Fig. 3.
Methods of biochemically enhancing PPIX accumulation by modulating enzymes in heme biosynthesis cycle. Iron chelators can enhance PPIX accumulation by depriving the enzyme ferrochelatase of the ferrous iron it needs to form heme. Differentiation agents (vitamin D, retinoids, methotrexate, calcium, or androgens) can increase expression of coproporphyrinogen oxidase producing more PPIX