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Giannakopoulos E, Katopodi A, Rallis M, Politopoulos K, Alexandratou E. The effect of low-dose photodynamic therapy using the photosensitizer chloroaluminum phthalocyanine on a scratch wound model in skin fibroblasts. JOURNAL OF BIOPHOTONICS 2024:e202400033. [PMID: 38962832 DOI: 10.1002/jbio.202400033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 07/05/2024]
Abstract
Different approaches on wound healing have been developed over the years but they suffer from high costs and adverse effects for the patients. The current paper was designed to study low dose PDT, a novel healing approach, in an in vitro fibroblasts wound healing model. Chloroaluminum phthalocyanine (AlClPc) was used as photosensitizer and was activated by a red diode laser at 661 nm. After PDT optimization, wound closure rate and reactive oxygen species were quantified by image processing and analysis. Our results revealed that wound healing rates were significantly higher in PDT treated groups than in the control. Additionally, the study revealed that a prolonged ROS increase did not promote wound closure, while a small increase acted as a trigger, resulting in faster wound closure. Concluding, low dose PDT using AlClPc enhances wound healing in vitro in a ROS dependent manner, allowing the assumption of similar positive effects in vivo.
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Affiliation(s)
- Efstathios Giannakopoulos
- Laboratory of Biomedical Optics and Applied Biophysics, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
- Division of Pharmaceutical Technology, School of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Annita Katopodi
- Laboratory of Organic Chemistry, School of Chemical Engineering, National Technical University of Athens, Athens, Greece
| | - Michail Rallis
- Division of Pharmaceutical Technology, School of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Politopoulos
- Laboratory of Biomedical Optics and Applied Biophysics, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Eleni Alexandratou
- Laboratory of Biomedical Optics and Applied Biophysics, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
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2
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Szymczak K, Woźniak-Pawlikowska A, Burzyńska N, Król M, Zhang L, Nakonieczna J, Grinholc M. Decrease of ESKAPE virulence with a cationic heme-mimetic gallium porphyrin photosensitizer: The Trojan horse strategy that could help address antimicrobial resistance. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2024; 256:112928. [PMID: 38723545 DOI: 10.1016/j.jphotobiol.2024.112928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 04/25/2024] [Accepted: 04/30/2024] [Indexed: 06/11/2024]
Abstract
INTRODUCTION Emerging antibiotic resistance among bacterial pathogens has forced an urgent need for alternative non-antibiotic strategies development that could combat drug resistant-associated infections. Suppression of virulence of ESKAPE pathogens' by targeting multiple virulence traits provides a promising approach. OBJECTIVES Here we propose an iron-blocking antibacterial therapy based on a cationic heme-mimetic gallium porphyrin (GaCHP), which antibacterial efficacy could be further enhanced by photodynamic inactivation. METHODS We used gallium heme mimetic porphyrin (GaCHP) excited with light to significantly reduce microbial viability and suppress both the expression and biological activity of several virulence traits of both Gram-positive and Gram-negative ESKAPE representatives, i.e., S. aureus and P. aeruginosa. Moreover, further improvement of the proposed strategy by combining it with routinely used antimicrobials to resensitize the microbes to antibiotics and provide enhanced bactericidal efficacy was investigated. RESULTS The proposed strategy led to substantial inactivation of critical priority pathogens and has been evidenced to suppress the expression and biological activity of multiple virulence factors in S. aureus and P. aeruginosa. Finally, the combination of GaCHP phototreatment and antibiotics resulted in promising strategy to overcome antibiotic resistance of the studied microbes and to enhance disinfection of drug resistant pathogens. CONCLUSION Lastly, considering high safety aspects of the proposed treatment toward host cells, i.e., lack of mutagenicity, no dark toxicity and mild phototoxicity, we describe an efficient alternative that simultaneously suppresses the functionality of multiple virulence factors in ESKAPE pathogens.
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Affiliation(s)
- Klaudia Szymczak
- Laboratory of Photobiology and Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland
| | - Agata Woźniak-Pawlikowska
- Laboratory of Photobiology and Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland
| | - Natalia Burzyńska
- Laboratory of Photobiology and Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland
| | - Magdalena Król
- Laboratory of Photobiology and Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland
| | - Lei Zhang
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), Tianjin University, Tianjin 300350, China
| | - Joanna Nakonieczna
- Laboratory of Photobiology and Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland.
| | - Mariusz Grinholc
- Laboratory of Photobiology and Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland.
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Sahu K, Krishna H, Shrivastava R, Majumdar A, Chowdhury A, Chakraborty S, Majumder SK. Evaluation of the potential of Delta-aminolevulinic acid for simultaneous detection of bioburden and anti-microbial photodynamic therapy of MRSA infected wounds in Swiss albino mice. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2024; 254:112892. [PMID: 38513542 DOI: 10.1016/j.jphotobiol.2024.112892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/13/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND The dramatic increase of drug-resistant bacteria necessitates urgent development of platforms to simultaneously detect and inactivate bacteria causing wound infections, but are confronted with various challenges. Delta amino levulinic acid (ALA) induced protoporphyrin IX (PpIX) can be a promising modality for simultaneous bioburden diagnostics and therapeutics. Herein, we report utility of ALA induced protoporphyrin (PpIX) based simultaneous bioburden detection, photoinactivation and therapeutic outcome assessment in methicillin resistant Staphylococcus aureus (MRSA) infected wounds of mice. METHODS MRSA infected wounds treated with 10% ALA were imaged with help of a blue LED (∼405 nm) based, USB powered, hand held device integrated with a modular graphic user interface (GUI). Effect of ALA application time, bacteria load, post bacteria application time points on wound fluorescence studied. PpIX fluorescence observed after excitation with blue LEDs was used to detect bioburden, start red light mediated antimicrobial photodynamic therapy (aPDT), determine aPDT effectiveness and assess selectivity of the approach. RESULTS ALA-PpIX fluorescence of wound bed discriminates infected from uninfected wounds and detects clinically relevant load. While wound fluorescence pattern changes as a function of ALA incubation and post infection time, intra-wound inhomogeneity in fluorescence correlates with the Gram staining data on presence of biofilms foci. Lack of red fluorescence from wound granulation tissue treated with ALA suggests selectivity of the approach. Further, significant reduction (∼50%) in red fluorescence, quantified using the GUI, relates well with bacteria load reduction observed post topical aPDT. CONCLUSION The potential of ALA induced PpIX for simultaneous detection of bioburden, photodynamic inactivation and "florescence-guided aPDT assessment" is demonstrated in MRSA infected wounds of mice.
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Affiliation(s)
- Khageswar Sahu
- Laser Biomedical Applications Division, Raja Ramanna Centre for Advanced Technology, Indore, Madhya Pradesh 452013, India; Homi Bhaba National Institute, Training School Complex, Anushakti Nagar, Mumbai 400 094, India.
| | - Hemant Krishna
- Laser Biomedical Applications Division, Raja Ramanna Centre for Advanced Technology, Indore, Madhya Pradesh 452013, India
| | - Rashmi Shrivastava
- Laser Biomedical Applications Division, Raja Ramanna Centre for Advanced Technology, Indore, Madhya Pradesh 452013, India; Homi Bhaba National Institute, Training School Complex, Anushakti Nagar, Mumbai 400 094, India
| | - Anamitra Majumdar
- Laser Biomedical Applications Division, Raja Ramanna Centre for Advanced Technology, Indore, Madhya Pradesh 452013, India
| | - Anupam Chowdhury
- Laser Biomedical Applications Division, Raja Ramanna Centre for Advanced Technology, Indore, Madhya Pradesh 452013, India
| | - Sourabrata Chakraborty
- Laser Biomedical Applications Division, Raja Ramanna Centre for Advanced Technology, Indore, Madhya Pradesh 452013, India
| | - Shovan Kumar Majumder
- Laser Biomedical Applications Division, Raja Ramanna Centre for Advanced Technology, Indore, Madhya Pradesh 452013, India; Homi Bhaba National Institute, Training School Complex, Anushakti Nagar, Mumbai 400 094, India
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Pires L, Khattak S, Pratavieira S, Calcada C, Romano R, Yucel Y, Bagnato VS, Kurachi C, Wilson BC. Femtosecond pulsed laser photodynamic therapy activates melanin and eradicates malignant melanoma. Proc Natl Acad Sci U S A 2024; 121:e2316303121. [PMID: 38551838 PMCID: PMC10998568 DOI: 10.1073/pnas.2316303121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/14/2024] [Indexed: 04/02/2024] Open
Abstract
Photodynamic therapy (PDT) relies on a series of photophysical and photochemical reactions leading to cell death. While effective for various cancers, PDT has been less successful in treating pigmented melanoma due to high light absorption by melanin. Here, this limitation is addressed by 2-photon excitation of the photosensitizer (2p-PDT) using ~100 fs pulses of near-infrared laser light. A critical role of melanin in enabling rather than hindering 2p-PDT is elucidated using pigmented and non-pigmented murine melanoma clonal cell lines in vitro. The photocytotoxicities were compared between a clinical photosensitizer (Visudyne) and a porphyrin dimer (Oxdime) with ~600-fold higher σ2p value. Unexpectedly, while the 1p-PDT responses are similar in both cell lines, 2p activation is much more effective in killing pigmented than non-pigmented cells, suggesting a dominant role of melanin 2p-PDT. The potential for clinical translational is demonstrated in a conjunctival melanoma model in vivo, where complete eradication of small tumors was achieved. This work elucidates the melanin contribution in multi-photon PDT enabling significant advancement of light-based treatments that have previously been considered unsuitable in pigmented tumors.
