Research progress in the application of IL-6 in photodynamic therapy

Li Shanshan, Li Jingjing, Mo Xingfan, Wu Minzhi

JOURNAL OF NEW MEDICINE ›› 2023, Vol. 54 ›› Issue (10) : 695-699.

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JOURNAL OF NEW MEDICINE ›› 2023, Vol. 54 ›› Issue (10) : 695-699. DOI: 10.3969/j.issn.0253-9802.2023.10.001
Editorial

Research progress in the application of IL-6 in photodynamic therapy

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Abstract

Photodynamic therapy (PDT) is a non-invasive treatment method that combines light sources and photosensitizers. It is currently widely applied in clinical practice to treat acne, genital warts, and multiple tumor diseases. The mechanism of PDT is complex. Researches have found that the efficacy of PDT seems to be closely related to the degree of acute inflammation it causes. IL-6 is a common pro-inflammatory factor that belongs to the category of interleukin (IL). It is produced by fibroblasts, monocytes/macrophages, and T lymphocytes. It exerts multiple effects on inflammation and immune responses. IL-6 can be induced by PDT in vivo and in vitro. In this article, research progress in the application of IL-6 in PDT was reviewed.

Key words

Interleukin-6 / Photodynamic therapy / Infection / Tumor

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Li Shanshan , Li Jingjing , Mo Xingfan , Wu Minzhi. Research progress in the application of IL-6 in photodynamic therapy[J]. JOURNAL OF NEW MEDICINE, 2023, 54(10): 695-699 https://doi.org/10.3969/j.issn.0253-9802.2023.10.001
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光动力疗法(PDT)是一种联合光源及光敏剂的非侵入性的治疗方法,目前在临床应用广泛,用于治疗痤疮、尖锐湿疣及多种肿瘤疾病,其可直接杀伤病变细胞,也可诱导非特异性和特异性免疫反应[1]。临床中我们观察到PDT后出现明显的急性炎症反应,且PDT的疗效似乎与其引起急性炎症的程度密切相关,有研究表明光动力治疗本质是激活炎症过程[2]。而IL-6是一种常见的促炎因子,属于白介素的一种,由纤维母细胞、单核/巨噬细胞及T淋巴细胞等产生,对炎症和免疫反应具有多重作用。IL-6可被光动力诱导,而关于IL-6对PDT疗效影响的报道不一致[3]。本文就IL-6在光动力治疗应用中的研究进行论述。

一、IL-6及其功能

IL-6是一种多效性细胞因子,是IL-6细胞因子家族的典型成员[4]。在肿瘤微环境中,其主要由肿瘤细胞、肿瘤性相关巨噬细胞和成纤维细胞分泌[5-6]。IL-6受体(IL-6R)主要以膜结合(mIL-6R)和可溶性形式(sIL-6R)与IL-6结合。IL-6与IL-6R结合后激活Janus激酶以及三条信号通路,即JAK-STAT3通路(参与细胞分化、迁移、成熟、免疫调节和血管生成过程)、Ras/Raf/MEK/MAPK信号通路(参与细胞增殖过程)和PI3K/PKB/Akt通路(参与细胞增殖、存活、凋亡、生长、代谢和氧化应激过程)[7]
IL-6是炎症和自身免疫的关键因子,其在急性炎症或慢性炎症中具有双重作用。IL-6在调节急性炎症中起着关键作用,急性炎症期IL-6可以恢复T淋巴细胞免疫反应,将其从免疫抑制状态转变为针对肿瘤的免疫刺激状态[8]。慢性炎症期IL-6活性可刺激免疫抑制信号,并抑制免疫反应的产生。此外,IL-6与多种癌症的发展和治疗耐药性有关,对新陈代谢、发育和组织修复的调节也有着复杂的贡献,并且在许多情况下启动先天性和适应性免疫反应[9]

