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Photochemistry and Photobiology, 1996, 64(3): 469-485 Invited Review Structure and Biodistrlbution Relationships of Photodynamic Sensitizers* Ross W. Boylet' and David Dolphin~1,2 'Department of Chemistry, University of British Columbia, Vancouver, B.C., Canada and 2QLT PhotoTherapeutics, Vancouver, B.C., Canada Received 8 February 1996j accepted 31 May 1996 ABSTRACT e.g. rose bengal and the hypericins, have also been omitted to allow meaningful comparisons to be made between different compounds. As the intracellular distribution of photosensitizers to organelles and other subcellular structures can have a large effect on PDT efficacy, a section will be devoted to this topic. Photodynamic therapy (PDT) has, during the last quarter century, developed into a fully fledged biomedical field with its own association, the International Photodynamic Association (IPA) and regular conferences devoted solely to this topic. Recent approval of the first PDT sensitizer, Photofrin® (pommer sodium), by health boards in Canada, Japan, the Netherlands and United States for use against certain types of solid tumors represents, perhaps, the single most significant indicator of the progress of PDT from a laboratory research concept to clinical reality. The approval of Photofrin® will undoubtedly encourage the accelerated development of second-generation photosensitizers, which have recently been the subject of intense study. Many of these second-generation drugs show significant ditTerences, when compared to Photofrin®, in terms of treatment times postinjection, light doses and drug doses required for optimal results. These differences can ultimately be attributed to variations in either the quantum efficiency of the photosensitizer in situ, which is in turn affected by aggregation state, localized concentration of endogenous quenchers and primary photophysics of the dye, or the intratumoral and intracellular localization of the photosensitizer at the time of activation with light. The purpose of this review is to bring together data relating to the biodistribution and pharmacokinetics of second-generation sensitizers and attempt to correlate this with structural and electronic features of these molecules. As this requires a clear knowledge of photosensitizer structure, only chemically well-characterized compounds are included, e.g. Photofrin® and crude sulfonated phthalocyanines have been excluded as they are known to be complex mixtures. Nonporphyrin-based photosensitizers, INTRACELLULAR DISTRIBUTION OF PHOTOSENSITIZERS Intracellular distributions in cultured cells have been determined for a range of photosensitizers with widely differing patterns of substitution. Roberts and Berns (I) reported that mono-aspartyl chlorin e6 (MACE)§ (1) localized in Iyso- (1) §Abbreviations: AlPeS •• sulfonated aluminum phthalocyanines; Bch-a, bacteriochlorophyll a; BPD, benzoporphyrin derivative; BPD-DA, BPD diacid; BPD-MA, BPD monoacid; BPD-MB, BPD-MA ring B; DMSO, dimethylsulfoxide; DPPC, 1,2-dipalmitoylphosphatidylcholine; EDA, ethylene diamine; GePcOBu8' germanium(lV)-octabutoxy phthalocyanine; ia, intraarterial; ID, injected dose; ip, intraperitoneal; isoBosinc, Bis(diisobutyloctadecylsiloxy)silicon-2,3-naphthalocyanine; iv, intravenous; LDL, low-density lipoprotein; MACE, mono-aspartyl chlorin e6; MF, monomeric fraction; Nc, naphthalocyanine; OOPS, 1,2-dioleoylphosphatidylserine; PBS, phosphate-buffered saline; Pc, phthalocyanine; PDT, photodynamic therapy; PEG, polyethylene glycol; Phe-a, pheophorbide a; pi, postinjection; POPC, I-palmitoyl-2- *This Review is dedicated to the memory of Dr. Brian E. Johnson. tPresent address: Department of Biological and Chemical Sciences, University of Essex, Central Campus, Wivenhoe Park, Colchester C04 3SQ, UK tTo whom correspondence should be addressed at: Department of Chemistry, University of British Columbia, 2036 Main Mall, Vancouver, B.C. V6T IZI, Canada. Fax: 604-822-9678; e-mail: [email protected]. © 1996 American Society for Photobiology 0031-8655196 $5.00+0.00 469 470 Ross W. Boyle and David Dolphin somes of Chinese hamster ovary cells (CHO-KI) after ingestion by endocytosis. This was attributed to the hydrophilic nature of MACE, which presents four ionizable carboxyl groups in an asymmetric arrangement around the central chlorin ring. It was suggested that these polar characteristics prevent passive diffusion of MACE into the cytoplasm and subsequent migration to the mitochondrion. A comparative study of meso-tetraphenylporphyrins (TPP) substituted to different degrees at the para positions of the phenyl rings with sulfonic acid groups (2) revealed a similar pattern of localization in cervical carcinoma cells (NHIK 3025) to that found above for MACE (1), although the tetrasulfonate (TPPS 4 ) (2) was also detected, to a lesser extent, in the R, croscopy to determine intracellular distribution of aluminum phthalocyanine, sulfonated to different levels, in human melanoma cells (LOX). It was found in this case that the tetraand trisulfonated phthalocyanines (AIPcS4 and AIPcS) (6,7) localized in the Iysosomes, whereas the lower sulfonates (AIPcS2 and AIPcSI) (8,9) exhibited a diffuse distribution throughout the cytoplasm. The power of the confocal technique was elegantly demonstrated by its ability to resolve (6) (7) R1 = R2 = R.:s= R... = S0.:sH R1 = H, R2 = R3= R4= 50 3 H (8) R,= R2 = H. (9) (2) (3) (4) (5) R 1= R 2 = R3 = 50 3 H R1 = R3 =H, R2 = 50 3 H RI = R2 = H, R3= 50 3H R1 = R2 = R3= H nucleus and cytoplasm. The distribution of both reglOlsomers of the disulfonate (TPPS 20 and TPPS 2a ) (3,4), bearing sulfonic acid moieties on the opposing and adjacent phenyl rings respectively, was found to mimic that of TPPS4 (2); however, the monosulfonate (TPPS 1) (5) was detected diffusely through the cell but more strongly in the perinuclear area. Interestingly, a subsequent study by this group (3) found that exposure of cells of the same line, preincubated with TPPS 4 (2) or TPPS 2 (3,4), to light doses that inactivated 20% of the cells resulted in relocalization of the sensitizers from the lysosomes to the cytoplasm in general, and, more specifically, the nucleus. This behavior was attributed to photodynamic permeabilization of the lysosomal membrane, thus allowing small molecules, including the photosensitizers, to leak out. The same effect was not observed for TPPS 1 (5), again suggesting that this sensitizer does not localize in lysosomes. Peng et al. (4) used confocal laser scanning mioleoylphosphatidy\Choline; PV A, polyvinyl alcohol; SiNe, silicon naphthalocyanine; m- THPC, meta-tetrahydroxyphenylchlorin; 3,1-Tpro, 3,I-meso-tetrakis(o-propionamidophenyl)porphyrin: TPP, telraphenylporphyrin; TPPS n, sulfonated TPP; ZnNe, zine Ne; ZnNcA4' tetraamino ZnNe; ZnNeM4' tetramethoxy ZnNe; ZnNeMA4 • tetra(methylamido) ZnNe. R3= R4= 50 3 H R 1= R2 = R3= H, R4= 50 3 H in three dimensions the granular pattern of lysosomal localization for AIPcS4 (6) and AlPeS) (7), a pattern that had previously been described as diffuse when using conventional fluorescence microscopy (5). The distribution of these anionic dyes suggests a relationship between the number of negatively charged groups attached to the photosensitizing "core" and its mode of entry into the cell, which, in tum, determines the intracellular distribution pattern. Neither the pKa of the acidic group nor charge distribution on the molecule seem to be critical. Rather, the number of negative charges is the determining factor. The exact amount of negative charge that prevents diffusion across the cell membrane and allows endocytosis to become the dominant mode of entry seems to be around - 2; however, the situation for AIPcS2 (8) is confused by conflicting reports of lysosomal localization (6) and diffuse distribution throughout the cytoplasm (4). This situation is most likely a reflection of difficulties in purifying this compound. Woodburn et al. (7) studied intracellular localization, in V79 Chinese hamster lung fibroblasts and C6 glioma cells, of a series of porphyrins derived from hemato- and protoporphyrin [X with side chains chemically modified to give hydrophobic and anionic or cationic residues at physiological pH (10-17). Compounds were selected to represent all combinations of these characteristics and it was found that those with a net cationic character localized in mitochondria, while those with net anionic character localized in Iysosomes. As the anionic porphyrins all bore two negative charges, these results are in accord with previous work suggesting that sensitizers with a net charge of - 2 or greater accumulate in Iysosomes. A porphyrin with both two