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Baumbach P, Schmidt-Winter C, Hoefer J, Derlien S, Best N, Herbsleb M, Coldewey SM. A Pilot Study on the Association of Mitochondrial Oxygen Metabolism and Gas Exchange During Cardiopulmonary Exercise Testing: Is There a Mitochondrial Threshold? Front Med (Lausanne) 2020; 7:585462. [PMID: 33409287 PMCID: PMC7779397 DOI: 10.3389/fmed.2020.585462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/15/2020] [Indexed: 12/28/2022] Open
Abstract
Background: Mitochondria are the key players in aerobic energy generation via oxidative phosphorylation. Consequently, mitochondrial function has implications on physical performance in health and disease ranging from high performance sports to critical illness. The protoporphyrin IX-triplet state lifetime technique (PpIX-TSLT) allows in vivo measurements of mitochondrial oxygen tension (mitoPO2). Hitherto, few data exist on the relation of mitochondrial oxygen metabolism and ergospirometry-derived variables during physical performance. This study investigates the association of mitochondrial oxygen metabolism with gas exchange and blood gas analysis variables assessed during cardiopulmonary exercise testing (CPET) in aerobic and anaerobic metabolic phases. Methods: Seventeen volunteers underwent an exhaustive CPET (graded multistage protocol, 50 W/5 min increase), of which 14 were included in the analysis. At baseline and for every load level PpIX-TSLT-derived mitoPO2 measurements were performed every 10 s with 1 intermediate dynamic measurement to obtain mitochondrial oxygen consumption and delivery (mito V . O2, mito D . O2). In addition, variables of gas exchange and capillary blood gas analyses were obtained to determine ventilatory and lactate thresholds (VT, LT). Metabolic phases were defined in relation to VT1 and VT2 (aerobic: <VT1, aerobic-anaerobic transition: ≥VT1 and <VT2 and anaerobic: ≥VT2). We used linear mixed models to compare variables of PpIX-TSLT between metabolic phases and to analyze their associations with variables of gas exchange and capillary blood gas analyses. Results: MitoPO2 increased from the aerobic to the aerobic-anaerobic phase followed by a subsequent decline. A mitoPO2 peak, termed mitochondrial threshold (MT), was observed in most subjects close to LT2. Mito D . O2 increased during CPET, while no changes in mito V . O2 were observed. MitoPO2 was negatively associated with partial pressure of end-tidal oxygen and capillary partial pressure of oxygen and positively associated with partial pressure of end-tidal carbon dioxide and capillary partial pressure of carbon dioxide. Mito D . O2 was associated with cardiovascular variables. We found no consistent association for mito V . O2. Conclusion: Our results indicate an association between pulmonary respiration and cutaneous mitoPO2 during physical exercise. The observed mitochondrial threshold, coinciding with the metabolic transition from an aerobic to an anaerobic state, might be of importance in critical care as well as in sports medicine.
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Affiliation(s)
- Philipp Baumbach
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany.,Septomics Research Center, Jena University Hospital, Jena, Germany
| | - Christiane Schmidt-Winter
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany.,Septomics Research Center, Jena University Hospital, Jena, Germany
| | - Jan Hoefer
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany.,Septomics Research Center, Jena University Hospital, Jena, Germany
| | - Steffen Derlien
- Institute of Physiotherapy, Jena University Hospital, Jena, Germany
| | - Norman Best
- Institute of Physiotherapy, Jena University Hospital, Jena, Germany
| | - Marco Herbsleb
- Department of Sports Medicine and Health Promotion, Friedrich Schiller University, Jena, Germany
| | - Sina M Coldewey
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany.,Septomics Research Center, Jena University Hospital, Jena, Germany.,Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
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Champeau M, Jary D, Mortier L, Mordon S, Vignoud S. A facile fabrication of dissolving microneedles containing 5-aminolevulinic acid. Int J Pharm 2020; 586:119554. [DOI: 10.1016/j.ijpharm.2020.119554] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/12/2020] [Accepted: 06/13/2020] [Indexed: 01/30/2023]
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3
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Krishnan V, Mitragotri S. Nanoparticles for topical drug delivery: Potential for skin cancer treatment. Adv Drug Deliv Rev 2020; 153:87-108. [PMID: 32497707 DOI: 10.1016/j.addr.2020.05.011] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 05/25/2020] [Accepted: 05/29/2020] [Indexed: 12/13/2022]
Abstract
Nanoparticles offer new opportunities for the treatment of skin diseases. The barrier function of the skin poses a significant challenge for nanoparticles to permeate into the tissue, although the barrier is partially compromised in case of injury or inflammation, as in the case of skin cancer. This may facilitate the penetration of nanoparticles. Extensive research has gone into developing nanoparticles for topical delivery; however, relatively little progress has been made in translating them to the clinic for treating skin cancers. We summarize the types of skin cancers and practices in current clinical management. The review provides a comprehensive outlook of the various nanoparticle technologies tested for topical therapy of skin cancers and summarizes the obstacles that impede its progress from the bench-to-bedside. The review also aims to provide an understanding of the pathways that govern nanoparticle penetration into the skin and a critical analysis of the approaches used to study nanoparticle interactions within the tissue.
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Affiliation(s)
- Vinu Krishnan
- John A. Paulson School of Engineering & Applied Sciences Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA 02138, United States of America
| | - Samir Mitragotri
- John A. Paulson School of Engineering & Applied Sciences Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA 02138, United States of America.
