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Carter S, Miller J, Cramer G, Yuan M, Guzman S, Putt ME, Cengel KA, Freedman GM, Busch TM. Adjuvant Photodynamic Therapy, Mediated via Topical Versus Systemic Administration of 5-Aminolevulinic Acid for Control of Murine Mammary Tumor after Surgical Resection. Photochem Photobiol 2022; 98:117-126. [PMID: 34224156 PMCID: PMC9682898 DOI: 10.1111/php.13482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/04/2021] [Accepted: 07/02/2021] [Indexed: 01/03/2023]
Abstract
Treatment de-escalation is sought in the management of precursor lesions of early stage breast cancer, driving the appeal of adjuvant modalities to lumpectomy that reduce toxicity and minimally detract from patient quality of life. We investigate photodynamic therapy (PDT), with the photosensitizing prodrug, 5-aminolevulinic acid (ALA), as adjuvant therapy to complete resection of murine mammary tumor (propagated from TUBO cells). ALA was delivered either systemically (oral, 250 mg kg-1 ) at 5 h before 632 nm illumination or topically (20% solution) to the resection site at 10 min before light delivery to 135 J cm-2 . Treatment with either oral-ALA-PDT (oALA-PDT) or topical-ALA-PDT (tALA-PDT) to the mammary fat pad after TUBO complete resection (CR) produced long-term tumor control with 90-day complete response rates of 21% and 32%, respectively, compared to control rates of 0-5% in mice receiving only CR. Thus, CR/tALA-PDT was equipotent to CR/oALA-PDT despite ~10-fold lower levels of ALA-induced protoporphyrin XI as photosensitizer after topical versus oral-ALA administration. CR/oALA-PDT produced more vascular damage, greater proportion of tissue-resident neutrophils and stronger inflammation when compared to CR/tALA-PDT. Collectively, these data provide rationale for ongoing investigation of ALA-PDT as adjuvant therapy after lumpectomy for increased probability of local control in the treatment of breast cancer.
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Affiliation(s)
- Shirron Carter
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Joann Miller
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gwendolyn Cramer
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Min Yuan
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Stacy Guzman
- Department of Biochemistry and Biophysics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mary E. Putt
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Keith A. Cengel
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gary M. Freedman
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Theresa M. Busch
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,Corresponding author (Theresa M. Busch)
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Sánchez V, Romero MP, Pratavieira S, Costa C. Physiological considerations acting on triplet oxygen for explicit dosimetry in photodynamic therapy. Photodiagnosis Photodyn Ther 2017; 19:298-303. [PMID: 28750754 DOI: 10.1016/j.pdpdt.2017.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/19/2017] [Accepted: 07/23/2017] [Indexed: 12/29/2022]
Abstract
The aims of this study were to determine the spatial and temporal theoretical distribution of the concentrations of Protoporphyrin IX, 3O2 and doses of 1O2. The type II mechanism and explicit dosimetry in photodynamic therapy were used. Furthermore, the mechanism of respiration and cellular metabolism acting on 3O2 were taken into account. The dermis was considered as an absorbing and a scattering medium. An analytical solution was used for light diffusion in the skin. The photophysical, photochemical and biological effects caused by PDT with the initial irradiances of 20, 60 and 150mW/cm2 were studied for a time of exposure of 20min and a maximum depth of 0.5cm. We found that the initial irradiance triples its value in 0.02cm and that almost 100% of PpIX is part of the dynamics of reactions in photodynamic therapy. Additionally, with about 40μMof 3O2 there is a balance between the consumed and supplied oxygen. Finally, we determined that with 60mW/cm2, the highest dose of 1O2 is obtained.
