Veterinary photodynamic therapy

Mass Spectrometric Analysis of the Photobleaching of Protoporphyrin IX Used in Photodynamic Diagnosis and Therapy of Cancer

Photobleaching and photoproduct formations are considered essential phenomena in improving the efficacy of photodynamic diagnosis and therapy (PDD and PDT). We investigated the photobleaching of protoporphyrin IX (PpIX) by measuring its concentration with mass spectrometry (MS). The reduction in the concentration of PpIX dissolved in dimethyl sulfoxide was measured during PDD and PDT conditions using lasers with wavelengths of 405 and 635 nm, respectively, at a power density of 10, 50 or 100 mW/cm² . The obtained results were compared with the results of conventional fluorescence spectroscopy and previously reported results. Our results demonstrate the variation in the MS-based photobleaching coefficient of PpIX with the power density, while the fluorescence-based photobleaching coefficient was independent of the power density. The results of MS also show faster photobleaching of PpIX in comparison with that obtained from fluorescence. The difference may be attributed to the change in the fluorescence quantum yield of PpIX with its concentration and the effect of fluorescence emission from the PpIX photoproducts. Thus, an MS-based investigation of the photobleaching poses to be a more stable investigation form. Our finding highlights the importance of recognizing the potential significance of these discoveries in the PDD and PDT dosimetry and efficacy.

Photodynamic therapy for the treatment of induced mammary tumor in rats

The objective of this work was to evaluate photodynamic therapy (PDT) by using a hematoporphyrin derivative as a photosensitizer and light-emitting diodes (LEDs) as light source in induced mammary tumors of Sprague-Dawley (SD) rats. Twenty SD rats with mammary tumors induced by DMBA were used. Animals were divided into four groups: control (G1), PDT only (G2), surgical removal of tumor (G3), and submitted to PDT immediately after surgical removal of tumor (G4). Tumors were measured over 6 weeks. Lesions and surgical were LEDs lighted up (200 J/cm(2) dose). The light distribution in vivo study used two additional animals without mammary tumors. In the control group, the average growth of tumor diameter was approximately 0.40 cm/week. While for PDT group, a growth of less than 0.15 cm/week was observed, suggesting significant delay in tumor growth. Therefore, only partial irradiation of the tumors occurred with a reduction in development, but without elimination. Animals in G4 had no tumor recurrence during the 12 weeks, after chemical induction, when compared with G3 animals that showed 60 % recurrence rate after 12 weeks of chemical induction. PDT used in the experimental model of mammary tumor as a single therapy was effective in reducing tumor development, so the surgery associated with PDT is a safe and efficient destruction of residual tumor, preventing recurrence of the tumor.

Photodynamic therapy against common bacteria causing wound and skin infections

Photodynamic therapy (PDT) uses the combination of a photosensitising (PS) agent and visible light. Historically, various injectable PS agents have been used with medical grade lasers to treat neoplasia. The objective of this in vitro study was to determine whether PDT using topical aminolevulinic acid (ALA) with a non-coherent light source would kill common wound infecting bacteria, namely, Staphylococcus intermedius, Streptococcus canis, Pseudomonas aeruginosa, and Escherichia coli. Bacterial strains were sensitised to light with ALA before exposing to the non-coherent light source. Colony counts were performed in triplicate and compared to controls. When compared with controls there was a significant decrease in bacterial survival following PDT for all organisms except E. coli. A single treatment required 2-3h of light exposure. These data suggest that PDT may be a possible treatment option for wound infections but repeated treatments or alterations in the PS or its carrier will be needed to decrease treatment times.

Non-coherent light for photodynamic therapy of superficial tumours in animals

Cultured 9L cells were incubated with varying concentrations of pheophorbide-a-hexyl ether (HPPH) and then exposed to 665-nm red light from a non-coherent light source or a dye laser. Cell death was produced by both light sources, with the non-coherent light being most effective at the highest HPPH concentrations. To assess the feasibility of using the non-coherent light source for clinical photodynamic therapy (PDT), four dogs and three cats presenting with spontaneous superficial tumours were injected intravenously with 0.15 mg kg(-1) of HPPH, 1 h before their tumours were irradiated with 665-nm non-coherent light (50 mW cm(-2), 100 J cm(-2)). Of the nine tumours treated, there were eight complete responses, all occurring in animals with squamous cell carcinoma. After 68 weeks of follow-up, the median initial disease-free interval had not been reached. These data suggest that non-coherent light sources may be efficacious for photodynamic therapy of spontaneous superficial tumours in animals, representing a cost-effective alternative to medical lasers in both veterinary and human oncology.

