光动力学疗法剂量学的研究进展

随着光动力学疗法 ( photodynamic therapy,PDT ) 基础研究的不断深入和临床应用的广泛开展,如何精确量化光动力剂量,并根据患者的个体差异进行剂量的实时调整和优化已成为亟待解决的挑战性难题,属PDT研究的前沿热点．综述了现有PDT剂量学研究方法及其相应检测技术的研究进展,其中包括：a．测定光通量密度、光敏剂浓度和氧分压;b．测量光敏剂的光漂白速率和光致产物;c．监测PDT前后组织的光生物学响应;d．检测单态氧在1 270 nm的近红外发光．同时,还分析了这些PDT剂量学方法的优点和局限性．最后,讨论了PDT剂量学研究中所面临的挑战．     

基于L-半胱氨酸修饰的Fe3O4@TiO2复合纳米颗粒体外光动力疗法灭活HL60细胞的试验研究

本文采用共沉淀法制备了L-半胱氨酸(L-Cys)修饰的Fe3O4包裹TiO2(Fe3O4@TiO2/L-Cys)复合纳米粒子。通过透射电子显微镜(TEM),X射线衍射(XRD)和傅立叶变换红外光谱仪(FTIR)对复合纳米粒子进行了表征,并讨论了复合纳米粒子对HL60细胞体外光动力疗法(PDT)灭活的影响。并对其PDT灭活机制进行了初步探索。试验表明,Fe3O4@TiO2/L-Cys复合纳米粒子分散性高,生物相容性好,对细胞的暗毒性更低,并可以有效增强靶向性,提高PDT灭活效率,在410nm波长的光激发下,光照剂量为18J/cm^2的情况下,当TiO2与Fe3O4的比例为1∶3时,整体PDT效率最高。PDT灭活效率可达69.36%。     

ALA-PDT对红斑狼疮患者外周血CD40阳性淋巴细胞的影响

探讨了δ氨基酮戊酸—光动力疗法 ( ALA PDT)对红斑狼疮患者外周血中 CD4 0阳性淋巴细胞的影响及其作用方式。方法 :采用免疫荧光双标记—流式细胞仪检测了 1 2例活动期红斑狼疮患者外周血淋巴细胞在光动力疗法前后 CD4 0、CD95的表达。结果 :1 ALA PDT后 CD4 0阳性淋巴细胞下降至 9.2 8± 1 .2 2 ,较 ALA PDT前的 1 3.36± 0 .89,有显著性的差异 ( P<0 .0 5)。2 CD95 /CD4 0 淋巴细胞在 ALA PDT后立即上升至 1 3.2 3± 2 .1 0 ,较 ALA PDT前的 7.84± 1 .93,有非常显著的差异 ( P<0 .0 1 )。 ALA PDT后继续培养 1 8小时检测 CD95 /CD4 0 淋巴细胞下降至 7.68± 1 .4 6,较 ALA PDT后即刻检测有显著性差异( 1 3.2 3± 2 .1 0 ,P<0 .0 1 )。结论 :ALA PDT能降低 CD4 0阳性淋巴细胞百分比 ,即可能抑制活动期红斑狼疮患者外周血中 B细胞的活性。这种作用可能与 Fas介导的凋亡有关     

光动力疗法防治损伤性血管内膜增生的实验研究

目的 :观察光动力疗法 (PDT)防治损伤性血管内膜增生的近期疗效 ,并筛选PDT参数。方法 :首先筛选PDT参数。兔 2 4只 ,按L4 ( 2 3)正交实验方案分为四组 ,处理因素为血啉甲醚 5或 10mg/kg、功率密度 30或 90mw/cm2 、照射时间 15或 30min。球囊法损伤髂总动脉内膜 ,随后进行PDT处理 ,2 1天后取材 ,以中膜与内膜面积的比值为指标分析各处理因素的作用。其次观察PDT疗效。兔 2 4只 ,随机分成 4组 :( 1)单纯损伤组 ;( 2 )PDT对照组 ,内膜损伤后先激光照射 ,后注射血啉甲醚 ;( 3)低PDT剂量组 ,内膜损伤后先注射血啉甲醚 5.0mg/kg ,然后以 30mw/cm2 照射 15min ;( 4 )高PDT剂量组 ,以 90mw/cm2 照射 ,其余同低剂量组。以内膜与中膜面积的比值为指标分析PDT疗效。结果 :预选参数的最优搭配为 :功率密度为 30mw/cm2 ,照射时间为 15min ,血啉甲醚剂量为 5mg/kg。低剂量组与高剂量组的S1/S2 比值分别比单纯损伤组低 71.9% (P <0 .0 1)和 59.4 % (P <0 .0 5) ,比PDT对照组低 63.1% (P <0 .0 1)和 4 6.5% (P <0 .0 5)。结论 :经皮血管内光动力疗法可能成为防治损伤性血管内膜增生的有效方法。     

