic Therapy applications.

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.

Effects of meta-tetrahydroxyphenylchlorin photodynamic therapy on isogenic colorectal cancer SW480 and SW620 cells with different metastatic potentials

The aim of this study is to investigate the antitumor effects and possible mechanisms of meta-tetrahydroxyphenylchlorin-mediated photodynamic therapy (m-THPC-PDT) on human primary (SW480) and metastatic (SW620) colon cancer cell lines. SW480 and SW620 cells were incubated with various concentrations of m-THPC, followed by photodynamic irradiation. Subcellular localization of m-THPC in cells was observed with confocal laser scanning microscopy (CLSM). Photocytotoxicity of m-THPC in the two cells was investigated by using MTT assay. The flow cytometry was employed to detect the cell apoptosis. The migration and long-term recovery ability were determined by scratch test and colony formation assay respectively. CLSM showed that m-THPC was mainly distributed within the endoplasmic reticulum (ER) and lysosome of SW480 cells and within the lysosome and mitochondria of SW620 cells. m-THPC-PDT induced a dose-dependent and light energy-dependent cytotoxicity in SW480 and SW620 cells. Apoptosis rate was approximately 65 and 25% in SW480 and SW620 respectively when the concentration of m-THPC increased to 11.76 μM. However, the rate of necrotic cells had no significant changes in two cell lines. The colony formation and migration ability of the two cell lines were decreased with m-THPC-PDT treatment in a dose-dependent manner. PDT with m-THPC not only could effectively inhibit cell proliferation and decrease migration ability and colony formation ability, but also could effectively kill SW480 and SW620 cells in a dose-dependent manner in vitro. These results suggest that m-THPC is a promising sensitizer that warrants further development and extensive studies towards clinical use of colorectal cancer.

A new therapeutic proposal for inoperable osteosarcoma: Photodynamic therapy

BACKGROUND

Osteosarcoma, a malignant tumor characterized by bone or osteoid formation, is the second most common primary bone neoplasm. Clinical symptoms include local and surrounding pain, unrelieved by rest or anesthesia. Osteosarcoma has a poor chemotherapeutic response with prognosis dependent on complete tumor excision. Therefore, for inoperable osteosarcoma new therapeutic strategies are needed. The present study aimed to develop murine models of cranial and vertebral osteosarcoma that facilitate simple clinical monitoring and real-time imaging to evaluate the outcome of photodynamic therapy based on a previously developed photosensitizer.

METHODS

Balb/c nude mice were divided into two groups: the cranial and vertebral osteosarcoma groups. Each group was further subdivided into the photodynamic therapy-treated and untreated groups. Images were obtained by scintigraphy with ^99mTc-MIBI and radiography. Tumor growth, necrotic area, osteoid matrix area, and inflammatory infiltration were analyzed.

RESULTS

Cranial and vertebral tumors could be macroscopically observed and measured. Radiographic and scintigraphic images showed tumor cells present at the inoculation sites. After photodynamic therapy, scintigraphy showed lower tumoral radiopharmaceutical uptake, which correlated histologically with increased necrosis. Osteoid matrix volume increased, and tumor size decreased in all photodynamic therapy-treated animals.

CONCLUSION

Cranial and vertebral osteosarcoma models in athymic mice are feasible and facilitate in vivo monitoring for the development of new therapies. Photodynamic therapy is a potential antitumoral treatment for surgically inoperable osteosarcoma.

2 μm laser oscillation of Ho3+:Tm3+-codoped silica microspheres

2 μm laser oscillation with a low threshold has been achieved in Ho³⁺:Tm³⁺-codoped silica microspheres (HTCSMs). Ho³⁺:Tm³⁺-codoped solgel functionalization film is applied to the surface of a silica microsphere, and an optical tapered fiber is adopted to couple an 808 nm continuous-wave laser to serve as the pump light source. Multimode and single-mode laser oscillations around 2 μm within the eye-safe wave band are observed due to the I₇5→I₈5 transitions of Ho³⁺ ions sensitized by Tm³⁺. The morphology characteristics of microspheres determine the multimode laser oscillation spectrum. The free spectral range is in good accordance with the calculated value based on Mie scattering theory. The HTCSM laser oscillation shows characteristics of good capability, simple process, high flexibility, and low cost.

