No abstract

Photodynamic therapy (PDT) is a clinical modality used to treat cancer and infectious diseases. The main agent is the photosensitizer (PS), which is excited by light and converted to a triplet excited state. This latter species leads to the formation of singlet oxygen and radicals that oxidize biomolecules. The main motivation for this review is to suggest alternatives for achieving high-efficiency PDT protocols, by taking advantage of knowledge on the chemical and biological processes taking place during and after photosensitization. We defend that in order to obtain specific mechanisms of cell death and maximize PDT efficiency, PSes should oxidize specific molecular targets. We consider the role of subcellular localization, how PS photochemistry and photophysics can change according to its nanoenvironment, and how can all these trigger specific cell death mechanisms. We propose that in order to develop PSes that will cause a breakthrough enhancement in the efficiency of PDT, researchers should first consider tissue and intracellular localization, instead of trying to maximize singlet oxygen quantum yields in in vitro tests. In addition to this, we also indicate many open questions and challenges remaining in this field, hoping to encourage future research.

Methylene Blue (MB + ) is a sensitizer that has been used for a variety of applications including energy conversion and photodynamic therapy (PDT). Although its photochemical properties in isotropic solution are well established, its effect in vivo and in restricted reaction environments is somewhat erratic. In order to understand its photochemical behavior when it interacts with biomolecules, in particular with membranes, MB + properties were studied in sodium dodecyl sulfate (SDS) and cetyl trimethylammonium bromide (CTAB) solutions. Because of an electrostatic attraction, SDS and MB + form complexes, changing the properties of both the micelles and the MB + solutions. Surface tension measurements show that the c.m.c. of SDS decreases from $7 mM to $70 mM when the MB + concentration increases from 0 to 45 mM. Above the c.m.c., binding of MB + in the micelle pseudo-phase causes the formation of aggregates (mostly dimers) as attested by the increase in the absorption at 580 nm and the decrease in fluorescence emission. The extent of dimer formation is dependent on the relative concentrations of MB + and SDS. In the presence of excess of SDS, MB + is mainly in the monomer form and at low SDS concentration dimers are favored. Such effect, which was not observed in CTAB micelles, was modeled qualitatively by considering that MB + molecules partition to the micelle pseudophase which favors or disfavors dimers as a function of its volume. MB + transient species were characterized by laser flash photolysis and NIR emission showing the presence of triplets and subsequently singlet oxygen at high SDS concentration and semi-reduced and semi-oxidized MB + radicals at low SDS concentration. Therefore it was shown that, depending on the ground state MB + monomer/dimer equilibrium, induced by the micelles, the photochemical properties of MB + can be shifted from a Type II (energy transfer to oxygen forming singlet oxygen) to a Type I mechanism (electron transfer forming the semi-reduced and the semi-oxidized radicals of MB + ).

Although the general mechanisms of lipid oxidation are known, the chemical steps through which photosensitizers and light permeabilize lipid membranes are still poorly understood. Herein we characterized the products of lipid photooxidation and their effects on lipid bilayers, also giving insight into their formation pathways. Our experimental system was designed to allow two phenothiazinium-based photosensitizers (methylene blue, MB, and DO15) to deliver the same amount of singlet oxygen molecules per second to 1-palmitoyl-2-oleoyl- sn-glycero-3-phosphocholine liposome membranes, but with a substantial difference in terms of the extent of direct physical contact with lipid double bonds; that is, DO15 has a 27-times higher colocalization with ω-9 lipid double bonds than MB. Under this condition, DO15 permeabilizes membranes at least 1 order of magnitude more efficiently than MB, a result that was also valid for liposomes made of polyunsaturated lipids. Quantification of reaction products uncovered a mixture of phospholipid hydroperoxides, alcohols, ketones, and aldehydes. Although both photosensitizers allowed the formation of hydroperoxides, the oxidized products that require direct reactions between photosensitizer and lipids were more prevalent in liposomes oxidized by DO15. Membrane permeabilization was always connected with the presence of lipid aldehydes, which cause a substantial decrease in the Gibbs free energy barrier for water permeation. Processes depending on direct contact between photosensitizers and lipids were revealed to be essential for the progress of lipid oxidation and consequently for aldehyde formation, providing a molecular-level explanation of why membrane binding correlates so well with the cell-killing efficiency of photosensitizers.

Oxidation can intimately influence and structurally compromise the levels of biological self-assembly embodied by intracellular and plasma membranes. Lipid peroxidation, a natural metabolic outcome of life with oxygen under light, is also a salient oxidation reaction in photomedicine treatments. However, the effect of peroxidation on the fate of lipid membranes remains elusive. Here we use a new photosensitizer that anchors and disperses in the membrane to achieve spatial control of the oxidizing species. We find, surprisingly, that the integrity of unsaturated unilamellar vesicles is preserved even for fully oxidized membranes. Membrane survival allows for the quantification of the transformations of the peroxidized bilayers, providing key physical and chemical information to understand the effect of lipid oxidation on protein insertion and on other mechanisms of cell function. We anticipate that spatially controlled oxidation will emerge as a new powerful strategy for tuning and evaluating lipid membranes in biomimetic media under oxidative stress.