光动力疗法对体外培养人胰腺癌细胞株PANC-1作用

目的:探讨血卟啉注射液(Hematoporphyrin Derivative,HPD)光动力疗法(Photodynamic Therapy,PDT)对体外培养的人胰腺癌细胞株PANC-1的生物作用。方法:实验分为4组,空白对照组、单纯HPD组、单纯光照组及HPD+PDT组。采用MTT法检测光动力作用后细胞的存活率,并用Annexin V-FITC/P I双染法检测其凋亡率。结果:在光敏剂浓度为5mg/L,光照剂量为10J/cm2时,光动力对PANC-1细胞达到最佳的实验效果,与对照组相比差异有显著性。在此实验参数条件下,流式细胞术(FCM)检测各组人胰腺癌细胞PANC-1凋亡率:HPD+PDT实验组达(36.40±4.21)%,明显高于单纯HPD(6.76±0.44)%,单纯PDT组(8.30±0.32)%及空白组(5.00±0.53)%三个对照组(P<0.05),三个对照组间差异无统计学意义(P>0.05)。结论:PDT光动力作用对体外培养人胰腺癌细胞PANC-1有明确抑制效应,并与HPD浓度及光照强度相关。     

Notch1在胆管癌细胞光动力疗法中的作用研究

目的:1、研究Photosan介导光动力疗法(Photodynamic Therapy,PDT)对胆管癌细胞的杀伤作用。2、探讨Notch1在胆管癌发生中的表达情况以及Notch1在PDT治疗胆管癌细胞中的作用。方法:1、体外培养人胆管癌QBC939细胞株,在细胞对数生长期用不同浓度Photosan处理,并用半导体激光治疗仪不同强度光照后,采用MTT法检测PDT对QBC939细胞的杀伤作用。观察不同的光敏剂孵育时间、光敏剂浓度及光照剂量对PDT效果的影响。2、采用免疫细胞化学方法和蛋白印迹法检测胆管癌细胞Notch1表达,经Photosan介导光动力作用胆管癌细胞后,检测胆管癌细胞内Notch1表达变化。结果:1、MTT结果显示Photosan介导的PDT对胆管癌细胞有杀伤作用(P0.05),而且这种杀伤作用在一定范围内随着光敏剂浓度增加、光敏剂孵育时间、光照剂量呈正相关。2、免疫细胞学检查发现Notch1在胆管癌细胞中高表达,其表达主要位于细胞膜及胞浆,并且经PDT处理后Notch1表达量较前减少(P0.05)。结论:Notch1与胆管癌细胞生长、增殖密切相关,且Notch1在PDT对胆管癌细胞产生的抑制、促凋亡和杀伤作用中有重要作用。     

基于CdSe-ZnS量子点的PDT体外灭活 HL60最佳实验参数的研究

随着光动力学疗法( photodynamic therapy,PDT)基础研究的不断深入和临床应用的广泛开展,根据患者的个体差异寻求高性能的光敏剂和精确量化光动力剂量,已成为亟待解决的难题,并日渐成为PDT研究的热点.以ZnS包裹的CdSe量子点(CdSe-ZnS)作为光敏剂,以人前髓细胞（早幼细胞）株HI6O为研究对...     

基于Fe-TiO_2和Ni-TiO_2的PDT体外灭活HL60细胞的试验研究

本文通过溶胶-凝胶法制备了Fe-TiO_2和Ni-TiO_2纳米颗粒,并研究这两种纳米颗粒体外光动力疗法(PDT)对HL60细胞的灭活效果。通过透射电镜(TEM)、能谱仪(EDS)、X射线衍射(XRD)、紫外-可见光(UVVis)吸收光谱等方法对纳米颗粒进行表征。使用CCK-8法分别测定Fe-TiO_2和Ni-TiO_2对HL60细胞的灭活效果。结果表明,不同终值浓度及掺杂量的Fe-TiO_2和Ni-TiO_2纳米颗粒对HL60细胞的暗毒性较低,但是PDT效率均显著高于未掺杂的TiO_2。在各自的最佳作用参数下,PDT灭活效率分别达到72. 5%±1. 6%和56. 4%±1. 2%。此外,还对这两种纳米颗粒灭活效果的差异进行了探讨。     

