Abstract
Photodynamic therapy (PDT) has emerged as a potential therapeutic option for most localized cancers. Its high measure of specificity and minimal risk of side effects compared to other therapies has put PDT on the forefront of cancer research in the current era. The primary cause of treatment failure and high mortality rates is the occurrence of cancer resistance to therapy. Hence, PDT is designed to be selective and tumor-specific. However, because of complex biological characteristics and cell signaling, cancer cells have shown a propensity to acquire cellular resistance to PDT by modulating the photosensitization process or its products. Fortunately, nanotechnology has provided many answers in biomedical and clinical applications, and modern PDT now employs the use of nanomaterials to enhance its efficacy and mitigate the effects of acquired resistance. This review, therefore, sought to scrutinize the mechanisms of cellular resistance that affect the therapeutic response with an emphasis on the use of nanomaterials as a way of overriding cancer cell resistance. The resistance mechanisms that have been reported are complex and photosensitizer (PS)-specific. We conclude that altering the structure of PSs using nanotechnology is an ideal paradigm for enhancing PDT efficacy in the presence of cellular resistance.
Highlights
The rapid effort in the search for new cancer therapies has in recent years, made a significant impact in cancer and biomedical research
Certain metal NPs, especially FeNPs, discussed in Section 3.1.2 above, have a lethal effect on the immune system [116]. These NPs are toxic to cells of the immune system and suppress the function of human T lymphocytes. They are suggested as a potential compound in the attenuation of resistance due to modulation of autophagy, their use in Photodynamic therapy (PDT) needs to be assessed with more focus given to the option of using them in drug delivery systems (DDS) to direct them to the targeted cancerous tissues using monoclonal antibodies or other targeting molecules
We examined the mechanisms of PDT and the acquisition of resistance to PDT
Summary
The rapid effort in the search for new cancer therapies has in recent years, made a significant impact in cancer and biomedical research. Numerous therapeutic options, including hormone therapies, gene expression modulators, immunotherapies, apoptosis inducers, angiogenesis inhibitors, hormone therapies, signal transduction inhibitors, therapeutic vaccines, and gene therapy, have been employed for treating different cancers, which have shown improved cancer therapy and prognosis [1,2,3] Another benefit from the field of cancer research is the advent of therapies with an interdisciplinary approach involving a close-fitting association between complex processes in biology, biophysics, and biochemistry, which aim at achieving targeted tumor eradication. Photodynamic therapy (PDT) is one example where a complex interplay between all these scientific domains is applied It employs the use of two individually distinct elements, i.e., a photoactivatable drug called a photosensitizer (PS) and light, especially from lasers, to achieve one purpose [5]. This review, sought to examine the cellular resistance patterns in PDT and the use of nanotechnology to discourse at great length on the biochemical and biological interplays that affect the therapeutic responses
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