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Affiliation(s)
- Layla Pires
- Department of Cancer Biology and Imaging, Princess Margaret Cancer Center, University Health Network, Toronto, ONM5G 1L7, Canada
- Departamento de Fisica e Ciencia dos Materiais, São Carlos Institute of Physics, University of São Paulo, Sao Carlos13566-590, Brazil
| | - Shireen Khattak
- Departments of Ophthalmology & Vision Sciences, St. Michael’s Hospital, University of Toronto, Toronto, ONM5B 1W8, Canada
| | - Sebastiao Pratavieira
- Departamento de Fisica e Ciencia dos Materiais, São Carlos Institute of Physics, University of São Paulo, Sao Carlos13566-590, Brazil
| | - Carla Calcada
- Department of Cancer Biology and Imaging, Princess Margaret Cancer Center, University Health Network, Toronto, ONM5G 1L7, Canada
| | - Renan Romano
- Departamento de Fisica e Ciencia dos Materiais, São Carlos Institute of Physics, University of São Paulo, Sao Carlos13566-590, Brazil
| | - Yeni Yucel
- Departments of Ophthalmology & Vision Sciences, St. Michael’s Hospital, University of Toronto, Toronto, ONM5B 1W8, Canada
- Faculty of Medicine, Department of Ophthalmology, Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BCV5Z 3N9, Canada
| | - Vanderlei S. Bagnato
- Departamento de Fisica e Ciencia dos Materiais, São Carlos Institute of Physics, University of São Paulo, Sao Carlos13566-590, Brazil
- Department of Biomedical Engineering, Texas A&M University, College Station, TX77843
| | - Cristina Kurachi
- Departamento de Fisica e Ciencia dos Materiais, São Carlos Institute of Physics, University of São Paulo, Sao Carlos13566-590, Brazil
| | - Brian C. Wilson
- Department of Cancer Biology and Imaging, Princess Margaret Cancer Center, University Health Network, Toronto, ONM5G 1L7, Canada
- Faculty of Medicine, Department of Medical Biophysics, University of Toronto, Toronto, ONM5G 1L7, Canada
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Burillo A, Pulido-Pérez A, Bouza E. Current challenges in acute bacterial skin infection management. Curr Opin Infect Dis 2024; 37:71-79. [PMID: 38179868 DOI: 10.1097/qco.0000000000000989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
PURPOSE OF REVIEW There are aspects of skin and soft tissue infections (SSTIs) that remain unresolved, such as current numbers, classification criteria, how best to define severity and predict the outcome, what diagnostic tests to perform, what new treatment options are available, or what the duration of antibiotic treatment should be. We have reviewed the literature over the last 18 months to clarify these issues and provide our opinion. RECENT FINDINGS SSTIs are common and among the top 10 most frequent infections worldwide. They represent a burden on the healthcare system and have a major impact on the quality of life of patients. Regarding classification, the Infectious Diseases Society of America (IDSA) provides a practical guide that distinguishes between uncomplicated and complicated infections, acute and chronic wound infections, and necrotising and nonnecrotizing infections based on skin extension and tissue necrosis. With new microbiological and imaging diagnostic techniques, SSTIs can now be better diagnosed. New PCR techniques are available, and mass spectrometry can be applied to samples collected in liquid transport media. Moreover, new treatment methods such as photodynamic therapy, reactive oxygen, and phages are emerging. SSTI patients can be treated with shorter antibiotic courses if they receive an active drug with good tissue penetration. Antibiotic treatment in necrotizing infections can be shortened to 48 h after the last debridement. SUMMARY SSTIs remain a challenge regarding rapid and accurate diagnosis and clinical management.
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Affiliation(s)
- Almudena Burillo
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón
- Medicine Department, School of Medicine, Universidad Complutense de Madrid
- Gregorio Marañón Health Research Institute, (IiSGM)
| | - Ana Pulido-Pérez
- Gregorio Marañón Health Research Institute, (IiSGM)
- Department of Dermatology, Hospital General Universitario Gregorio Marañón
| | - Emilio Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón
- Medicine Department, School of Medicine, Universidad Complutense de Madrid
- Gregorio Marañón Health Research Institute, (IiSGM)
- CIBER of Respiratory Diseases (CIBERES CB06/06/0058), Madrid, Spain
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Zdubek A, Maliszewska I. On the Possibility of Using 5-Aminolevulinic Acid in the Light-Induced Destruction of Microorganisms. Int J Mol Sci 2024; 25:3590. [PMID: 38612403 PMCID: PMC11011456 DOI: 10.3390/ijms25073590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Antimicrobial photodynamic inactivation (aPDI) is a method that specifically kills target cells by combining a photosensitizer and irradiation with light at the appropriate wavelength. The natural amino acid, 5-aminolevulinic acid (5-ALA), is the precursor of endogenous porphyrins in the heme biosynthesis pathway. This review summarizes the recent progress in understanding the biosynthetic pathways and regulatory mechanisms of 5-ALA synthesis in biological hosts. The effectiveness of 5-ALA-aPDI in destroying various groups of pathogens (viruses, fungi, yeasts, parasites) was presented, but greater attention was focused on the antibacterial activity of this technique. Finally, the clinical applications of 5-ALA in therapies using 5-ALA and visible light (treatment of ulcers and disinfection of dental canals) were described.
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Affiliation(s)
| | - Irena Maliszewska
- Department of Organic and Medicinal Chemistry, Faculty of Chemistry, Wrocław University of Science and Technology, 50-370 Wrocław, Poland;
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Ribeiro IS, Muniz IPR, Galantini MPL, Gonçalves CV, Lima PHB, Silva NR, de Oliveira SL, Nunes MS, Novaes AKS, de Oliveira MES, Costa DJ, Amaral JG, da Silva RAA. Antimicrobial photodynamic therapy with Brazilian green propolis controls intradermal infection induced by methicillin-resistant Staphylococcus aureus and modulates the inflammatory response in a murine model. Photochem Photobiol Sci 2024; 23:561-573. [PMID: 38372844 DOI: 10.1007/s43630-024-00539-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 01/13/2024] [Indexed: 02/20/2024]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is one of the leading causes of skin and soft tissue infections worldwide. This microorganism has a wide range of antibiotics resistance, a fact that has made the treatment of infections caused by MRSA difficult. In this sense, antimicrobial photodynamic therapy (aPDT) with natural products has emerged as a good alternative in combating infections caused by antibiotic-resistant microorganisms. The objective of the present study was to evaluate the effects of aPDT with Brazilian green propolis against intradermal MRSA infection in a murine model. Initially, 24 Balb/c mice were infected intradermally in the ears with 1.5 × 108 colony-forming units of MRSA 43300. After infection, they were separated into 4 groups (6 animals per group) and treated with the vehicle, only Brazilian green propolis, only blue LED light or with the aPDT protocol (Brazilian green propolis + blue LED light). It was observed in this study that aPDT with Brazilian green propolis reduced the bacterial load at the site of infection. Furthermore, it was able to inhibit weight loss resulting from the infection, as well as modulate the inflammatory response through greater recruitment of polymorphonuclear cells/neutrophils to the infected tissue. Finally, aPDT induced an increase in the cytokines IL-17A and IL-12p70 in the draining retromaxillary lymph node. Thus, aPDT with Brazilian green propolis proved to be effective against intradermal MRSA infection in mice, reducing bacterial load and modulating the immune response in the animals. However, more studies are needed to assess whether such effects are repeated in humans.
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Affiliation(s)
- Israel Souza Ribeiro
- Universidade Federal da Bahia, Campus Anísio Teixeira, Instituto Multidisciplinar Em Saúde, Rua Hormindo Barros, 58, Bairro Candeias, Vitória da Conquista, Bahia, CEP: 45.029-094, Brazil
- Universidade Federal Do Sul da Bahia, Campus Paulo Freire, 250 Praça Joana Angélica, Bairro São José, Teixeira de Freitas, Bahia, 45.988-058, Brazil
| | - Igor Pereira Ribeiro Muniz
- Universidade Federal da Bahia, Campus Anísio Teixeira, Instituto Multidisciplinar Em Saúde, Rua Hormindo Barros, 58, Bairro Candeias, Vitória da Conquista, Bahia, CEP: 45.029-094, Brazil
| | - Maria Poliana Leite Galantini
- Universidade Federal da Bahia, Campus Anísio Teixeira, Instituto Multidisciplinar Em Saúde, Rua Hormindo Barros, 58, Bairro Candeias, Vitória da Conquista, Bahia, CEP: 45.029-094, Brazil
| | - Caroline Vieira Gonçalves
- Universidade Federal da Bahia, Campus Anísio Teixeira, Instituto Multidisciplinar Em Saúde, Rua Hormindo Barros, 58, Bairro Candeias, Vitória da Conquista, Bahia, CEP: 45.029-094, Brazil
| | - Paulo Henrique Bispo Lima
- Universidade Federal da Bahia, Campus Anísio Teixeira, Instituto Multidisciplinar Em Saúde, Rua Hormindo Barros, 58, Bairro Candeias, Vitória da Conquista, Bahia, CEP: 45.029-094, Brazil
| | - Nathalia Rosa Silva
- Universidade Federal da Bahia, Campus Anísio Teixeira, Instituto Multidisciplinar Em Saúde, Rua Hormindo Barros, 58, Bairro Candeias, Vitória da Conquista, Bahia, CEP: 45.029-094, Brazil
| | - Samara Lopes de Oliveira
- Universidade Federal da Bahia, Campus Anísio Teixeira, Instituto Multidisciplinar Em Saúde, Rua Hormindo Barros, 58, Bairro Candeias, Vitória da Conquista, Bahia, CEP: 45.029-094, Brazil
| | - Marlon Silva Nunes
- Universidade Federal da Bahia, Campus Anísio Teixeira, Instituto Multidisciplinar Em Saúde, Rua Hormindo Barros, 58, Bairro Candeias, Vitória da Conquista, Bahia, CEP: 45.029-094, Brazil
| | - Amanda Kelle Santos Novaes
- Universidade Federal da Bahia, Campus Anísio Teixeira, Instituto Multidisciplinar Em Saúde, Rua Hormindo Barros, 58, Bairro Candeias, Vitória da Conquista, Bahia, CEP: 45.029-094, Brazil
| | - Maria Eduarda Santos de Oliveira
- Universidade Federal da Bahia, Campus Anísio Teixeira, Instituto Multidisciplinar Em Saúde, Rua Hormindo Barros, 58, Bairro Candeias, Vitória da Conquista, Bahia, CEP: 45.029-094, Brazil
| | - Dirceu Joaquim Costa
- Universidade Estadual Do Sudoeste da Bahia, Campus Vitória da Conquista, Av. Edmundo Silveira Flores, 27-43 - Lot, Alto da Boa Vista, Vitória da Conquista, Bahia, CEP: 45029-066, Brazil
| | - Juliano Geraldo Amaral
- Universidade Federal da Bahia, Campus Anísio Teixeira, Instituto Multidisciplinar Em Saúde, Rua Hormindo Barros, 58, Bairro Candeias, Vitória da Conquista, Bahia, CEP: 45.029-094, Brazil
| | - Robson Amaro Augusto da Silva
- Universidade Federal da Bahia, Campus Anísio Teixeira, Instituto Multidisciplinar Em Saúde, Rua Hormindo Barros, 58, Bairro Candeias, Vitória da Conquista, Bahia, CEP: 45.029-094, Brazil.
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8
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Gu R, Fei S, Liu Z, Liu X, Fang X, Wu H, Zhang X, Xu G, Xu F. Effects of photodynamic therapy in patients with infected skin ulcers: A meta-analysis. Int Wound J 2024; 21:e14747. [PMID: 38445778 PMCID: PMC10915826 DOI: 10.1111/iwj.14747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 03/07/2024] Open
Abstract
The purpose of the meta-analysis was to evaluate and compare the photodynamic therapy's effectiveness in treating infected skin wounds. The results of this meta-analysis were analysed, and the odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were calculated using dichotomous or contentious random- or fixed-effect models. For the current meta-analysis, 6 examinations spanning from 2013 to 2021 were included, encompassing 154 patients with infected skin wounds were the used studies' starting point. Photodynamic therapy had a significantly lower wound ulcer size (MD, -4.42; 95% CI, -7.56--1.28, p = 0.006), better tissue repair (MD, -8.62; 95% CI, -16.76--0.48, p = 0.04) and lower microbial cell viability (OR, 0.13; 95% CI, 0.04-0.42, p < 0.001) compared with red light exposure in subjects with infected skin wounds. The examined data revealed that photodynamic therapy had a significantly lower wound ulcer size, better tissue repair and lower microbial cell viability compared with red light exposure in subjects with infected skin wounds. However, given that all examinations had a small sample size, consideration should be given to their values.
