In vivo monitoring of singlet oxygen using delayed chemiluminescence during photodynamic therapy

It is known that singlet oxygen ((1)O(2)) is the main factor mediating cytotoxicity in photodynamic therapy (PDT). The effectiveness of a PDT treatment is directly linked to the (1)O(2) produced in the target. Although the luminescence from (1)O(2) is suggested as an indicator for evaluating photodynamic therapy, the inherent disadvantages limit its potential for in vivo applications. We have previously reported that chemiluminescence can be used to detect (1)O(2) production in PDT and have linked the signal to the cytotoxicity. We further our investigation for monitoring (1)O(2) production during PDT. The lifetime of 3,7-dihydro-6-{4-[2-(N(')-(5-fluoresceinyl)thioureido)ethoxy]phenyl}-2-methylimidazo {1,2-a} pyrazin-3-one-chemiluminescence (FCLA-CL) is evaluated, and the results show that it is much longer than that of direct luminescence of (1)O(2). A gated measurement algorithm is developed to fully utilize the longer lifetime for a clean measurement of the CL without the interference from the irradiation light. The results show that it is practically feasible to use the technique to monitor the (1)O(2). Compared to the direct (1)O(2) luminescence measurement, our new technique is sensitive and can be realized with a conventional optical detector with excellent signal-to-noise ratio. It thus provides a means for real-time in vivo monitoring of (1)O(2) production during PDT.     

Monitoring singlet oxygen in situ with delayed chemiluminescence to deduce the effect of photodynamic therapy

Singlet oxygen ((1)O(2)) is an important factor mediating cell killing in photodynamic therapy (PDT). We previously reported that chemiluminescence (CL) can be used to detect (1)O(2) production in PDT and linked the signal to the PDT-induced cytotoxicity in vitro. We develop a new CL detection apparatus to achieve in vivo measurements. The system utilizes a time-delayed CL signal to overcome the interference from scattered excitation light, thus greatly improving the accuracy of the detection. The system is tested on healthy skin of BALB/ca mouse for its feasibility and reliability. The CL measurement is made during a synchronized gating period of the irradiation light. After each PDT treatment and in situ CL measurement, the skin response is scored over a period of 2 weeks. A remarkable relationship is observed between the score and the CL, regardless of the PDT treatment protocol. Although there are many issues yet to be addressed, our results clearly demonstrate the feasibility of CL measurement during PDT and its potential for in vivo PDT dosimetry. This requires further investigations.     

Monte Carlo modeling of in vivo protoporphyrin IX fluorescence and singlet oxygen production during photodynamic therapy for patients presenting with superficial basal cell carcinomas

We present protoporphyrin IX (PpIX) fluorescence measurements acquired from patients presenting with superficial basal cell carcinoma during photodynamic therapy (PDT) treatment, facilitating in vivo photobleaching to be monitored. Monte Carlo (MC) simulations, taking into account photobleaching, are performed on a three-dimensional cube grid, which represents the treatment geometry. Consequently, it is possible to determine the spatial and temporal changes to the origin of collected fluorescence and generated singlet oxygen. From our clinical results, an in vivo photobleaching dose constant, β of 5-aminolaevulinic acid-induced PpIX fluorescence is found to be 14 ± 1 J/cm(2). Results from our MC simulations suggest that an increase from our typical administered treatment light dose of 75-150 J/cm(2) could increase the effective PDT treatment initially achieved at a depth of 2.7-3.3 mm in the tumor, respectively. Moreover, this increase reduces the surface PpIX fluorescence from 0.00012 to 0.000003 of the maximum value recorded before treatment. The recommendation of administrating a larger light dose, which advocates an increase in the treatment time after surface PpIX fluorescence has diminished, remains valid for different sets of optical properties and therefore should have a beneficial outcome on the total treatment effect.     

Deposition of complement proteins on cells treated by photodynamic therapy in vitro.

