Meta-tetra Hydroxyphenyl Chlorin Research Articles

De rol van fotodynamische therapie bij de behandeling van het stadium I en II lipcarcinoom

In this research project the outcomes of photodynamic therapy for the treatment of stage I and II carcinoma of the lip are presented. Retrospectively, 15 patients diagnosed with a primary stage I or II lip carcinoma and treated with meta-tetra hydroxyphenyl chlorin mediated photodynamic therapy were evaluated. The primary outcome measure was disease free survival; the secondary outcome measure was the functional and aesthetic outcome after treatment. A total of 16 primary lip carcinomas were evaluated (75% stage I; 25% stage II). In 94% of the primary lip carcinomas, photodynamic therapy led to a complete remission after a variable follow-up of 14 months to 11 years. The functional and aesthetic long-term outcomes were considered excellent. Photodynamic therapy for the treatment of stage I and II lip carcinoma has a disease free survival rate comparable to surgery or radiotherapy and has outstanding functional and aesthetic outcomes.

Photochemical internalization (PCI)-mediated enhancement of bleomycin cytotoxicity by liposomal mTHPC formulations in human head and neck cancer cells.

Photodynamic therapy (PDT) with photosensitizers that locate in endocytic vesicles of cancer cells can be exploited to promote the intracellular release of anticancer drugs entrapped in endolysosomal vesicles. This new approach is commonly referred to as Photochemical Internalization (PCI). Here we report on the PCI effects of three different formulations (Foscan, Foslip, and Fospeg) of the clinically approved photosensitizer, meta-tetrahydroxyphenyl chlorin (mTHPC) on the anticancer drug bleomycin (BLM) in the head and neck cancer cell lines. Uptake and localization of Foscan, Foslip, and Fospeg in head and neck cancer cells were evaluated by fluorescence spectrophotometry and fluorescence microscopy. Photodynamic efficacy of Foscan, Foslip, and Fospeg were compared with cell proliferation assay. Moreover, PCI effects of Foscan, Foslip, and Fospeg on BLM were compared using protocols in which PDT was applied after or before BLM treatment. Cellular uptake of Foscan, Foslip, and Fospeg increased in a dose-dependent fashion with consistent higher uptakes of Foslip and Fospeg than Foscan. Fluorescence microscopy showed diffuse intracellular localization pattern for Foscan, Foslip, and Fospeg similar to that of a specific ER probe. However, the subcellular localization pattern of the Rhodamine-labelled same type of pegylated liposomes as Fospeg was similar to that of a specific endolysosomal probe, suggesting that Fospeg uptake appeared to initially proceed via endolysosomal trafficking. Foscan, Foslip, and Fospeg showed no apparent PCI-mediated cytotoxicity when PDT was performed after BLM treatment. However, significantly increased cytotoxicity of BLM (P < 0.05) was observed for both Foslip and Fospeg when PDT was performed before BLM treatment. The observed differences of PCI-mediated cytotoxicity between these two timing protocols appears to be related to the differential intracellular trafficking and localization of Foscan, Foslip, and Fospeg. Liposomal formulations of mTHPC may be candidates for developing mTHPC-based PCI protocols to enhance the efficacy of anticancer drugs entrapped in endolysosomal vesicles.

Meta-tetrahydroxyphenyl chlorine mediated photodynamic therapy inhibits the migration and invasion of a nasopharyngeal carcinoma KJ-1 cell line

Different photosensitizer-mediated photodynamic therapy (PDT) has different intracellular cytotoxic cascades. Previous reports showed that 5-aminolevulinic acid (5-ALA)-mediated PDT suppressed the migration and invasion of head and neck cancer cells. Unlike from 5-ALA, which mainly targets the mitochondria of cells, meta-tetrahydroxyphenyl chlorin (m-THPC) mainly accumulates in the endoplasmic reticulum and Golgi complex. Does m-THPC PDT inhibit the migration and invasion of cancer cells? The effect of m-THPC PDT with a sublethal dose sufficient to kill around 20% of cells on the migration and invasion of a nasopharyngeal carcinoma KJ-1 cell line was studied by wound healing and Matrigel invasion assays. In the wound healing assay, the migration distance of KJ-1 cells decreased significantly from 0.71 ± 0.02 mm in the control cells to 0.31 ± 0.03 mm in the PDT-treated cells 24 hours after light treatment (p < 0.05) and the migration distance also decreased significantly from 1.02 ± 0.07 mm in the control cells to 0.32 ± 0.04 mm in the PDT-treated cells 48 hours after treatment (p < 0.05). In the Matrigel invasion assay, the number of the invaded KJ-1 cells in PDT treated group was also statistically significantly less than those without PDT treatment (p < 0.05). This study demonstrates that a sublethal dose of m-THPC PDT inhibits the migration and invasion of nasopharyngeal carcinoma cells in vitro.

