Bacteria-Targeted Supramolecular Photosensitizer Delivery Vehicles for Photodynamic Ablation Against Biofilms

A multifunctional nanoplatform for precision-guided therapeutic intervention in bacterial infection

Skin wound infection has become a global clinical problem in recent years. Curcumin (Cur) and polylysine (PLL) are natural products with strong antibacterial properties. However, the poor water solubility and low stability of Cur and the cationic toxicity of PLL limit their application. In this study, we synthesized a macromolecular hyaluronic acid (HA)-curcumin drug (HC) via esterification. HC was attracted by electrostatic interactions with positively charged PLL to form a spherical nanocomplex (HCP) with hyaluronidase (HAase) and pH dual response under ultrasonication. HCP was found to target the bacterial infection microenvironment and release Cur and PLL for synergistic antibacterial action. In addition, HCP was proven to exhibit good biocompatibility and broad spectrum antibacterial activity to bacterial strains S. aureus and E. coli and antibacterial biofilm activities in vitro. In vivo experiments showed that HCP could inhibit pathogens and promote wound healing. These results prove that HCP can be used as a new strategy for the treatment and management of infected wounds.

Photochemical Strategies toward Precision Targeting against Multidrug-Resistant Bacterial Infections

Infectious diseases pose a serious threat and a substantial economic burden on global human and public health security, especially with the frequent emergence of multidrug-resistant (MDR) bacteria in clinical settings. In response to this urgent need, various photobased anti-infectious therapies have been reported lately. This Review explores and discusses several photochemical targeted antibacterial therapeutic strategies for addressing bacterial infections regardless of their antibiotic susceptibility. In contrast to conventional photobased therapies, these approaches facilitate precise targeting of pathogenic bacteria and/or infectious microenvironments, effectively minimizing toxicity to mammalian cells and surrounding healthy tissues. The highlighted therapies include photodynamic therapy, photocatalytic therapy, photothermal therapy, endogenous pigments-based photobleaching therapy, and polyphenols-based photo-oxidation therapy. This comprehensive exploration aims to offer updated information to facilitate the development of effective, convenient, safe, and alternative strategies to counter the growing threat of MDR bacteria in the future.

Nanomaterials-Enabled Physicochemical Antibacterial Therapeutics: Toward the Antibiotic-Free Disinfections

Bacterial infection continues to be an increasing global health problem with the most widely accepted treatment paradigms restricted to antibiotics. However, the overuse and misuse of antibiotics have triggered multidrug resistance of bacteria, frustrating therapeutic outcomes, and leading to higher mortality rates. Even worse, the tendency of bacteria to form biofilms on living and nonliving surfaces further increases the difficulty in confronting bacteria because the extracellular matrix can act as a robust barrier to prevent the penetration of antibiotics and resist environmental damage. As a result, the inability to eliminate bacteria and biofilms often leads to persistent infection, implant failure, and device damage. Therefore, it is of paramount importance to develop alternative antimicrobial agents while avoiding the generation of bacterial resistance to prevent the large-scale growth of bacterial resistance. In recent years, nano-antibacterial materials have played a vital role in the antibacterial field because of their excellent physical and chemical properties. This review focuses on new physicochemical antibacterial strategies and versatile antibacterial nanomaterials, especially the mechanism and types of 2D antibacterial nanomaterials. In addition, this advanced review provides guidance on the development direction of antibiotic-free disinfections in the antibacterial field in the future.

Phage-Ce6-Manganese Dioxide Nanocomposite-Mediated Photodynamic, Photothermal, and Chemodynamic Therapies to Eliminate Biofilms and Improve Wound Healing

Biofilms have become one of the fundamental issues for chronic infections, while traditional therapies are often ineffective in removing quiescent (persister) cells from biofilms, resulting in a variety of implant-related or nosocomial infections. Recently, bacteriophage (phage) therapy has reflourished in research and clinical trials. However, phage therapy alone manifested many intrinsic defects, including poor biofilm penetration, incomplete clearance of quiescent cells, etc. In this study, a phage-Chlorin e6 (Ce6)-manganese dioxide nanocomposite (PCM) was constructed by mild biomineralization. The results demonstrated that PCM contained both the vigorous activities of host bacterial targeting and efficient delivery of Ce6 to penetrate the biofilm. Assisted with NIR irradiation, robust reactive oxygen species (ROS) was triggered within the biofilm. In the weak acidic and GSH-rich infection niche, PCM was degraded into ultra-small nanosheets, endowing PCM with moderate photothermal therapy (PTT) effects and considerable Mn²⁺ release, thus exerting strong chemodynamic therapy (CDT) effects in situ. In vivo application demonstrated that the combination of PCM application and NIR irradiation strikingly reduced the pathogen loading, activated innate and adaptive immunity, promoted neocollagen rearrangement, and attenuated cicatricial tissue formation. Our research may pave a new way for bacterial treatment, biofilm-related infections, and other diseases caused by bacteria.

