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Photodynamic therapy – mechanisms, photosensitizers and combinations
Abstract
Photodynamic therapy (PDT) is a modern and non-invasive form of therapy, used in the treatment of non-oncological diseases as well as cancers of various types and locations. It is based on the local or systemic application of a photosensitive compound - the photosensitizer, which is accumulated in pathological tissues. The photosensitizer molecules absorb the light of the appropriate wavelength, initiating the activation processes leading to the selective destruction of the inappropriate cells. The photocytotoxic reactions occur only within the pathological tissues, in the area of photosensitizer distribution, enabling selective destruction. Over the last decade, a significant acceleration in the development of nanotechnology has been observed. The combination of photosensitizers with nanomaterials can improve the photodynamic therapy efficiency and eliminate its side effects as well. The use of nanoparticles enables achievement a targeted method which is focused on specific receptors, and, as a result, increases the selectivity of the photodynamic therapy. The object of this review is the anticancer application of PDT, its advantages and possible modifications to potentiate its effects.
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“PDT can produce ROS that induce tumor cell death by stimulating photosensitizers with specific wavelengths of therapeutic light [101–103].”
From Nanosensitizer-assisted sonodynamic therapy for breast cancer (2025) · cites this paper as [101]
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“Second-generation PS have notable features compared to fi rst-generation PS [34, 35].”
BackgroundLuo, H., & Gao, S. (2023) · Journal of Controlled Release · doi:10.1016/j.jconrel.2023.08.056 · Cited by 139
Potential of Cyanine Derived Dyes in Photodynamic Therapy
Lange, N., Szlasa, W., Saczko, J., & Chwiłkowska, A. (2021) · Pharmaceutics · doi:10.3390/pharmaceutics13060818 · Cited by 137
“The photodynamic reaction might propagate in two main ways [3].”
BackgroundSelf-citationReactive Oxygen Species-Based Nanomaterials for Cancer Therapy
Li, Y., Yang, J., & Sun, X. (2021) · Frontiers in Chemistry · doi:10.3389/fchem.2021.650587 · Cited by 114
“Before returning to the basic state, the activated photosensitizer sends energy directly to its surroundings, which induces production of ROS (Ozog et al., 2016; Prazmo et al., 2016; Kwiatkowski et al., 2018).”
BackgroundLighting up Micro-/Nanorobots with Fluorescence
Yang, M., Guo, X., Mou, F., & Guan, J. (2022) · Chemical Reviews · doi:10.1021/acs.chemrev.2c00062 · Cited by 139
New guidelines and definitions for type I photodynamic therapy
Li, M., Xiong, J., Zhang, Y., Yu, L., Yue, L., Yoon, C., Kim, Y., Zhou, Y., Chen, X., Xu, Y., et al. (2025) · Chemical Society Reviews · doi:10.1039/d1cs01079d · Cited by 209
Zhao, Y., Kim, H., Nguyen, V.-N., Jang, S., Jang, W. J., & Yoon, J. (2023) · Coordination Chemistry Reviews · doi:10.1016/j.ccr.2023.215560 · Cited by 133
Inorganic Nanoparticles Applied for Active Targeted Photodynamic Therapy of Breast Cancer
Montaseri, H., Kruger, C. A., & Abrahamse, H. (2021) · Pharmaceutics · doi:10.3390/pharmaceutics13030296 · Cited by 124
“PDT is painless and its selectivity to cancer cells is well tolerated by patients [12].”
BackgroundLiao, S., Cai, M., Zhu, R., Fu, T., Du, Y., Kong, J., Zhang, Y., Qu, C.-H., Dong, X., Ni, J., et al. (2023) · Molecular Pharmaceutics · doi:10.1021/acs.molpharmaceut.2c00824 · Cited by 108
Light-activated tetrazines enable precision live-cell bioorthogonal chemistry
Liu, L., Zhang, D.-Y., Johnson, M., & Devaraj, N. (2022) · Nature Chemistry · doi:10.1038/s41557-022-00963-8 · Cited by 107
An APN-activated NIR photosensitizer for cancer photodynamic therapy and fluorescence imaging
Zhou, X., Li, H.-D., Shi, C., Xu, F., Zhang, Z., Yao, Q., Ma, H. R., Sun, W., Shao, K., Du, J.-J., et al. (2020) · Biomaterials · doi:10.1016/j.biomaterials.2020.120089 · Cited by 106
Yang, Q.-Q., Farha, A. K., Kim, G., Gul, K., Gan, R.-Y., & Corke, H. (2020) · Trends in Food Science & Technology · doi:10.1016/j.tifs.2020.01.023 · Cited by 106
“Mechanism of PDT Three preconditions are required in PDT, including PS, light of appropriate wavelength, and oxygen dissolved in cells (Kwiatkowski et al., 2018) (Fig.”