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Affiliation(s)
- Rui Gu
- Graduate School of Beijing University of Chinese Medicine, Beijing University of Chinese MedicineBeijingChina
| | - Sha'ni Fei
- Graduate School of Beijing University of Chinese Medicine, Beijing University of Chinese MedicineBeijingChina
| | - Zhaoyu Liu
- Graduate School of Beijing University of Chinese Medicine, Beijing University of Chinese MedicineBeijingChina
| | - Xiaoqi Liu
- Graduate School of Beijing University of Chinese Medicine, Beijing University of Chinese MedicineBeijingChina
| | - Xiaoxiao Fang
- Graduate School of Beijing University of Chinese Medicine, Beijing University of Chinese MedicineBeijingChina
| | - Hengjin Wu
- Graduate School of Beijing University of Chinese Medicine, Beijing University of Chinese MedicineBeijingChina
| | - Xia Zhang
- Department of NeurologyPeking University Aerospace School of Clinical MedicineBeijingChina
| | - Guomei Xu
- Department of DermatologyBeijing University of Chinese Medicine Third Affiliated HospitalBeijingChina
| | - Fengquan Xu
- Department of PsychosomaticsGuang'anmen Hospital, China Academy of Chinese Medical SciencesBeijingChina
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9
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Xie Y, Li J, Liu C, Zhang X, Zhang X, Wang Q, Zhang L, Yang S. Antimicrobial efficacy of aloe-emodin mediated photodynamic therapy against antibiotic-resistant Pseudomonas aeruginosa in vitro. Biochem Biophys Res Commun 2024; 690:149285. [PMID: 37995454 DOI: 10.1016/j.bbrc.2023.149285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023]
Abstract
Multidrug-resistant Pseudomonas aeruginosa is a common pathogen that causes topical infections following burn injuries. Antimicrobial photodynamic therapy (aPDT) has emerged as a promising approach for treating antibiotic-resistant bacterial infections. The objective of this study was to evaluate the aPDT efficacy of aloe-emodin (AE), which is a photosensitizer extracted from traditional Chinese herbs, on antibiotic-sensitive and antibiotic-resistant P. aeruginosa in vitro. In this study, we confirmed the effectiveness of AE-mediated aPDT against both standard and MDR P. aeruginosa, explored the effects of irradiation time and AE concentration on bacterial survival in AE-mediated aPDT, and observed the structural damage of P. aeruginosa by using transmission electron microscope. Our results showed that neither AE nor light irradiation alone caused cytotoxic effects on P. aeruginosa. However, AE-mediated aPDT effectively inactivated both antibiotic-sensitive and antibiotic-resistant P. aeruginosa. The transmission electron microscope investigation showed that aPDT mediated by AE primarily caused damage to the cytoplasm and cell membrane. Our findings suggest that AE is a photosensitizer in the aPDT of MDR P. aeruginosa-caused topical infections following burn injuries. Future investigations will concentrate on the safety and efficacy of AE-mediated aPDT in animal models and clinical trials.
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Affiliation(s)
- Yun Xie
- Department of Clinical Laboratory, Northwest Women's and Children's Hospital, Xi'an, China
| | - Jiao Li
- Department of Clinical Laboratory, Northwest Women's and Children's Hospital, Xi'an, China
| | - Chengcheng Liu
- Department of Pathogenic Microbiology and Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Xiaofei Zhang
- Department of Clinical Laboratory, Northwest Women's and Children's Hospital, Xi'an, China
| | - Xinran Zhang
- Department of Clinical Laboratory, Northwest Women's and Children's Hospital, Xi'an, China
| | - Qi Wang
- Department of Clinical Laboratory, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lixia Zhang
- Department of Clinical Laboratory, Shaanxi Provincial People's Hospital, Xi'an, China.
| | - Shaoqing Yang
- Department of Oral Biology, School of Stomatology, The Fourth Military Medical University, Xi'an, China.
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10
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Wang X, Wang X, Lei X, He Y, Xiao T. Photodynamic therapy: a new approach to the treatment of Nontuberculous Mycobacterial skin and soft tissue infections. Photodiagnosis Photodyn Ther 2023; 43:103645. [PMID: 37270047 DOI: 10.1016/j.pdpdt.2023.103645] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/05/2023]
Abstract
Nontuberculous mycobacterial skin and soft tissue infections are rising and are causing social concern due to the growth of cosmetic dermatology and immune-compromised populations. For the treatment of nontuberculous mycobacteria, several novel strategies have been investigated. One of them, photodynamic therapy, is a recently developed therapeutic strategy that has shown promise in managing nontuberculous mycobacterial skin and soft tissue infections. In this review, we first present an overview of the current status of the therapy and then summarize and analyze the cases of photodynamic therapy used to treat nontuberculous mycobacterial skin and soft tissue infections. We also discussed the feasibility of photodynamic therapy for treating nontuberculous mycobacterial skin soft tissue infections and the related mechanisms, providing a potential new option for clinical treatment.
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Affiliation(s)
- Xiao Wang
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, CN
| | - Xiaoyu Wang
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, CN
| | - Xia Lei
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, CN.
| | - Yongqing He
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, CN
| | - Tianzhen Xiao
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, CN
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Chin JD, Zhao L, Mayberry TG, Cowan BC, Wakefield MR, Fang Y. Photodynamic Therapy, Probiotics, Acetic Acid, and Essential Oil in the Treatment of Chronic Wounds Infected with Pseudomonas aeruginosa. Pharmaceutics 2023; 15:1721. [PMID: 37376169 PMCID: PMC10301549 DOI: 10.3390/pharmaceutics15061721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
As a prevalent medical problem that burdens millions of patients across the world, chronic wounds pose a challenge to the healthcare system. These wounds, often existing as a comorbidity, are vulnerable to infections. Consequently, infections hinder the healing process and complicate clinical management and treatment. While antibiotic drugs remain a popular treatment for infected chronic wounds, the recent rise of antibiotic-resistant strains has hastened the need for alternative treatments. Future impacts of chronic wounds are likely to increase with aging populations and growing obesity rates. With the need for more effective novel treatments, promising research into various wound therapies has seen an increased demand. This review summarizes photodynamic therapy, probiotics, acetic acid, and essential oil studies as developing antibiotic-free treatments for chronic wounds infected with Pseudomonas aeruginosa. Clinicians may find this review informative by gaining a better understanding of the state of current research into various antibiotic-free treatments. Furthermore. this review provides clinical significance, as clinicians may seek to implement photodynamic therapy, probiotics, acetic acid, or essential oils into their own practice.
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Affiliation(s)
- Jaeson D. Chin
- Department of Microbiology, Immunology & Pathology, Des Moines University, Des Moines, IA 50312, USA
| | - Lei Zhao
- The Department of Respiratory Medicine, The Second People’s Hospital of Hefei and Hefei Hospital Affiliated to Anhui Medical University, Hefei 230002, China
| | - Trenton G. Mayberry
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - Braydon C. Cowan
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - Mark R. Wakefield
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USA
- Ellis Fischel Cancer Center, University of Missouri, Columbia, MO 65212, USA
| | - Yujiang Fang
- Department of Microbiology, Immunology & Pathology, Des Moines University, Des Moines, IA 50312, USA
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12
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Zhang Y, Liu W, Wang Q. Positive effects of low-dose photodynamic therapy with aminolevulinic acid or its methyl ester in skin rejuvenation and wound healing: An update. JOURNAL OF BIOPHOTONICS 2023; 16:e202200293. [PMID: 36602479 DOI: 10.1002/jbio.202200293] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/28/2022] [Accepted: 01/02/2023] [Indexed: 06/17/2023]
Abstract
In dermatology, photodynamic therapy (PDT) is widely used in skin tumors, infections, etc., because of the killing effect triggered by toxic reactive oxygen species (ROS). However, the ROS concentration is determined by various photosensitizer concentrations and formulations, as well as various irradiation parameters. Low-dose PDT leads to sufficiently low ROS level, which results in biological effects that are the exact opposite of the killing potency. Therefore, in recent years, low-dose PDT has been exploited in improving aging and wound. Low-dose ALA/MAL PDT might improve aging through promoting the proliferation of fibroblasts, blocking DNA damage, counteracting oxidative stress, inhibiting melanogenesis, and remodeling lymphatic vessels in aged skin. Promoting fibroblasts and epidermal stem cells proliferation and migration, promoting granulation tissue formation and angiogenesis and regulating the inflammatory process might be the mechanisms of low-dose ALA/MAL PDT in wound healing. Nevertheless, the positive effects of low-dose PDT have not been thoroughly investigated in dermatology, and high-quality studies are still needed to fill the relevant vacancy.
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Affiliation(s)
- YuWei Zhang
- The Institute of Dermatology and Venereology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Wei Liu
- The Institute of Dermatology and Venereology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Qian Wang
- The Institute of Dermatology and Venereology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
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13
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Wang L, Zhang W, Cen R, Yue C, Xiao T, Deng Y, Li L, Sun K, Lei X. ALA-PDT regulates macrophage M1 polarization via ERK/MAPK-NLRP3 pathway to promote the early inflammatory response. Lasers Surg Med 2022; 54:1309-1320. [PMID: 36403288 DOI: 10.1002/lsm.23618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 07/20/2022] [Accepted: 11/02/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) is a promising new approach to promote wound healing and its effectiveness has been demonstrated in both clinical and animal studies. Macrophages are the key cells in wound healing and inflammatory response. However, the mechanism of action of PDT on macrophages in promoting wound healing is still unclear. METHODS In this study, RAW264.7 cells were used. We analyzed the expression levels of macrophage markers arginase 1 (Arg-1), CD206, iNOS, CD86, and inflammatory factors IL-6, TNF-α, and IL-1β by reverse transcription-polymerase chain reaction and Western blot, Milliplex microtubule-associated protein multiplex assay was performed to analyze the expression of inflammatory factors in the supernatant. Live cell Imaging System to observe the dynamic process of macrophage phagocytosis. Western blot was performed to observe the activation of extracellular signal-regulated kinase/mitogen-activated protein kinase (ERK/MAPK) and NOD-like receptor protein 3 (NLRP3) inflammasome. RESULTS 5-Aminolevulinic acid (ALA)-PDT increased the expression of M1 marker iNOS/CD86 and decreased the expression of Arg-1/CD206 in RAW264.7 cells, while, proinflammatory factors IL-6, TNF-α, and IL-1β expression was enhanced and macrophage phagocytosis was increased. We also found that these phenomena were associated with activation of the ERK/MAPK-NLRP3 pathway. CONCLUSION ALA-PDT promotes early inflammatory responses by regulating macrophage M1 polarization through the ERK/MAPK-NLRP3 pathway. It also promotes macrophage phagocytosis.
