Photodynamic therapy in dermatology

Tailoring photobiomodulation to enhance tissue regeneration

Photobiomodulation (PBM), the use of biocompatible tissue-penetrating light to interact with intracellular chromophores to modulate the fates of cells and tissues, has emerged as a promising non-invasive approach to enhancing tissue regeneration. Unlike photodynamic or photothermal therapies that require the use of photothermal agents or photosensitizers, PBM treatment does not need external agents. With its non-harmful nature, PBM has demonstrated efficacy in enhancing molecular secretions and cellular functions relevant to tissue regeneration. The utilization of low-level light from various sources in PBM targets cytochrome c oxidase, leading to increased synthesis of adenosine triphosphate, induction of growth factor secretion, activation of signaling pathways, and promotion of direct or indirect gene expression. When integrated with stem cell populations, bioactive molecules or nanoparticles, or biomaterial scaffolds, PBM proves effective in significantly improving tissue regeneration. This review consolidates findings from in vitro, in vivo, and human clinical outcomes of both PBM alone and PBM-combined therapies in tissue regeneration applications. It encompasses the background of PBM invention, optimization of PBM parameters (such as wavelength, irradiation, and exposure time), and understanding of the mechanisms for PBM to enhance tissue regeneration. The comprehensive exploration concludes with insights into future directions and perspectives for the tissue regeneration applications of PBM.

Voltage-Gated Ion Channels: Structure, Pharmacology and Photopharmacology

Voltage-gated ion channels are transmembrane proteins responsible for the generation and propagation of action potentials in excitable cells. Over the last decade, advancements have enabled the elucidation of crystal structures of ion channels. This progress in structural understanding, particularly in identifying the binding sites of local anesthetics, opens avenues for the design of novel compounds capable of modulating ion conduction. However, many traditional drugs lack selectivity and come with adverse side effects. The emergence of photopharmacology has provided an orthogonal way of controlling the activity of compounds, enabling the regulation of ion conduction with light. In this review, we explore the central pore region of voltage-gated sodium and potassium channels, providing insights from both structural and pharmacological perspectives. We discuss the different binding modes of synthetic compounds that can physically occlude the pore and, therefore, block ion conduction. Moreover, we examine recent advances in the photopharmacology of voltage-gated ion channels, introducing molecular approaches aimed at controlling their activity by using photosensitive drugs.

Peptide-AIE Nanofibers Functionalized Sutures with Antimicrobial Activity and Subcutaneous Traceability

As one of the most widely used medical devices, sutures face challenges related to surgical site infections (SSIs) and lack of subcutaneous traceability. In the present study, a facile and effective approach using peptide-AIE nanofibers (NFs-K18) to create fluorescent-traceable antimicrobial sutures, which have been applied to four commercially available sutures is developed. The functionalized sutures of PGAS-NFs-K18 and PGLAS-NFs-K18 exhibit fluorescence with excellent penetration from 4 mm chicken breasts. They also demonstrate remarkable stability after 24 h of white light illumination and threading through chicken breasts 10 times. These sutures efficiently generate ROS, resulting in significant suppression of four clinical bacteria, with the highest antimicrobial rate of ≈100%. Moreover, the sutures exhibit favorable hemocompatibility and biocompatibility. In vivo experiments demonstrate that the optimized PGLAS-NFs-K18 suture displays potent antimicrobial activity against MRSA, effectively inhibiting inflammation and promoting tissue healing in both skin wound and abdominal wall wound models, outperforming the commercially available Coated VICRYL Plus Antibacterial suture. Importantly, PGLAS-NFs-K18 exhibits sensitive subcutaneous traceability, allowing for accurate in situ monitoring of its degradation. It is believed that this straightforward strategy offers a new pathway for inhibiting SSIs and monitoring the status of sutures.

Synthesis and Study of Building Blocks with Dibenzo[b,f]oxepine: Potential Microtubule Inhibitors

The synthesis of biphenylmethoxydibenzo[b,f]oxepine or photoswitchable fluorinated dibenzo[b,f]oxepine derivatives with one or three azo bonds, potential microtubule inhibitors, is described. Our studies provide a concise method for constructing derivatives containing the dibenzo[b,f]oxepine skeleton. An analysis of products was run using experimental and theoretical methods. Next, we evaluated the E/Z isomerization of azo-dibenzo[b,f]oxepine derivatives, which could be photochemically controlled using visible-wavelength light.

Recent progress of UCNPs-MoS2 nanocomposites as a platform for biological applications

Composite materials can take advantages of the functional benefits of multiple pure nanomaterials to a greater degree than single nanomaterials alone. The UCNPs-MoS2 composite is a nano-application platform that combines upconversion luminescence and photothermal properties. Upconversion nanoparticles (UCNPs) are inorganic nanomaterials with long-wavelength excitation and short-wavelength tunable emission capabilities, and are able to effectively convert near-infrared (NIR) light into visible light for increased photostability. However, UCNPs have a low capacity for absorbing visible light, whereas MoS2 shows better absorption in the ultraviolet and visible regions. By integrating the benefits of UCNPs and MoS2, UCNPs-MoS2 nanocomposites can convert NIR light with a higher depth of detection into visible light for application with MoS2 through fluorescence resonance energy transfer (FRET), which compensates for the issues of MoS2's low tissue penetration light-absorbing wavelengths and expands its potential biological applications. Therefore, starting from the construction of UCNPs-MoS2 nanoplatforms, herein, we review the research progress in biological applications, including biosensing, phototherapy, bioimaging, and targeted drug delivery. Additionally, the current challenges and future development trends of UCNPs-MoS2 nanocomposites for biological applications are also discussed.

Trends in photodynamic therapy for dermatology in recent 20 years: A scientometric review based on CiteSpace

OBJECTIVE

Analyze the research state and development trend of photodynamic therapy for dermatology using visual knowledge graphs derived from the Web of Science Core Collection database.

METHODS

The Web of Science Core Collection database was utilized as the search data source for the bibliometric analysis, and the associated articles published between January 1, 2000, and December 31, 2022, were obtained using the search terms "photodynamic therapy" and "dermatology". CiteSpace, VOSviewer, and additional tools were utilized for bibliometric analysis, and visual knowledge graphs were created.