Inhibition of Specific Cellular Antioxidant Pathways Increases the Sensitivity of Neurons to Meta‐tetrahydroxyphenyl Chlorin‐Mediated Photodynamic Therapy in a 3D Co‐culture Model

The effect of photodynamic therapy (PDT) on neurons is of critical importance when treating cancers within or adjacent to the nervous system. Neurons show reduced sensitivity to meta-tetrahydroxyphenyl chlorin (mTHPC) mediated PDT, so the aim of this study was to investigate whether neuron sparing is due to endogenous cellular antioxidant activity. Dorsal root ganglion (DRG) neurons and their associated satellite glia were subjected to mTHPC-PDT in a 3D co-culture system following incubation with antioxidant inhibitors: diethyl dithiocarbamate (DDC, SOD-1 inhibitor), 2-methoxyestradiol (2-MeOH(2), SOD-2 inhibitor) and L-buthionine sulfoximine (L-BSO, glutathione synthase inhibitor). Sensitivity of each cell type was assessed using a combination of live/dead staining and immunofluorescence. Pretreatment with DDC and with L-BSO significantly increased the sensitivity of neurons to mTHPC-PDT and also affected satellite glial cell viability, whereas 2-MeOE(2) caused only a small increase in neuron sensitivity (not significant). Pretreatment using a combination of DDC and L-BSO caused a near total loss of neuron and glial cell viability in treatment and control conditions. These findings suggest that the SOD-1 and glutathione pathways are likely to be involved in the neuronal sparing associated with mTHPC-PDT.

Meta-tetra(hydroxyphenyl)chlorin-loaded liposomes sterically stabilised with poly(ethylene glycol) of different length and density: characterisation, in vitro cellular uptake and phototoxicity

We studied the effects of density and thickness of PEG coating on in vitro cellular uptake, and dark- and photo-toxicity of liposomal formulations (Fospeg) of the photodynamic agent meta-tetrahydroxyphenyl chlorin (m-THPC). The cellular uptake of various Fospeg formulations was determined by flow cytometry in CCD-34Lu human normal fibroblasts and A549 lung cancer cells. Dark and light-induced cytotoxicity was measured by MTS assay after exposure to increasing concentrations of Fospeg only and followed by irradiation with red light. Intracellular localization of m-THPC delivered by Fospeg was determined by fluorescence microscopy. The studies were carried out in comparison with m-THPC delivered by the standard solvent. In the dark all Fospeg formulations were less cytotoxic than m-THPC in standard solvent (ethanol/poly(ethylene glycol 400/water; 20 : 30 : 50 by vol.) and cytotoxicity decreased by increasing PEGylation. m-THPC delivered as Fospeg was internalised by endocytosis and localised mainly in the Golgi apparatus and endoplasmic reticulum. The efficiency of cellular uptake of Fospeg was reduced by 30-40% with respect to m-THPC in standard solution causing a slight reduction of the phototoxicity but without serious impairment of the efficacy of the treatment. Our study suggests that PEGylated liposomes are promising nanocarriers for the delivery of photosensitisers for photodynamic therapy because they reduce dark cytotoxicity while preserving therapeutic efficacy.

Peripheral neural cell sensitivity to mTHPC-mediated photodynamic therapy in a 3D in vitro model

Background:The effect of photodynamic therapy (PDT) on neural cells is important when tumours are within or adjacent to the nervous system. The purpose of this study was to investigate PDT using the photosensitiser, meta-tetrahydroxyphenyl chlorin (mTHPC), on rat neurons and satellite glia, compared with human adenocarcinoma cells (MCF-7).Methods:Fluorescence microscopy confirmed that mTHPC was incorporated into all three cell types. Sensitivity of cells exposed to mTHPC-PDT (0–10 μg ml–1) was determined in a novel 3-dimensional collagen gel culture system. Cell death was quantified using propidium iodide and cell types were distinguished using immunocytochemistry. In some cases, neuron survival was confirmed by measuring subsequent neurite growth in monolayer culture.Results:MCF-7s and satellite glia were significantly more sensitive to PDT than neurons. Importantly, 4 μg ml–1 mTHPC-PDT caused no significant neuron death compared with untreated controls but was sufficient to elicit substantial cell death in the other cell types. Initially, treatment reduced neurite length; neurons then extended neurites equivalent to those of untreated controls. The protocol was validated using hypericin (0–3 μg ml–1), which caused neuron death equivalent to other cell types.Conclusion:Neurons in culture can survive mTHPC-PDT under conditions sufficient to kill tumour cells and other nervous system cells.

