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Nishimura N, Miyake M, Onishi S, Fujii T, Miyamoto T, Tomizawa M, Shimizu T, Morizawa Y, Hori S, Gotoh D, Nakai Y, Torimoto K, Tanaka N, Fujimoto K. Photodynamic Therapeutic Effect during 5-Aminolevulinic Acid-Mediated Photodynamic Diagnosis-Assisted Transurethral Resection of Bladder Tumors. Adv Urol 2024; 2024:7548001. [PMID: 39104915 PMCID: PMC11300098 DOI: 10.1155/2024/7548001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/11/2024] [Indexed: 08/07/2024] Open
Abstract
Background Photodynamic diagnosis-assisted transurethral resection of bladder tumors (PDD-TURBT) enhances detection of elusive lesions compared to standard white light-transurethral resection of bladder tumors (WL-TURBT). If minimal light exposure during PDD-TURBT induces the accumulation of reactive oxygen species (ROS), potentially resulting in phototoxicity in small lesions, apoptosis may be triggered in residual small tumors, allowing them to escape resection. We investigated the hypothesis of a potential photodynamic therapeutic effect during PDD-TURBT. Methods and Materials Our study, conducted between January 2016 and December 2020 at Nara Medical University Hospital, focused on a specific emphasis on ROS production. Immunohistochemical analysis for thymidine glycol and N ε -hexanoyl-lysine was performed on 69 patients who underwent 5-aminolevulinic acid-mediated PDD-TURBT and 28 patients who underwent WL-TURBT. Additionally, we incrementally applied the minimal irradiation energy to T24 and UM-UC-3 cells treated with 5-aminolevulinic acid using instruments similar to those used in PDD-TURBT and evaluated intracellular ROS production and phototoxicity. Results Immunohistochemical analysis revealed a significant increase in production of thymidine glycol and N ε -hexanoyl-lysine within the PDD-TURBT group. In T24 and UM-UC-3 cells treated with 5-aminolevulinic acid and light exposure, immunofluorescent staining demonstrated a dose-dependent increase in intracellular ROS production. In addition, higher irradiation energy levels were associated with a greater increase in ROS production and phototoxicity, as well as more significant decrease in mitochondrial membrane potential. Conclusion Although the irradiation energy used in PDD-TURBT did not reach the levels commonly used in photodynamic therapy, our findings support the presence of a potential cytotoxic effect on bladder lesions during PDD-TURBT.
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Affiliation(s)
- Nobutaka Nishimura
- Department of UrologyNara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Makito Miyake
- Department of UrologyNara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Sayuri Onishi
- Department of UrologyNara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Tomomi Fujii
- Department of Diagnostic PathologyNara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Tatsuki Miyamoto
- Department of UrologyNara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Mitsuru Tomizawa
- Department of UrologyNara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Takuto Shimizu
- Department of UrologyNara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Yosuke Morizawa
- Department of UrologyNara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Shunta Hori
- Department of UrologyNara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Daisuke Gotoh
- Department of UrologyNara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Yasushi Nakai
- Department of UrologyNara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Kazumasa Torimoto
- Department of UrologyNara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Nobumichi Tanaka
- Department of Prostate BrachytherapyNara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Kiyohide Fujimoto
- Department of UrologyNara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
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Dick M, Jamal H, Liu YR, Celli JP, Lilge L. On the need for standardized reporting of photophysical parameters of in vitro photodynamic therapy studies. Photodiagnosis Photodyn Ther 2022; 41:103263. [PMID: 36587862 DOI: 10.1016/j.pdpdt.2022.103263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/22/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