RESULTS

Eight hundred and thirty two articles were retrieved in total, and 747 were included following de-duplication and transformation. The country with the greatest number of publications is the United States; the primary research institution was University of Copenhagen; and the references with the highest centrality were primarily concerned with the selection of photosensitizers; High frequency keywords primarily comprised 5 aminolevulinic acid and basal cell carcinoma; and the clustering graph revealed that all keywords fell into 11 categories.

CONCLUSION

In numerous areas of dermatology, photodynamic treatment is commonly employed. Current research focuses on nonneoplastic skin diseases and the choice of photosensitizers. Nonetheless, its specific mechanism and other applications merit further investigation.

Current Advances in Photodynamic Therapy (PDT) and the Future Potential of PDT-Combinatorial Cancer Therapies

Photodynamic therapy (PDT) is a two-stage treatment that implies the use of light energy, oxygen, and light-activated compounds (photosensitizers) to elicit cancerous and precancerous cell death after light activation (phototoxicity). The biophysical, bioengineering aspects and its combinations with other strategies are highlighted in this review, both conceptually and as they are currently applied clinically. We further explore the recent advancements of PDT with the use of nanotechnology, including quantum dots as innovative photosensitizers or energy donors as well as the combination of PDT with radiotherapy and immunotherapy as future promising cancer treatments. Finally, we emphasize the potential significance of organoids as physiologically relevant models for PDT.

Limitations of ALA-PDT as a reliable therapy for AK in clinical practice

BACKGROUND

Numerous clinical studies have demonstrated the effectiveness of 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) in treating actinic keratosis (AK). This therapy has achieved an average lesion clearance rate of approximately 80 % and has also shown to produce satisfactory cosmetic outcomes. However, in our clinical practice, the utilization and adherence to ALA-PDT treatment among AK patients has been lower than anticipated, possibly due to various factors.

OBJECTIVE

The objectives of this study are twofold: (1) To analyze the actual therapeutic effects of ALA-PDT treatment on AK lesions in clinical practice; and (2) To identify the factors that hinder acceptance of ALA-PDT therapy among AK patients with large area or multiple lesions situated on the head and face.

METHOD

This study included a group of 20 AK patients, comprising 15 females and 5 males, with an age range of 57-87 years. All patients received a complete course of ALA-PDT therapy, consisting of 3-6 treatments. The study analyzed various factors, including the cure rate, recurrence rate, cosmetic effects, and adverse reactions following treatment. To investigate the factors affecting the acceptance of ALA-PDT treatment among AK patients with large or multiple lesions on the head and face, we also examined a separate group of 43 AK patients. This group included individuals who either had incomplete courses of ALA-PDT treatment or declined the therapy for the first time. The factors potentially influencing patients' acceptance of PDT were analyzed based on the outcomes of these investigations.

RESULT

Among the 20 patients who completed the full course of ALA-PDT treatment, the cure rate was 95 % (19/20). The recurrence rates at 1 month, 3 months, and 6 months were 0 %, 5 %, and 10 %, respectively. Out of the 19 cured patients, only 2 experienced heavy pigmentation, and no scarring was reported 1-3 months post-treatment. Based on the survey of 43 patients who either had an incomplete course of ALA-PDT treatment or declined the therapy initially, several factors were identified as limiting their choice of PDT therapy. These factors include: (1) Intolerable adverse effects of treatment. (2) Higher treatment cost than expected. (3) Inconvenient transportation. (4) Coexistence of other senile diseases. (5) Unsatisfactory clinical efficacy observed. (6) Inadequate understanding of AK. (7) Lost to follow-up.

CONCLUSION

The study concludes that ALA-PDT is a beneficial and aesthetically pleasing treatment for AK patients, particularly those with extensive or multiple lesions on the head and face. However, various factors can impede the selection of ALA-PDT therapy, potentially depriving patients of the most suitable option. The study aims to assist dermatologists and AK patients in considering treatment plans and exploring alternative options. Overall, the findings of this study may provide valuable guidance for improving treatment outcomes and patient satisfaction.

Guidelines for the diagnosis and treatment of basal cell carcinoma: a GRADE approach for evidence evaluation and recommendations by the Italian Association of Medical Oncology

Basal cell carcinoma (BCC) is the most common form of cancer, with a high impact on the public health burden and social costs. Despite the overall prognosis for patients with BCC being excellent, if lesions are allowed to progress, or in a small subset of cases harboring an intrinsically aggressive biological behavior, it can result in local spread and significant morbidity, and conventional treatments (surgery and radiotherapy) may be challenging. When a BCC is not amenable to either surgery or radiotherapy with a reasonable curative intent, or when metastatic spread occurs, systemic treatments with Hedgehog inhibitors are available. These guidelines were developed, applying the GRADE approach, on behalf of the Italian Association of Medical Oncologists (AIOM) to assist clinicians in treating patients with BCC. They contain recommendations with regard to the diagnosis, treatment and follow-up, from primitive tumors to those locally advanced or metastatic, addressing the aspects of BCC management considered as priorities by a panel of experts selected by AIOM and other national scientific societies. The use of these guidelines in everyday clinical practice should improve patient care.

Comparison of photodynamic therapy and corticosteroid therapy in management of oral lichen planus: A systematic review of randomized controlled trials

INTRODUCTION

Photodynamic therapy (PDT) has emerged as an effective therapy for various dermatology conditions, including oral lichen planus (OLP). The objective of this study was to evaluate the efficacy of PDT in managing OLP and to compare its effectiveness with corticosteroid therapy (CST).

MATERIALS AND METHODS

A comprehensive electronic search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, utilizing databases such as PubMed, Embase, Google Scholar, Semantic Scholar, X-mole, and Dimensions. The inclusion criteria encompassed randomized controlled clinical trials (RCTs) that included patients with OLP undergoing treatment with PDT and CST, with no limitations on sample size or patient age.