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Affiliation(s)
- Víctor Sánchez
- Departamento de Física, Facultad de Ciencias, Escuela Politécnica Nacional, Quito, Ecuador
| | - María Paulina Romero
- Departamento de Materiales, Facultad de Ingeniería Mecánica, Escuela Politécnica Nacional, Quito, Ecuador
| | | | - César Costa
- Departamento de Física, Facultad de Ciencias, Escuela Politécnica Nacional, Quito, Ecuador
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3
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Lopez N, Mulet R, Rodríguez R. Tumor reactive ringlet oxygen approach for Monte Carlo modeling of photodynamic therapy dosimetry. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2016; 160:383-91. [PMID: 27197059 DOI: 10.1016/j.jphotobiol.2016.04.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 04/01/2016] [Accepted: 04/03/2016] [Indexed: 01/26/2023]
Abstract
Photodynamic therapy (PDT) is an emergent technique used for the treatment of several diseases. It requires the interaction of three components: a photosensitizer, a light source and tissue oxygen. Knowledge of the biophysical aspects of PDT is important for improving dosimetry protocols and treatment planning. In this paper we propose a model to simulate the spatial and temporal distribution of ground state oxygen ((3)O2), cumulative singlet excited state oxygen ((1)O2)rx and photosensitizer, in this case protoporphyrin IX (PpIX) in an ALA mediated PDT treatment. The results are analyzed in order to improve the treatment dosimetry. We compute the light fluence in the tissue using Monte Carlo simulations running in a GPU system. The concentration of (3)O2, ((1)O2)rx and the photosensitizer are calculated using this light fluence and a set of differential equations describing the photochemical reactions involved in PDT. In the model the initial photosensitizer concentration depends on tissue depth and type, moreover we consider blood vessel damage and its effect in the ground state oxygen concentration in the tissue. We introduce the tumor reactive single oxygen (TRSO) as a new dosimetry metric. It represents the amount of singlet oxygen per tumor volume that reacts, during the treatment, with the molecules in the tumor. This quantity integrates the effect of the light irradiance, the optical properties of the tumor and the normal tissue, the oxygen consumption and supply, and the photosensitizer biodistribution on the skin.
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Affiliation(s)
- N Lopez
- Group of Complex Systems and Statistical Physics, Department of General Physics, Physics Faculty, University of Havana, La Habana CP 10400, Cuba.
| | - R Mulet
- Group of Complex Systems and Statistical Physics, Department of Theoretical Physics, Physics Faculty, University of Havana, La Habana CP 10400, Cuba.
| | - R Rodríguez
- Department of Computational Medicine, National Institute of Nephrology. La Habana CP 10600, Cuba; Department of General Physics, Physics Faculty, University of Havana, La Habana CP 10400, Cuba.
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Danino T, Prindle A, Kwong GA, Skalak M, Li H, Allen K, Hasty J, Bhatia SN. Programmable probiotics for detection of cancer in urine. Sci Transl Med 2016; 7:289ra84. [PMID: 26019220 DOI: 10.1126/scitranslmed.aaa3519] [Citation(s) in RCA: 238] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Rapid advances in the forward engineering of genetic circuitry in living cells has positioned synthetic biology as a potential means to solve numerous biomedical problems, including disease diagnosis and therapy. One challenge in exploiting synthetic biology for translational applications is to engineer microbes that are well tolerated by patients and seamlessly integrate with existing clinical methods. We use the safe and widely used probiotic Escherichia coli Nissle 1917 to develop an orally administered diagnostic that can noninvasively indicate the presence of liver metastasis by producing easily detectable signals in urine. Our microbial diagnostic generated a high-contrast urine signal through selective expansion in liver metastases (10(6)-fold enrichment) and high expression of a lacZ reporter maintained by engineering a stable plasmid system. The lacZ reporter cleaves a substrate to produce a small molecule that can be detected in urine. E. coli Nissle 1917 robustly colonized tumor tissue in rodent models of liver metastasis after oral delivery but did not colonize healthy organs or fibrotic liver tissue. We saw no deleterious health effects on the mice for more than 12 months after oral delivery. Our results demonstrate that probiotics can be programmed to safely and selectively deliver synthetic gene circuits to diseased tissue microenvironments in vivo.
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Affiliation(s)
- Tal Danino
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA
| | - Arthur Prindle
- Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Gabriel A Kwong
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA
| | - Matthew Skalak
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA
| | - Howard Li
- Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Kaitlin Allen
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA
| | - Jeff Hasty
- Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA. BioCircuits Institute, University of California, San Diego, La Jolla, CA 92093, USA. Molecular Biology Section, Division of Biological Science, University of California, San Diego, La Jolla, CA 92093, USA
| | - Sangeeta N Bhatia
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA. Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA. Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA. Electrical Engineering and Computer Science and David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA. Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA.
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5
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Chen D, Ren J, Wang Y, Li B, Gu Y. Intraoperative monitoring of blood perfusion in port wine stains by laser Doppler imaging during vascular targeted photodynamic therapy: A preliminary study. Photodiagnosis Photodyn Ther 2016; 14:142-51. [PMID: 27068654 DOI: 10.1016/j.pdpdt.2016.04.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 03/11/2016] [Accepted: 04/05/2016] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The objective of this study was to monitor blood perfusion dynamics of port wine stains (PWS) during vascular targeted photodynamic therapy (V-PDT) with laser Doppler imaging (LDI). METHODS The PWS lesions of 30 facial PWS patients received V-PDT, while the normal skins on the forearm of 5 healthy subjects were treated as light-only controls for comparison. Furthermore, two different PWS lesions in the same individual from each of 3 PWS patients successively received laser irradiation only and V-PDT, respectively. LDI was used to monitor intraoperative blood perfusion dynamics. RESULTS During V-PDT, the blood perfusion (278±96 PU) in PWS lesions for 31 of 33 PWS patients significantly increased after the initiation of V-PDT treatment, then reached a peak (638±105 PU) within 10min, followed by a slow decrease to a relatively lower level (515±100 PU). Furthermore, the time for reaching peak and the subsequent magnitude of decrease in blood perfusion varied with different patients. For light-only controls, an initial perfusion peak at 3min followed by a nadir and a secondary increase were found not only in normal skin, but also in PWS lesions. CONCLUSION The preliminary results showed that the LDI permits non-invasive monitoring blood perfusion changes of PWS lesions during V-PDT. There was a clear trend in blood perfusion responses during V-PDT and laser irradiation. The blood perfusion changes during treatment were due to V-PDT effects as well as local temperature increase induced by laser irradiation.