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Abdulrahman H, Misba L, Ahmad S, Khan AU. Curcumin induced photodynamic therapy mediated suppression of quorum sensing pathway of Pseudomonas aeruginosa: An approach to inhibit biofilm in vitro. Photodiagnosis Photodyn Ther 2019; 30:101645. [PMID: 31899376 DOI: 10.1016/j.pdpdt.2019.101645] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 12/22/2019] [Accepted: 12/30/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The objective of this study was to inhibit the Pseudomonas aeruginosa biofilm through curcumin-mediated antimicrobial photodynamic therapy (A-PDT). BACKGROUND The mechanism behind A-PDT mediated photoinactivation depend upon reactive oxygen species (ROS) production, like singlet oxygen and free radicals. METHODS To evaluate the antibacterial efficacy of curcumin induced A-PDT on P. aeruginosa by colony forming unit (CFU) while antibiofilm action was determined by the use of crystal violet, XTT, congored binding assay and confocal laser scanning microscope (CLSM). RESULTS We found that curcumin with 10 J/cm2 of light reduces P. aeruginosa biofilm more efficiently than without light. Extracellular polymeric substances (EPS) production was also reduced by approx 94 % with 10 J/cm2 of light dose. CLSM images showed that the thickness of biofilms were reduced from >30 μm to <5 μm after treatment with curcumin followed by 10 J/cm2 of light irradiation. Curcumin showed better bacteriostatic activity than bactericidal activity. Singlet oxygen is primarily responsible for photodamage and cytotoxic reactions caused by curcumin-mediated APDT. Genes involved in quorum sensing (QS) pathway was also found to be inhibited after APDT. Curcumin with 5 J/cm2 light inhibits QS genes and on increasing light dose i.e10 J/cm2, we found a drastic reduction in gene expression. CONCLUSION We conclude that the curcumin mediated A-PDT inhibits biofilm formation ofP. aeruginosa through QS pathway by the action of singlet oxygen generation which in turn reduced EPS of the biofilm.
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Affiliation(s)
- Hayder Abdulrahman
- Medical Microbiology and Molecular Biology Lab., Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, 202002, India
| | - Lama Misba
- Medical Microbiology and Molecular Biology Lab., Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, 202002, India
| | - Shabbir Ahmad
- Department of Physics, Aligarh Muslim University, Aligarh, 202002, India
| | - Asad U Khan
- Medical Microbiology and Molecular Biology Lab., Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, 202002, India.
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Cutaneous microenvironment responsive microneedle patch for rapid gene release to treat subdermal tumor. J Control Release 2019; 314:72-80. [DOI: 10.1016/j.jconrel.2019.10.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/23/2019] [Accepted: 10/02/2019] [Indexed: 12/24/2022]
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Champeau M, Vignoud S, Mortier L, Mordon S. Photodynamic therapy for skin cancer: How to enhance drug penetration? JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2019; 197:111544. [PMID: 31295716 DOI: 10.1016/j.jphotobiol.2019.111544] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 06/14/2019] [Accepted: 06/25/2019] [Indexed: 12/27/2022]
Abstract
Photodynamic therapy (PDT) induced by protoporphyrin IX (PpIX) has been widely used in dermatological practices such as treatment of skin cancers. Clearance rate depends on different factors such as light irradiation, skin oxygenation and drug penetration. The poor penetration of 5-aminolevulinic acid (5-ALA) with topical application is limited and restrains the production of PpIX which could restrict PDT outcomes. This review will focus on techniques already used to enhance drug penetration in human skin, and will present their results, advantages, and drawbacks. Chemical and physical pretreatments will be discussed. Chemical pre-treatments comprise of drug formulation modification, use of agents that modify the heme cycle, enhance PpIX formation, and the combination of differentiation-promoting agent prior to PDT. On the other hand, physical pretreatments affect the skin barrier by creating holes in the skin or by removing stratum corneum. To promote drug penetration, iontophoresis and temperature modulation are interesting alternative methods. Cellular mechanisms enrolled during chemical or physical pretreatments have been investigated in order to understand how 5-ALA penetrates the skin, why it is preferentially metabolized in PpIX in tumour cells, and how it could be accumulated in deeper skin layers. The objective of this review is to compare clinical trials that use innovative technology to conventional PDT treatment. Most of these pretreatments present good or even better clinical outcomes than usual PDT.
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Affiliation(s)
- Mathilde Champeau
- LETI-DTBS, CEA, 17 rue des Martyrs, Grenoble Cedex, France; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, CHU Lille, Univ. Lille, Inserm, F-59000 Lille, France.
| | | | - Laurent Mortier
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, CHU Lille, Univ. Lille, Inserm, F-59000 Lille, France
| | - Serge Mordon
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, CHU Lille, Univ. Lille, Inserm, F-59000 Lille, France
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Zhao X, Li X, Zhang P, Du J, Wang Y. Tip-loaded fast-dissolving microneedle patches for photodynamic therapy of subcutaneous tumor. J Control Release 2018; 286:201-209. [PMID: 30056119 DOI: 10.1016/j.jconrel.2018.07.038] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/10/2018] [Accepted: 07/25/2018] [Indexed: 12/22/2022]
Abstract
5-Aminolevulinic acid (ALA) based photodynamic therapy (PDT) is a modality for the treatment of cancers. However, due to its hydrophilicity and zwitterionic nature, the transdermal delivery of ALA is limited for the PDT of subcutaneous tumor. To address this problem, tip-loaded fast-dissolving microneedles made of sodium hyaluronate (HA) were fabricated by two casting method. 122 μg of ALA was loaded per microneedle patch and mainly distributed in the tips, which could improve the utilization of drug and avoid the waste of drug residue in the base of microneedle patch after use. The HA microneedles could pierce stratum corneum with insertion depth about 200 μm in isolated skin. After insertion, HA microneedles were rapidly dissolved to release the encapsulated drug to improve patients' convenience and compliance. Importantly, in a subcutaneous mouse tumor model established in BALB/c nude mice, the PDT efficacy of ALA-loaded HA microneedle group was much better than ALA injection group in spite of a relatively lower ALA dose with HA microneedles. The tumor inhibition rate of ALA-loaded HA microneedle group (containing 0.61 mg of ALA) was up to 97%, while the tumor inhibition rate of ALA injection group (containing 1.65 mg of ALA) was just 66%. In addition, microchannels created by microneedle patch were quickly recovered within 3 h after insertion. Overall, the tip-loaded fast-dissolving HA microneedle patch with ALA as drug was promising and might improve topical PDT efficacy of subcutaneous tumor in an efficient and safe manner.
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Affiliation(s)
- Xiao Zhao
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, PR China
| | - Xinfang Li
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, PR China
| | - Peng Zhang
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, PR China
| | - Jianwei Du
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, PR China
| | - Youxiang Wang
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, PR China..