Activation of the complement system has emerged as a critical event in the response of tumors to photodynamic therapy (PDT) due to its involvement in the vascular effects as well as in the inflammatory and immune reactions observed with this treatment modality. However, the exact mechanism of PDT-induced complement activation has not been precisely characterized. The present study examines the potential of PDT at the cellular level to directly activate the complement system. Mouse tumor SCCVII cells treated by Photofrin-based PDT and post-incubated in the presence of homologous (mouse) serum were analyzed by flow cytometry for binding of complement proteins on their surface. The results show that PDT induced the fixation of complement C3 protein, probably in the form of its activated fragments, and of the terminal membrane attacks complex of complement on the treated SCCVII cells. Deposition of C3/C3 fragments on human umbilical vein endothelial cells (HUVEC) treated by Photofrin-PDT and post-incubated in the presence of human serum was also detected. Complement fixation was preferentially elevated on SCCVII cell undergoing PDT-induced apoptosis. The induction of surface expression of heat shock protein 70 (HSP70) on PDT-treated cells also triggered complement deposition, since the presence of anti-HSP70 antibodies during the post-PDT incubation blocked the anchoring of C3/C3 fragments to SCCVII cells. The fact that PDT-treated cells are recognized by the complement system as their target adds an important element for understanding the mechanism of tumor response to PDT.     

Time dependence of singlet oxygen luminescence provides an indication of oxygen concentration during oxygen consumption

Singlet oxygen plays a major role in photodynamic inactivation of tumor cells or bacteria. Its efficacy depends critically on the oxygen concentration [O(2)], which can decrease in case oxygen is consumed caused by oxidative reactions. When detecting singlet oxygen directly by its luminescence at 1270 nm, the course of the luminescence signal is critically affected by [O(2)]. Thus, it should be feasible to monitor oxygen consumption during photo-oxidative processes. Singlet oxygen was generated by exciting a photosensitizer (TMPyP) in aqueous solution (H(2)O or D(2)O) of albumin. Chromatography shows that most of the TMPyP molecules are unbound, and therefore singlet oxygen molecules can diffuse in the solution. A sensor device for oxygen concentration revealed a rapid decrease of [O(2)] (oxygen depletion) in the solution during irradiation. The extent of oxygen depletion in aqueous albumin solution depends on the radiant exposure and the solvent. When detecting the luminescence signal of singlet oxygen, the shape of the luminescence signal significantly changed with irradiation time. Thus, local oxygen consumption could be monitored during photodynamic action by evaluating the course of singlet oxygen luminescence.     

A comprehensive mathematical model of microscopic dose deposition in photodynamic therapy

We have developed a comprehensive theoretical model for rigorously describing the spatial and temporal dynamics of oxygen (3O2) consumption and transport and microscopic photodynamic dose deposition during photodynamic therapy (PDT) in vivo. Previously published models have been improved by considering perfused vessels as a time-dependent 3O2 source and linking the 3O2 concentration in the vessel to that within the tissue through the Hill equation. The time-dependent photochemical 3O2 consumption rate incorporates sensitizer photobleaching effects and an experimentally determined initially nonuniform photosensitizer distribution. The axial transport of 3O2 is provided for in the capillaries and in the surrounding tissue. A self-sensitized singlet oxygen (1O2)-mediated bleaching mechanism and the measured, initially nonuniform distribution of mesotetrahydroxyphenyl chlorin at 3 h after intravascular administration were used to demonstrate the capabilities of the model. Time-evolved distributions of 3O2 concentration were obtained by numerically solving two-dimensional diffusion-with-reaction equations both in the capillary and the adjacent tissue. Using experimentally established physiological and photophysical parameters, the mathematical model allows computation of the dynamic variation of hemoglobin-3O2 saturation (SO2) within the vessels, irreversible sensitizer degradation due to photobleaching, and the microscopic distributions of 3O2, sensitizer concentration, and 1O2 dose deposition under various irradiation conditions. The simulations reveal severe axial gradients in 3O2 and in photodynamic dose deposition in response to a wide range of clinically relevant treatment parameters. Thus, unlike former Krogh cylinder-based models, which assume a constant 3O2 concentration at the vessel, this new model identifies conditions in which 3O2 depletion and minimal deposition of reacting 1O2 exist near the end of axial segments of vessels and shows that treatment-limiting 3O2 depletion is induced at fluence rates as low as 10 mW cm(-2). These calculations also demonstrate that intercapillary heterogeneity of photosensitizer contributes significantly to the distribution of photodynamic dose. This more rigorous mathematical model enables comparison with experimentally observable, volume-averaged quantities such as SO2 and the loss of sensitizer fluorescence through bleaching that have not been included in previous analyses. Further, it establishes some of the intrinsic limitations of such measurements. Specifically, our simulations demonstrate that tissue measurements of SO2 and of photobleaching are necessarily insensitive to microscopic heterogeneity of photodynamic dose deposition and are sensitive to intercapillary spacing. Because prior knowledge of intercapillary distances in tumors is generally unavailable, these measurements must be interpreted with caution. We anticipate that this model will make useful dosimetry predictions that should inform optimal treatment conditions and improve current clinical protocols.     