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Affiliation(s)
- Defu Chen
- School of Information and Electronics, Beijing Institute of Technology, Beijing 100081, China
| | - Jie Ren
- Department of Laser Medicine, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Ying Wang
- Department of Laser Medicine, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Buhong Li
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory for Photonics Technology, Fujian Normal University, Fujian 350007, China
| | - Ying Gu
- School of Information and Electronics, Beijing Institute of Technology, Beijing 100081, China; Department of Laser Medicine, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
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Mallidi S, Mai Z, Rizvi I, Hempstead J, Arnason S, Celli J, Hasan T. In vivo evaluation of battery-operated light-emitting diode-based photodynamic therapy efficacy using tumor volume and biomarker expression as endpoints. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:048003. [PMID: 25909707 PMCID: PMC4408448 DOI: 10.1117/1.jbo.20.4.048003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 03/30/2015] [Indexed: 05/12/2023]
Abstract
In view of the increase in cancer-related mortality rates in low- to middle-income countries (LMIC), there is an urgent need to develop economical therapies that can be utilized at minimal infrastructure institutions. Photodynamic therapy (PDT), a photochemistry-based treatment modality, offers such a possibility provided that low-cost light sources and photosensitizers are available. In this proof-of-principle study, we focus on adapting the PDT light source to a low-resource setting and compare an inexpensive, portable, battery-powered light-emitting diode (LED) light source with a standard, high-cost laser source. The comparison studies were performed in vivo in a xenograft murine model of human squamous cell carcinoma subjected to 5-aminolevulinic acid-induced protoporphyrin IX PDT. We observed virtually identical control of the tumor burden by both the LED source and the standard laser source. Further insights into the biological response were evaluated by biomarker analysis of necrosis, microvessel density, and hypoxia [carbonic anhydrase IX (CAIX) expression] among groups of control, LED-PDT, and laser-PDT treated mice. There is no significant difference in the percent necrotic volume and CAIX expression in tumors that were treated with the two different light sources. These encouraging preliminary results merit further investigations in orthotopic animal models of cancers prevalent in LMICs.
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Affiliation(s)
- Srivalleesha Mallidi
- Massachusetts General Hospital, Wellman Center for Photomedicine, 40 Blossom Street, Boston, Massachusetts 02114, United States
| | - Zhiming Mai
- Massachusetts General Hospital, Wellman Center for Photomedicine, 40 Blossom Street, Boston, Massachusetts 02114, United States
| | - Imran Rizvi
- Massachusetts General Hospital, Wellman Center for Photomedicine, 40 Blossom Street, Boston, Massachusetts 02114, United States
- Brigham and Women’s Hospital, Department of Medicine, Boston, Massachusetts, United States
| | - Joshua Hempstead
- University of Massachusetts, Department of Physics, 100 Morrissey Boulevard, Boston, Massachusetts 02125, United States
| | - Stephen Arnason
- University of Massachusetts, Department of Physics, 100 Morrissey Boulevard, Boston, Massachusetts 02125, United States
| | - Jonathan Celli
- University of Massachusetts, Department of Physics, 100 Morrissey Boulevard, Boston, Massachusetts 02125, United States
| | - Tayyaba Hasan
- Massachusetts General Hospital, Wellman Center for Photomedicine, 40 Blossom Street, Boston, Massachusetts 02114, United States
- Address all correspondence to: Tayyaba Hasan, E-mail:
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7
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van Leeuwen-van Zaane F, de Bruijn HS, van der Ploeg-van den Heuvel A, Sterenborg HJMC, Robinson DJ. The effect of fluence rate on the acute response of vessel diameter and red blood cell velocity during topical 5-aminolevulinic acid photodynamic therapy. Photodiagnosis Photodyn Ther 2014; 11:71-81. [PMID: 24709508 DOI: 10.1016/j.pdpdt.2014.03.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 03/21/2014] [Accepted: 03/22/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND In a previous study it is shown that for topically applied ALA-PDT, PpIX concentration correlates with vascular changes including vasoconstriction and/or vascular leakage of small vessels and arterioles in the mouse epidermis and dermis. In this study we report on vascular responses induced by ALA-PDT for different fluence rates, including both changes in vessel diameter and dynamics in RBC velocity in arterioles, imaged using intra-vital confocal microscopy in skinfold chambers in hairless mice. Our interest is in the dynamics of vascular changes in the early stages of illumination. METHODS We have determined the total PDT dose to be relatively low, 13 J cm(-2), and fluence rates of 26, 65 and 130 mW cm(-2) were investigated. Local vascular effects occurred very soon after the start of the therapeutic illumination in ALA-PDT. RESULTS In this study, we did not find a significant difference between fluence rates. Arterioles were particularly sensitive to vasoconstriction during low dose PDT, often resulting in complete vasoconstriction. When we observed complete vasoconstriction, this coincided with changes in RBC velocity. CONCLUSION Since the therapeutic effects of PDT are dependent on a fine balance between the need for oxygen during illumination and disruption of the vasculature, the results of the present study add to our understanding of acute vascular effects during ALA-PDT and aid our efforts to optimize PDT using porphyrin pre-cursors.
