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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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Yu, X., Fang, C., Zhang, K., & Su, C. (2022) · Pharmaceutics · doi:10.3390/pharmaceutics14081581 · Cited by 48
“Mechanistically, PS molecules are activated by the light with an appropriate wavelength, aiming to destroy the target cells in the pathological tissues [44].”
BackgroundNanoparticle-Mediated Delivery Systems in Photodynamic Therapy of Colorectal Cancer
Simelane, N. W. N., & Abrahamse, H. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms222212405 · Cited by 47
“Moreover, they suffer from poor chemical purity [43].”
BackgroundWan, G.-Y., Chen, X.-H., Wang, H., Hou, S., Wang, Q., Cheng, Y., Chen, Q., Lv, Y., Chen, H.-L., & Zhang, Q.-Q. (2021) · Journal of Nanobiotechnology · doi:10.1186/s12951-021-01094-x · Cited by 41
“For example, PDT utilizes photosensitizers and light to convert oxygen into reactive oxygen species (ROS) [25, 26], which can induce immunogenic cell death (ICD) in cancer cells by exposing and releasing damage-associated molecular patterns (DAMPs) and subsequently convert the immunosuppressive microenvironment (“cold…”
BackgroundLi, A.-R., Liang, C., Xu, L.-H., Wang, Y., Liu, W., Zhang, K.-X., Liu, J.-J., & Shi, J.-J. (2021) · Acta Pharmaceutica Sinica B · doi:10.1016/j.apsb.2021.03.017 · Cited by 41
“The tumor-bearing mice were treated by tail vein every other day with (1) saline, (2) 5-ALA, (3) DFO, (4) 5-ALA þ DFO, (5) MFLs@5-ALA, (6) CLs@5-ALA/DFO, (7) MFLs@5-ALA/ DFO (at the dose of 25 mg/kg of 5-ALA) 6 h after injection, the mice were irradiated with 532 nm laser (300 mW/cm(2)) for 5 min.”
MethodBuglak, A., Charisiadis, A., Sheehan, A., Kingsbury, C. J., Senge, M., & Filatov, M. (2021) · Chemistry · doi:10.1002/chem.202100922 · Cited by 41
Wang, X.-T., Gong, Q., Song, C.-F., Fang, J., Yang, Y., Liang, X., Huang, X., & Liu, J.-W. (2021) · Toxicology and Applied Pharmacology · doi:10.1016/j.taap.2021.115484 · Cited by 41
Application of photodynamic therapy for liver malignancies
Zou, H., Wang, F., Zhou, J., Liu, X., He, Q., Wang, C., Zheng, Y., Wen, Y., & Xiong, L. (2020) · Journal of Gastrointestinal Oncology · doi:10.21037/jgo.2020.02.10 · Cited by 50
“The triple state either can undergo a type I reaction, which is oxygen independent and reacts with an organic molecule directly to form free radicals, or a type II reaction in which the excess energy is transferred to molecular oxygen (O2), leading to the formation of singlet oxygen ((1)O2) (14,15).”
BackgroundDiaz-Angulo, J., Porras, J., Mueses, M., Torres-Palma, R., Hernández-Ramírez, A., & Machuca-Martínez, F. (2019) · Journal of Photochemistry and Photobiology A: Chemistry · doi:10.1016/j.jphotochem.2019.112015 · Cited by 41
Therapeutic Approaches for Non-Melanoma Skin Cancer: Standard of Care and Emerging Modalities
Sol, S., Boncimino, F., Todorova, K. A., Waszyn, S., & Mandinova, A. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25137056 · Cited by 40
“Alternatively, the management of cSCC includes various physical treatment options such as laser therapies, cryotherapy, curettage, and photodynamic therapy [64–66].”