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Affiliation(s)
- Liqun Wang
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Wentao Zhang
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Ruiyan Cen
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Chenda Yue
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Tianzhen Xiao
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Yumeng Deng
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Lingfei Li
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Kedai Sun
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Xia Lei
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
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Photodynamic therapy for treating infected skin wounds: A systematic review and meta-analysis from randomized clinical trials. Photodiagnosis Photodyn Ther 2022; 40:103118. [PMID: 36109003 DOI: 10.1016/j.pdpdt.2022.103118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/16/2022] [Accepted: 09/09/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Infected skin wounds represent a public health problem that effects 20 million people worldwide. Photodynamic therapy (PDT) is a treatment option with excellent results against several infections. OBJECTIVE This study aimed to perform a systematic review and meta-analysis on PDT efficacy for treating infected wounds based on randomized clinical trials (RCTs). METHODS PubMed, Scopus, Web of Science, SciELO, and the Cochrane library were searched. The Delphi List criteria and the Revised Cochrane risk-of-bias (Rob 2) were used for evaluating the quality of clinical trials. Meta-analyses were performed with the random-effect model. The odds ratio was the effect measure for binary outcomes, while the standard mean difference was used for continuous outcomes. The trim-and-fill method was used to detect small-study effects. The quality of evidence was verified for each outcome. RESULTS Only four out of 573 articles were selected for the qualitative and quantitative analyses. The most frequent cause of infected wounds was impaired venous circulation (75%). All studies used red LED light. PDT reduced healing time and improved the healing process and wound oxygenation. Patients treated with PDT showed 15% to 17% (p = 0.0003/ I2=0%) lower microbial cell viability in the wound and a significantly smaller wound size (0.72 cm2/p = 0.0187/I2=0%) than patients treated with placebo or red-light exposure. There was a high level of evidence for each meta-analysis outcome. CONCLUSION PDT can be an excellent alternative treatment for infected skin wounds, though larger trials are needed.
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Pierfelice TV, D'Amico E, Iezzi G, Petrini M, Schiavone V, Santalucia M, Pandolfi A, D'Arcangelo C, Piattelli A, Di Pietro N. Effect of a 5-aminolevulinic acid gel and 660 nm red LED light on human oral osteoblasts: a preliminary in vitro study. Lasers Med Sci 2022; 37:3671-3679. [PMID: 36192667 PMCID: PMC9708760 DOI: 10.1007/s10103-022-03651-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 09/22/2022] [Indexed: 11/26/2022]
Abstract
This study aimed to evaluate the effects of a new photodynamic protocol (ALAD-PDT) on primary human osteoblasts (hOBs). The ALAD-PDT protocol consists of a heat-sensitive gel with 5% 5-delta aminolevulinic acid commercialized as Aladent (ALAD), combined with 630 nm LED. For this purpose, the hOBs, explanted from human mandible bone fragments, were used and treated with different ALAD concentrations (10%, 50%, 100% v/v) incubated for 45 min and immediately afterwards irradiated with a 630 nm LED device for 7 min. The untreated and unirradiated cells were considered control (CTRL). The cellular accumulation of the photosensitizer protoporphyrin IX (PpIX), the proliferation, the alkaline phosphatase (ALP) activity, and the calcium deposition were assessed. All concentrations (10, 50, 100%) determined a significant increment of PpIX immediately after 45 min of incubation (0 h) with the highest peak by ALAD (100%). The consequent 7 min of light irradiation caused a slight decrease in PpIX. At 48 h and 72 h, any increment of PpIX was observed. The concentration 100% associated with LED significantly increased hOB proliferation at 48 h (+ 46.83%) and 72 h (+ 127.75%). The 50% and 100% concentrations in combination to the red light also stimulated the ALP activity, + 12.910% and + 14.014% respectively. The concentration 100% with and without LED was selected for the assessment of calcium deposition. After LED irradiation, a significant increase in calcium deposition was observed and quantified (+ 72.33%). In conclusion, the ALAD-PDT enhanced proliferation, the ALP activity, and mineralized deposition of human oral osteoblasts, highlighting a promising potential for bone tissue regeneration.
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Affiliation(s)
- Tania Vanessa Pierfelice
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy
| | - Emira D'Amico
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy
| | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy
| | - Morena Petrini
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy.
| | - Valeria Schiavone
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy
- Center for Advanced Studies and Technology-CAST (Ex CeSI-MeT), University G. d'Annunzio of Chieti-Pescara, 66013, Chieti, Italy
| | - Manuela Santalucia
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy
- Center for Advanced Studies and Technology-CAST (Ex CeSI-MeT), University G. d'Annunzio of Chieti-Pescara, 66013, Chieti, Italy
| | - Assunta Pandolfi
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy
- Center for Advanced Studies and Technology-CAST (Ex CeSI-MeT), University G. d'Annunzio of Chieti-Pescara, 66013, Chieti, Italy
| | - Camillo D'Arcangelo
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International, University of Health and Medical Sciences, Via di Sant'Alessandro 8, 00131, Rome, Italy
- Dental School, University of Belgrade, Belgrade, Serbia
- Fondazione Villa Serena Per La Ricerca, 65013, Città Sant'Angelo, Italy
- Casa Di Cura Villa Serena del Dott. L. Petruzzi, 65013, Città Sant'Angelo, Italy
| | - Natalia Di Pietro
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy
- Center for Advanced Studies and Technology-CAST (Ex CeSI-MeT), University G. d'Annunzio of Chieti-Pescara, 66013, Chieti, Italy
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Dey A, Singhvi G, Puri A, Kesharwani P, Dubey SK. An insight into photodynamic therapy towards treating major dermatological conditions. J Drug Deliv Sci Technol 2022; 76:103751. [PMID: 36159728 PMCID: PMC9495279 DOI: 10.1016/j.jddst.2022.103751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Photodynamic therapy (PDT), as the name suggests is a light-based, non-invasive therapeutic treatment method that has garnered immense interest in the recent past for its efficacy in treating several pathological conditions. PDT has prominent use in the treatment of several dermatological conditions, which consequently have cosmetic benefits associated with it as PDT improves the overall appearance of the affected area. PDT is commonly used for repairing sun-damaged skin, providing skin rejuvenation, curbing pre-cancerous cells, treating conditions like acne, keratosis, skin-microbial infections, and cutaneous warts, etc. PDT mediates its action by generating oxygen species that are involved in bringing about immunomodulation, suppression of microbial load, wound-healing, lightening of scarring, etc. Although there are several challenges associated with PDT, the prominent ones being pain, erythema, insufficient delivery of the photosensitizing agent, and poor clinical outcomes, still PDT stands to be a promising approach with continuous efforts towards maximizing clinical efficacy while being cautious of the side effects and working towards lessening them. This article discusses the major skin-related conditions which can be treated or managed by employing PDT as a better or comparable alternative to conventional treatment approaches such that it also brings about aesthetic improvements thereof.
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Affiliation(s)
- Anuradha Dey
- R&D Healthcare Division, Emami Ltd, 13, BT Road, Belgharia, Kolkata 700056, India
| | - Gautam Singhvi
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani, Pilani Campus, Rajasthan, India-333031
| | - Anu Puri
- RNA Structure and Design Section, RNA Biology Laboratory (RBL), Center for Cancer Research, National Cancer Institute — Frederick, Frederick, MD, 21702, USA
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India
- University Institute of Pharma Sciences, Chandigarh University, Mohali, Punjab, India
| | - Sunil Kumar Dubey
- R&D Healthcare Division, Emami Ltd, 13, BT Road, Belgharia, Kolkata 700056, India
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Wang Y, Cao C, Zhu Y, Fan H, Liu Q, Liu Y, Chen K, Wu Y, Liang S, Li M, Li L, Liu X, Zhang Y, Wu C, Lu G, Wu M. TREM2/β-catenin attenuates NLRP3 inflammasome-mediated macrophage pyroptosis to promote bacterial clearance of pyogenic bacteria. Cell Death Dis 2022; 13:771. [PMID: 36068223 PMCID: PMC9448748 DOI: 10.1038/s41419-022-05193-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/07/2022] [Accepted: 08/15/2022] [Indexed: 01/21/2023]
Abstract
Triggering receptors expressed on myeloid cells 2 (TREM2) is considered a protective factor to protect host from bacterial infection, while how it elicits this role is unclear. In the present study, we demonstrate that deficiency of triggering receptors expressed on myeloid cells 2 (TREM2) significantly enhanced macrophage pyroptosis induced by four common pyogenic bacteria including Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumoniae, and Escherichia coli. TREM2 deficiency also decreased bacterial killing ratio of macrophage, while Caspase-1 or GSDMD inhibition promoted macrophage-mediated clearance to these bacteria. Further study demonstrated that the effect of TREM2 on macrophage pyroptosis and bacterial eradication mainly dependents on the activated status of NLRP3 inflammasome. Moreover, as the key downstream of TREM2, β-catenin phosphorylated at Ser675 by TREM2 signal and accumulated in nucleus and cytoplasm. β-catenin mediated the effect of TREM2 on NLRP3 inflammasome and macrophage pyroptosis by reducing NLRP3 expression, and inhibiting inflammasome complex assembly by interacting with ASC. Collectively, TREM2/β-catenin inhibits NLRP3 inflammasome to regulate macrophage pyroptosis, and enhances macrophage-mediated pyogenic bacterial clearance.
