Comparative pharmacokinetic and photodynamic studies with zinc(II) phthalocyanine in hamsters bearing an induced or transplanted rhabdomyosarcoma

Advances in Liposome-Encapsulated Phthalocyanines for Photodynamic Therapy

This updated review aims to describe the current status in the development of liposome-based systems for the targeted delivery of phthalocyanines for photodynamic therapy (PDT). Although a number of other drug delivery systems (DDS) can be found in the literature and have been studied for phthalocyanines or similar photosensitizers (PSs), liposomes are by far the closest to clinical practice. PDT itself finds application not only in the selective destruction of tumour tissues or the treatment of microbial infections, but above all in aesthetic medicine. From the point of view of administration, some PSs can advantageously be delivered through the skin, but for phthalocyanines, systemic administration is more suitable. However, systemic administration places higher demands on advanced DDS, active tissue targeting and reduction of side effects. This review focuses on the already described liposomal DDS for phthalocyanines, but also describes examples of DDS used for structurally related PSs, which can be assumed to be applicable to phthalocyanines as well.

Smart nanocomposite assemblies for multimodal cancer theranostics

Despite great strides in anticancer research, performance statistics of current treatment modalities remain dismal, highlighting the need for safe, efficacious strategies for tumour mitigation. Non-invasive fusion technology platforms combining photodynamic, photothermal and hyperthermia therapies have emerged as alternate strategies with potential to meet many of the unmet clinical demands in the domain of cancer. These therapies make use of metallic and magnetic nanoparticles with light absorbing properties, which are manipulated to generate either reactive cytotoxic oxygen species or heat for tumour ablation. Combination therapies integrating light, heat and magnetism-mediated nanoplatforms with the conventional approaches of chemotherapy, radiotherapy and surgery are emerging as precision medicine for targeted interventions against cancer. This article aims to compile recent developments of advanced nanocomposite assemblies that integrate multimodal therapeutics for cancer treatment. Amalgamation of various effective, non-invasive technological platforms such as photodynamic therapy (PDT), photothermal therapy (PTT), magnetic hyperthermia (MHT), and chemodynamic therapy (CDT) have tremendous potential in presenting safe and efficacious solutions to the formidable challenges in cancer therapeutics.

Enhancement of Photodynamic Cancer Therapy by Physical and Chemical Factors

The viable use of photodynamic therapy (PDT) in cancer therapy has never been fully realized because of its undesirable effects on healthy tissues. Herein we summarize some physicochemical factors that can make PDT a more viable and effective option to provide future oncological patients with better-quality treatment options. These physicochemical factors include light sources, photosensitizer (PS) carriers, microwaves, electric fields, magnetic fields, and ultrasound. This Review is meant to provide current information pertaining to PDT use, including a discussion of in vitro and in vivo studies. Emphasis is placed on the physicochemical factors and their potential benefits in overcoming the difficulty in transitioning PDT into the medical field. Many advanced techniques, such as employing X-rays as a light source, using nanoparticle-loaded stem cells and bacteriophage bio-nanowires as a photosensitizer carrier, as well as integration with immunotherapy, are among the future directions.

Zinc(II) phthalocyanines as photosensitizers for antitumor photodynamic therapy

Photodynamic therapy (PDT) is a highly specific and clinically approved method for cancer treatment in which a nontoxic drug known as photosensitizer (PS) is administered to a patient. After selective tumor irradiation, an almost complete eradication of the tumor can be reached as a consequence of reactive oxygen species (ROS) generation, which not only damage tumor cells, but also lead to tumor-associated vasculature occlusion and the induction of an immune response. Despite exhaustive investigation and encouraging results, zinc(II) phthalocyanines (ZnPcs) have not been approved as PSs for clinical use yet. This review presents an overview on the physicochemical properties of ZnPcs and biological results obtained both in vitro and in more complex models, such as 3D cell cultures, chicken chorioallantoic membranes and tumor-bearing mice. Cell death pathways induced after PDT treatment with ZnPcs are discussed in each case. Finally, combined therapeutic strategies including ZnPcs and the currently available clinical trials are mentioned.