BackgroundXu, F., Li, H.-D., Yao, Q., Ge, H.-Y., Fan, J.-L., Sun, W., Wang, J.-Y., & Peng, X.-J. (2019) · Chemical Science · doi:10.1039/c9sc03355f · Cited by 106
The role of photodynamic therapy on multidrug resistant breast cancer
Aniogo, E. C., George, B. P. A., & Abrahamse, H. (2019) · Cancer Cell International · doi:10.1186/s12935-019-0815-0 · Cited by 122
Photoredox catalysis may be a general mechanism in photodynamic therapy
Li, M., Xu, Y., Pu, Z., Xiong, T., Huang, H., Long, S., Son, S., Yu, L., Singh, N., Tong, Y., et al. (2022) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2210504119 · Cited by 131
Multifunctional Porphyrin‐Based Sonosensitizers for Sonodynamic Therapy
Chen, J., Zhou, Q., & Cao, W. (2024) · Advanced Functional Materials · doi:10.1002/adfm.202405844 · Cited by 101
Some Natural Photosensitizers and Their Medicinal Properties for Use in Photodynamic Therapy
Kubrak, T., Kołodziej, P., Sawicki, J., Mazur, A., Koziorowska, K., & Aebisher, D. (2022) · Molecules · doi:10.3390/molecules27041192 · Cited by 102
“To date, PDT has been used successfully in dermatology, gynecology and urology [19].”
Curcumin a Natural Phenol and Its Therapeutic Role in Cancer and Photodynamic Therapy: A Review
Kah, G., Chandran, R., & Abrahamse, H. (2023) · Pharmaceutics · doi:10.3390/pharmaceutics15020639 · Cited by 102
Cheng, K.-M., Guo, Q., Shen, Z.-F., Yang, W.-G., Wang, Y.-L., Sun, Z.-J., & Wu, H.-Y. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2022.927219 · Cited by 99
Advances in photosensitizer-related design for photodynamic therapy
Zhou, Z., Zhang, L., Zhang, Z., & Liu, Z. (2021) · Asian Journal of Pharmaceutical Sciences · doi:10.1016/j.ajps.2020.12.003 · Cited by 100
Antibacterial Sonodynamic Therapy: Current Status and Future Perspectives
Roy, J., Pandey, V., Gupta, I., & Shekhar, H. (2021) · ACS Biomaterials Science & Engineering · doi:10.1021/acsbiomaterials.1c00587 · Cited by 116
Jerjes, W., Theodossiou, T. A., Hirschberg, H., Høgset, A., Weyergang, A., Selbo, P. K., Hamdoon, Z., Hopper, C., & Berg, K. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9020528 · Cited by 120
Tumor microenvironment-responsive fenton nanocatalysts for intensified anticancer treatment
Wang, Y., Gao, F., Li, X., Niu, G., Yang, Y., Li, H., & Jiang, Y. (2022) · Journal of Nanobiotechnology · doi:10.1186/s12951-022-01278-z · Cited by 108
“c Inhibitory rates of B16F10 tumors at day 14 post-treatment [133].”
BackgroundInfluentialUtility of Photodynamic Therapy in Dentistry: Current Concepts
Stájer, A., Kajári, S., Gajdács, M., Musah-Eroje, A., & Baráth, Z. (2020) · Dentistry Journal · doi:10.3390/dj8020043 · Cited by 117
Akbar, A., Khan, S., Chatterjee, T., & Ghosh, M. (2023) · Journal of Photochemistry and Photobiology B Biology · doi:10.1016/j.jphotobiol.2023.112796 · Cited by 121
Combination of phototherapy with immune checkpoint blockade: Theory and practice in cancer
Zhao, Y., Liu, X., Liu, X., Yu, J. X., Bai, X., Wu, X. L., Guo, X., Liu, Z., & Liu, X. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.955920 · Cited by 95
“Persistent tumor tissue hypoxia caused by the aggregation of platelets and the blockage of blood vessels leads to cell death (49).”
