Photodynamic therapy for the treatment of oral squamous carcinoma—Clinical implications resulting from in vitro research

Indocyanine-Green-Loaded Liposomes for Photodynamic and Photothermal Therapies: Inducing Apoptosis and Ferroptosis in Cancer Cells with Implications beyond Oral Cancer

Oral cancer represents a global health burden, necessitating novel therapeutic strategies. Photodynamic and photothermal therapies using indocyanine green (ICG) have shown promise due to their distinctive near-infrared (NIR) light absorption characteristics and FDA-approved safety profiles. This study develops ICG-loaded liposomes (Lipo-ICGs) to further explore their potential in oral cancer treatments. We synthesized and characterized the Lipo-ICGs, conducted in vitro cell culture experiments to assess cellular uptake and photodynamic/photothermal effects, and performed in vivo animal studies to evaluate their therapeutic efficacy. Quantitative cell apoptosis and gene expression variation were further characterized using flow cytometry and RNA sequencing, respectively. Lipo-ICGs demonstrated a uniform molecular weight distribution among particles. The in vitro studies showed a successful internalization of Lipo-ICGs into the cells and a significant photodynamic treatment effect. The in vivo studies confirmed the efficient delivery of Lipo-ICGs to tumor sites and successful tumor growth inhibition following photodynamic therapy. Moreover, light exposure induced a time-sensitive photothermal effect, facilitating the further release of ICG, and enhancing the treatment efficacy. RNA sequencing data showed significant changes in gene expression patterns upon Lipo-ICG treatment, suggesting the activation of apoptosis and ferroptosis pathways. The findings demonstrate the potential of Lipo-ICGs as a therapeutic tool for oral cancer management, potentially extending to other cancer types.

Immunomodulatory Effect of Hypericin-Mediated Photodynamic Therapy on Oral Cancer Cells

In 2020, there were 377,713 new oral and lip cancer diagnoses and 177,757 deaths. Oral cancer is a malignancy of the head and neck region, and 90% of cases are squamous cell carcinomas (OSCCs). One of the alternative methods of treating pre-cancerous lesions and oral cancer is photodynamic therapy (PDT). In addition to the cytotoxic effect, an important mechanism of PDT action is the immunomodulatory effect. This study used the OSCC (SCC-25) cell line and the healthy gingival fibroblast (HGF-1) line. A compound of natural origin-hypericin (HY)-was used as the photosensitizer (PS). The HY concentrations of 0-1 µM were used. After two hours of incubation with PS, the cells were irradiated with light doses of 0-20 J/cm2. The MTT test determined sublethal doses of PDT. Cell supernatants subjected to sublethal PDT were assessed for interleukin 6 (IL-6), soluble IL-6 receptor alpha (sIL-6Ralfa), sIL-6Rbeta, IL-8, IL-10, IL-11 IL-20, IL-32, and Pentraxin-3 using the Bio-Plex ProTM Assay. The phototoxic effect was observed starting with a light dose of 5 J/cm2 and amplified with increasing HY concentration and a light dose. HY-PDT affected the SCC-25 cell secretion of sIL-6Rbeta, IL-20, and Pentraxin-3. HY alone increased IL-8 secretion. In the case of HGF-1, the effect of HY-PDT on the secretion of IL-8 and IL-32 was found.

Mucoadhesive liquid crystal precursor system for photodynamic therapy of oral cancer mediated by methylene blue

Oral cancer is one of the most prevalent types of cancer head and neck cancers worldwide. Photodynamic therapy (PDT) has demonstrated great potential against cancers, reducing long-term morbidity. In this study, we investigated the incorporation of methylene blue (MB) in a mucoadhesive liquid crystal precursor system (LCPS) for oral cancer treatment. The photostability and the in vitro release, permeation, and retention profile of MB-loaded LCPS (MB-LCPS) were investigated, as well as its in vitro PDT activity against normal (HaCaT) and tumoral (HSC-3) cell lines. LCPS increased the photostability of MB and exhibited a prolonged release profile of MB. In addition, LCPS increased the retention of MB in the porcine esophageal mucosa by around 3 times higher than the MB solution. The retention of MB in LCPS was around 2 times greater than its permeability, which is suitable for guaranteeing the maintenance of the therapy in the oral cavity. In vitro cytotoxicity assay indicated that MB-LCPS increased the antitumoral activity of MB after 20 min of irradiation at 660 nm and 12.5 J/cm2. The results obtained suggest that the developed formulation is an interesting strategy for the potential application in the treatment of oral cancer by PDT.