Construction of Graphene Quantum Dot-based Dissolving Microneedle Patches for the Treatment of Bacterial Keratitis

Bacterial keratitis (BK) is an ophthalmic infection caused by bacteria and poses a risk of blindness. Numerous drugs have been used to treat BK, the majority suffered from limited effect owing to their backward antimicrobial and delivery efficacy. Herein, we evaluated the antibacterial effect of a cationic carbon-based nanomaterial, i.e., imidazole-modified graphene quantum dots (IMZ-GQDs), which exhibits disinfection rates of >90% against three typical Gram-positive strains within 3 h owing to the loss of membrane integrity and decline in membrane potential. For ocular application, we further developed IMZ-GQDs-loaded dissolving microneedle patches (IMZ-GQDs MNs) via a typical two-step micromolding method. IMZ-GQDs MNs showed sufficient dissolution and penetration for intrastromal delivery in vitro and successfully overcome the rabbit corneal epithelial layer in vivo. The excellent biocompatibility of IMZ-GQDs MNs was demonstrated both in cell and animal models, and they exhibited low cytotoxicity, low invasiveness and low ocular irritation. The topical application of IMZ-GQDs MNs has the benefits of both high antibacterial activity and effective drug delivery, thereby leading to the resolution of Staphylococcus aureus-induced BK in rabbits in 7 days. Therefore, IMZ-GQDs MNs is a promising approach for BK treatment, which is safe and efficient.

The biological functions of europium-containing biomaterials: A systematic review

The biological functions of rare-earth elements (REEs) have become a focus of intense research. Recent studies have demonstrated that ion doping or alloying of some REEs can optimize the properties of traditional biomaterials. Europium (Eu), which is an REE with low toxicity and good biocompatibility, has promising applications in biomedicine. This article systematically reviews the osteogenic, angiogenic, neuritogenic, antibacterial, and anti-tumor properties of Eu-containing biomaterials, thereby paving the way for biomedical applications of Eu. Data collection for this review was completed in October 2022, and 30 relevant articles were finally included. Most articles indicated that doping of Eu ions or Eu-compound nanoparticles in biomaterials can improve their osteogenic, angiogenic, neuritogenic, antibacterial, and anti-tumor properties. The angiogenic, antibacterial, and potential neuritogenic effects of Eu(OH)₃ nanoparticles have also been demonstrated.

Supramolecular Assemblies based on Polymeric Cyclodextrin Nanosponges and a Cationic Porphyrin with Antimicrobial Photodynamic Therapy Action

Within of the increasing requirement of alternative approaches to fight emerging infections, nano-photosensitisers (nanoPS) are currently designed with the aim to optimize the antimicrobial photodynamic (aPDT) efficacy. The utilize of less expensive nanocarriers prepared by simple and eco-friendly methodologies and commercial photosensitisers are highly desiderable. In this direction, here we propose a novel nanoassembly composed of water soluble anionic polyester β-CD nanosponges (β-CD-PYRO hereafter named βNS) and the cationic 5,10,15,20-tetrakis(1-methylpyridinium-4- yl)porphine (TMPyP). Nanoassemblies were prepared in ultrapure water by mixing PS and βNS, by exploiting their mutual electrostatic interaction, and characterized by various spectroscopic techniques such as UV/Vis, Steady-State and Time Resolved Fluorescence, Dynamic Light Scattering and ζ-potential. NanoPS produce appreciable amount of single oxygen similar to free porphyrin and a prolonged stability after 6 days of incubations in physiological conditions and following photoirradiation. Antimicrobial photodynamic action against fatal hospital-acquired infections such as P. aeruginosa and S. aureus was investigated by pointing out the ability of cationic porphyrin loaded- CD nanosponges to photo-kill bacterial cells at prolonged time of incubation and following irradiation (MBC₉₉ = 3.75 µM, light dose = 54.82 J/cm²).

Thermoresponsive Liposomes for Photo-Triggered Release of Hypericin Cyclodextrin Inclusion Complex for Efficient Antimicrobial Photodynamic Therapy

Antimicrobial strategies with high efficacy against bacterial infections are urgently needed. The development of effective therapies to control bacterial infections is still a challenge. Herein, near-infrared (NIR)-activated thermosensitive liposomes (TSL) were loaded with the NIR-dye 1,1-dioctadecyl-3,3,3,3-tetramethylindotricarbocyanine iodide (DiR) and the water-soluble hypericin (Hyp) β-cyclodextrin inclusion complex (Hyp-βCD). DiR and Hyp-βCD loaded thermosensitive liposomes (DHβCD-TSL) are functionalized for photothermal triggered release and synergistic photodynamic therapy to eliminate the gram-positive Staphylococcus saprophyticus. The dually active liposomes allow the production of heat and singlet oxygen species with the help of DiR and Hyp, respectively. The elevated temperature, generated by the NIR irradiation, irreversibly damages the bacterial membrane, increases the permeation, and melts the liposomes via a phase-transition mechanism, which allows the release of the Hyp-βCD complex. The photodynamic effect of Hyp-βCD eradicates the bacterial cells owing to its toxic oxygen species production. DHβCD-TSL measured the size of 130 nm with an adequate encapsulation efficiency of 81.3% of Hyp-βCD. They exhibited a phase transition temperature of 42.3 °C, while they remained stable at 37 °C, and 44% of Hyp-βCD was released after NIR irradiation (T > 47 °C). The bacterial viability dropped significantly after the synergistic treatment (>4 log₁₀), indicating that the NIR-activated TSL have immense therapeutic potential to enhance the antibacterial efficacy. The liposomes showed good biocompatibility, which was confirmed by the cellular viability of mouse fibroblasts (L929).