Phase I clinical trial of the use of zinc phthalocyanine tetrasulfonate as a photosensitizer for photodynamic therapy in dogs

OBJECTIVE

To determine the threshold for acute toxicosis of parenterally administered zinc phthalocyanine tetrasulfonate (ZnPcS(4)), a candidate second-generation photosensitizer, in mice and evaluate the compound's safety in a phase I clinical trial of ZnPcS(4)-based photodynamic therapy (PDT) in pet dogs with naturally occurring tumors.

ANIMALS

Male Swiss-Webster mice and client-owned dogs with naturally occurring neoplasms.

PROCEDURES

For the study of acute toxicosis, mice were given graded doses of ZnPcS(4). To determine safety, a rapid-titration phase I clinical trial of ZnPcS(4)-based PDT in tumor-bearing dogs was conducted.

RESULTS

In mice, administration of >or= 100 mg of ZnPcS(4)/kg resulted in renal tubular necrosis 24 hours after IP injection. In tumor-bearing dogs, ZnPcS(4) doses <or= 4 mg/kg induced no signs of toxicosis and resulted in partial to complete tumor responses in 10 of 12 dogs 4 weeks after PDT. Tumor remission was observed with ZnPcS(4) doses as low as 0.25 mg/kg.

CONCLUSIONS AND CLINICAL RELEVANCE

A conservative starting dose of ZnPcS(4) was arrived at on the basis of mouse toxicosis findings. Zinc phthalocyanine tetrasulfonate-based PDT was tolerated well by all dogs and warrants further study. The identification of the maximum tolerated dose through traditional phase I clinical trials may be unnecessary for evaluating novel PDT protocols.

Liposomal delivery of photosensitising agents

Photodynamic therapy is a clinically approved treatment for cancer and noncancer diseases. This modality utilises light-activatable chemicals (photosensitising agents) to capture photons and use light energy for the production of cytotoxic reactive molecular species. Most photosensitisers that are in use clinically or in preclinical development are hydrophobic and tend to aggregate in the aqueous environment, which limits their delivery and photosensitising efficiency. Liposomal delivery of photosensitisers will often overcome or decrease these problems. In addition, as with chemotherapeutic agents, liposomal formulations of photo-sensitising agents may help to achieve better selectivity for tumour tissue compared with normal tissue. Over the past years, liposomal photosensitisers have emerged as therapeutic agents in many experimental studies, and have obtained approval for clinical applications. Recent progress in liposomal technology further opens up the possibility of generating more selectively targeted photosensitisers encapsulated in liposomes. This review will cover progress in the use of liposomal photosensitisers, summarise current liposomal formulations, and project future directions for the liposomal delivery of photosensitising agents.

Photodynamic effect on cancer cells influenced by electromagnetic fields

The synergism of low-frequency electromagnetic field treatment and photodynamic effect on killing of human cancer cells is presented. The weak pulsating electromagnetic field (PEMF) generated by Helmholtz coils in the mT range influences the permeability of cell membranes for photosensitizers. Several types of sensitizers were excited by visible light during incorporation without and with two kinds of PEMF treatment. In the first part suitable photosensitizers were selected in the absorption range between 400 and 700 nm against human myeloid leukaemia K562 and human histiocytic lymphoma U937 cells by treatment of PEMF consisting of rectangular pulse groups. In the second part amplitude and frequency dependencies were measured using sinuous PEMF and white light with the result that after 12 min the PEMF treatment enhanced photodynamic effectivity by more than 40% over the control value. Taking into account the influence of many parameters, an additional optimization will be possible by photodynamic PEMF synergism for an increased drug delivery in general.