RESULTS

Out of 197 studies identified, only 8 met the inclusion criteria, involving 210 patients (104 in Group I: PDT, 106 in Group II: CST), with a female to male ratio of 3.75. Three studies reported OLP lesion numbers, six studies described lesion types, and five studies provided lesion location information. The efficacy of both PDT and CST was assessed using lesion size, pain, Thongprasom sign (ThS) scoring, efficacy index (EI), and clinical severity index (CSI). The limited and inconsistent reporting of data hindered to conduct a meta-analysis.

CONCLUSIONS

PDT effectively treats OLP lesions, leading to significant symptom reduction and improved functionality. However, limited relevant RCTs and heterogeneous data reporting hinder definitive conclusions regarding the efficacy of PDT compared to CTS.

Does aPDT reduce bacterial load in endodontic infected teeth? A systematic review and meta-analysis

This systematic review investigated whether antimicrobial photodynamic therapy (aPDT) after chemomechanical root canal disinfection (CD) yields a greater microbial load reduction than only CD. An electronic literature search was conducted on four databases up to November 2022, with no language or publication date restrictions. Randomized and non-randomized clinical trials were included if participants had a primary endodontic infection in permanent teeth, and if microbial loads before and after using aPDT were compared. Two researchers independently screened titles and abstracts to determine study eligibility. Assessments included risk of bias and methodological quality. This review was registered in PROSPERO (CRD42020181783). Eight studies were included in the qualitative analysis, and six were eligible for meta-analysis. In the random effects model, aPDT significantly improved the results of root canal disinfection when compared with standard protocols for cleaning and shaping (p = 0.04, 95% CI -1.72, -0.05). Subgroup analysis suggested that aPDT has a better effect on reducing the load of anaerobic microorganisms (p = 0.003, 95% CI -3.36, -0.69). The use of aPDT as an adjunct to chemomechanical disinfection promotes additional reduction of the microbial load and, therefore, seems to improve the results of root canal treatments in permanent teeth with a primary endodontic infection. However, certainty of evidence should be improved.

PDT-Induced Activation Enhanced by Hormone Response to Treatment

Photodynamic therapy (PDT) is a medical treatment with the use of a photosensitizing agent (PS), which, when activated by light, results in selective tissue damage with a cytotoxic effect on tumor cells. PDT leads to the induction of an acute-phase response, which results in the involvement of adrenal glucocorticoid (GC) hormones. PDT, by activating the hormonal response, affects the treatment of cancer. GC release is observed due to adrenal activity, which is driven by changes in the hypothalamic pituitary-adrenal axis triggered by stress signals emanating from the PDT treated tumor. The hormones released in this process in the context of the PDT-induced acute-phase response perform many important functions during anticancer therapy. They lead, among other things, to the systemic mobilization of neutrophils and the production of acute-phase reagents, and also control the production of immunoregulatory proteins and proteins that modulate inflammation. GCs can radically affect the activity of various inflammatory and immune cells, including the apoptosis of cancer cells. A better understanding of the modulation of GC activity could improve the outcomes of cancer patients treated with PDT.

Probing Near-infrared Absorbance of E and Z Diazene Isomers via Antiaromaticity

The photoswitching behaviors of heteroaryl azos and azobenzenes have attracted considerable interest due to their applications from material science to pharmacology. However, the use of UV light limits their application, especially in biomedicine and photopharmacology. In this work, using several aromaticity descriptors, including anisotropy of the induced current density analysis and nucleus-independent chemical shifts, we systematically investigate the relationship between anti-aromaticity and the absorption of a series of heterocyclic azos. We have demonstrated that the antiaromatic heterocycles substituted with diazenes enable the significant red shifts of the n → π* and π → π* transition bands of E and Z isomers via density functional theory calculations. Moreover, introducing substituents into heterocycles could further tune the absorption. Finally, the λmax of the first transition bands of the E (ca. 1026 nm) and Z isomers (ca. 1167 nm) of azos is achieved in the near-infrared region.

Combinations of Photodynamic Therapy with Other Minimally Invasive Therapeutic Technologies against Cancer and Microbial Infections

The rapid rise in research and development following the discovery of photodynamic therapy to establish novel photosensitizers and overcome the limitations of the technology soon after its clinical translation has given rise to a few significant milestones. These include several novel generations of photosensitizers, the widening of the scope of applications, leveraging of the offerings of nanotechnology for greater efficacy, selectivity for the disease over host tissue and cells, the advent of combination therapies with other similarly minimally invasive therapeutic technologies, the use of stimulus-responsive delivery and disease targeting, and greater penetration depth of the activation energy. Brought together, all these milestones have contributed to the significant enhancement of what is still arguably a novel technology. Yet the major applications of photodynamic therapy still remain firmly located in neoplasms, from where most of the new innovations appear to launch to other areas, such as microbial, fungal, viral, acne, wet age-related macular degeneration, atherosclerosis, psoriasis, environmental sanitization, pest control, and dermatology. Three main value propositions of combinations of photodynamic therapy include the synergistic and additive enhancement of efficacy, the relatively low emergence of resistance and its rapid development as a targeted and high-precision therapy. Combinations with established methods such as chemotherapy and radiotherapy and demonstrated applications in mop-up surgery promise to enhance these top three clinical tools. From published in vitro and preclinical studies, clinical trials and applications, and postclinical case studies, seven combinations with photodynamic therapy have become prominent research interests because they are potentially easily applied, showing enhanced efficacy, and are rapidly translating to the clinic. These include combinations with chemotherapy, photothermal therapy, magnetic hyperthermia, cold plasma therapy, sonodynamic therapy, immunotherapy, and radiotherapy. Photochemical internalization is a critical mechanism for some combinations.

