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Methylene blue in anticancer photodynamic therapy
- Thread starter ginfreely
- Start date
Abstract
Background: Methylene blue has a long history of clinical application. Thanks to phenothiazine chromophore, it has potential in photodynamic anticancer therapy. In spite of the growing body of literature that has evaluated the action of this dye on different types of cancer, the systematic understanding of this problem is still lacking. Therefore, this systematic review was performed to study the efficacy of methylene blue in photodynamic anticancer therapy.Methods: This systematic review was carried out in accordance with the PRISMA guidelines, and the study protocol was registered in PROSPERO (CRD42022368738). Articles for the systematic review were identified through the PubMed database. SYRCLE’s risk of bias tool was used to assess the studies. The results of systematic analysis are presented as narrative synthesis.
Results: Ten studies met the inclusion criteria and these full texts were reviewed. In the selected articles, the dosage of dye infusion ranged from 0.04 to 24.12 mg/kg. The effectiveness of photodynamic therapy with methylene blue against different types of cancer was confirmed by a decrease in tumor sizes in seven articles.
Conclusion: The results of the systematic review support the suggestions that photodynamic therapy with methylene blue helps against different types of cancer, including colorectal tumor, carcinoma, and melanoma. In cases of nanopharmaceutics use, a considerable increase of anticancer therapy effectiveness was observed. The further research into methylene blue in photodynamic anticancer therapy is needed.
Conclusion: The results of the systematic review support the suggestions that photodynamic therapy with methylene blue helps against different types of cancer, including colorectal tumor, carcinoma, and melanoma. In cases of nanopharmaceutics use, a considerable increase of anticancer therapy effectiveness was observed. The further research into methylene blue in photodynamic anticancer therapy is needed.
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1 Introduction
Effective, safe, and low-cost anticancer compounds continue to be widely searched for and investigated, and they appear especially relevant today. In spite of the fact that biological medicinal products are in focus of pharmaceutical industry nowadays, the small molecules are continuing to be actual for clinical practice (Avdeeva et al., 2015). Drug discovery is a long, expensive, and labor-intensive process, that, however, may be optimized due to modern computational methods (Mandal and Mandal, 2009; Taldaev et al., 2022). Therefore, the re-examination of the pharmacological potential of well-known compounds is a promising focus of drug development. Methylene blue (MB)—methylthioninium chloride—can be considered as one such substance (Figure 1).
This compound was firstly synthesized as a textile dyestuff by Caro in 1876 (Friedlaender, 1877). Later, Ehrlich in cooperation with coauthors described the ability of MB to stain the nervous tissue (Ehrlich, 1886) and to act as an analgesic (Ehrlich and Leppmann, 1890) and antimalarial (Kaufmann, 1919) component. Although the clinical use of this dye was canceled due to the blue colorization of urine, it was used in malaria management throughout the 19th century (Schirmer et al., 2003). Nowadays, in the United States and the European Union, MB is applied in methemoglobinemia treatment and for staining of colorectal tumors.
Oncology seems to be a promising area for MB use thanks to its pronounced photosensitizing action that results in the disruption of pathological cells under the influence of light (Cecatto et al., 2020). This effect occurs because of the phenothiazine chromophore. It absorbs the light in the range of wavelengths from 630 to 680 nm, which leads to the generation of reactive oxygen species and the following cell death (Lim, 2021). Furthermore, MB selectively accumulates in cancer cells. These properties may be used in photodynamic anticancer therapy.
Oncology seems to be a promising area for MB use thanks to its pronounced photosensitizing action that results in the disruption of pathological cells under the influence of light (Cecatto et al., 2020). This effect occurs because of the phenothiazine chromophore. It absorbs the light in the range of wavelengths from 630 to 680 nm, which leads to the generation of reactive oxygen species and the following cell death (Lim, 2021). Furthermore, MB selectively accumulates in cancer cells. These properties may be used in photodynamic anticancer therapy.
There are several clinical guidelines for photodynamic anticancer therapy, including the management of skin, pulmonary, esophageal, and cervical cancer (Yoo and Ha, 2012). However, MB is not treated as an active pharmaceutical ingredient in these guidelines. At the same time, to date, the anticancer properties of MB has received attention in the research literature. Surprisingly, systematic understanding of how effective photodynamic therapy with MB is against different types of cancer is still lacking.
Therefore, the aim of this systematic review was to evaluate the efficacy of MB in anticancer photodynamic therapy in animal models of different oncological diseases.
Therefore, the aim of this systematic review was to evaluate the efficacy of MB in anticancer photodynamic therapy in animal models of different oncological diseases.
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