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The photodynamic effects of photofrin II, hematoporphyrin derivative, hematoporphyrin, and tetrasodium-mesotetra(4-sulfonatophenyl)porphine in vitro: clonogenic cell survival and drug uptake studies.

The human colon adenocarcinoma cell line, WiDr, was exposed to Photofrin II, hematoporphyrin derivative (HPD), hematoporphyrin (HP) or tetrasodium-meso-tetra(4-sulfonatophyenyl)porphine (TPPS4) followed by irradiation with light. Clonogenicity was determined and the resultant survival curves compared and shown to be qualitatively similar in shape. However, for equal amounts of drug in the medium, there were large differences in photosensitizing efficiency with Photofrin II approximately 5, 25 and 50 fold more effective than HPD, HP and TTPS4, respectively. For the same power used, all drugs were less efficient photosensitizers under red light (600-1100 nm) than under white light (300-110 nm). For all drugs this could be explained in terms of changes in light absorption over the two wavelength ranges. Differences in clonogenic cell survival could not be explained in terms of differences in singlet oxygen production (from published values). A reduction in drug uptake into the cells was sufficient to explain the differences between Photofrin II, HPD and HP, while TPPS4 was 5-fold less effective compared to other drugs than would be expected from drug uptake measurements. Two methods for measuring drug uptake were compared and shown to give different results for Photofrin II. Measurements of drug fluorescence in 0.1 N NaOH yielded 5-fold lower values than when measurements were in 1 N HCl following heat treatment to monomerise aggregated drug. Clearly the reliability of the method used in determining drug uptake must be carefully ascertained.

Adenocarcinoma↗

Cystoscopic fluorescence detector for photodetection of bladder carcinoma with hematoporphyrin derivative.

Hematoporphyrin derivative, a fluorogenic substance, tends to accumulate at higher levels in most tumor tissues after intravenous injection. These properties provide a potential application for the detection of malignant tumors. We report the development and in vitro evaluation of an instrument designed to excite and detect low levels of hematoporphyrin derivative fluorescence emitted by tumor cells in the bladder after hematoporphyrin derivative administration. The light source of the instrument for specific hematoporphyrin derivative excitation is at a wavelength of 405 nanometers. Optical fibers for both the excitation and detection of fluorescence were bundled in a single 7 French ureteral catheter which can be inserted into a standard cystoscope. The fluorescence is initially detected as an electrical signal which is amplified and then converted into an audio signal. The interference of the cystoscope illuminating white light to the fluorescence signal is eliminated by a phase-sensitive electronic circuit. The instrument thus allows simultaneous viewing of the bladder and detection of hematoporphyrin derivative fluorescence produced from tumor tissues. In vitro testings using hematoporphyrin derivative solutions on filter paper indicated that the instrument detects as little as 30 nanograms per milliliter of hematoporphyrin derivative and has relatively low noise levels from normal tissues. The utility of this instrument for hematoporphyrin derivative photodetection of small tumors and carcinoma in situ in bladder is currently under clinical evaluation.

Animals↗

Photodynamic therapy is potentiated by Co60 and intratumoral injection of hematoporphyrin derivative.

Hematoporphyrin derivative injected directly into a subcutaneous rat glioma resulted in a significant greater tumor growth inhibition than hematoporphyrin derivative injected parenterally upon stimulation by light, Co60 or by combination of the above. The photodynamic effect was analyzed in an in vivo and in an in vitro clonogenic assay. The directly injected hematoporphyrin derivative without external activation inhibited tumor growth to 34%. Light and directly injected HPD inhibited tumor growth to 3%, whereas 4, 8 and 16 Gy of Co60 produced a growth inhibition to 11%, 0.05% and 0.00% respectively. This cytotoxic effect of the ionizing radiation is further potentiated by the addition of light, resulting in a growth inhibition to 0.1%, 0.00% and 0.00% respectively for the three corresponding radiation doses. The direct intratumoral injection of HPD minimizes the side effects and increases the effect of the photodynamic therapy as compared to the parenterally administered HPD. This direct injection modality could be of potential value in the treatment of human gliomas or other tumors.

Animals↗

Nature of the tumor-localizing components of hematoporphyrin derivative.