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Affiliation(s)
- F van Leeuwen-van Zaane
- Department of Radiation Oncology, Center for Optical Diagnostics and Therapy, Postgraduate School Molecular Medicine, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - H S de Bruijn
- Department of Otolaryngology - Head and Neck Surgery, Erasmus MC, Rotterdam, The Netherlands
| | - A van der Ploeg-van den Heuvel
- Department of Radiation Oncology, Center for Optical Diagnostics and Therapy, Postgraduate School Molecular Medicine, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - H J M C Sterenborg
- Department of Radiation Oncology, Center for Optical Diagnostics and Therapy, Postgraduate School Molecular Medicine, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - D J Robinson
- Department of Otolaryngology - Head and Neck Surgery, Erasmus MC, Rotterdam, The Netherlands.
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Middelburg TA, de Bruijn HS, Tettero L, van der Ploeg van den Heuvel A, Neumann HAM, de Haas ERM, Robinson DJ. Topical hexylaminolevulinate and aminolevulinic acid photodynamic therapy: complete arteriole vasoconstriction occurs frequently and depends on protoporphyrin IX concentration in vessel wall. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2013; 126:26-32. [PMID: 23892187 DOI: 10.1016/j.jphotobiol.2013.06.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 06/11/2013] [Accepted: 06/22/2013] [Indexed: 12/28/2022]
Abstract
Vascular responses to photodynamic therapy (PDT) may influence the availability of oxygen during PDT and the extent of tumor destruction after PDT. However, for topical PDT vascular effects are largely unknown. Arteriole and venule diameters were measured before and after hexylaminolevulinate (HAL) and aminolevulinic acid (ALA) PDT and related to the protoporphyrin IX (PpIX) concentration in the vessel wall. A mouse skin fold chamber model and an intravital confocal microscope allowed direct imaging of the subcutaneous vessels underlying the treated area. In both HAL and ALA groups over 60% of arterioles constricted completely, while venules generally did not respond, except for two larger veins that constricted partially. Arteriole vasoconstriction strongly correlated with PpIX fluorescence intensity in the arteriole wall. Total PpIX fluorescence intensity was significantly higher for HAL than ALA for the whole area that was imaged but not for the arteriole walls. In conclusion, complete arteriole vasoconstriction occurs frequently in both HAL and ALA based topical PDT, especially when relatively high PpIX concentrations in arteriole walls are reached. Vasoconstriction will likely influence PDT effect and should be considered in studies on topical HAL and ALA-PDT. Also, our results may redefine the vasculature as a potential secondary target for topical PDT.