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Campbell CL, Brown CTA, Wood K, Moseley H. Modelling topical photodynamic therapy treatment including the continuous production of Protoporphyrin IX. Phys Med Biol 2016; 61:7507-7521. [DOI: 10.1088/0031-9155/61/21/7507] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Is There a Relationship between the Stratum Corneum Thickness and That of the Viable Parts of Tumour Cells in Basal Cell Carcinoma? J Skin Cancer 2016; 2016:6146091. [PMID: 26942011 PMCID: PMC4749825 DOI: 10.1155/2016/6146091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 01/10/2016] [Indexed: 12/31/2022] Open
Abstract
Basal cell carcinoma (BCC) is an invasive epithelial skin tumour. The thickness of the outermost epidermal layer of the skin, the stratum corneum (SC), influences drug uptake and penetration into tumour and may thereby affect the response of BCC to topical treatment. The aim was to investigate a possible relationship between the thickness of the SC and that of the viable part of BCC. Histopathological evaluations of the corresponding SC and viable tumour thickness measurements of individual BCCs of different subtypes were explored. A total of 53 BCCs from 46 patients were studied. The median tumour thickness was 1.7 mm (0.8–3.0 mm), with a significant difference between subtypes (p < 0.001). The SC had a median thickness of 0.3 mm (0.2–0.4 mm), with no difference between tumour subtypes (p = 0.415). Additionally, no significant association between the thickness of the SC and that of the viable part of the tumour was demonstrated (p = 0.381). In conclusion our results indicate that SC thickness is relatively constant in BCC.
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Moreno E, Schwartz J, Fernández C, Sanmartín C, Nguewa P, Irache JM, Espuelas S. Nanoparticles as multifunctional devices for the topical treatment of cutaneous leishmaniasis. Expert Opin Drug Deliv 2014; 11:579-97. [PMID: 24620861 DOI: 10.1517/17425247.2014.885500] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Cutaneous and mucocutaneous leishmaniasis are major tropical skin diseases. Topical treatment is currently limited to the least severe forms of cutaneous leishmaniasis (CL) without risk of dissemination. It is also recommended in combination with systemic therapy for more severe forms. Progresses in this modality of treatment are hindered by the heterogeneity of the disease and shortcomings in the clinical trials. AREAS COVERED This review overlooks three major modalities of topical therapies in use or under investigation against CL: chemotherapy, photodynamic therapy and immunotherapy; either with older compounds such as paramomycin or more recent nitric oxide donors, antimicrobial peptides or silver derivatives. The advantages and limitations of their administration with newer formulation strategies such as nanoparticles (NPs) are discussed. EXPERT OPINION The efficacy of a topical treatment against CL depends not only on the intrinsic antileishmanial activity of the drug but also on the amount of drug available in the dermis. NPs as sustained release systems and permeation enhancers could favour the creation of a drug reservoir in the dermis. Additionally, certain NPs have immunomodulatory properties or wound healing capabilities of benefit in CL treatment. Pending task is the selective delivery of active compounds to intracellular amastigotes, because even small NPs are unable to penetrate deeply into the skin to encounter infected macrophages (except in ulcerative lesions).
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Affiliation(s)
- Esther Moreno
- University of Navarra, Tropical Health Institute , Irunlarrea, 1 E-31008 Pamplona , Spain +34948425600 ; +34948425619 ;
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Hsieh BC, Chen RLC, Tsai T. Quantification of 5-aminolevulinic acid by CE using dynamic pH junction technique. J Sep Sci 2013; 36:803-8. [DOI: 10.1002/jssc.201200889] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 11/02/2012] [Accepted: 11/04/2012] [Indexed: 11/10/2022]
Affiliation(s)
- Bo-Chuan Hsieh
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Oral Medicine; Taipei Medical University; Taipei Taiwan
| | - Richie L. C. Chen
- Department of Bio-Industrial Mechatronics Engineering; National Taiwan University; Taipei Taiwan
| | - Tsuimin Tsai
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Oral Medicine; Taipei Medical University; Taipei Taiwan
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Donnelly RF, McCarron PA, Morrow DIJ, Woolfson AD. Fast-drying multi-laminate bioadhesive films for transdermal and topical drug delivery. Drug Dev Ind Pharm 2012; 39:1818-31. [DOI: 10.3109/03639045.2012.738683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Electrically-responsive anti-adherent hydrogels for photodynamic antimicrobial chemotherapy. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2012; 114:61-72. [DOI: 10.1016/j.jphotobiol.2012.05.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2012] [Revised: 05/07/2012] [Accepted: 05/15/2012] [Indexed: 11/21/2022]
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Anand S, Ortel BJ, Pereira SP, Hasan T, Maytin EV. Biomodulatory approaches to photodynamic therapy for solid tumors. Cancer Lett 2012; 326:8-16. [PMID: 22842096 DOI: 10.1016/j.canlet.2012.07.026] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 07/19/2012] [Accepted: 07/19/2012] [Indexed: 12/12/2022]
Abstract
Photodynamic Therapy (PDT) uses a photosensitizing drug in combination with visible light to kill cancer cells. PDT has an advantage over surgery or ionizing radiation because PDT can eliminate tumors without causing fibrosis or scarring. Disadvantages include the dual need for drug and light, and a generally lower efficacy for PDT vs. surgery. This minireview describes basic principles of PDT, photosensitizers available, and aspects of tumor biology that may provide further opportunities for treatment optimization. An emerging biomodulatory approach, using methotrexate or Vitamin D in combination with aminolevulinate-based PDT, is described. Finally, current clinical uses of PDT for solid malignancies are reviewed.
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Affiliation(s)
- Sanjay Anand
- Department of Dermatology, Cleveland Clinic, Cleveland, OH 44195, USA
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Sengee GI, Badraa N, Shim YK. Synthesis and photodynamic activity of new imidazole substituted pyropheophorbide-a derivatives. J PORPHYR PHTHALOCYA 2012. [DOI: 10.1142/s1088424609001017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Two new imidazole substituted chlorin derivatives, namely (4-[1-imidazolyl]-phenyl)-amide pyropheophorbide-a and (3-[1-imidazolyl]-propyl)-amide pyropheophorbide-a have been synthesized. Their cell viabilities on A549 human lung adenocarcinoma cells were investigated and compared with that of pyropheophorbide-a. According to the phototoxicity study, (4-[1-imidazolyl]-phenyl)-amide pyropheophorbide-a and (3-[1-imidazolyl]-propyl)-amide pyropheophorbide-a were found superior to pyropheophorbide-a with respect to high phototoxicity. This work demonstrates that imidazole substituted chlorin derivatives could be a promising candidate for photodynamic therapy and are worth further investigations.