BODIPY derivatives modified with carborane clusters: synthesis, characterization and DFT studies

An efficient approach for the preparation of 3,5-dicarborane-substituted BODIPY conjugates was developed via the functionalization of 3,5-dibromo-8-pentafluorophenyl-BODIPY with neutral and anionic carborane S-nucleophiles. It was found that 3,5-dicarborane-substituted BODIPYs could be easily modified with a third carborane cluster using S_NAr substitution reactions of the para-fluorine atom in the meso-pentafluorophenyl BODIPY substituent with the corresponding carborane S-nucleophile affording boron-enriched BODIPYs in good yields. The influence of bromine atom substitution with carborane moieties on the position of absorption and fluorescence bands and the fluorescence quantum yields of the prepared BODIPYs were analyzed. The crystal structures of BODIPYs 4 and 8 were investigated. Density functional theory methods (DFT wb97xd/6-31G* and wb97xd/lanl2dz) were performed to study the geometrical structures, electronic characteristics, the highest occupied and the lowest unoccupied molecular orbitals (HOMOs and LUMOs) and other chemical descriptors of the synthesized compounds.

Dual-Functional Nanoplatform Based on Bimetallic Metal-Organic Frameworks for Synergistic Starvation and Chemodynamic Therapy

Tumor microenvironment (TME)-responsive chemodynamic therapy (CDT) mediated by nanozymes has been extensively studied in oral squamous cell carcinoma. However, the low catalytic efficiency due to insufficient H₂O₂ in the TME is still a major challenge for its clinical translation. Herein, we present an antitumor nanoplatform based on a Mn-Co organometallic framework material (MnCoMOF), which shows peroxidase-like (POD-like) activity, loaded with glucose oxidase (GOx@MnCoMOF), demonstrating the ability of H₂O₂ self-supply and H₂O₂ conversion to toxic hydroxyl radicals. The encapsulated GOx efficiently catalyzes glucose into gluconic acid and H₂O₂ at the tumor site, which can cut off the energy supply to inhibit tumor growth and produce a large amount of H₂O₂ and acid to compensate for their lack in the tumor microenvironment. The POD-like activity of MnCoMOF can convert H₂O₂ into hydroxyl radicals and eliminate tumor cells. The nanoplatform exhibits enhanced tumor cell cytotoxicity in a high-glucose medium compared with a low-glucose medium, illustrating sufficient generation of H₂O₂ from glucose by GOx. The in vivo results indicate that GOx@MnCoMOF has excellent antitumor efficacy and can remodel the immune-suppressive tumor microenvironment. In conclusion, the GOx@MnCoMOF nanoplatform possesses dual enzymatic activities, i.e., POD-like and glucose oxidase, to achieve improved tumor-suppressive efficiency through synergistic starvation and chemodynamic therapy, thus providing a new strategy for the clinical treatment of oral cancer.

Effects of methylene blue photodynamic therapy on oral carcinoma and leukoplakia cells

Objective

Methylene blue (MB) is a readily available and affordable substrate that can be used as a photosensitizer for photodynamic therapy (PDT). The objective of this study was to determine if PDT with MB can downregulate matrix metalloproteinases (MMPs) related to oral carcinoma.

Methods

Cell cultures of oral squamous cell carcinoma (CA-9-22), oral leukoplakia (MSK-Leuk1), and immortalized keratinocytes (Rhek-1A) were photosensitized with MB and treated with PDT. MMP-9 gene expression was interrogated via qRT-PCR. The 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay was used to confirm the efficacy of MB PDT.

Results

MMP-9 gene expression was found to be significantly decreased in oral carcinoma, leukoplakia, and immortalized keratinocytes with use of MB PDT.

