光动力疗法中氧的弥散模型仿真及其意义

组织中的氧是由血管中扩散而来,存在一定的差异。光动力疗法使用的卟啉类光敏剂主要是通过将能量转移到氧分子产生单线态氧来产生毒性物质,因此在光动力治疗中有氧的消耗,使组织中氧分布对光动力作用具有特殊意义。本文对氧在靶组织和正常组织中的分布、光动力效应对组织中氧含量的影响、以及氧含量对光动力效应的反作用等方面进行了综述。     

Tumor PO(2) changes during photodynamic therapy depend upon photosensitizer type and time after injection

In this study, the vascular and tissue oxygen changes induced by photodynamic therapy in the RIF-1 tumor were examined, using electron paramagnetic resonance (EPR) oximetry. Two photosensitizers, including verteporfin (BPD-MA in a lipid-based formulation) and aminolevulinic acid-induced protoporphyrin IX (ALA-PPIX), were investigated with optical irradiation, sufficient to induce sub-curative damage in the tumor tissue, and the transient changes in PO(2) and vascular perfusion were examined. A large increase in tissue oxygenation (from 3 up to 9.5 mmHg) was observed when treated with ALA-PPIX based photodynamic therapy, which lasted during the treatment and a small residual increase that returned back to baseline levels by 48 h after treatment. With verteporfin-based photodynamic therapy, one group of animals was irradiated 15 min after injection and exhibited a small decrease in oxygenation relative to pre-irradiation levels. The second group was irradiated at 3 h after injection and exhibited a large increase in the average PO(2), (from 3 to 15 mmHg) by the end of the treatment. These observations indicate that photodynamic therapy significantly increases tissue PO(2) under certain treatment conditions, with the potential cause being either increased local blood flow or decreased local oxygen metabolic consumption due to cellular damage.     

Dosimetry in photodynamic therapy: oxygen and the critical importance of capillary density.

Recently published results of tumor response to various photoradiation protocols in photodynamic therapy appear to contradict accepted definitions of photodynamic dose. In this report, the failure of standard dosimetry models to predict therapeutic outcome is interpreted on the basis of PDT-induced oxygen consumption in tumors with relatively low capillary densities. Calculated estimates of oxygen consumption in photodynamic therapy are combined with the Krogh cylinder model of oxygen diffusion. It is shown that, for tissue volumes in which the intercapillary spacing is less than a specific critical distance, oxygen may be considered constant and unaffected by the therapy. Under these conditions, the 1O2 delivered to a given volume of tissue is spatially uniform and proportional to the number of photons absorbed by the sensitizer. When the intercapillary spacing exceeds the critical distance, the dose of 1O2 varies with radial distance from the capillary wall. In this situation, dose may no longer be considered simply in terms of the product of the photon fluence and the sensitizer absorption coefficient. Since fractionation will increase the 1O2 dose only to cells relatively remote from the capillary wall, the analysis further suggests that fractionating the radiation dose should result in an improved therapeutic ratio for photodynamic therapy.     

藻蓝蛋白亚基脂质体光动力学抗乳腺癌细胞的实验研究

目的:研究PEG修饰的藻蓝蛋白亚基光敏剂长循环脂质体介导的光动力疗法抗乳腺癌的效果.方法:采用薄膜水合-超声分散法制备PEG修饰的藻蓝蛋白亚基脂质体(PEG-PCS-lip),MTT法检测藻蓝蛋白亚基脂质体对MCF-7(人乳腺癌细胞)、MA-782(鼠乳腺癌细胞)的光动力杀伤效果,流式细胞术(FCM)分析其对肿瘤细胞周期的影响,并对乳腺癌模型鼠做PDT治疗.结果:PEG-PCS-lip介导的PDT作用对乳腺癌细胞有良好的光动力疗效,对MCF-7及MA-782细胞IC_(50)(半数抑制浓度)分别为68 μg/mL、70 μg/mL;FCM的结果显示,当PEG-PCS-lip 浓度为50 μg/mL时,MCF-7凋亡率约为30.5 %; 用10 mg/kg PEG-PCS-lip静脉注射荷瘤小鼠,光照剂量为208.2 J/cm~2时,其抑瘤率可达到72 %;组织切片观察PDT作用后的肿瘤组织,瘤体中间以细胞凋亡为主,瘤体外周以细胞坏死为主,由血管损伤而形成的空腔增多.结论:PEG-PCS-lip在体外对乳腺癌细胞有良好的光动力杀伤效果,肿瘤细胞凋亡及瘤血管破坏是导致肿瘤细胞死亡的主要原因.     