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Affiliation(s)
- Gerelt-Ireedui Sengee
- PDT Research Institute, School of Nano Systems Engineering, Inje University, Gimhae 621-749, South Korea
| | - Narangerel Badraa
- PDT Research Institute, School of Nano Systems Engineering, Inje University, Gimhae 621-749, South Korea
| | - Young Key Shim
- PDT Research Institute, School of Nano Systems Engineering, Inje University, Gimhae 621-749, South Korea
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Harris F, Pierpoint L. Photodynamic therapy based on 5-aminolevulinic acid and its use as an antimicrobial agent. Med Res Rev 2011; 32:1292-327. [PMID: 21793017 DOI: 10.1002/med.20251] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Exogenous 5-aminolevulinic acid (ALA) is taken up directly by bacteria, yeasts, fungi, and some parasites, which then induces the accumulation of protoporphyrin IX (PPIX). Subsequent light irradiation of PPIX leads to the inactivation of these organisms via photodamage to their cellular structures. ALA uptake and light irradiation of PPIX produced by host cells leads to the inactivation of other parasites, along with some viruses, via the induction of an immune response. ALA-mediated PPIX production by host cells and light irradiation result in the inactivation of other viruses via either the induction of a host cell response or direct photodynamic attack on viral particles. This ALA-mediated production of light-activated PPIX has been extensively used as a form of photodynamic therapy (PDT) and has shown varying levels of efficacy in treating conditions that are associated with microbial infection, ranging from acne and verrucae to leishmaniasis and onychomycosis. However, for the treatment of some of these conditions by ALA-based PDT, the role of an antimicrobial effect has been disputed and in general, the mechanisms by which the technique inactivates microbes are not well understood. In this study, we review current understanding of the antimicrobial mechanisms used by ALA-based PDT and its role in the treatment of microbial infections along with its potential medical and nonmedical applications.
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Affiliation(s)
- Frederick Harris
- School of Forensic and Investigative Sciences, University of Central Lancashire, Preston, Lancashire, United Kingdom. fharris1@.ac.uk
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Oh EK, Jin SE, Kim JK, Park JS, Park Y, Kim CK. Retained topical delivery of 5-aminolevulinic acid using cationic ultradeformable liposomes for photodynamic therapy. Eur J Pharm Sci 2011; 44:149-57. [PMID: 21782942 DOI: 10.1016/j.ejps.2011.07.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 06/10/2011] [Accepted: 07/05/2011] [Indexed: 11/30/2022]
Abstract
5-Aminolevulinic acid (5-ALA), inducing photodynamic protoporphyrin (PpIX), is a hydrophilic molecule, resulting in leashing the capacity to cross tissue barriers like stratum corneum (SC) of skin. Here, we aimed to develop 5-ALA loaded ultradeformable liposomes (UDL) with different surface charges, and to investigate their physicochemical characteristics and capability for the skin penetration and retention of 5-ALA for topical photodynamic therapy (PDT). The effects of surface charges of UDL on in vitro permeation of 5-ALA and in vivo accumulation of 5-ALA-induced PpIX in viable skin were determined and then compared with conventional neutral liposomes (nLiposome). All UDL showed smaller particle size and better deformability than nLiposome. However, entrapment efficiency of 5-ALA was similar to each vesicle. Among vesicles, the cationic UDL (cUDL) demonstrated higher stability and permeability, and could deliver 5-ALA into deep skin tissue by topical application. Moreover, the 5-ALA loaded in cUDL was long retained, and induced more amount of PpIX in viable skin than those in other UDL and nLiposome. Considering that the conversion of 5-ALA into PpIX occurs preferentially in epidermis, these results suggested that topical delivery of 5-ALA loaded in cUDL could be an interesting proposal to optimize PDT related to 5-ALA.
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Affiliation(s)
- Eun Kyung Oh
- College of Pharmacy, Seoul National University, Seoul, Republic of Korea
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Zhang LW, Fang YP, Fang JY. Enhancement techniques for improving 5-aminolevulinic acid delivery through the skin. DERMATOL SIN 2011. [DOI: 10.1016/j.dsi.2011.02.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Microneedle Pre-treatment of Human Skin Improves 5-Aminolevulininc Acid (ALA)- and 5-Aminolevulinic Acid Methyl Ester (MAL)-Induced PpIX Production for Topical Photodynamic Therapy Without Increase in Pain or Erythema. Pharm Res 2010; 27:2213-20. [DOI: 10.1007/s11095-010-0227-2] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Accepted: 07/21/2010] [Indexed: 10/19/2022]
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20
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Lee WR, Shen SC, Pai MH, Yang HH, Yuan CY, Fang JY. Fractional laser as a tool to enhance the skin permeation of 5-aminolevulinic acid with minimal skin disruption: A comparison with conventional erbium:YAG laser. J Control Release 2010; 145:124-33. [DOI: 10.1016/j.jconrel.2010.03.017] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Revised: 01/29/2010] [Accepted: 03/21/2010] [Indexed: 11/17/2022]
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Araújo LMPDC, Thomazine JA, Lopez RFV. Development of microemulsions to topically deliver 5-aminolevulinic acid in photodynamic therapy. Eur J Pharm Biopharm 2010; 75:48-55. [PMID: 20083197 DOI: 10.1016/j.ejpb.2010.01.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2009] [Revised: 01/06/2010] [Accepted: 01/13/2010] [Indexed: 10/20/2022]
Abstract
The aim of this study was to obtain and to characterize microemulsions containing 5-aminolevulinic acid (5-ALA) and to investigate the influence of these systems in drug skin permeation for further topical photodynamic therapy (PDT). 5-ALA was incorporated in water-in-oil (W/O), bicontinuous (Bc), and oil-in-water (O/W) microemulsions obtained by the titration of ethyl oleate and PEG-8 caprylic/capric glycerides:polyglyceryl-6 dioleate (3:1) mixtures with water. Selected systems were characterized by conductivity, viscosity, size of the droplets, and drug release. The stability of the drug in the microemulsions was also assessed. Moreover, the in vitro and in vivo skin permeation of 5-ALA was investigated using diffusion cells and confocal scanning laser microscopy (CSLM), respectively. Despite the fact that the O/W microemulsion decreased the 5-ALA diffusion coefficient and retarded the drug release, it also significantly increased the in vitro drug skin permeation when compared to other 5-ALA carriers. It was observed by CSLM that the red fluorescence of the skin increased homogeneously in the deeper skin layers when the 5-ALA microemulsion was applied in vivo, probably due to the formation of the photoactive protoporphyrin IX. The microemulsion developed carried 5-ALA to the deeper skin layers, increasing the red fluorescence of the skin and indicating the potentiality of the system for topical 5-ALA-PDT.