anionic carboxylate residues and hydrophilic chains, however, showed a diffuse distribution in the cytoplasm, indicating a subtle involvement of the charge-to-mass ratio in the distribution of anionic sensitizers. A time-dependent redistribu- Photochemistry and Photobiology, 1996, 64(3) 471 tion of two cationic sensitizers from the mitochondria to the lysosomes was attributed to internalization of porphyrinloaded mitochondria by the Iysosomes. Recently, a dynamic method for following the uptake and intracellular distribution of photosensitizers was reported (8). The authors followed the uptake of two cationic meso-tetra- Rl R2 Rl (10) HC(CH..,)OCH.., OCH.., NH(CH 2 )2 N(CH "')2 (12) HC(CH.., )O(CH 2)2 OCH 2 CH.., OH (13) HC(CH.., )O(CH 2 )2 OCH 2 CH.., NH(CH 2 ) 2 N(CH..,h (14) HC(CH..,)SCH 2 CONHNH(CH 2 )2 N(CH..,)2 -(CH2 )2 N(CH"')2 (11) CH=CH 2 (15) HC(CH..,)S(CH 2hNO OH (16) HC(CH l )S(CH 2 hNO (17) HC(CH l )O(CH 2 h N(CH l)2 NH(CH 2 ) 2 N(CH..,h OH pyridyl porphyrins, quartemized with methyl (18) and hexyl (19) residues, in human dermal fibroblasts (0532). Important IN VIVO PHARMACOKINETICS AND BIODISTRIBUTION OF PHOTOSENSITIZERS In reviewing the in vivo pharmacokinetic and biodistribution behavior of photodynamic therapy (PDT) sensitizers, it soon becomes apparent that direct correlation between photosensitizer structure and these biological parameters is complicated for many compounds; this is especially true for the "hydrophobic" sensitizers, which, due to lack of water solubility, must be injected in a suitable transport vehicle, e.g. liposomes, oil in water emulsions and nanoparticles. As it has been shown that the nature of the delivery vehicle affects the relative transfer of the drug to different serum proteins (10-12), which can in tum alter the in vivo pharmacokinetics and biodistribution, wherever possible, comparisons will be made among similar modes of delivery. The use of different tumor types and animals presents yet another problem of heterogeneity, so these parameters will be quoted in every case. Finally, certain physical characteristics of the photosensitizer have been used to classify them into three major groups: (l) Hydrophobic sensitizers are defined here as those bearing no charged peripheral substituents and which have negligible solubility in water or alcohol. (2) Hydrophilic sensitizers have three or more charged substituents and are freely soluble in water at physiological pH. (3) Amphiphilic sensitizers have two or less charged substituents and are soluble in alcohol or water at physiological pH. The above classifications are, of course, only intended to make comparison between in vivo results more clear, and some photosensitizers may be on the borderline between groups. Amphiphilic character is especially difficult to define, as it involves not only the number of hydrophilic substituents, but also their spacial distribution, e.g. both isomers of TPPS 2 are amphiphilic by the above definition and only one atropisomer of m-tetrahydroxyphenylchlorin could truly be described as amphiphilic, yet it is assigned to this subsection. These ambiguities will. however, be addressed individually in the text and where appropriate cross reference will be made between groups. HYDROPHOBIC SENSITIZERS (18) R = CH J (19) R = n-C S H1J differences were found. with the methyl derivative being taken up faster and localizing in the nucleus, while the hexyl analogue entered the cells much more slowly and exhibited a particulate distribution in the cytoplasm. These results again illustrate the importance of charge/mass ratio in determining intracellular distribution. A more comprehensive review of the role of lysosomal localization has been published by Geze et al. (9). The most prevalent family of hydrophobic PDT sensitizers are the phthalocyanines (Pc) and closely related naphthalocyanines (Nc). these compounds have a basic photosensitizing core that is formally a tetrabenztetraazaporphyrin or tetranaphthotetraazaporphyrin (13). The structure of the molecules allows substitution around the periphery of the macrocycle on the four benzenoid or naphthalenoid rings. Further substitution is also possible by chelation of metals bearing axial ligands within the central cavity of the Pc or Nc. The Pc and Nc used for PDT are, without exception, metallated. This is in contrast with the porphyrin-based sensitizers, which are most often unmetallated. One of the simplest of these compounds, zinc phthalocyanine (ZnPc) (20), has no peripheral substituents and a centrally chelated zinc ion and has been the subject of several in vivo studies. Reddi et al. performed a series of studies using ZnPc encapsulated in small unilamellar liposomes of dipalmitoylphosphatidylcholine (OPPC). Female BALB/C mice bearing MS-2 fibrosarcoma were used in all these experiments; however. the mode of administration was intra- 472 Ross W. Boyle and David Dolphin peritoneal (ip) in the first case (14) and this was altered to intravenous (iv) subsequently. For ip injection of 0.5 mg kg-I body weight a maximal tumor concentration of 0.6 V-g g-I tissue was reported at 24 h postinjection (pi) representing a tumor/muscle ratio of -7.5. Levels of ZnPc (20) in skin (20) M =Zn, R1 = R2= RJ= R4= H (25) M = 67GaCI, R1= R2 =R3 =R4 = O(n-C ta H37) (26) M = Ge(OSiPh 2 (Cholesterol»2 never exceeded 0.1 j.Lg g-I tissue between I and 168 h pi. Interestingly, a comparison can be made between these results and others obtained by the same group using iv injection (15), although a lower dose of 0.12 mg kg-I was used. Under these conditions maximal tumor concentrations of -0.3 V-g g-I tissue were reached 3 h pi and this level was maintained up to 45 h pi. This is in contrast with ip injection where tumor concentrations were less than half the maximal by 45 h pi. Tumor/muscle ratio at 24 h pi was 3.71; however. the peak value for this parameter was 3.84 attained 168 h pi. Skin levels of ZnPc (20) again never exceeded 0.1 V-g g-I tissue between 1 and 168 h pi. The authors also investigated the possibility of manipulating ZnPc (20) biodistribution by: (a) complexation with human low-density lipoprotein (LDL) (15) and (b) addition of 15% mole cholesterol to the DPPC liposomes (16). The results show an increased maximal tumor concentration (0.55 V-g g-I tissue at 24 h pi) using LDL and also a higher tumor/muscle ratio (5.71); however, the maxima were more transient and by 45 h pi the tumor concentration had fallen to -0.43 j.Lg g<1 tissue. Levels of ZnPc (20) in liver and muscle were reported to be similar whether delivered by DPPC liposomes or LDL. Incorporation of 15% mole cholesterol in the Iiposomes resulted in a maximal uptake of 0,42 V-g g-I tissue at 24-48 h pi with a corresponding tumor/muscle ratio of 5. Other research groups have studied ZnPc (20) distribution in different animals, bearing a variety of tumors. Shopova et al. (17) used male golden hamsters with 7,12-dimethylbenz(a)-anthracene-induced tumors and compared these with a similar population bearing transplanted tumors derived from the original induced neoplasms. Injection (iv) of 0.2 mg kg-I ZnPc (20) in DPPC Iiposomes gave a maximal concentration of ~ US V-g g-I tissue for the induced tumor 24 h pi, while the transplanted tumor accumulated -0.7 V-g g-I tissue but at the later time of 72 h pi. Clearance of ZnPc (20) from the induced tumor was essentially linear from the maximum and had dropped to 0.9 V-g g-I tissue by 72 h pi. Tumor/muscle ratios for the induced and transplanted tumors were 1.05 and 0.8, respectively, at 24 h pi, while by 72 h the corresponding values were 1.29 and 0.97. Intratumoral distribution in vivo of ZnPc (20) in DPPC liposomes has been reported (18) and, although no absolute values are given. relative fluorescence from tumor, vessels and normal tissue are supplied for female WAGIRIJ rats with isogeneic mammary carcinoma. Twentyfour hours after iv injection of 0.14 mg kg-I body weight the fluorescence intensity from tumor and vessels was almost identical but is double that of normal tissue. Perhaps the most comprehensive study of pharmacokinetics and biodistribution of ZnPc (20) was published recently by lsele et at. (19). In this report ZnPc (20) was delivered in a liposomal formulation consisting of a mixture of I-palmitoyl2-0leoylphosphatidylcholine (POPC) and 1.2-dioleoylphosphatidylserine (OOPS) (9: I). this is the same formulation used for the only clinical trials on humans conducted to date with ZnPc (20). By altering the formulation procedure, different degrees of aggregation of the ZnPc (20) within the liposomes was induced and this was correlated with pharmacokinetic and biodistribution parameters. Aggregation state was expressed as