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Affiliation(s)
- Yi Wang
- grid.411866.c0000 0000 8848 7685Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120 China
| | - Can Cao
- grid.12981.330000 0001 2360 039XProgram of Infection and Immunity, Affiliated Guangzhou Women and Children’s Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China ,grid.12981.330000 0001 2360 039XKey Laboratory of Tropical Diseases Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080 China
| | - Yanting Zhu
- grid.411866.c0000 0000 8848 7685Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120 China
| | - Huifeng Fan
- grid.12981.330000 0001 2360 039XProgram of Infection and Immunity, Affiliated Guangzhou Women and Children’s Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Qiaojuan Liu
- grid.12981.330000 0001 2360 039XProgram of Infection and Immunity, Affiliated Guangzhou Women and Children’s Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China ,grid.12981.330000 0001 2360 039XKey Laboratory of Tropical Diseases Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080 China
| | - Yiting Liu
- grid.12981.330000 0001 2360 039XProgram of Infection and Immunity, Affiliated Guangzhou Women and Children’s Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China ,grid.12981.330000 0001 2360 039XKey Laboratory of Tropical Diseases Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080 China
| | - Kang Chen
- grid.12981.330000 0001 2360 039XProgram of Infection and Immunity, Affiliated Guangzhou Women and Children’s Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China ,grid.12981.330000 0001 2360 039XKey Laboratory of Tropical Diseases Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080 China
| | - Yongjian Wu
- grid.12981.330000 0001 2360 039XProgram of Infection and Immunity, Affiliated Guangzhou Women and Children’s Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China ,grid.12981.330000 0001 2360 039XKey Laboratory of Tropical Diseases Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080 China
| | - Siping Liang
- grid.12981.330000 0001 2360 039XProgram of Infection and Immunity, Affiliated Guangzhou Women and Children’s Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China ,grid.12981.330000 0001 2360 039XKey Laboratory of Tropical Diseases Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080 China
| | - Meiyu Li
- grid.12981.330000 0001 2360 039XProgram of Infection and Immunity, Affiliated Guangzhou Women and Children’s Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China ,grid.12981.330000 0001 2360 039XKey Laboratory of Tropical Diseases Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080 China
| | - Lexi Li
- grid.12981.330000 0001 2360 039XProgram of Infection and Immunity, Affiliated Guangzhou Women and Children’s Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Xi Liu
- grid.12981.330000 0001 2360 039XKey Laboratory of Tropical Diseases Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080 China
| | - Yuanqing Zhang
- grid.12981.330000 0001 2360 039XSchool of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, 510006 China
| | - Chenglin Wu
- grid.12981.330000 0001 2360 039XOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Gen Lu
- grid.12981.330000 0001 2360 039XProgram of Infection and Immunity, Affiliated Guangzhou Women and Children’s Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Minhao Wu
- grid.12981.330000 0001 2360 039XProgram of Infection and Immunity, Affiliated Guangzhou Women and Children’s Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China ,grid.12981.330000 0001 2360 039XKey Laboratory of Tropical Diseases Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080 China ,grid.12981.330000 0001 2360 039XGuangdong Engineering & Technology Research Center for Disease-Model Animals, Sun Yat-sen University, Guangzhou, 510006 China
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Ning X, He G, Zeng W, Xia Y. The photosensitizer-based therapies enhance the repairing of skin wounds. Front Med (Lausanne) 2022; 9:915548. [PMID: 36035433 PMCID: PMC9403269 DOI: 10.3389/fmed.2022.915548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/26/2022] [Indexed: 11/29/2022] Open
Abstract
Wound repair remains a clinical challenge and bacterial infection is a common complication that may significantly delay healing. Therefore, proper and effective wound management is essential. The photosensitizer-based therapies mainly stimulate the photosensitizer to generate reactive oxygen species through appropriate excitation source irradiation, thereby killing pathogenic microorganisms. Moreover, they initiate local immune responses by inducing the recruitment of immune cells as well as the production of proinflammatory cytokines. In addition, these therapies can stimulate the proliferation, migration and differentiation of skin resident cells, and improve the deposition of extracellular matrix; subsequently, they promote the re-epithelialization, angiogenesis, and tissue remodeling. Studies in multiple animal models and human skin wounds have proved that the superior sterilization property and biological effects of photosensitizer-based therapies during different stages of wound repair. In this review, we summarize the recent advances in photosensitizer-based therapies for enhancing tissue regeneration, and suggest more effective therapeutics for patients with skin wounds.
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Affiliation(s)
- Xiaoying Ning
- Department of Dermatology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Gang He
- State Key Laboratory for Strength and Vibration of Mechanical Structures, Frontier Institute of Science and Technology, Xi’an Jiaotong University, Xi’an, China
- Xi’an Key Laboratory of Sustainable Energy Materials Chemistry, Frontier Institute of Science and Technology, Xi’an Jiaotong University, Xi’an, China
| | - Weihui Zeng
- Department of Dermatology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yumin Xia
- Department of Dermatology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Yumin Xia,
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19
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Xiao P, Shen Z, Wang D, Pan Y, Li Y, Gong J, Wang L, Wang D, Tang BZ. Precise Molecular Engineering of Type I Photosensitizers with Near-Infrared Aggregation-Induced Emission for Image-Guided Photodynamic Killing of Multidrug-Resistant Bacteria. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2104079. [PMID: 34927383 PMCID: PMC8844491 DOI: 10.1002/advs.202104079] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/03/2021] [Indexed: 05/16/2023]
Abstract
Multidrug resistance (MDR) bacteria pose a serious threat to human health. The development of alternative treatment modalities and therapeutic agents for treating MDR bacteria-caused infections remains a global challenge. Herein, a series of near-infrared (NIR) anion-π+ photosensitizers featuring aggregation-induced emission (AIE-PSs) are rationally designed and successfully developed for broad-spectrum MDR bacteria eradication. Due to the strong intramolecular charge transfer (ICT) and enhanced highly efficient intersystem crossing (ISC), these electron-rich anion-π+ AIE-PSs show boosted type I reactive oxygen species (ROS) generation capability involving hydroxyl radicals and superoxide anion radicals, and up to 99% photodynamic killing efficacy is achieved for both Methicillin-resistant Staphylococcus aureus (MRSA) and multidrug resistant Escherichia coli (MDR E. coli) under a low dose white light irradiation (16 mW cm-2 ). In vivo experiments confirm that one of these AIE-PSs exhibit excellent therapeutic performance in curing MRSA or MDR E. coli-infected wounds with negligible side-effects. The study would thus provide useful guidance for the rational design of high-performance type I AIE-PSs to overcome antibiotic resistance.
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Affiliation(s)
- Peihong Xiao
- Center for AIE ResearchShenzhen Key Laboratory of Polymer Science and TechnologyGuangdong Research Center for Interfacial Engineering of Functional MaterialsCollege of Materials Science and EngineeringShenzhen UniversityShenzhen518060China
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education and Guangdong ProvinceCollege of Physics and Optoelectronic EngineeringShenzhen UniversityShenzhen518060China
- Department of ChemistryHong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and ReconstructionThe Hong Kong University of Science and TechnologyClear Water BayKowloonHong Kong999077China
| | - Zipeng Shen
- Center for AIE ResearchShenzhen Key Laboratory of Polymer Science and TechnologyGuangdong Research Center for Interfacial Engineering of Functional MaterialsCollege of Materials Science and EngineeringShenzhen UniversityShenzhen518060China
| | - Deliang Wang
- Center for AIE ResearchShenzhen Key Laboratory of Polymer Science and TechnologyGuangdong Research Center for Interfacial Engineering of Functional MaterialsCollege of Materials Science and EngineeringShenzhen UniversityShenzhen518060China
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education and Guangdong ProvinceCollege of Physics and Optoelectronic EngineeringShenzhen UniversityShenzhen518060China
| | - Yinzhen Pan
- Center for AIE ResearchShenzhen Key Laboratory of Polymer Science and TechnologyGuangdong Research Center for Interfacial Engineering of Functional MaterialsCollege of Materials Science and EngineeringShenzhen UniversityShenzhen518060China
| | - Ying Li
- Center for AIE ResearchShenzhen Key Laboratory of Polymer Science and TechnologyGuangdong Research Center for Interfacial Engineering of Functional MaterialsCollege of Materials Science and EngineeringShenzhen UniversityShenzhen518060China
| | - Junyi Gong
- Department of ChemistryHong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and ReconstructionThe Hong Kong University of Science and TechnologyClear Water BayKowloonHong Kong999077China
| | - Lei Wang
- Center for AIE ResearchShenzhen Key Laboratory of Polymer Science and TechnologyGuangdong Research Center for Interfacial Engineering of Functional MaterialsCollege of Materials Science and EngineeringShenzhen UniversityShenzhen518060China
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education and Guangdong ProvinceCollege of Physics and Optoelectronic EngineeringShenzhen UniversityShenzhen518060China
| | - Dong Wang
- Center for AIE ResearchShenzhen Key Laboratory of Polymer Science and TechnologyGuangdong Research Center for Interfacial Engineering of Functional MaterialsCollege of Materials Science and EngineeringShenzhen UniversityShenzhen518060China
| | - Ben Zhong Tang
- Department of ChemistryHong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and ReconstructionThe Hong Kong University of Science and TechnologyClear Water BayKowloonHong Kong999077China
- Shenzhen Institute of Molecular Aggregate Science and EngineeringSchool of Science and EngineeringThe Chinese University of Hong Kong, Shenzhen2001 Longxiang Boulevard, Longgang DistrictShenzhen CityGuangdong518172China
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20
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López-Molina S, Galiana-Roselló C, Galiana C, Gil-Martínez A, Bandeira S, González-García J. Alkaloids as Photosensitisers for the Inactivation of Bacteria. Antibiotics (Basel) 2021; 10:1505. [PMID: 34943717 PMCID: PMC8698950 DOI: 10.3390/antibiotics10121505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 12/14/2022] Open
Abstract
Antimicrobial photodynamic therapy has emerged as a powerful approach to tackle microbial infections. Photodynamic therapy utilises a photosensitiser, light, and oxygen to generate singlet oxygen and/or reactive oxygen species in an irradiated tissue spot, which subsequently react with nearby biomolecules and destroy the cellular environment. Due to the possibility to irradiate in a very precise location, it can be used to eradicate bacteria, fungus, and parasites upon light activation of the photosensitiser. In this regard, natural products are low-cost molecules capable of being obtained in large quantities, and some of them can be used as photosensitisers. Alkaloids are the largest family among natural products and include molecules with a basic nature and aromatic rings. For this study, we collected the naturally occurring alkaloids used to treat microorganism infections using a photodynamic inactivation approach. We gathered their main photophysical properties (excitation/emission wavelengths, quantum yields, and oxygen quantum yield) which characterise the ability to efficiently photosensitise. In addition, we described the antibacterial activity of alkaloids upon irradiation and the mechanisms involved in the microorganism killing. This review will serve as a reference source to obtain the main information on alkaloids used in antimicrobial photodynamic therapy.
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Affiliation(s)
- Sònia López-Molina
- Department of Inorganic Chemistry, Institute of Molecular Science, Catedrático José Beltran 2, 46980 Paterna, Spain; (S.L.-M.); (C.G.-R.); (A.G.-M.); (S.B.)
| | - Cristina Galiana-Roselló
- Department of Inorganic Chemistry, Institute of Molecular Science, Catedrático José Beltran 2, 46980 Paterna, Spain; (S.L.-M.); (C.G.-R.); (A.G.-M.); (S.B.)
| | - Carolina Galiana
- Department of Pharmacy, CEU Cardenal Herrera University, Ramón y Cajal s/n, 46115 Alfara del Patriarca, Spain;
| | - Ariadna Gil-Martínez
- Department of Inorganic Chemistry, Institute of Molecular Science, Catedrático José Beltran 2, 46980 Paterna, Spain; (S.L.-M.); (C.G.-R.); (A.G.-M.); (S.B.)
| | - Stephane Bandeira
- Department of Inorganic Chemistry, Institute of Molecular Science, Catedrático José Beltran 2, 46980 Paterna, Spain; (S.L.-M.); (C.G.-R.); (A.G.-M.); (S.B.)
| | - Jorge González-García
- Department of Inorganic Chemistry, Institute of Molecular Science, Catedrático José Beltran 2, 46980 Paterna, Spain; (S.L.-M.); (C.G.-R.); (A.G.-M.); (S.B.)
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21
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Aroso RT, Schaberle FA, Arnaut LG, Pereira MM. Photodynamic disinfection and its role in controlling infectious diseases. Photochem Photobiol Sci 2021; 20:1497-1545. [PMID: 34705261 PMCID: PMC8548867 DOI: 10.1007/s43630-021-00102-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/03/2021] [Indexed: 12/23/2022]
Abstract
Photodynamic therapy is witnessing a revival of its origins as a response to the rise of multi-drug resistant infections and the shortage of new classes of antibiotics. Photodynamic disinfection (PDDI) of microorganisms is making progresses in preclinical models and in clinical cases, and the perception of its role in the clinical armamentarium for the management of infectious diseases is changing. We review the positioning of PDDI from the perspective of its ability to respond to clinical needs. Emphasis is placed on the pipeline of photosensitizers that proved effective to inactivate biofilms, showed efficacy in animal models of infectious diseases or reached clinical trials. Novel opportunities resulting from the COVID-19 pandemic are briefly discussed. The molecular features of promising photosensitizers are emphasized and contrasted with those of photosensitizers used in the treatment of solid tumors. The development of photosensitizers has been accompanied by the fabrication of a variety of affordable and customizable light sources. We critically discuss the combination between photosensitizer and light source properties that may leverage PDDI and expand its applications to wider markets. The success of PDDI in the management of infectious diseases will ultimately depend on the efficacy of photosensitizers, affordability of the light sources, simplicity of the procedures, and availability of fast and efficient treatments.