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Juzeniene A, Juzenas P, Moan J. Application of 5-aminolevulinic acid and its derivatives for photodynamic therapy in vitro and in vivo. Methods Mol Biol 2010; 635:97-106. [PMID: 20552342 DOI: 10.1007/978-1-60761-697-9_7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) is the most widely used form of PDT in clinical practice. Topical application of ALA leads to overproduction of the endogenous photosensitizer protoporphyrin IX (PpIX). ALA-PDT is efficient treatment of superficial skin lesions, but not for thicker lesions. The main reason for this is suboptimal penetration of ALA molecules through cellular membranes and through stratum corneum of intact skin. Different approaches (formulations, mechanical and physical penetration enhancers, ALA derivatives) are currently used to increase the penetration. The content and distribution of ALA intracellularly and in tissues is difficult to measure, but PpIX content, on a relative scale, can be easily measured by fluorimetric assays.
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Affiliation(s)
- Asta Juzeniene
- Department of Radiation Biology, Institute for Cancer Research, The Norwegian Radium Hospital, Montebello, Oslo, Norway
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Designing photosensitizers for photodynamic therapy: strategies, challenges and promising developments. Future Med Chem 2009; 1:667-91. [DOI: 10.4155/fmc.09.55] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Photodynamic therapy (PDT) and photodynamic antimicrobial chemotherapy (PACT) are techniques that combine the effects of visible light irradiation with subsequent biochemical events that arise from the presence of a photosensitizing drug (possessing no dark toxicity) to cause destruction of selected cells. Despite its still widespread clinical use, Photofrin® has several drawbacks that limit its general clinical use. Consequently, there has been extensive research into the design of improved alternative photosensitizers aimed at overcoming these drawbacks. While there are many review articles on the subject of PDT and PACT, these have focused on the photosensitizers that have been used clinically, with little emphasis placed on how the chemical aspects of the molecule can affect their efficacy as PDT agents. Indeed, many of the PDT/PACT agents used clinically may not even be the most appropriate within a given class. As such, this review aims to provide a better understanding of the factors that have been investigated, while aiming at improving the efficacy of a molecule intended to be used as a photosensitizer. Recent publications, spanning the last 5 years, concerning the design, synthesis and clinical usage of photosensitizers for application in PDT and PACT are reviewed, including 5-aminolevulinic acid, porphyrins, chlorins, bacteriochlorins, texaphyrins, phthalocyanines and porphycenes. It has been shown that there are many important considerations when designing a potential PDT/PACT agent, including the influence of added groups on the lipophilicity of the molecule, the positioning and nature of these added groups within the molecule, the presence of a central metal ion and the number of charges that the molecule possesses. The extensive ongoing research within the field has led to the identification of a number of potential lead molecules for application in PDT/PACT. The development of the second-generation photosensitizers, possessing shorter periods of photosensitization, longer activation wavelengths and greater selectivity for diseased tissue provides hope for attaining the ideal photosensitizer that may help PDT and PACT move from laboratory investigation to clinical practice.
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Delivery of Methylene Blue and meso-tetra (N-methyl-4-pyridyl) porphine tetra tosylate from cross-linked poly(vinyl alcohol) hydrogels: a potential means of photodynamic therapy of infected wounds. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2009; 96:223-31. [PMID: 19651522 DOI: 10.1016/j.jphotobiol.2009.06.010] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Accepted: 06/25/2009] [Indexed: 11/20/2022]
Abstract
Poly(vinyl alcohol)-borate complexes were evaluated as a potentially novel drug delivery platform suitable for in vivo use in photodynamic antimicrobial chemotherapy (PACT) of wound infections. An optimised formulation (8.0%w/w PVA, 2.0%w/w borax) was loaded with 1.0 mg ml(-1) of the photosensitisers Methylene Blue (MB) and meso-tetra (N-methyl-4-pyridyl) porphine tetra tosylate (TMP). Both drugs were released to yield receiver compartment concentrations (>5.0 microg ml(-1)) found to be phototoxic to both planktonic and biofilm-grown methicillin-resistant Staphylococcus aureus (MRSA), a common cause of wound infections in hospitals. Newborn calf serum, used to simulate the conditions prevalent in an exuding wound, did not adversely affect the properties of the hydrogels and had no significant effect on the rate of TMP-mediated photodynamic kill of MRSA, despite appreciably reducing the fluence rate of incident light. However, MB-mediated photodynamic kill of MRSA was significantly reduced in the presence of calf serum and when the clinical isolate was grown in a biofilm. Results support the contention that delivery of MB or TMP using gel-type vehicles as part of PACT could make a contribution to the photodynamic eradication of MRSA from infected wounds.