光动力治疗中光的有效吸收光剂量及其确定

光动力治疗中真正有效的光剂量是达到病变组织并且被组织中的光敏剂所吸收的那部分剂量,即有效吸收光剂量。明确组织中的有效吸收光剂量可以指导临床治疗,从而避免治疗剂量不足(治疗不彻底)或剂量过量(造成正常组织的热损伤)。而确定PDT中光的有效吸收剂量时,需测定组织中考察点的光辐射能流率。在目前计算和模拟组织中光辐射能流率的方法中,都需要首先确定所研究组织的光学特性参数。本文概述了常用的测定组织中光辐射能流率及组织光学特性参数的测量方法。     

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．     

Current trends in photodynamic therapy of neoplasms and non-neoplastic diseases

The photodynamic therapy of tumors is a modern therapeutic modality for organ-preserving treatment of oncological diseases. The method is based on selective laser irradiation of tumor tissues previously sensitized by tumorotropic dyes. During the last decades, photodynamic therapy has become worldwide known as a proper approach to the treatment of the patients with malignant tumors of various locations and a number of nontumoral diseases. The characteristics of modern photosensitizers and light sources for photodynamic therapy and their clinical applications are reviewed.     

藻红蛋白光敏剂研究进展

光动力学治疗法作为一种新的肿瘤治疗方法,近年来发展十分迅速。从红藻中提取的藻红蛋白可以作为光动力学治疗法的一种新的光敏剂。本概述了我国红藻藻红蛋白资源概况、光疗法和光敏剂作用机理及其研究发展历史与现状,重点阐述了藻红蛋白光敏剂的应用现状、前景和发展趋势,并认为藻红蛋白是光动力学治疗法中一种非常有前景的光敏剂。藻红蛋白在490nm有吸收光谱,而发射光谱位于560nm;藻红蛋白能特异性地聚集在肿瘤细胞周围,吸收周围环境光能并传递给氧分子,使氧分子转化为具有强氧化性的多线态氧,从而可以大量杀死肿瘤细胞。     

Photodynamic Therapy Using Systemic Administration of 5-Aminolevulinic Acid and a 410-nm Wavelength Light-Emitting Diode for Methicillin-Resistant Staphylococcus aureus-Infected Ulcers in Mice

Bacterial resistance to antibiotics has become a worldwide problem. One potential alternative for bacterial control is photodynamic therapy. 5-aminolevulinic acid is a natural precursor of the photosensitizer protoporphyrin IX. Relatively little is known about the antibacterial efficacy of photodynamic therapy using the systemic administration of 5-aminolevulinic acid; a few reports have shown that 5-aminolevulinic acid exerts photodynamic effects on methicillin-resistant Staphylococcus aureus (MRSA) in vitro. In this study, we evaluated the effectiveness of photodynamic therapy using 5-aminolevulinic acid and a 410-nm wavelength light-emitting diode in vitro and in vivo for the treatment of MRSA. We found that 5-aminolevulinic acid photodynamic therapy with the light-emitting diode had an in-vitro bactericidal effect on MRSA. In vivo, protoporphyrin IX successfully accumulated in MRSA on ulcer surfaces after intraperitoneal administration of 5-aminolevulinic acid to mice. Furthermore, 5-aminolevulinic acid photodynamic therapy accelerated wound healing and decreased bacterial counts on ulcer surfaces; in contrast, vancomycin treatment did not accelerate wound healing. Our findings indicate that 5-aminolevulinic acid photodynamic therapy may be a new treatment option for MRSA-infected wounds.     