BackgroundRecent advancement in photosensitizers for photodynamic therapy
Singh, P. P., Sinha, S., Gahtori, P., Mishra, D. N., Pandey, G., & Srivastava, V. (2024) · Dyes and Pigments · doi:10.1016/j.dyepig.2024.112262 · Cited by 47
Arshad, R., Razlansari, M., Hosseinikhah, S. M., Pandey, A. T., Ajalli, N., Manicum, A.-L. E., Thorat, N. D., Rahdar, A., Zhu, Y., & Tabish, T. A. (2023) · Drug Discovery Today · doi:10.1016/j.drudis.2023.103673 · Cited by 47
Advances in Photodynamic Therapy Based on Nanotechnology and Its Application in Skin Cancer
Zhang, P., Han, T., Xia, H., Dong, L.-J., Chen, L., & Lei, L. (2022) · Frontiers in Oncology · doi:10.3389/fonc.2022.836397 · Cited by 40
“The structures of second-generation PSs (PSs2) are clear compared with those of PSs1, and the photosensitizing activity, absorption spectra, and penetration to deeply located tissues of PSs2 have been greatly improved (2, 6).”
BackgroundMkhobongo, B., Chandran, R., & Abrahamse, H. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22189726 · Cited by 42
Nanosensitizer-assisted sonodynamic therapy for breast cancer
Yu, J., Hu, J.-R., Tian, Y., Lei, Y.-M., Hu, H.-M., Lei, B.-S., Zhang, G., Sun, Y., & Ye, H.-R. (2025) · Journal of Nanobiotechnology · doi:10.1186/s12951-025-03311-3 · Cited by 43
“PDT can produce ROS that induce tumor cell death by stimulating photosensitizers with specific wavelengths of therapeutic light [101–103].”
Olszowy, M., Nowak-Perlak, M., & Woźniak, M. (2023) · Pharmaceutics · doi:10.3390/pharmaceutics15061712 · Cited by 49
“the effectiveness of a lower chemotherapy dose, the overcoming of multidrug resistance, and the therapeutic effect in late-stage patients [9].”
BackgroundFerritin-based nanomedicine for disease treatment
Zhu, Y., Zhu, Y., Cao, T., Liu, X., Liu, X., Yan, Y., Shi, Y., & Wang, J. (2023) · Medical Review · doi:10.1515/mr-2023-0001 · Cited by 47
“Photodynamic therapy (PDT) is an emerging tumor treatment method [153].”
BackgroundNanoparticle-Based Drug Delivery Systems for Photodynamic Therapy of Metastatic Melanoma: A Review
Nkune, N. W., & Abrahamse, H. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms222212549 · Cited by 41
“PSs are photoactive molecules, which are activated with an appropriate wavelength of light to trigger photochemical and photophysical reactions [23].”
BackgroundInfluentialApplication of phototherapeutic-based nanoparticles in colorectal cancer
Yan, J., Wang, C., Jiang, X., Wei, Y., Wang, Q., Cui, K., Xu, X. L., Wang, F., & Zhang, L. (2021) · International Journal of Biological Sciences · doi:10.7150/ijbs.58773 · Cited by 43
Recent advances in the biomedical applications of black phosphorus quantum dots
Miao, Y.-H., Wang, X.-J., Sun, J., & Yan, Z. (2021) · Nanoscale Advances · doi:10.1039/d0na01003k · Cited by 39
Korupalli, C., Kalluru, P., Nuthalapati, K., Kuthala, N., Thangudu, S., & Vankayala, R. (2020) · Bioengineering · doi:10.3390/bioengineering7030094 · Cited by 45
“Photodynamic therapy (PDT) is a clinically approved non-invasive therapy that can be used in the selective treatment of various types of cancers [86].”
BackgroundPhotodynamic therapy of lung cancer, where are we?
Crous, A., & Abrahamse, H. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2022.932098 · Cited by 38
“The use of nanoparticles enables the development of a targeted method that is focused on specific receptors, thereby increasing PDT selectivity (Kwiatkowski et al., 2018) and sensitivity (Xiang et al.”