Trial watch: an update of clinical advances in photodynamic therapy and its immunoadjuvant properties for cancer treatment

Photodynamic therapy (PDT) is a medical treatment used to target solid tumors, where the administration of a photosensitizing agent and light generate reactive oxygen species (ROS), thus resulting in strong oxidative stress that selectively damages the illuminated tissues. Several preclinical studies have demonstrated that PDT can prime the immune system to recognize and attack cancer cells throughout the body. However, there is still limited evidence of PDT-mediated anti-tumor immunity in clinical settings. In the last decade, several clinical trials on PDT for cancer treatment have been initiated, indicating that significant efforts are being made to improve current PDT protocols. However, most of these studies disregarded the immunological dimension of PDT. The immunomodulatory properties of PDT can be combined with standard therapy and/or emerging immunotherapies, such as immune checkpoint blockers (ICBs), to achieve better disease control. Combining PDT with immunotherapy has shown synergistic effects in some preclinical models. However, the value of this combination in patients is still unknown, as the first clinical trials evaluating the combination of PDT with ICBs are just being initiated. Overall, this Trial Watch provides a summary of recent clinical information on the immunomodulatory properties of PDT and ongoing clinical trials using PDT to treat cancer patients. It also discusses the future perspectives of PDT for oncological indications.

A biophotonic device based on a conjugated polymer and a macrophage-laden hydrogel for triggering immunotherapy

A biophotonic device is fabricated by a 3D printing technique for tumor immunotherapy utilizing a flexible organic light-emitting diode (OLED) with deep blue emission and a gelatin-alginate hydrogel that contains a poly(phenylene vinylene) (PPV) derivative and live immune cells of macrophages (M₀-RAW264.7). PPV is excited by the OLED to generate reactive oxygen species (ROS), enabling the macrophages to polarize to the M₁ phenotype and secrete cytotoxic cytokines to induce the apoptosis of tumor cells. This strategy provides a new method for fabricating cell-involved biophotonic devices for immunotherapy.

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.

Methyl Aminolaevulinic Acid versus Aminolaevulinic Acid Photodynamic Therapy of Actinic Keratosis with Low Doses of Red-Light LED Illumination: Results of Long-Term Follow-Up

Photodynamic therapy (PDT) treatment for multiple actinic keratosis (AK) has been found effective when lower doses of red light were used with methyl aminolaevulinic acid (MAL). The aim of this study was to compare the results of lower doses of red light conventional PDT (h-PDT, 16 J/cm2) with MAL and aminolaevulinic acid (ALA) in a long-term follow-up. Patients with more than five symmetrical AK on the scalp who were candidates for PDT were selected and divided randomly between MAL and ALA treatment and patients were followed at 3 and 12 months. The responses were assessed by counting the total AK and the AK per patient. Pain and adverse events were also compiled. A total of 46 patients were treated, 24 with MAL, and 22 with ALA. The two groups were comparable at baseline (p > 0.005). No significant differences were found in the results of both treatments at 12 months, despite ALA exhibiting slightly better results at 3 months. No differences in pain and adverse events were assessed. Both ALA and MAL were effective when lower doses of red light were used in c-PDT. Long term efficacy was also documented. Further studies are necessary to determine the inferior point of red-light illumination without losing efficacy.

Topical methylene blue nanoformulation for the photodynamic therapy of acne vulgaris

Acne vulgaris is a common skin disease caused by multifactorial reasons involving excessive sebum secretion and inflammation by Cutibacterium acnes (C. acnes). Various conventional therapies are available for the treatment of acne vulgaris; however, topical photodynamic therapy (PDT) has attracted much attention because of its great potential for sebum-reducing, anti-inflammatory, and antimicrobial activities. Although 5-aminolevulinic acid (ALA) has been broadly used as a photosensitizer for topical PDT, it has several limitations such as long incubation time, pain, and post-inflammatory hyperpigmentation. Here, we report a biocompatible nanoformulation consisting of methylene blue and salicylic acid (MBSD), as a potent PDT and acne therapeutics, enclosed within oleic acid. Photoactivated MBSD showed antimicrobial activity against C. acnes along with long-term stability. When 24 patients with acne were treated with MBSD and light irradiation 5 times at 1-week intervals, MBSD-based PDT exhibited a remarkable reduction in acne lesions and sebum production. In addition, the therapeutic procedure was painless and safe, without any adverse events. Therefore, MBSD is a promising topical PDT agent for biocompatible, safe, and effective acne treatment.

An insight into photodynamic therapy towards treating major dermatological conditions

Photodynamic therapy (PDT), as the name suggests is a light-based, non-invasive therapeutic treatment method that has garnered immense interest in the recent past for its efficacy in treating several pathological conditions. PDT has prominent use in the treatment of several dermatological conditions, which consequently have cosmetic benefits associated with it as PDT improves the overall appearance of the affected area. PDT is commonly used for repairing sun-damaged skin, providing skin rejuvenation, curbing pre-cancerous cells, treating conditions like acne, keratosis, skin-microbial infections, and cutaneous warts, etc. PDT mediates its action by generating oxygen species that are involved in bringing about immunomodulation, suppression of microbial load, wound-healing, lightening of scarring, etc. Although there are several challenges associated with PDT, the prominent ones being pain, erythema, insufficient delivery of the photosensitizing agent, and poor clinical outcomes, still PDT stands to be a promising approach with continuous efforts towards maximizing clinical efficacy while being cautious of the side effects and working towards lessening them. This article discusses the major skin-related conditions which can be treated or managed by employing PDT as a better or comparable alternative to conventional treatment approaches such that it also brings about aesthetic improvements thereof.

Stepping Out of the Blue: From Visible to Near-IR Triggered Photoswitches

Light offers unique opportunities for controlling the activity of materials and biosystems with high spatiotemporal resolution. Molecular photoswitches are chromophores that undergo reversible isomerization between different states upon irradiation with light, allowing a convenient means to control their influence over the system of interest. However, a significant limitation of classical photoswitches is the requirement to initiate the switching in one or both directions using deleterious UV light with poor tissue penetration. Red-shifted photoswitches are hence in high demand and have attracted keen recent research interest. In this Review, we highlight recent progress towards the development of visible- and NIR-activated photoswitches characterized by distinct photochromic reaction mechanisms. We hope to inspire further endeavors in this field, allowing the full potential of these tools in biotechnology and materials chemistry applications to be realized.