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Affiliation(s)
- T A Middelburg
- Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands
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Master A, Livingston M, Sen Gupta A. Photodynamic nanomedicine in the treatment of solid tumors: perspectives and challenges. J Control Release 2013; 168:88-102. [PMID: 23474028 DOI: 10.1016/j.jconrel.2013.02.020] [Citation(s) in RCA: 266] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 02/16/2013] [Accepted: 02/21/2013] [Indexed: 12/13/2022]
Abstract
Photodynamic therapy (PDT) is a promising treatment strategy where activation of photosensitizer drugs with specific wavelengths of light results in energy transfer cascades that ultimately yield cytotoxic reactive oxygen species which can render apoptotic and necrotic cell death. Without light the photosensitizer drugs are minimally toxic and the photoactivating light itself is non-ionizing. Therefore, harnessing this mechanism in tumors provides a safe and novel way to selectively eradicate tumor with reduced systemic toxicity and side effects on healthy tissues. For successful PDT of solid tumors, it is necessary to ensure tumor-selective delivery of the photosensitizers, as well as, the photoactivating light and to establish dosimetric correlation of light and drug parameters to PDT-induced tumor response. To this end, the nanomedicine approach provides a promising way towards enhanced control of photosensitizer biodistribution and tumor-selective delivery. In addition, refinement of nanoparticle designs can also allow incorporation of imaging agents, light delivery components and dosimetric components. This review aims at describing the current state-of-the-art regarding nanomedicine strategies in PDT, with a comprehensive narrative of the research that has been carried out in vitro and in vivo, with a discussion of the nanoformulation design aspects and a perspective on the promise and challenges of PDT regarding successful translation into clinical application.
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Affiliation(s)
- Alyssa Master
- Department of Biomedical Engineering, Case Western Reserve University, 2071 Martin Luther King Drive, Cleveland 44106, USA
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10
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Milstein DMJ, van Kuijen AM, Copper MP, Karakullukçu B, Tan IB, Lindeboom JAH, Fokkens WJ, Ince C. Monitoring microcirculatory alterations in oral squamous cell carcinoma following photodynamic therapy. Photodiagnosis Photodyn Ther 2011; 9:69-75. [PMID: 22369731 DOI: 10.1016/j.pdpdt.2011.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 11/08/2011] [Accepted: 11/10/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND One of the mechanisms through which photodynamic therapy (PDT) is thought to elicit tumour destruction is by producing microvascular damage and obstruction of nutritive blood flow. The aim of this study was to directly monitor and quantify microcirculatory changes following tissue illumination by PDT for oral squamous cell carcinoma. METHODS Ten consecutive patients receiving PDT for a carcinoma in situ, a T1 or T2 tumour in the oral cavity without evidence of lymph node metastasis were selected for this study. Tumour and marginal healthy mucosa total capillary density (TCD) and functional capillary density (FCD) inside the field of illumination were measured and compared using sidestream dark-field (SDF) imaging prior to tissue illumination, immediately after PDT, and again after 15min. RESULTS Baseline mean tumour TCD was 21.2±5capillaries per square millimetres (cpll/mm²) and 24.9±19cpll/mm² in the surrounding marginal healthy tissue; there were no significant differences between tumour and healthy tissue or time points. Comparisons between baseline and post-illumination time points revealed significant differences in both tumour and healthy tissue FCD (P<0.05). No significant differences in FCD were observed between the two tissues. CONCLUSIONS Our findings using SDF imaging demonstrate that PDT significantly attenuates tumour and marginal healthy tissue perfusion by directly disrupting the functionality of the microcirculation.
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Affiliation(s)
- Dan M J Milstein
- Department of Translational Physiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
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11
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Tyrrell J, Thorn C, Shore A, Campbell S, Curnow A. Oxygen saturation and perfusion changes during dermatological methylaminolaevulinate photodynamic therapy. Br J Dermatol 2011; 165:1323-31. [DOI: 10.1111/j.1365-2133.2011.10554.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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12
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Marrero A, Becker T, Sunar U, Morgan J, Bellnier D. Aminolevulinic acid-photodynamic therapy combined with topically applied vascular disrupting agent vadimezan leads to enhanced antitumor responses. Photochem Photobiol 2011; 87:910-9. [PMID: 21575001 DOI: 10.1111/j.1751-1097.2011.00943.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The tumor vascular-disrupting agent (VDA) vadimezan (5,6-dimethylxanthenone-4-acetic acid, DMXAA) has been shown to potentiate the antitumor activity of photodynamic therapy (PDT) using systemically administered photosensitizers. Here, we characterized the response of subcutaneous syngeneic Colon26 murine colon adenocarcinoma tumors to PDT using the locally applied photosensitizer precursor aminolevulinic acid (ALA) in combination with a topical formulation of vadimezan. Diffuse correlation spectroscopy (DCS), a noninvasive method for monitoring blood flow, was utilized to determine tumor vascular response to treatment. In addition, correlative CD31-immunohistochemistry to visualize endothelial damage, ELISA to measure induction of tumor necrosis factor-alpha (TNF-α) and tumor weight measurements were also examined in separate animals. In our previous work, DCS revealed a selective decrease in tumor blood flow over time following topical vadimezan. ALA-PDT treatment also induced a decrease in tumor blood flow. The onset of blood flow reduction was rapid in tumors treated with both ALA-PDT and vadimezan. CD31-immunostaining of tumor sections confirmed vascular damage following topical application of vadimezan. Tumor weight measurements revealed enhanced tumor growth inhibition with combination treatment compared with ALA-PDT or vadimezan treatment alone. In conclusion, vadimezan as a topical agent enhances treatment efficacy when combined with ALA-PDT. This combination could be useful in clinical applications.