BackgroundPhotoactive Dye‐Loaded Polymer Materials: A New Cutting Edge for Antibacterial Photodynamic Therapy
Elian, C., Méallet‐Renault, R., & Versace, D. (2024) · Advanced Functional Materials · doi:10.1002/adfm.202407228 · Cited by 53
Hao, Y., Chung, C. K., Gu, Z., Schomann, T., Dong, X., Veld, R. V. H. I. ‘., Camps, M. G. M., ten Dijke, P., OSSENDORP, F. A., & Cruz, L. J. (2022) · Molecular Biomedicine · doi:10.1186/s43556-022-00086-z · Cited by 44
Wu, N., Tu, Y., Fan, G.-R., Ding, J.-H., Luo, J., Wang, W., Zhang, C., Yuan, C., Zhang, H.-D., Chen, P., et al. (2022) · Asian Journal of Pharmaceutical Sciences · doi:10.1016/j.ajps.2022.01.002 · Cited by 38
“[11] Kwiatkowski S , Knap B , Przystupski D , Saczko J , Kedzierska E , Knap-Czop K , et al.”
BackgroundLabban, N. Y., Al‐Shibani, N., Al‐Kattan, R., Alfouzan, A. F., Binrayes, A., & Assery, M. K. A. (2021) · Photodiagnosis and Photodynamic Therapy · doi:10.1016/j.pdpdt.2021.102350 · Cited by 45
Functional gadolinium-based nanoscale systems for cancer theranostics
Li, H., Zeng, Y., Zhang, H., Gu, Z., Gong, Q., & Luo, K. (2020) · Journal of Controlled Release · doi:10.1016/j.jconrel.2020.08.064 · Cited by 45
Fluorescent glycoconjugates and their applications
Thomas, B., Yan, K., Hu, X., Donnier‐Maréchal, M., Chen, G., He, X., & Vidal, S. (2020) · Chemical Society Reviews · doi:10.1039/c8cs00118a · Cited by 74
Metal-based nanomedicines for cancer theranostics
Yu, H., Liu, J.-H., Liu, W., Niu, R., Zhang, B., Xiong, Y., Liu, Y., Wang, Y., & Zhang, H. (2025) · Military Medical Research · doi:10.1186/s40779-025-00627-x · Cited by 20
“Alternatively, the triplet-excited PSs can directly transfer their energy to O 2 in their ground triplet state, facilitating the production of 1 O 2 (type II photodynamic reaction) [260].”
Zou, Y., Chen, J., Luo, X., Qu, Y., Zhou, M., Xia, R., Wang, W., & Zheng, X. (2024) · Frontiers in Pharmacology · doi:10.3389/fphar.2024.1481168 · Cited by 40
Hlapisi, N., Songca, S. P., & Ajibade, P. A. (2024) · Pharmaceutics · doi:10.3390/pharmaceutics16101268 · Cited by 44
Recurrent Glioblastoma—Molecular Underpinnings and Evolving Treatment Paradigms
Chang, C., Chavarro, V. S., Gerstl, J. V. E., Blitz, S. E., Spanehl, L., Dubinski, D., Valdes, P. A., Tran, L. N., Gupta, S., Esposito, L., et al. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25126733 · Cited by 45
“In PDT, a photosensitizer is activated using a specific wavelength of light, which leads to the generation of reactive oxygen species in tissue that has accumulated the photosensitizer and undergone irradiation, which ultimately leads to the death of tumor cells [219].”
BackgroundMetkar, S. P., Fernandes, G. J., Navti, P. D., Nikam, A. N., Kudarha, R. R., Dhas, N. L., Seetharam, R. N., Venkata, S. K., Rao, B. S. S., & Mutalik, S. (2023) · OpenNano · doi:10.1016/j.onano.2023.100159 · Cited by 39
Application of nano‐radiosensitizers in combination cancer therapy
Varzandeh, M., Sabouri, L., Mansouri, V., Gharibshahian, M., Beheshtizadeh, N., Hamblin, M. R., & Rezaei, N. (2023) · Bioengineering & Translational Medicine · doi:10.1002/btm2.10498 · Cited by 45
“Generally, XMPs can be categorized into two groups, PS decorated agents and high-Z NPs. PS molecules can be anchored onto the surface of common radio- sensitizer NPs to generate additional ROS.”