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Affiliation(s)
- Rafael T Aroso
- Chemistry Department, University of Coimbra, 3004-535, Coimbra, Portugal
| | - Fábio A Schaberle
- Chemistry Department, University of Coimbra, 3004-535, Coimbra, Portugal
| | - Luís G Arnaut
- Chemistry Department, University of Coimbra, 3004-535, Coimbra, Portugal.
| | - Mariette M Pereira
- Chemistry Department, University of Coimbra, 3004-535, Coimbra, Portugal.
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22
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Shiratori M, Ozawa T, Ito N, Awazu K, Tsuruta D. Open study of photodynamic therapy for skin ulcers infected with MRSA and Pseudomonas aeruginosa. Photodiagnosis Photodyn Ther 2021; 36:102484. [PMID: 34403825 DOI: 10.1016/j.pdpdt.2021.102484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Drug-resistant bacterial infections are a global problem. Novel treatment methods that simultaneously control infection and promote wound healing without leading to new resistant bacteria are needed. Photodynamic therapy (PDT) is a useful antibiotic-free treatment approach. Our previous studies have shown that PDT for skin ulcers infected with methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PA) can achieve infection control and promoting wound healing in vitro and in vivo murine model. Here, we investigated the safety and effectiveness of PDT with 5-aminolevulinic acid (ALA-PDT) for human skin ulcers infected with MRSA and PA. METHODS ALA-PDT with macrogol ointment containing 0.5% ALA-HCl and 0.005% EDTA-2Na (wavelength 410 nm, 10 J/cm2) was performed on consecutive days in patients aged ≥20 years who had skin ulcers infected with MRSA and PA. RESULTS Six of our seven patients showed a clear tendency for ulcer area reduction to ≤60% of that measured at baseline. ALA-PDT was judged to be completely safe in all patients; only one patient had an increase in bacterial count. CONCLUSIONS ALA-PDT is safe and effective for MRSA and PA infected skin ulcers to control and heal wound.
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Affiliation(s)
- Miyu Shiratori
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan: 1-4-3 Asahimachi, Abeno-ku, Osaka, Japan
| | - Toshiyuki Ozawa
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan: 1-4-3 Asahimachi, Abeno-ku, Osaka, Japan; Research Center for Infectious Disease Sciences, Osaka City University Graduate School of Medicine, Osaka, Japan: 1-4-3 Asahimachi, Abeno-ku, Osaka, Japan.
| | - Nobuhisa Ito
- Medical Beam Physics Laboratory, Osaka University Graduate School of Engineering, Osaka, Japan: 2-1 Yamadaoka, Suita, Osaka, Japan
| | - Kunio Awazu
- Medical Beam Physics Laboratory, Osaka University Graduate School of Engineering, Osaka, Japan: 2-1 Yamadaoka, Suita, Osaka, Japan
| | - Daisuke Tsuruta
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan: 1-4-3 Asahimachi, Abeno-ku, Osaka, Japan; Research Center for Infectious Disease Sciences, Osaka City University Graduate School of Medicine, Osaka, Japan: 1-4-3 Asahimachi, Abeno-ku, Osaka, Japan
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23
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Rosa LP, Silva FCD, Luz SCL, Vieira RL, Tanajura BR, Silva Gusmão AGD, de Oliveira JM, Jesus Nascimento FD, Dos Santos NAC, Inada NM, Blanco KC, Carbinatto FM, Bagnato VS. Follow-up of pressure ulcer treatment with photodynamic therapy, low level laser therapy and cellulose membrane. J Wound Care 2021; 30:304-310. [PMID: 33856908 DOI: 10.12968/jowc.2021.30.4.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE A pressure ulcer (PU) is an area of tissue trauma caused by continuous and prolonged pressure, often associated with hospitalised patients immobilised due to neurological problems, negatively affecting their quality of life, and burdening the public budget. The aim of this study was to report the follow-up, for 45 weeks, of three patients with neurological lesions due to trauma who subsequently developed PUs, and who were treated with a combination of photodynamic therapy (PDT), low level laser therapy (LLLT) and cellulose membrane (CM). METHOD PDT was mediated by the photosensitiser curcumin on a 1.5% emulsion base. Blue LED light at 450 nm was delivered continuously for 12 minutes at an irradiance of 30mW/cm2 and total energy delivered to the tissue was 22J/cm2. LLLT was performed with 660 nm laser, punctuated and continuous, twice a week with parameters: spot size 0.04cm2, power of 40mW, 10 seconds per point, fluence of 10J/cm2 and irradiance of 1000mW/cm2. RESULTS All PUs had a significant reduction (range: 95.2-100%) of their area after 45 weeks of follow-up and two PUs had complete healing at 20 weeks and 30 weeks. All of the PUs showed a reduction in contamination with the PDT treatments in different proportions. CONCLUSION From the results obtained, we conclude that the combination of PDT, LLLT and CM is a promising treatment for PU healing.
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Affiliation(s)
- Luciano Pereira Rosa
- Multidisciplinary Health Institute, Federal University of Bahia, Hormindo Barros Street, 58. Candeias. Vitória da Conquista, Bahia, Brazil
| | - Francine Cristina da Silva
- Multidisciplinary Health Institute, Federal University of Bahia, Hormindo Barros Street, 58. Candeias. Vitória da Conquista, Bahia, Brazil
| | - Suzete Carvalho Landulfo Luz
- Multidisciplinary Health Institute, Federal University of Bahia, Hormindo Barros Street, 58. Candeias. Vitória da Conquista, Bahia, Brazil
| | | | - Beatriz Rocha Tanajura
- Multidisciplinary Health Institute, Federal University of Bahia, Hormindo Barros Street, 58. Candeias. Vitória da Conquista, Bahia, Brazil
| | - Alana Gonçalves da Silva Gusmão
- Multidisciplinary Health Institute, Federal University of Bahia, Hormindo Barros Street, 58. Candeias. Vitória da Conquista, Bahia, Brazil
| | - Janeide Muritiba de Oliveira
- Multidisciplinary Health Institute, Federal University of Bahia, Hormindo Barros Street, 58. Candeias. Vitória da Conquista, Bahia, Brazil
| | - Fabiana de Jesus Nascimento
- Multidisciplinary Health Institute, Federal University of Bahia, Hormindo Barros Street, 58. Candeias. Vitória da Conquista, Bahia, Brazil
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24
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Grandi V, Paroli G, Puliti E, Bacci S, Pimpinelli N. Single ALA-PDT irradiation induces increase in mast cells degranulation and neuropeptide acute response in chronic venous ulcers: A pilot study. Photodiagnosis Photodyn Ther 2021; 34:102222. [PMID: 33601002 DOI: 10.1016/j.pdpdt.2021.102222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/14/2021] [Accepted: 02/08/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The behavior of mast cells, their interaction with neuronal cells or nerve fibers, the expression of neuropeptides and the distribution of skin neuronal cells or nerve fibers after ALA-PDT treated vs untreated chronic wounds were investigated. METHODS Nineteen patients suffering from chronic venous ulcers (CVU) were enrolled in this study. Skin samples from wound bed before and after irradiation with ALA-PDT were taken. All specimens were anonymized and analyzed by immunohistochemistry. RESULTS After completion of ALA-PDT, mast cells showed an increase of degranulation index and expression of NGF and VIP. Amongst all the neuronal mediators tested, all except for SP showed an increase of cellular expression after ALA-PDT therapy. CONCLUSION Our study shows preliminary evidences that ALA-PDT induces rapid recruitment of mast cells around dermal fibers in chronic venous ulcers. This finding is also associated with increase in expression of multiple peripheral neuropeptides except SP by skin neuronal cells. ALA-PDT may promote healing of chronic venous ulcers via stimulation of quiescent peripheral nerves, possibly after release of inflammatory molecules by degranulating mast cells.
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Affiliation(s)
- Vieri Grandi
- Department of Health Sciences, Division of Dermatology, University of Florence, Italy; St John's Institute of Dermatology, GSTT NHS Foundation Trust, London, United Kingdom
| | - Gaia Paroli
- Department of Biology, Research Unit of Histology and Embriology, University of Florence, Italy
| | - Elisa Puliti
- Department of Biology, Research Unit of Histology and Embriology, University of Florence, Italy
| | - Stefano Bacci
- Department of Biology, Research Unit of Histology and Embriology, University of Florence, Italy.
| | - Nicola Pimpinelli
- Department of Health Sciences, Division of Dermatology, University of Florence, Italy
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25
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de Oliveira AB, Ferrisse TM, Basso FG, Fontana CR, Giro EMA, Brighenti FL. A systematic review and meta-analysis of the effect of photodynamic therapy for the treatment of oral mucositis. Photodiagnosis Photodyn Ther 2021; 34:102316. [PMID: 33940208 DOI: 10.1016/j.pdpdt.2021.102316] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 02/09/2023]
Abstract
BACKGROUND Oral mucositis is a significant reaction to antineoplastic treatment characterized with pain, nutritional compromise, impact on the quality of life, interruption in cancer therapy and risk for infection. There is no effective standard protocol for the treatment of oral mucositis. This study aims to synthesize the scientific evidence available about the effects of photodynamic therapy on treatment of oral mucositis. METHODS PubMed, Scopus, Web of Science, Science Direct, Scielo, Embase and Cochrane libraries were searched. Two independent and calibrated researchers (kappa = 0.92) performed all systematic steps according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). To access the risk of bias, RoB 2 and Delphi list criteria for clinical trials were used. Meta-analysis was conducted using the R software with "META" package. RESULTS Clinical and randomized clinical trials were included with a total of five articles. Meta-analysis, level of evidence, and risk of bias assessment were performed showing that photodynamic therapy was effective in reducing healing time in association with low-power laser therapy when compared to low-power laser therapy alone (p = 0.0005). CONCLUSION Photodynamic therapy presents promising results for the treatment of oral mucositis. It may be an effective therapeutic option, contributing to the healing of injured tissues especially in the time needed for repair.
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Affiliation(s)
- Analú Barros de Oliveira
- São Paulo State University (UNESP), School of Dentistry - Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara, SP, Brazil
| | - Túlio Morandin Ferrisse
- São Paulo State University (UNESP), School of Dentistry - Department of Dental Materials and Prosthesis, Araraquara, SP, Brazil
| | | | - Carla Raquel Fontana
- São Paulo State University (UNESP), School of Pharmaceutical Sciences - Department of Clinical Analysis, Araraquara, SP, Brazil
| | - Elisa Maria Aparecida Giro
- São Paulo State University (UNESP), School of Dentistry - Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara, SP, Brazil
| | - Fernanda Lourenção Brighenti
- São Paulo State University (UNESP), School of Dentistry - Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara, SP, Brazil.