The application of photodynamic therapy in plastic and reconstructive surgery

Photodynamic therapy (PDT) is a modern clinical treatment paradigm with the advantages of high selectivity, non-invasiveness, rare side-effect, no obvious drug resistance and easy combination with other therapies. These features have endowed PDT with high focus and application prospects. Studies of photodynamic therapy have been expanded in a lot of biomedical and clinical fields, especially Plastic and Reconstructive Surgery (PRS) the author major in. In this review, we emphasize the mechanism and advances in PDT related to the PRS applications including benign pigmented lesions, vascular malformations, inflammatory lesions, tumor and others. Besides, combined with clinical data analysis, the limitation of PDT and current issues that need to be addressed in the field of PRS have also been discussed. At last, a comprehensive discussion and outlooking represent future progress of PDT in PRS.

Ring-Fused meso-Tetraarylchlorins as Auspicious PDT Sensitizers: Synthesis, Structural Characterization, Photophysics, and Biological Evaluation

Novel 4,5,6,7-tetrahydropyrazolo[1,5-a]pyridine-fused meso-tetraarylchlorins, with different degrees of hydrophilicity (with methyl ester, hydroxymethyl, and carboxylic acid moieties), have been synthesized and their photophysical characterization as well as in vitro photocytotoxicity assessment against human melanoma and esophageal and bladder carcinomas was carried out. An integrated analysis of the photosensitizers’ performance, considering the singlet oxygen generation data, cell internalization, and intracellular localization, allowed to establish relevant structure-photoactivity relationships and the rationalization of the observed photocytotoxicity. In the diacid and monoalcohol series, chlorins derived from meso-tetraphenylporphyrin proved to be the most efficient photodynamic therapy agents, showing IC50 values of 68 and 344 nM against A375 cells, respectively. These compounds were less active against OE19 and HT1376 cells, the diacid chlorin with IC50 values still in the nano-molar range, whereas the monohydroxymethyl-chlorin showed significantly higher IC50 values. The lead di(hydroxymethyl)-substituted meso-tetraphenylchlorin confirmed its remarkable photoactivity with IC50 values below 75 nM against the studied cancer cell lines. Subcellular accumulation of this chlorin in the mitochondria, endoplasmic reticulum, and plasma membrane was demonstrated.

Controlled and Selective Photo-oxidation of Amyloid-β Fibrils by Oligomeric p-Phenylene Ethynylenes

Photodynamic therapy (PDT) has been explored as a therapeutic strategy to clear toxic amyloid aggregates involved in neurodegenerative disorders such as Alzheimer's disease. A major limitation of PDT is off-target oxidation, which can be lethal for the surrounding cells. We have shown that a novel class of oligo-p-phenylene ethynylenes (OPEs) exhibit selective binding and fluorescence turn-on in the presence of prefibrillar and fibrillar aggregates of disease-relevant proteins such as amyloid-β (Aβ) and α-synuclein. Concomitant with fluorescence turn-on, OPE also photosensitizes singlet oxygen under illumination through the generation of a triplet state, pointing to the potential application of OPEs as photosensitizers in PDT. Herein, we investigated the photosensitizing activity of an anionic OPE for the photo-oxidation of Aβ fibrils and compared its efficacy to the well-known but nonselective photosensitizer methylene blue (MB). Our results show that, while MB photo-oxidized both monomeric and fibrillar conformers of Aβ40, OPE oxidized only Aβ40 fibrils, targeting two histidine residues on the fibril surface and a methionine residue located in the fibril core. Oxidized fibrils were shorter and more dispersed but retained the characteristic β-sheet rich fibrillar structure and the ability to seed further fibril growth. Importantly, the oxidized fibrils displayed low toxicity. We have thus discovered a class of novel theranostics for the simultaneous detection and oxidization of amyloid aggregates. Importantly, the selectivity of OPE's photosensitizing activity overcomes the limitation of off-target oxidation of traditional photosensitizers and represents an advancement of PDT as a viable strategy to treat neurodegenerative disorders.

A guide to designing photocontrol in proteins: methods, strategies and applications

Light is essential for various biochemical processes in all domains of life. In its presence certain proteins inside a cell are excited, which either stimulates or inhibits subsequent cellular processes. The artificial photocontrol of specifically proteins is of growing interest for the investigation of scientific questions on the organismal, cellular and molecular level as well as for the development of medicinal drugs or biocatalytic tools. For the targeted design of photocontrol in proteins, three major methods have been developed over the last decades, which employ either chemical engineering of small-molecule photosensitive effectors (photopharmacology), incorporation of photoactive non-canonical amino acids by genetic code expansion (photoxenoprotein engineering), or fusion with photoreactive biological modules (hybrid protein optogenetics). This review compares the different methods as well as their strategies and current applications for the light-regulation of proteins and provides background information useful for the implementation of each technique.

Triggered azobenzene-based prodrugs and drug delivery systems

Azobenzene-based molecules show unique trans-cis isomerization upon ultraviolet light irradiation, which induce the change of polarity, crystallinity, stability, and binding affinity with pharmacological target. Moreover, azobenzene is the substrate of azoreductase that is often overexpressed in many pathological sites, e.g. hypoxic solid tumor. Therefore, azobenzene can be a multifunctional molecule in material science, pharmaceutical science and biomedicine because of its sensitivity to light, hypoxia and certain enzymes, hence showing potential application in site-specific smart therapy. Herein we focus on the employment of azobenzene and its derivatives for engineering triggered prodrug and drug delivery systems, and provide an overview of photoswitchable azo-based prodrugs, the associated problems regarding ultraviolet light and reversible isomerization, as well as the potential solutions. We also present the advance of azo-bearing delivery vehicles wherein azobenzene act as the linker, capping agent, and building block, and discuss the corresponding mechanisms for controlled cargo release, endocytosis enhancement and sensitization of free radical cancer therapy.