In vitro dose escalation experiments are one of the first gatekeepers in therapeutic evaluation and development. This also holds for evaluating novel photosensitizers (PS) and Photodynamic Therapy (PDT) co-therapies as needed to provide dose response guidelines before engaging in further pre-clinical studies. The dose needed to achieve 50% cell kill (LD50) is a standard metric to report the potency of a therapeutic agents that is widely accepted for single-drug therapies. In reporting results of PDT experiments, which involve delivery of both drug and light, it is inherently more complicated to identify such a convenient dose response metric that actually captures the larger space of treatment parameters. In addition to ubiquitous sources of biological variability that apply broadly in biomedical research, PDT treatment efficacy is determined by multiple key parameters that may or may not have been documented, including PS concentration and light fluence, where the latter is itself a function of the spectral properties of the light source used (often not described), not to mention dose rate, fractionation and other parameters that potentially vary between individual studies. It is impossible to compare results between two study when, for example one reports LD50 PS concentration without providing essential light dosimetry details. Motivated by this challenge in comparing outcomes and establishing reproducibility of in vitro PDT studies, we endeavored to perform a meta-analysis of the reporting of PDT results by converting, where possible, the disparately reported experimental details into a consistent metric that could be used to compare across studies. In this context we adopt here the number of photons absorbed by photosensitizers per unit volume to affect a 50% decline in cell survival as a standardized metric. By choosing this metric one can acknowledge the quantum-based generation of cytotoxins. While this metric does not cover every possible source of variability between any two studies, for a PS with known optical properties, this does encapsulate PS concentration as well as irradiance and spectral properties of light delivered. For the sake of focus we adopt this approach for study of reported results with two photosensitizers, Protoporphyrin IX, either synthesized in the cells by aminolevulinic acid or administered exogenously, and Chlorin e6. A literature search was performed to identify in vitro studies with these two photosensitizers and collect necessary information to calculate the absorbed photon LD50 threshold for each study. Only approximately 1/10 of the manuscripts reporting on in vitro studies provide the minimum required information to calculate the threshold values. While the majority of the determined threshold values are within a factor of 10, the range of threshold values spanned close to 7 orders of magnitude for both photosensitizers. To contrast with single-agent therapies, a similar exercise was performed for chemotherapeutic drugs targeting cellular mitosis or tyrosine kinase inhibitors resulted in an LD50 or IC50 range of 1-2 orders of magnitude, with LD50 or IC50 values for a single cell line being within a factor of 5. This review underscores challenges in the reporting of in vitro PDT efficacy. In many cases it takes considerable effort to extract the necessary methodology information to make meaningful comparison between PDT studies. Only when results between studies can be compared is it possible to begin to assess reproducibility which, as shown here, can be a major issue. Hence, guidelines need to be developed and enforced through the peer review process for meaningful reporting of preclinical PDT results in order for the most promising sensitizers and co-therapies to be identified and translated into the clinic.
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Affiliation(s)
- Madison Dick
- Princess Margaret Cancer Centre at University Health Network, Toronto, Ontario, Canada
| | - Hunain Jamal
- Princess Margaret Cancer Centre at University Health Network, Toronto, Ontario, Canada
| | - Yi Ran Liu
- Department of Physics, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Jonathan P Celli
- Department of Physics, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Lothar Lilge
- Princess Margaret Cancer Centre at University Health Network, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.