二、PDT

PDT是一种非侵入性的现代疗法,是一种利用光能破坏异常及病变组织的药械联用技术,需要特定波长的光、氧分子和光敏剂三大要素,其作用机制主要包括细胞性损伤、血管性损伤、诱导和调节免疫反应[10]。PDT可通过产生氧化自由基和单线态氧,从而诱导细胞的凋亡和坏死,引起细胞性损伤。PDT中产生的单线态氧也会破坏肿瘤相关血管组织,导致肿瘤相关血管出血或血管内形成血栓,引起血管性损伤,最终导致肿瘤细胞因缺氧和营养丧失而坏死。此外,光动力还可诱导和调节免疫反应,PDT引起病变细胞内细胞因子的释放及急性炎症反应的发生,促使了免疫细胞侵入病变组织,从而破坏病变组织[11]
PDT包括局部或全身应用光敏剂。光敏剂的发展主要经历了三代,从以血卟啉衍生物为代表的一代光敏剂到现在的一些具有药物传输系统的三代新型功能型光敏剂,疗效、毒性、理化性质等方面都有了很大的改善。目前常用的光敏剂有5-氨基酮戊酸(ALA)、焦脱镁叶绿酸-a、姜黄素、竹红菌素以及酞菁等[12-13]。随着光动力研究的进展及多种光敏剂的研发,目前光动力治疗应用越来越广泛,被用于许多医学领域,包括非肿瘤疾病和各种肿瘤的治疗,如口腔炎症、尖锐湿疣、皮肤鳞状细胞癌(鳞癌)及消化道肿瘤等,在皮肤科、肿瘤科及眼科等疾病的治疗中有着良好的疗效,具有独特的不可替代的优势。

三、IL-6在光动力治疗非肿瘤疾病中的应用

1.口腔炎症疾病

PDT目前广泛应用于口腔疾病的治疗,如正畸、根管治疗、牙龈和牙周炎症、种植体周围疾病以及扁平苔藓等白色病变[14-15]。IL-6是宿主介导的主要促炎症生物标志物,与牙周和种植体周围疾病的发病有关[16]。PDT目前是牙周炎的主要治疗方式,并可作为洁治和根面平整的辅助手段。研究发现在光动力治疗牙周炎3个月后可观察到促炎因子IL-6和IL-8降低;在正畸治疗引起的牙龈增生的治疗中,PDT可明显降低IL-6的表达,有助于减少牙周细菌并改善牙龈增生[17-19]。急性重度冠周炎在光动力治疗后炎性因子IL-6及TNF-α降低,疼痛较前减轻[20]
此外,有研究发现,PDT能够增加发炎部位的人牙龈成纤维细胞和健康部位的人牙龈成纤维细胞中IL-6、COL1、FN和bFGF的表达,IL-6的表达已被证明对胶原合成和细胞外基质生成等功能表现至关重要,表明PDT在牙周伤口愈合中具有积极作用[21]。此外,PDT不仅可以控制牙周炎及拔牙后牙槽内的微生物环境,还可通过提高IL-6的水平,改善拔牙后牙槽骨修复过程,防止颌骨骨坏死的发生[22]

2.其他感染性疾病

多重耐药菌感染已经成为全球的威胁。抗菌PDT作为细菌感染的替代疗法受到了广泛的关注[23]。各种研究表明PDT对革兰阴性及阳性细菌、病毒、真菌和寄生虫等具有高度杀菌性,对周围组织几乎没有损伤。姜黄素介导的PDT可降低抗万古霉素的金黄色葡萄球菌感染者的IL-6和TNF-α水平,用于治疗耐多药细菌的感染[24]。抗菌PDT还可治愈常规治疗无效的慢性腿部溃疡患者,除了杀菌作用外,其还可通过IL-6信号通路改变伤口的微环境,作为顽固性感染性溃疡患者的有效治疗方法[25]。此外,研究发现ALA-PDT可提高血管内皮生长因子和转化生长因子-β1的表达,并显著抑制IL-1β和IL-6,为难治性伤口提供一种有希望的创新治疗方案[26]
在痤疮的治疗中,ALA-PDT治疗痤疮后患者血清IL-1β、IL-6、CRP水平降低,提示光动力治疗有利于减轻痤疮患者的炎性反应[27]。在溃疡性结肠炎的治疗中,PDT明显抑制血清或结肠组织中IL-1、IL-6和TNF-α的表达,从而降低了结肠炎的严重程度[28-29]。在口唇单纯疱疹的治疗中,PDT可联合局部抗病毒治疗明显降低IL-6的表达,有助于减轻青少年唇疱疹患者的疼痛及提高疗效[30]。在尖锐湿疣的治疗中,研究发现尖锐湿疣患者治疗前血清IL-6明显低于正常人,治愈后IL-6水平基本恢复到正常人的水平,提示可通过监测血清IL-6表达来评估尖锐湿疣的治疗效果,进一步研究发现IL-6能调节B淋巴细胞增殖分化,辅助T淋巴细胞增生活化,从而具有抗病毒效应,而光动力治疗后尖锐湿疣患者血清中的IL-6表达较治疗前升高,说明PDT可通过促进IL-6的表达调节机体免疫,提高尖锐湿疣的治愈率[31]