Hematoporphyrin derivative linked by ether bonds (HE) was synthesized by unambiguous procedures in order to compare its properties to hematoporphyrin derivative (HpD). Reverse phase high performance liquid and gel filtration chromatography were used to compare the HE derivatives to HpD. The cellular uptake of HE derivatives was compared to HpD using the WEHI 3B (D+) cell line and was shown to be taken up to a degree and in a manner similar to HpD. The efficiency of HE porphyrins as photosensitizers was compared to HpD using the V79 cell line. HE porphyrins were more efficient in sensitizing the V79 cells than was HpD. The in vivo tumor localizing properties of HE porphyrins were compared to HpD in CBA mice bearing the C6 cerebral glioma, and BALB/c mice bearing the EMT6 mammary tumor. HE derivatives localized in both tumor models as effectively as HpD. We conclude that the properties of ether linked hematoporphyrin derivatives are very similar to properties of HpD.

Animals↗

Prospective study of cutaneous phototoxicity after systemic hematoporphyrin derivative.

Hematoporphyrin derivative (HpD) is a photoactive, oncophilic substance that produces cutaneous photosensitivity as its only significant side effect. Twenty-three patients who received systemic HpD and the usual light-avoidance precautions were studied prospectively to determine the incidence and severity of cutaneous phototoxicity (CP). Seventeen of the 23 patients (74%) reported CP, including three patients (18%) who experienced blister formation. Symptoms of CP occurred for a mean duration of 6 weeks (range 5-23 weeks). Lack of compliance with restrictive photoprotective measures was felt to be a major contributing factor. Other HpD-related complications included skin hyperpigmentation, ocular discomfort, pruritus, pain at injection site, and urticaria. CP and the restrictive measures to avoid it represent major disadvantages of the clinical use of HpD.

Adult↗

Bactericidal effects of photoradiation therapy with hematoporphyrin derivative.

Hematoporphyrin derivative (Hpd) localizes selectively in malignant and rapidly metabolizing tissues and undergoes a cytotoxic reaction when exposed to light of a specific wavelength. Hpd has been studied extensively with regard to the diagnosis and treatment of tumors but not with regard to bactericidal activity. This investigation assessed the effect of light-activated Hpd on various microorganisms, on human polymorphonuclear leukocytes, and on the interactions of polymorphonuclear leukocytes and bacteria. Light-activated Hpd was 99.9% bactericidal against Staphylococcus aureus, Streptococcus faecalis, Bacteroides fragilis, Streptococcus M-G intermedius, Streptococcus mutans, Peptostreptococcus anaerobius, Peptococcus magnus, and Clostridium perfringens, but did not affect Escherichia coli, Pseudomonas aeruginosa, or Candida albicans. Photoactivation of Hpd rendered 98% of polymorphonuclear leukocytes inviable. Combinations of light-activated Hpd and polymorphonuclear leukocytes had a 4-log (99.99%) bactericidal effect on both intra- and extracellular S. aureus. The ability of Hpd to localize in inflammatory tissues may have therapeutic applications in the treatment of abscesses.

Bacteria↗

[Experimental study of anti-tumor effect with conjugates of monoclonal antibodies and hematoporphyrin derivative].

Hematoporphyrin derivative (HPD) is a photosensitizer for use in photodynamic therapy (PDT). In this paper, HPD was conjugated with monoclonal antibodies 3G9 or 3H11 for use against gastric cancer in order to enhance the photosensitive effect and reduce side effect of PDT. The biological activities of the McAb conjugates were demonstrated. The killing effect on BGC-823 cells of 3G9-HPD or 3H11-HPD conjugates plus exposure to light showed 17 fold and 8.6 fold greater cytotoxicity, respectively than free HPD at an equivalent HPD concentration in vitro. When 3G9-HPD and 3H11-HPD were used in combination at 7:3, 5:5 and 3:7 proportion, the cytotoxicity was increased 12.9, 11.8 and 9.4 fold on target cells, respectively. The results indicate that the cytotoxicity was not further enhanced by the combination scheme. When tumor-bearing nude mice were treated with the different conjugates. Significant inhibition of tumor growth was observed and the survival period of animals was markedly prolonged in comparison with PBS, free HPD and NIgG-HPD treated groups.

Animals↗

A comparative study of 28 porphyrins and their abilities to localize in mammary mouse carcinoma: uroporphyrin I superior to hematoporphyrin derivative.