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Callaghan S, Vindstad BE, Flanagan KJ, Melø TB, Lindgren M, Grenstad K, Gederaas OA, Senge MO. Structural, Photophysical, and Photobiological Studies on BODIPY‐Anthracene Dyads. CHEMPHOTOCHEM 2020. [DOI: 10.1002/cptc.202000191] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Susan Callaghan
- Medicinal Chemistry Trinity Translational Medicine Institute Trinity Centre for Health Sciences Trinity College Dublin The University of Dublin St. James's Hospital Dublin 8 Ireland
| | - Benedikte E. Vindstad
- Department of Physics Norwegian University of Science and Technology 7491 Trondheim Norway
| | - Keith J. Flanagan
- Medicinal Chemistry Trinity Translational Medicine Institute Trinity Centre for Health Sciences Trinity College Dublin The University of Dublin St. James's Hospital Dublin 8 Ireland
| | - Thor B. Melø
- Department of Physics Norwegian University of Science and Technology 7491 Trondheim Norway
| | - Mikael Lindgren
- Department of Physics Norwegian University of Science and Technology 7491 Trondheim Norway
| | - Kristin Grenstad
- Department of Physics Norwegian University of Science and Technology 7491 Trondheim Norway
| | - Odrun A. Gederaas
- Department of Physics Norwegian University of Science and Technology 7491 Trondheim Norway
| | - Mathias O. Senge
- Medicinal Chemistry Trinity Translational Medicine Institute Trinity Centre for Health Sciences Trinity College Dublin The University of Dublin St. James's Hospital Dublin 8 Ireland
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Peiró Cadahía J, Previtali V, Troelsen NS, Clausen MH. Prodrug strategies for targeted therapy triggered by reactive oxygen species. MEDCHEMCOMM 2019; 10:1531-1549. [PMID: 31673314 PMCID: PMC6786010 DOI: 10.1039/c9md00169g] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 05/03/2019] [Indexed: 12/15/2022]
Abstract
Increased levels of reactive oxygen species (ROS) have been associated with numerous pathophysiological conditions including cancer and inflammation and the ROS stimulus constitutes a potential trigger for drug delivery strategies. Over the past decade, a number of ROS-sensitive functionalities have been identified with the purpose of introducing disease-targeting properties into small molecule drugs - a prodrug strategy that offers a promising approach for increasing the selectivity and efficacy of treatments. This review will provide an overview of the ROS-responsive prodrugs developed to date. A discussion on the current progress and limitations is provided along with a reflection on the unanswered questions that need to be addressed in order to advance this novel approach to the clinic.
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Affiliation(s)
| | - Viola Previtali
- Center for Nanomedicine & Theranostics , Department of Chemistry , Technical University of Denmark , Kemitorvet 207 , DK 2800 , Kongens Lyngby , Denmark .
| | - Nikolaj S Troelsen
- Center for Nanomedicine & Theranostics , Department of Chemistry , Technical University of Denmark , Kemitorvet 207 , DK 2800 , Kongens Lyngby , Denmark .
| | - Mads H Clausen
- Center for Nanomedicine & Theranostics , Department of Chemistry , Technical University of Denmark , Kemitorvet 207 , DK 2800 , Kongens Lyngby , Denmark .
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Gederaas OA, Husebye H, Johnsson A, Callaghan S, Brunsvik A. In vitro and in vivo effects of HAL on porphyrin production in rat bladder cancer cells (AY27). J PORPHYR PHTHALOCYA 2019. [DOI: 10.1142/s1088424619500615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Aminolevulinic acid and hexyl-aminolevulinate serve as biological precursors to produce photosensitive porphyrins in cells via the heme biosynthetic pathway. This pathway is integral to porphyrin-based photodynamic diagnosis and therapy. By adding exogenous hexyl-aminolevulinate to rat bladder cancer cells (AY27, in vitro) and an animal bladder cancer model (in vivo), fluorescent endogenous porphyrin production was stimulated. Lipophilic protoporphyrin IX was identified as the dominant species by reverse high-pressure liquid chromatography. Subcellular porphyrin localization in the AY27 cells was evaluated by confocal laser scanning microscopy and showed almost quantitative bleaching after 20 s. From this study, we ascertained that the protocol described herein is suitable for hexyl-aminolevulinate-mediated photodynamic therapy and diagnosis when protoporphyrin IX is the active agent.