Conclusion

This work demonstrates that MB-mediated PDT can downregulate MMPs which are critical to the invasion and metastasis of oral cancer. These results suggest that MB PDT could be a clinically significant and cost-effective treatment for oral leukoplakia and carcinoma.

Level of Evidence

NA.

Approaches for Head and Neck Cancer Research - Current Status and the Way Forward

Head and neck cancers (HNCs) are seeing an increasing trend in their prevalence among both genders and are the seventh most common cancer type occurring at the global level. Studies addressing both the cancer cell physiology and individual differences in response to a specific treatment modality should be understood for arriving at effective treatment and management of the HNCs. In this article, we discuss the trends in HNC research and their various approaches starting from 2D in vitro models, which are the traditional experimental materials to recently established Cancer-Tissue Originated Spheroids (CTOS) distinctly contributing towards personalized or precision medicine.

Synthesis of N-aryl-2,6-diphenyl-2H-pyrazolo[4,3-c]pyridin-7-amines and their photodynamic properties in the human skin melanoma cell line G361

A small series of N-aryl-2,6-diphenyl-2H-pyrazolo[4,3-c]pyridin-7-amines was synthesized from easily accessible 1-phenyl-1H-pyrazol-3-ol via 7-iodo-2,6-diphenyl-2H-pyrazolo[4,3-c]pyridine and 7-iodo-4-methyl-2,6-diphenyl-2H-pyrazolo[4,3-c]pyridine intermediates and their subsequent use in palladium catalyzed Buchwald-Hartwig cross-coupling reaction with various anilines. Majority of the compounds were not significantly cytotoxic to melanoma G361 cells in the dark up to 10 µM concentration, but their activity could be increased by irradiation with visible blue light (414 nm). The most active compound 10 possessed EC₅₀ values of 3.5, 1.6 and 0.9 µM in cells irradiated with 1, 5 and 10 J/cm², respectively. The treatment caused generation of reactive oxygen species in cells and extensive DNA damage, documented by the comet assay and by detection of phosphorylated histone H2A.X, followed by apoptotic cell death. Our results suggest that N-aryl-2,6-diphenyl-2H-pyrazolo[4,3-c]pyridin-7-amines could serve as a potential source of photosensitizing compounds with anticancer activities.

Photodynamic Therapy in Orthodontics: A Literature Review

Treatment of malocclusions using fixed orthodontic appliances makes it difficult for patients to perform hygiene procedures. Insufficient removal of bacterial biofilm can cause enamel demineralization, manifesting by visible white spot lesions or periodontal diseases, such as gingivitis periodontitis or gingival hyperplasia. The classic methods of preventing the above problems include, in addition to proper hygiene, ultrasonic scaling, periodontal debridement, and oral rinses based on chlorhexidine. New alternative methods of reducing plaque around brackets are being developed. There is a growing interest among researchers in the possibility of using photodynamic therapy in orthodontics. A literature search for articles corresponding to the topic of this review was performed using the PubMed and Scopus databases and the following keywords: ‘photodynamic therapy’, ‘orthodontics’, and ‘photosensitizer(s)’. Based on the literature review, two main directions of research can be distinguished: clinical research on the use of photodynamic therapy in the prevention of white spot lesions and periodontal diseases, and ex vivo research using a modified orthodontic adhesive by adding photosensitizers to them. Methylene blue is the most frequently used photosensitizer in clinical trials. The effectiveness of antimicrobial photodynamic therapy is mainly compared to the ultrasonic scaler as a single therapy or as an adjunct to the ultrasonic scaler. In their conclusions, the researchers most often emphasize the effectiveness of antimicrobial photodynamic therapy in reducing microbial levels in patients treated with fixed appliances and the possibility of using it as an alternative to routine procedures aimed at maintaining a healthy periodontium. The authors suggest further research on the use of photodynamic therapy to prove the validity of this method in orthodontics. It should also not be forgotten that proper hygiene is the basis for maintaining oral cavity health, and its neglect is a contraindication to orthodontic treatment.