Nanotechnologies for control of pathogenic microbial biofilms

Biofilms are formed at interfaces by microorganisms, which congregate in microstructured communities embedded in a self-produced extracellular polymeric substance (EPS). Biofilm-related infections are problematic due to the high resistance towards most clinically used antimicrobials, which is associated with high mortality and morbidity, combined with increased hospital stays and overall treatment costs. Several new nanotechnology-based approaches have recently been proposed for targeting resistant bacteria and microbial biofilms. Here we discuss the impacts of biofilms on healthcare, food processing and packaging, and water filtration and distribution systems, and summarize the emerging nanotechnological strategies that are being developed for biofilm prevention, control and eradication. Combination of novel nanomaterials with conventional antimicrobial therapies has shown great potential in producing more effective platforms for controlling biofilms. Recent developments include antimicrobial nanocarriers with enzyme surface functionality that allow passive infection site targeting, degradation of the EPS and delivery of high concentrations of antimicrobials to the residing cells. Several stimuli-responsive antimicrobial formulation strategies have taken advantage of the biofilm microenvironment to enhance interaction and passive delivery into the biofilm sites. Nanoparticles of ultralow size have also been recently employed in formulations to improve the EPS penetration, enhance the carrier efficiency, and improve the cell wall permeability to antimicrobials. We also discuss antimicrobial metal and metal oxide nanoparticle formulations which provide additional mechanical factors through externally induced actuation and generate reactive oxygen species (ROS) within the biofilms. The review helps to bridge microbiology with materials science and nanotechnology, enabling a more comprehensive interdisciplinary approach towards the development of novel antimicrobial treatments and biofilm control strategies.

Stimuli-responsive nanoplatforms for antibacterial applications

The continuously increasing bacterial resistance has become a big threat to public health worldwide, which makes it urgent to develop innovative antibacterial strategies. Nanotechnology-based drug delivery systems are considered as promising strategies in combating bacterial infections which are expected to improve the therapeutic efficacy and minimize the side effects. Unfortunately, the conventional nanodrug delivery systems always suffer from practical dilemmas, including incomplete and slow drug release, insufficient accumulation in infected sites, and weak biofilm penetration ability. Stimuli-responsive nanoplatforms are hence developed to overcome the disadvantages of conventional nanoparticles. In this review, we provide an extensive review of the recent progress of endogenous and exogenous stimuli-responsive nanoplatforms in the antibacterial area, including planktonic bacteria, intracellular bacteria, and bacterial biofilms. Taking advantage of the specific infected microenvironment (pH, enzyme, redox, and toxin), the mechanisms and strategies of the design of endogenous stimuli-responsive nanoplatforms are discussed, with an emphasis on how to improve the therapeutic efficacy and minimize side effects. How to realize controlled drug delivery using exogenous stimuli-responsive nanoplatforms especially light-responsive nanoparticles for improved antibacterial effects is another topic of this review. We especially highlight photothermal-triggered drug delivery systems by the combination of photothermal agents and thermo-responsive materials. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Infectious Disease Therapeutic Approaches and Drug Discovery > Emerging Technologies.

Nanomaterials enabling clinical translation of antimicrobial photodynamic therapy

Antimicrobial photodynamic therapy (aPDT) has emerged as a promising approach to aid the fight against looming antibiotic resistance. aPDT harnesses the energy of light through photosenstizers to generate highly reactive oxygen species that can inactivate bacteria and fungi with no resistance. To date aPDT has shown great efficacy against microbes causing localized infections in the skin and the oral cavity. However, its wide application in clinical settings has been limited due to both physicochemical and biological challenges. Over the past decade nanomaterials have contributed to promoting photosensitizer performance and aPDT efficiency, yet further developments are required to establish accredited treatment options. In this review we discuss the challenges facing the clinical application of aPDT and the opportunities that nanotechnology may offer to promote the safety and efficiency of aPDT.

Use of Photodynamic Therapy Associated with Antimicrobial Peptides for Bacterial Control: A Systematic Review and Meta-Analysis

Considering the challenges related to antimicrobial resistance, other strategies for controlling infections have been suggested, such as antimicrobial photodynamic therapy (aPDT) and antimicrobial peptides (AMP). This study aims to perform a systematic review and meta-analysis to obtain evidence on the antimicrobial effectiveness of aPDT associated with AMP and establish in vitro knowledge on this topic for further study designs. The PubMed, Scopus, Web of Science, Science Direct, Scielo, and Cochrane Library databases were searched. Two independent and calibrated researchers (Kappa = 0.88) performed all the systematic steps according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The odds ratio (OR) was used as the effect measure. The Peto method was used to perform the meta-analysis due to the sparse data. Twenty studies were included in the present review. The result was significant (OR = 0.14/p = 0.0235/I-squared = 0%), showing better outcomes of aPDT associated with peptides than those of aPDT alone for controlling the microbial load. Only 20% of the studies included evaluated this approach in a biofilm culture. Combined treatment with aPDT and AMP highly increased the ability of microbial reduction of Gram-positive and Gram-negative bacteria. However, additional blind studies are required to evaluate the efficacy of this therapy on microbial biofilms.

On-Demand Multifunctional Electrostatic Complexation for Synergistic Eradication of MRSA Biofilms