四、IL-6在光动力治疗肿瘤疾病中的应用

1.胆管癌

在胆管癌的治疗中,胆管癌与血清IL-6水平升高有关,IL-6是胆管细胞和胆管癌细胞的有效有丝分裂原,其可通过刺激丝裂原激活的蛋白激酶信号通路促进胆管癌细胞的生长。血清IL-6水平与胆管癌患者CT测量的肿瘤负荷相关;胆管癌患者血清IL-6水平升高,对胆管癌具有高度敏感性。Yang等(2016年)发现IL-6可作为胆管癌的生物标志物,且光动力治疗后血清IL-6值降低。这些研究结果表明,血清IL-6浓度可作为胆管癌鉴别诊断的检测指标,并可作为监测PDT治疗胆管癌疗效的标志物。

2.肺癌

据报道,PDT可诱导肺癌细胞表达IL-6和TNF-α等细胞因子,Usuda 等(2001年)用单甲氧基卟啉e6介导的PDT处理Lewis肺癌细胞,发现治疗6小时后IL-2、IL-6和TNF-α的mRNA表达增加,IL-6的表达调节了肺癌细胞对PDT的敏感性,增强了PDT对肺癌细胞的细胞毒性作用,其作用机制可能由于IL-6依赖的凋亡途径中Bax与Bcl-2的高比率所致。总之,IL-6的表达在肺癌细胞对PDT的敏感性中起着重要作用,其可能是PDT在肺癌治疗中抗瘤作用的决定因素。

3.结肠癌和乳腺癌

ALA-PDT可以替代手术切除治疗癌前病变、早期结直肠癌、结肠息肉以及晚期结直肠癌的姑息性治疗。Brackett等(2011年)在Colo26结肠癌和4T1乳腺癌这两种小鼠肿瘤模型中发现,IL-6明显抑制PDT对肿瘤生长的长期控制作用,IL-6似乎对小鼠结肠癌和乳腺癌模型的抗肿瘤免疫记忆和光动力疗效的产生具有负面调节作用。在结肠癌的治疗中,研究发现光动力不仅能有效地破坏恶性组织,而且在亚致死剂量下也能通过减少IL-6和IL-10的分泌发挥其抗癌活性,进一步验证了IL-6在光动力治疗结肠癌中发挥负面调节作用[32]

4.食管鳞癌和头颈部鳞癌

食管鳞癌是全球第六大癌症。PDT是目前治疗食管鳞癌的替代疗法之一。Reginato等(2014年)在食管鳞癌患者血清样本中发现光动力治疗后IL-6表达高度上调,而IL-6参与调节性T淋巴细胞(Treg)功能的调节,在体内小鼠模型中发现,参与抑制Treg功能的IL-6在光动力治疗后的肿瘤组织中的表达增强,说明IL-6参与光动力诱导的Treg功能丧失从而发挥抗瘤作用。在头颈部鳞癌的治疗研究中发现IL-6启动急性期蛋白和补体激活的释放,并参与中性粒细胞迁移,与头颈部鳞癌患者的预后相关。而Theodoraki等(2017)认为PDT能够明显影响头颈部鳞癌患者细胞因子IL-6和IL-10的表达,并可能通过提高IL-6的表达来增强抗肿瘤免疫,但目前确切的作用机制尚不清楚,需要进一步研究。