percentage monomeric fraction (% MF) of ZnPe (20) and four states were obtained: 28, 78, 88 and 100% MF. Female BALB/e mice bearing Meth-A sarcoma were injected iv with 0.25 mg kg-I body weight of each aggregate fraction. Both tumor uptake and plasma elimination curves had similar kinetic profiles; however. maximal tumor uptake increased linearly with increasing % MF (670 ng g-I tissue for 100% MF vs 200 ng g-I for 28% MF, both at 48 h pi) and elimination of ZnPc (20) from the liver was similarly affected by aggregation state with 28% MF hardly eliminated after 7 days, while the 100% MF eliminated with a half life of 4-12 days. Hydrophobic Pes with peripheral substituents have also been studied. Cuomo et al. (20) injected female BALB/c mice bearing MS-2 fibrosarcoma iv with 0.5 mg kg-I body weight germanium(IV)-octabutoxy phthalocyanine (GePcOBus) (21) in DPPC liposomes. Maximal tumor uptake of (21) M Ge(OSi(C 2Hs h h (22) M Ge(OSi(CH 3 h (CH 2 h OOCCH 3 h (23) M Ge(OSi(n-C6Hl~J h (24) M Ge(OSi(n-C,oH21 )J h 0.42 V-g g-1 tissue was attained 12 and 48 h pi, this represented tumor/muscle ratios of 42 and 3.2. Rapid clearance from the serum, liver and spleen was also reported. This was attributed to the eight aJkoxy residues imparting some polar Photochemistry and Photobiology, 1996, 64(3) 473 character on the hydrophobic Pc. In an extension of this work a series of GePcOBug derivatives were synthesized in which the triethylsiloxy axial ligands were exchanged for dimethyl(3-acetoxypropyl)-. trihexyl- and tridecyl-siloxy ligands (22.23,24) (21). Using the same animals, tumor cell line and liposomal formulation as for the original study 0.35 IJ.mol kg-' body weight was injected iv. Maximal tumor sensitizer levels were achieved 24 h pi, with the trihexyl and tridecyl analogues giving the highest uptake (0.15 nmol g' tissue), whereas the triethyl and dimethyl(3-acetoxypropyl) derivatives achieved 0.11 nmol g'" tissue and 0.09 nmol g~' tissue, respectively. Converting previous results for ZnPc (20) in DPPC liposomes to molarity allows comparisons to be made: 0.21 IJ.mol kg~' ZnPc (20) injected dose equated to a maximal tumor uptake of 0.52 nmol g-I tissue at 24 h pi (15). Tumor/muscle ratios at 24 h pi were lower for the dimethyl(3acetoxypropyl) and triethyl GePc (22.21) (2.61 and 2.2) but higher for trihexyl and tridecyl GePc (23,24) (5A and 6.26) than ZnPc (20) (3.71). The four GePc (21-24) derivatives were also delivered in Cremophor EL emulsions and this resulted in an increased tumor uptake by all sensitizers of between 3.3 (tridecyl) and 5.6 (trimethYH3-acetoxypropyl]) times. Tumor/muscle ratios were also increased between 1.57 (trihexyl) and 3.35 (triethyl) times. Rousseau et ai. (22) used radiolabeled [67Galchlorogallium tetraoctadecyloxyphthalocyanine (25) to determine the biodistribution of this compound in male C3H mice bearing RIF tumors at an ip injected does of 8 mg kg-I. The maximal tumor concentration, attained at 24 h pi, was 1.05% of the injected dose tissue. and this corresponded to a tumor/muscle ratio of 0.73. Sulfonation of this compound and delivery iv in saline doubled the tumor maximum to 2.16% and increased the tumor/muscle ratio by almost an order of magnitude to 7.2. Germanium phthalocyanine. with two axially ligated cholesterol moieties (26), was encapsulated in liposomes composed of a 9: I mixture of POPC and OOPS (the same formulation used for ZnPc (20) clinical trials and in the study of ZnPc (20) aggregation by Isele et al. (19» and studied by Segal\a et al. (23). Two doses, 0.76 and 1.52 mg kg-I body weight, were injected iv in female BALB/c mice bearing MS-2 fibrosarcoma and biodistribution was measured. For the lower dose maximal tumor concentrations were attained at 3 h pi (~0.9 IJ.g g~1 tissue); however, levels were similar at 24 h pi (0.74 IJ.g g-' tissue), for the higher dose maximal tumor drug levels were measured at 24 h pi (1.87 IJ.g g~' tissue). Although doubling the drug dose resulted in a 2.5 times increase in tumor concentration at 24 h the corresponding tumor/muscle ratios (4.35 for the lower dose and 5.67 for the higher) increased by a factor of only 1.3. The authors also report low concentrations of sensitizer in the brain and skin and rapid clearance from the liver and spleen. Two reports have been published on the potential use of zinc hexadecafluorophthalocyanine (ZnPcF I6 ) (27) delivered to male BALB/c bearing EMT -6 mammary tumors. The compound was formulated in Cremophor (24) and polyethyleneglycol (PEG)-coated poly(iactic acid) nanoparticles (25). In the first study ZnPcF'6 (27) and ZnPc (20) were labeled with radioactive MZn and comparative biodistribution data were obtained. The maximal tumor concentration obtained for [65ZnjZnF,6 (27), at 48 h pi, represented 11% of the injected dose gl tissue (% ID g~I). compared to 8% ID g-' for [65ZnlZnPc (20) at 24 h pi. The rates of clearance from (27) blood were high, resulting in a tumorlblood ratio of 14 at 72 h pi, tumor/muscle and tumorlskin ratios at this time poim were 12 and 5, respectively, suggesting that this sensitizer has better characteristics for activation at longer intervals after injection than ZnPc (20). The second study with this compound. using PEG-coated nanopanicles as the delivery vehicle, indicated a similar distribution to the original Cremophor study, with maximal tumor uptake at 48 h (20% ID g-I tissue) and favorable tumor/muscle ratio at 72 h pi (11.03); however, direct comparison between the two studies was difficult due to the use of extraction/fluorescence measurements in the nanoparticle work. Naphthalocyanines (Nc) have been proposed as PDT sensitizers due, mainly, to their intense absorption in the 750800 nm region of the spectrum. The Nc are similar to Pc; however, the four additional benzenoid rings make these compounds even more hydrophobic. Biodistribution of bis(diisobutyloctadecylsiloxy)silicon-2,3-naphthalocyanine (isoBosinc) (28) in both female BALB/c mice with MS-2 R (28) (29) (30) (31) (32) M M M M M (33) M R Si(OSi(i-C 4 Hgh n-C,aHJ7h, R In, R - H H In, R- NHCOCHJ In, R= NH2 In, R = OCH J Si(OSi(CH J )2 n-C s Huh, R=H fibrosarcoma (26) and male Fischer 344 CrlBR rats with AY-27 FANFf-induced urothelial tumors (27) have been reported. The mouse study used iv-injected doses of 2 and 0.5 474 Ross W. Boyle and David Dolphin mg kg-I body weight in DPPC liposomes and maximal tumor concentrations of 1.2 and 0.34 f.1g g-I tissue were reported at 24 h pi. The corresponding tumor/muscle ratios were 6.32 and 17, respectively. Serum clearance was rapid with 90% eliminated at 24 h pi and skin accumulation with the lower dose never exceeded 0.03 f.1g g-I tissue, equating to a tumor/skin ratio at 24 h pi of 17. In the rat model accumulation in the tumor at 24 h pi was ~0.61 f.1g g-I tissue for a dose of 0.25 mg kg-I body weight injected iv in 10% Tween. This was the maximum achieved and represented a tumor/muscle ratio of 8.7. Serum clearance was again rapid (85% at 24 h) but skin levels were high at 24 h pi (0.42 f.1g g-I tissue) and the tumor/skin ratio (1.45) was correspondingly low, compared with liposomally formulated material. The isoBosinc was also the subject of a study involving the highly pigmented B 16 melanoma neoplasm grown on female C57BLl6 mice (28). Two doses (0.5 and 1.0 mg kg-I) were injected iv in DPPC liposomes and maximal tumor levels of 0.35 f.1g g-I tissue at 24 h pi for the 0.5 mg kg-I dose and -0.57 f.1g g-I tissue at 24-48 h pi for the 1.0 mg kg-I dose were found. Corresponding tumor/skin ratios, which, in this case, represented the tumor/peri tumoral tissue ratio more commonly expressed by tumor/muscle, were -1.1 for both injected doses at the time of maximal tumor accumulation. Serum clearance was rapid, with isoBosinc levels falling by 95% (1.0 mg kg-lID) and 90% (0.5 mg kg-lID) between I and 24 h pi. Liver uptake was high throughout the experiment, -10-50 times tumor levels. WhorIe et al. (29) and Shopova et al. (30) determined biodistributionlpharmacokinetic parameters for zinc naphthalocyanine (ZnNc) (29) and three tetrasubstituted derivatives (30-32) in DPPC liposomes. In golden hamsters bearing DMBA-induced rhabdomyosarcoma 0.7 f.1g g-I tissue accumulated in the tumor 24 h after injection ip of 0.15 mg kg-I body weight ZnNe (29), and corresponding tumor/muscle and tumor/liver ratios were 1.4 and I. I, respectively. No serum or skin data was reported. In the second study, biodistribution of ZnNc (29) was compared with tetra(methylamido)(ZnNcMA4 ) (30), tetraamino (ZnNcA4) (31) and tetramethoxy (ZnNcM 4 ) (32) derivatives in male C57/BL mice with implanted Lewis lung carcinomas. Intraperitoneal injection of 0.25 mg kg-I body weight