光动力治疗与抗肿瘤免疫

光动力治疗是通过特定波长的光激发光敏剂产生活性氧反应物实现对微生物和肿瘤细胞的杀伤。由于光动力治疗的疗效确切,副作用小,并易于与其他治疗方式联用,因而已成为临床肿瘤治疗的新手段。近年来,抗肿瘤免疫的基础研究和临床应用获得了重大进展。研究表明,光动力治疗与抗肿瘤免疫治疗的联合应用具有显著的协同抗肿瘤效应。本文综述了光动力治疗研究进展及其在抗肿瘤免疫治疗的应用,讨论了其面临的障碍及发展前景。     

聚合物纳米粒在肿瘤光动力治疗中的研究进展

光动力治疗创伤小,在恶性肿瘤治疗方面的应用已经得到了临床认可。治疗过程中需要给予光敏剂,在光照下产生分子氧对肿瘤细胞产生杀伤作用。但是,大多数光敏剂缺乏对肿瘤细胞的特异性,其在肿瘤中的富集主要与细胞高代谢有关,并且在水相媒介中溶解度比较差。纳米技术应用于光动力治疗提供了一种有效地体内运输光敏剂的方式。目前,聚合物纳米粒与光动力药物传递的研究越来越多,光敏剂通过纳米粒的运输为弥补光动力治疗的不足提供了可能,这是因为纳米载体可以将治疗浓度的光敏剂运送到肿瘤细胞而不造成非靶向组织的副损伤。本文将介绍对肿瘤光动力治疗中具有特异性的聚合物纳米粒的种类及在临床中的应用情况,为肿瘤靶向治疗提供新思路。     

5-ALA在胶质瘤光动力治疗应用的进展

胶质瘤作为常见的颅内恶性肿瘤,传统的手术与放疗化疗联合的治疗方法难以取得令人满意的治疗效果。光动力治疗作为治疗恶性肿瘤有效的辅助方法,在胶质瘤治疗中得到广泛应用。5-氨基乙酰丙酸(5-aminolevulinic acid,5-ALA)是在光动力治疗中应用最多的光敏剂前体物质。多年来针对5-氨基乙酰丙酸(5-aminolevulinic acid,5-ALA)在胶质瘤光动力治疗中的研究主要集中在如何增强光动力效应,这也是许多神经外科医生的兴趣所在。本文结合相关文献,对5-ALA在胶质瘤光动力治疗的研究进展及未来在此领域面临的挑战进行了综述。     

生物可降解聚乙二醇-嵌段-聚乳酸的协同给药研究

肿瘤单一药物治疗的效果往往不佳,且易产生耐药性,因此,肿瘤的多药协同治疗具有明显优势,并逐渐引起重视。本工作基于具有良好生物相容性和生物可降解性的聚乙二醇-嵌段-聚乳酸(PEG-b-PLA)两嵌段聚合物,物理包埋两种化疗药物,阿霉素(Doxorubicin,DOX)和喜树碱(Camptothecin,CPT),实现两种化疗药物的共传输、药物释放与协同给药,表现出良好的抗肿瘤活性。     

纳米药物递送系统在基于化疗的联合治疗中的研究进展

肿瘤是一种病理过程复杂的疾病。大多数肿瘤患者接受化疗和放疗，但这些治疗通常只对部分有效，并产生各种严重的副作用。因此，有必要开发新的治疗策略。联合治疗是目前肿瘤治疗的热点，联合用药引起的多种协同作用是提高抗肿瘤活性的关键。纳米药物递送系统的出现对临床治疗产生了深远的影响。药物的体内递送常不能达到令人满意的治疗效果，而纳米药物递送系统可以实现肿瘤靶向给药，在提高抗肿瘤效果的同时降低药物的毒副作用。本文介绍了多种基于化疗的联合治疗方法，重点阐述了纳米药物递送系统在基于化疗的联合治疗中的运用，并对该领域面临的挑战和未来发展方向进行了展望。     

带有功能性多肽的光敏剂及其应用

光动力治疗( photodynamic therapy,PDT )是光敏剂在特定波长光源的激发下、在氧分子存在下产生细胞毒性物质的一种治疗方法,主要用于抗肿瘤治疗．目前临床应用的光敏剂对肿瘤细胞的靶向性比较有限,近来的一个热门研究方向是靶向性光敏剂．结合作者多年来在该方向的工作,综合近年来光敏剂研究的发展,比较全面地阐述了带有功能性多肽的靶向性光敏剂及其在光动力治疗中的应用．阐述多肽作为靶向基团的优势,总结了包括透膜多肽、血管靶向多肽、细胞受体靶向多肽等功能多肽与光敏剂偶合物的生物效应,说明了多肽能够实现光敏剂的靶向作用．     