Recently, methicillin-resistant Staphylococcus aureus (MRSA) severely threatened the public health, especially when the biofilms developed. Although the biofilm eradication capability of nanoparticles (NPs) has been proposed and confirmed, efficient biofilm penetration and retention are still a big challenge. To solve this problem, a multifunctional electrostatic complexation (denoted as TDZ-G4@CA) was constructed for biofilm combination therapy. TDZ-G4@CA was composed of a TDZ-grafted amino-ended poly(amidoamine) dendrimer (TDZ-PAMAM) as the inner core and cis-aconitic anhydride-modified d-tyrosine (CA-Tyr) wrapped outside via electrostatic interaction. In our design, TDZ-G4@CA could simultaneously reduce the particle size and reverse the surface charge under an acidic microenvironment, which was designed for efficient biofilm penetration and retention. Meanwhile, the on-demand two-step sequential delivery of biofilm dispersal and antibacterial agents was also obtained. The acid responsiveness of TDZ-G4@CA triggered the immediate release of d-Tyr to damage the matrix of the biofilm. Subsequently, TDZ-G4 could penetrate over the depth of the biofilm and bind tightly to MRSA, which could enhance the permeability of the bacterial membrane for TDZ internalization. Additionally, TDZ exhibited a sustained-release pattern as a response to lipase to maintain an effective bactericidal concentration for a long time. As expected, in vitro experiments demonstrated that surface charge/particle size-adaptive TDZ-G4@CA with a sequential delivery strategy exhibited intensive infiltration in the biofilm matrix and excellent biofilm eradication capabilities. Afterward, in vivo experimental results also confirmed the prolonged circulation time and comprehensive therapeutic efficacy of TDZ-G4@CA against MRSA-induced subcutaneous abscess without any systemic side effects. Based on the comprehensive evaluation of the therapeutic outcome, the electrostatic complexation (TDZ-G4@CA) can serve as a promising strategy for enhanced antibiotic therapy for combating biofilm-associated infections.

Parietin Cyclodextrin-Inclusion Complex as an Effective Formulation for Bacterial Photoinactivation

Multidrug resistance in pathogenic bacteria has become a significant public health concern. As an alternative therapeutic option, antimicrobial photodynamic therapy (aPDT) can successfully eradicate antibiotic-resistant bacteria with a lower probability of developing resistance or systemic toxicity commonly associated with the standard antibiotic treatment. Parietin (PTN), also termed physcion, a natural anthraquinone, is a promising photosensitizer somewhat underrepresented in aPDT because of its poor water solubility and potential to aggregate in the biological environment. This study investigated whether the complexation of PTN with (2-hydroxypropyl)-β-cyclodextrin (HP-β-CD) could increase its solubility, enhance its photophysical properties, and improve its phototoxicity against bacteria. At first, the solubilization behavior and complexation constant of the PTN/HP-β-CD inclusion complexes were evaluated by the phase solubility method. Then, the formation and physicochemical properties of PTN/HP-β-CD complexes were analyzed and confirmed in various ways. At the same time, the photodynamic activity was assessed by the uric acid method. The blue light-mediated photodegradation of PTN in its free and complexed forms were compared. Complexation of PTN increased the aqueous solubility 28-fold and the photostability compared to free PTN. PTN/HP-β-CD complexes reduce the bacterial viability of Staphylococcus saprophyticus and Escherichia coli by > 4.8 log and > 1.0 log after irradiation, respectively. Overall, the low solubility, aggregation potential, and photoinstability of PTN were overcome by its complexation in HP-β-CD, potentially opening up new opportunities for treating infections caused by multidrug-resistant bacteria.

Heterostructures Made of Upconversion Nanoparticles and Metal-Organic Frameworks for Biomedical Applications

Heterostructure nanoparticles (NPs), constructed by two single-component NPs with distinct nature and multifunctional properties, have attracted intensive interest in the past few years. Among them, heterostructures made of upconversion NPs (UCNPs) and metal-organic frameworks (MOFs) can not only integrate the advantageous characteristics (e.g., porosity, structural regularity) of MOFs with unique upconverted optical features of UCNPs, but also induce cooperative properties not observed either for single component due to their special optical or electronic communications. Recently, diverse UCNP-MOF heterostructures are designed and synthesized via different strategies and have demonstrated appealing potential for applications in biosensing and imaging, drug delivery, and photodynamic therapy (PDT). In this review, the synthesis strategies of UCNP-MOF heterostructures are first summarized, then the authors focus mainly on discussion of their biomedical applications, particularly as PDT agents for cancer treatment. Finally, the authors briefly outlook the current challenges and future perspectives of UCNP-MOF hybrid nanocomposites. The authors believe that this review will provide comprehensive understanding and inspirations toward recent advances of UCNP-MOF heterostructures.

Polymeric Nanomaterials for Efficient Delivery of Antimicrobial Agents

Bacterial infections have threatened the lives of human beings for thousands of years either as major diseases or complications. The elimination of bacterial infections has always occupied a pivotal position in our history. For a long period of time, people were devoted to finding natural antimicrobial agents such as antimicrobial peptides (AMPs), antibiotics and silver ions or synthetic active antimicrobial substances including antimicrobial peptoids, metal oxides and polymers to combat bacterial infections. However, with the emergence of multidrug resistance (MDR), bacterial infection has become one of the most urgent problems worldwide. The efficient delivery of antimicrobial agents to the site of infection precisely is a promising strategy for reducing bacterial resistance. Polymeric nanomaterials have been widely studied as carriers for constructing antimicrobial agent delivery systems and have shown advantages including high biocompatibility, sustained release, targeting and improved bioavailability. In this review, we will highlight recent advances in highly efficient delivery of antimicrobial agents by polymeric nanomaterials such as micelles, vesicles, dendrimers, nanogels, nanofibers and so forth. The biomedical applications of polymeric nanomaterial-based delivery systems in combating MDR bacteria, anti-biofilms, wound healing, tissue engineering and anticancer are demonstrated. Moreover, conclusions and future perspectives are also proposed.

