Abstract
Photodynamic therapy (PDT) and fluorescence diagnosis (FD) are effective modalities for treatment or detection of tumors and various other diseases. Both are based on the same principle: accumulation of a photosensitizer (PS) in target cells (or tissue) and irradiation with visible light. Subsequently, the photo-activated PS either returns to the ground state by fluorescence (used for detection and diagnosis, FD) or crosses to its triplet state and reacts chemically with surrounding molecules. When molecular oxygen is present, reactive oxygen species (ROS) including singlet oxygen are generated, which oxidize, amongst others, proteins and lipids affecting the target and leading dose-dependently to its destruction (PDT). Since most PSs accumulate selectively in tumor tissue, PDT and FD are especially suited for tumor therapy or diagnosis, respectively. Although different kinds of tumors can be treated due to the unspecific action of ROS, PDT is mainly restricted to flat tumors located at inner or outer surfaces of the body as light accessibility has to be guaranteed. Various PSs such as porphyrins are approved or currently tested in clinical trials.
After administration to a patient, the PS is transported to the target and localizes in specific cell compartments. Following PS irradiation cells react in different ways to the oxidizing ROS. Low numbers of ROS can be quenched by antioxidants present in the cell and the damage be repaired. Even stimulation of proliferation or of immune reactions was observed. However, ROS levels above a specific threshold induce cell death mainly via apoptosis and necrosis.
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Krammer, B., Verwanger, T. (2016). Photodynamic Therapy. In: Bergamini, G., Silvi, S. (eds) Applied Photochemistry. Lecture Notes in Chemistry, vol 92. Springer, Cham. https://doi.org/10.1007/978-3-319-31671-0_8
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