Structural and Epimeric Isomers of HPPH [3-Devinyl 3-{1-(1-hexyloxy) ethyl}pyropheophorbide-a]: Effects on Uptake and Photodynamic Therapy of Cancer

The tetrapyrrole structure of porphyrins used as photosentizing agents is thought to determine uptake and retention by malignant epithelial cancer cells. To assess the contribution of the oxidized state of individual rings to these cellular processes, bacteriochlorophyll a was converted into the ring "D" reduced 3-devinyl-3-[1-(1-hexyloxy)ethyl]pyropheophorbide-a (HPPH) and the corresponding ring "B" reduced isomer (iso-HPPH). The carboxylic acid analogs of both ring "B" and ring "D" reduced isomers showed several-fold higher accumulation into the mitochondria and endoplasmic reticulum by primary culture of human lung and head and neck cancer cells than the corresponding methyl ester analogs that localize primarily to granular vesicles and to a lesser extent to mitochondria. However, long-term cellular retention of these compounds exhibited an inverse relationship with tumor cells generally retaining better the methyl-ester derivatives. In vivo distribution and tumor uptake was evaluated in the isogenic model of BALB/c mice bearing Colon26 tumors using the respective ¹⁴C-labeled analogs. Both carboxylic acid derivatives demonstrated similar intracellular localization and long-term tumor cure with no significant skin phototoxicity. PDT-mediated tumor action involved vascular damage, which was confirmed by a reduction in blood flow and immunohistochemical assessment of damage to the vascular endothelium. The HPPH stereoisomers (epimers) showed identical uptake (in vitro & in vivo), intracellular retention and photoreaction.

Photophysical properties of sinoporphyrin sodium and explanation of its high photo-activity

Sinoporphyrin sodium (DVDMS) is a novel photosensitizer with high photodynamic therapy (PDT) effect. Reasons for its high photo-activity were investigated according to the study of photophysical characteristics of DVDMS. Extinction coefficients ([Formula: see text] of DVDMS at 405 nm and 630 nm are 4.36 × 105 and 1.84 × 104 M[Formula: see text].cm[Formula: see text]; fluorescence quantum yield ([Formula: see text] is 0.026; quantum yield of lowest triplet state formation is 0.94 and singlet oxygen quantum yield ([Formula: see text] is 0.92. Although [Formula: see text] of DVDMS is only 10% higher than that of Photofrin[Formula: see text] (0.83), the extinction coefficient of DVDMS at 630 nm is 10-fold greater than that of Photofrin[Formula: see text]. This leads to its higher singlet oxygen generation efficiency ([Formula: see text]. The higher [Formula: see text] of DVDMS can result in an effective reduction of dosage (1/10 of Photofrin[Formula: see text] reaching the same cytotoxic effect as Photofrin[Formula: see text]. Even though [Formula: see text] is approximately equal to that of Photofrin[Formula: see text], brightness ([Formula: see text] of DVDMS is 10-fold greater than that of Photofrin[Formula: see text] because of the 10-fold greater extinction coefficient. Thus, fluorescence diagnosis ability of 0.2 mg/kg DVDMS is comparable to that of 2 mg/kg Photofrin[Formula: see text] used in PDT. Overall, the 10-fold greater extinction coefficients are responsible for the high brightness and singlet oxygen generation efficiency of DVDMS.

Retinoblastoma: might photodynamic therapy be an option?

Retinoblastoma is a tumor that mainly affects children under 5 years, all over the world. The origin of these tumors is related with mutations in the RB1 gene, which may result from genetic alterations in cells of the germ line or in retinal somatic cells. In developing countries, the number of retinoblastoma-related deaths is higher due to less access to treatment, unlike what happens in developed countries where survival rates are higher. However, treatments such as chemotherapy and radiotherapy, although quite effective in treating this type of cancer, do not avoid high indices of mortality due to secondary malignances which are quite frequent in these patients. Additionally, treatments such as cryotherapy, thermotherapy, thermochemotherapy, or brachytherapy represent other options for retinoblastoma. When all these approaches fail, enucleation is the last option. Photodynamic therapy might be considered as an alternative, particularly because of its non-mutagenic character. Photodynamic therapy is a treatment modality based on the administration of photosensitizing molecules that only upon irradiation of the tumor with a light source of appropriate wavelength are activated, triggering its antitumor action. This activity may be not only due to direct damage to tumor cells but also due to damage caused to the blood vessels responsible for the vascular supply of the tumor. Over the past decades, several in vitro and in vivo studies were conducted to assess the effectiveness of photodynamic therapy in the treatment of retinoblastoma, and very promising results were achieved.

