School of Chemistry and Physics, College of Agriculture Engineering and Science, Pietermaritzburg Campus, University of KwaZulu-Natal, Pietermaritzburg 3209, South Africa.
Int J Mol Sci. 2023 Jun 29;24(13):10875. doi: 10.3390/ijms241310875.
The rapid rise in research and development following the discovery of photodynamic therapy to establish novel photosensitizers and overcome the limitations of the technology soon after its clinical translation has given rise to a few significant milestones. These include several novel generations of photosensitizers, the widening of the scope of applications, leveraging of the offerings of nanotechnology for greater efficacy, selectivity for the disease over host tissue and cells, the advent of combination therapies with other similarly minimally invasive therapeutic technologies, the use of stimulus-responsive delivery and disease targeting, and greater penetration depth of the activation energy. Brought together, all these milestones have contributed to the significant enhancement of what is still arguably a novel technology. Yet the major applications of photodynamic therapy still remain firmly located in neoplasms, from where most of the new innovations appear to launch to other areas, such as microbial, fungal, viral, acne, wet age-related macular degeneration, atherosclerosis, psoriasis, environmental sanitization, pest control, and dermatology. Three main value propositions of combinations of photodynamic therapy include the synergistic and additive enhancement of efficacy, the relatively low emergence of resistance and its rapid development as a targeted and high-precision therapy. Combinations with established methods such as chemotherapy and radiotherapy and demonstrated applications in mop-up surgery promise to enhance these top three clinical tools. From published in vitro and preclinical studies, clinical trials and applications, and postclinical case studies, seven combinations with photodynamic therapy have become prominent research interests because they are potentially easily applied, showing enhanced efficacy, and are rapidly translating to the clinic. These include combinations with chemotherapy, photothermal therapy, magnetic hyperthermia, cold plasma therapy, sonodynamic therapy, immunotherapy, and radiotherapy. Photochemical internalization is a critical mechanism for some combinations.
光动力疗法发现后，研究与开发迅速兴起，为克服该技术临床转化后的局限性，研发出了一些新型光敏剂，这也促成了几个重要的里程碑。这些包括几代新型光敏剂的出现、应用范围的扩大、利用纳米技术提高疗效、提高对疾病的选择性、降低对宿主组织和细胞的选择性、与其他类似微创治疗技术联合治疗的出现、刺激响应性输送和疾病靶向的应用，以及激活能的穿透深度增加。所有这些里程碑共同促成了仍被认为是一项创新技术的显著增强。然而，光动力疗法的主要应用仍然牢牢地定位在肿瘤领域，大多数新的创新似乎都从这里开始向其他领域发展，如微生物、真菌、病毒、痤疮、湿性年龄相关性黄斑变性、动脉粥样硬化、银屑病、环境卫生消毒、害虫控制和皮肤病。光动力疗法联合应用的三个主要价值主张包括增效的协同和相加作用、相对较低的耐药性出现以及作为靶向和高精度治疗方法的快速发展。与化疗和放疗等既定方法联合，并在清除手术中得到应用，有望增强这三种主要的临床工具。从已发表的体外和临床前研究、临床试验和应用以及临床后病例研究中，有七种与光动力疗法联合的方法成为了突出的研究热点，因为它们具有潜在的易于应用、增效作用显著以及快速转化为临床应用的特点。这些方法包括与化疗、光热疗法、磁热疗、冷等离子体疗法、声动力疗法、免疫疗法和放疗的联合。光化学内化是一些联合治疗的关键机制。
Zotero 插件