五、展望

光动力治疗可导致肿瘤细胞直接死亡,血管系统破坏,随后诱发急性炎症。这些事件与各种炎症介质的释放、天然免疫细胞的招募和激活以及随后特异性抗肿瘤免疫反应的激活有关。PDT激活抗肿瘤免疫反应对其治疗效果至关重要。PDT可以触发快速炎症反应,这对激活抗肿瘤免疫至关重要。IL-6是一种促炎症细胞因子,其可通过多种肿瘤细胞和免疫介导的机制产生对PDT的耐药性,也通过旁分泌信号转导到肿瘤细胞增强光动力的效应。光动力治疗可诱导局部和全身产生IL-6,在不同的疾病治疗中发挥不同的免疫作用,随着临床研究的深入,IL-6和PDT的联合应用可能为多种疾病治疗提供新的策略,为广大患者带来福音。

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Cytotoxic chemotherapeutics primarily function through DNA damage-induced tumor cell apoptosis, although the inflammation provoked by these agents can stimulate anti-cancer immune responses. The mechanisms that control these distinct effects and limit immunogenic responses to DNA-damage mediated cell death in vivo are currently unclear. Using a mouse model of BCR-ABL B-cell acute lymphoblastic leukemia, we show that chemotherapy-induced anti-cancer immunity is suppressed by the tumor microenvironment through production of the cytokine IL-6. The chemotherapeutic doxorubicin is curative in IL-6-deficient mice through the induction of CD8 T-cell-mediated anti-cancer responses, while moderately extending lifespan in wild type tumor-bearing mice. We also show that IL-6 suppresses the effectiveness of immune-checkpoint inhibition with anti-PD-L1 blockade. Our results suggest that IL-6 is a key regulator of anti-cancer immune responses induced by genotoxic stress and that its inhibition can switch cancer cell clearance from primarily apoptotic to immunogenic, promoting and maintaining durable anti-tumor immune responses.© 2021. The Author(s).
[9]
Millrine D, Jenkins R H, Hughes S T O, et al. Making sense of IL-6 signalling cues in pathophysiology. FEBS Lett, 2022, 596(5): 567-588.
[10]
Kubrak T, Karakuła M, Czop M, et al. Advances in management of bladder cancer-the role of photodynamic therapy. Molecules, 2022, 27(3): 731.
Photodynamic therapy (PDT) is a non-invasive and modern form of therapy. It is used in the treatment of non-oncological diseases and more and more often in the treatment of various types of neoplasms in various locations including bladder cancer. The PDT method consists of local or systemic application of a photosensitizer, i.e., a photosensitive compound that accumulates in pathological tissue. Light of appropriate wavelength is absorbed by the photosensitizer molecules, which in turn transfers energy to oxygen or initiates radical processes that leads to selective destruction of diseased cells. The technique enables the selective destruction of malignant cells, as the photocytotoxicity reactions induced by the photosensitizer take place strictly within the pathological tissue. PDT is known to be well tolerated in a clinical setting in patients. In cited papers herein no new safety issues were identified. The development of anti-cancer PDT therapies has greatly accelerated over the last decade. There was no evidence of increased or cumulative toxic effects with each PDT treatment. Many modifications have been made to enhance the effects. Clinically, bladder cancer remains one of the deadliest urological diseases of the urinary system. The subject of this review is the anti-cancer use of PDT, its benefits and possible modifications that may lead to more effective treatments for bladder cancer. Bladder cancer, if localized, would seem to be a good candidate for PDT therapy since this does not involve the toxicity of systemic chemotherapy and can spare normal tissues from damage if properly carried out. It is clear that PDT deserves more investment in clinical research, especially for plant-based photosensitizers. Natural PS isolated from plants and other biological sources can be considered a green approach to PDT in cancer therapy. Currently, PDT is widely used in the treatment of skin cancer, but numerous studies show the advantages of related therapeutic strategies that can help eliminate various types of cancer, including bladder cancer. PDT for bladder cancer in which photosensitizer is locally activated and generates cytotoxic reactive oxygen species and causing cell death, is a modern treatment. Moreover, PDT is an innovative technique in oncologic urology.