of each of the sensitizers gave the following tumor maximal concentrations: ZnNc (29): -1.5 f.1g g-I tissue at 16 h pi, ZnNcMA4 (30): -1.15 f.1g g-I tissue at 16 h pi, ZnNcA4 (31): -0.9 f.1g g-I tissue at II h pi and ZnNcM4 (32): -1.2 f.1g g-I at 16 h pi. Tumor/liver and tumor/skin data were provided for 20 h pi and were similar for all the sensitizers tested with tumor/liver ratios varying from -1.2 (ZnNcMA 4) (30) to -1.6 (ZnNcA 4 ) (31) and tumor/skin ratios from -3.0 (ZnNc) (29) to 4.0 (ZnMA4) (30). In a wide-ranging study of the effects of varying the axial ligands on silicon naphthalocyanine (SiNc) Brasseur et al. (31) studied PDT effects of several compounds; however, only the bis(dimethylhexylsiloxy) analogue (33) was examined with respect to biodistribution. Injection of I mg kg-I drug in Cremophor emulsion iv in male BALB/c mice bearing EMT-6 mammary tumors gave maximal tumor concentrations of 0.9 f.1g g-I tissue at 12 h pi and a tumor/muscle ratio of 10 at this time. Tumor/skin ratios were relatively low, 1.6 compared with 17 for isoBosinc (28), at this point, and the tumor/plasma ratio at the same time (0.16) was also poor. Several other hydrophobic PDT sensitizers have been the subject of biodistributionlpharmacokinetic studies. Tetra-npropylporphycene (34), a structural isomer of tetra-n-pro- (34) pylporphyrin, has been incorporated in DPPC liposomes and injected into female BALB/c mice with MS-2 fibrosarcoma at a dose of 2 mg kg-I (32). Resulting maximal tumor levels of 1.5 f.1g g-I tissue were found at 24 h pi. This corresponded to tumor/muscle, tumor/skin and tumor/liver ratios of 16.67, 3.41 and 0.14, respectively. Tetraphenylporphyrins conjugated to a carotenoid moiety (35) and the corresponding TPP without the carotenoid (36) R, R, (35) (36) R,= OCH 3 • R2 = o NA. H were injected iv as Cremophor emulsions in female BALB/c mice with MS-2 fibrosarcoma at a dose of 4.2 f.1mol kg-I body weight (33). Twenty hours pi tumor accumulation of the TPP (36) was -10 f.1mol kg-I vs -9 f.1mol kg-I for the carotenoid-TPP (35). These were the maximum values attained and corresponded to tumor/muscle ratios of 94 and 27, while tumor/skin ratios were 29 and 7, respectively. Clearance of the TPP-carotenoid (35) from serum was reported to be rapid, a feature common to most hydrophobic sensitizers and associated with sequestration by components Photochemistry and Photobiology, 1996, 64(3) 475 of the reticuloendothelial system; however, no comparison was made with the nonconjugated TPP analogue (36). An unusual hydrophobic sensitizer comprising one atropisomer of a "picket fence" porphyrin, 3,I-meso-tetrakis(opropionamidophenyl)porphyrin (3,1-Tpro) (37) has recently (37) been radiolabeled with 14C and studied in female Fischer rats bearing R3230AC mammary adenocarcinoma (34). A dose of 33.75 mg kg-I body weight was administered ip in Cremophor emulsion. Tumor levels of sensitizer were low at 4, 24 and 48 h pi, 2.7, 1.4 and 0.5 fLg g-I tissue, respectively, compared to most other normal tissue. The liver and spleen initially took up large amounts of drug (23 and 52 fLg g-I tissue) and the skin. in contrast to all other tissue. continued to accumulate drug throughout the course of the experiment, rising from 3 fLg g 1 tissue at 4 h pi to 12 fLg g-I tissue at 48 h pi. Tumor/muscle and tumor/skin ratios never exceeded I. The authors believed, however, that some in vivo metabolism of the radiolabeled sensitizer may have taken place. Analysis of biodistribution data for hydrophobic PDT sensitizers (Table I) suggests that the maximal concentration in the tumor is affected by the nature of the delivery vehicle, which expresses its effect by altering the relative transfer to different serum components. Not surprisingly, a concentration dependency can also be seen. however, in cases where both delivery vehicle and concentration are constant, but sensitizer structure is altered, a clear difference can be seen in tumor concentrations. It is probable that this is a reflection of the aggregation state of the drug within the lipid environment of the delivery vehicle. HYDROPHILIC SENSITIZERS Hydrophilic sensitizers are typified by ionic substituents. which lend the compounds their "water-loving" character. In the case of PDT drugs these ionic groups are most often anionic in nature, and the most frequently encountered of these are sulfonic and carboxylic acids. The Pcs once again provide a major part of the available data. due to the ready availability of sulfonated analogues. long known in the dye and pigment industry. The most widely studied of these are the sulfonated aluminum phthalocyanines (AIPcS n) and the tetra- and trisulfonates (AIPcS4 and AIPcS,) (6,7). which fall under our classification of hydrophilic sensitizers. Aluminum. being trivalent, bears one axial ligand when chelated by Pc. which. depending upon the method of preparation, is usually a chloride of hydroxide moiety. Intravenous injection of 9.1 fLmol kg-I body weight AIPcS 4 (6) and AIPcS, (7) into BALB/c mice bearing Colo 26 tumors (35) gave maximal tumor concentrations of II nmol g-I tissue at 24 h pi for AIPcS4 (6) and 7 nmol g-I tissue at 3-50 h pi for AlPcS, (7). These values were much higher than for the mono- and disulfonated AIPc (AIPcS I and AIPcS2) (9,8), which gave concentrations of < I and 5 nmol g-I tissue, respectively. Tumor/muscle and tumor/skin ratios were 28 and 2 for AIPcS4 (6) at 24 h pi and 14 and 2.8 for AIPcS, (7) at the same time point. Comparing these values with the corresponding ratios for AIPcS I (9) and AIPcS2 (8) the monosulfonate levels were so low that they could not be accurately measured. and for the disulfonate the tumor/muscle ratio was 10 while the tumor/skin ratio was -5. The liver and spleen concentrated much lesser amounts of the drug with the hydrophilic AIPcS4 and S, (6,7) (I-IO nmol g-I tissue) vs the amphiphilic AlPeS 1 and S2 (9,8) (- 100-200 nmol g-I tissue). Initial plasma levels, however, reversed this trend with AIPcS4 (6) and S, (7), much higher than AlPcSI (9) and S2 (8). By 48 h pi serum levels for all the compounds had fallen to below I nmol mL -I. Peng et al. (36) studied biodistribution of AlPcS 4 (6) in female BALB/c nu/nu mice bearing the LOX human melanoma. Twenty mg kg-I body weight of AIPcS 4 (6) was injected ip and a maximal tumor concentration of 21 fLg g- 1 tissue was found -40 min after injection. This concentration was, however. transient and by 24 h it had fallen to 3.2 fLg g -1 tissue. Tumor/muscle ratio rose from < 1 at 30 min pi to a maximum of 10 at 15 h pi. Tumor/skin ratios showed less variability. increasing from 0.8 at 30 min pi to 1.1 at 4 h. Both tumor/muscle and tumor/skin ratios decreased rapidly after attaining the maxima and fell to 3 at 120 h pi for the former and 0.3 for the latter at 75 h pi. Surprisingly, the tumor/skin ratio rose again to 0.8 at 120 h. To allow comparisons with the previous results for AIPcS4 (6) to be made. the injected dose here equated to 20 fLmOI kg-I body weight and the tumor concentration at 24 h pi was 3.3 nmol g-I tissue. Intratumoral distributions of AIPcS n have been the subject of several studies; however, little quantitative data exist with regard to this topic. Peng et al. (37-39) used female BALB/c nu/nu athyrnic nude mice implanted with LOX human malignant melanoma and laser scanning fluorescence microscopy to study AlPcS n distribution. In the first two of these reports (37,38) a relatively simple distribution amongst the compartments of the tumor was found, in which AIPcS4 and S, (6.7) localized extracellularly and were. presumably. weakly bound as the fluorescence decreased from 4 to 48 h pi. This was in contrast with AIPcSI (9) and S2 (8), which localized intracellularly and gave increasing fluorescence over this time period. At 120 h pi significant amounts of fluorescence were detected with AlPcSI (9) and S2 (8) while no fluorescence was detected for AIPcS 4 (6) and S, (7). The same authors (39) extended this work for AIPcS4 (6) and found strong fluorescence in specific extracellular compartments. i.e. the subcutaneous fatty tissue surrounding the tumor, stroma and blood vessels. Once again no fluorescence was detected 72-120 h pi. Sulfonated aluminum and ZnPc were compared with respect to localization in tumor, tumor neovasculature and subcutis in female W AGIRIJ rats bearing transplanted isogeneic mammary carCinomas (40). Although no absolute concentrations were reported. relative measures of fluorescence were provided. The compound AIPcS 4 (6) achieved a tu- 476 Ross W. Boyle and David Dolphin Table I. Selected biodistribution data for hydrophobic photosensitizers Sensitizer (animal) ZnPc ZnPc ZnPc ZnPc (20)(mouse) (20)(mouse) (20)(mouse) (20)(mouse) ZnPc (20)(hamster) ZnPc (20)(100% MF)(mouse) ZnPc (20)(28% MF)(mouse) GePc(OBu)s-Et (21)(mouse) Delivery vehicle (route) DPPC Iiposomes (ip) DPPC 1iposomes (iv) LDL (iv) DPPC liposomes + 15% mole cholesterol (iv) DPPC liposomes (iv) POPC/OOPS liposomes (iv) POPC/OOPS liposomes (iv) DPPC lipsomes (iv) Injected dose (mg kg-I) 0.25 1.05 0.97 N/A 19 0.25 0.2 (24) N/A 19 0.5 0.35 0.35 0.35 0.35 0.35 0.35 0.35 0.35 0.76 1.52 0.87 0.87 0.42 (24) 0.42 (48) 0.14(24) 0.18 (24) 0.26 (24) 0.31 (24) 0.76 (24) 0.8 (24) 1.19(24) 1.05 (24) 0.9 (3) 1.87 (24) 2.2 (48) 4.01 (48) 42 3.2 2.61 2.2 5.4 6.26 5.68 7.37 8.48 11.81 9.0 5.7 13.0 11.0 20 20 21 21 21 21 21 21 21 21 23 0.34 (24) 1.2 (24) 0.61 (24) 0.35 (24) 0.57 (24--48) 0.7 (24) 1.5 (16) 1.15(16) 0.9 (II) 1.2 (\6) 0.9 (12) 17.0 6.32 8.7 1.I l.l 1.4 N/A N/A N/A N/A 10.0 26 29 30 30 30 30 31 1.5 (24) 9.0 (24) 2.7 (4) \6.7 27 0.6 32 33 34 Tween 80 (iv) DPPC Iiposomes (iv) 211Nc (29)(hamster) ZnNe (29)(mouse) ZnNe-M~ (30)(mouse) ZnNc_A4 (31)(mouse) ZnNc-M4 (32)(mouse) SiNe Bis(dimethylhexylsiloxy) (33)(mouse) Tetra-n-propylporphyeene (34 )(mouse) TPP-carotenoid (35)(mouse) 3,1-TPro (37)(rat) DPPC Iiposomes (ip) DPPC Iiposomes (ip) DPPC liposomes (ip) DPPC Iiposomes (ip) DPPC Iiposomes (ip) Cremophor EL (iv) DPPC Iiposomes (iv) Cremophor EL (i v) Cremophor EL (ip) 2.0 5.2 33.75 M = Gael, R1 = R2 = H. R,3= R4 = So,3 H M= 55Fe, R1= R2 = R,3= R4 = SO,3H 17 LIS (24) Induced tumor 0.7 (72) Transplanted tumor 0.67 (24) IsoBosine (28)(rat) IsoBosine (28)(mouse) M=Zn. R1= R2= R3= R4= S03 H M=GaCI. R 1= H, R2= R,3= R4= S03 H 14 15 15 16 0.2 0.5 2.0 0.25 0.5 1.0 0.15 0.25 0.25 0.25 0.25 1.0 (38) (39) (40) (41) 7.5 3.71 5.71 5.0 0.6 0.3 0.55 0.42 IsoBosinc (28)(mouse) ZnPcF I6 (27)(mouse) ZnPcF I6 (27)(mouse) (24) (24) (24) (24) Reference 0.5 0.12 0.12 0.12 DPPC liposomes (iv) DPPC liposomes (iv) DPPC Iiposomes (iv) DPPC liposomes (iv) Cremophor EL (iv) Cremophor EL (iv) Cremophor EL (iv) Cremophor EL (iv) POPC/OOPS Liposomes (iv) Cremophor EL (iv) PEG-Coated polylactic acid nanoparticles (iv) DPPC liposomes (iv) GePc(OBu)s-OAc (22)(mouse) GePc(OBu)g-Et (21)(mouse) GePc(OBukhex (23)(mouse) GePc(OBu)g-dec (24)(mouse) GePc(OBu)g-OAc (22)(mouse) GePc(OBu)g-Et (21)(mouse) GePc(OBu)g-hex (23)(mouse) GePc(OBu)g-dec (24)(mouse) GePc-cho1esterol (26)(mouse) Maximal tumor uptake (J.Lg g-I tissue) (time attained pi in hours) Tumor/ peritumoral tissue ratio 24 25 27 28 mor/normal tissue ratio of >3 by 15 min pi and this was maintained to 6 h pi. The compound ZnPcS4 (38) exhibited a similar pattern with the tumor/normal tissue ratio exceeding 2 from 5 min to 7 h pi. Purified GaPeS) (39) radiolabeled with 14C was compared with GaPCS2 (40) in C3H mice inoculated with RIF tumors (41). Nine mg kg-I body weight of each compound in phosphate-buffered saline (PBS) was administered by iv injection and resulted in maximal tumor concentrations of 11.2% ID at 48 h pi for the trisulfonate and 7.64% ID for the disulfonate with corresponding tumor/muscle ratios of 15.3 and 6.9, and tumor/skin ratios of 4.7 and 2.8. Eckhauser et al. (42) used radiolabeled 55Fe(H) phthalocyanine tetrasulfonate (55FePcS4) (41) to study biodistribution in male AJ mice with implanted Ta,Ha mouse mammary carcinoma. Two doses, 5 mg kg~ 1 and 10 mg kg I. were injected ip and resulted in maximal tumor uptake be- Photochemistry and Photobiology, 1996, 64(3) 477 tween 24 and 48 h pi in both cases. Tumor/muscle ratios of 5.1 and 6 were found for the two doses 24 h pi, while tumor/skin ratios peaked later at 5 days pi with values of 7.6 and 4. Biodistribution of TPP sulfonated to differing degrees has been studied. Kessel et al. (43) reported concentrations between 30 and 50 fLg g-l tissue 48 h pi, regardless of sulfonation level, in Panc 02 pancreatic tumors implanted in female C57BU6 mice injected with 10 mg kg-I body weight porphyrin. Fluorescence microscopic investigation of the tumors revealed a similar intratumoral distribution to that found with the sulfonated phthalocyanines, with the tetraand trisulfonated TPP (2,42) located in the stroma, while the mono- and disulfonates (5,3.4) were within the neoplastic cells. These results were later confirmed by Peng et al. (37) who detected TPPS 1 (5) and TPPS 2• (4) in LOX malignant melonoma cells of female BALB/c nu/nu athymic mice, while TPPS 20 (3), TPPS 3 (42) and TPPS 4 (2) were visualized declined by 40% from the maximal value. Gomer and Ferario (45) circumvented the need for artificially high injected doses of MACE (1) by radiolabeling the compound with 14C. Intravenous injection of 5 mg kg- 1 in female C3H1HeJ mice bearing BA mammary carcinoma gave peak concentrations in the tumor of 3.84 ILg g-I tissue at 2 min pi; however, levels of - 3 ILg g-I tissue were maintained to 8 h pi resulting in tumor/muscle and tumor/skin ratios of 10.6 and 2.2, respectively. Plasma levels fell from 42.74 fLg g-I tissue at 2 min pi to 0.64 ILg g-l at 8 h pi. A comparative study of iv vs ip administration indicated that, while at 4 h pi iv injection resulted in 25% higher tumor concentrations. by 24 h pi no difference could be detected. In a subsequent report Ferrario et ai. (46) studied MACE (1) with 14C incorporated into the pyrrolic rings of the sensitizer vs 14C in the aspartyl residue and found similar biodistribution and pharmacokinetics, indicating that MACE (1) was not significantly metabolized during the course of the experiment. Chlorin e6 (43) and pheophorbide a (53) chelated with M 2H, = OH Rl = H, R 2 = OH (45) M 2H, R,= CH 3 , (43) M =48 V, R, = H, R 2 (44) (42) only in the extracellular space. The more hydrophilic sensitizers also cleared more quickly from the tumor and could no longer be detected by 120 h pi. Mono-L-aspartyl chlorin e6 (1) is a derivative of chlorin e6 in which an L-aspartic acid residue has been attached via an amide bond to the propylcarboxy group on the o-pyrrolic ring of the chlorin. The effect of the modification, in terms of hydrophilicity, is to increase this parameter by adding an additional ionizable carboxyl residue. Being water-soluble, MACE (1) falls under the definition of a hydrophilic sensitizer for the purposes of this review; however, it should be appreciated that MACE (1) also has considerable amphiphilic character by virtue of the "clustering" of the four carboxyl groups on one side of the otherwise hydrophobic chlorin molecule. Preliminary work on biodistribution of MACE (1) was conducted by Aizawa et al. (44) using female BALB/c mice bearing m-KSA mouse kidney sarcoma. As this study was conducted using fluorescence, and consequently a high iv injected dose of 200 mg kg I was used. only relative values were obtained. Some selected values were, at 3 h pi: tumorlliver. 1.7; tumor/skin, 1.0; after 12 h pi fluorescence values from skin and muscle were 40% and 30% relative to the sarcoma. By 72 h pi little fluorescence was detected in normal tissue; however, fluorescence in the tumor had only = NH(CH 2 ) 2NH2 R2 positron-emitting [48V]vanadyl chloride have been injected iv in male C3HIHe mice implanted with FM3A mammary carcinoma (47). Tumor/muscle and tumor/skin ratios were higher, at 24 h pi. for the chlorin (l2.{)6 and 6.68% ID g-l tissue) compared with the pheophorbide (8.89 and 5.66% ID g-l tissue); however, maximal tumor concentrations of chlorin were attained 6 h pi (4.87% ID) with corresponding tumor/muscle and tumor/skin ratios of 9.19 and 5.66. No time-dependent data were reported for the pheophorbide. A comparison of chlorin e 6 (44) with an ethylene diamine (EDA) (45) derivative in which the EDA moiety was attached by an amide linkage to the carboxyl group on the pyrroltc C ring of the chiorin has been made by Gurinivich et al. (48). Ten mg kg-I body weight of each chlodn was injected ip in PBS into Af mice bearing transplanted methyIcholanthrene-induced sarcomas. For the chlorin e6 the maximal tumor uptake (\.5 ILg g-I tissue) occurred at 6 h pi, compared with the EDA derivative, which attained a maximal tumor concentration of 40 ILg g-I tissue but at the later time of 18 h pi. This disparity in accumulated dose and kinetics of uptake translated into a large difference in tumor/muscle ratios at the time of maximal tumor uptake with this parameter for chlorin e6 being - 3 compared to 20 for chlorin e6 EDA. A comprehensive study of biodistribution 478 Ross W. Boyle and David Dolphin and photodynamic effects of chlorin e6 has been published recently (49) in which Wi star rats bearing sarcoma M-I and sarcoma 45 tumors were injected ip with 10 mg kg~ I body weight of dye. Maximal tumor concentrations were attained at different times pi for the different tumors with sarcoma M-I accumulating 