BackgroundCopper incorporated biomaterial-based technologies for multifunctional wound repair
Zhang, Z., Xue, H., Xiong, Y., Geng, Y., Panayi, A. C., Knoedler, S. A., Dai, G., Shahbazi, M., Mi, B., & Liu, G. (2023) · Theranostics · doi:10.7150/thno.87193 · Cited by 109
“Photodynamic therapy (PDT) refers to the production of superoxide anion radicals (O 2 •− ) by type I photodynamic reaction or singlet oxygen ( 1 O 2 ) by type II photodynamic reaction of photosensitizers under specific wavelength laser irradiation [52, 53].”
BackgroundGlobal Research Trends of Ferroptosis: A Rapidly Evolving Field With Enormous Potential
Wu, H., Wang, Y., Tong, L., Yan, H., & Sun, Z. (2021) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2021.646311 · Cited by 94
Feng, L., Qian, C., & Zhao, Y. (2020) · ACS Materials Letters · doi:10.1021/acsmaterialslett.0c00260 · Cited by 125
Abd-El-Azim, H. M., Tekko, I., Ali, A. A., Ramadan, A., Nafee, N., Khalafallah, N., Rahman, T., Mcdaid, W., Aly, R. G., Vora, L. K., et al. (2022) · Journal of Controlled Release · doi:10.1016/j.jconrel.2022.06.027 · Cited by 91
Photodynamic cancer therapy using liposomes as an advanced vesicular photosensitizer delivery system
Moghassemi, S., Dadashzadeh, A., Azevedo, R. B., Féron, O., & Amorim, C. A. (2021) · Journal of Controlled Release · doi:10.1016/j.jconrel.2021.09.024 · Cited by 112
Clinical impact of the worldwide shortage of verteporfin (Visudyne®) on ophthalmic care
Sirks, M. J., van Dijk, E. V., Rosenberg, N., Hollak, C., Aslanis, S., Cheung, C. M. G., Chowers, I., Eandi, C., Freund, K. B., Holz, F., et al. (2022) · Acta ophthalmologica · doi:10.1111/aos.15148 · Cited by 88
“History of Photodynamic Therapy PDT is the activation of a photosensitive drug using laser treatment, which creates free oxygen radicals that induce a local cytotoxic reaction (Kwiatkowski et al. 2018).”
Backgroundde Oliveira, A. B., Ferrisse, T. M., Marques, R. S., de Annunzio, S. R., Brighenti, F. L., & Fontana, C. R. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20143585 · Cited by 90
“The success of PDT depends on factors such as the administrated dose of light in the target cells and the time of exposure to light [46].”
BackgroundHamdy, N. Μ., Basalious, E. B., El-Sisi, M. G., Nasr, M., Kabel, A. M., Nossier, E. S., & Abadi, A. (2024) · Current Medical Research and Opinion · doi:10.1080/03007995.2024.2416985 · Cited by 95
“Utilizing NPs makes it possible to develop a targeted strategy that is concentrated on particular receptors, increasing the selectivity of whatever treatment 38 .”
Sono/Photodynamic Nanomedicine‐Elicited Cancer Immunotherapy
Li, Y., Xie, J., Um, W., You, D. G., Kwon, S., Zhang, L., Zhu, J., & Park, J. H. (2020) · Advanced Functional Materials · doi:10.1002/adfm.202008061 · Cited by 99
Nanoparticle-based drug delivery systems for controllable photodynamic cancer therapy.
Zheng, Y., Li, Z., Chen, H.-J., & Gao, Y. (2020) · European Journal of Pharmaceutical Sciences · doi:10.1016/j.ejps.2020.105213 · Cited by 87
Singlet Oxygen in Photodynamic Therapy
Cui, S., Guo, X., Wang, S., Wei, Z., Huang, D., Zhang, X., Zhu, T. C., & Huang, Z. W. (2024) · Pharmaceuticals · doi:10.3390/ph17101274 · Cited by 92
“Porphyrins are a widely used PS, which include Porfimer Sodium, PhotoGem, and Hiporfin [3], also known as hematoporphyrin derivative (HpD), which is the complex mixture of water-soluble porphyrin monomers and oligomers that are purified from animal blood [4].”