[11]
程梦星, 邱丽华. 光动力治疗在宫颈疾病中的应用. 现代妇产科进展, 2020, 29 (5): 397-399.
[12]
Kubrak T P, Kołodziej P, Sawicki J, et al. Some natural photosensitizers and their medicinal properties for use in photodynamic therapy. Molecules, 2022, 27(4): 1192.
Despite significant advances in early diagnosis and treatment, cancer is one of the leading causes of death. Photodynamic therapy (PDT) is a therapy for the treatment of many diseases, including cancer. This therapy uses a combination of a photosensitizer (PS), light irradiation of appropriate length and molecular oxygen. The photodynamic effect kills cancer cells through apoptosis, necrosis, or autophagy of tumor cells. PDT is a promising approach for eliminating various cancers but is not yet as widely applied in therapy as conventional chemotherapy. Currently, natural compounds with photosensitizing properties are being discovered and identified. A reduced toxicity to healthy tissues and a lower incidence of side effects inspires scientists to seek natural PS for PDT. In this review, several groups of compounds with photoactive properties are presented. The use of natural products has been shown to be a fruitful approach in the discovery of novel pharmaceuticals. This review focused on the anticancer activity of furanocoumarins, polyacetylenes, thiophenes, tolyporphins, curcumins, alkaloid and anthraquinones in relation to the light-absorbing properties. Attention will be paid to their phototoxic and anti-cancer effects on various types of cancer.
[13]
Zhou Z, Zhang L, Zhang Z, et al. Advances in photosensitizer-related design for photodynamic therapy. Asian J Pharm Sci, 2021, 16(6): 668-686.
Photodynamic therapy (PDT) is highly effective in treating tumors located near body surface, offering strong tumor suppression and low damage to normal tissue nearby. PDT is also effective for treating a number of other conditions. PDT not only provide a precise and selective method for the treatment of various diseases by itself, it can also be used in combination with other traditional therapies. Because PDT uses light as the unique targeting mechanism, it has simpler and more direct targeting capability than traditional therapies. The core material of a PDT system is the photosensitizer which converts light energy to therapeutic factors/substances. Different photosensitizers have their distinct characteristics, leading to different advantages and disadvantages. These could be enhanced or compensated by using proper PDT system. Therefore, the selected type of photosensitizer would heavily influence the overall design of a PDT system. In this article, we evaluated major types of inorganic and organic PDT photosensitizers, and discussed future research directions in the field.© 2021 Published by Elsevier B.V. on behalf of Shenyang Pharmaceutical University.
[14]
Kamran M A. Clinical,microbiological and immunological outcomes with photodynamic therapy as an adjunct to full-mouth scaling in patients undergoing fixed orthodontic treatment. Photodiagnosis Photodyn Ther, 2020, 29: 101585.
[15]
Akram Z, Shafqat S S, Niaz M O, et al. Clinical efficacy of photodynamic therapy and laser irradiation as an adjunct to open flap debridement in the treatment of chronic periodontitis: a systematic review and meta-analysis, Photodermatol.Photoimmunol. Photomed, 2020, 36 (1): 3-13.
[16]
Labban N, Shibani N A, Al-Kattan R, et al. Clinical, bacterial, and inflammatory outcomes of indocyanine green-mediated photodynamic therapy for treating periimplantitis among diabetic patients: a randomized controlled clinical trial. Photodiagnosis Photodyn Ther, 2021, 35: 102350.
[17]
Kolte A, Kharkar V, Kolte R, et al. Influence of adjunctive photodynamic therapy on Interleukin-6, Interleukin-8, and Interleukin-10 gingival crevicular fluid levels in chronic periodontitis-A randomized controlled trial. Contemp Clin Dent, 2021, 12(3): 235-240.
[18]