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Vallejo MCS, Moura NMM, Gomes ATPC, Joaquinito ASM, Faustino MAF, Almeida A, Gonçalves I, Serra VV, Neves MGPMS. The Role of Porphyrinoid Photosensitizers for Skin Wound Healing. Int J Mol Sci 2021; 22:4121. [PMID: 33923523 PMCID: PMC8072979 DOI: 10.3390/ijms22084121] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/04/2021] [Accepted: 04/10/2021] [Indexed: 12/14/2022] Open
Abstract
Microorganisms, usually bacteria and fungi, grow and spread in skin wounds, causing infections. These infections trigger the immune system and cause inflammation and tissue damage within the skin or wound, slowing down the healing process. The use of photodynamic therapy (PDT) to eradicate microorganisms has been regarded as a promising alternative to anti-infective therapies, such as those based on antibiotics, and more recently, is being considered for skin wound-healing, namely for infected wounds. Among the several molecules exploited as photosensitizers (PS), porphyrinoids exhibit suitable features for achieving those goals efficiently. The capability that these macrocycles display to generate reactive oxygen species (ROS) gives a significant contribution to the regenerative process. ROS are responsible for avoiding the development of infections by inactivating microorganisms such as bacteria but also by promoting cell proliferation through the activation of stem cells which regulates inflammatory factors and collagen remodeling. The PS can act solo or combined with several materials, such as polymers, hydrogels, nanotubes, or metal-organic frameworks (MOF), keeping both the microbial photoinactivation and healing/regenerative processes' effectiveness. This review highlights the developments on the combination of PDT approach and skin wound healing using natural and synthetic porphyrinoids, such as porphyrins, chlorins and phthalocyanines, as PS, as well as the prodrug 5-aminolevulinic acid (5-ALA), the natural precursor of protoporphyrin-IX (PP-IX).
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Affiliation(s)
- Mariana C. S. Vallejo
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal; (M.C.S.V.); (A.S.M.J.)
| | - Nuno M. M. Moura
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal; (M.C.S.V.); (A.S.M.J.)
| | - Ana T. P. C. Gomes
- CESAM, Department of Biology, University of Aveiro, 3810-193 Aveiro, Portugal; (A.T.P.C.G.); (A.A.)
| | - Ana S. M. Joaquinito
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal; (M.C.S.V.); (A.S.M.J.)
- CESAM, Department of Biology, University of Aveiro, 3810-193 Aveiro, Portugal; (A.T.P.C.G.); (A.A.)
| | - Maria Amparo F. Faustino
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal; (M.C.S.V.); (A.S.M.J.)
| | - Adelaide Almeida
- CESAM, Department of Biology, University of Aveiro, 3810-193 Aveiro, Portugal; (A.T.P.C.G.); (A.A.)
| | - Idalina Gonçalves
- CICECO, Department of Materials and Ceramic Engineering, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Vanda Vaz Serra
- Centro de Química Estrutural, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal;
| | - Maria Graça P. M. S. Neves
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal; (M.C.S.V.); (A.S.M.J.)
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27
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Guedes GMM, Santos-Filho ASP, Regis WFM, Ocadaque CJ, Amando BR, Sidrim JJC, Brilhante RSN, Cordeiro RA, Bandeira SP, Rocha MFG, Castelo-Branco DSCM. Ex situ model of biofilm-associated wounds: providing a host-like environment for the study of Staphylococcus aureus and Pseudomonas aeruginosa biofilms. J Appl Microbiol 2021; 131:1487-1497. [PMID: 33556197 DOI: 10.1111/jam.15026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 01/17/2021] [Accepted: 02/02/2021] [Indexed: 12/20/2022]
Abstract
AIM This study aimed to assess an ex situ model of biofilm-associated wounds on porcine skin for the study of Staphylococcus aureus and Pseudomonas aeruginosa biofilms in a host-like environment, after 48 to 120 h of incubation. MATERIAL AND RESULTS Ex situ and in vitro biofilms were comparatively analysed. Overall, CFU-counts and matrix quantification yielded significantly (P < 0·05) higher results for ex situ than in vitro biofilms. Confocal microscopy revealed greater (P < 0·05) biomass and thickness at 48-72 h and greater (P < 0·05) robustness at 72 h of growth. S. aureus ex situ biofilms produced less (P < 0·05) siderophore and proteases than in vitro biofilms, while P. aeruginosa ex situ biofilms produced more (P < 0·05) siderophores and less proteases than in vitro biofilms. CONCLUSIONS Biofilms grown ex situ present a greater amount of bacterial cells and polymeric matrix than their in vitro counterparts, reaching maturity at 72 h of growth. Moreover the production of virulence factors differs between ex situ and in vitro biofilms. SIGNIFICANCE AND IMPACT OF THE STUDY These findings emphasize the importance of using ex situ biofilm models, once they mimic in vivo conditions. The use of these models brings perspectives for the pursuit of therapeutic alternatives, as tests may be performed in a host-like environment.
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Affiliation(s)
- G M M Guedes
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - A S P Santos-Filho
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - W F M Regis
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - C J Ocadaque
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - B R Amando
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - J J C Sidrim
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - R S N Brilhante
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - R A Cordeiro
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - S P Bandeira
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - M F G Rocha
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Ceará, Brazil.,Postgraduate Program in Veterinary Sciences, College of Veterinary, State University of Ceará, Fortaleza, Ceará, Brazil
| | - D S C M Castelo-Branco
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil.,Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
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Duan W, Qiao S, Zhuo M, Sun J, Guo M, Xu F, Liu J, Wang T, Guo X, Zhang Y, Gao J, Huang Y, Zhang Z, Cheng P, Ma S, Chen Y. Multifunctional Platforms: Metal-Organic Frameworks for Cutaneous and Cosmetic Treatment. Chem 2021. [DOI: 10.1016/j.chempr.2020.11.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Yasui H, Takahashi K, Taki S, Shimizu M, Koike C, Umeda K, Rahman S, Akashi T, Nguyen VS, Nakagawa Y, Sato K. Near Infrared Photo‐Antimicrobial Targeting Therapy for
Candida albicans. ADVANCED THERAPEUTICS 2021. [DOI: 10.1002/adtp.202000221] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Hirotoshi Yasui
- Respiratory Medicine Nagoya University Graduate School of Medicine 65 Tsuumai‐cho, Showa‐ku Nagoya Aichi 466‐8550 Japan
| | - Kazuomi Takahashi
- Respiratory Medicine Nagoya University Graduate School of Medicine 65 Tsuumai‐cho, Showa‐ku Nagoya Aichi 466‐8550 Japan
| | - Shunichi Taki
- Respiratory Medicine Nagoya University Graduate School of Medicine 65 Tsuumai‐cho, Showa‐ku Nagoya Aichi 466‐8550 Japan
| | - Misae Shimizu
- Advanced Analytical and Diagnostic Imaging Center (AADIC)/Medical Engineering Unit (MEU), B3 Unit Nagoya University Institute for Advanced Research 65 Tsuumai‐cho, Showa‐ku Nagoya Aichi 466‐8550 Japan
| | - Chiaki Koike
- Advanced Analytical and Diagnostic Imaging Center (AADIC)/Medical Engineering Unit (MEU), B3 Unit Nagoya University Institute for Advanced Research 65 Tsuumai‐cho, Showa‐ku Nagoya Aichi 466‐8550 Japan
| | - Koji Umeda
- EW Nutrition Japan Immunology Research Institute in Gifu 839‐7, Gifu‐City Sano Gifu 501‐1101 Japan
| | - Shofiqur Rahman
- EW Nutrition Japan Immunology Research Institute in Gifu 839‐7, Gifu‐City Sano Gifu 501‐1101 Japan
| | - Tomohiro Akashi
- Division of OMICS Analysis Nagoya University Graduate School of Medicine 65 Tsuumai‐cho, Showa‐ku Nagoya Aichi 466‐8550 Japan
- Division of Systems Biology Nagoya University Graduate School of Medicine 65 Tsuumai‐cho, Showa‐ku Nagoya Aichi 466‐8550 Japan
- S‐YLC Nagoya University Institute for Advanced Research Furo‐cho, Chikusa‐ku Nagoya Aichi 464‐8601 Japan
| | - Van Sa Nguyen
- EW Nutrition Japan Immunology Research Institute in Gifu 839‐7, Gifu‐City Sano Gifu 501‐1101 Japan
| | - Yoshiyuki Nakagawa
- Division of OMICS Analysis Nagoya University Graduate School of Medicine 65 Tsuumai‐cho, Showa‐ku Nagoya Aichi 466‐8550 Japan
| | - Kazuhide Sato
- Respiratory Medicine Nagoya University Graduate School of Medicine 65 Tsuumai‐cho, Showa‐ku Nagoya Aichi 466‐8550 Japan
- CREST, JST Honcho Kawaguchi Saitama 332‐0012 Japan
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Yang T, Tan Y, Zhang W, Yang W, Luo J, Chen L, Liu H, Yang G, Lei X. Effects of ALA-PDT on the Healing of Mouse Skin Wounds Infected With Pseudomonas aeruginosa and Its Related Mechanisms. Front Cell Dev Biol 2020; 8:585132. [PMID: 33344449 PMCID: PMC7746815 DOI: 10.3389/fcell.2020.585132] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 11/11/2020] [Indexed: 11/24/2022] Open
Abstract
Photodynamic therapy (PDT) is a promising new method to eliminate microbial infection and promote wound healing. Its effectiveness has been confirmed by some studies; however, the mechanisms of PDT in wound healing remain obscure. We used mouse skin wounds infected with Pseudomonas aeruginosa as a research object to explore the therapeutic effects and mechanisms of 5-aminolevulinic acid photodynamic therapy (ALA-PDT). ALA-PDT treatment significantly reduced the load of P. aeruginosa in the wound and surrounding tissues and promoted the healing of skin wounds in mice. Hematoxylin-eosin (HE) and Sirius red staining showed that ALA-PDT promoted granulation tissue formation, angiogenesis, and collagen regeneration and remodeling. After ALA-PDT treatment, the expression of inflammatory factors (TNF-α and IL-1β) first increased and then decreased, while the secretion of growth factors (TGF-β-1 and VEGF) increased gradually after treatment. Furthermore, ALA-PDT affected the polarization state of macrophages, activating and promoting macrophages from an M1 to an M2 phenotype. In conclusion, ALA-PDT can not only kill bacteria but also promote wound healing by regulating inflammatory factors, collagen remodeling and macrophages. This study further clarifies the mechanism of PDT in the healing of infectious skin wounds and provides further experimental evidence for its clinical treatment of skin wounds infected by P. aeruginosa.