Hematoporphyrin-based photodynamic therapy for cutaneous squamous cell carcinoma in cats

Photodynamic therapy (PDT) using a haematoporphyrin derivative (Photogem, General Physics Institute and clustes Ltda) as photosensitizer and light emitting diodes (LEDs) as the light source was evaluated in 12 cats with cutaneous squamous cell carcinoma. Lesions were illuminated with LEDs, (300 J/cm for 30 min) 24 h after the administration of the photosensitizer. Clinical responses were classified as complete disappearance of the tumour with total re-epithelialization; partial response (a reduction greater than 50%); and no response (less than 50% reduction). Tumours localized to the pinna treated with one (n = 3) or two (n = 4) applications of PDT yielded no response. Highly invasive tumours of the nose and nasal planum also showed no response, after two treatments (n = 2). A combination of PDT and surgery was performed in three cases. Two cats showed partial response and one complete response with one application of therapy 30 days after nasal surgery. Small and noninfiltrative lesions (n = 3) of the nasal planum showed a PR with one application (n = 2) and a CR with two applications (n = 1). This study shows that PDT using Photogem and LEDs can provide local control of low-grade feline squamous cell carcinoma. The addition of PDT to surgery in more invasive cases may help prevent recurrence.

Phase I clinical trial of the use of zinc phthalocyanine tetrasulfonate as a photosensitizer for photodynamic therapy in dogs

OBJECTIVE

To determine the threshold for acute toxicosis of parenterally administered zinc phthalocyanine tetrasulfonate (ZnPcS(4)), a candidate second-generation photosensitizer, in mice and evaluate the compound's safety in a phase I clinical trial of ZnPcS(4)-based photodynamic therapy (PDT) in pet dogs with naturally occurring tumors.

ANIMALS

Male Swiss-Webster mice and client-owned dogs with naturally occurring neoplasms.

PROCEDURES

For the study of acute toxicosis, mice were given graded doses of ZnPcS(4). To determine safety, a rapid-titration phase I clinical trial of ZnPcS(4)-based PDT in tumor-bearing dogs was conducted.

RESULTS

In mice, administration of >or= 100 mg of ZnPcS(4)/kg resulted in renal tubular necrosis 24 hours after IP injection. In tumor-bearing dogs, ZnPcS(4) doses <or= 4 mg/kg induced no signs of toxicosis and resulted in partial to complete tumor responses in 10 of 12 dogs 4 weeks after PDT. Tumor remission was observed with ZnPcS(4) doses as low as 0.25 mg/kg.

CONCLUSIONS AND CLINICAL RELEVANCE

A conservative starting dose of ZnPcS(4) was arrived at on the basis of mouse toxicosis findings. Zinc phthalocyanine tetrasulfonate-based PDT was tolerated well by all dogs and warrants further study. The identification of the maximum tolerated dose through traditional phase I clinical trials may be unnecessary for evaluating novel PDT protocols.

Clinical pharmacokinetics of anti-angiogenic photodynamic therapy with benzoporphyrin derivative monoacid ring-A in dogs having naturally occurring neoplasms

The aim of this study was to examine the pharmacokinetics of clinically applied benzoporphyrin derivative monoacid ring-A (BPD-MA; Verteporfin), a second-generation photosensitizer, during a trial of photodynamic therapy (PDT) in nine dogs having naturally occurring neoplasms. After injecting BPD-MA at 0.5 mg/kg intravenously, its mean half-life (t1/2) was found to be 8.14 +/- 5.34 h, mean clearance (Cl) 35.13 +/- 9.62 ml/(h kg), the mean value of the volume of distribution (Vc) 0.08 +/- 0.01 l/kg and the mean steady state volume of distribution (Vss) 0.38 +/- 0.31 l/kg respectively. With the exception of a transitional increase in serum alkaline phosphatase activity, no other clinical abnormalities were observed. The t1/2 in dogs with naturally occurring tumours was longer than that in humans, but similar to that in rats. The values of Cl and Vss in dogs having naturally occurring neoplasms were lower than those in humans. It is suggested that the pharmacokinetics of BPD-MA in tumour-bearing dogs would be helpful in determining the protocol of a short drug-light interval PDT with BPD-MA that mainly targets the tumour vasculature.