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Affiliation(s)
- Allison Marrero
- Department of Molecular Pharmacology and Cancer Therapeutics, Roswell Park Cancer Institute, Buffalo, NY, USA
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Becker TL, Paquette AD, Keymel KR, Henderson BW, Sunar U. Monitoring blood flow responses during topical ALA-PDT. BIOMEDICAL OPTICS EXPRESS 2010; 2:123-30. [PMID: 21326642 PMCID: PMC3028487 DOI: 10.1364/boe.2.000123] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Revised: 12/14/2010] [Accepted: 12/15/2010] [Indexed: 05/18/2023]
Abstract
Photodynamic therapy (PDT) using topical 5-aminolevulinic acid (ALA) is currently used as a clinical treatment for nonmelanoma skin cancers. In order to optimize PDT treatment, vascular disruption early in treatment must be identified and prevented. We present blood flow responses to topical ALA-PDT in a preclinical model and basal cell carcinoma patients assessed by diffuse correlation spectroscopy (DCS). Our results show that ALA-PDT induced early blood flow changes and these changes were irradiance dependent. It is clear that there exists considerable variation in the blood flow responses in patients from lesion to lesion. Monitoring blood flow parameter may be useful for assessing ALA-PDT response and planning.
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Affiliation(s)
- Theresa L. Becker
- Department of Dermatology, Roswell Park Cancer Institute, Buffalo, NY, 14263
| | - Anne D. Paquette
- Department of Dermatology, Roswell Park Cancer Institute, Buffalo, NY, 14263
| | - Kenneth R. Keymel
- Department of Cell Stress Biology & PDT Center, Roswell Park Cancer Institute, Buffalo, NY, 14263
| | - Barbara W. Henderson
- Department of Cell Stress Biology & PDT Center, Roswell Park Cancer Institute, Buffalo, NY, 14263
| | - Ulas Sunar
- Department of Cell Stress Biology & PDT Center, Roswell Park Cancer Institute, Buffalo, NY, 14263
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Liu B, Farrell TJ, Patterson MS. A dynamic model for ALA-PDT of skin: simulation of temporal and spatial distributions of ground-state oxygen, photosensitizer and singlet oxygen. Phys Med Biol 2010; 55:5913-32. [DOI: 10.1088/0031-9155/55/19/019] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Wang KKH, Cottrell WJ, Mitra S, Oseroff AR, Foster TH. Simulations of measured photobleaching kinetics in human basal cell carcinomas suggest blood flow reductions during ALA-PDT. Lasers Surg Med 2010; 41:686-96. [PMID: 19802891 DOI: 10.1002/lsm.20847] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND OBJECTIVE In a recently completed pilot clinical study at Roswell Park Cancer Institute, patients with superficial basal cell carcinoma (sBCC) received topical application of 20% 5-aminolevulinic acid (ALA) and were irradiated with 633 nm light at 10-150 mW cm(-2). Protoporphyrin IX (PpIX) photobleaching in the lesion and the adjacent perilesion normal margin was monitored by fluorescence spectroscopy. In most cases, the rate of bleaching slowed as treatment progressed, leaving a fraction of the PpIX unbleached despite sustained irradiation. To account for this feature, we hypothesized a decrease in blood flow during ALA-photodynamic therapy (PDT) that reduced the rate of oxygen transported to the tissue and therefore attenuated the photobleaching process. We have performed a detailed analysis of this hypothesis. STUDY DESIGN/MATERIALS AND METHODS We used a comprehensive, previously published mathematical model to simulate the effects of therapy-induced blood flow reduction on the measured PpIX photobleaching. This mathematical model of PDT in vivo incorporates a singlet-oxygen-mediated photobleaching mechanism, dynamic unloading of oxygen from hemoglobin, and provides for blood flow velocity changes. It permits simulation of the in vivo photobleaching of PpIX in this patient population over the full range of irradiances and fluences. RESULTS The results suggest that the physiological equivalent of discrete blood flow reductions is necessary to simulate successfully the features of the bleaching data over the entire treatment fluence regime. Furthermore, the magnitude of the blood flow changes in the normal tissue margin and lesion for a wide range of irradiances is consistent with a nitric-oxide-mediated mechanism of vasoconstriction. CONCLUSION A detailed numerical study using a comprehensive PDT dosimetry model is consistent with the hypothesis that the observed trends in the in vivo PpIX photobleaching data from patients may be explained on the basis of therapy-induced blood flow reductions at specific fluences.