Aggregation-Induced Emission-Based Platforms for the Treatment of Bacteria, Fungi, and Viruses

The prevention and control of pathogenic bacteria, fungi, and viruses is a herculean task for all the countries since they greatly threaten global public health. Rapid detection and effective elimination of these pathogens is crucial for the treatment of related diseases. It is urgently demanded to develop new diagnostic and therapeutic strategies to combat bacteria, fungi, and viruses-induced infections. The emergence of aggregation-induced emission (AIE) luminogens (AIEgens) is a revolutionary breakthrough for the treatment of many diseases, including pathogenic infections. In this review, the main focus is on the applications of AIEgens for theranostic treatment of pathogenic bacteria, fungi, and viruses. Due to the AIE characteristic, AIEgens are promising fluorescent probes for the detection of bacteria, fungi, and viruses with excellent sensitivity and photostability. Moreover, AIEgen-based theranostic platforms can be fabricated by introducing bactericidal moieties or designing AIE photosensitizers and AIE photothermal agents. The current strategies and ongoing developments of AIEgens for the treatment of pathogenic bacteria, fungi, and viruses will be discussed in detail.

Infection microenvironment-related antibacterial nanotherapeutic strategies

The emergence and spread of antibiotic resistance is one of the biggest challenges in public health. There is an urgent need to discover novel agents against the occurrence of multidrug-resistant bacteria, such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci. The drug-resistant pathogens are able to grow and persist in infected sites, including biofilms, phagosomes, or phagolysosomes, which are more difficult to eradicate than planktonic ones and also foster the development of drug resistance. For years, various nano-antibacterial agents have been developed in the forms of antibiotic nanocarriers. Inorganic nanoparticles with intrinsic antibacterial activity and inert nanoparticles assisted by external stimuli, including heat, photon, magnetism, or sound, have also been discovered. Many of these strategies are designed to target the unique microenvironment of bacterial infections, which have shown potent antibacterial effects in vitro and in vivo. This review summarizes ongoing efforts on antibacterial nanotherapeutic strategies related to bacterial infection microenvironments, including targeted antibacterial therapy and responsive antibiotic delivery systems. Several grand challenges and future directions for the development and translation of effective nano-antibacterial agents are also discussed. The development of innovative nano-antibacterial agents could provide powerful weapons against drug-resistant bacteria in systemic or local bacterial infections in the foreseeable future.

Nanostructured Antimicrobial Peptides: Crucial Steps of Overcoming the Bottleneck for Clinics

The security issue of human health is faced with dispiriting threats from multidrug-resistant bacteria infections induced by the abuse and misuse of antibiotics. Over decades, the antimicrobial peptides (AMPs) hold great promise as a viable alternative to treatment with antibiotics due to their peculiar antimicrobial mechanisms of action, broad-spectrum antimicrobial activity, lower drug residue, and ease of synthesis and modification. However, they universally express a series of disadvantages that hinder their potential application in the biomedical field (e.g., low bioavailability, poor protease resistance, and high cytotoxicity) and extremely waste the abundant resources of AMP database discovered over the decades. For all these reasons, the nanostructured antimicrobial peptides (Ns-AMPs), based on a variety of nanosystem modification, have made up for the deficiencies and pushed the development of novel AMP-based antimicrobial therapies. In this review, we provide an overview of the advantages of Ns-AMPs in improving therapeutic efficacy and biological stability, reducing side effects, and gaining the effect of organic targeting and drug controlled release. Then the different material categories of Ns-AMPs are described, including inorganic material nanosystems containing AMPs, organic material nanosystems containing AMPs, and self-assembled AMPs. Additionally, this review focuses on the Ns-AMPs for the effect of biological activities, with emphasis on antimicrobial activity, biosecurity, and biological stability. The "state-of-the-art" antimicrobial modes of Ns-AMPs, including controlled release of AMPs under a specific environment or intrinsic antimicrobial properties of Ns-AMPs, are also explicated. Finally, the perspectives and conclusions of the current research in this field are also summarized.

Molecular engineering of antimicrobial peptide (AMP)-polymer conjugates

As antimicrobial resistance becomes an increasing threat, bringing significant economic and health burdens, innovative antimicrobial treatments are urgently needed. While antimicrobial peptides (AMPs) are promising therapeutics, exhibiting high activity against resistant bacterial strains, limited stability and toxicity to mammalian cells has hindered clinical development. Attaching AMPs to polymers provides opportunities to present AMPs in a way that maximizes bacterial killing while enhancing compatibility with mammalian cells, stability, and solubility. Conjugation of an AMP to a linear hydrophilic polymer yields the desired improvements in stability, mammalian cell compatibility, and solubility, yet often markedly reduces bactericidal effects. Non-linear polymer architectures and supramolecular assemblies that accommodate multiple AMPs per polymer chain afford AMP-polymer conjugates that strike a superior balance of antimicrobial activity, mammalian cell compatibility, stability, and solubility. Therefore, we review the design criteria, building blocks, and synthetic strategies for engineering AMP-polymer conjugates, emphasizing the connection between molecular architecture and antimicrobial performance to inspire and enable further innovation to advance this emerging class of biomaterials.

Photosensitization With Supramolecular Arrays for Enhanced Antimicrobial Photodynamic Treatments

Microbial infections represent a silent threat to health that has worsened in recent decades due to microbial resistance to multiple drugs, preventing the fight against infectious diseases. Therefore, the current postantibiotic era forces the search for new microbial control strategies. In this regard, antimicrobial photodynamic therapy (aPDT) using supramolecular arrays with photosensitizing capabilities showed successful emerging applications. This exciting field makes it possible to combine applied aspects of molecular photochemistry and supramolecular chemistry, together with the development of nano- and biomaterials for the design of multifunctional or "smart" supramolecular photosensitizers (SPS). This minireview aims to collect the concepts of the photosensitization process and supramolecular chemistry applied to the development of efficient applications of aPDT, with a brief discussion of the most recent literature in the field.