纯氧及LED阵列光动力复合治疗设备的研制

基于变压吸附制氧原理产生纯氧,并采用微透镜阵列多光谱LED发光器件与二次透镜阵列相结合构成光动力治疗辐照器,研制一种纯氧及LED阵列光动力复合治疗设备。其辐照器输出纯氧浓度大于90%,照射光包括波长625 nm红光、465 nm蓝光和520 nm绿光,应用光排序辐照技术实现纯氧及多光谱光动力复合治疗。通过辐照器上纯氧和照射光同步输出等多种外源性给氧保持光动力治疗区域的富氧状态,解决由于乏氧影响光动力疗效的问题。辐照器光学系统解决现有技术采用LED阵列排布替代激光器作为光动力治疗光源时存在的光能利用率低、光功率密度分布不均匀、不同波长光束在目标靶面光功率密度分布曲面差异大等缺陷。     

Effects of photodynamic exposure on endothelial cells in vitro

Experiments on cultured human umbilical vein endotheliocytes showed that accumulation of photosensitive dye (aluminum phthalocyanin; PHOTOSENSE) in cells and laser exposure alone were inessential for the viability of endothelial cells. Contrary to this, exposure of the cells which have accumulated aluminum phthalocyanin (an average of 111.1 ng/mg protein) to low-intensity laser (λ=675 nm) led to a dose-dependent reduction of endotheliocyte viability. Hence, cultured endothelial cells can be used for screening of various photosensitizers and preliminary optimization of photodynamic therapy.     

Assessment of cellular damage by comet assay after photodynamic therapy in vitro

The aim of this study was analysis of DNA damage in the cell line of the human melanoma G361 after photodynamic therapy (PDT) by comet assay. Photodynamic therapy is based on cytotoxic action of sensitizers (10 microM ZnTPPS4 fixed into 1 mM cyclodextrin hpbetaCD) and light with a suitable wavelength. Single-cell gel electrophoresis (SCGE, comet assay) is a rapid and sensitive method for detecting DNA strand breaks at the level of single cells. Great amount of DNA damage was detected with the dose of irradiation of 0.1; 0.5 J and 2.5 J x cm(-2). Only radiation dose of visible light in the presence of sensitizers can induce DNA breaks of tumour cells. Cells with DNA damage appear as fluorescent comets with tails of DNA fragmentation. In contrast, cells with undamage DNA appear as round spots, because their intact DNA does not migrate out of the cell.     

In vitro evaluation of the genotoxic and clastogenic potential of photodynamic therapy

Photodynamic therapy (PDT) was recently introduced in clinical practice for the management of cancer. As far as PDT relies on the combined action of a photosensitizer and a laser source, there is a need to evaluate the genotoxic and mutagenic potential of this treatment modality. This paper reports the effects of various photosensitizer and photo-irradiation doses on lethality to the MIA PaCa cell line using ZnPcS4 as the photosensitizer. The sister chromatid exchange (SCE) assay was used to evaluate the genotoxicity of various photosensitizer and photo-irradiation doses. Also, chromosomal aberrations at various time intervals post-irradiation were evaluated. The results showed that a combination of 3 J/cm2 irradiance with 5 microM ZnPcS4 concentration leads to the LD90 72 h post-irradiation. Eight days post-irradiation the LD90 level was achieved using a light dose of 3 J/cm2, independent of ZnPcS4 concentration. The SCE assay showed that cells treated with various light and drug doses presented no genotoxic potential, as SCE levels were not different from untreated (control) cells. Chromosomal analysis after PDT treatment at various time intervals post-irradiation showed that there was no significant chromosomal damage in cells treated photodynamically compared with untreated controls. The results show that the cell killing mechanism after PDT is not at the chromosome level, but may be at a different cellular level, such as plasma membranes, mitochondria, etc.     

On the use of fluorescence probes for detecting reactive oxygen and nitrogen species associated with photodynamic therapy

Fluorescent probes are frequently employed for the detection of different reactive oxygen and nitrogen species formed during the irradiation of photosensitized cells and tissues. Investigators often interpret the results in terms of information provided with the different probes without examining specificity or determinants of fluorogenic reactions. We examine five fluorescent probes in a cell-free system: reduced 2',7'-dichlorofluorescein, dihydroethidine, dihydrorhodamine, 3'-(p aminophenyl) fluorescein (APF), and 4',5'-diaminofluorescein. Of these, only APF demonstrates a high degree of specificity for a single reactive species. There is a substantial influence of peroxidase activity on all fluorogenic interactions. The fluorescence of the photosensitizing agent also must be taken into account in evaluating results.     