Cell death pathways and phthalocyanine as an efficient agent for photodynamic cancer therapy

The mechanisms of cell death can be predetermined (programmed) or not and categorized into apoptotic, autophagic and necrotic pathways. The process of Hayflick limits completes the execution of death-related mechanisms. Reactive oxygen species (ROS) are associated with oxidative stress and subsequent cytodamage by oxidizing and degrading cell components. ROS are also involved in immune responses, where they stabilize and activate both hypoxia-inducible factors and phagocytic effectors. ROS production and presence enhance cytodamage and photodynamic-induced cell death. Photodynamic cancer therapy (PDT) uses non-toxic chemotherapeutic agents, photosensitizer (PS), to initiate a light-dependent and ROS-related cell death. Phthalocyanines (PCs) are third generation and stable PSs with improved photochemical abilities. They are effective inducers of cell death in various neoplastic models. The metallated PCs localize in critical cellular organelles and are better inducers of cell death than other previous generation PSs as they favor mainly apoptotic cell death events.

DFT/TD-DFT study of solvent effect as well the substituents influence on the different features of TPP derivatives for PDT application

Spectral characteristics study of meso-tetraphenylporphyrin derivatives (TPP1 and TPP2) used as photosensitizers for utilization in photodynamic therapy (PDT) has been performed by density functional theory (DFT) and time dependent DFT (TD-DFT) calculations at B3LYP/6-31 G(d) level of theory using PCM solvation model. The geometrical parameters of porphyrins have been studied for ground and excited-state geometry to deduce the influence of various substituents as well as solvent effect on the deformation of porphyrin ring. Two theoretical approaches - linear response (LR) and external iteration (EI) - have been performed to replicate absorption and fluorescence emission spectra. Experimental and theoretical investigations have shown that EI method reproduces the absorption energies very well for both singlet-singlet and triplet-triplet transitions, whereas the LR approach is more coherent with experimental fluorescence emission spectra. Spectral features and HOMO-LUMO band gap analysis have shown that TPP1 can be more useful in PDT. Calculations have revealed that two the highest occupied and two the lowest unoccupied molecular orbitals are responsible for the Q-band absorption and are located mainly on the porphyrin ring. In order to verify the substituent effect on the activity of tested compounds in their ground and excited states, the molecular electrostatic potential surfaces have been analyzed.

Photodynamic therapy based on 5-aminolevulinic acid and its use as an antimicrobial agent

Exogenous 5-aminolevulinic acid (ALA) is taken up directly by bacteria, yeasts, fungi, and some parasites, which then induces the accumulation of protoporphyrin IX (PPIX). Subsequent light irradiation of PPIX leads to the inactivation of these organisms via photodamage to their cellular structures. ALA uptake and light irradiation of PPIX produced by host cells leads to the inactivation of other parasites, along with some viruses, via the induction of an immune response. ALA-mediated PPIX production by host cells and light irradiation result in the inactivation of other viruses via either the induction of a host cell response or direct photodynamic attack on viral particles. This ALA-mediated production of light-activated PPIX has been extensively used as a form of photodynamic therapy (PDT) and has shown varying levels of efficacy in treating conditions that are associated with microbial infection, ranging from acne and verrucae to leishmaniasis and onychomycosis. However, for the treatment of some of these conditions by ALA-based PDT, the role of an antimicrobial effect has been disputed and in general, the mechanisms by which the technique inactivates microbes are not well understood. In this study, we review current understanding of the antimicrobial mechanisms used by ALA-based PDT and its role in the treatment of microbial infections along with its potential medical and nonmedical applications.

Rare-earth ions doped heavy metal germanium tellurite glasses for fiber lighting in minimally invasive surgery

In Er(3+)/Yb(3+) codoped Na(2)O-ZnO-PbO-GeO(2)-TeO(2) (NZPGT) glass fiber, a clear and compact green upconversion amplified spontaneous emission (ASE) trace is observed, and the NZPGT glasses are proved to be a desirable candidate in fabricating low-phonon energy fiber. Intense green upconversion luminescence of Er(3+), balanced green and red upconversion emissions of Ho(3+), and dominant three-photon blue upconversion fluorescence of Tm(3+) have been represented. By varying the excitation power of 974 nm wavelength laser diode, a series of green and white fluorescences have been achieved in Tm(3+)/Er(3+)/Yb(3+) and Tm(3+)/Ho(3+)/Yb(3+) triply doped glass systems, respectively. These results reveal that high-intensity blue, green, and white upconversion ASE fluorescences, which can be adopted for lighting in minimally invasive photodynamic therapy and minimally invasive surgery, are reasonable to be expected in rare-earth doped NZPGT glass fibers.