Tissue Retention and Adverse Reaction after Intravenous Injection of Hematoporphyrin Derivatives in Dogs

We evaluated changes in hematology and chemical profile, and the tissue retention of hematoporphyrin derivative (HpD) following the intravenous injection in dogs. HpD at concentrations of 1, 5, 10, and 15 mg/kg was intravenously injected to 16 dogs (n=4 each) and complete blood count (CBC) and blood chemistry were performed on days 1, 3, 5, and 7 after the injection. To examine tissue retention, HpD (5 mg/kg) was administered to 15 dogs and 3 dogs were euthanized on days 1, 2, 7, 14, and 28 after the injection, respectively, to collect the skin, muscle, small intestine, spleen, kidney and liver as tissue samples. There were no significant changes in CBC and blood chemical profile except for an increase in LDH concentrations in dogs given 10 and 15 mg/kg of HpD at day 3. The levels of HpD retention in the tissues were ranked in the following order: liver > kidney > spleen > intestine > muscle > skin.

Photodynamic therapy for the treatment of intranasal tumors in 3 dogs and 1 cat

Three dogs and 1 cat with intranasal tumors were treated with pyropheophorbide-a-hexyl ether-based photodynamic therapy (PDT). PDT was well tolerated by all the animals, and no adverse effects from photosensitizer injection, such as cutaneous photosensitization, were observed. Facial swelling was observed in all animals after each PDT treatment but resolved spontaneously within 72 hours after treatment. All animals had a decrease in severity of epistaxis, frequency of sneezing, and amount of nasal discharge after PDT. Clinical signs were controlled for variable time, although long-term responses were comparable with radiation therapy in 2 animals. This small case series demonstrates another application for PDT in veterinary medicine. On the basis of these findings. further studies are warranted to define the role of PDT in the management of intranasal tumors in dogs and cats.

Phototoxic effects of 635-nm light on canine transitional cell carcinoma cells incubated with 5-aminolevulinic acid

OBJECTIVE

To determine whether transitional cell carcinoma (TCC) cells incubated in media containing 5-aminolevulinic acid (ALA) would produce sufficient protoporphyrin IX (PpIX) to cause lethal phototoxic effects when exposed to 635-nm light.

SAMPLE POPULATION

Canine TCC cells (K9TCC).

PROCEDURE

Cultured K9TCC cells were exposed to graded doses of ALA, and PpIX concentrations were determined. Cells then were exposed to various doses of 635-nm light from a diode laser, and cell viability was assayed.

RESULTS

Production of PpIX was dependent on time and dose of ALA. The K9TCC cells incubated with ALA produced sufficient PpIX to cause lethal phototoxic effects when exposed to 635-nm light. Phototoxic effects were dependent on time and dose of ALA. Increasing laser power density and energy density decreased cell survival.

CONCLUSIONS AND CLINICAL RELEVANCE

ALA is an effective photosensitizer for in vitro photodynamic treatment of K9TCC cells. Further studies are warranted to assess the safety and efficacy of ALA as a photosensitizer for use in treating dogs with TCC. Impact for Human Medicine-On the basis of this study, dogs with TCC may be useful in the development of protocols for ALA-based photodynamic therapy of humans affected with muscle-invasive bladder cancer.

Lasers in ophthalmology

Laser technology continues to progress with the addition of new lasers, new delivery systems, and new applications. The introduction of lasers to veterinary ophthalmology has radically changed the level of care that we can provide to our patients. The development of the diode laser has particularly had an impact on veterinary ophthalmology. The diode's affordability, portability, and broad applications for veterinary patients have allowed laser surgery to become a routine part of veterinary ophthalmology practice. Educating the public and veterinary community in available laser techniques will generate improved ophthalmic care and provide more data on which to build future applications.

Soft tissue application of lasers

Despite increasing numbers of veterinarians incorporating lasers into their clinical practices, little information has been published about laser clinical applications in soft tissue surgery. This article reviews soft tissue interaction, describes laser equipment and accessories commonly marketed to veterinarians, and discusses clinical applications of the carbon dioxide laser in a systems-based approach. A table of recommended laser tips and settings based on the authors' experiences using a carbon dioxide laser (AccuVet Novapulse LX-20SP, Bothell, WA) is provided.

Photodynamic therapy for companion animals with cancer

Photodynamic therapy is an emerging form of cancer therapy in veterinary medicine, which capitalizes on a photochemical reaction to kill malignant cells. Photodynamic therapy has been used to successfully treat a variety of veterinary cancers, with documented efficacy similar to radiation therapy. However, equipment expense and availability of photosensitizer have limited the widespread use of photodynamic therapy by veterinarians.