Fluorinated Polyethylenimine to Enable Transmucosal Delivery of Photosensitizer-Conjugated Catalase for Photodynamic Therapy of Orthotopic Bladder Tumors Postintravesical Instillation

Photodynamic therapy (PDT) by insertion of an optical fiber into the bladder cavity has been applied in the clinic for noninvasive treatment of bladder tumors. To avoid systemic phototoxicity, bladder intravesical instillation of a photosensitizer may be an ideal approach for PDT treatment of bladder cancer, in comparison to conventional intravenous injection. However, the instillation-based PDT for bladder cancer treatment remains to be less effective due to the poor urothelial uptake of photosensitizer, as well as the tumor hypoxia-associated PDT resistance. Herein, it is uncovered that fluorinated polyethylenimine (F-PEI) achieved by mixing with Chorin-e6-conjugated catalase (CAT-Ce6) is able to form self-assembled CAT-Ce6/F-PEI nanoparticles, which show greatly improved cross-membrane, transmucosal, and intratumoral penetration capacities compared with CAT-Ce6 alone or nonfluorinated CAT-Ce6/PEI nanoparticles. Owing to the decomposition of tumor endogenous H₂O₂ by CAT-Ce6/F-PEI nanoparticles penetrating into bladder tumors, the tumor hypoxia would be effectively relieved to further favor PDT. Therefore, bladder intravesical instillation with CAT-Ce6/F-PEI nanoparticles could offer remarkably improved photodynamic therapeutic effect to destruct orthotopic bladder tumors with reduced systemic toxicity compared to hematoporphyrin, the first-line photosensitizer used for bladder cancer PDT in clinic. This work presents a unique photosensitizer nanomedicine formulation, promising for clinical translation in instillation-based PDT to treat bladder tumors.