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Giuntini F, Bourré L, MacRobert AJ, Wilson M, Eggleston IM. Improved Peptide Prodrugs of 5-ALA for PDT: Rationalization of Cellular Accumulation and Protoporphyrin IX Production by Direct Determination of Cellular Prodrug Uptake and Prodrug Metabolization. J Med Chem 2009; 52:4026-37. [DOI: 10.1021/jm900224r] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Francesca Giuntini
- Wolfson Laboratory of Medicinal Chemistry, Department of Pharmacy and Pharmacology, University of Bath, Bath BA2 7AY, U.K., National Medical Laser Centre, Division of Surgical and Interventional Sciences, UCL Medical School, University College London, London W1W 7EJ, U.K., Division of Microbial Diseases, UCL Eastman Dental Institute, University College London, London WC1X 8LD, U.K
| | - Ludovic Bourré
- Wolfson Laboratory of Medicinal Chemistry, Department of Pharmacy and Pharmacology, University of Bath, Bath BA2 7AY, U.K., National Medical Laser Centre, Division of Surgical and Interventional Sciences, UCL Medical School, University College London, London W1W 7EJ, U.K., Division of Microbial Diseases, UCL Eastman Dental Institute, University College London, London WC1X 8LD, U.K
| | - Alexander J. MacRobert
- Wolfson Laboratory of Medicinal Chemistry, Department of Pharmacy and Pharmacology, University of Bath, Bath BA2 7AY, U.K., National Medical Laser Centre, Division of Surgical and Interventional Sciences, UCL Medical School, University College London, London W1W 7EJ, U.K., Division of Microbial Diseases, UCL Eastman Dental Institute, University College London, London WC1X 8LD, U.K
| | - Michael Wilson
- Wolfson Laboratory of Medicinal Chemistry, Department of Pharmacy and Pharmacology, University of Bath, Bath BA2 7AY, U.K., National Medical Laser Centre, Division of Surgical and Interventional Sciences, UCL Medical School, University College London, London W1W 7EJ, U.K., Division of Microbial Diseases, UCL Eastman Dental Institute, University College London, London WC1X 8LD, U.K
| | - Ian M. Eggleston
- Wolfson Laboratory of Medicinal Chemistry, Department of Pharmacy and Pharmacology, University of Bath, Bath BA2 7AY, U.K., National Medical Laser Centre, Division of Surgical and Interventional Sciences, UCL Medical School, University College London, London W1W 7EJ, U.K., Division of Microbial Diseases, UCL Eastman Dental Institute, University College London, London WC1X 8LD, U.K
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Donnelly RF, McCarron PA, Al-Kassas R, Juzeniene A, Juzenas P, Iani V, Woolfson AD, Moan J. Influence of formulation factors on PpIX production and photodynamic action of novel ALA-loaded microparticles. Biopharm Drug Dispos 2009; 30:55-70. [DOI: 10.1002/bdd.645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Donnelly RF, Morrow DIJ, McCarron PA, David Woolfson A, Morrissey A, Juzenas P, Juzeniene A, Iani V, McCarthy HO, Moan J. Microneedle Arrays Permit Enhanced Intradermal Delivery of a Preformed Photosensitizer. Photochem Photobiol 2009; 85:195-204. [DOI: 10.1111/j.1751-1097.2008.00417.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Donnelly RF, McCarron PA, Morrow DIJ, Sibani SA, Woolfson AD. Photosensitiser delivery for photodynamic therapy. Part 1: Topical carrier platforms. Expert Opin Drug Deliv 2008; 5:757-66. [PMID: 18590460 DOI: 10.1517/17425247.5.7.757] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) is a medical treatment in which a combination of a photosensitising drug and visible light causes destruction of selected cells. Due to the lack of true selectivity of preformed photosensitisers for neoplastic tissue and their high molecular weights, PDT of superficial skin lesions has traditionally been mediated by topical application of the porphyrin precursor 5-aminolevulinic acid (ALA). OBJECTIVE This article aims to review the traditional formulation-based approaches taken to topical delivery of ALA and discusses the more innovative strategies investigated for enhancement of PDT mediated by topical application of ALA and preformed photosensitisers. METHODS All of the available published print and online literature in this area was reviewed. As drug delivery of agents used in PDT is still something of an emerging field, it was not necessary to go beyond literature from the last 30 years. RESULTS/CONCLUSION PDT of neoplastic skin lesions is currently based almost exclusively on topical application of simple semisolid dosage forms containing ALA or its methyl ester. Until expiry of patents on the current market-leading products, there is unlikely to be a great incentive to engage in design and evaluation of innovative formulations for topical PDT, especially those containing the more difficult-to-deliver preformed photosensitisers.
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Affiliation(s)
- Ryan F Donnelly
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast, UK.
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Maisch T, Worlicek C, Babilas P, Landthaler M, Szeimies RM. A HCl/alcohol formulation increased 5-aminolevulinic acid skin distribution using anex vivofull thickness porcine skin model. Exp Dermatol 2008; 17:813-20. [DOI: 10.1111/j.1600-0625.2008.00705.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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30
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Chin WWL, Heng PWS, Lim PL, Lau WKO, Olivo M. Membrane transport enhancement of chlorin e6-polyvinylpyrrolidone and its photodynamic efficacy on the chick chorioallantoic model. JOURNAL OF BIOPHOTONICS 2008; 1:395-407. [PMID: 19343663 DOI: 10.1002/jbio.200810005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We have determined the influences of polyvinylpyrrolidone (PVP) on the topical delivery of chlorin e6 (Ce6) in malignant bladder cells. The chick chorioallantoic membrane (CAM) was used to model the tumor spheroids that resemble small residual bladder tumors prior to vascularization. Macroscopic fluorescence imaging showed that Ce6-PVP-induced fluorescence had a higher sensitivity and specificity for delineating tumor from the adjacent normal CAM compared to Ce6 alone. Nonlinear regression analyses have shown that Ce6-PVP has a longer half-life in the tumor compared to Ce6. The uptake ratio of Ce6-PVP was found to have a 2-fold increase across the CAM when compared to that of Ce6, indicating that PVP was able to facilitate diffusion of Ce6 across the membrane. Confocal laser scanning microscopy further confirmed that Ce6-PVP has better penetration in the CAM as well as in the tumor cells compared to Ce6. The present work contributes to our understanding of the Ce6-PVP drug-polymer system by demonstrating for the first time that the presence of PVP facilitates the transport of Ce6 across the chorioallantoic membrane.
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Affiliation(s)
- William Wei Lim Chin
- Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, 169610 Singapore.
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31
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Dögnitz N, Salomon D, Zellweger M, Ballini JP, Gabrecht T, Lange N, van den Bergh H, Wagnières G. Comparison of ALA- and ALA hexyl-ester-induced PpIX depth distribution in human skin carcinoma. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2008; 93:140-8. [PMID: 18818091 DOI: 10.1016/j.jphotobiol.2008.07.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 01/14/2008] [Revised: 07/20/2008] [Accepted: 07/28/2008] [Indexed: 11/24/2022]
Abstract
Photodynamic therapy (PDT) based on the use of photoactivable porphyrins, such as protoporphyrin IX (PpIX), induced by the topical application of amino-levulinic acid (ALA) or its derivatives, ALA methyl-ester (m-ALA), is a treatment for superficial basal cell carcinoma (BCC), with complete response rates of over 80%. However, in the case of deep, nodular-ulcerative lesions, the complete response rates are lower, possibly related to a lower bioavailability of PpIX. Previous in vitro skin permeation studies demonstrated an increased penetration of amino-levulinic acid hexyl-ester (h-ALA) over ALA. In this study, we tested the validity of this approach in vivo on human BCCs. An emulsion containing 20% ALA (w/w) and preparations of h-ALA at different concentrations were applied topically to the normal skin of Caucasian volunteers to compare the PpIX fluorescence intensities with an optical fiber-based spectrofluorometer. In addition, the PpIX depth distribution and fluorescence intensity in 26 BCCs were investigated by fluorescence microscopy following topical application of 20% ALA and 1% h-ALA. We found that, for application times up to 24h, h-ALA is identical to ALA as a PpIX precursor with respect to PpIX fluorescence intensity, depth of penetration, and distribution in basal cell carcinoma, but has the added advantage that much smaller h-ALA concentrations can be used (up to a factor 13). We observed a non-homogenous distribution in BCCs with both precursors, independent of the histological type and depth of invasion in the dermis.