光动力疗法对人肝癌细胞SSMC-7721凋亡及suivivin表达的影响

目的:探讨血卟啉衍生物(hematoporphyrin derivative,HPD)光动力作用(photodynamic therapy,PDT)诱导人肝癌细胞SMMC-7721凋亡的作用及其机制.方法:采用MTT法测定PDT对人肝癌细胞的相对抑制率,并筛选最佳实验参数.应用流式细胞术检测PDT后细胞凋亡率.并用细胞免疫组化法检测survivin及caspase-3蛋白表达水平.结果:当HPD浓度为4mg/L,光照剂量为10J/cm2时,实验效果最佳,PDT光动力组人肝癌细胞SMMC-7721相对抑制率为(64.28±2.73)%,凋亡率达(35.28±1.52)%,与对照组相比,差异有显著意义(P＜0.01);PDT后survivin蛋白表达水平显著低于对照组(P＜0.05),而caspase-3却高于对照组.结论:血卟啉衍生物光动力作用具有诱导人肝癌细胞SMMC-7721凋亡的生物学效应,其作用机制可能与光动力作用抑制凋亡调控蛋白survivin表达,并直接或间接促进caspase-3的表达,从而促进细胞凋亡.     

具有自噬抑制作用的卟啉金属有机框架的制备及其光动力癌症治疗的研究*

光动力疗法(PDT)具有微创、可控、低毒、可重复治疗等优点,已成为临床医学中不可缺少的治疗手段。但由于肿瘤细胞的自我保护机制,大大降低了PDT疗效。使用PDT治疗方法的同时实施药理自噬抑制策略,切断因光动力治疗下严重氧化损伤下的保护性自噬。通过油浴加热法合成卟啉金属有机框架PCN-224,并在PCN-224上负载自噬抑制剂硫酸羟氯喹(HCQ),通过扫描电子显微镜(SEM)、粒径测试(DLS)、紫外可见光谱测试等方法检测,结果表明成功地合成了该材料,增强了卟啉光敏剂的水溶性,并且光照后对4T1小鼠乳腺癌细胞毒性明显增强,且装载了HCQ后进一步提高了肿瘤杀伤能力。     

Direct observation of singlet oxygen production by merocyanine 540 associated with phosphatidylcholine liposomes

The production of singlet molecular oxygen (1O2) by the photosensitizing dye merocyanine 540 (MC540) bound to phosphatidylcholine liposomes has been demonstrated by direct detection of 1O2 luminescence at 1268 nm. 1O2 phosphorescence emission was enhanced in deuterated buffer and upon saturation of the sample with oxygen and could be quenched by the addition of sodium azide to the external medium. No 1O2 luminescence was detected in nitrogen-saturated samples, in the absence of dye, or with MC540 in aqueous solution. Photobleaching of liposome-bound MC540 was also observed to be dependent on oxygen concentration. These studies are consistent with 1O2 intermediacy in the mechanism of MC540-mediated photosensitization.     

Photosensitized formation of singlet oxygen in water solutions of covalent porphyrin-antibody conjugates

The effective photogeneration of singlet molecular oxygen (1O2) by porphyrins (coproporphyrin I; 2,4-bi (alpha-methoxyethyl) deuteroporphyrin IX and cyclopanten-coproporphyrin I) conjugated with antibodies (mouse monoclonal IgG and IgM and human gamma-globulin) have been observed with the direct luminescence method of 1O2 detection. Absolute quantum yields of 1O2 formation by the conjugates have been determined. The data suggest that porphyrin-antibody conjugates are promising for the use as drugs in photodynamic tumor treatment.     

An oxygen imaging system for medical applications: preliminary results.

The examination of functional processes in tissue is gaining importance in medical research. As a result the imaging and monitoring of biochemical parameters in vivo is the goal of many imaging methods. One key parameter in photodynamic therapy (PDT) is the molecular oxygen concentration. Two-dimensional monitoring of oxygen is demanded for PDT but has not yet been achieved. The use of optical methods provides a possible means of measuring molecular oxygen. The basis of this method is the measurement of the luminescence lifetime of a dye that is quenched by molecular oxygen. The molecular oxygen concentration can be monitored two-dimensionally by pixel-wise determination of the luminescence lifetime with a CCD-camera. A new O(2)-imaging system based on this principle is presented in this article. The dye Ru(bpy)(3)(2+) is quenched by molecular oxygen and was used in the first experiments with the system.     