4.4 /-Lg g-I tissue at 18 h pi, while the sarcoma 45 gave a peak value of 3.6 /-Lg g-I tissue at 12 h pi. Tumor/muscle ratios were 8.8 for the M-I and 6 for the sarcoma 45 at these times. Concentrations of dye in the blood exceeded those in all internal organs, muscular tissues and neoplastic tissues at all time points to 72 h pi. A series of porphyrin dimers linked by aliphatic carbon chains of varying lengths (46) were studied by Kessel et al. OH o ip and iv to CBA mice implanted with C 6 glioma intracerebrally. Uptake and release of drug from the neoplasm was quite rapid for the lower dose, with peak concentrations of 17.5 /-Lg g-I tissue at 24 h pi for ip injection and 40 /-Lg g - I tissue at the same pi for iv injection. The higher dose gave similar uptake kinetics but slower release of drug from the tumor. Peak concentrations in this case were 90 /-Lg g-I tissue and -100 /-Lg g~1 tissue for ip and iv routes, respectively, at 24 h pi. High tumor/normal brain ratios were obtained with this compound, the maximum being 402 at 48 h after iv injection of 100 mg kg-I body weight; however, at 24 h pi, when the tumor concentrations were maximal, these values were: 157 (ip; 10 mg kg-I), 136 (iv; 10 mg kg-I), 203 (ip; 100 mg kg-I) and 238 (iv; 100 mg kg-I). A series of three hematoporphyrin analogues with side chain modifications such that the porphyrin bore four carboxyl, four amino or two carboxyl and two amino groups (48-50) were synthesized and investigated (52). The highest R, (46) (50). Four /-Lmol kg~1 body weight of each of the dimers was injected iv, in isotonic aqueous saline solution, into C3H1HeJ mice bearing RIF tumors. At 4 hand 24 h pi no significant differences were detected in tumor concentrations for dimers with 3, 4 and 5 carbon chains; however, both 6 and 13 carbon chain dimers gave significantly higher tumor concentrations at both time points. Plasma levels at 4 h pi, however, showed a steady increase in going from 3 carbons to 13 carbons. This trend was present, but less accentuated, for the same parameter measured at 24 h pi. In an innovative approach to combining photodynamic and neutron capture therapies Hill et ai. (51) investigated the biodistribution of a tetrakis carboranecarboxylate ester of 2,4-his(a,j3-dihydroxyethyl)deuteroporphyrin IX (47). Doses R O={ o OH (47) OH R=C2 B,aH, 1 of 10 and 100 mg kg I body weight were administered both (48) R, = CH(CH 3 )SCH 2 COOH, = OH R, = CH(CH 3 )S(CH2 h N R2 (49) ~ 0 '--I' R2 = OH ' = CH(CH )S(CH h Nb = NH(CH 2 )2 N(CH 3 )2 (50) R, R2 3 2 '--I' ' concentrations found, in POVD small cell lung carcinoma grown on male athymic Swiss mice injected iv with 20 mg kg-I body weight of each porphyrin, were 5 /-Lg g~1 tissue at 6 h pi for the tetracarboxylate and the same value, but at 24 h pi, for the amphoteric compound. The tumor concentration for these two drugs exceeded that for the tetraamine by a factor of > 3 at all time points. Tumor/muscle ratios for these compounds were 5.3 at 6 h pi for the tetracarboxylate; however, this rose to 16.7 at 24 h pi, 8.3 at 24 h pi for the amphoteric porphyrin and for the tetraamine a maximal value of 1.1 was attained at 6 h pi. Tumorlblood ratios increased throughout the course of the experiment and by 24 h pi these values were 12.5 for the tetracarboxylate and 0.94 for the tetraamine, while for the amphoteric drug sensitizer levels in the blood were below measurable levels. These results are in contrast with a previous study on these compounds by Woodburn et al. (53) who found that the tetraamine had the most favorable localization characteristics (8.23 IJ.g g~ I tissue at 24 h pi; tumor/peritumoral tissue ratio: 41.2) in female CBA mice bearing C 6 glioma. The cationic sensitizer meso-tetra(4N-methylpyridyl) Photochemistry and Photobiology, 1996, 64(3} 479 porphyrin (18) were studied by Villanueva and Jori (54). A dose of 2.1 mg kg-I body weight was administered iv to female BALB/c mice bearing MS-2 fibrosarcoma. A peak tumor concentration of 1.19 /kg g~ I tissue was attained at 24 h pi, and at this time no drug could be detected in the blood or skin. The liver and spleen were. however, major reservoirs for this sensitizer with levels of 2.64 and 1.29 /kg g-I tissue at 24 h pi. In an example of a water-soluble photosensitizer without ionic groups. tritiated benzoporphyrin derivative (BPD) was conjugated with polyvinyl alcohol (PVA) (51) at a ratio of o cation of the chlorin e6 structure by esterification of the meso-carboxyl group and amidation of the D ring propionic acid group with ethylene diamine increased the maximal tumor concentration by a factor of 27. Another amphoteric sensitizer also gave the higher tumor/peritumoral tissue ratio when compared to fully cationic or anionic sensitizers derived from the same porphyrin. Finally, of the two tetracationic drugs studied, the formally quarternized compound. i.e. one bearing four positive charges independent of pH, concentrated in tumor tissue at a much higher concentration compared with a porphyrin analogue bearing four tertiary amino residues, which were free to establish a pH-dependent equilibrium between charged and neutral species. AMPHIPHILIC PHOTOSENSITIZERS (51) R Polyvinyl alcohol (56) R H 25 (BPD) : 1 (PV A) and injected iv in PBS into male DBAI2 mice bearing P815 mastocytoma (55). Administration of a dose equivalent to 0.5 mg kg I body weight BPD resulted in a tumor/muscle ratio of 4 at 3 h pi and this had risen slightly to 4.5 by 24 h pi. Corresponding results for nonconjugated, and therefore water-insoluble. BPD injected in Iiposomes were 2.75 and 3.0. The most striking differences were seen in the tumorlbrain ratios, which were 3.75 and 3.0 at 3 and 24 h pi for liposomal BPD, while for the PVAconjugated BPD the corresponding values were 7.25 and 9.5. These large differences were attributed to altered bloodlbrain barrier kinetics. Comparison of biodistribution data for the hydrophilic photosensitizers is. generally, more easy than for their hydrophobic counterparts as one of the variables, delivery vehicle, has been eliminated. However, as in all cases differences in tumor morphology, vascularization and host tissue must be taken into account, although a rigorous treatment of this subject could constitute a review in itself, it is outside the scope of this work. Differences in tumor type notwithstanding, some general structure/tumor accumulation trends can be seen. Amongst the tetraanionic sensitizers the highest % ID in the tumor was found for AlPcS4 (6), while a tetracarboxyl porphyrin gave a maximal tumor concentration approximately half that of AIPcS4 (6), but at twice the injected dose. The compound MACE (1), however, which is also a tetracarboxylated compound. gave tumor concentrations only slightly lower than AIPcS4 (6), albeit at 2 min ip, thus highlighting the importance of regioisomerization in biodistribution. Trianionic compounds again revealed a sulfonated AIPc, AIPcS) (7) to be the most efficient, with tumor concentrations approximately four times that for the tricarboxyl chlorin eo (44) at similar injected doses. However, modifi- Amphiphilic photosensitizers are generally recognized to be compounds that have present in their structure both a hydrophilic and a hydrophobic region. In the case of the porphyrin-based PDT agents this often results from an asymmetric distribution of charge groups around the periphery of the macrocycle. The region of the porphyrin most distant from the charged groups then acts as the hydrophobic region. This class of sensitizer is, arguably. the most important of the three drug types described in this review, as it includes the most potent of PDT agents, with respect to "direct" activity on neoplastic cells, and also two of the compounds on which most clinical data have been amassed, meta-tetrahydroxyphenylchlorin (m-THPC) (52) and benzoporphyrin derivative (52) monoacid ring A (verteporfin. BPD-MA) (56). Once again the sulfonated Pc were the focus of much of the original work relating to amphiphilic sensitizers; however, as most of these data have been covered in the context of comparisons with their hydrophilic higher sulfonated analogues, only a brief summary will be included here. The lower sulfonated Pc (PcS I and PCS2) generally give lower maximal tumor concentrations, when compared to PcS} and PCS4 (see Tables 2 and 3); however, intratumoral distribution studies suggest that the more hydrophilic sulfonates localize in the extracellular space and associate with connective tissue in the tumor, while the amphiphilic dyes penetrate and accumulate within the neoplastic cells themselves. Localization within the various compartments of the tumor is thought to be influenced