This study was designed to examine modes of cell death after photodynamic therapy (PDT). Murine leukemia L1210 cells and human prostate Bax-deficient DU-145 cells were examined after PDTinduced photodamage to the endoplasmic reticulum (ER). Previous studies indicated that this treatment resulted in a substantial loss of Bcl-2 function. Both apoptosis and autophagy occurred in L1210 cells after ER photodamage with the latter predominating after 24 hr. These processes were characterized by altered cellular morphology, chromatin condensation, loss of mitochondrial membrane potential and formation of vacuoles containing cytosolic components. Western blots demonstrated processing of LC3-I to LC3-II, a marker for autophagy. In DU145 cells, PDT initiated only autophagy. Phosphatidylinositol (PI) 3-kinase inhibitors suppressed autophagy in both cell lines as indicated by inhibition of vacuolization and LC3 processing. Inhibitors of apoptosis and/or autophagy were then used to delineate the contributions of the two pathways to the effects of PDT. Given the ability of autophagy to upregulate MHC-11 peptide presentation, autophagy may play a role in the ability of photodynamic therapy to stimulate immunologic recognition of target cells.
Keywords
apoptosis; autophagy; photodynamic therapyPhotodynamic therapy (PDT) involves the photosensitization of neoplastic cells and tissues with porphyrins or related structures that catalyze, upon irradiation, formation of reactive oxygen species. 1 While effects of PDT on tissues also include vascular shutdown and the evoking of immunologic responses, there is also an element of direct cell kill that can reduce the neoplastic cell population by 2-3 logs. 1 This might be useful in a surgical context since it has been estimated that tumor cells are often left at surgical margins. 2 It was initially believed that PDT killed cells via necrosis, and in 1991, Oleinick's group demonstrated that PDT could trigger the induction of apoptosis. 3 Numerous subsequent studies documented the induction of apoptosis in a variety of cell types, by an array of different sensitizers and a variety of mechanisms. The cytotoxicity of PDT protocols, however, cannot be fully explained by the apoptotic response. Cells lacking procaspase-3 4 or Bax 5 die after PDT, but do not display the characteristics of necrotic or apoptotic cell death.Autophagy was originally characterized as a survival response to nutrient deprivation and other forms of cellular stress, 6 but studies within the past decade clearly indicate that the induction of autophagy can sometimes lead to cell death. [7][8][9][10][11][12][13] Indeed, autophagic death is important during