UVA and endogenous photosensitizers--the detection of singlet oxygen by its luminescence

UVA irradiation (320-400 nm) comprises about 95 percent of incident midday solar ultraviolet irradiation. It penetrates skin much deeper than UVB irradiation. The absorption of UVA irradiation in endogenous chromophores frequently leads to the generation of reactive oxygen species such as singlet oxygen ((1)O(2)). (1)O(2) is an important biochemical intermediate in multiple biological processes. Beside other procedures, the direct detection of (1)O(2) by its luminescence is a powerful tool that helps to understand the generation of (1)O(2) during UVA exposure in solution, in vitro and in vivo. This article describes the endogenous photosensitizers, their ability to generate (1)O(2) under UVA irradiation, and the detection technology to visualize the action of (1)O(2).     

蛛网膜下腔移植脐血干细胞治疗一氧化碳中毒后迟发性脑病的临床研究

目的观察蛛网膜下腔途径移植脐血干细胞治疗一氧化碳中毒后迟发性脑病（DEACMP）的安全性及治疗效果。方法26例DEACMP患者,按治疗方式分两组,其中12例经脐血干细胞移植治疗为治疗组,14例经高压氧治疗为对照组,对每例患者在治疗前和治疗后进行MMSE评分、ADL评分及颅脑CT检查。所有患者连续随访1年,观察预后及有无不良反应。采用两样本t检验、方差分析及卡方检验进行统计学分析。结果治疗组患者在干细胞移植术中均无特殊不适感,术中及术后24h内生命体征平稳,无发热,无穿刺点感染、出血等,术后门诊随访,均未出现移植相关并发症。1年后治疗组患者MMSE评分为25．08±4．10,高于对照组11．7±10．33（t=4．199,P=0．0003）;治疗组ADL评分为93．33±13．37,高于对照组41．07±38．39（t=4．478,P=0．0002）,差异均有统计学意义。治疗组CT检查结果好转率为83．33％,对照组好转率为30．00％两组比较差异有统计学意义（Х^2=4．402,P=0．0359）;治疗组临床痊愈率为50．00％,对照组为7．69％,差异有统计学意义（Х^2=4．055,P=0．0442）;治疗组临床有效率为100．00％,对照组为50．00％差异有统计学意义（Х^2=5．866,P=0．0154）。结论脐血干细胞移植治疗DEACMP疗效优于高压氧治疗,是一种安全有效的生物治疗方法,应得到重视和深入的研究。     

Effects of scavengers of reactive oxygen and radical species on cell survival following photodynamic treatment in vitro: comparison to ionizing radiation

The effects of various scavengers of reactive oxygen and/or radical species on cell survival in vitro of EMT6 and CHO cells following photodynamic therapy (PDT) or gamma irradiation were compared. None of the agents used exhibited major direct cytotoxicity. Likewise, none interfered with cellular porphyrin uptake, and none except tryptophan altered singlet oxygen production during porphyrin illumination. The radioprotector cysteamine (MEA) was equally effective in reducing cell damage in both modalities. In part, this protection seems to have been induced by oxygen consumption in the system due to MEA autoxidation under formation of H2O2. The addition of catalase, which prevents H2O2 buildup, reduced the effect of MEA to the same extent in both treatments. Whether the remaining protection was due to MEA's radical-reducing action or some remaining oxygen limitation is unclear. The protective action of MEA was not mediated by a doubling of cellular glutathione levels, since addition of buthionine sulfoximine, which prevented glutathione increase, did not diminish the observed MEA protection. The hydroxyl radical scavenger mannitol also afforded protection in both kinds of treatment, but it was approximately twice as effective in gamma irradiation as in PDT. This is consistent with the predominant role of OH radicals in ionizing radiation damage and their presumed minor involvement in PDT damage. Superoxide dismutase, a scavenger of O2, acted as a radiation protector but was not significantly effective in PDT. Catalase, which scavenges H2O2, was ineffective in both modalities. Tryptophan, an efficient singlet oxygen scavenger, reduced cell death through PDT by several orders of magnitude while being totally ineffective in gamma irradiation. These data reaffirm the predominant role of 1O2 in the photodynamic cell killing but also indicate some involvement of free radical species.     

