光动力疗法基础研究与临床应用的新进展  

Recent Progress in Photodynamic Therapy:From Fundamental Research to Clinical Applications

作　　者：李步洪[1] 陈天龙 林立[1] 陈兵 邱海霞[3] 顾瑛[3] Li Buhong;Chen Tianlong;Lin Li;Chen Bing;Qiu Haixia;Gu Ying(MOE Key Laboratory of Optoelectronic Science and Technology for Medicine,Fujian Provincial Key Laboratory for Photonics Technology,Fujian Normal University,Fuzhou,Fujian 350117,China;Fuzhou Tucsen Photonics Co.,Ltd.,Fuzhou,Fujian 350007,China;Department of Laser Medicine,First Medical Center,Chinese PLA General Hospital,Beijing 100039,China)

机构地区：[1]福建师范大学医学光电科学与技术教育部重点实验室,福建省光子技术重点实验室,福建福州350117 [2]福州图鑫光电有限公司,福建福州350007 [3]解放军总医院第一医学中心激光医学科,北京100039

出　　处：《中国激光》2022年第5期3-19,共17页Chinese Journal of Lasers

基　　金：国家自然科学基金(61935004,61635014,61835015,62005047);福建省科技计划项目(2019Y4004);福建医科大学孟超肝胆医院重点实验室开放课题(2018ZDS2006)。

摘　　要：光动力疗法(PDT)是一种综合利用光敏剂、光和氧分子,通过光动力反应选择性地治疗恶性肿瘤、血管性病变和微生物感染等疾病的新型疗法。PDT作为光治疗的一种重要方法,已逐渐成为继手术、放疗和化疗之后治疗肿瘤的第四种微创疗法,同时还是治疗鲜红斑痣等特殊疾病的首选疗法。本文简要回顾PDT的研究现状;以提高PDT疗效为目标,重点分析光敏剂、光源、组织氧含量、协同治疗、量效评估等基础研究以及临床应用的研究进展;讨论临床个性化精准PDT及其推广应用所面临的挑战和发展方向。Significance Photodynamic therapy(PDT) is an effective treatment modality for different types of cancer, vascular-related diseases, and microbiological infections. PDT uses photosensitizer(PS), the light of a specific wavelength, and molecular oxygen to produce highly toxic reactive oxygen species(ROS), which causes cell death via different mechanisms such as vessel constriction, immunological response, and cell damage by apoptosis, autophagy, and necrosis pathways. Fundamental studies of PDT suggest that ROS yield can be affected by various factors such as transportation efficiency and tumor-targeting ability of PSs, illumination strategy of excitation sources, oxygen supply or dependence of the ROS-generation process, and combination with other therapeutic methods, hence directly determining the therapeutic efficacy. Additionally, the relationship between treatment dose and PDT efficacy is still under investigation. The evaluation for PDT indirectly but considerably affects the PDT efficacy by accurately monitoring dosimetric parameters of PDT, which is followed by efficiently regulating and upgrading the therapeutic scheme. In this study, the recent advances in PSs, light sources, tissue oxygenation, synergistic treatment, and dosimetry for improving the clinical PDT efficacy are summarized.Progress Several novel PSs such as C60, black phosphorus, graphene quantum dots, and PSs with aggregationinduced emission, have been developed to improve the quantum yield of 1O2. The delivery efficiency of PSs has been improved by different PS delivery strategies and the tumor-microenvironment-responsive release scheme. PS absorption has been enhanced by organelle targeting and photochemical internalization, and PS hypoxia resistance has been resolved through loading with oxygen carriers or oxygen-generating reactants. Further, PS development with the synergistic therapeutic function will be used to enhance PDT efficacy.As for PDT excitation sources, solar light, broad-spectrum lamps, lasers, light-emitting diodes(LEDs), X

关 键 词：生物光学 光动力疗法 光敏剂 光源 氧含量 协同治疗 剂量 临床应用 

分 类 号：R454.2[医药卫生—治疗学]