Hematoporphyrin derivative (HPD), a complex mixture of porphyrins has been used clinically as a tumor localizer both for diagnostic and therapeutic purposes. Relative lack of tumor specific uptake limits widespread clinical application. In an attempt to circumvent this problem, we studied 28 porphyrins with widely differing properties using a transplantable KHJJ mammary carcinoma in the mouse (Balb C) as a tumor model. Twenty hours after porphyrin (P) administration, the tumor, skin and gastrointestinal tract were excised and the latter lavaged with physiologic saline. Tissue porphyrin content was assessed visually by red U.V. fluorescence, and by quantitative fluorometric extraction, and photodynamic activity was evaluated in vivo using a tuneable dye laser emitting red light (615-640 nm). (1) Of the five porphyrins which were taken up by tumor tissue, i.e. HPD (photofrin), photofrin II, meso-tetra (4-carboxyphenyl) porphine (TCPP), tetra sodium-meso-tetra (4-sulfonatophenyl) porphine (TPSS), and uroporphyrin I (UROP I), skin and intestinal fluorescence also was marked with the notable exception of those mice receiving UROP I. (2) UROP I clearly was superior to HPD in this study in that the tumor to skin porphyrin content ratio was more than seven times greater than the ratio observed with both HPD and photofrin II, (3) As no measureable UROP was present in the gut, the tumor:intestinal P ratio under conditions of assay was for practical purposes infinity. (4) Photodynamic necrosis in the tumors of UROP I treated animals was similar to that seen following treatment with HPD. We conclude that UROP I appears the most specific tumor localizing porphyrin yet studied. This specificity suggests major potential clinical application both as a diagnostic marker for early mucosal cancer, and in photoradiation therapy. Moreover, the prolonged photocutaneous side effects as seen with HPD are unlikely.

Animals↗

Quantum yield of singlet oxygen production by monomeric and aggregated forms of hematoporphyrin derivative.

Hematoporphyrin derivative (HpD) is a complex mixture of monoporphyrinic compounds, including hematoporphyrin, and oligomers containing up to eight porphyrin units. In methanol a sensitizer concentration-independent quantum yield of 0.64 is measured for the HpD-induced production of singlet molecular oxygen O2 (1Delta(g)). This finding is consistent with the dye components remaining unassociated in this solvent. In water pH 7.4 HpD consists of a complex mixture of non-aggregated and self- and cross-aggregated monoporphyrinic and oligomeric species, and the quantum yield of O2 (1Delta(g)) formation decreases significantly with increasing HpD concentration due to the lower quantum yield of aggregates. These variations can be quantitatively described in terms of a monomer-dimer equilibrium, with quantum yields of 0.64 and 0.11, respectively, for monomers and dimers. The yields of unassociated species are identical in methanol and water.

Dimerization↗

[Microcirculatory effects of photodynamic therapy with hematoporphyrin derivative].

Hematoporphyrin derivative photosensitizes selectively malignant tumors following intravenous administration and shows typical fluorescence patterns in the range between 630 nm and 690 nm. Irradiation with laser light (630 nm) causes selective tumor necrosis due to a phototoxic effect. The site of action of this "photodynamic treatment (PDT)" remains obscure. In this study it could be demonstrated that directly after PDT a selective haemorrhage and thrombosis of blood vessels occurs in the tumor tissue. Furthermore, the arterioles of the surrounding normal tissue constrict completely. Venules of normal tissue showed slow thrombosis. Basically, the result of photodynamic treatment was a complete breakdown of tumor tissue microcirculation accompanied by partial damage to the surrounding normal tissue perfusion. This evaluation of the impact of PDT on tumor microcirculation led to the conclusion that a primary site of action of photodynamic therapy may contribute to the selective destruction of tumor microcirculation.

Animals↗

Induction of superficial bladder tumors in the female Fischer 344 rats with AY-27 tumor cells for the study of diffusion and localization of hemoglobin derived components (hematoporphyrin derivative) in view of photochemotherapy.

Photochemotherapy (PCT) consists in administration of a photosensitizer and subsequent irradiation of the tumor with visible light. Routinely, the photosensitizer is given intravenously (i.v.), but the major drawback of this procedure is the resulting skin photosensitivity. The goal of our study is to examine whether intravesical (i.b.) instillation of the photosensitizer for PDT of bladder cancer might be feasible in order to target the tumors and to avoid the photosensitization phenomenon. After first studying the biodistribution of hematoporphyrin derivative (HpD) in vivo in the rat bladder, two and four hours after intravesical administration, by fluorescence microscopy, we compared two different methods for the induction of superficial bladder tumors in rats with AY-27 tumor cell line in order to perform the same study on bladder tumors. The best results for the penetration depth of HpD in the normal bladder wall were obtained two hours after the bladder instillation where the photosensitizer was detected only in the bladder surface (urothelium and small part of the chorion). That's why we must choose the most appropriate bladder tumor model in order to obtain superficial bladder tumors that mimic the clinical behavior of superficial bladder cancer in man. Both techniques used in this study gave a high tumor take rate in a short time (> 90%). But we really obtained superficial bladder tumors directly attached to the bladder surface with one of the two methods of tumor induction consisting in the abrasion of the bladder surface prior to the administration of the tumoral cells in the bladder cavity.