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Affiliation(s)
- Nora Dögnitz
- Laboratory of Photomedicine, Ecole Polytechnique Fédérale de Lausanne (EPFL), SB, ISIC-GE, Building CH, Station 6, 1015 Lausanne, CH, Switzerland.
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Donnelly RF, Morrow DI, McCarron PA, Woolfson AD, Morrissey A, Juzenas P, Juzeniene A, Iani V, McCarthy HO, Moan J. Microneedle-mediated intradermal delivery of 5-aminolevulinic acid: Potential for enhanced topical photodynamic therapy. J Control Release 2008; 129:154-62. [DOI: 10.1016/j.jconrel.2008.05.002] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Revised: 04/30/2008] [Accepted: 05/05/2008] [Indexed: 10/22/2022]
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Donnelly RF, McCarron PA, Woolfson DA. Derivatives of 5-Aminolevulinic Acid for Photodynamic Therapy. PERSPECTIVES IN MEDICINAL CHEMISTRY 2007. [DOI: 10.1177/1177391x0700100005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Photodynamic therapy (PDT) is a clinical treatment that combines the effects of visible light irradiation with subsequent biochemical events that arise from the presence of a photosensitising drug (possessing no dark toxicity) to cause destruction of selected cells. Today, the most common agent used in dermatological PDT is 5-aminolevulinic acid (ALA). As a result of its hydrophilic character, ALA penetrates skin lesions poorly when applied topically. Its systemic bioavailability is limited and it is known to cause significant side effects when given orally or intravenously. Numerous chemical derivatives of ALA have been synthesised with the aims of either improving topical penetration or enhancing systemic bioavailability, while reducing side effects. In vitro cell culture experiments with ALA derivatives have yielded promising results. However, if ALA derivatives are to demonstrate meaningful clinical benefits, a rational approach to topical formulation design is required, along with a systematic study aimed at uncovering the true potential of ALA derivatives in photodynamic therapy. With respect to systemic ALA delivery, more study is required in the developing area of ALA-containing dendrons and dendrimers.
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Affiliation(s)
- Ryan F. Donnelly
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, U.K
| | - Paul A. McCarron
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, U.K
| | - David A. Woolfson
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, U.K
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Donnelly RF, Morrow DI, McCarron PA, Garland MJ, Woolfson AD. Influence of solution viscosity and injection protocol on distribution patterns of jet injectors: Application to photodynamic tumour targeting. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2007; 89:98-109. [DOI: 10.1016/j.jphotobiol.2007.09.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2007] [Revised: 09/17/2007] [Accepted: 09/17/2007] [Indexed: 10/22/2022]
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36
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Donnelly RF, McCarron PA, Cassidy CM, Elborn JS, Tunney MM. Delivery of photosensitisers and light through mucus: investigations into the potential use of photodynamic therapy for treatment of Pseudomonas aeruginosa cystic fibrosis pulmonary infection. J Control Release 2006; 117:217-26. [PMID: 17196290 DOI: 10.1016/j.jconrel.2006.11.010] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2006] [Revised: 10/30/2006] [Accepted: 11/07/2006] [Indexed: 11/18/2022]
Abstract
Respiratory disease is the main cause of morbidity and mortality in patients with cystic fibrosis (CF). In such patients chronic Pseudomonas aeruginosa infection is virtually impossible to eradicate using antibiotic therapy. Photodynamic antimicrobial chemotherapy (PACT) could be one potential alternative antimicrobial method. As photosensitisers could be delivered to the lungs of CF patients via inhalation, the current in vitro study investigated the potential use of PACT in the treatment of P. aeruginosa CF pulmonary infection. Delivery of red light (635 nm) and two photosensitisers (toluidine blue O (TBO) and meso-tetra (N-methyl-4-pyridyl) porphine tetra tosylate (TMP)) across artificial CF mucus was successfully achieved. Artificial CF mucus reduced the measured fluence of incident light in an almost exponential manner with increasing depth. The presence of dissolved photosensitisers also reduced light fluence. TMP diffused more efficiently across artificial CF mucus than TBO. However, receiver compartment concentrations of both drugs after 6 h were of the same order as those required to achieve high rates of kill (>99%) of P. aeruginosa isolates growing both planktonically and in biofilms. TMP required significantly higher concentrations (2.5 mg ml(-1)) than TBO to achieve high rates of kill (>99%) of P. aeruginosa isolates growing planktonically. Higher concentrations (5.0 mg ml(-1)) of both photosensitisers were required to achieve high rates of kill (>99%) of P. aeruginosa isolates growing in biofilms. When photosensitisers were prepared in artificial mucus, higher concentrations were required to achieve reasonably high kill rates (>80%) of P. aeruginosa (PAO1) growing both planktonically and in biofilm.
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Affiliation(s)
- Ryan F Donnelly
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, Belfast, UK.
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Donnelly RF, Ma LW, Juzenas P, Iani V, McCarron PA, Woolfson AD, Moan J. Topical bioadhesive patch systems enhance selectivity of protoporphyrin IX accumulation. Photochem Photobiol 2006; 82:670-5. [PMID: 16475870 DOI: 10.1562/2005-08-08-ra-641] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In clinical 5-aminolevulinic acid (ALA)-based photodynamic therapy (PDT) of skin tumors it is desirable to develop vehicles that minimize the penetration of ALA through normal stratum corneum and maximize it through the compromised stratum corneum of the tumors to improve tumor selectivity. We have designed a bioadhesive patch, which may be able to achieve this aim. It induces levels of protoporphyrin IX (PpIX) in skin overlying tumors similar to those induced by the proprietary cream (Porphin) but at the same time induces less PpIX to form in normal skin and at distant sites. The mechanisms of action of the patch, as compared with that of the cream, were studied by means of Cuprophan barriers that mimic compromised tumor stratum corneum and in a mouse model with transplanted tumors.