Calcium phosphate nanoparticles as efficient carriers for photodynamic therapy against cells and bacteria

Calcium phosphate nanoparticles were surface-functionalized with different polymers, and photosensitizers were incorporated into this layer. The charge was adjusted by choosing the appropriate polymer. Methylene blue and 5,10,15,20-tetrakis(3-hydroxyphenyl)porphyrin (mTHPP) were used as photosensitizers. The particles showed a good performance with HIG-82 synoviocytes. For J774A.1 macrophages, they were toxic also in the dark, probably due to a lethal uptake of calcium. For HT29 epithelial cells, a moderate activity was observed. A good photoxicity was observed against the bacterial strain Staphylococcus aureus (Gram-positive), both with positively and negatively charged nanoparticles loaded with mTHPP. Against Pseudomonas aeruginosa (Gram-negative), good photoxicity was observed only with positively charged nanoparticles loaded with mTHPP. At higher concentrations, methylene blue-loaded nanoparticles were active against S. aureus. Thus, it is possible to prepare a water-dispersable system of dye-loaded calcium phosphate nanoparticles, but the efficiency depends on a number of parameters, e.g. particle charge, kind of polymer, and cell culture medium (e.g. the presence of proteins).     

Fluorescence photobleaching of ALA and ALA-heptyl ester induced protoporphyrin IX during photodynamic therapy of normal hairless mouse skin: a comparison of two light sources and different illumination schemes

This study investigated photobleaching of protoporphyrin IX (PpIX) induced by 5-aminolevulinic acid (ALA) and ALA-heptyl ester during superficial photodynamic therapy (PDT) in normal skin of the female BALB/c-nu/nu athymic mouse. We examined the effects of two light sources (laser and broadband lamp) and two different illumination schemes (fractionated light and continuous irradiation) on the kinetics of photobleaching. Our results show that light exposure (0-30 minutes, 10 mW/cm2) of wavelengths of approximately 420 nm (blue light) and 635 nm (red light) induced time-dependent PpIX photobleaching for mouse skin of 2% ALA and ALA-heptyl ester. Blue light (10 mW/cm2) caused more rapid PpIX photobleaching than did red light (100 mW/cm2), which is attributed to stronger absorption at 407 nm than at 632 nm for PpIX. In the case of light fractionation, fractionated light induced faster photobleaching compared with continuous light exposure after topical application of 2% ALA and ALA-heptyl ester in vivo. These have been suggested to allow reoxygenation of the irradiated tissue, with a consequent enhancement of singlet oxygen production in the second and subsequent fractions.     

Cardiac toxicity of singlet oxygen: implication in reperfusion injury

Oxygen-derived free radicals (O2.-, H2O2, and .OH) that are produced during postischemic reperfusion are currently suspected to be involved in the pathogenesis of tissue injury. Another reactive oxygen species, the electronically excited molecular oxygen (1O2), is of increasing interest in the area of experimental research in cardiology. In this review are discussed the main potential sources of singlet oxygen in the organism, particularly in the myocardium, the various cardiovascular cytotoxic effects induced by this reactive oxygen intermediate, and the growing evidence of its involvement in ischemia/reperfusion injury.     

Real-time optoacoustic monitoring of vascular damage during photodynamic therapy treatment of tumor

The optoacoustic technique is a noninvasive imaging method with high spatial resolution. It potentially can be used to monitor anatomical and physiological changes. Photodynamic therapy (PDT)-induced vascular damage is one of the important mechanisms of tumor destruction, and real-time monitoring of vascular changes can have therapeutic significance. A unique optoacoustic system is developed for neovascular imaging during tumor phototherapy. In this system, a single-pulse laser beam is used as the light source for both PDT and for concurrently generating ultrasound signals for optoacoustic imaging. To demonstrate its feasibility, this system is used to observe vascular changes during PDT treatment of chicken chorioallantoic membrane (CAM) tumors. The photosensitizer used in this study is protoporphyrin IX (PpIX) and the laser wavelength is 532 nm. Neovascularization in tumor angiogenesis is visualized by a series of optoacoustic images at different stages of tumor growth. Damage of the vascular structures by PDT is imaged before, during, and after treatment. Rapid, real-time determination of the size of targeted tumor blood vessels is achieved, using the time difference of positive and negative ultrasound peaks during the PDT treatment. The vascular effects of different PDT doses are also studied. The experimental results show that a pulsed laser can be conveniently used to hybridize PDT treatment and optoacoustic imaging and that this integrated system is capable of quantitatively monitoring the structural change of blood vessels during PDT. This method could be potentially used to guide PDT and other phototherapies using vascular changes during treatment to optimize treatment protocols, by choosing appropriate types and doses of photosensitizers and doses of light.     