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Affiliation(s)
- Odrun A. Gederaas
- Department of Chemistry, Faculty of Natural Science, Norwegian University of Science and Technology (NTNU), N-7489, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), N-7489, Trondheim, Norway
| | - Harald Husebye
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), N-7489, Trondheim, Norway
- Centre of Molecular Inflammation Research (CEMIR), Norwegian University of Science and Technology (NTNU), N-7489, Trondheim, Norway
| | - Anders Johnsson
- Department of Physics, Norwegian University of Science and Technology (NTNU), N-7491 Trondheim, Norway
| | - Susan Callaghan
- School of Chemistry, SFI Tetrapyrrole Laboratory, Trinity Biomedical Sciences Institute, Trinity College Dublin, the University of Dublin, 152-160 Pearse Street, Dublin 2, Ireland
| | - Anders Brunsvik
- SINTEF Industry, Department of Biotechnology and Nanomedicine, N-7489, Trondheim, Norway
- Department of Clinical Pharmacology, St. Olav’s Hospital, N-7000 Trondheim, Norway
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Renninger M, Fahmy O, Schubert T, Schmid MA, Hassan F, Stenzl A, Gakis G. The prognostic impact of hexaminolevulinate-based bladder tumor resection in patients with primary non-muscle invasive bladder cancer treated with radical cystectomy. World J Urol 2019; 38:397-406. [PMID: 31030231 DOI: 10.1007/s00345-019-02780-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 04/20/2019] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To investigate whether hexaminolevulinate-based (HAL) bladder tumor resection (TURBT) impacts on outcomes of patients with primary non-muscle-invasive bladder cancer (NMIBC) who were eventually treated with radical cystectomy (RC). METHODS A total of 131 consecutive patients exhibiting NMIBC at primary diagnosis were retrospectively investigated whether they had undergone any HAL-guided TURBT prior to RC. Uni- and multivariable analyses were used to evaluate the impact of HAL-TURBT on cancer-specific (CSS) and overall survival (OS). The median follow-up was 38 months (IQR 13-56). RESULTS Of the 131 patients, 69 (52.7%) were managed with HAL- and 62 (47.3%) with white light (WL)-TURBT only prior to RC. HAL-TURBT was associated with a higher number of TURBTs prior to RC (p = 0.002) and administration of intravesical chemotherapy (p = 0.043). A trend towards a higher rate of tumor-associated immune cell infiltrates in RC specimens (p = 0.07) and a lower utilization rate of post-operative systemic chemotherapy (p = 0.10) was noted for patients who were treated with HAL-TURBT. The 5-year CSS/OS was 90.9%/74.5% for the HAL-group and 73.8%/55.8% for the WL-group (p = 0.042/0.038). In multivariable analysis, lymph node tumor involvement (p = 0.007), positive surgical margins (p = 0.001) and performance of WL-TURBT only (p = 0.040) were independent predictors for cancer-specific death. CONCLUSIONS The present data suggest that the resection of NMIBC under HAL exerts a beneficial impact on outcomes of patients who will need to undergo RC during their course of disease. This finding may be due to improved risk stratification as the resection under HAL may allow more patients to be treated timely and adequately.
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Affiliation(s)
- Markus Renninger
- Department of Urology, University Hospital of Tübingen, Eberhard-Karls University, Tübingen, Germany
| | - Omar Fahmy
- Department of Urology, University Hospital of Tübingen, Eberhard-Karls University, Tübingen, Germany.,Department of Urology, University Putra Malaysia (UPM), Selangor, Malaysia
| | - Tina Schubert
- Department of Urology, University Hospital of Tübingen, Eberhard-Karls University, Tübingen, Germany.,Department of Urology and Pediatric Urology, University Hospital of Würzburg, Julius-Maximillians University, Oberduerrbacher Strasse 6, 97080, Würzburg, Germany
| | - Manuel Alexander Schmid
- Department of Urology, University Hospital of Tübingen, Eberhard-Karls University, Tübingen, Germany
| | - Fahmy Hassan
- Department of Urology, University Hospital of Tübingen, Eberhard-Karls University, Tübingen, Germany.,Department of Urology and Pediatric Urology, University Hospital of Würzburg, Julius-Maximillians University, Oberduerrbacher Strasse 6, 97080, Würzburg, Germany
| | - Arnulf Stenzl
- Department of Urology, University Hospital of Tübingen, Eberhard-Karls University, Tübingen, Germany
| | - Georgios Gakis
- Department of Urology, University Hospital of Tübingen, Eberhard-Karls University, Tübingen, Germany. .,Department of Urology and Pediatric Urology, University Hospital of Würzburg, Julius-Maximillians University, Oberduerrbacher Strasse 6, 97080, Würzburg, Germany.
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7
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Bio M, Rajaputra P, Lim I, Thapa P, Tienabeso B, Hurst RE, You Y. Efficient activation of a visible light-activatable CA4 prodrug through intermolecular photo-unclick chemistry in mitochondria. Chem Commun (Camb) 2017; 53:1884-1887. [DOI: 10.1039/c6cc09994g] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mitochondria-targeted and visible light-activatable CA4 prodrug was efficiently activated through intermolecular photo-unclick chemistry in mitochondria for the combination therapy.