Chorioallantoic Membrane Models of Various Avian Species: Differences and Applications

The chorioallantoic membrane model (CAM) of an avian embryo is used as an experimental model in various fields of research, including angiogenesis research and drug testing, xenografting and cancer research, and other scientific and commercial disciplines in microbiology, biochemistry, cosmetics, etc. It is a low-cost, low-maintenance, and well-available in vivo animal model that is non-sentient and can be used as an alternative for other mammal experimental models. It respects the principles of the "3R" rule (Replacement, Reduction, and Refinement)-conditions set out for scientific community providing an essential framework for conducting a more human animal research, which is also in line with constantly raising public awareness of welfare and the ethics related to the use of animal experimental models. In this review, we describe the chorioallantoic membrane of an avian embryo, focusing on its properties and development, its advantages and disadvantages as an experimental model, and the possibilities of its application in various fields of biological research. Since the most common chicken CAM model is already well known and described in many publications, we are particularly focusing on the advantages and application of less known avian species that are used for the CAM model-quail, turkey, and duck.

Photodynamic therapy in the treatment of oral squamous cell carcinoma - The state of the art in preclinical research on the animal model

BACKGROUND

Oral cavity squamous cell carcinoma is a common cancer of the head and neck region. Due to the frequency of diagnoses, high rate of mortality, mutilating nature of classic therapy and numerous complications, new methods of treatment are being sought. One promising solution for treatment that is utilized in many fields of oncology is photodynamic therapy. The purpose of this article is to present a general overview of the use of photodynamic therapy in preclinical in vivo studies on the animal model.

MATERIAL AND METHODS

A literature search for articles corresponding to the topic of this review was performed using the PubMed and MEDLINE databases using the following keywords: 'oral cavity squamous cell carcinoma,' 'photodynamic therapy,' 'photosensitizer(s),' 'in vivo', and 'animal model'.

RESULTS

Based on the literature review, the two most used animal models can be distinguished in research on the use of photodynamic therapy for oral squamous cell carcinoma. Studies mainly focus on the evaluation of tumor growth inhibition after using therapies with various photosensitizers on the murine or hamster cheek pouch models.

CONCLUDING REMARKS

The animal model is a part of preclinical research. Unfortunately, each of the models has its limitations, so it is difficult to extrapolate the results to clinical trials.

Effect of photodynamic therapy on expression of HRAS, NRAS and caspase 3 genes at mRNA levels, apoptosis of head and neck squamous cell carcinoma cell line

OBJECTIVES

This study aimed to assess the effect of photodynamic therapy (PDT) on expression of CASP3, NRAS and HRAS genes at mRNA levels, and apoptosis of head and neck squamous cell carcinoma (HNSCC) cell line.

MATERIALS AND METHODS

In order to complete the present in vitro study, HNSCC cell line (NCBI C196 HN5) purchased from Pasteur Institute. Cells were divided into four groups; Group 1: photodynamic treatment (laser + methylene blue (MB) as photosensitizer), group 2: MB, group 3: laser (with 660 nm wavelength), and group 4: control (without any treatment). To determine the optimal concentration of MB, in a pilot study, toxicity of MB in different concentration was assessed using MTT assay. Cells in group 1, 2 and 3 was treated at optimal concentration of MB (1.6 μg/mL). Gene expression at mRNA levels was assessed after 24 h incubation, using real-time (qRT)-PCR. The expression of BAX and BCL2 genes at the mRNA levels was analyzed to evaluate apoptosis. 2^-ΔΔCt values of BCL2, BAX, CASP3, NRAS, and HRAS in groups was analyzed using ANOVA. Tukey's HSD and Games Howell test was used to compare between two groups.

RESULTS

Over-expression of BAX (p < 0.001), CASP3 (p < 0.001) and down-regulation of BCL2 (p = 0.004), HRAS (p = 0.023) and NRAS (p = 0.045) were noted in group 1 (PDT), compared with the control group. Treatment by laser alone induce down-regulation of CASP3 (p < 0.05), BAX (p < 0.05), BCL2 (p > 0.05), HRAS (p > 0.05) and NRAS (p > 0.05).

