Photodynamic therapy for atherosclerosis. The potential of indocyanine green

Abstract

The aim of this article is to summarize and review the use of photodynamic therapy for the treatment of atherosclerotic plaque and the prevention of intimal hyperplasia. Different photosensitizers are discussed and more specific the role of indocyanine green as a potential photosensitizer. Methods: Literature search with focus on the use of photodynamic therapy in atherosclerosis, the mechanism of action and the different photosensitizers for photodynamic therapy. Results: In-vitro and in-vivo studies confirm the use of photodynamic therapy for the treatment of atherosclerosis and the prevention of restenosis. Non-specific accumulation of photosensitizer and thus phototoxicity, remains an important problem. Indocyanine green is a photosensitizer with features in favor of photodynamic therapy. The results of photodynamic therapy with indocyanine green point towards the potential of indocyanine green as a photosensitizer in photodynamic therapy for atherosclerosis. Conclusion: Photodynamic therapy is a promising tool for atherosclerosis. Many of the studied photosensitizers have toxic effects. Indocyanine green might be a good photosensitizer for the use of photodynamic therapy in atherosclerosis. These data justify further research to the use of indocyanine green as a photosensitizer in the treatment of atherosclerotic plaque both de novo or in restenotic lesions.

Oxidative Damage Induced by Phototoxic Pheophorbide a 17-Diethylene Glycol Ester Encapsulated in PLGA Nanoparticles

“…The current PDT application is significantly expanding; it is already applied in the treatment of cancer, atherosclerosis, microbial, and fungal diseases, the stimulation of immune response, and the reduction of adipogenesis and lipogenesis, etc. [ 2 , 3 , 4 , 5 ]. The PDT mechanism is based on the photosensitizer (PS) transition to the excited state under light irradiation and follows the formation of reactive oxygen species (ROS) and free radicals that result in apoptosis or necrosis [ 6 ].…”

Photodynamic Therapy Review: Principles, Photosensitizers, Applications, and Future Directions

“…PDT is a minimally invasive procedure that is clinically used in the treatment of several oncologic human diseases, such as skin, esophageal, head and neck, lung, and bladder cancers [ 57 ]. However, PDT also has several non-oncologic applications [ 58 ], including the treatment of non-cancerous human diseases, such as dermatologic (acne [ 59 ], warts [ 60 ], photoaging [ 61 ], psoriasis [ 62 ], vascular malformations [ 63 ], hirsutism [ 64 ], keloid [ 50 ], and alopecia areata [ 65 ]), ophthalmologic (central serous chorioretinopathy [ 66 ] and corneal neovascularization [ 67 ]), cardiovascular (atherosclerosis [ 68 ] and esophageal varix [ 69 ]), dental (oral lichen planus [ 70 ]), neurologic (Alzheimer’s disease [ 71 ]), skeletal (rheumatoid arthritis [ 72 ]), and gastrointestinal (Crohn’s disease [ 73 ]).…”

Targeted theranostic photoactivation on atherosclerosis

“…Then, these macrophage-derived foam cells are presented at initial stages in the development of atherosclerosis [ 6 , 7 ]. Photoactivation, the process of activating a photosensitizer by means of laser irradiation, has emerged as a promising therapeutic strategy for atherosclerosis therapy because this approach reduces activated macrophages in atheroma and thus stabilizes atherosclerotic plaques [ 8 – 10 ]. Photoactivation utilizes a specific wavelength of light to activate photosensitizers, converting oxygen to reactive oxygen species (ROS) such as singlet oxygen ( 1 O 2 ) [ 8 ].…”

“…Photoactivation, the process of activating a photosensitizer by means of laser irradiation, has emerged as a promising therapeutic strategy for atherosclerosis therapy because this approach reduces activated macrophages in atheroma and thus stabilizes atherosclerotic plaques [ 8 – 10 ]. Photoactivation utilizes a specific wavelength of light to activate photosensitizers, converting oxygen to reactive oxygen species (ROS) such as singlet oxygen ( 1 O 2 ) [ 8 ]. ROS generated by light energy eradicated the inflammatory cells via induction of apoptosis, and even promoted the vascular healing [ 9 , 11 , 12 ].…”