沙门菌用于肿瘤生物治疗的研究进展

沙门菌(Salmonella)是用于抗肿瘤生物治疗很有前景的一种生物反应调节剂(biological response modifier, BRM)。鼠伤寒沙门菌(Salmonella typhimurium)是肿瘤生物治疗研究中最为常用的沙门菌之一。沙门菌可以在肿瘤细胞中定植,通过激活抗肿瘤免疫应答、诱导肿瘤细胞死亡等途径抑制肿瘤细胞的生长及转移。沙门菌可与其他抗肿瘤疗法联合使用,增强化疗药物的作用,也可作为抗肿瘤制剂的载体。现就沙门菌用于肿瘤的生物治疗作一概述。     

一种新型细胞摄取增强的两亲性卟啉类光敏剂及肿瘤光动力治疗研究

光敏剂能否被肿瘤细胞高效吸收是影响光动力治疗效率的重要因素。亲脂性光敏剂易于被肿瘤组织摄取,但会使光敏剂发生自猝灭;亲水性光敏剂则有利于光敏剂在体内的转运,但肿瘤细胞摄取率会下降。本工作通过亲酯性的乙二醇缩合支链和亲水性季膦基团与卟啉相连接,成功制备一种新型两亲性卟啉锌化合物(ZnTP-TP),实验表明该化合物具有较高的单线态氧量子产率和良好的两亲性,可被细胞快速摄取,并表现出较低的细胞毒性和良好的肿瘤光动力治疗效应。     

综述——基于纳米材料的生物检测与医学诊断技术：吲哚菁绿纳米颗粒在癌症诊断和治疗中的应用

吲哚菁绿(ICG)是一种传统的临床近红外(NIR)荧光染料,同时能够高效吸收激光用于光热和光动力治疗．但是ICG在水溶液中的不稳定性及在体内的快速清除限制了它的应用．纳米技术的快速发展为ICG的进一步开发应用提供了新材料和新思路．本文主要介绍ICG纳米颗粒在肿瘤近红外诊断及光热和光动力治疗领域研究的最新进展．     

纳米金提高光敏剂单态氧产率的研究

光动力疗法是效果很好的癌症微创治疗方法,主要依靠光敏性药物(也称为光敏剂)进行癌细胞杀伤。在光动力治疗中,光敏剂单态氧产率是影响光动力效果的关键因素。利用纳米金的光学特性来提高光敏剂的单态氧产率为研制新型光敏剂来改进光动力治疗方法提供了一种新的途径。利用绿光LED灯、红光LED灯、氙灯和635 nm连续激光四种光源对混合有光敏剂原卟啉Ⅸ和纳米金的溶液进行光照。用单态氧检测试剂测定了光照后的单态氧产率。     

Coordination conjugates of therapeutic proteins with drug carriers: a new approach for versatile advanced drug delivery

We present here a general system for the coordination attachment of therapeutic proteins to a drug delivery system and its application in combined therapy. Proof of concept is demonstrated by the synthesis and testing of the targeted drug delivery system for cytostatics, which is based on a combination of the drug carrier Zn-porphyrin-cyclodextrin conjugates and their supramolecular coordination complexes with immunoglobulins. This system can be as readily used for a variety of therapeutic and targeting proteins including PAs, MAs, lectins, and HSA. Moreover, it allows combined photodynamic therapy, cell targeted chemotherapy and immunotherapy. When tested in a mouse model with human C32 carcinoma, the therapeutic superiority of the coordination assembly nanosystem was shown in comparison with the efficacy of building blocks used for the construction of the system.     

Indocyanine green as a prospective sensitizer for photodynamic therapy of melanomas

Spectroscopic, photochemical and biological properties of indocyanine green (ICG) are presented. Light over 800 nm is effectively absorbed by ICG. This property as well as photochemical behaviour of ICG make it a very suitable dye for photodynamic treatment of melanoma cells. Cytotoxicity of ICG itself and the effect of photodynamic therapy (PDT) were evaluated by following the growth of human (SKMEL 188) and mouse (S91) melanoma cells. The surviving fraction of the cells irradiated (lambda(ex) = 830 nm) vs non-irradiated, treated with the same dose of ICG, is significantly decreased (5- to 10-fold). These results show that ICG is a very promising dye for photodynamic therapy of melanomas.     

Targeting of the vascular system of solid tumours by photodynamic therapy (PDT).