Oxidative damage induced by a novel porphyrin on rat brain mitochondria and its possible implications in therapy

Summary

Free radical-induced oxidative damage is involved in several pathological disorders. On the other hand, selective induction of peroxidation in diseased tissue is a promising approach to the treatment of cancer by photodynamic therapy. In this study we have used rat brain mitochondria as a model to evaluate the ability of a new water soluble porphyrin, 5,10,15,20-tetrakis[4-(carboxymethyleneoxy)phenyl]porphyrin (T4CPP), to induce peroxidative damage during photosensitization. Peroxidation in mitochondria, one of the crucial targets of the photodynamic effect, was assessed from the formation of thiobarbituric acid reactive substances and lipid hydroperoxides. The effect on mitochondrial function was estimated from the loss of a mitochondrial marker enzyme, succinate dehydrogenase (SDH). The photodamage was observed to be time- and concentration-dependent of T4CPP. Inhibition studies suggested involvement of singlet oxygen (¹O₂) and, to a lesser extent, of hydroxyl (OH), peroxyl (ROO^?) and superoxide radicals (O₂^?) in the photodamage. The addition of γ-linolenic acid (a promoter of lipid peroxidation) to the system led to an enhancement of the T4CPP-induced peroxidative damage. Thus, our study indicated that the combination of γ-linolenic acid and T4CPP could enhance the photodynamic effect and has potential applications in photodynamic therapy.     

Effect of curcumin-nanoemulsion associated with photodynamic therapy in breast adenocarcinoma cell line

Curcumin, a natural compound has several antineoplastic activities and is a promising natural photosensitizer used in photodynamic therapy. However, its low solubility in physiological medium limit the clinical use of curcumin. This study aimed to analyze the action of curcumin-nanoemulsion, a new and well-designed Drug Delivery System (DDS+) molecule, used as a photosensitizing agent in photodynamic therapy in an in vitro breast cancer model, MCF-7 cells. The empty nanoemulsion fulfils all necessary requirements to be an excellent DDS. Furthermore, the use of curcumin-nanoemulsion in photodynamic therapy resulted in a high phototoxic effect after activation at 440?nm, decreasing to <10% viable tumor cells after two irradiations and increasing the reactive oxygen species (ROS) production. The use of curcumin-nanoemulsion associated with photodynamic therapy resulted in an increase in the levels of caspase 3/7 activity for the studied MCF-7 cell model, indicating that this therapy triggers a cascade of events that lead to cell death, such as cellular apoptosis. In conclusion, curcumin-nanoemulsion proved to be efficient as a photosensitizing agent, had phototoxic effects, significantly decreased the proliferation of MCF-7 cells and stimulating the ROS production in combination with photodynamic therapy, so, this formulation has a great potential for use in treatment of breast cancer.     

在光动力疗法中应用的量子点

概述了现存的主要量子点的构成及其特点,阐述了量子点的性质主要由量子点的成分、结构、包覆和尺寸所决定。并重点讨论量子点在光动力疗法中,量子点直接代替传统光敏剂、量子点的荧光共振能量转移、量子点作为宽禁带半导体材料TiO2的敏化剂等三种不同应用中,对量子点的要求,通过讨论指出由于其特性,量子点将在光动力疗法中得到更广泛的应用,也对在光动力疗法中应用的量子点的毒性及其他可能产生的问题提出了展望。     

类风湿性关节炎的动物模型

本文对在光动力疗法治疗类风湿性关节炎的研究中有关的动物模型的制作、发病过程、病理、发病原因及应用作一系统论述。     

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.     

光敏剂特性影响光动力治疗鲜红斑痣的数学仿真研究

目的：通过建立光动力治疗鲜红斑痣中激光、光敏剂、氧的分布及其相互作用关系的数学模型,对表皮、真皮、血管中单线态氧的产生过程进行仿真,了解光敏剂的药代动力学和扩散特性对单线态氧产生的影响,进而了解光敏剂特性在光动力治疗鲜红斑痣中的作用和意义。方法：用’Monte Carlo方法描述光在组织中的分布;用药代动力学描述光敏剂在血管中的变化规律;用Fick定律描述光敏剂和氧在组织中的扩散和分布;用与氧含量有关的二级动力学描述光敏剂的漂白;用Lambert—Beer定律和单线态氧的量子产率来计算各层组织中单线态氧的产生。结果：光敏剂药代动力学的变化,使注射光敏剂后开始照光的时间对各层组织中单线态氧产量有明显的影响。光敏剂扩散特性的改变,对真皮和表皮中单线态氧的产生有较大影响,对血管中单线态氧的产生没有影响。结论：光敏剂的特性对光动力治疗鲜红斑痣有明显的影响,数学仿真能较全面地反应这种作用的特点和意义。     

