Photoactivation of phthalocyanine-loaded low density lipoproteins induces a local oxidative stress that propagates to human erythrocytes: protection by caffeic acid

Toxic effects imposed to human erythrocytes by low density lipoproteins carrying phthalocyanines used in photodynamic therapy (PDT) of tumors are described. This study was aimed at evaluating cytotoxic effects induced by reactive species produced locally in photosensitizer-loaded lipoproteins and further transferred to the cells. The experimental set up designed to examine these interactions starts with the loading of human plasma with the photosensitizer, the subsequent rapid purification and dialysis of the LDL fraction and incubation with human erythrocytes. This experimental model was assessed by following leakage of endogenous K+ from cells, electrochemical detection of oxygen, spectroscopic determination of conjugated dienes, phthalocyanine, SH groups and hemoglobin, analysis of fatty acids by gas chromatography and identification of a-tocopherol by HPLC. Photosensitizer-loaded lipoproteins become more susceptible to oxidation, exhibiting shorter lag phases of lipid oxidation, higher rates of oxidation and increased loss of endogenous alpha-tocopherol when challenged with peroxyl radicals and copper, as compared with native lipoproteins from the same plasma sample. Incubation of photosensitized lipoproteins with erythrocytes under light (>560 nm) results in a sigmoidal efflux of K+ followed by hemolysis. The phenolic antioxidant caffeic acid inhibits lipoprotein oxidation induced by peroxyl radicals, either in native or photosensitizer-loaded fractions, delays hemolysis of erythrocytes and partially prevents membrane loss of SH groups in ghosts, but not the efflux of K+. Mechanistically, a chain lipid peroxidation reaction does not participate in the toxic effects to cells but a specific pool of membrane SH groups sensitive to caffeic acid is likely to be involved. This study suggests that an oxidative stress occurring locally in phthalocyanine-loaded low density lipoproteins may further induce cytotoxic effects by targeting specific SH groups at the cell membrane level. The physiological relevance of these findings and the beneficial use of antioxidants are discussed in the context of PDT.