Prolonged lipid oxidation after photodynamic treatment. Study with oxidation-sensitive probe C11-BODIPY581/591

Photodynamic treatment (PDT) is an emerging procedure for the therapy of cancer, based on photosensitizers, compounds that generate highly reactive oxygen species on illumination with visible light. Photodynamic peroxidation of cellular lipids is a consequence of PDT associated with cytolethality. We used chloromethyl dichlorodihydrofluorescein diacetate and a novel fluorescent ratiometric oxidation-sensitive probe, C11-BODIPY581/591 (C11-BO), which reports on lipid peroxidation, for visualizing oxidative stress in cells subjected to PDT with a phthalocyanine photosensitizer Pc4. With C11-BO loaded into the cells before or immediately after PDT, we observed a prolonged oxidation, which continued up to 30 min after illumination. In contrast, H2O2 caused oxidation of C11-BO only when the cells were in direct contact with H2O2. PDT-induced oxidative stress was most pronounced in vesicular perinuclear organelles, most likely photodamaged lysosomes. We hypothesize that the lysosomal localization of the prolonged oxidative stress is a consequence of the presence of redox-active iron in lysosomes. In conclusion, we have found that oxidative stress induced in cells by PDT differs from one induced by H2O2 in respect of induction of prolonged oxidation of lipids.     

皮肤组织模型中吸收和散射系数对单线态氧发光特性的影响

构建由脂肪乳剂和墨水组成的皮肤组织模型,定量研究皮肤组织模型的吸收系数μa和散射系数μs对光敏化单线态氧(singlet oxygen,~1O_2)发光特性的影响。利用~1O_2发光检测系统测量含光敏剂四硫磺基酞菁氯化铝的皮肤组织模型分别在中心波长为1 230,1 270和1 310 nm处的时间分辨发光光谱,对扣除背景信号后的时间分辨~1O_2发光光谱进行积分和拟合,获得~1O_2发光积分强度以及激发三重态寿命τ_T和~1O_2寿命τ_D。结果表明在皮肤组织模型中,~1O_2发光积分强度随着μ_a和μ_s的增大而减小,μ_a对τ_T和τ_D没有影响。τ_T随着μs的增加而增加,τ_D随μ_s的增加先骤降而后缓慢上升。当μ_a1.5 mm~(-1)和μ_s32 cm~(-1)时,~1O_2发光积分强度和τ_T、τ_D均趋于稳定,其中τ_T和τ_D分别为3.4±0.6μs和3.3±0.7μs。     

线粒体呼吸链与活性氧

已知有氧真核生物细胞吸收的氧分子绝大部分都是在线粒体呼吸链末端细胞色素氧化酶上通过四步单电子还原生成水。但同时也有1％-2％的氧可在呼吸链中途接受单电子或双电子被部分还原生成超氧（O2·^-和过氧化氢（H2O2）作为呼吸作用的正常代谢产物。此种来源于线粒体呼吸链的O2·^-和H2O2不但在多种病理的氧化损伤中起关键作用,同样它们也是正常生理条件下对多种细胞过程具有基本调控意义的氧还信号。基于Chance实验室约自20世纪70到90年代的早期研究贡献以及20世纪90年代后其他各实验室的研究新进展,我们聚焦于下述四个相关问题的评述和讨论：（1）由于线粒体内膜面积及其含有的呼吸链复合体酶活力远远高出细胞中所有膜系数量和相关酶活力之总和,因而线粒体呼吸链产生的O2·^-和H2O2构成生物体内最大数量ROS的恒定来源;（2）线粒体呼吸链复合体III的Q循环中Qo位点中半醌自由基（UQH·）已明确是O2·^-的单电子来源;还原细胞色素C-P66^SHC是生成H2O2的双电子供体。虽然复合体I也是产生线粒体基质内O2·^-的主要来源,但由于其确切生成位点尚未明确,在invivo条件下能否产生大量O2·^-也尚有争议;（3）线粒体呼吸链产生O2·^-后的分配和跨膜转移涉及其生理病理作用机制和作用靶点等复杂而重要的问题,直到目前尚未意见一致。“质子和O2·^-循环双回路解偶联模型”整合了目前提出的几种假说的联系点,指出H^＋和O2·^-相互作用生成HO2·及其跨膜很可能是这一复杂问题的中心环节,并与O2·^-对“脂肪酸shuttling model”或O2·^-对“UCPS激活”模型形成了内在的联系;（4）线粒体呼吸形成的△P（△ψ和△pH）能直接控制呼吸链的ROS生成,并以非线性（非欧姆）相关方式通过影响Q循环中的Qo半醌的氧还态和寿命来调节O2·^-生成的急速?