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Affiliation(s)
- Ken Kang-Hsin Wang
- Department of Physics and Astronomy, University of Rochester, Rochester, New York 14627, USA
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Huang Z, Xu H, Meyers AD, Musani AI, Wang L, Tagg R, Barqawi AB, Chen YK. Photodynamic therapy for treatment of solid tumors--potential and technical challenges. Technol Cancer Res Treat 2008; 7:309-20. [PMID: 18642969 DOI: 10.1177/153303460800700405] [Citation(s) in RCA: 222] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Photodynamic therapy (PDT) involves the administration of photosensitizer followed by local illumination with visible light of specific wavelength(s). In the presence of oxygen molecules, the light illumination of photosensitizer can lead to a series of photochemical reactions and consequently the generation of cytotoxic species. The quantity and location of PDT-induced cytotoxic species determine the nature and consequence of PDT. Much progress has been seen in both basic research and clinical application in recent years. Although the majority of approved PDT clinical protocols have primarily been used for the treatment of superficial lesions of both malignant and non-malignant diseases, interstitial PDT for the ablation of deep-seated solid tumors are now being investigated worldwide. The complexity of the geometry and non-homogeneity of solid tumor pose a great challenge on the implementation of minimally invasive interstitial PDT and the estimation of PDT dosimetry. This review will discuss the recent progress and technical challenges of various forms of interstitial PDT for the treatment of parenchymal and/or stromal tissues of solid tumors.
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Affiliation(s)
- Zheng Huang
- University of Colorado Denver, Aurora Campus, CO, USA.
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Photodynamic therapy for prostate cancer: One urologist's perspective. Photodiagnosis Photodyn Ther 2006; 4:26-30. [PMID: 25047187 DOI: 10.1016/j.pdpdt.2006.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2006] [Revised: 09/29/2006] [Accepted: 10/09/2006] [Indexed: 11/20/2022]
Abstract
Photodynamic therapy (PDT) has slowly found its place in the treatment of human disease. Currently, photodynamic therapy is being explored as a treatment option for localized prostate cancer. PDT for the treatment of prostate cancer will require ablation of both malignant and non-malignant glandular epithelium. Ablation of both malignant and normal epithelium adds a new treatment dimension since traditionally PDT has not targeted normal epithelial tissue. PDT for prostate cancer as currently envisioned will present challenges in terms of in situ monitoring of light, drug concentration, [Formula: see text] levels and biologic endpoints. The introduction of vascular-targeted photosensitizers fundamentally alters the traditional axioms for successful PDT treatment by obviating the need for "selective" tumor localization. Should clinical trials demonstrate the utility of this approach, patients with organ-confined disease will benefit.
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Seshadri M, Spernyak JA, Mazurchuk R, Camacho SH, Oseroff AR, Cheney RT, Bellnier DA. Tumor Vascular Response to Photodynamic Therapy and the Antivascular Agent 5,6-Dimethylxanthenone-4-Acetic Acid: Implications for Combination Therapy. Clin Cancer Res 2005; 11:4241-50. [PMID: 15930363 DOI: 10.1158/1078-0432.ccr-04-2703] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Photodynamic therapy (PDT) is a clinically approved treatment for a variety of solid malignancies. 5,6-Dimethylxanthenone-4-acetic acid (DMXAA) is a potent vascular targeting agent that has been shown to be effective against a variety of experimental rodent tumors and xenografts and is currently undergoing clinical evaluation. We have previously reported that the activity of PDT against transplanted mouse tumors is selectively enhanced by DMXAA. In the present study, we investigated the in vivo tumor vascular responses to the two treatments given alone and in combination. EXPERIMENTAL DESIGN Vascular responses to (i) four different PDT regimens using the photosensitizer 2-[1-hexyloxyethyl]-2-devinyl pyropheophorbide-a (HPPH) at two different fluences (128 and 48 J/cm(2)) and fluence rates (112 and 14 mW/cm(2)), (ii) 5-aminolevulinic acid (ALA)-sensitized PDT (135 J/cm(2) at 75 mW/cm(2)), (iii) DMXAA at a high (30 mg/kg) and low dose (25 mg/kg), and (iv) the combination of HPPH-PDT (48 J/cm(2) at 112 mW/cm(2)) and low-dose DMXAA were studied in BALB/c mice bearing Colon-26 tumors. RESULTS PDT-induced changes in vascular permeability, determined using noninvasive magnetic resonance imaging with a macromolecular contrast agent, were regimen dependent and did not predict tumor curability. However, a pattern of increasing (4 hours after treatment) and then decreasing (24 hours after) contrast agent concentrations in tumors, seen after high-dose DMXAA or the combination of PDT and low-dose DMXAA, was associated with long-term cure rates of >70%. This pattern was attributed to an initial increase in vessel permeability followed by substantial endothelial cell damage (CD31 immunohistochemistry) and loss of blood flow (fluorescein exclusion assay). Low dose-rate PDT, regardless of the delivered dose, increased the level of magnetic resonance contrast agent in peritumoral tissue, whereas treatment with either DMXAA alone, or PDT and DMXAA in combination resulted in a more selective tumor vascular response. CONCLUSIONS The observed temporal and spatial differences in the response of tumor vessels to PDT and DMXAA treatments could provide valuable assistance in the optimization of scheduling when combining these therapies. The combination of PDT and DMXAA provides therapeutically synergistic and selective antitumor activity. Clinical evaluation of this combination is warranted.