BackgroundInfluentialZhou, R., Zeng, X., Zhao, H., Chen, Q., & Wu, P. (2021) · Coordination Chemistry Reviews · doi:10.1016/j.ccr.2021.214306 · Cited by 41
Koga, K., Tagami, T., & Ozeki, T. (2021) · Colloids and Surfaces A Physicochemical and Engineering Aspects · doi:10.1016/j.colsurfa.2021.127038 · Cited by 37
Wu, A.-Y., Li, Q., Ling, J., Gu, L., Hong, Z.-B., Di, W., & Qiu, L. (2021) · Photodiagnosis and Photodynamic Therapy · doi:10.1016/j.pdpdt.2021.102517 · Cited by 37
Verger, A., Brandhonneur, N., Molard, Y., Cordier, S., Kowouvi, K., Amela‐Cortes, M., & Dollo, G. (2021) · International Journal of Pharmaceutics · doi:10.1016/j.ijpharm.2021.120763 · Cited by 47
Meng, L., Ma, W., Zhang, M., Zhou, R.-H., Li, Q., Sun, Y., Fu, W., Cai, X.-X., & Lin, Y.-F. (2021) · Applied Materials Today · doi:10.1016/j.apmt.2021.101010 · Cited by 37
Probing the Interactions of Porphyrins with Macromolecules Using NMR Spectroscopy Techniques
Gjuroski, I., Furrer, J., & Vermathen, M. (2021) · Molecules · doi:10.3390/molecules26071942 · Cited by 46
“In PDT, the phototoxic reaction that leads to a selective tissue destruction is based on the formation of singlet oxygen and reactive oxygen species (ROS) via light excitation of the porphyrinic photosensitizer (PS) in the target tissue [21,29].”
BackgroundSilvestre, A. L. P., Filippo, L. D. D., Besegato, J. F., de Annunzio, S. R., de Camargo, B. A. F., de Melo, P. B. G., Rastelli, A. N. D. S., Fontana, C. R., & Chorilli, M. (2020) · International Journal of Pharmaceutics · doi:10.1016/j.ijpharm.2020.120078 · Cited by 45
Manganese dioxide (MnO2) based nanomaterials for cancer therapies and theranostics
Zhu, D. Y., Zhu, X., Ren, S., Lu, Y., & Zhu, H. (2020) · Journal of drug targeting · doi:10.1080/1061186x.2020.1815209 · Cited by 61
Ma, M., Cheng, L., Zhao, A., Zhang, H., & Zhang, A.-P. (2019) · Photodiagnosis and Photodynamic Therapy · doi:10.1016/j.pdpdt.2019.101640 · Cited by 37
Pramana, A., Firmanda, A., Arnata, I. W., Sartika, D., & Sari, E. O. (2024) · International Journal of Food Microbiology · doi:10.1016/j.ijfoodmicro.2024.110866 · Cited by 38
Cardozo, A., da Silva, D. D. F. T., Fernandes, K., Ferreira, R. D. C., Lino-dos-Santos-Franco, A., Rodrigues, M. F. S. D., Motta, L., & Cecatto, R. B. (2024) · Photodermatology, Photoimmunology & Photomedicine · doi:10.1111/phpp.12978 · Cited by 36
Enhancing 5-ALA-PDT efficacy against resistant tumor cells: Strategies and advances
Ebrahimi, S., Ghadiri, M. K., Stummer, W., & Gorji, A. (2024) · Life Sciences · doi:10.1016/j.lfs.2024.122808 · Cited by 38
Self-assembled nanoplatforms for chemodynamic therapy
Meng, X., Sun, Z., Chu, H., & Wang, Y. (2023) · Chemical Engineering Journal · doi:10.1016/j.cej.2023.147702 · Cited by 35
Atta, D., elarif, A., & Bahrawy, M. A. (2023) · Lasers in Medical Science · doi:10.1007/s10103-023-03876-1 · Cited by 40
“[8] The in vitro bactericidal effect of a diode laser with photoablative energies, together with ICG, has been recently studied for the first time by Ahrari et al.”