Owing to morphological and rheological differences of the tumour vascular system as compared to the vascular system of the surrounding tissue, the efficacy of several experimental and clinical therapeutic approaches is limited. This fact has put the vascular system of solid tumours into focus and two new therapeutic strategies, anti-angiogenesis and vascular targeting, have emerged. Under the term vascular targeting various therapeutic approaches are summarized, e.g. chemoembolization, chemotherapy, hyperthermia, vascular targeting agents (VTA) and photodynamic therapy (PDT). As shown using the clinically approved photosensitiser Photofrin the irreversible destruction of the tumour vascular system is primarily responsible for an effective PDT of solid tumours. However, the clinical disadvantages of Photofrin are well known. Thus, several new photosensitisers, e.g. aminolaevulinic acid (ALA), porphycenes and indocyanine green (ICG), have been evaluated in vitro and in vivo regarding their suitability for vascular targeting of solid tumours. The promising experimental findings with the photosensitiser ICG led to first clinical results in treating Kaposi's sarcomas. In summary, systemic PDT is only effective when leading to complete ischaemia of solid tumours with subsequent necrosis. An essential prerequisite is the use of a chemically and photophysically defined photosensitiser localizing in the intravascular space due to e.g. a high molecular weight. The specific properties of such a photosensitiser are outlined.     

New therapies for the treatment of age-related macular degeneration]

Age-related macular degeneration has a natural progression from the precursors (the drusen) towards atrophic or neovascular complications. Choroidal neovascularization is undoubtedly the aspect of the disease that benefits most from new therapeutical approaches. Destructive photocoagulation based on fluorescein angiography has demonstrated since 20 years its efficiency on choroidal neovascularization. The same approach based on indocyanine green (ICG) angiography would increase the number of patients available to therapy. Very recently photodynamic therapy has demonstrated its efficiency to stabilize visual acuity at least at two years in patients with choroidal new vessels predominantly well defined. Other treatment developments are considered, such as refinement of photocoagulation techniques or of surgery. Until now, none has demonstrated its efficiency although they raise justified hopes. The future approaches rely upon the progress of the research both in physiopathology of the disease and on the angiogenic process requiring a constant interaction with all thematics of research. Finally, palliative treatments will be required before heading up to a preventive treatment.     

Emerging concepts in designing next-generation multifunctional nanomedicine for cancer treatment

Nanotherapy has emerged as an improved anticancer therapeutic strategy to circumvent the harmful side effects of chemotherapy. It has been proven to be beneficial to offer multiple advantages, including their capacity to carry different therapeutic agents, longer circulation time and increased therapeutic index with reduced toxicity. Over time, nanotherapy evolved in terms of their designing strategies like geometry, size, composition or chemistry to circumvent the biological barriers. Multifunctional nanoscale materials are widely used as molecular transporter for delivering therapeutics and imaging agents. Nanomedicine involving multi-component chemotherapeutic drug-based combination therapy has been found to be an improved promising approach to increase the efficacy of cancer treatment. Next-generation nanomedicine has also utilized and combined immunotherapy to increase its therapeutic efficacy. It helps in targeting tumor immune response sparing the healthy systemic immune function. In this review, we have summarized the progress of nanotechnology in terms of nanoparticle designing and targeting cancer. We have also discussed its further applications in combination therapy and cancer immunotherapy. Integrating patient-specific proteomics and biomarker based information and harnessing clinically safe nanotechnology, the development of precision nanomedicine could revolutionize the effective cancer therapy.     

Oleanolic acid increases the anticancer potency of doxorubicin in pancreatic cancer cells

Combination therapy is a novel cancer therapy approach that combines two or more chemotherapy drugs. This treatment modality enhances the efficacy of chemotherapy by targeting key pathways in an additive or synergistic manner. Therefore, we investigated the efficacy of combination therapy by widely used chemotherapy drug doxorubicin (DOX) and oleanolic acid (OA) to induction of apoptosis for pancreatic cancer (PC) therapy. The effects of DOX, OA, and their combination (DOX-OA) were investigated on proliferation and viability of PC cell line (PANC-1) by MTT assay. Moreover, migration and invasion of the cancer cells were evaluated by trans-well migration assay and wound healing assay. Flow cytometry and DAPI (4′,6-diamidino-2-phenylindole) staining were employed to investigate apoptosis quantification and qualification of the treated cancer cells. Finally, mRNA expression of apoptosis-related genes was assessed by quantitative real-time polymerase chain reaction. Our results demonstrated that the proliferation and metastasis potential of PC cells significantly decreased after treatment by DOX, OA, and DOX-OA. Moreover, we observed an increase in apoptosis percentage in the treated cancer cells. The apoptosis-related gene expression was modified to increase the apoptosis rate in all of the treatment groups. However, the anticancer potency of DOX-OA combination was significantly more than that of DOX and OA treatments alone. Our study suggested that DOX-OA combination exerts more profound anticancer effects against PC cell lines than DOX or OA monotherapy. This approach may increase the efficiency of chemotherapy and reduce unintended side effects by lowering the prescribed dose of DOX.     