Comparative characterization of the efficiency and cellular pharmacokinetics of Foscan®- and Foslip®-based photodynamic treatment in human biliary tract cancer cell lines

Due to the poor prognosis and limited management options for perihilar cholangiocarcinoma (CC) the development of alternatives for treatment is an important topic. Photodynamic therapy (PDT) with porfimer as palliative or neoadjuvant endoscopic treatment of non-resectable perihilar CC has improved quality of life and survival time, but cannot eradicate the primary tumors because of inadequate tumoricidal depth (4 mm only around the tumor stenoses). The use of meta-tetrahydroxyphenyl chlorin (mTHPC) and photoactivation at higher wavelengths (650-660 nm) provides high tumoricidal depth (10 mm) for PDT of pancreatic cancer and should yield similar tumoricidal depth in CC. This study investigates the photodynamic characteristics of mTHPC in solvent-based formulation (Foscan) and in liposomal (water soluble) formulation (Foslip) in an in vitro model system consisting of two biliary cancer cell lines (GBC, gall bladder cancer and BDC, bile duct cancer cells). Dark toxicity, photodynamic efficiency, time-dependent uptake and retention and intracellular localization of Foscan and Foslip were studied. The results prove mTHPC as a potent photosensitizing agent with high phototoxic potential in biliary cancer cells as a concentration of 600 ng ml(-1) and irradiation with 1.5 J cm(-2) (660 +/- 10 nm) is sufficient for about 90% cell killing. Addition of foetal bovine serum (FBS) to the incubation medium and analysis of the uptake and phototoxic properties reveals that both photosensitizer formulations bind to serum protein fractions, i.e. no difference between Foscan and Foslip can be found in the presence of FBS. Laser scanning fluorescence microscopy indicates a similar pattern of perinuclear localization of both sensitizers. This study demonstrates the potential of mTHPC for treatment of bile duct malignancies and provides evidence that Foslip is an equivalent water-soluble formulation of mTHPC that should ease intravenous application and thus clinical use of mTHPC.

Identification and Partial Characterization of an Unusual Distribution of the Photosensitizer meta-Tetrahydroxyphenyl Chlorin (Temoporfin) in Human Plasma

Abstract— Temoporfin (m-THPC) is an extremely powerful photosensitizing drug, more than 100-fold more photocytotoxic than Photofrin and many other drugs. The reasons for this are not yet known but are likely to be associated with the mechanism of uptake of the drug and its intratumoral and intracellular localization. Uptake itself is likely to be dependent upon the plasma binding of the drug following administration. In the current work, we have shown that the addition of m-THPC to human plasma in vitro at clinically relevant doses of sensitizer and administration solvent (diluant) gives rise to a protein-binding pattern quite different to that of Photofrin and other hydrophobic drugs as judged by density-gradient ultra centrifugation. Analysis of the binding immediately after addition to human plasma has shown that lipoprotein binding accounts for only a minor proportion of the sensitizer, which is mainly associated with a high-density protein fraction that is not coincident with serum albumin. The m-THPC protein complex does not fluoresce significantly even on dilution. This binding pattern is highly dependent on administration conditions and storage. Over a period of 6–8 h at 37°C the m-THPC that is associated with this unidentified fraction redistributes to the plasma lipoproteins. Plasma collected from rats after intravenous administration of m-THPC also contains this low fluorescent complex, showing that this phenomenon is not limited to human plasma and also occurs in vivo. It is postulated that the m-THPC bound to the unknown protein fraction is highly aggregated and that it is likely to be taken up into tissues in this form. This unusual uptake may possibly be associated with the very high activity of m-THPC and also to the recent finding of a second peak in the plasma pharmacokinetics of the drug.

New photosensitizers for photodynamic therapy in gastroenterology.

Most applications of photodynamic therapy (PDT) in gastroenterology to date have used porfimer sodium as the photosensitizing agent. For destroying small lesions in the wall of the gastrointestinal tract in inoperable patients, it has proved to be most effective, but attempts to achieve circumferential mucosal ablation, as in the treatment of Barrett's esophagus, have led to a high incidence of strictures, and all patients have cutaneous photosensitivity, which can last up to three months. Two new photosensitizers are of particular interest to gastroenterologists. PDT with metatetrahydroxyphenyl chlorin produces a similar biological effect as PDT with porfimer sodium, but the light doses required are much smaller, and cutaneous photosensitivity lasts only two to three weeks. Further, it can be used with percutaneous light delivery to destroy localized pancreatic cancers. The photosensitizing agent 5-amino levulinic acid, converted in vivo into the photoactive derivative protoporphyrin IX, sensitizes the mucosa much more than the underlying layers. This makes it feasible to destroy areas of abnormal mucosa without damaging the underlying muscle and is, therefore, better for treating Barrett's esophagus. Detailed clinical studies are required to establish the real role of PDT with the use of these and other new photosensitizers.

