Ferroptosis is a programmed death mode that regulates redox homeostasis in cells, and recent studies suggest that it is a promising mode of tumor cell death. Ferroptosis is regulated by iron metabolism, lipid metabolism, and intracellular reducing substances, which is the mechanism basis of its combination with photodynamic therapy (PDT). PDT generates reactive oxygen species (ROS) and1O2through type I and type II photochemical reactions, and subsequently induces ferroptosis through the Fenton reaction and the peroxidation of cell membrane lipids. PDT kills tumor cells by generating excessive cytotoxic ROS. Due to the limited laser depth and photosensitizer enrichment, the systemic treatment effect of PDT is not good. Combining PDT with ferroptosis can compensate for these shortcomings. Nanoparticles constructed by photosensitizers and ferroptosis agonists are widely used in the field of combination therapy, and their targeting and biological safety can be improved through modification. These nanoparticles not only directly kill tumor cells but also further exert the synergistic effect of PDT and ferroptosis by activating antitumor immunity, improving the hypoxia microenvironment, and inhibiting the tumor angiogenesis. Ferroptosis-agonist-induced chemotherapy and PDT-induced ablation also have good clinical application prospects. In this review, we summarize the current research progress on PDT and ferroptosis and how PDT and ferroptosis promote each other.
铁死亡是一种调节细胞内氧化还原稳态的程序性死亡模式，近期研究表明其是一种具有前景的肿瘤细胞死亡方式。铁死亡受铁代谢、脂质代谢及细胞内还原性物质调控，这是其与光动力疗法相结合的作用机制基础。光动力疗法通过I型和II型光化学反应产生活性氧与单线态氧，随后通过芬顿反应及细胞膜脂质过氧化诱导铁死亡。光动力疗法通过产生过量细胞毒性活性氧杀伤肿瘤细胞，由于激光穿透深度及光敏剂富集的局限性，其全身治疗效果欠佳。将光动力疗法与铁死亡相结合可弥补这些不足。由光敏剂与铁死亡激动剂构建的纳米颗粒在联合治疗领域应用广泛，通过修饰可提升其靶向性与生物安全性。这些纳米颗粒不仅能直接杀伤肿瘤细胞，还能通过激活抗肿瘤免疫、改善缺氧微环境及抑制肿瘤血管生成，进一步发挥光动力疗法与铁死亡的协同作用。铁死亡激动剂诱导的化疗与光动力疗法诱导的消融亦具有良好的临床应用前景。本文综述了当前光动力疗法与铁死亡的研究进展，以及二者如何相互促进。
Photodynamic Therapy Combined with Ferroptosis Is a Synergistic Antitumor Therapy Strategy
肿瘤(癌症)患者之家