Study on the effect of 5-aminolevulinic acid-mediated photodynamic therapy combined with cisplatin on human ovarian cancer OVCAR-3 ​cells

Adv Med Sci. 2023 Mar;68(1):147-156. doi: 10.1016/j.advms.2023.03.001. Epub 2023 Mar 23.


Purpose: This article explores the effect of 5-aminolevulinic acid (5-ALA)-mediated photodynamic therapy (PDT) combined with cisplatin (CDDP) on the apoptosis of human ovarian cancer cells and the mechanism of action of the combination therapy.

Materials and methods: Human ovarian cancer OVCAR-3 ​cells were cultured in vitro and divided into 5-ALA/PDT group, CDDP group and combined treatment group (5-ALA/PDT combined with different concentrations of CDDP). After administration of the corresponding drugs, a CCK-8 assay was used to detect the inhibition rate of cell proliferation. After Rhodamine 123 staining, mitochondrial membrane potential changes were observed under fluorescence microscopy. The apoptosis rate and reactive oxygen species (ROS) content were detected by flow cytometry. Western blotting was used to detect protein expression.

Results: The CCK-8 assay showed that CDDP in combination with 5-ALA/PDT significantly enhanced cytotoxicity compared to treatment with CDDP alone and that low doses of CDDP were sufficient to induce these combination effects. The mitochondrial membrane potential in each combination treatment group gradually decreased with increasing CDDP concentration, while the apoptosis rate and reactive oxygen species (ROS) content detected by flow cytometry gradually increased. Western blotting assay showed that the expression of bax, cleaved caspase-9, cleaved caspase-3, and cleaved PARP was increased, while the expression of bcl-2, caspase-9, caspase-3, and PARP was decreased, and the differences were statistically significant (P ​< ​0.05).

Conclusions: In summary, 5-ALA/PDT combined with CDDP can effectively inhibit cell proliferation and promote apoptosis, and this combination may induce apoptosis by activating the mitochondrial pathway.

Keywords: 5-ALA/PDT; Apoptosis; Caspase-3; Cisplatin; Ovarian cancer.

MeSH terms

  • Aminolevulinic Acid / pharmacology
  • Aminolevulinic Acid / therapeutic use
  • Apoptosis
  • Caspase 3 / metabolism
  • Caspase 9 / metabolism
  • Caspase 9 / pharmacology
  • Cell Line, Tumor
  • Cisplatin / metabolism
  • Cisplatin / pharmacology
  • Cisplatin / therapeutic use
  • Female
  • Humans
  • Ovarian Neoplasms* / drug therapy
  • Photochemotherapy*
  • Photosensitizing Agents / pharmacology
  • Poly(ADP-ribose) Polymerase Inhibitors / pharmacology
  • Reactive Oxygen Species / metabolism
  • Sincalide / metabolism
  • Sincalide / pharmacology


  • Aminolevulinic Acid
  • Cisplatin
  • Photosensitizing Agents
  • Reactive Oxygen Species
  • Caspase 3
  • Caspase 9
  • Poly(ADP-ribose) Polymerase Inhibitors
  • Sincalide