Interaction of Cyanine-D112 with Binary Lipid Mixtures: Molecular Dynamics Simulation and Differential Scanning Calorimetry Study

This comprehensive molecular dynamics (MD) simulation and experimental study investigates the lipid bilayer interactions of dye D112 for potential photodynamic therapy (PDT) applications. PDT involves formation of a reactive oxidant species in the presence of a light sensitive molecule and light, interrupting cellular functions. D112 was developed as a photographic emulsifier, and we hypothesized that its combined cationic and lipophilic nature can render a superior photosensitizing property-crucial in various light therapies. The focus of this study is to elucidate the binding and insertion mechanisms of D112 with mixed lipid bilayers of anionic dipalmitoyl-phosphatidylserine (DPPS) and zwitterionic dipalmitoyl-phosphatidylcholine (DPPC) lipids to resemble cancer cell membranes. Our studies confirm initial electrostatic binding between the positively charged moieties of D112 and negatively charged lipid headgroups. Additionally, MD simulations combined with differential scanning calorimetry (DSC) studies confirm that D112-lipid interactions are governed by enthalpy-driven nonclassical hydrophobic effects in the membrane interior. It was further noted that despite the electrostatic preference of D112 toward the anionic lipids, D112 molecules colocalized on DPPC-rich domains after insertion. Atomistic level MD studies point toward two possible insertion mechanisms for D112: harpoon and flip. Further insights from the simulation showcase the interactions of low and high aggregates of D112 with the bilayer as the concentration of D112 increases in solution. The size of aggregates modulates the orientation and degree of insertion, providing important information for future studies on membrane permeation mechanisms.

Nanoscintillator-Based X-Ray-Induced Photodynamic Therapy

Photodynamic therapy (PDT) is an emerging treatment option for cancer. In PDT, photosensitizers are delivered to tumors and stimulated by light to generate reactive oxygen species (ROS)-most importantly singlet oxygen (¹O₂)-to damage tumor cells or induce tissue ischemia. PDT is associated with a low level of systemic toxicity because photosensitizers are usually pharmaceutically inactive in the dark and photoirradiation is applied only to tumor areas in the procedure. Additionally, PDT can be applied repeatedly without cumulative toxicity or incurring resistance, and may stimulate systemic anti-tumor immunity. However, PDT's clinical use has been restricted due to the limited penetration of visible light through tissues. X-rays possess superior tissue penetration capability and are exploited in X-ray-induced photodynamic therapy to overcome this limitation. Herein we have demonstrated this principle with a novel LiGa₅O₈:Cr (LGO:Cr)-based nanoscintillator which emits near-infrared X-ray luminescence to both guide external beam therapy and induce PDT with the photosensitizer (2,3-naphthalocyanine) encapsulated in a mesoporous silica shell of the nanoscintillator.

The effect of photodynamic therapy on head and neck squamous cell carcinoma cell lines using spirulina platensis with different laser energy densities

BACKGROUND

Considering the anti-cancer properties of spirulina platensis (S. platensis), we aimed to investigate the effectiveness of this algae as a novel natural photosensitizer for photodynamic therapy (PDT) against oral and hypopharyngeal cancer cells. The appropriate laser energy density to apply during PDT was also determined.

METHODS AND MATERIALS

CAL-27, FaDu and HGF cell lines were exposed to S. platensis with concentrations of 0.3 g/l and 0.6 g/l and were irradiated with 635 nm diode laser using 2, 4, 12, and 24 J/cm² energy densities with constant power. MTT assay was performed to investigate cell viability and cytotoxicity after 24 h. The results were analyzed using two-way ANOVA and post hoc Tukey tests (P-value<0.05).

RESULTS

survival rate in CAL-27 (P-Value<0.001) and FaDu (P-Value<0.001) cell lines were significantly different following irradiation with various laser energy densities. Different concentrations of S. platensis had no significant effect on the viability of CAL-27 cells (P-Value=0.158) and FaDu cells (P-Value=0.072) and showed no significant cytotoxicity against HGF cells, with or without laser.

CONCLUSION

S. platensis could be considered as a novel safe and effective natural photosensitizer for cancer PDT with no cytotoxic effect on normal cells. When combined with laser using appropriate energy densities, it has the ability to induce death in oral and hypopharyngeal cancer cell lines.

Phthalocyanine and Its Formulations: A Promising Photosensitizer for Cervical Cancer Phototherapy

Cervical cancer is one of the most common causes of cancer-related deaths in women worldwide. Despite advances in current therapies, women with advanced or recurrent disease present poor prognosis. Photodynamic therapy (PDT) has emerged as an effective therapeutic alternative to treat oncological diseases such as cervical cancer. Phthalocyanines (Pcs) are considered good photosensitizers (PS) for PDT, although most of them present high levels of aggregation and are lipophilic. Despite many investigations and encouraging results, Pcs have not been approved as PS for PDT of invasive cervical cancer yet. This review presents an overview on the pathophysiology of cervical cancer and summarizes the most recent developments on the physicochemical properties of Pcs and biological results obtained both in vitro in tumor-bearing mice and in clinical tests reported in the last five years. Current evidence indicates that Pcs have potential as pharmaceutical agents for anti-cervical cancer therapy. The authors firmly believe that Pc-based formulations could emerge as a privileged scaffold for the establishment of lead compounds for PDT against different types of cervical cancer.

Painless Photodynamic Therapy Triggers Innate and Adaptive Immune Responses in a Murine Model of UV-induced Squamous Skin Pre-cancer

Painless photodynamic therapy (p-PDT), which involves application of photosensitizer and immediate exposure to light to treat actinic keratosis (AK) in patients, causes negligible pain on the day of treatment but leads to delayed inflammation and effective lesion clearance (Kaw et al., J Am Acad Dermatol 2020). To better understand how p-PDT works, hairless mice with UV-induced AK were treated with p-PDT and monitored for 2 weeks. Lesion clearance after p-PDT was similar to clearance after conventional PDT (c-PDT). However, lesion biopsies showed minimal cell death and less production of reactive oxygen species (ROS) in p-PDT treated than in c-PDT-treated lesions. Interestingly, p-PDT triggered vigorous recruitment of immune cells associated with innate immunity. Neutrophils (Ly6G+) and macrophages (F4/80+) appeared at 4 h and peaked at 24 h after p-PDT. Damage-associated molecular patterns (DAMPs), including calreticulin, HMGB1, and HSP70, were expressed at maximum levels around 24 h post-p-PDT. Total T cells (CD3+) were increased at 24 h, whereas large increases in cytotoxic (CD8+) and regulatory (Foxp3+) T cells were observed at 1 and 2 weeks post-p-PDT. In summary, the ability of p-PDT to eliminate AK lesions, despite very little overt cellular damage, appears to involve stimulation of a local immune response.