Naphthalocyanine complexes as potential photosensitizers for photodynamic therapy of tumors

In the present paper information about the synthesis and results on the pharmacokinetic and experimental photodynamic therapy (PDT) of naphthalocyanines are given. The photodynamic activity of differently substituted zinc(II)- and silicon(IV)-naphthalocyanines using liposomes or Cremophor EL as drug-delivery systems is shown on different tumor models. For the evaluation of the phototherapeutic effect different assessment criteria were used, including light and electron microscopy observations. The main conclusions which can be arrived at on the basis of our findings are the following: silicon(IV)-naphthalocyanine seems to be not a very effective tumor sensitizer, especially in the treatment of pigmented melanoma, while zinc(II)-naphthalocyanines appear to be very promising for PDT of tumors. Their selective targeting and slow clearance from tumor tissue, fast clearance from skin and pronounced phototherapeutic effect on different tumor models and especially at melanotic tumors, even after application of low drug doses, make this group of photosensitizers very attractive for successful PDT of cancer. © 1999 Society of Photo-Optical Instrumentation Engineers.

The biology of photodynamic therapy

The subcellular, cellular and tissue/tumour interactions with non-toxic photosensitizing chemicals plus non-thermal visible light (photodynamic therapy (PDT) are reviewed. The extent to which endothelium/vasculature is the primary target is discussed, and the biochemical opportunities for manipulating outcome highlighted. The nature of tumour destruction by PDT lends itself to imaging outcome by MRI and PET.

Photodynamic therapy of 9L gliosarcoma with liposome-delivered photofrin

The effect of Photofrin encapsulated in a liposome delivery vehicle for photodynamic therapy (PDT) of the 9L gliosarcoma and normal rat brain was tested. We hypothesized that the liposome vehicle enhances therapeutic efficacy, possibly by increasing tumor tissue concentration of Photofrin. Male Fisher rats bearing a 9L gliosarcoma were treated 16 days after intracerebral tumor implantation with either Photofrin in dextrose (n = 5) or Photofrin in liposome (n = 6). Nontumor-bearing animals were treated with Photofrin delivered either in dextrose (n = 4) or liposome (n = 4) vehicle. Tissue concentrations of Photofrin delivered either in dextrose (n = 4) or liposome (n = 4) vehicle were measured in tumor, brain adjacent to tumor and in normal brain tissue. Photofrin was administered (intraperitoneally) at a dose of 12.5 mg/kg and PDT (17 J/cm2 of 632 nm light at 100 mW/cm2) was performed 24 h after Photofrin administration. Brains were removed 24 h after PDT and stained with hematoxylin and eosin for analysis of cellular damage. The PDT using Photofrin in the liposome vehicle caused significantly more damage to the tumor (P < 0.001) than did PDT with Photofrin in dextrose. The PDT of tumor with Photofrin delivered in liposomes caused a 22% volume of cellular necrosis, while PDT of tumor with Photofrin delivered in dextrose caused only scattered cellular damage. Photofrin concentration in tumors was significantly higher (P = 0.021) using liposome (33.8 +/- 18.9 micrograms/g) compared to dextrose delivery (5.5 +/- 1.5 micrograms/g). Normal brain was affected similarly in both groups, with only scattered cellular necrosis. Our data suggest that the liposome vehicle enhances the therapeutic efficacy of PDT treatment of 9L tumors.

Structure and biodistribution relationships of photodynamic sensitizers

Photodynamic therapy (PDT) has, during the last quarter century, developed into a fully fledged biomedical field with its own association, the International Photodynamic Association (IPA) and regular conferences devoted solely to this topic. Recent approval of the first PDT sensitizer, Photofrin (porfimer sodium), by health boards in Canada, Japan, the Netherlands and United States for use against certain types of solid tumors represents, perhaps, the single most significant-indicator of the progress of PDT from a laboratory research concept to clinical reality. The approval of Photofrin will undoubtedly encourage the accelerated development of second-generation photosensitizers, which have recently been the subject of intense study. Many of these second-generation drugs show significant differences, when compared to Photofrin, in terms of treatment times postinjection, light doses and drug doses required for optimal results. These differences can ultimately be attributed to variations in either the quantum efficiency of the photosensitizer in situ, which is in turn affected by aggregation state, localized concentration of endogenous quenchers and primary photophysics of the dye, or the intratumoral and intracellular localization of the photosensitizer at the time of activation with light. The purpose of this review is to bring together data relating to the biodistribution and pharmacokinetics of second-generation sensitizers and attempt to correlate this with structural and electronic features of these molecules. As this requires a clear knowledge of photosensitizer structure, only chemically well-characterized compounds are included, e.g. Photofrin and crude sulfonated phthalocyanines have been excluded as they are known to be complex mixtures. Nonporphyrin-based photosensitizers, e.g. rose bengal and the hypericins, have also been omitted to allow meaningful comparisons to be made between different compounds. As the intracellular distribution of photosensitizers to organelles and other subcellular structures can have a large effect on PDT efficacy, a section will be devoted to this topic.

