Photodynamic therapy for the treatment of atherosclerotic plaque: Lost in translation?

Abstract

Summary Acute coronary syndrome is a life‐threatening condition of utmost clinical importance, which, despite recent progress in the field, is still associated with high morbidity and mortality. Acute coronary syndrome results from a rupture or erosion of vulnerable atherosclerotic plaque with secondary platelet activation and thrombus formation, which leads to partial or complete luminal obstruction of a coronary artery. During the last decade, scientific evidence demonstrated that when an acute coronary event occurs, several nonculprit plaques are in a “vulnerable” state. Among the promising approaches, several investigations provided evidence of photodynamic therapy (PDT)‐induced stabilization and regression of atherosclerotic plaque. Significant development of PDT strategies improved its therapeutic outcome. This review addresses PDT's pertinence and major problems/challenges toward its translation to a clinical reality.

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“…PDT is also being used to kill viruses , microbial cells and bacteria . It is also clinically used to treat a wide range of non‐oncological medical conditions , including treatment of acne and wet, age‐related macular degeneration .…”

Tumor Microenvironment-Responsive Nanomaterials as Targeted Delivery Carriers for Photodynamic Anticancer Therapy

“…These ROS can damage most types of biomolecules. ROS are the direct effectors that PDT kills tumor cells with (Oleinick et al, 2002 ; Jain et al, 2017 ; Dobson et al, 2018 ; Jiang et al, 2019 ), however, most PS lack targeting capability and induce cytotoxicity on neighbor normal cells by releasing ROS during photodynamic anticancer therapy. Thus, there is an urgent need to precisely control the production of ROS in target cells for improving the clinical outcome of PDT.…”

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“…There are two different cell death pathways after photosensitization, namely, nonprogrammed (necrosis) and programmed (apoptotic and autophagy) pathways. Generally, the apoptotic pathway requires a low intensity of light irradiation, whereas the necrotic pathway needs a higher dose of light …”

“…The photosensitizers can generate ROS, such as singlet oxygen, free radicals, or peroxides, under the stimulation of a suitable light wavelength, which can induce cell death and facilitate plaque stabilization. After photosensitization, nonprogrammed (necrosis) and programmed (apoptotic and autophagy) cell death pathways can be achieved via high and low intensities of light irradiation, respectively …”