by the relative association of differently sulfonated Pc with serum components and the amount of free sensitizer 480 Ross W. Boyle and David Dolphin Table 2. Selected biodistribution data for hydrophilic photosensitizers Delivery vehicle (route) Sensitizer (animal) AIPcS4 (6)(mouse) AIPcS3 (7)(mouse) AIPcS 4 (6)(mouse) 55Fe(II)PcS4 (41)(mouse) PBS PBS PBS PBS (iv) (iv) (ip) (ip) MACE (l)(mouse) Chlorin e6 (44)(mouse) Chlorin e6-EDA (4S)(mouse) Chlorin e6 (44)(rat) PBS PBS PBS PBS (iv) (ip) (ip) (ip) Tetrakiscarborane Deuteroporphyrin (47)(mouse) PBS (iv) PBS (ip) Hp(COOH)4 (48)(mouse) Hp(COOH)iaminoh (49)(mouse) Hp(amino)4 (SO)(mouse) Meso-tetra(4N-methylpyridyl) porphine (18)(mouse) PBS PBS PBS PBS (iv) (iv) (iv) (iv) Injected dose (mg kg-I) Maximal tumor uptake (fLg g-I tissue) (time attained pi in hours) 9.0 8.0 20 5 10 5 10 10 10 10.8 (24) 6.2 (24) (0.5) 21 0.4 (24) 1.0 (24) 3.84 (2 min) 1.5 (6) (18) 40 4.4 (18) M 1 sarcoma 3.6 (12) sarcoma 45 (24) 40 (24) 100 17.5 (24) (24) 90 (6) 5 (24) 5 (2) -1 1.2 (24) 10 100 10 100 20 20 20 2.1 dissociated from these components within the extracellular space (56). Pheophorbide a (phe-a) (53) and chemically modified derivatives have been the subject of several biodistribution studies. Nishiwaki et al. (57) compared methods of delivery for this compound by injecting in either PBS or a lipoidal solution. Male New Zealand white rabbits inoculated with YX-2 liver tumors were injected iv or directly into the hepatic artery (ia) with 1.0 mg kg-I body weight Phe-a. After 24 h ia delivery of the lipoidal solution gave a tumor concentration of -85 I-lg g-I tissue and the same delivery route with PBS solution gave -129 I-lg g-I tissue. Intravenous OH (53) R, = CH=CH2. R2 = COOH (54) R, R2 = CH(CH3)O(n-C6 H'3). =H injection, however, resulted in only -5 I-lg g-I tissue. Tumor/liver ratios were 19 (lipoidal; ia), 20 (PBS; ia) and 0.3 (PBS; iv), while levels in skin and blood were below detection limits for ia lipoidal administration, 0.75 and 0.41 I-lg g-I tissue for ia PBS and 1.89 I-lg g-I tissue for skin with iv PBS solution, but blood levels were below detection limits. Iwai et al. (58) chelated Phe-a (53) with positron emitting 48y and investigated its biodistribution in C3H/He mice im- Tumor/peritumoral tissue ratio Reference 28 14 < 1.0 5.1 6.0 2.6 3.0 20 8.8 6.0 136 238 157 203 5.3 8.3 -1.0 Peri tumoral below detection limit 35 35 36 42 45 48 48 49 51 52 52 52 54 planted with FM3A mammary carcinoma or MH 134 heptoma. Male ddY mice with transplanted S 180 sarcoma were also used in the study. Injected doses were based on radioactivity, rather than directly on the sensitizer concentration. so all data were reported as % ID g-I tissue. However, controls with inorganic 48YOCI 2 indicated no demetallation took place in vivo. Interestingly all three tumor types exhibited very similar % ID g-I tissue values at 24 h pi and these were all peak levels, suggesting common pharmacokinetics. Tumor/muscle and tumor/skin ratios for the FM3A carcinoma were 8.9 and 5.7 at 24 h pi. A parallel study with 14C-Iabeled Phe-a (53) gave similar biodistribution results, confirming that tumor localization was controlled by the nature of the macrocyclic ligand, rather than the metal. Pheophorbide a (53) has also been studied in Lewis rats with azaserine-induced acinar pancreatic tumors (59). Injection of 3 mg kg-I body weight drug in ethanollPBS (1: I vol/vol) iv led to a maximal tumor concentration of 0.98 I-lg g-I tissue I h after injection; however. the maximal tumor/pancreas ratio of 7.8 was attained at 48 h pi and tumor concentration at this time was 0.39 I-lg g-I tissue. Skin levels of drug were very low 48 h pi (0.04 I-lg g-I), while blood and muscle showed somewhat higher levels of 0.26 and 0.47 I-lg g-I tissue. The chlorin 2-[I-hexyloxyethYll-2-devinyl pyropheophorbide a (54), a chemically modified derivative of Phe-a (53) has been labeled with 14C and studied in female C3H mice bearing RIFI tumors and female DBAl2 mice bearing SMT-F tumors (60). One mg kg-I body weight drug formulated in 0.1 % Tweenl2% ethanol/5% dextrose in water was injected iv and resulted in a maximum concentration in the tumor of 2.5 I-lg g-I tissue 7 h pi and a corresponding tumor/skin ratio of 5.6. Drug uptake in SMT-F tumors was measured by fluorescence; however. it was only reported that relative fluorescence in this tissue increased steadily to 24 h pi. Bacteriochlorin a (Bch-a) (55), a derivative of the photo- Photochemistry and Photobiology, 1996, 64(3) 481 Table 3. Selected biodistribution data for amphiphilic photosensitizers Sensitizer (animal) AIPeS2 (8)(mouse) AIPeS , (9)(mouse) Pheophorbide a (53)(rabbit) Pheophorbide a (53)(rabbit) Pheophorbide a (53)(rabbit) Pheophorbide a (53)(rat) 2-[ I-Hexyloxyethyl]-2-devinyl pyropheophorbide a (54)(mouse) Ketochlorin (57) Ketoehlorin (57) m-THPC «52)(mouse) BPD-MA (56)(mouse) BPD-MA (56)(mouse) BPD-MA (56)(mouse) Delivery vehicle (route) Injected dose (mg kg I) PBS (iv) 40% EtOHIPBS (iv) PBS (ia) PBS (iv) Lipoidol (ia) EtOHIPBS (I:I)(iv) 0.1 % Tween 80/2% EtOW5% dextrose in water (iv) Tween 80IPBS (iv) Cremophor EL (iv) EtOHIPEG 400/water (2:3:5)(ip) 10% DMSOIPBS (iv) DMPC/egg PG liposomes (iv) 6% DMSOIPBS (iv) 6.8 6.0 1.0 1.0 1.0 3.0 1.0 5.0 5.0 0.3 Maximal tumor uptake (f.l.g g-I tissue) (time attained pi in hours) 2.6 -0.5 129 -5 -85 0.98 2.5 (24) (24) (24) (24) (24) (I) -17 synthetic pigment bacteriochlorophyll a, has been labeled with radioactive 99mtechnetium and studied in male Syrian golden hamsters implanted with Greene melanoma (6\). Intravenous injection of 20 mg kg- ' body weight in dimethylsulfoxide (DMSO)IPBS (25:75) resulted in a peak tumor concentration of 0.8% of radioactivity g-I wet tissue at 2 h pi, tumor/skin and tumorlblood ratios at this time point were 1.6 and 0.3, respectively. However, maximal values for these parameters were found at later time points, 1.67 for tumor/skin at 3 h pi and 0.92 for tumorlblood at 24 h. No data could be recorded after 24 h pi due to the short half life of 99mTc (tl/2 = 6 h). Relative intratumoral distribution of Bch-a in isogeneic RMA mammary tumors grown on female W AGIRJJ rats has been reported by van Leengoed et al. (62). A dose of 20 mg kg-I body weight was injected ip as a Cremophor EL aqueous emulsion and time-dependent distribution was followed by fluorescence. Tumor/normal tissue ratios rose from 1.9 at 5 min pi to a maximum of 2.5 at 1530 min pi and then decreased steadily to a value of 0.5 at 24 h pi. The tumorlblood vessel ratios were maximal 5 min pi (2.5) and also declined throughout the course of the experiment, reaching a value of 0.8 at 24 h pi. Woodburn et al. (63) synthesized a ketochlorin with propionic acid groups on rings C and D and octyl chains on rings A and B (57). Injection of female C3H mice bearing N/A 4.2 4.0 1.3 63 63 67 -2.8 1.6 72 76 3.8 76 20 0.3 18 1.72 (7) 3.5 (24) 6.7 (24) 57.5 (36) 4.0 4.0 2.94 (3) 2.0 (0.25) 4.0 1.5 (3) Referenee 35 35 57 57 57 59 60 N/A OH (55) Tumorl peri tumoral tissue ratio OH (57) RIF tumors iv with 5 mg kg-I body weight drug in either Tween 80 or Cremophor EL gave maximal tumor concentrations of 6.69 j.1g g-I tissue for Cremophor and 3.5 j.1g g-I for Tween, both at 24 h pi. The corresponding tumor/muscle and tumor/skin ratios were 4.0 and 3.0 for Cremophor and 4.2 and 2.4 for Tween. Plasma concentrations were greater than those in the tumor at both 3 and 24 h pi. The last two photosensitizers covered in this section are, perhaps, the most important drugs currently being studied. Both are in advanced clinical trials on human patients and, therefore, one of these compounds will most likely be the first second-generation photosensitizer to be brought before a regulatory board for approval. The first of these drugs, mTHPC (52) is a totally synthetic analogue of meso-tetraphenylporphyrin, one of the simplest "model" porphyrins. The m- THPC (52) is a single substance but due to rotation around the porphyrin/phenyl bond four atropisomers are possible. However, at in vivo temperatures (-37°C), rotation is fast enough to prevent different spatial orientations of the four hydroxy groups from being recognized by biological components. This freedom of movement of peripheral hydroxy groups has been demonstrated to have important implications with respect to in vivo activity for tetrahydroxyphthalocyanines (64). Preliminary results of relative values 482 Ross W. Boyle and David Dolphin for tumor, skin and muscle uptake in human patients were reported by Braichotte et al. (65). Patients were injected iv with 0.3 mg kg-I body weight, three patients had malignant mesothelioma, while a fourth had a malignant fibrous histiocytoma. Comparing