Photodynamic therapy (PDT) is a multicomponent cancer treatment in which tumors are exposed to lethal singlet oxygen (1O2)-mediated photooxidative stress induced by a localized sensitizing drug. Much has been learned about mechanism of tumor cell photokilling by various sensitizers, apoptosis (programmed cell death) occurring in some cases and necrosis (non-programmed death) in others. However, the roles of metabolic and environmental factors in PDT-induced apoptotic vs. necrotic cell death are still not well understood. Studies supported by the existing grant have focused on the effects of nitric oxide (NO) in this regard. Using breast tumor cells metabolically sensitized with protoporphyrin IX (PpIX), we found that (i) NO delivered during irradiation (NO-now) protected against necrotic photokilling by inhibiting free radical (chain) peroxidation of plasma membrane (PM) lipids; importantly, residual killing was switched from necrosis to apoptosis; (ii) NO delivered much earlier and no longer present during irradiation (NO-then) inhibited photokilling as well, preliminary data suggesting involvement of an iron signaling mechanism. In a liposome system, NO also protected PpIX from photodegradation, thus prolonging its 'Degenerating lifetime. The proposed studies will delve more deeply into these novel effects of NO with the following hypotheses proposed: (a) NO-now and NO-then generated by neighboring microvascular cells can enhance tumor cell resistance to PDT killing; (b) By inhibiting PM lipid chain peroxidation, NO-now can foster apoptosis by reducing ion pump inactivation and membrane permeabilization, thereby supporting pro-apoptotic energy metabolism; (c) By also protecting membrane- bound sensitizer from free radical-mediated degradation, NO-now can result in a """"""""selection"""""""" for pro-apoptotic 1O2 targets. The proposed in vitro studies for testing these hypotheses will involve model membranes, two human breast tumor lines (COH-BR1, MCF-7), PpEX and merocyanine 540 (MC540) as sensitizers, chemical and cellular (macrophage, endothelial) NO donors, and techniques such as fluorescence microscopy, spectrofluorimetry, immunoblotting, electrophoretic mobility shift assays, and high-performance liquid and thin layer chromatography with electrochemical and phosphorimaging detection, respectively. The specific plan is to investigate (i) sensitizer protection by NO-now with prolonged 1O2 photogeneration in model systems and cells; (ii) ability of NO-now to facilitate apoptotic photokilling while inhibiting necrosis; (iii) mechanisms by which NO-now accommodates apoptosis; (iv) characteristics of NO-then-induced photoresistance; and (v) underlying mechanisms of NO-then-induced resistance. Although significant NO is produced by macrophages and endothelial cells in tumor vascular systems, little is known about how it might impact PDT efficacy. These studies will provide important new insights along these lines and in the case of NO-now may suggest novel approaches for accommodating apoptosis in PDT, this end-point being preferred over necrosis because inflammation is minimized. ? ? ?

National Institute of Health (NIH)
National Cancer Institute (NCI)
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Radiation Therapeutics and Biology Study Section (RTB)
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Wong, Rosemary S
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Medical College of Wisconsin
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Fahey, Jonathan M; Stancill, Jennifer S; Smith, Brian C et al. (2018) Nitric oxide antagonism to glioblastoma photodynamic therapy and mitigation thereof by BET bromodomain inhibitor JQ1. J Biol Chem 293:5345-5359
Girotti, Albert W; Korytowski, Witold (2018) Cholesterol Peroxidation as a Special Type of Lipid Oxidation in Photodynamic Systems. Photochem Photobiol :
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Fahey, Jonathan M; Girotti, Albert W (2015) Accelerated migration and invasion of prostate cancer cells after a photodynamic therapy-like challenge: Role of nitric oxide. Nitric Oxide 49:47-55

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