CONCLUSION

PDT caused down-regulation of NRAS, HRAS and BCL2 and over-expression of CASP3 and BAX genes at mRNA levels in HNSCC cell line. The present study raises the possibility that the role of MB on BCL2 down-regulation and BAX and CASP3 over-expression was higher than laser alone while it seems that laser alone was more effective than MB in HRAS and NRAS down-regulation.

Effect of TTLL12 on tubulin tyrosine nitration as a novel target for screening anticancer drugs in vitro

Nitrotyrosine, a structural analogue of tyrosine, is present in cells in pathological conditions and is incorporated into tubulin to form tubulin tyrosine nitration, which disrupts the normal function of microtubules. There is limited research on the functional aspects of tubulin tyrosine nitration in different types of tumor. In the present study, the effect of tubulin tyrosine nitration and tubulin tyrosine ligase like 12 (TTLL12) on the proliferation of SCC-25 cells was investigated. TTLL12-overexpressing cell lines were constructed and used to assess the effect of tubulin tyrosine nitration and TTLL12 on the proliferation of SCC-25 cells via western blotting, immunofluorescent and MTT assays. An TTLL12-stably overexpressing SCC-25 cell line and the enzyme-linked immunosorbent assay were used to establish a novel experiment in vitro for screening anticancer drugs targeting tubulin tyrosine nitration by assessing its sensitivity, specificity and repeatability, and using it to find an effective drug. The results demonstrated that the proliferative rate of the control cells was notably inhibited in the presence of nitrotyrosine compared with that of TTLL12-overexpressing cells. The results of the MTT assay revealed that the proliferation of TTLL12-silenced cells was significantly inhibited compared with that of the control group. The sensitivity, specificity and repeatability of the experiment were positive. It was found that nocodazole could have better anticancer effect than paclitaxel. Taken together, the results of the present study suggest that TTLL12 enhances SCC-25 cell survival in the presence of nitrotyrosine by disrupting nitration of the tyrosine residues of tubulin, and tubulin tyrosine nitration may be developed for the basic research of anticancer drugs.

S-seco-porphyrazine as a new member of the seco-porphyrazine family - Synthesis, characterization and photocytotoxicity against cancer cells

An important subgroup within the porphyrazine (Pz) family constitutes seco-porphyrazines, in the chemical structure of which one pyrrole unit is opened in the oxidative process. So far, there are only limited data on N-seco- and C-seco-Pzs. Here, the synthesis of a novel member of the Pzs seco-family, represented by an S-seco-tribenzoporphyrazine analogue, 22,23-bis(4-(3,5-dibutoxycarbonylphenoxy)butylsulfanyl)tribenzo[b,g,l]-22,23-dioxo-22,23-seco-porphyrazinato magnesium(II), is reported, with moderate 34% yield. The new derivative was characterized using NMR spectroscopy, UV-Vis spectroscopy, and mass spectrometry. In the photochemical study performed following the indirect chemical method with 1,3-diphenylisobenzofuran, S-seco-Pz revealed a high singlet oxygen quantum yield of 0.27 in DMF. Potential photocytotoxicity of S-seco-Pz was assessed in vitro on three cancer cell lines - two oral squamous cell carcinoma cell lines derived from the tongue (CAL 27, HSC-3) and human cervical epithelial adenocarcinoma cells (HeLa). In the biological study, the macrocycle was tested in its free form and after loading into liposomes. It is worth noting that S-seco-Pz was found to be non-toxic in the dark, with cell viability levels over 80%. The photocytotoxic IC₅₀ values for free S-seco-Pz were 0.61, 0.18, and 4.1 µM for CAL 27, HSC-3 and HeLa cells, respectively. Four different liposomal compositions were analyzed, and the cationic liposomes revealed the highest photokilling efficacy, with the IC₅₀ values for CAL 27, HSC-3, and HeLa cells at 0.24, 0.25, and 0.31 µM, respectively. The results of the photocytotoxicity study indicate that the new S-seco-tribenzoporphyrazine can be considered as a potential photosensitizer in photodynamic therapy of cancer, along with the developed cationic liposomal nanocarrier.

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.