Alshahrani A, Togoo R A, Kamran M A, et al. Clinical periodontal,bacterial, and immunological outcomes of antimicrobial photodynamic therapy in orthodontic treatment-induced gingival enlargement. Photodiagnosis Photodyn Ther, 2020, 31: 101934.
[19]
Baeshen H A, Alshahrani A, Kamran M A, et al. Effectiveness of antimicrobial photodynamic therapy in restoring clinical, microbial, proinflammatory cytokines and pain scores in adolescent patients having generalized gingivitis and undergoing fixed orthodontic treatment. Photodiagnosis Photodyn Ther, 2020, 32: 101998.
[20]
Elsadek M F, Ahmed B M, Eskandrani R M. Level of pain intensity, cytokine profiling and microbial load after photodynamic therapy in acute severe pericoronitis. Photodiagnosis Photodyn Ther, 2020, 31: 101830.
[21]
Yang R, Guo S, Xiao S, et al. Enhanced wound healing and osteogenic potential of photodynamic therapy on human gingival fibroblasts. Photodiagnosis Photodyn Ther, 2020, 32: 101967.
[22]
Ervolino E, Statkievicz C, Toro L F, et al. Antimicrobial photodynamic therapy improves the alveolar repair process and prevents the occurrence of osteonecrosis of the jaws after tooth extraction in senile rats treated with zoledronate. Bone, 2019, 120: 101-113.
This study evaluated the effects of antimicrobial photodynamic therapy (aPDT) in the alveolar repair of rats with major risk factors for bisphosphonate-related osteonecrosis of the jaws (BRONJ). Senile rats received 0.45 ml of vehicle (VEH and VEH/aPDT) or 0.45 ml of zoledronate (ZOL and ZOL/aPDT) every three days for seven weeks. After three weeks of treatment, the first lower left molar was extracted. VEH/aPDT and ZOL/aPDT were submitted to aPDT on the extraction site at 0, 2 and 4 days postoperatively. Euthanasia was performed 28 days postoperatively and the extraction site was evaluated by clinical, histological, histometric, histochemical and immunohistochemical analysis. ZOL showed tissue repair impairment; lower percentage of newly formed bone tissue (NFBT); higher percentage of non-vital bone tissue (NVBT); fewer mature collagen fibers and increased immunolabeling for tumor necrosis factor (TNFα), interleukin (IL)-1β and IL-6. ZOL/aPDT showed clinical and histological characteristics of the extraction site, percentage of NFBT and percentage of mature collagen fiber similar to VEH. Percentage of NVBT and immunolabeling for inflammatory cytokines in ZOL/aPDT was lower than in ZOL. Immunolabeling for tartarato-resistant acid phosphatase (TRAP) was lower in ZOL and ZOL/aPDT. aPDT in the dental extraction site improves tissue repair process and prevents the occurrence of BRONJ-like lesions after tooth extraction.Copyright © 2018 Elsevier Inc. All rights reserved.
[23]
Akhtar F, Khan A U, Misba L, et al. Antimicrobial and antibiofilm photodynamic therapy against vancomycin resistant Staphylococcus aureus (VRSA) induced infection in vitro and in vivo. Eur J Pharm Biopharm, 2021, 160: 65-76.
Biofilm mediated infection caused by multi-drug resistant bacteria are difficult to treat since it protects the microorganisms by host defense system, making them resistant to antibiotics and other antimicrobial agents. Combating such type of nosocomial infection, especially in immunocompromised patients, is an urgent need and foremost challenge faced by clinicians. Therefore, antimicrobial photodynamic therapy (aPDT) has been intensely pursued as an alternative therapy for bacterial infections. aPDT leads to the generation of reactive oxygen species (ROS) that destroy bacterial cells in the presence of a photosensitizer, visible light and oxygen. Here, we elucidated a possibility of its clinical application by reducing the treatment time and exposing curcumin to 20 J/cm of blue laser light, which corresponds to only 52 s to counteract vancomycin resistant Staphylococcus aureus (VRSA) both in vitro and in vivo. To understand the mechanism of action, the generation of total reactive oxygen species (ROS) was quantified by 2'-7'-dichlorofluorescein diacetate (DCFH-DA) and the type of phototoxicity was confirmed by fluorescence spectroscopic