The development of phenothiazinium photosensitisers

Methylene blue has been widely used since the late 19th century in biomedical research, and was the lead compound in several important clinical areas, including therapeutics for malaria and schizophrenia. The photodynamic therapy (PDT) of cancer and, more recently, of microbial infection (photodynamic antimicrobial chemotherapy (PACT)) has also employed methylene blue and its congeners, among other chemical types, due to the low human toxicities and efficient photosensitising properties of the group. However, little work has been carried out in terms of derivative and structure-activity development, most reports covering standard, commercially available compounds. This review deals with the evolution of phenothiazinium photosensitisers for both PACT and PDT use.