Pharmacokinetics and body distribution of liposomal zinc phthalocyanine in tumor-bearing mice: influence of aggregation state, particle size, and composition

The pharmacokinetics and body distribution of zinc phthalocyanine (ZnPc) intravenously administered in liposomes composed of ZnPc, 1-palmitoyl-2-oleoylphosphatidylcholine (POPC), and 1,2-dioleoylphosphatidylserine (OOPS) (1:90:10 or 1:70:30 w/w) to tumor (Meth A sarcoma) bearing mice were studied. It was found that aggregation of ZnPc in the liposomes (i) increases the clearance rate of the dye from plasma, (ii) lowers the maximal dye concentration in tumor tissue, and (iii) increases the maximal dye concentration in the liver. In addition, aggregated dye is hardly eliminated from the liver and monomeric dye is eventually completely eliminated from this organ. Liposomes in the size range of 48-123 nm, containing the dye with the same aggregation state, showed the same pharmacokinetics and body distribution of the dye. The PS-content of the ZnPc liposomes (POPC alone versus POPC/OOPS 7:3) did not influence tumor, liver, and plasma pharmacokinetics during the studied time intervals. Free flow electrophoretic analysis showed in lyophilisates of ZnPc liposomes containing aggregated ZnPc the presence of two distinct populations differing in size, aggregation state of the dye, and PC/PS and ZnPc/phospholipid ratio. The liposomal formulation with monomeric ZnPc has a compositional homogeneity and demonstrated selectivity and reached high uptake in tumors, 48 h after intravenous administration and appears promising for photodynamic therapy.

Large-scale production of liposomes containing monomeric zinc phthalocyanine by controlled dilution of organic solvents

This work describes the development of an organic solvent dilution method suitable for the large scale manufacturing of small unilamellar liposomes containing the water-insoluble photosensitizer zinc phthalocyanine in the monomeric state. N-Methyl pyrrolidone (NMP)/tert-butyl alcohol was selected as water miscible organic phase in which the phospholipids 1-palmitoyl, 2-oleoylphosphatidylcholine (POPC), and 1,2-dioeloylphosphatidylserine (OOPS) and the dye were dissolved. This organic phase was mixed with an excess of a water phase using a dynamic mixing device, yielding reproducibly unilamellar liposomes with a mean size of 50-150 nm as measured with quasielastic light scattering. After concentration, the organic solvents were efficiently removed by cross-flow filtration. The liposomes were then sterile filtered and freeze-dried. A method to measure the aggregation state of the dye in the liposomes was developed. A stable lyophilized formulation containing monomeric liposomal ZnPc could be obtained by using a solution of ZnPc in NMP (2 mg/mL) and ZnPc/phospholipid (1:100 w/w ratio) and performing concentration and dialysis at 4 degrees C and lyophilization in presence of a mixture of lactose and phospholipid (5:1 w/w ratio).

Hydrophobic Zn(II)-naphthalocyanines as photodynamic therapy agents for Lewis lung carcinoma