Effects of hyperthermia and photodynamic therapy on BALB/c mice bearing subcutaneous tumors

The therapeutic effects of photodynamic therapy and hyperthermia on mice bearing subcutaneous tumors were investigated. Ehrlich ascites tumor cells (1 x 10(7)) were implanted subcutaneously into the femoral area of BALB/c mice. A total of 134 tumor-bearing mice were treated with photodynamic therapy, i.e., administration of laser irradiation (514.5 nm, 112.5 mW/cm2 for 11.12 min with a total energy 75 J/cm2) after injection (i.p.) of hematoporphyrin derivative (HPD, 7.5 and 10.0 mg/kg body weight) and/or hyperthermia (by electric heating needles to 44 and 45 degrees C for 30 min) once a day for three successive days. The results revealed that the therapeutic effects of the combination of photodynamic therapy and hyperthermia were improved when compared with photodynamic therapy or hyperthermia alone. A combination of photodynamic therapy (10.0 mg HPD/kg body weight and 75 J/cm2 of total laser irradiation energy) and hyperthermia (44 degrees C for 30 min) had the best therapeutic effect, indicating that the mortality rate within 120 days (MR120) was 12.5% and the mean survival time (MST120) was 113.8 days.     

A nanosensitizer self-assembled from oleanolic acid and chlorin e6 for synergistic chemo/sono-photodynamic cancer therapy

BackgroundSono-photodynamic therapy (SPDT) which is the combination of photodynamic therapy (PDT) and sonodynamic therapy (SDT), could exert much better anti-cancer effects than monotherapy. The combination of chemotherapy and PDT or SDT has shown great potential for cancer treatment. However, the combination of SPDT and chemotherapy for cancer treatment is rarely explored.PurposeWe utilized a natural hydrophobic anti-cancer drug oleanolic acid (OA) and a photosensitizer chlorin e6 (Ce6) through self-assembly technology to form a carrier-free nanosensitizer OC for combined chemotherapy and SPDT for cancer treatment. No studies involving using carrier-free nanomedicine for combined chemotherapy/SPDT have been reported yet.Study designAfter fully characterization of OC, the in vitro and in vivo anti-cancer activities of OC were investigated and the mechanisms of the synergistic therapeutic effects were studied.MethodsOC were synthesized through self-assembly technology and characterized by dynamic light scattering (DLS) and an atomic force microscope (AFM). Confocal microscope was used to investigate the intracellular uptake efficiency and the penetration ability of OC. The cell viability of PC9 and 4T1 cells treated with OC under laser and ultrasound (US) irradiation was determined by MTT assay. Furthermore, flow cytometry was performed to detect the reactive oxygen species (ROS) generation, loss of mitochondrial membrane potential (MMP), cell apoptosis and cell cycle arrest. Finally, the anti-tumor therapeutic efficacy of OC was investigated in orthotopic 4T1 breast tumor-bearing mouse model.ResultsOC showed an average particle size of around 100 nm with excellent light stability. OC increased more than 23 times accumulation of Ce6 in cancer cells and had strong tumor penetration ability in three-dimensional (3D) multicellular tumor spheroids (MCTSs). Compared with other therapeutic options, OC showed obvious synergistic inhibitory effects under light and US irradiation in PC9 and 4T1 cells with a significant decrease in IC₅₀ values. Mechanism studies showed that OC could generate high ROS, induce MMP loss, and cause apoptosis and cell cycle arrest. In vivo studies also approved the synergistic therapeutic effects of OC in 4T1 mouse models.ConclusionSelf-assembled carrier-free nanosensitizer OC could be a promising therapeutic agent for synergistic chemo/sono-photodynamic therapy for cancer treatment.     

Ecological photodynamic therapy: New trend to disrupt the intricate networks within tumor ecosystem

As with natural ecosystems, species within the tumor microenvironment are connected by pairwise interactions (e.g. mutualism, predation) leading to a strong interdependence of different populations on each other. In this review we have identified the ecological roles played by each non-neoplastic population (macrophages, endothelial cells, fibroblasts) and other abiotic components (oxygen, extracellular matrix) directly involved with neoplastic development. A way to alter an ecosystem is to affect other species within the environment that are supporting the growth and survival of the species of interest, here the tumor cells; thus, some features of ecological systems could be exploited for cancer therapy. We propose a well-known antitumor therapy called photodynamic therapy (PDT) as a novel modulator of ecological interactions. We refer to this as “ecological photodynamic therapy.” The main goal of this new strategy is the improvement of therapeutic efficiency through the disruption of ecological networks with the aim of destroying the tumor ecosystem. It is therefore necessary to identify those interactions from which tumor cells get benefit and those by which it is impaired, and then design multitargeted combined photodynamic regimes in order to orchestrate non-neoplastic populations against their neoplastic counterpart. Thus, conceiving the tumor as an ecological system opens avenues for novel approaches on treatment strategies.