Recent Innovations in Bacterial Infection Detection and Treatment

Bacterial infections are a major threat to human health, exacerbated by increasing antibiotic resistance. These infections can result in tremendous morbidity and mortality, emphasizing the need to identify and treat pathogenic bacteria quickly and effectively. Recent developments in detection methods have focused on electrochemical, optical, and mass-based biosensors. Advances in these systems include implementing multifunctional materials, microfluidic sampling, and portable data-processing to improve sensitivity, specificity, and ease of operation. Concurrently, advances in antibacterial treatment have largely focused on targeted and responsive delivery for both antibiotics and antibiotic alternatives. Antibiotic alternatives described here include repurposed drugs, antimicrobial peptides and polymers, nucleic acids, small molecules, living systems, and bacteriophages. Finally, closed-loop therapies are combining advances in the fields of both detection and treatment. This review provides a comprehensive summary of the current trends in detection and treatment systems for bacterial infections.

Surface modification of intraocular lenses via photodynamic coating for safe and effective PCO prevention

Posterior capsular opacification (PCO) is an emerging complication in cataract phacoemulsification and intraocular lens (IOL) implantation surgery, mainly stemming from the adhesion, proliferation, and trans-differentiation of the post-surgery residual lens epithelial cells (LECs). Previous investigations have shown that an anti-proliferative drug eluting coating on the IOL surface provides an effective way to inhibit PCO. However, due to the undesirable elution of the anti-proliferative drug, the safety of such modification is one of the important issues to be solved. In this investigation, photodynamic coating was introduced into IOL surface modification. The photosensitizer chlorin e6 grafted α-cyclodextrin (α-CD-Ce6) was synthesized and self-assembled onto the poly(poly(ethylene glycol) methacrylate) (PPEGMA) brush established IOL surface via the supramolecular interaction between α-CD and poly(ethylene glycol) chains. The results of investigation into its optical properties, including transmittance, refractive index, and surface morphology, showed no obvious alterations after photodynamic coating modification on the IOL surface. The in vitro LEC behaviour investigation optimized the photodynamic therapy parameters when light illumination was used for the cell elimination on the photodynamic coating modified IOL. The results have also shown that this functional coating modification effectively eliminates the cells on the surface of the IOL material when treated with light illumination, whereas it keeps excellent cytocompatibility in the absence of light illumination. The investigation of the cell elimination mechanism shows that this kind of functional coating eliminates the adherent cells by ROS induced apoptosis. The in vivo implantation result confirms the excellent PCO inhibition effect, as well as their safety and biocompatibility to the surrounding tissues. As a result, the proposed photodynamic coating provides a safer and effective alternative of IOL modification for preventing PCO.

Design of Photosensitizing Agents for Targeted Antimicrobial Photodynamic Therapy

Photodynamic inactivation of microorganisms has gained substantial attention due to its unique mode of action, in which pathogens are unable to generate resistance, and due to the fact that it can be applied in a minimally invasive manner. In photodynamic therapy (PDT), a non-toxic photosensitizer (PS) is activated by a specific wavelength of light and generates highly cytotoxic reactive oxygen species (ROS) such as superoxide (O2-, type-I mechanism) or singlet oxygen (1O2*, type-II mechanism). Although it offers many advantages over conventional treatment methods, ROS-mediated microbial killing is often faced with the issues of accessibility, poor selectivity and off-target damage. Thus, several strategies have been employed to develop target-specific antimicrobial PDT (aPDT). This includes conjugation of known PS building-blocks to either non-specific cationic moieties or target-specific antibiotics and antimicrobial peptides, or combining them with targeting nanomaterials. In this review, we summarise these general strategies and related challenges, and highlight recent developments in targeted aPDT.

Photodynamic therapy to control microbial biofilms

Microorganisms thrive in well-organized biofilm ecosystems. Biofilm-associated cells typically show increased resistance to antibiotics and contribute significantly to treatment failure. This has prompted investigations aimed at developing advanced and novel antimicrobial approaches that could effectively overcome the shortcomings associated with conventional antibiotic therapy. Studies are ongoing to develop effective curative strategies ranging from the use of peptides, small molecules, nanoparticles to bacteriophages, sonic waves, and light energy targeting various structural and physiological aspects of biofilms. In photodynamic therapy, a light source of a specific wavelength is used to irradiate non-toxic photosensitizers such as tetrapyrroles, synthetic dyes or, naturally occurring compounds to generate reactive oxygen species that can exert a lethal effect on the microbe especially by disrupting the biofilm. The photosensitizer preferentially binds to and accumulates in the microbial cells without causing any damage to the host tissue. Currently, photodynamic therapy is increasingly being used for the treatment of oral caries and dental plaque, chronic wound infections, infected diabetic foot ulcers, cystic fibrosis, chronic sinusitis, implant device-associated infections, etc. This approach is recognized as safe, as it is non-toxic and minimally invasive, making it a reliable, realistic, and promising therapeutic strategy for reducing the microbial burden and biofilm formation in chronic infections. In this review article, we discuss the current and future potential strategies of utilizing photodynamic therapy to extend our ability to impede and eliminate biofilms in various medical conditions.