Animals↗

The effect of hematoporphyrin derivative and human erythrocyte ghost encapsulated hematoporphyrin derivative on a mouse myeloma cell line.

The effect of hematoporphyrin derivative (HPD) in combination with HeNe laser radiation on a mouse myeloma cell line, P3X63Ag8U1, has been examined. The effects of varying doses of radiation and photosensitizer were assessed using both dye exclusion and clonogenic assay systems. Development of photosensitivity by those cells in the presence of hematoporphyrin (HP) and HPD has been examined. In addition, with a view towards assessing erythrocyte encapsulation as a vehicle for an immunotargeting system for HPD, the effect of HPD encapsulated in such a manner, on the mouse myeloma cell line has been examined. From the results obtained from these in vitro experiments the authors believe that this may be a convenient means of packaging HPD for antibody-mediated delivery to tumour cells.

Cell Fusion↗

Parameters of hematoporphyrin derivative tumor cell killing efficiency: decomposition of hematoporphyrin derivative at high power densities.

Hematoporphyrin derivative (HpD) tumor cell killing efficiency has been evaluated as a function of power density, optical spectrum, HpD concentration, and HpD preparation using trypan blue exclusion assay. Cell survival curves for Mayo Clinic HpD and for Photofrin were equivalent at all concentrations and power densities for both violet and red light. Survival curves for red light demonstrated a two-fold increased cellular killing efficiency at higher densities (160 mW/cm2). However, for violet light an irreversible and marked decrease in cellular killing efficiency was found as the power density was increased. This phenomena of decreased cellular killing efficiency of violet light at high power densities is consistent with a process of photo-decomposition of HpD and is most pronounced at low concentrations (less than 25 micrograms/ml).

Cell Survival↗

Pharmacokinetic studies of hematoporphyrin derivatives on rat hepatocytes. Protoporphyrin dimethyl ester hematoporphyrin ether versus dihematoporphyrin ether-free hematoporphyrin derivative.

Rat liver cells incorporate monomeric as well as dimeric hematoporphyrin derivatives. Time-dependent incubation assays gave evidence that monomeric compounds are more efficiently incorporated compared to protoporphyrin dimethyl ester hematoporphyrin ether. HL60 cells take up dimeric porphyrins in substantially higher quantities than hepatocytes do. These results allow the conclusion that physiological versus tumor cells behave differently with respect to porphyrin uptake: Whereas physiological cells prefer monomeric porphyrins, tumor cells preferentially incorporate dimeric porphyrins.

Animals↗

The main photosensitizing components of hematoporphyrin derivative.

Commercial hematoporphyrin (Hp) and the tumor-localizing and photosensitizing agent hematoporphyrin derivative (Hpd) were analysed by means of high pressure lipid chromatography (HPLC). Furthermore, their efficiencies in sensitizing the photoinactivation of human cells in vitro were compared. The comparison showed that the least polar components of Hpd played the major role in this sensitization. In Hpd solutions used for injection in photochemotherapeutic treatment of cancer, these active components seem to be present as aggregates.

Cell Line↗

Immunological suppression in mice treated with hematoporphyrin derivative photoradiation.

Hematoporphyrin derivative (HPD) is a potent photosensitizer which localizes preferentially in malignant tumors. Parenteral administration of this compound followed by irradiation with the appropriate wavelengths of light has been used for the diagnosis and treatment of various epithelial neoplasms. In this study the effects of such treatment on immunological responses were evaluated by examining the capacity of HPD and light to inhibit contact hypersensitivity to dinitrofluorobenzene (DNFB) in C3H mice. Pretreatment of mice with HPD photoradiation resulted in 50% suppression of contact hypersensitivity to DNFB. Inhibition of the response could be produced even when sensitization with DNFB was attempted 2 weeks after a single irradiation procedure, indicating that HPD and light-induced inhibition of contact sensitivity was sustained phenomenon. Prior sensitization with DNFB followed by treatment with HPD and light elicited no immunosuppression. The immunosuppressive response required photoactivation of the porphyrin molecule, since mice treated with HPD alone or light alone developed little or no suppression. In adoptive transfer studies, it was shown that the immunosuppression was associated with the development of suppressor cells. These results indicate that photoradiation therapy with HPD and light can produce systemic suppression of contact hypersensitivity in mice. These data suggest that HPD photoradiation of malignant tumors may inhibit certain types of immune responses in humans.

Animals↗