Photodynamic therapy in dermatology: Beyond current indications

Queirós, Catarina; Garrido, Pedro; Silva, João Maia; Filipe, Paulo

doi:10.1111/dth.13997

Cited by 35 publications

(26 citation statements)

References 37 publications

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“…It was stated that PDT could be used in the treatment of various illnesses ( Dougherty, 2002 ; Karrer and Szeimies, 2007 ). For instance, PDT is used to treat multiple dermatological and infectious diseases such as psoriasis vulgaris, Darier’s disease (DAR), cutaneous sarcoidosis (granulomatous disease), lichen planus, acne vulgaris, acne inversa, rosacea, sebaceous hyperplasia, verrucae vulgaris, cutaneous leishmaniasis, condyloma acuminatum (genital warts), and circumscribed scleroderma ( Karrer and Szeimies, 2007 ; Babilas et al, 2010 ; Kharkwal et al, 2011 ; Queiros et al, 2020 ). In addition, PDT is used as a treatment method for dental ailments such as periodontitis, cardiovascular diseases such as atherosclerosis, esophageal varices, and neurological disorders such as Alzheimer’s disease and prion diseases ( Meisel and Kocher, 2005 ; Al Habashneh et al, 2015 ; Yoo et al, 2021 ).…”

Section: Mechanisms Of Actionmentioning

confidence: 99%

Photodynamic Therapy—Current Limitations and Novel Approaches

2021

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Photodynamic therapy (PDT) mostly relies on the generation of singlet oxygen, via the excitation of a photosensitizer, so that target tumor cells can be destroyed. PDT can be applied in the settings of several malignant diseases. In fact, the earliest preclinical applications date back to 1900’s. Dougherty reported the treatment of skin tumors by PDT in 1978. Several further studies around 1980 demonstrated the effectiveness of PDT. Thus, the technique has attracted the attention of numerous researchers since then. Hematoporphyrin derivative received the FDA approval as a clinical application of PDT in 1995. We have indeed witnessed a considerable progress in the field over the last century. Given the fact that PDT has a favorable adverse event profile and can enhance anti-tumor immune responses as well as demonstrating minimally invasive characteristics, it is disappointing that PDT is not broadly utilized in the clinical setting for the treatment of malignant and/or non-malignant diseases. Several issues still hinder the development of PDT, such as those related with light, tissue oxygenation and inherent properties of the photosensitizers. Various photosensitizers have been designed/synthesized in order to overcome the limitations. In this Review, we provide a general overview of the mechanisms of action in terms of PDT in cancer, including the effects on immune system and vasculature as well as mechanisms related with tumor cell destruction. We will also briefly mention the application of PDT for non-malignant diseases. The current limitations of PDT utilization in cancer will be reviewed, since identifying problems associated with design/synthesis of photosensitizers as well as application of light and tissue oxygenation might pave the way for more effective PDT approaches. Furthermore, novel promising approaches to improve outcome in PDT such as selectivity, bioengineering, subcellular/organelle targeting, etc. will also be discussed in detail, since the potential of pioneering and exceptional approaches that aim to overcome the limitations and reveal the full potential of PDT in terms of clinical translation are undoubtedly exciting. A better understanding of novel concepts in the field (e.g. enhanced, two-stage, fractional PDT) will most likely prove to be very useful for pursuing and improving effective PDT strategies.

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Section: Mechanisms Of Actionmentioning

confidence: 99%

Photodynamic Therapy—Current Limitations and Novel Approaches

2021

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“…PDT is approved in Europe for the treatment of actinic keratosis, squamous cell carcinoma in situ, and some forms of basal cell carcinoma. However, as an “off-label” treatment, PDT has also demonstrated efficacy in inflammatory and infectious dermatoses ( Queirós et al, 2020 ). There is also one case report describing aPDI application for skin treatment in an AD patient.…”

Section: Future Perspectives For the Antistaphylococcal Treatmentmentioning

confidence: 99%

Colonization With Staphylococcus aureus in Atopic Dermatitis Patients: Attempts to Reveal the Unknown

et al. 2021

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Atopic dermatitis (AD) patients are massively colonized with Staphylococcus aureus (S. aureus) in lesional and non-lesional skin. A skin infection may become systemic if left untreated. Of interest, the incidence of multi-drug resistant S. aureus (MRSA) in AD patients is higher as compared to a healthy population, which makes treatment even more challenging. Information on the specific genetic background of S. aureus accompanying and/or causing AD flares would be of great importance in terms of possible treatment option development. In this review, we summarized the data on the prevalence of S. aureus in general in AD skin, and the prevalence of specific clones that might be associated with flares of eczema. We put our special interest in the presence and role of staphylococcal enterotoxins as important virulence factors in the epidemiology of AD-derived S. aureus. Also, we summarize the present and potentially useful future anti-staphylococcal treatment.

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“…It is mainly used for nonmelanoma skin cancers and actinic keratosis, but the list of indications is enlarging. It is necessary to apply a photosensitizing substance followed by a light irradiation [ 63 , 64 , 65 , 66 , 67 ]. The reaction between the photosensitizer and light leads to the formation of cytotoxic reactive oxygen species (ROS), and as a result, to the destruction of targeted cells [ 68 , 69 ].…”

Section: The Clinical Use Of Blue Lightmentioning

confidence: 99%

“…However, the penetration of blue light into the skin is more superficial than the penetration of red light [ 67 ]. As a consequence, only red light is used to treat skin cancers, whereas blue light may be used for the nonhyperkeratotic actinic keratosis therapy [ 63 , 64 , 71 ].…”

Section: The Clinical Use Of Blue Lightmentioning

confidence: 99%

Blue Light in Dermatology

Sadowska

Lesiak

2021

Life

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Phototherapy is an important method of dermatological treatments. Ultraviolet (280–400 nm) therapy is of great importance; however, there are concerns of its long-term use, as it can lead to skin aging and carcinogenesis. This review aims to evaluate the role and the mechanism of action of blue light (400–500 nm), a UV-free method. The main mediators of cellular responses to blue light are nitric oxide (NO) and reactive oxygen species (ROS). However, the detailed mechanism is still not fully understood. It was demonstrated that blue light induces an anti-inflammatory and antiproliferative effect; thus, it may be beneficial for hyperproliferative and chronic inflammatory skin diseases such as atopic dermatitis, eczema, and psoriasis. It was also found that blue light might cause the reduction of itching. It may be beneficial on hair growth and may be used in the treatment of acne vulgaris by reducing follicular colonization of Propionibacterium acnes. Further studies are needed to develop accurate protocols, as the clinical effects depend on the light parameters as well as the treatment length. There are no major adverse effects observed yet, but long-term safety should be monitored as there are no studies considering the long-term effects of blue light on the skin.

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Photodynamic therapy in dermatology: Beyond current indications

Cited by 35 publications

References 37 publications

Photodynamic Therapy—Current Limitations and Novel Approaches

Photodynamic Therapy—Current Limitations and Novel Approaches

Colonization With Staphylococcus aureus in Atopic Dermatitis Patients: Attempts to Reveal the Unknown

Blue Light in Dermatology

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