CC BY
12DOI 10.24412/cl-37136-2023-1-53-54
ENHANCED PHOTODYNAMIC THERAPY BUHONG LI YI SHEN2 AND XUEJIAO SONG3
1School of Science, Hainan University, China
2Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Normal
University, China
3Key Laboratory of Flexible Electronics and Institute of Advanced Materials, Nanjing Technology University, China
ABSTRACT
Photodynamic therapy (PDT), a minimally invasive therapeutic modality, utilizes photosensitizes (PSs) together with irradiation light of specific wavelength interacting with molecular oxygen in tissue to generate cytotoxic reactive oxygen species (ROS), thereby destroying malignant and nonmalignant diseases. Most recently, the applications of PDT have been extended to the treatment of anti-microbial infections, such as bacterial, fungal and virus. For clinical PDT, PS, light and oxygen are the three important components for effective photodynamic activity.
Firstly, several novel PSs, including C60, black phosphorus, graphene quantum dots and PSs with aggregation-induced emission, have been developed to improve the quantum yield of singlet oxygen. The delivery efficiency of PSs has been improved by the different PS delivery strategies and the tumor-microenvironment-responsive release scheme. The absorption of PSs has been enhanced by organelle targeting and photochemical internalization, while the hypoxia resistance of PSs has been resolved through loading with oxygen carriers or oxygen-generating reactants. Moreover, the development of PSs with synergistic therapeutic function will be used to further enhance PDT efficacy.
Secondly, solar light, broad-spectrum lamps, lasers, light-emitting diodes (LEDs), X-ray sources, ultrasonic sources and in vivo self-excited light sources capable of bioluminescence, chemiluminescence and Cherenkov light, have been widely studied as PDT excitation sources. In clinical practice, LEDs and lasers are the most popular light sources. In particular, wearable, implantable, and disposable PDT light sources have greatly progressed through the development of inorganic LED array, flexible LEDs, and wireless driven LEDs. In vivo self-excited light source has been studied to avoid the absorption and scattering of light by biological tissues. Additionally, to ensure the oxygen supply during PDT treatment, new illumination schemes of light fractionation PDT and metronomic PDT have been proposed.
Moreover, oxygen carrier with strong oxygen storage capacity or the chemical reaction substance could be delivered to the target lesion for in situ oxygen generation, which is the most popular methods to enhance the oxygen supply for PDT. In addition, hypoxia-activated linkers or prodrugs have been applied to compensate for the low efficacy caused by hypoxia. Meanwhile, the reduction of oxygen consumption during PDT could be achieved by limiting certain oxygen-consuming intracellular chemical reactions or reducing oxygen dependence by using type I or type III PDT.
Finally, PDT has been combined with clinical surgery, radiotherapy, chemotherapy, photothermal therapy, sonodynamic therapy, magnetic hyperthermia and immunotherapy in order to improve the therapeutic efficacy. In addition, Multi-modes for synergistic treatment with PDT will be presented. Meanwhile, the simultaneous employment of two PSs targeting at different subcellular organelle also employed to improve PDT efficacy.
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