BackgroundYu, L., Liu, Z., Xu, W., Jin, K., Liu, J., Zhu, X., Zhang, Y., & Wu, Y. (2023) · Acta Pharmaceutica Sinica B · doi:10.1016/j.apsb.2023.11.007 · Cited by 100
“The 2nd generation photosensitizers mainly include chlorine, bacterio-chlorin analogues, phthalocyanines, and protoporphyrin IX (PPIX) compounds 69 .”
BackgroundChen, C., Wu, C., Yu, J., Zhu, X., Wu, Y., Liu, J., & Zhang, Y. (2022) · Coordination Chemistry Reviews · doi:10.1016/j.ccr.2022.214495 · Cited by 107
The Role of Photoactivated and Non-Photoactivated Verteporfin on Tumor
Wei, C., & Li, X. (2020) · Frontiers in Pharmacology · doi:10.3389/fphar.2020.557429 · Cited by 93
Interrogating biological systems using visible-light-powered catalysis
Ryu, K. A., Kaszuba, C. M., Bissonnette, N. B., Oslund, R., & Fadeyi, O. (2021) · Nature Reviews Chemistry · doi:10.1038/s41570-021-00265-6 · Cited by 128
Yakavets, I., Millard, M., Zorin, V. P., Lassalle, H., & Bezdetnaya, L. (2019) · Journal of Controlled Release · doi:10.1016/j.jconrel.2019.05.035 · Cited by 97
Emerging nanosonosensitizers augment sonodynamic-mediated antimicrobial therapies
Xu, Q., Xiu, W., Li, Q., Zhang, Y., Li, X., Ding, M., Yang, D., Mou, Y., & Dong, H. (2023) · Materials Today Bio · doi:10.1016/j.mtbio.2023.100559 · Cited by 75
Lu, Z.-X., Bai, S., Jiang, Y., Wu, S., Xu, D., Chen, Y., Lan, Y., An, Y.-B., Mao, J.-S., Liu, X., et al. (2022) · Advanced Functional Materials · doi:10.1002/adfm.202207749 · Cited by 80
Type I AIE photosensitizers: Mechanism and application
Li, J., Zhuang, Z., Zhao, Z., & Tang, B. Z. (2021) · Open Research (University of Surrey) · doi:10.1002/viw.20200121 · Cited by 192
Recent progress in the development of organometallics for the treatment of cancer
Murray, B. S., & Dyson, P. J. (2019) · Current Opinion in Chemical Biology · doi:10.1016/j.cbpa.2019.11.001 · Cited by 100
“photosensitizers involves the photocatalytic generation of HO2 or O2 from O2 (Type I mechanism) and generation of (1)O2 from (3)O2 (Type II mechanism) in endothelial cells, which close the blood vessels around the tumor via oxidative damage to cut off the supply of nutrients [30], whereas [Ir(ttpy)(pq)Cl] functions in…”
BackgroundWang, W., Zhang, G., Wang, Y., Ran, J., Chen, L., Wei, Z., Zou, H., Cai, Y., & Han, W. (2023) · Journal of Nanobiotechnology · doi:10.1186/s12951-023-02124-6 · Cited by 92
“In addition, PDT is an emerging non-invasive treatment modus, which consists of three components: photosensitizer, light and radical oxygen singlet (ROS) [22, 23].”
BackgroundEnhanced Photodynamic Therapy: A Review of Combined Energy Sources
Rodrigues, J. A., & Correia, J. H. (2022) · Cells · doi:10.3390/cells11243995 · Cited by 83
“, liposomes micelles, nanoparticles) [12,15,16].”
BackgroundHypericin-mediated photodynamic therapy for the treatment of cancer: a review.
Dong, X., Zeng, Y.-W., Zhang, Z.-Q., Fu, J., You, L.-T., He, Y., Hao, Y., Gu, Z.-L., Yu, Z., Qu, C.-H., et al. (2020) · The Journal of pharmacy and pharmacology · doi:10.1093/jpp/rgaa018 · Cited by 78
Lighting the Path: Light Delivery Strategies to Activate Photoresponsive Biomaterials In Vivo
Pearson, S., Feng, J., & del Campo, A. (2021) · Advanced Functional Materials · doi:10.1002/adfm.202105989 · Cited by 96
Guo, Y. L., Wang, M., Zou, Y., Jin, L., Zhao, Z., Liu, Q., Wang, S., & Li, J. (2022) · Journal of Nanobiotechnology · doi:10.1186/s12951-022-01586-4 · Cited by 91
“Photodynamic therapy (PDT) involves the application of photosensitizing drugs and laser activation to treat tumors [180].”