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Affiliation(s)
- Moses Bio
- Department of Pharmaceutical Sciences
- University of Oklahoma Health Sciences Center
- Oklahoma City
- USA
| | - Pallavi Rajaputra
- Department of Pharmaceutical Sciences
- University of Oklahoma Health Sciences Center
- Oklahoma City
- USA
| | - Irene Lim
- Department of Pharmaceutical Sciences
- University of Oklahoma Health Sciences Center
- Oklahoma City
- USA
| | - Pritam Thapa
- Department of Pharmaceutical Sciences
- University of Oklahoma Health Sciences Center
- Oklahoma City
- USA
| | - Bomaonye Tienabeso
- Department of Pharmaceutical Sciences
- University of Oklahoma Health Sciences Center
- Oklahoma City
- USA
| | - Robert E. Hurst
- Department of Urology
- University of Oklahoma Health Sciences Center
- Oklahoma City
- USA
| | - Youngjae You
- Department of Pharmaceutical Sciences
- University of Oklahoma Health Sciences Center
- Oklahoma City
- USA
- Department of Chemistry and Biochemistry
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Bogoeva V, Siksjø M, Sæterbø KG, Melø TB, Bjørkøy A, Lindgren M, Gederaas OA. Ruthenium porphyrin-induced photodamage in bladder cancer cells. Photodiagnosis Photodyn Ther 2016; 14:9-17. [PMID: 26845686 DOI: 10.1016/j.pdpdt.2016.01.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 01/27/2016] [Accepted: 01/29/2016] [Indexed: 12/18/2022]
Abstract
Photodynamic therapy (PDT) is a noninvasive treatment for solid malignant and flat tumors. Light activated sensitizers catalyze photochemical reactions that produce reactive oxygen species which can cause cancer cell death. In this work we investigated the photophysical properties of the photosensitizer ruthenium(II) porphyrin (RuP), along with its PDT efficiency onto rat bladder cancer cells (AY27). Optical spectroscopy verified that RuP is capable to activate singlet oxygen via blue and red absorption bands and inter system crossing (ISC) to the triplet state. In vitro experiments on AY27 indicated increased photo-toxicity of RuP (20μM, 18h incubation) after cell illumination (at 435nm), as a function of blue light exposure. Cell survival fraction was significantly reduced to 14% after illumination of 20μM RuP with 15.6J/cm(2), whereas the "dark toxicity" of 20μM RuP was 17%. Structural and morphological changes of cells were observed, due to RuP accumulation, as well as light-dependent cell death was recorded by confocal microscopy. Flow cytometry verified that PDT-RuP (50μM) triggered significant photo-induced cellular destruction with a photoxicity of (93%±0.9%). Interestingly, the present investigation of RuP-PDT showed that the dominating mode of cell death is necrosis. RuP "dark toxicity" compared to the conventional chemotherapeutic drug cisplatin was higher, both evaluated by the MTT assay (24h). In conclusion, the present investigation shows that RuP with or without photoactivation induces cell death of bladder cancer cells.
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Affiliation(s)
- Vanya Bogoeva
- Department Molecular Biology of Cell Cycle, Institute of Molecular Biology, Bulgarian Academy of Sciences, Acad. "G. Bonchev" Str., Bl. 21, Sofia 1113, Bulgaria.
| | - Monica Siksjø
- Department of Physics, Norwegian University of Science and Technology, N-7491 Trondheim, Norway
| | - Kristin G Sæterbø
- Department of Physics, Norwegian University of Science and Technology, N-7491 Trondheim, Norway
| | - Thor Bernt Melø
- Department of Physics, Norwegian University of Science and Technology, N-7491 Trondheim, Norway
| | - Astrid Bjørkøy
- Department of Physics, Norwegian University of Science and Technology, N-7491 Trondheim, Norway
| | - Mikael Lindgren
- Department of Physics, Norwegian University of Science and Technology, N-7491 Trondheim, Norway; Department of Physics, Chemistry and Biology, Linköping University, SE-58183 Linköping, Sweden
| | - Odrun A Gederaas
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, N-7491 Trondheim, Norway
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