BackgroundApplication of intelligent responsive DNA self-assembling nanomaterials in drug delivery
Ji, H., & Zhu, Q. (2023) · Journal of Controlled Release · doi:10.1016/j.jconrel.2023.08.036 · Cited by 42
Yuan, C., Li, Y., Xu, Z., Wang, C., Zhang, J., Jin, Y., Chen, Z., Sun, H., Wu, F., Zhang, Q., et al. (2022) · ACS Applied Nano Materials · doi:10.1021/acsanm.2c03390 · Cited by 36
Cellular Mechanisms in Acute and Chronic Wounds after PDT Therapy: An Update
Grandi, V., Corsi, A., Pimpinelli, N., & Bacci, S. (2022) · Biomedicines · doi:10.3390/biomedicines10071624 · Cited by 47
2-Hydroxychalcone as a Potent Compound and Photosensitizer Against Dermatophyte Biofilms
Bila, N. M., Costa-Orlandi, C. B., Vaso, C. O., Bonatti, J. L. C., de Assis, L. R., Regasini, L. O., Fontana, C. R., Fusco‐Almeida, A. M., & Mendes‐Giannini, M. J. S. (2021) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2021.679470 · Cited by 40
Nanoparticle-Based Approaches towards the Treatment of Atherosclerosis
Prilepskii, A. Y., Serov, N., Kladko, D. V., & Vinogradov, V. V. (2020) · Pharmaceutics · doi:10.3390/pharmaceutics12111056 · Cited by 38
“Concerning PDT, the main struggles are related to the fact that the ability of light to penetrate tissues is highly wavelength-dependent (Figure 2).”
BackgroundInfluentialChen, L., Wu, M., Chen, S., Hu, R., Wang, Y., Zeng, W., Feng, S., Ke, M., Wang, L., Chen, S., et al. (2024) · Advanced Materials · doi:10.1002/adma.202407268 · Cited by 37
Pandey, G., Phatale, V., Khairnar, P., Kolipaka, T., Shah, S., Famta, P., Jain, N., Srinivasarao, D. A., Rajinikanth, P. S., Raghuvanshi, R. S., et al. (2023) · International Journal of Biological Macromolecules · doi:10.1016/j.ijbiomac.2023.128452 · Cited by 43
Nanomaterial-based photodynamic therapy for antibacterial applications: a comprehensive review
Gao, Y., Lin, H., Luo, Y., Li, J., Gong, C., Chen, H., & Gong, R. (2023) · Frontiers in Materials · doi:10.3389/fmats.2023.1260887 · Cited by 40
Zhuo, X., Liu, Z., Aishajiang, R., Wang, T., & Yu, D. N. (2023) · Pharmaceutics · doi:10.3390/pharmaceutics15092293 · Cited by 38
“O2 oxidizes unsaturated fatty acid constituents of the membrane to malondialdehyde, damaging the integrity of the membrane which causes rapid utilization of intracellular adenosine triphosphate (ATP), inducing necrosis [71,72].”
BackgroundUpconversion rare Earths nanomaterials applied to photodynamic therapy and bioimaging
Rezende, T. K. D. L., Barbosa, H. P., dos Santos, L. F., Lima, K. D. O., de Matos, P. A., Tsubone, T. M., Gonçalves, R. R., & Ferrari, J. L. (2022) · Frontiers in Chemistry · doi:10.3389/fchem.2022.1035449 · Cited by 49
“Besides that, fewer side effects, greater selectivity for tissue cancer cells, and faster elimination from the body (Kwiatkowski et al., 2018).”
BackgroundRed blood cell membrane nanoparticles for tumor phototherapy
Zheng, B.-D., & Xiao, M. (2022) · Colloids and Surfaces B Biointerfaces · doi:10.1016/j.colsurfb.2022.112895 · Cited by 39
Makuch, S., Dróżdż, M., Makarec, A., Ziolkowski, P. P., & Woźniak, M. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23179845 · Cited by 38
“These compounds produce strong reactivity with lipids, nucleic acids, proteins, and other biochemical substrates, leading to the activation of pathogenetic mechanisms, which have been thoroughly described in various reviews [8,12,13].”
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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