Terapia fotodynamiczna – założenia, mechanizm, aplikacje kliniczne**

*Anna Choromańska, Julita Kulbacka, Jolanta Saczko

Summary
The photodynamic therapy (PDT) is a noninvasive method of treatment, involving the interaction of light, photosensitizer and oxygen present in the tissues. The result of this interaction is a cascade of processes with induction of phototoxic effect. The main cytotoxic mechanism of PDT is damaging cell membranes, intracellular organelles and nucleus. High concentrations of photosensitizer and a short time of incubation lead to the destruction of the cells by necrosis, while lower concentrations of photosensitizer and a longer time of incubation cause apoptotic cell death processes. Photodynamic therapy gives the best results in the treatment of precancerous lesions. Particularly is preferred where surgical, radiological or chemotherapy is impossible. Recently, there is also non-oncological use, including ophthalmology, dentistry or photoangioplasty. Increasing the feasibility and efficiency of the method depends mainly on the availability of photosensitizers as well as their bioavailability within malignant tissue. The main limitation of PDT is not efficient selectivity of photosensitizing drugs. The most common side effects are associated with the fact that the photosensitizers accumulate in normal tissues. Currently, studies are being conducted on how to improve the efficiency of transport medicine to the affected tissue. Currently, nanomaterials play an important role here. Liposomes, lipoproteins, monoclonal antibodies and electroporation are also applied. In combination with photosensitizers they can improve the performance of photodynamic therapy and limit its side effects.

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