Host-guest complexes - Boosting the performance of photosensitizers

In this review, we will show the diversity of supramolecular host-guest complexes of cyclodextrins, cucurbit[n]urils, calix[n]- and pillar[n]arenes with photosensitizers, like porphyrins and phthalocyanines. Host-guest complexes are one of the main building blocks in supramolecular chemistry. For example, they have been widely used to encapsulate hydrophobic drug molecules to enhance the bioavailability in the human body. In these days of multiresistant bacteria and difficulties in cancer therapy, supramolecular host-guest systems with photosensitizers for the photodynamic therapy(PDT) gain more and more interest. In general, photosensitizers with a (large) conjugated aromatic π-system are used, which tend to π-πstacking in aqueous media suppressing the cell toxicity by singletoxygen production quenching. This can be overcome by the formation of host-guest complexes. Besides that, encapsulation of the photosensitizers in host molecules can enhance the solubility, increase cellular uptake, lead to hydrogels, rotaxanes, and switchable systems.

Functionalized biomaterials to combat biofilms

Pathogenic microbial biofilms that readily form on implantable medical devices or human tissues have posed a great threat to worldwide healthcare. Hopes are focused on preventive strategies towards biofilms, leaving a thought-provoking question: how to tackle the problem of established biofilms? In this review, we briefly summarize the functionalized biomaterials to combat biofilms and highlight current approaches to eradicate pre-existing biofilms. We believe that all of these strategies, alone or in combination, could represent a blueprint for fighting biofilm-associated infections in the postantibiotic era.

Size and Charge Adaptive Clustered Nanoparticles Targeting the Biofilm Microenvironment for Chronic Lung Infection Management

Chronic lung infection caused by bacterial biofilms is an extremely serious clinical problem, which can lead to the failure of antibiotic therapy. Although nanoparticles have shown great potential in the treatment of biofilms, the efficient penetration and retention of nanoparticles in biofilms is still a big challenge. To address this issue, we herein fabricate size and charge adaptive azithromycin (AZM)-conjugated clustered nanoparticles (denoted as AZM-DA NPs) as therapeutic agents for treating biofilms. The AZM-DA NPs are prepared by electrostatic complexation between AZM conjugated amino-ended poly(amidoamine) dendrimer (PAMAM) and 2,3-dimethyl maleic anhydride (DA) modified poly(ethylene glycol)-block-polylysine (PEG-b-PLys). It is noteworthy that the AZM-DA NPs can disassemble in an acidic biofilm microenvironment (pH 6.0), leading to the release of secondary AZM-conjugated PAMAM nanoparticles (PAMAM-AZM NPs). PAMAM-AZM NPs with small size and positive charge are beneficial for improved penetration and retention inside biofilms, enhanced permeabilization of the bacterial membrane, and increased internalization of AZM, thus exhibiting excellent antibiofilm activities. AZM-DA NPs are also favorable as long-term antibacterial agents due to the reduced occurrence of drug resistance. In vivo therapeutic performance is confirmed by the reduced bacterial burden and the alleviated inflammation in the chronic lung infection model. This research not only develops an innovative strategy for antibiotic delivery in vivo but also provides an effective way for the management of biofilm-associated infections, including chronic lung infection.

pH-Responsive hyperbranched polypeptides based on Schiff bases as drug carriers for reducing toxicity of chemotherapy

Polymeric micelles have great potential in drug delivery systems because of their multifunctional adjustability, excellent stability, and biocompatibility. To further increase the drug loading efficiency and controlled release ability, a pH-responsive hyperbranched copolymer methoxy poly(ethylene glycol)-b-polyethyleneimine-poly(Nε-Cbz-l-lysine) (MPEG-PEI-PBLL) was synthesized successfully. MPEG-PEI-NH2 was synthesized to initiate the ring-opening polymerization of benzyloxycarbonyl substituted lysine N-carboxyanhydride (Z-lys NCA). The introduction of Schiff bases in the polymer make it possible to respond to the variation of pH values, which cleaved at pH 5.0 while stable at pH 7.4. As the polymer was amphiphilic, MPEG-PEI-PBLL could self-assemble into micelles. Owing to the introduction of PEI, which make the copolymer hyperbranched, the pH-responsive micelles could efficiently encapsulate theranostic agents, such as doxorubicin (DOX) for chemotherapy and NIRF dye DiD for in vivo near-infrared (NIR) imaging. The drug delivery system prolonged the drug circulation time in blood and allowed the drug accumulate effectively at the tumor site. Following the guidance, the DOX was applied in chemotherapy to achieve cancer therapeutic efficiency. All the results demonstrate that the polymer micelles have great potential for cancer theranostics.

Conjugating biomaterials with photosensitizers: advances and perspectives for photodynamic antimicrobial chemotherapy

Antimicrobial resistance is threatening to overshadow last century's medical advances. Previously eradicated infectious diseases are now resurgent as multi-drug resistant strains, leading to expensive, toxic and, in some cases, ineffective antimicrobial treatments. Given this outlook, researchers are willing to investigate novel antimicrobial treatments that may be able to deal with antimicrobial resistance, namely photodynamic therapy (PDT). PDT relies on the generation of toxic reactive oxygen species (ROS) in the presence of light and a photosensitizer (PS) molecule. PDT has been known for almost a century, but most of its applications have been directed towards the treatment of cancer and topical diseases. Unlike classical antimicrobial chemotherapy treatments, photodynamic antimicrobial chemotherapy (PACT) has a non-target specific mechanism of action, based on the generation of ROS, working against cellular membranes, walls, proteins, lipids and nucleic acids. This non-specific mechanism diminishes the chances of bacteria developing resistance. However, PSs usually are large molecules, prone to aggregation, diminishing their efficiency. This review will report the development of materials obtained from natural sources, as delivery systems for photosensitizing molecules against microorganisms. The present work emphasizes on the biological results rather than on the synthesis routes to prepare the conjugates. Also, it discusses the current state of the art, providing our perspective on the field.