analysis. The data showed more production of singlet oxygen, indicating type-II phototoxicity. Different anti-biofilm assays (crystal violet and congo red assays) and microscopic studies were performed at sub-MIC concentration of curcumin followed by treatment with laser light against preformed biofilm of VRSA. The result showed significant reduction in the preformed biofilm formation. Finally, its therapeutic potential was validated in skin abrasion wistar rat model. The result showed significant inhibition of bacterial growth. Furthermore, immunomodulatory analysis with rat serum was performed. A significant reduction in expression of proinflammatory cytokines TNF-α and IL-6 were observed. Hence, we conclude that curcumin mediated aPDT with 20 J/cm of blue laser treatment (for 52 s) could be used against multi-drug resistant bacterial infections and preformed biofilm formation as a potential therapeutic approach.Copyright © 2021 Elsevier B.V. All rights reserved.
[24]
Lin M H, Lee J Y, Pan S C, et al. Enhancing wound healing in recalcitrant leg ulcers with aminolevulinic acid-mediated antimicrobial photodynamic therapy. Photodiagnosis Photodyn Ther, 2021, 33: 102149.
[25]
Johnson B Z, Stevenson A W, Prêle C M, et al. The role of IL-6 in skin fibrosis and cutaneous wound healing. Biomedicines, 2020, 8 (5): 101.
The timely resolution of wound healing is critical for restoring the skin as a protective barrier. The switch from a proinflammatory to a reparative microenvironment must be tightly regulated. Interleukin (IL)-6 is a key modulator of the inflammatory and reparative process: it is involved in the differentiation, activation, and proliferation of leukocytes, endothelial cells, keratinocytes, and fibroblasts. This review examines the role of IL-6 in the healing of cutaneous wounds, and how dysregulation of IL-6 signaling can lead to either fibrosis or a failure to heal. The role of an IL-6/TGF-β feedback loop is discussed in the context of fibrogenesis, while IL-6 expression and responses in advanced age, diabetes, and obesity is outlined regarding the development of chronic wounds. Current research on therapies that modulate IL-6 is explored. Here, we consider IL-6′s diverse impact on cutaneous wound healing.
[26]
Huang J, Wu S, Wu M, et al. Efficacy of the therapy of 5-aminolevulinic acid photodynamic therapy combined with human umbilical cord mesenchymal stem cells on methicillin-resistant Staphylococcus aureus-infected wound in a diabetic mouse model. Photodiagnosis Photodyn Ther, 2021, 36:102480.
[27]
高春岩, 钱青, 申宇鸿, 等. 5%5-氨基酮戊酸光动力疗法对痤疮患者皮损症状及IL-1β、IL-6和CRP水平的影响. 河北医药, 2019, 41(18): 2840-2842.
[28]
Li H, Fan C, Lu H, et al. Protective role of berberine on ulcerative colitis through modulating enteric glial cells-intestinal epithelial cells-immune cells interactions. Acta Pharm Sin B, 2020, 10(3): 447-461.
Ulcerative colitis (UC) manifests as an etiologically complicated and relapsing gastrointestinal disease. The enteric nervous system (ENS) plays a pivotal role in rectifying and orchestrating the inflammatory responses in gut tract. Berberine, an isoquinoline alkaloid, is known as its anti-inflammatory and therapeutic effects in experimental colitis. However, little research focused on its regulatory function on ENS. Therefore, we set out to explore the pathological role of neurogenic inflammation in UC and the modulating effects of berberine on neuro-immune interactions. Functional defects of enteric glial cells (EGCs), with decreased glial fibrillary acidic protein (GFAP) and increased substance P expression, were observed in DSS-induced murine UC. Administration of berberine can obviously ameliorate the disease severity and restore the mucosal barrier homeostasis of UC, closely accompanying by maintaining the residence of EGCs and attenuating inflammatory infiltrations and immune cells overactivation., berberine showed direct protective effects on monoculture of EGCs, bone marrow-derived dendritic cells (BMDCs), T cells, and intestinal epithelial cells (IECs) in the simulated inflammatory conditions. Furthermore, berberine could modulate gut EGCs-IECs-immune cell interactions in the co-culture systems. In summary, our study indicated the EGCs-IECs-immune cell interactions might function as a crucial paradigm in mucosal inflammation and provided an infusive mechanism of berberine in regulating enteric neurogenic inflammation.© 2020 Chinese Pharmaceutical Association and Institute of Materia Medica, Chinese Academy of Medical Sciences. Production and hosting by Elsevier B.V.