Methylene blue-mediated photodynamic therapy may be superior to 5% amorolfine nail lacquer for non-dermatophyte onychomycosis

BACKGROUND

Methylene blue-mediated photodynamic therapy as an antimicrobial has been reported to improve onychomycosis.

OBJECTIVES

To compare the short-term efficacy of methylene blue-mediated photodynamic therapy (MB-PDT) and 5% amorolfine nail lacquer (AMO) for toenail onychomycosis using higher intensity and shorter total treatment period than previously reported.

METHODS

Twenty-seven toenails with onychomycosis were randomized to receive either six biweekly sessions of MB-PDT or AMO for twelve weeks. Dermoscopic photography was used for onychomycosis severity index assessment under a dermoscopic inspection (d-OSI) at baseline, weeks 6, 10, 14 and 22 as well as microscopic and microbiological tests. Adverse events were recorded.

RESULTS

All subjects completed the study. Causative organisms found were exclusively non-dermatophytes including Fusarium spp., Asperillus spp.,and yeasts. Fifteen toenails received MB-PDT, whilst 12 received AMO. D-OSI showed greater improvement in MB-PDT than in AMO groups at weeks 6, 10, 14 as well as 22, with median changes of -2, -3, -4 (P = .055). and - 3 respectively in the MB-PDT group. The AMO group displayed the median d-OSI change of 0 throughout the study period. Mycological cure rate at 22 weeks in MB-PDT and AMO group was 73.3% and 66.67% (P > .05). Clinical cure rate at 22 weeks in MB-PDT (26.7%) was higher than AMO (16.7%), (P > .05). All patients only felt comfortably warm during the MB-PDT treatment. No major adverse events were found in both groups.

CONCLUSIONS

MB-PDT appeared to be more efficacious for non-dermatophyte onychomycosis than AMO particularly in a limited period and moderately severe onychomycosis.

Novel fluorinated ring-fused chlorins as promising PDT agents against melanoma and esophagus cancer

Investigation of novel 4,5,6,7-tetrahydropyrazolo[1,5-a]pyridine-fused chlorins, derived from 5,10,15,20-tetrakis(pentafluorophenyl)porphyrin, as PDT agents against melanoma and esophagus cancer is disclosed. Diol and diester fluorinated ring-fused chlorins, including derivatives with 2-(2-hydroxyethoxy)ethanamino groups at the phenyl rings, were obtained via a two-step methodology, combining SNAr and [8π + 2π] cycloaddition reactions. The short-chain PEG groups at the para-position of the phenyl rings together with the diol moiety at the fused pyrazole ring promote a red-shift of the Soret band, a decrease of the fluorescence quantum yield and an increase of the singlet oxygen formation quantum yield, improving the photophysical characteristics required to act as a photosensitizer. Introduction of these hydrophilic groups also improves the incorporation of the sensitizers by the cells reaching cellular uptake values of nearly 50% of the initial dose. The rational design led to a photosensitizer with impressive IC50 values, 13 and 27 nM against human melanoma and esophageal carcinoma cell lines, respectively.

Role of Photo-Biomodulation Therapy in Facial Rejuvenation and Facial Plastic Surgery

Photo-biomodulation (PBM) also known as low-level laser therapy is a rising technology with multiple potential uses in medicine and recently in the cosmetic field for the treatment of skin conditions and skin rejuvenation. Due to its wound healing and anti-inflammatory properties, there is an increase in popularity in its use as adjunctive treatment before and after surgical procedures in the face and neck.

Carbon Spacer Strategy: Control the Photoswitching Behavior of Donor-Acceptor Stenhouse Adducts

Understanding the relationship between chemical structure and photoswitching property of donor-acceptor Stenhouse adducts (DASAs) is necessary for developments and applications of the novel photoresponsive molecule. In the current work, we demonstrated a close relationship between the length of carbon spacer and photoswitching property of DASAs. A series of DASAs with barbituric acid substituted electron-withdrawing part and N-methylaniline substituted electron-donating part were synthesized. With shortening the carbon spacer between the phenyl and amine groups in the electron-donating part, the efficiency and rate of the light-induced linear-to-cyclic isomerization are improved in all the test solvents. The molecular energy variation during the isomerization process was investigated by density functional theory calculation to further understand the mechanism. This work provides a reliable carbon spacer strategy to control the photoswitching behavior of DASAs using chemical methods.

Transformation of COUPY Fluorophores into a Novel Class of Visible-Light-Cleavable Photolabile Protecting Groups

Although photolabile protecting groups (PPGs) have found widespread applications in several fields of chemistry, biology and materials science, there is a growing interest in expanding the photochemical toolbox to overcome some of the limitations of classical caging groups. In this work, the synthesis of a new class of visible-light-sensitive PPGs based on low-molecular weight COUPY fluorophores with several attractive properties, including long-wavelength absorption, is reported. Besides being stable to spontaneous hydrolysis in the dark, COUPY-based PPGs can be efficiently photoactivated with yellow (560 nm) and red light (620 nm) under physiological-like conditions, thereby offering the possibility of unmasking functional groups from COUPY photocages under irradiation conditions in which other PPGs remain stable. Additionally, COUPY photocages exhibit excellent cellular uptake and accumulate selectively in mitochondria, opening the door to the delivery of caged analogues of biologically active compounds into these organelles.

Photodynamic therapy in dermatology: Beyond current indications

Photodynamic therapy (PDT) has long been used in dermatology as a therapeutic strategy for several malignant and premalignant conditions. Currently, it is approved in Europe for the treatment of actinic keratosis, squamous cell carcinoma in situ, and some forms of basal cell carcinoma, with favorable clearance rates associated with satisfying aesthetic results. Nonetheless, in the past few years, PDT has also demonstrated efficacy in many other conditions, including inflammatory and infectious dermatoses. These results, probably explained by its immunomodulatory, anti-inflammatory, and bactericidal effects, may lead to an expansion of PDT indications in the upcoming years. In this article, conditions where PDT may be useful are reviewed, thus highlighting the potential of this therapeutic modality for the dermatologist.