Photodynamic therapy using mTHPC for malignant disease in the oral cavity.

Photodynamic therapy (PDT) produces local tumor necrosis, on activation of a previously administered sensitizer with non-thermal light of an appropriate wavelength. It is attractive for treating tumors of the mouth as tissue healing is particularly good. We describe the use of the photosensitizing agent meta tetrahydroxyphenyl chlorin (mTHPC, Foscan) for PDT of oral cancer, including patients with field cancerization. Nineteen patients with histologically confirmed oral cancer (8 with field change disease) and one with severe dysplasia, were sensitised with mTHPC intravenously. Activation was carried out 72-96 hr later with laser light at 652 nm using a range of light doses. The results were assessed clinically and histologically. Multiple biopsies were taken during the ulcerative stages to look at the effects of PDT and after healing to assess the overall treatment result. All single lesions up to stage T3 cleared after one PDT treatment (total of 6 patients). Three out of 6 T4 tumours were also cleared. Lesions in patients with field change disease did less well, only 9 of 14 T1 and T2s clearing, including 4 that required extra treatments with a higher light dose. Most healed very well, but tongue tethering was seen in 1 patient and another had necrosis in normal areas due to light scattering within the mouth. PDT using mTHPC is a promising new treatment for patients with oral cancer.

Photodynamic therapy using mTHPC for malignant disease in the oral cavity

Photodynamic therapy (PDT) produces local tumor necrosis, on activation of a previously administered sensitizer with non-thermal light of an appropriate wavelength. It is attractive for treating tumors of the mouth as tissue healing is particularly good. We describe the use of the photosensitizing agent meta tetrahydroxyphenyl chlorin (mTHPC, Foscan®) for PDT of oral cancer, including patients with field cancerization. Nineteen patients with histologically confirmed oral cancer (8 with field change disease) and one with severe dysplasia, were sensitised with mTHPC intravenously. Activation was carried out 72–96 hr later with laser light at 652 nm using a range of light doses. The results were assessed clinically and histologically. Multiple biopsies were taken during the ulcerative stages to look at the effects of PDT and after healing to assess the overall treatment result. All single lesions up to stage T3 cleared after one PDT treatment (total of 6 patients). Three out of 6 T4 tumours were also cleared. Lesions in patients with field change disease did less well, only 9 of 14 T1 and T2s clearing, including 4 that required extra treatments with a higher light dose. Most healed very well, but tongue tethering was seen in 1 patient and another had necrosis in normal areas due to light scattering within the mouth. PDT using mTHPC is a promising new treatment for patients with oral cancer. Int. J. Cancer 73:25–32, 1997. © 1997 Wiley-Liss, Inc.

Expression of the collagen-related heat shock protein HSP47 in fibroblasts treated with hyperthermia or photodynamic therapy.

Heat shock protein (HSP) 47 is associated with collagen type I metabolism, both constitutively and after stress-inflicted injury. It has been claimed that, in contrast to hyperthermia (HT), photodynamic therapy (PDT) does not damage collagen, as measured at the level of tissue. We have studied HSP47 expression in normal murine skin fibroblasts (3T6) treated with hyperthermia or photodynamic therapy (PDT) mediated by three different photosensitizers: (1) haematoporphyrin ester (HpE), (2) meta tetra hydroxyphenyl chlorin (mTHPC) and (3) riboflavin (RB). Riboflavin is not an established photosensitizer for PDT and was chosen here because it is known to provoke collagen damage. The applied doses of the treatments were isoeffective in terms of 3T6 clonogenic cell survival. Analysis, at both transcriptional and translational levels, revealed HSP47 elevation after hyperthermia and after PDT with RB. PDT sensitized by HpE and mTHPC did not significantly alter HSP47 expression. These observations are consistent with our hypothesis that this collagen chaperone is up-regulated by laser-mediated modalities known to damage collagen (i.e. HT and RB PDT) but not by more conventional PDT treatments. Additionally, unexpected significant up-regulation of HSP47 was detected after illumination alone (no photosensitizer) of 3T6 cells at 653 nm laser light, but not at 630 nm.