Polymyxin B-Polysaccharide Polyion Nanocomplex with Improved Biocompatibility and Unaffected Antibacterial Activity for Acute Lung Infection Management

The decade-old antibiotic, polymyxin B (PMB), is regarded as the last line defense against gram-negative "superbug." However, the serious nephrotoxicity and neurotoxicity strongly obstruct further application of this highly effective antibiotic. Herein, a charge switchable polyion nanocomplex exhibiting pH-sensitive property is proposed to deliver PMB which is expected to improve the biosafety of PMB on the premise of retaining excellent antibacterial activity. The polyion nanocomplex is prepared through electrostatic interaction of positively charged PMB and negatively charged 2,3-dimethyl maleic anhydride (DA) grafted chitoligosaccharide (CS). The negative charge of CS-DA will convert to positive due to the hydrolysis of amide bonds in acidic infectious environment, leading to the disassembly of CS-DA/PMB nanocomplex and release of PMB. CS-DA/PMB nanocomplex does not show significant toxicity to mammalian cells while retaining excellent bactericidal capability equivalent to free PMB. The nephrotoxicity and neurotoxicity of CS-DA/PMB dramatically decrease compared to free PMB. Moreover, CS-DA/PMB nanocomplex exhibits superior bactericidal activity against Pseudomonas aeruginosa in an acute lung infection mouse model. The pH-sensitive polyion nanocomplexes may provide a new way to reduce the side effects of highly toxic antibiotics without reducing their intrinsic antibacterial activity, which is the key factor to achieve extensive in vivo clinical applications.

Surface Charge Switchable Supramolecular Nanocarriers for Nitric Oxide Synergistic Photodynamic Eradication of Biofilms

Biofilm has resulted in numerous obstinate clinical infections, posing severe threats to public health. It is urgent to develop original antibacterial strategies for eradicating biofilms. Herein, we develop a surface charge switchable supramolecular nanocarrier exhibiting pH-responsive penetration into an acidic biofilm for nitric oxide (NO) synergistic photodynamic eradication of the methicillin-resistant Staphylococcus aureus (MRSA) biofilm with negligible damage to healthy tissues under laser irradiation. Originally, by integrating the glutathione (GSH)-sensitive α-cyclodextrin (α-CD) conjugated nitric oxide (NO) prodrug (α-CD-NO) and chlorin e6 (Ce6) prodrug (α-CD-Ce6) into the pH-sensitive poly(ethylene glycol) (PEG) block polypeptide copolymer (PEG-(KLAKLAK)₂-DA) via host-guest interaction, the supramolecular nanocarrier α-CD-Ce6-NO-DA was finely prepared. The supramolecular nanocarrier shows complete surface charge reversal from negative charge at physiological pH (7.4) to positive charge at acidic biofilm pH (5.5), promoting efficient penetration into the biofilm. Once infiltrated into the biofilm, the nanocarrier exhibits rapid NO release triggered by the overexpressed GSH in the biofilm, which not only produces abundant NO for killing bacteria but also reduces the biofilm GSH level to improve photodynamic therapy (PDT) efficiency. On the other hand, NO can react with reactive oxygen species (ROS) to produce reactive nitrogen species (RNS), further improving the PDT efficiency. Due to the effective penetration into the biofilm and depletion of biofilm GSH, the surface charge switchable GSH-sensitive NO nanocarrier can greatly improve the PDT efficiency at a low photosensitizer dose and laser intensity and cause negligible side effect to healthy tissues. Considering the above advantages, the strategy developed in this work may offer great possibilities to fight against biofilm infections.

An on-demand nanoplatform for enhanced elimination of drug-resistant bacteria

We establish an “on-demand” nanoplatform based on acid-degradable scaffolds by conjugating glycomimetic-based galactose ligands to target a key lectin on P. aeruginosa and guanidine moieties.

Emerging antibacterial nanomedicine for enhanced antibiotic therapy

This review highlights the different mechanisms of current nano-antibiotic systems for combatting serious antibiotic resistance of bacteria.

Supramolecular Nanorods of (N-Methylpyridyl) Porphyrin With Captisol: Effective Photosensitizer for Anti-bacterial and Anti-tumor Activities

Porphyrins, especially the 5,10,15,20-tetrakis(4-N-methylpyridyl) porphyrin (TMPyP), are well-accepted as photosensitizers due to strong absorption from visible to near-infrared region, good singlet oxygen quantum yields as well as chemical versatility, all of which can be further modulated through planned supramolecular strategies. In this study, we report the construction of supramolecular nanorods of TMPyP dye/drug with captisol [sulfobutylether-β-cyclodextrin (SBE₇βCD)] macrocycle through host-guest interaction. The availability of four cationic N-methylpyridyl groups favors multiple binding interaction with the captisol host, building an extended supramolecular assembly of captisol and TMPyP. In addition to the spectroscopic characterizations for the assembly formation, the same has been pictured in SEM and FM images as nanorods of ~10 μm in length or more. Complexation of TMPyP has brought out beneficial features over the uncomplexed TMPyP dye; enhanced singlet oxygen yield, improved photostability, and better photosensitizing effect, all supportive of efficient photodynamic therapy activity. The Captisol:TMPyP complex displayed enhanced antibacterial activity toward E. coli under white light irradiation as compared to TMPyP alone. Cell viability studies performed in lung carcinoma A549 cells with light irradiation documented increased cytotoxicity of the complex toward the cancer cells whereas reduced dark toxicity is observed toward normal CHO cells. All these synergistic effects of supramolecular nanorods of Captisol-TMPyP complex make the system an effective photosensitizer and a superior antibacterial and antitumor agent.