A few-layer graphene/chlorin e6 hybrid nanomaterial and its application in photodynamic therapy against Candida albicans

The global emergence of multidrug resistance of fungal infections and the decline in the discovery of new antibiotics are increasingly prevalent causes of hospital-acquired infections, among other major challenges in the global health care sector. There is an urgent need to develop noninvasive, nontoxic, and new antinosocomial approaches that work more effectively and faster than current antibiotics. In this work, we report on a biocompatible hybrid nanomaterial composed of few-layer graphene and chlorin e6 (FLG-Ce6) for the photodynamic treatment (PDT) of Candida albicans. We show that the FLG-Ce6 hybrid nanomaterial displays enhanced reactive oxygen species (ROS) generation compared with Ce6. The enhancement is up to 5-fold when irradiated for 15 min at 632 nm with a red light-emitting diode (LED). The viability of C. albicans in the presence of FLG-Ce6 was measured 48 h after photoactivation. An antifungal effect was observed only when the culture/FLG-Ce6 hybrid was exposed to the light source. C. albicans is rendered completely unviable after exposure to ROS generated by the excited FLG-Ce6 hybrid nanomaterial. An increased PDT effect was observed with the FLG-Ce6 hybrid nanomaterial by a significant reduction in the viability of C. albicans, by up to 95%. This is a marked improvement compared to Ce6 without FLG, which reduces the viability of C. albicans to only 10%. The antifungal action of the hybrid nanomaterial can be activated by a synergistic mechanism of energy transfer of the absorbed light from Ce6 to FLG. The novel FLG-Ce6 hybrid nanomaterial in combination with the red LED light irradiation can be used in the development of a wide range of antinosocomial devices and coatings.

Photodynamic Therapy for Photodamage, Actinic Keratosis, and Acne in the Cosmetic Practice

Photodynamic therapy is the combination of the initial application of a photosensitive chemical on the skin and then using typically a blue filter light of varying spectrums. This treatment protocol has been more useful and functional than other chemical peels and lasers for a variety of conditions. There has been efficacy in antiviral treatments, such as herpetic lesions; malignant cancers of the head and neck; and lung, bladder, and skin cancers. It has been tested for prostate cancers, cervical cancer, colorectal cancer, lung cancer, breast cancer, esophageal cancer, stomach cancer, pancreatic cancer, vaginal cancer, gliomas, and erythroplasia of Queyrat.

Study on injection molding analysis of glasses-type wearable device for facial skin care

BACKGROUND:

With the improvement in the standard of living, there has been increasing interest in facial skin care. In particular, it has been observed that people pay extra attention to eye-skin when they visit skin care parlors for special treatment and care.

OBJECTIVE:

There is a need for skin care devices that would enable convenient skin care anywhere, including at home and on the move. In this research, we developed a prototype of a glasses-type skin care device with a LED (Light-Emitting Diode) irradiation function and performed injection molding analysis of the skin care device model for mass production.

METHODS:

First, the product was designed using a universal design to improve the wearability of the glasses-type skin care device. The first prototype of the skin care device was produced using an integrated LED optical module capable of irradiating at three LED wavelengths to investigate the structural function of the product. The prototype was classified into three mechanisms and injection molding analysis was performed. The fill time, temperature at flow front, injection pressure, clamp force, and deflection values were analyzed according to the appropriate number and location of gates into which the PC + PBT (Polycarbonate + Polybutylene terephthalate) resin was introduced.

RESULTS:

We found that all the other parts except the temple section of the device were inferior in moldability.

CONCLUSION:

In further studies, the 3D prototype will be modified to enhance moldability, and injection molding analysis with other materials as well as with PC + PBT resin will be performed.

Low-level PDT treatment modulated photoaging mediated by UVA irradiation through regulating Bach2

OBJECTIVE

To investigate low-level ALA-PDT (Aminolevulinic acid photodynamic therapy) effects on photorejuvenation in vitro and in vivo, exploring the basic mechanism of Bach2 involved in PDT treatment in photoaging.

METHOD

Photoaging model was established by UVA chronic irradiation in human fibroblasts and mice skins. Cell viability was determined by MTS assay and cell senescence was detected by SA-β-gal activity. PDT treatment and Bach2 knockdown with adenovirus in fibroblasts were confirmed by Western blot.

RESULTS

UVA chronic irradiation induced photoaging in vitro and in vivo. Treatment of low-level PDT reduced photoaging by decreasing SA-β-gal activity and cell senescence-related proteins levels of p16 and p21 in fibroblasts. Moreover, low-level PDT treatment accompany with Bach2 accumulation increased in fibroblasts and in mice skin tissues. Bach2 knockdown with adenovirus induced cell senescence and Bach2 depletion with PDT treatment some extent decreased SA-β-gal activity, but was with no significant change of Bach2 itself and p16 protein levels in fibroblasts.

CONCLUSION

Low-level PDT treatment decreased skin photoaging which might be through up-regulating Bach2.

Molecular Biology of Basal and Squamous Cell Carcinomas

The prevalent keratinocyte-derived neoplasms of the skin are basal cell carcinoma and squamous cell carcinoma. Both so-called non-melanoma skin cancers comprise the most common cancers in humans by far. Common risk factors for both tumor entities include sun exposure, DNA repair deficiencies leading to chromosomal instability, or immunosuppression. Yet, fundamental differences in the development of the two different entities have been and are currently unveiled. The constitutive activation of the sonic hedgehog signaling pathway by acquired mutations in the PTCH and SMO genes appears to represent the early basal cell carcinoma developmental determinant. Although other signaling pathways are also affected, small hedgehog inhibitory molecules evolve as the most promising basal cell carcinoma treatment options systemically as well as topically in current clinical trials. For squamous cell carcinoma development, mutations in the p53 gene, especially UV-induced mutations, have been identified as early events. Yet, other signaling pathways including epidermal growth factor receptor, RAS, Fyn, or p16INK4a signaling may play significant roles in squamous cell carcinoma development. The improved understanding of the molecular events leading to different tumor entities by de-differentiation of the same cell type has begun to pave the way for modulating new molecular targets therapeutically with small molecules.