1. Enhancing 5-ALA-PDT efficacy against resistant tumor cells: Strategies and advances.
- Author
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Ebrahimi S, Khaleghi Ghadiri M, Stummer W, and Gorji A
- Subjects
- Humans, Animals, Protoporphyrins pharmacology, Protoporphyrins metabolism, Aminolevulinic Acid pharmacology, Photochemotherapy methods, Drug Resistance, Neoplasm, Neoplasms drug therapy, Neoplasms pathology, Photosensitizing Agents pharmacology, Photosensitizing Agents therapeutic use
- Abstract
As a precursor of protoporphyrin IX (PpIX), an endogenous pro-apoptotic and fluorescent molecule, 5-Aminolevulinic acid (5-ALA) has gained substantial attention for its potential in fluorescence-guided surgery as well as photodynamic therapy (PDT). Moreover, 5-ALA-PDT has been suggested as a promising chemo-radio sensitization therapy for various cancers. However, insufficient 5-ALA-induced PpIX fluorescence and the induction of multiple resistance mechanisms may hinder the 5-ALA-PDT clinical outcome. Reduced efficacy and resistance to 5-ALA-PDT can result from genomic alterations, tumor heterogeneity, hypoxia, activation of pathways related to cell surveillance, production of nitric oxide, and most importantly, deregulated 5-ALA transporter proteins and heme biosynthesis enzymes. Understanding the resistance regulatory mechanisms of 5-ALA-PDT may allow the development of effective personalized cancer therapy. Here, we described the mechanisms underlying resistance to 5-ALA-PTD across various tumor types and explored potential strategies to overcome this resistance. Furthermore, we discussed future approaches that may enhance the efficacy of treatments using 5-ALA-PDT., Competing Interests: Declaration of competing interest The authors declare no conflict of interest. All authors have been participated in the preparation of the manuscript, and have given their agreement to submit this manuscript in the present format., (Copyright © 2024. Published by Elsevier Inc.)
- Published
- 2024
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