Photodynamic Therapy (PDT) offers a minimally invasive approach for treating various health conditions, employing a photosensitizer (PS) and specific light. Recent enhancements make PDT outpatient-friendly and less discomforting. Effectiveness hinges on selecting the appropriate PS. This article delves into natural and synthetic PSs, emphasizing the rising interest in natural alternatives for their safety. It explores their mechanisms, characteristics, and applications, offering insights into their potential contributions to advancing PDT. This extensive review delves into the preclinical and clinical landscape of natural PSs for PDT, shedding light on their diverse applications and promising outcomes. Compounds like curcumin, piperine, riboflavin, psoralen, hypericin, and others show significant potential in preclinical in vitro studies across various cell lines. In vivo, these photosensitizers prove effective against skin tumors, carcinomas, and sarcomas, inducing apoptosis, autophagy, and ROS generation for therapeutic efficacy. The review underscores the critical role of proper dosing and monitoring in balancing therapeutic benefits and risks. It highlights the advantages and limitations of natural PSs, emphasizing their specific targeting, bioavailability, and limited side effects. The future of PDT holds promising breakthroughs, taking from some evidence like Bergamot oil in nanostructured lipid carriers for dermatological conditions. Second-generation photosensitizer Tookad shows potential in prostate cancer treatment, while Tripterygium wilfordii Hook. F. emerges as an antimicrobial PDT source etc. Thus, environmental concerns in PDT prompt a shift to plant extracts for PS purification. The evidence-supported focus on natural PSs establishes this article as a key resource for advancing natural compounds in PDT and their therapeutic applications.
Keywords: Green PDT; Natural alternatives; Photodynamic therapy (PDT); Photosensitizer (PS); Therapeutic efficacy.
© 2024. The Author(s), under exclusive licence to the European Photochemistry Association, European Society for Photobiology.