[29]
Rong Y, Hong G, Zhu N, et al. Photodynamic therapy of novel photosensitizer ameliorates TNBS-induced ulcerative colitis via inhibition of AOC1. Front Pharmacol, 2021, 12:746725.
Ulcerative colitis (UC), a chronic, nonspecific inflammatory bowel disease characterized by continuous and diffuse inflammatory changes in the colonic mucosa, requires novel treatment method. Photodynamic therapy (PDT), as a promising physico-chemical treatment method, were used to treat UC rats’ model with novel photosensitizer LD4 in this paper, the treatment effect and mechanism was investigated. LD4-PDT could improve the survival rate of 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced UC model rats, decrease expression of interleukin (IL)-6, IL-1, tumor necrosis factor (TNF)-α, malondialdehyde (MDA), myeloperoxidase (MPO) and increase the expression of glutathione (GSH) and superoxide oxidase (SOD), while protecting the integrity of the intestinal epithelium. LD4-PDT treatment could rebuild the intestinal microflora composition and reprogram the colonic protein profiles in TNBS-induced rats to almost the normal state. Proteomics analysis based upon TNBS-induced UC model rats revealed that Amine oxidase copper-containing 1 (AOC1) was a potential target of LD4-PDT. Novel photosensitizer agent LD4-PDT represents an efficient treatment method for UC, and AOC1 may be a promising target.
[30]
Ajmal M. Effectiveness of photodynamic therapy as an adjunct to topical antiviral therapy in the treatment of herpes labialis: a randomized controlled clinical trial. Photodiagnosis Photodyn Ther, 2021, 34: 102302.
[31]
王希晶, 王谦可, 梁凤仪, 等. ALA-PDT联合CO2激光治疗尖锐湿疣疗效观察及治疗前后外周血TNF-α和IL-6变化. 中国皮肤性病学杂志, 2012, 26(3): 233-234, 237.
[32]
Kawczyk-Krupka A, Latos W, Oleś P, et al. The influence of 5-aminolevulinic photodynamic therapy on colon cancer cell interleukin secretion in hypoxia-like condition in vitro. Photodiagnosis Photodyn Ther, 2018, 23: 240-243.
Photodynamic therapy (PDT) becomes a method of personalized cancer treatment, based on the individual determination of cancer biomarkers. The aim of the study was to evaluate the influence of PDT with δ-aminolevulinic acid (ALA-PDT) used in sub-lethal dose on the interleukins secretion (IL-6, IL-8 and IL-10) by the residual colon cancer cells (CCC) under hypoxia-like conditions (addition of cobalt chloride- CoCl). CCC: SW480 and SW620 cells were incubated with ALA, CoCl and irradiated with red light. The cells viability was detected using MTT assay, LDH and apoptosis tests. Determination of interleukins was carried out using the Bio- Plex Assay Pro kit on the Bio- Plex Suspension Array System. After ALA-PDT we found no change in the IL-6 level secreted by SW480 cells, but decrease of IL-6, IL-10 secretion by SW620 cells, an increase in the IL-8 secreted by both cells lines. The levels of IL-6, IL-8 and IL-10 secreted by more aggressive SW620 cells were higher than released by SW480 cells. We concluded, that PDT not only effectively destroy malignant tissue, but also used in sub-lethal dose can develops its anticancer activity through the reduction of IL-6 and IL-10 secretion. On the other hand, we reveal an unfavorable PDT effect, connected with increase of IL-8 secretion by both treated colon cancer cell lines, which implicates the use of adjuvant immunotherapy against IL-8, as a part of individualized colon cancer therapy.Copyright © 2018 Elsevier B.V. All rights reserved.
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