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Affiliation(s)
- Mukund Seshadri
- Department of Cell Stress Biology (Photodynamic Therapy Center), Roswell Park Cancer Institute, Buffalo, New York 14263, USA
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Kelleher DK, Bastian J, Thews O, Vaupel P. Enhanced effects of aminolaevulinic acid-based photodynamic therapy through local hyperthermia in rat tumours. Br J Cancer 2003; 89:405-11. [PMID: 12865936 PMCID: PMC2394247 DOI: 10.1038/sj.bjc.6601036] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The possibility of enhancing aminolaevulinic acid (ALA)-based photodynamic therapy (PDT) by simultaneous application of localised hyperthermia (HT) was evaluated. Treatments of rat DS-sarcomas included: (i) control, (ii) ALA administration (375 mg kg(-1), i.p.), no illumination, (iii) 'nonthermal' illumination, (iv) ALA-PDT: that is, ALA administration, 'nonthermal' illumination, (v) localised HT, 43 degrees C, 60 min (vi) ALA-PDT+HT: ALA administration with full spectrum irradiation resulting in ALA-PDT and HT. Tumour volume was monitored for 90 days or until a target volume (3.5 ml) was reached. No differences were seen between the first three groups, with all tumours reaching the target volume by 8-11 days. A total of 13 and 15% of tumours did not reach the target volume by day 90 following HT or ALA-PDT treatment, respectively. ALA-PDT+HT showed the greatest antitumour effect (P=0.0001), with 61% of the tumours not reaching the target volume. Viability and in vitro growth were also assessed in cells from tumours excised after treatment. ALA-PDT+HT reduced the fraction of viable tumour cells by 85%, and in vitro culture showed pronounced growth delay compared to control cells. These results demonstrate an enhanced antitumour effect upon ALA+HT, which appears to involve direct cell toxicity rather than solely vascular damage.
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Affiliation(s)
- D K Kelleher
- Institute of Physiology and Pathophysiology, Johannes Gutenberg-University Mainz, 55099 Mainz, Germany.
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Sharfaei S, Viau G, Lui H, Bouffard D, Bissonnette R. Systemic photodynamic therapy with aminolaevulinic acid delays the appearance of ultraviolet-induced skin tumours in mice. Br J Dermatol 2001; 144:1207-14. [PMID: 11422043 DOI: 10.1046/j.1365-2133.2001.04232.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) with topical aminolaevulinic acid (ALA) has recently been approved by the US Food and Drug Administration for the treatment of actinic keratoses. OBJECTIVES To determine whether weekly systemic suberythemogenic ALA-PDT could prevent the appearance of ultraviolet (UV) -induced skin tumours in hairless mice. METHODS One group of 20 mice received daily UV radiation from FS 20 tubes, and weekly intraperitoneal injections of ALA 40 mg kg(-1), each followed 3 h later by 12 J cm(-2) of white light (ALA-PDT). Control groups consisted of mice exposed only to UV, to UV and ALA without white light, or UV and white light without ALA, as well as untreated mice. RESULTS The tumour-free survival was significantly longer for mice exposed to daily UV and weekly ALA-PDT as compared with the control groups. Neither the mortality nor the incidence of large skin tumours was higher in the UV/ALA-PDT group than in mice exposed only to UV. In vivo fluorescence spectroscopy showed that the 635-nm fluorescence emission within tumours was lower than in normal skin 3 h after ALA administration. This was also confirmed by quantitative fluorescence microscopy. CONCLUSIONS Systemic ALA-PDT can delay the appearance of UV-induced skin tumours in mice without increasing mortality or the incidence of large tumours.
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Affiliation(s)
- S Sharfaei
- Division of Dermatology, University of Montreal Hospital Centre, Notre-Dame Hospital, Room K-5201, Sherbrooke Street East, Montreal, Québec H2L 4M1, Canada
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