Meningeal cells increase in vitro astrocytic gap junctional communication as measured by fluorescence recovery after laser photobleaching

Summary The presence of meningeal cells is necessary for the normal development of the glia limitans. Astrocytes comprising the adult glia limitans have several unique features, including many more gap junctions than is typical for astrocytes in the underlying molecular layer. This study examines the possible influence of meningeal cells on the establishment and maintenance of specific characteristics of astrocytes in the glia limitans. Primary cultures of rat astrocytes and meningeal cells were used to examine whether meningeal cells could alter astrocytic gap junctional dye coupling. Astrocytes and meningeal cells were grown on separate glass slides and co-cultured by forming a sandwich with the slides. The sides of the slides containing the cells faced each other and were separated by a 1 mm thick gasket along the edge of the slides. Although the meningeal cells and astrocytes were bathed in the same medium, they were separated by a distance of 1 mm and were not in direct contact during the co-culture period. The cells were co-cultured for 24, 48 or 72 hours, and astrocytic gap junctional dye coupling was examined using the gap-FRAP technique. The mean total recovery of fluorescence for control astrocytes was 14%. Astrocytes co-cultured with meningeal cells for 24 hours did not show a significant difference in the fluorescence recovery when compared to the control values. After 48 hours of co-culture, there was a significant increase in the gap junctional dye coupling. After 72 hours, gap junctional dye coupling continued to increase (total fluorescence recovery=53%). These results indicate that meningeal cells can influencein vitro gap junctional coupling. It is speculated that the prevalence of gap junctions in the glia limitans is due to-the meningeal-glial interaction.     

A new method for photodynamic therapy of melanotic melanoma -- effects of depigmentation with violet light photodynamic therapy

Melanotic melanomas have a poor response to photodynamic therapy (PDT). The reason for this is that melanin absorbs light over the entire wavelength region used for PDT (400-750 nm). Photobleaching of melanin is an approach to overcome this obstacle. In the present work, reflectance spectroscopy was applied to study depigmentation of human and murine skin with different melanin contents, and effects induced by PDT with topical application of methyl 5-aminolevulinate (MAL) on B16F10 melanotic melanomas transplanted to nude mice. Depigmentation and inhibition of tumor growth after violet light (420 nm) exposure, red light (634 nm) exposure, and combinations of both were studied. Reflectance spectroscopy was suitable for evaluation of the pigmentation of both human and murine skin. Skin depigmentation leads to increase in reflectance. PDT with violet light bleached some of the melanin in the skin above the B16F10 melanomas, and possibly also in the upper part of the melanomas. This resulted in a larger growth inhibition of tumors first given PDT with violet light and then with red light compared to treatments using the reverse order of illumination, namely, red light before violet light. It is concluded that violet light PDT can bleach melanin in melanotic tumors and therefore increase their sensitivity to red light PDT. This finding indicates a new PDT modality that can be further developed for treatment of superficial melanotic melanomas and possibly other diseases where pigmentation is a problem.     

Determination of in vivo light fluence distribution in a heterogeneous prostate during photodynamic therapy

Light fluence delivered to the tumor volume is an important dosimetry quantity in photodynamic therapy (PDT). The in vivo measurements in four patients showed that light fluence rates varied significantly in a prostate during PDT. The maximum and the mean fluence rates in a quadrant varied from 74 to 777 mW cm(-2) and from 45 to 385 mW cm(-2), respectively, among 13 quadrants of four patients' prostates. To determine three-dimensional (3D) light fluence rate distribution in a heterogeneous prostate, a kernel model was developed. The accuracy of the model was examined with a finite-element-method (FEM) model calculation, a phantom measurement, and the in vivo measurements. The kernel model calculations showed good agreements with the FEM model calculation and the measurements. The maximum and the mean deviations of the kernel model calculation from the in vivo measurements in the four patients were 23% and 4%, respectively. The kernel model, which is based on an analytic expression of a point source in a spherically symmetrical heterogeneity, has the advantage of fast calculation and is suitable for real-time PDT treatment planning.