BackgroundZhang, Y., Wang, B., Zhao, R., Zhang, Q., & Kong, X. (2020) · Materials Science and Engineering C · doi:10.1016/j.msec.2020.111099 · Cited by 95
Advances in Medicine: Photodynamic Therapy
Aebisher, D., Szpara, J., & Bartusik‐Aebisher, D. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25158258 · Cited by 78
“Below (Table 1) is a collection of the most popular photosensitizers, including their clinical use and manufacturer [27–36].”
BackgroundLipid droplet‐targeted NIR AIE photosensitizer evoking concurrent ferroptosis and apoptosis
Jia, J., Ma, Z., Zhuang, J., Huo, L., Zhou, C., Li, N., & Zhao, N. (2024) · Aggregate · doi:10.1002/agt2.516 · Cited by 89
Zheng, B.-D., Ye, J., Zhang, X., Zhang, N., & Xiao, M. (2021) · Coordination Chemistry Reviews · doi:10.1016/j.ccr.2021.214155 · Cited by 103
Triggered Drug Release From Liposomes: Exploiting the Outer and Inner Tumor Environment
Franco, M. S., Gomes, E. R., Roque, M. C., & Oliveira, M. C. (2021) · Frontiers in Oncology · doi:10.3389/fonc.2021.623760 · Cited by 100
Santos, K. L. M., Barros, R. M., Lima, D. P. D. S., Nunes, A. M. A., Sato, M. R., Faccio, R., Damasceno, B. P. G. D. L., & Oshiro, J. A. (2020) · Photodiagnosis and Photodynamic Therapy · doi:10.1016/j.pdpdt.2020.102032 · Cited by 94
Xu, D., Liu, J., Wang, Y., Jian, Y., Wu, W., & Lv, R. (2020) · ACS Biomaterials Science & Engineering · doi:10.1021/acsbiomaterials.0c00984 · Cited by 94
Recent advances in access to overcome cancer drug resistance by nanocarrier drug delivery system
Sun, X., Zhao, P., Lin, J., Chen, K., & Shen, J. (2023) · Cancer Drug Resistance · doi:10.20517/cdr.2023.16 · Cited by 90
UV Radiation in DNA Damage and Repair Involving DNA-Photolyases and Cryptochromes
Vechtomova, Y. L., Telegina, T. A., Buglak, A. A., & Kritsky, M. (2021) · Biomedicines · doi:10.3390/biomedicines9111564 · Cited by 98
“Porphyrins (Figure 1) are well-known photosensitizers in medicine, and their ability to generate ROS underlies the photodynamic cancer therapy [15].”
Background
Metadata
- Authors
- Kwiatkowski, S., Knap, B., Przystupski, D., Saczko, J., Kędzierska, E., Knap-Czop, K., Kotlińska, J., Michel, O., Kotowski, K., & Kulbacka, J.
- Affiliations
- Wroclaw Medical University (PL)
- Medical University of Lublin (PL)
- Corresponding author
- Kulbacka, Julita
- ORCID
- Venue
- Biomedicine & Pharmacotherapy
- Publisher
- Elsevier BV
- Published
- 2018-10
- Volume
- 106
- Pages
- 1098-1107
- ISSN
- 0753-3322 (ISSN-L)
- OpenAlex
- W2884145325
- Cited by
- 2,173
- References
- 0
- Citations by year
- 2026: 192 · 2025: 360 · 2024: 404 · 2023: 362 · 2022: 340 · 2021: 272 · 2020: 174 · 2019: 61 · 2018: 7
- FWCI
- 22.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Biomedicine & Pharmacotherapy (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Uniwersytet Medyczny im. Piastów Slaskich we Wroclawiu
- Uniwersytet Medyczny w Lublinie
- Servier
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Photodynamic Therapy Research Studies
- Physical Sciences › Engineering › Biomedical Engineering › Nanoplatforms for cancer theranostics
- Physical Sciences › Materials Science › Materials Chemistry › Porphyrin and Phthalocyanine Chemistry
- Keywords
- photodynamic therapy, photosensitizers, photocytotoxicity, targeted drug delivery, nanoparticles, nanomaterials, combination therapy
- MeSH terms
- Animals, Drug Carriers, Humans, Neoplasms, Photochemotherapy, Drug Delivery Systems, Photosensitizing Agents, Nanomedicine, Electrochemotherapy, Nanoparticles
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