Four Zn(II) 2,3-naphthalocyanines (unsubstituted ZnNc1, tetracetylamido substituted ZnNc2, tetramino substituted ZnNc3 and tetramethoxy substituted ZnNc4) incorporated into unilamellar liposomes of dipalmitoylphosphatidylcholine have been injected intra-peritoneally (i.p.) (0.25-0.3 mg kg-1) to male C57/Black mice bearing a transplanted Lewis lung carcinoma. The pharmacokinetic investigations show that three of the four studied ZnNcs, 1, 2 and 4, are good tumor-localizers in Lewis lung carcinoma. The highest concentration is detected after ZnNc1 administration. The lowest tumor concentration as well as the lowest phototherapeutic effect were established with ZnNc3. In previous work it was shown that this ZnNc did not differ from the other three studied ZnNcs regarding the quantum yield of 1O2-formation and the photoinduced electron transfer. Obviously not only the good photochemical properties but also the tumor drug uptake can be an important factor of effective PDT. The biodistribution investigations also show that 72 h after drug injection, the skin concentration of the studied ZnNcs returns to the original base line. Indeed, we can expect that the skin photosensitivity will last for no longer than three days after PDT. The established higher drug concentration in the tumor rather than in the liver tissue (20 h after injection) shows again the tumor targeting selectivity of the applied liposome-sensitiser delivered procedure. Evaluating the PDT effect as reflected in the dynamics of the mean tumor diameter, we obtained unambiguous data on the potential capacity of ZnNcs 1,2,4 as PDT-photosensitisers. The data obtained from the assessment of the cytotoxic effect of PDT on the basis of the degree of induced necrosis, gave an adequate characterization of the tumor tissue destruction.(ABSTRACT TRUNCATED AT 250 WORDS)

On the mechanism of the tumour-localising effect in photodynamic therapy

The proposed mechanisms by which tumours concentrate photosensitisers are reviewed. Tumour-associated macrophages have been shown by others to accumulate up to nine times the level of porphyrins as do tumour cells. Macrophages also take up and degrade oxidised or otherwise modified low-density lipoprotein (LDL). We propose that the interaction of photosensitisers with LDL is an important factor, leading to accumulation in macrophages. Uptake into these cells via liposomes and high-density lipoprotein is also possible. There may be three separate mechanisms for tumour destruction in photodynamic therapy: (i) direct damage to tumour cells; (ii) damage to the endothelial cells of the tumour microvasculature; and (iii) macrophage-mediated immune infiltration of the tumour. The association of photosensitisers with lipoproteins may accentuate the latter two (endothelial cells can also accumulate modified lipoproteins). Accumulation in macrophages may also largely explain the high porphyrin retention observed in atheromatous plaques.

Liposome-delivered Zn(II)-2,3-naphthalocyanines as potential sensitizers for PDT: synthesis, photochemical, pharmacokinetic and phototherapeutic studies

The aim of this investigation is to report the synthesis and fundamental photochemical properties of naphthalocyanines with potential interest for photodynamic therapy (PDT), as well as their pharmacokinetics and phototherapeutic effects in a tumor model. Four zinc naphthalocyanines (ZnNc), unsubstituted ZnNc 1, tetraacetylamido-substituted ZnNc 2, tetraamino-substituted ZnNc 3 and tetramethoxy-substituted ZnNc 4 absorbing around 760-770 nm, were synthesized. The dye-sensitized photo-oxidation of 1,3-diphenylisobenzofuran via 1O2 was studied in dimethylsulfoxide (DMSO). Quantum yields for this photoreaction are 0.135-0.164 and are relatively independent of the kind of substituent. In addition, the photoinduced electron transfer studied in N,N-dimethylformamide-water in the presence of methylviologen and mercaptoethanol is only slightly influenced by the kind of substituent. The pharmacokinetic properties of ZnNc 1 in hamsters bearing a transplanted rhabdomyosarcoma were studied using dipalmitoylphosphatidylcholine liposomes. Experimental PDT of rhabdomyosarcoma was carried out using liposome-delivered ZnNc 1-4. The phototherapeutic effect was evaluated by tumor photonecrosis, the mean tumor diameter during the observation period and the percentage of cured animals. The best effect was found after PDT with ZnNc 2 (50% of the treated animals were cured). A slightly lower effect was observed after application of ZnNc 4 (40% cured animals). No effect at all was noted after PDT with ZnNc 3 and a very low efficiency was found after treatment with ZnNc 1 as photosensitizer. Obviously, the photodynamic effect depends on the biological characteristics as well as on the nature of the substituents.