Combined effects of radiotherapy and photodynamic therapy on an in vitro human prostate model

Human prostate cancer cells were evaluated for growth after photodynamic therapy, radiotherapy, and combined treatment. Indocyanine green was tested as a photosensitizer and radiosensitizer. Two human cell lines were used: PC-3 derived from prostate carcinoma, and EPN derived from normal prostate tissue. The light source used for the photoactivation experiments was a diode laser peaked at 805 nm. The light dose incident on cells was 108 J/cm(2). Ionizing radiation was produced by a linear accelerator, and the dose was 2, 4 and 6 Gy. Cytotoxicity was evaluated by measuring the colony forming ability of cells. Our results show that indocyanine green induces cell death by photoactivation, but it does not act as a radiosensitizer if used with ionizing radiation. The combined treatment of photodynamic therapy and radiotherapy produces an additive effect which does not depend on the sequence of the two treatments. Combined treatments could be more useful since they allow the reduction of the ionizing radiation dose to obtain the same effect as one obtainable by radiotherapy alone.     

Effect of chloroquine wash-out period of photosensitizers in the skin and selected organs in rats

In the last decade, photodynamic therapy has become an alternative method for the diagnosis and therapy of tumors. In human medicine hematoporphyrin derivatives, sulfonated hydrophilic meso-tetraphenylporphyrin (TPPS4) and an oligomer of hematoporphyrin (Photosan 3), are widely used. Chloroquine is used for the treatment of porphyria cutanea tarda for its power to release porphyrins from the liver tissue. The kinetics of two porphyrin photosensitizers TPPS4 and Photosan 3 in the skin and some organs as well as the effect of chloroquine on the porphyrin excretion and their accumulation in skin and organs of Wistar rats were studied. TPPS4 exhibited maximum fluorescence in skin 48 h after application with decreasing to basal level from the 8th to the 14th day. Maximum fluorescence was reached at 72 hours after Photosan 3 application and it decreased to basal level during 96 hours after application. TPPS4 caused significantly higher fluorescence compared to Photosan 3. Chloroquine after oral administration did not change the fluorescence of skin, but it significantly decreased the TPPS4 concentration in rat organs if chloroquine treatment started 3 days or 2 weeks after TPPS4 application. Chloroquine significantly decreased the serum TPPS4 concentration during the period of 28 days. Fluorescence of skin was significantly higher and lasted longer after application of TPPS4 compared to Photosan 3. Chloroquine after oral administration did not influence the fluorescence of the skin, but it significantly decreased the TPPS4 concentration in rat organs. This effect could be useful in photodynamic therapy for mobilizing exogenous porphyrins from tissues after parenteral photodynamic therapy.     

喜树碱聚前药纳米粒子包埋吲哚箐绿用于化疗与光动力联合抗肿瘤治疗

肿瘤单一药物化疗的效果往往达不到理想的肿瘤治疗效果,且容易导致耐药。因此,肿瘤的药物化疗与其他的抗肿瘤治疗方法,如光热治疗和光动力治疗等,联合治疗具有明显优势,并受到越来越多的关注。本工作构建了一种还原性响应的新型智能纳米体系,采用喜树碱聚前药两亲分子(PEG-b-PCPTM)物理包埋光敏剂吲哚箐绿(ICG)。在肿瘤细胞的还原性微环境中,控制释放化疗药物喜树碱,激活化疗;同时,光敏剂ICG用于光动力治疗,从而实现化疗与光动力的联合治疗,表现出良好的抗肿瘤活性。     

螺旋藻藻蓝蛋白光敏作用的研究进展

螺旋藻是一种广泛养殖的丝状体蓝藻。从螺旋藻中提取的藻蓝蛋白具有抗肿瘤和增强免疫等多种生物学功能,作为光敏剂,藻蓝蛋白可应用于肿瘤治疗。本文阐述了藻蓝蛋白的结构、光动力疗法的原理和藻蓝蛋白光敏作用的研究进展,并介绍了藻蓝蛋白在光动力疗法中的应用现状与前景。     

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.