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Affiliation(s)
- Ryan F Donnelly
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, UK.
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Allison RR, Sibata CH, Downie GH, Cuenca RE. A clinical review of PDT for cutaneous malignancies. Photodiagnosis Photodyn Ther 2006; 3:214-26. [PMID: 25046986 DOI: 10.1016/j.pdpdt.2006.05.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2006] [Revised: 04/28/2006] [Accepted: 05/04/2006] [Indexed: 11/29/2022]
Abstract
More critical than for most other anatomy, intervention to cutaneous malignancy must not only be therapeutically successful but also achieve excellent cosmetic and functional outcome. As it can achieve those ends, PDT has moved to the forefront in the management of skin cancer. A number of well designed clinical trials and large patient series have reported outstanding outcomes for many histologies. This paper will review the rationale and outcomes of cutaneous PDT to malignancy using both topical and systemic photosensitizers. The benefits and drawbacks of cutaneous PDT are also examined.
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Affiliation(s)
- Ron R Allison
- PDT Center, Leo Jenkins Cancer Institute, The Brody School of Medicine at ECU, Greenville, NC 27834, USA
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Donnelly RF, Juzenas P, McCarron PA, Ma LW, Woolfson AD, Moan J. Influence of formulation factors on methyl-ALA-induced protoporphyrin IX accumulation in vivo. Photodiagnosis Photodyn Ther 2006; 3:190-201. [PMID: 25049154 DOI: 10.1016/j.pdpdt.2006.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2006] [Revised: 03/09/2006] [Accepted: 03/13/2006] [Indexed: 11/19/2022]
Abstract
Photodynamic therapy (PDT) is a medical treatment by which a combination of a photosensitising drug and visible light cause the destruction of selected cells. Thick lesions, such as nodular basal cell carcinomas (BCCs), or lesions with overlying keratinous debris, are reported as being difficult to eradicate using 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT). Such treatment failures have been attributed to the shallow penetration of water-soluble drugs like ALA. In addition, the current scarcity of sophisticated drug delivery research centered on PDT applications has meant that accurate comparison of similar clinical studies is difficult. This paper investigates, for the first time, novel drug delivery systems for controlled drug delivery of methyl-ALA (M-ALA). Pressure sensitive adhesive (PSA) and bioadhesive patches containing defined M-ALA loadings and a standard cream containing equivalent amounts of drug were applied to the skin of mice for defined periods of time and the fluorescence of the protoporphyrin IX (PpIX) induced measured over 24h. Of major importance, the PSA patches containing low drug loadings induced high PpIX levels, which were limited to the site of application, after only 1h applications. Such systems have the potential to improve selectivity of PpIX accumulation, increase simplicity of treatment and, due to the low drug loadings required, reduce costs of clinical PDT. PSA patches would be most suitable for application to areas of dry skin, while bioadhesive patches would be suitable for moist areas, such as the mouth or lower female reproductive tract and have been shown here to induce significant PpIX production at the site of application after 4h applications of patches containing high drug loadings.
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Affiliation(s)
- Ryan F Donnelly
- School of Pharmacy, Queens University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK; Department of Radiation Biology, Institute for Cancer Research, The Norwegian Radium Hospital, Montebello 0310, Oslo, Norway
| | - Petras Juzenas
- Department of Radiation Biology, Institute for Cancer Research, The Norwegian Radium Hospital, Montebello 0310, Oslo, Norway; Fellow of the Norwegian Cancer Society, P.O. Box 4 Sentrum 0101, Oslo, Norway
| | - Paul A McCarron
- School of Pharmacy, Queens University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Li-Wei Ma
- Department of Radiation Biology, Institute for Cancer Research, The Norwegian Radium Hospital, Montebello 0310, Oslo, Norway
| | - A David Woolfson
- School of Pharmacy, Queens University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Johan Moan
- Department of Radiation Biology, Institute for Cancer Research, The Norwegian Radium Hospital, Montebello 0310, Oslo, Norway; Institute of Physics, University of Oslo, P.O. Box 1048 Blindern 0316, Oslo, Norway
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Uehlinger P, Ballini JP, van den Bergh H, Wagnières G. On the Role of Iron and one of its Chelating Agents in the Production of Protoporphyrin IX Generated by 5-Aminolevulinic Acid and its Hexyl Ester Derivative Tested on an Epidermal Equivalent of Human Skin. Photochem Photobiol 2006; 82:1069-76. [PMID: 17205631 DOI: 10.1562/2005-12-04-ra-745] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) or its derivatives as precursors of protoporphyrin IX (PPIX) is routinely used in dermatology for the treatment of various pathologies. However, this methodology suffers to some extent from a limited efficacy. Therefore, the main goal of this study was to investigate the modulation and pharmacokinetics of PPIX buildup after a 5 h incubation with ALA (1.5 mM) and one of its derivatives, the hexyl ester of ALA (h-ALA) (1.5 mM), on the human epidermal equivalent Epidex. PPIX production was modulated with (L+) ascorbic acid iron (II) salt (LAI) or the iron (II)-specific chelating agent deferoxamine (DFO). PPIX fluorescence from the Epidex layers was measured up to 150 h after the precursor administration using a microspectrofluorometer (lambda(ex): 400 +/- 20 nm; lambda(det): 635 nm). The maximum PPIX fluorescence intensity induced by h-ALA was about 1.7 x larger than that induced by ALA. The addition of DFO resulted in a more than 50% increase in PPIX fluorescence for both precursors. The decay half life measured for PPIX fluorescence is 30 and 42.5 h, respectively, for ALA and h-ALA. These half lives are doubled when the samples contain DFO. In the samples with the highest fluorescence intensity, a modified fluorescence spectrum was observed after 10 h, with the emergence of a peak at 590 nm, which is attributed to zinc protoporphyrin IX (Zn PPIX).
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Affiliation(s)
- Pascal Uehlinger
- Swiss Federal Institute of Technology in Lausanne, Laboratory of Photomedicine, EPFL, Switzerland
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