patients with the same cancer, fluorescence in the tumor increased steadily from 24 h pi to 72 h pi, as did the tumor/muscle ratios (1.5 at 24 h pi and 6 at 72 h pi); however, the tumor/skin ratio of the patient from whom the 72 h biopsy was extracted was low (-0.9) compared with biopsies taken at 24 (1.5) and 61 (3.25) h pi. The patient with the histiocytoma showed a maximal tumor uptake of more than twice that of the other three patients at 72 h pi and also very high tumor/muscle and tumor/skin ratios of 14.3 and 10.8 respectively. It should be stressed that these results were obtained from individual patients for each time point and therefore no statistical analysis of the data was possible. Another study of pharmacokinetics in human patients was conducted a year later (66). Two patients, one with invasive epidermoid carcinoma on the tongue and the other with a microinvasive carcinoma on the palatoglossal arch were injected iv with a dose of 0.15 mg kg- I body weight and fluorescence of m-THPC (52) was measured, noninvasively, in tumor, skin and normal tissue as a function of time. Maximal tumor fluorescence was obtained between 25 and 50 h pi for the patient with the epidermoid carcinoma, while skin and normal tissue maxima occurred at 4090 h pi and 50 h pi respectively. Tumor/normal tissue ratios increased rapidly over the first 3 h, reaching values of 14, then fell to values of 5 and 3 at 24 and 48 h pi. Results for the second patient showed similar kinetics, with maximal tumor fluorescence at 30 h pi and normal tissue at 45 h pi. Maximal tumor/normal tissue ratios were lower at 6 (1-6 h pi) and this had fallen to 2.5 by 45 h pi. More conventional biodistribution studies have also been performed in mice (67) and rats (68). In the first of these reports male nude BALB/c mice bearing human malignant mesothelioma xenographs were injected ip with 0.3 mg kg I body weight m· THPC (52) in ethanollPEG 400/water (2:3:5). At 36 h pi a maximal concentration in the tumor of 57.7 ng g-I tissue was found. Uptake kinetics were similar for both tumor and normal tissue; however, the drug persisted for longer in the normal tissue such that, while maximal tumor/normal tissue ratio (1.3) coincided with the highest concentration in the tumor, by 72 h pi this had fallen below I. The authors be· lieve this effect may be due to drug dilution on tumor-cell doubling. Laser-induced fluorescence was used to study biodistribution in male WistarlFurth rats bearing colon adenocarcinoma. A dose of 1.3 mg kg-I body weight m-THPC (52) was injected iv in the same formulation medium as used above for mice. At 24 hand 48 pi relative measurements of drug concentrations in various tissues were made. Maximal tumor/muscle ratio was 9 at 24 h pi and this had fallen to 7 by 48 h pi; however. while ratios were still high at 48 h the tumor fluorescence had fallen to -37% and -50% of the 24 h values for tumor surface and tumor interior, respectively. Fluorescence signals from the liver, lung and spleen dropped more rapidly, compared with the tumor, such that only 7~ 14% of the 24 h levels were detected at 48 h pi. The drop in liver values, which had been relatively high (-63% of tumor surface and 130% of tumor interior) at 24 h pi, was attributed to metabolism of the drug in this organ. No skin values were reported in this study. Recently Morlet el aJ. (69) injected male Swiss nude/nude mice bearing human co10rectal adenocarcinoma ip with increasing doses (0.05-1.6 mg kg- I body weight) of m-THPC (52) in ethanollPEG 400/water (2:3:5) and biodistribution was studied by fluorescence. Maximal tumor fluorescence was obtained 72 h after injection of 1.6 mg kg-I; however, tumor/muscle and tumor/skin ratios decreased between 24 and 72 h from 15 to 2.1 for the former and 15 to 1.1 for the latter, indicating that tumor selectivity decreased with time after injection. In contrast with these results Whelpton et al. (70) reported that tumor/muscle ratio increased from 24 h pi (3.5) to 72 h pi (5.0) when female BALB/c mice bearing Colo 26 colorectal carcinomas were injected iv with 0.51 mg kg- I m-THPC. The authors report high tumor/intestine and tumorlliver ratios of 8.6 and 6.9, respectively, at 96 h pi. while a tumor/muscle ratio of 4.6 was maintained at this time. Absolute tumor concentrations remained between 1 and 2 JLg g-I tissue from 20 to 96 h pi. Discrepancies between these two sets of results may be due to the use of chromatographic vs spectrof!uorometric detection methods. The final photosensitizer to be covered in this review. BPD-MA (verteporfin) (56). is a chlorin with extended conjugation formed by an electrocyclic Diets Alder reaction on protoporphyrin IX dimethyl ester. followed by base-induced isomerization of an isolated double bond to bring it into conjugation and hydrolysis of one methoxycarbonyl group (71). The BPD-MA (56) is currently in phase II clinical trials. Richter et at. (72) synthesized tritiated BPD·MA (56) for the purpose of preliminary biodistribution studies on female DBAl2J mice bearing P815 mastocytoma. Intravenous injection of 4 mg kg-I body weight in DMSOIPBS (I: 10) gave a maximal tumor concentration of 2.94 f,Lg g-I tissue at 3 h pi; however, while tumor concentrations fell over the following 46 h to l.0 f,Lg g-I tissue, tumor/muscle ratios remained essentially the same over this period (-2.8). Tumor/skin ratios fell from 3 h pi (2.57) to 24 h pi 0.64), but then rose again at 48 h pi (1.95). Blood levels of BPD·MA (56) fell steadily although the maximal tumorlblood ratio (l,45) was attained at 24 h pi. Comparing these results with I4C-Iabeled BPD-MA (56) (5 mg kg-I) administered in the same delivery vehicle to the same strain of mice, but bearing M I rhabdomyosarcoma (73), peak tumor concentration was again found 3 h pi (2.7% ID g-I tissue); however, tumor/muscle ratios at this time (l.08) were quite different but by 8 h pi (2.71) were similar to those found with tritiated BPD-MA (56). Tumor/skin ratios also rose from 3 h pi (1.68) to 8 h pi (3.17). Biodistribution results for two BPD-MA analogues, BPD·MA ring B (BPD·MB) and BPD diacid (BPDDA), have been reported and compared with BPD-MA in male DBAl2 mice bearing MI rhabdomyosarcoma (74). All BPD analogues were injected iv in 10% DMSO in PBS at a dose of 3.5 mg kg- l body weight and no significant differences were found between them at 24 h pi. These data are interesting in view of the fact that BPD-MA is consistently a much more effective PDT agent, compared with BPD-MB and BPD-DA, and once again highlights the complexity of the in vivo situation. In an even mote in·depth study Richter et al. (75) examined biodistribution and photosensitizing efficiency of two regioisomers of BPD·MA (56), one with the Photochemistry and Photobiology, 1996, 64(3) 483 free propionic acid residue located on the pyrrolic C ring (A I), and the other in which this group is attached on the D ring (A2). Similar mice, tumor type and injection protocols were used as for the previous study; however, detection of A I and A2 regioisomers was achieved by chromatographic analysis. Tumor concentrations of both regioisomers remained essentially equivalent up to 3 h pi; however, a selective clearance from the blood was detected with ~3.6 times more A I present at 3 h pi. Initially the authors thought the effect was mediated by specific esterases, but subsequent plasma studies indicated that this was unlikely. Finally a comparative study of BPD-MA (56) delivered in unilamellar liposomes (dimyristoyl phosphatidyl choline/egg phosphatidyl glycerol; <200 nm average particle size) or 6% DMSOIPBS was conducted (76). Male BALB/c mice bearing MI rhabdomyosarcoma were injected iv with 4 mg kg-I body weight of 14C-labeled BPD-MA (56) in each delivery vehicle. Peak concentrations in the tumor were obtained at 15 min pi (2 J..Lg g- I tissue) for Iiposomal BPD-MA (56) but at 3 h pi (1.5 J..Lg g-I tissue) for DMSOIPBS administered material. Tumor/tissue ratios showed both formulations attained maximal tumor/muscle ratios at 24 h pi, 19.2 for Iiposomal and 12.6 for DMSOIPBS, while tumor/skin ratios peaked at 3 h pi, 4.3 for liposomal and 5.9 for DMSOIPBS. Significant accumulations of BPD-MA (56) in the liver and gall bladder were also reported, but no absolute data were given. Comparisons between biodistribution and pharmacokinetic data for different amphiphilic photosensitizers are, once again, complicated by differences in delivery vehicles and, as can be seen from Table 3, this problem is worse for amphiphilic than for hydrophobic compounds. In fact, in this section no two data sets utilize the same delivery protocol in the same animal! 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