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Affiliation(s)
- Tao Yang
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Yang Tan
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Wentao Zhang
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Weijiang Yang
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Jiefu Luo
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Ling Chen
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Hong Liu
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Guihong Yang
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Xia Lei
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
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Klausen M, Ucuncu M, Bradley M. Design of Photosensitizing Agents for Targeted Antimicrobial Photodynamic Therapy. Molecules 2020; 25:E5239. [PMID: 33182751 PMCID: PMC7696090 DOI: 10.3390/molecules25225239] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/18/2022] Open
Abstract
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.
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Affiliation(s)
- Maxime Klausen
- School of Chemistry and the EPSRC IRC Proteus, University of Edinburgh, Joseph Black Building, David Brewster Road, Edinburgh EH9 3FJ, UK;
| | - Muhammed Ucuncu
- School of Chemistry and the EPSRC IRC Proteus, University of Edinburgh, Joseph Black Building, David Brewster Road, Edinburgh EH9 3FJ, UK;
- Department of Analytical Chemistry, Faculty of Pharmacy, Izmir Katip Celebi University, Izmir 35620, Turkey
| | - Mark Bradley
- School of Chemistry and the EPSRC IRC Proteus, University of Edinburgh, Joseph Black Building, David Brewster Road, Edinburgh EH9 3FJ, UK;
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Shen X, Dong L, He X, Zhao C, Zhang W, Li X, Lu Y. Treatment of infected wounds with methylene blue photodynamic therapy: An effective and safe treatment method. Photodiagnosis Photodyn Ther 2020; 32:102051. [PMID: 33059110 DOI: 10.1016/j.pdpdt.2020.102051] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND Bacterial resistance is a problem during the process of healing of infected wounds. As a therapy, photodynamic therapy (PDT) has broad-spectral antibacterial activity and non-selective action, which makes it possible to deal with antibiotic resistance.. Methylene blue is a commonly used medicine, but it is rarely used in clinical practice as a photosensitizer. The effect of methylene blue photodynamic therapy (MB-PDT) on infected wounds remains unclear. Our study aims to evaluate the safety and efficacy of MB-PDT on infected wounds. METHODS In this study, 5 patients with infected wounds were included, all of them were treated with MB-PDT by using the red LED which irradiated the wounds directly (635 nm, 120 J/cm2, 100 mW/cm2). The frequency and course of treatment were determined by the severity of the wound. RESULTS After an average of 4 PDT session, infected wounds of all the patients healed.. The treatment also showed an excellent cosmetic effect. According to the follow-up periods of patients ranged from 3 to 12 months, there were no recurrences and side effects. CONCLUSIONS MB-PDT has a great healing effect on infected wounds, and it is a safe, cheap and active clinical therapy.
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Affiliation(s)
- Xiaoxiao Shen
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Amy Medical University, Chongqing 400042, PR China
| | - Liwen Dong
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Amy Medical University, Chongqing 400042, PR China
| | - Xuan He
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Amy Medical University, Chongqing 400042, PR China
| | - Chuanqi Zhao
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Amy Medical University, Chongqing 400042, PR China
| | - Wanqi Zhang
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Amy Medical University, Chongqing 400042, PR China
| | - Xinying Li
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Amy Medical University, Chongqing 400042, PR China
| | - Yuangang Lu
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Amy Medical University, Chongqing 400042, PR China.
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Sun Y, Tosa M, Takada H, Ogawa R. Photodynamic Therapy Delays Cutaneous Wound Healing in Mice. J NIPPON MED SCH 2020; 87:110-117. [PMID: 32655090 DOI: 10.1272/jnms.jnms.2020_87-301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cutaneous wound healing is a complex, dynamic physiological process. Traditional methods of promoting wound healing are not always effective. Consequently, alternative modalities, such as photodynamic therapy (PDT), are needed. We examined the effectiveness and underlying mechanisms of PDT in a murine model of acute wound healing. METHODS Two excisional wounds were produced, one on each side of the midline, in C57bL/6J mice. Methyl 5-aminolevulinate hydrochloride (MAL) was applied to the right-side wound. After 1 to 3 hours of incubation, the wound was irradiated with red light. The left-side wound was not treated with MAL or red light. On Day 14, the wounds were excised and subjected to histological and immunohistochemical analysis. RESULTS During the first week, no difference was seen between the two sides. However, at week 2, PDT-treated wounds exhibited delayed re-epithelialization. On Day 14, hematoxylin and eosin (HE) staining showed a continuous epithelial lining in untreated wounds. In contrast, PDT-treated wounds partially lacked epithelium in the wound bed. Masson's Trichrome (MTC) staining showed a thicker dermis and more collagen fibers and inflammatory cells in PDT-treated wounds than in untreated wounds. Immunohistochemical analyses showed significantly fewer CD31+ blood vessels and greater collagen III density in PDT-treated wounds than in untreated wounds. However, treated and untreated wounds did not differ in collagen I density. CONCLUSIONS PDT delayed acute wound healing in a murine model of secondary intention wound healing.
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Affiliation(s)
- Yan Sun
- Department of Dermatology, The First Hospital of China Medical University.,Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School
| | - Mamiko Tosa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School
| | - Hiroya Takada
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School
| | - Rei Ogawa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School
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Antibacterial photodynamic activity of photosensitizer-embedded alginate-pectin-carboxymethyl cellulose composite biopolymer films. Lasers Med Sci 2020; 36:763-772. [PMID: 32767164 DOI: 10.1007/s10103-020-03083-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 06/17/2020] [Indexed: 10/23/2022]
Abstract
Antimicrobial photodynamic therapy (APDT) is a promising approach for treatment of wounds infected with antibiotic-resistant bacteria. In this approach, delivery of appropriate concentration of photosensitizer (PS) at the infected site is a critical step; it is therefore essential that PS need to be administered at the infected site in a suitable formulation. Here, we report preparation of PS-embedded composite biopolymer films and their photobactericidal properties against methicillin-resistant Staphylococcus aureus (MRSA) and biocompatibility. Sodium alginate (SA), pectin (PC), and carboxymethyl cellulose (CMC) were used for preparing films containing chlorin p6 (Cp6, anionic PS) or methylene blue (MB, cationic PS). Films containing 1% CMC (15 mm diameter; 110 ± 09 μm thickness) showed ~ 55% light transmission in 500 to 750 nm region and high swelling rate as indicated by ~ 38% increase in diameter within 1 h. Absorption spectroscopic studies of PS-embedded films revealed that while Cp6 existed mainly in monomeric state, MB existed in both dimeric and monomeric forms. MRSA incubated with the film for 1 h displayed substantial uptake of Cp6 and MB as indicated by the presence of Cp6 fluorescence and MB staining in cells under the microscope. Furthermore, photodynamic treatment (660 nm, 10 J/cm2) of MRSA with Cp6 embedded in film or free Cp6 resulted in ~ 3 log reduction in colony-forming units (cfu), whereas decrease in cfu was less (~ 1 log) for MB-embedded film than for free MB (~ 6 logs). Studies on human keratinocyte (HaCaT) cells showed that there was no significant change in the viability of cells when they were incubated with solubilized films (plain) for 24 h or subjected to treatment with PS-containing films followed by PDT. These results suggest that films are biocompatible and have potential application in photodynamic treatment of MRSA-infected wounds.
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Monfrecola G, Megna M, Rovati C, Arisi M, Rossi M, Calzavara-Pinton I, Fabbrocini G, Calzavara-Pinton P. A Critical Reappraisal of Off-Label Use of Photodynamic Therapy for the Treatment of Non-Neoplastic Skin Conditions. Dermatology 2020; 237:262-276. [PMID: 32554971 DOI: 10.1159/000507926] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 04/16/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In the past 30 years, topical photodynamic therapy (PDT) has been investigated for the treatment of a broad spectrum of cosmetic, inflammatory, and infectious skin conditions with variable, and often contrasting, results. However, the non-expert clinician may be in difficulty evaluating these results because different sensitizers, concentrations, formulations, light sources, and irradiation protocols have been used. In addition, many of these studies have poor quality design being case reports and uncontrolled studies of few cases. SUMMARY With the aim to clarify the potential usefulness of PDT for the treatment of infectious and inflammatory skin diseases as well as selected cosmetic indications, we searched for randomized controlled clinical trials, non-randomized comparative studies, retrospective studies, and case series studies with a number of at least 10 patients, published since 1990. Later, we reappraised the results in order to give a simple critical overview. Key Messages: Evidence from the literature seems to strongly support the use of ALA- and MAL-PDT for the treatment of common skin diseases such as acne, warts, condylomata, and Leishmania skin infection and for photorejuvenation, i.e., the correction of selected cosmetic changes of aging and photoaging. For other disorders, the level of evidence and strength of recommendation are lower, and controlled randomized studies with prolonged follow-ups are necessary in order to assess the clinical usefulness and other potential advantages over current treatment options.
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Affiliation(s)
- Giuseppe Monfrecola
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Chiara Rovati
- Dermatology Department, University of Brescia, Brescia, Italy
| | | | | | | | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Zhang LC, Hao LM, Huang YB, Huang HF, Hu J, Bi MY. Satisfactory response of a back carbuncle to 5-aminolevulinic acid (ALA) photodynamic therapy: A case report. Photodiagnosis Photodyn Ther 2020; 30:101618. [DOI: 10.1016/j.pdpdt.2019.101618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/01/2019] [Accepted: 12/05/2019] [Indexed: 10/25/2022]
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Tan Y, Bai Y, Li F, Chen J, Cheng Q, Wang J, Li J, Lei X. Evaluation of ALA-PDT combined with antibiotics for the treatment of skin ulcers with sinus tract formation: A pilot study. Photodiagnosis Photodyn Ther 2020; 31:101802. [PMID: 32360850 DOI: 10.1016/j.pdpdt.2020.101802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 04/24/2020] [Accepted: 04/24/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) is considered an important and innovative treatment for healing skin wounds. Skin ulcers with sinus tract formation are rare and difficult to treat in the field of dermatology. Herein, we utilized optical fibers as a light source to penetrate the sinus tract and applied PDT to treat the sinus tract. OBJECTIVES To evaluate the efficacy and safety of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) and provide insight into the use of ALA-PDT in the treatment of skin ulcers with sinus tracts. METHODS Seven patients with skin ulcers with sinus tract formation who were previously unsuccessfully treated with systemic antibiotics, debridement and dressing changes were examined. In the present study, these patients also received ALA-PDT treatment (the ulcers were irradiated with a red LED, and the sinus tracts were irradiated with semiconductor laser optical fibers), which was locally administered every 10 days with a total of 1-5 sessions. RESULTS Six patients enrolled in the study were fully cured after receiving combination therapy with ALA-PDT and antibiotics for three months. The sinus tract of one patient was cured and the ulcer area of this patient was reduced. All patients experienced varying degrees of redness and pain during treatment but no severe discomfort, and all patients were satisfied with the outcome of the treatment. CONCLUSION Local ALA-PDT combined with antibiotics could be a safe and effective treatment approach for skin ulcers with sinus tract formation.
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Affiliation(s)
- Yang Tan
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing 400042, China
| | - Yaqiong Bai
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing 400042, China
| | - Feng Li
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing 400042, China
| | - Jinyi Chen
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing 400042, China
| | - Qionghui Cheng
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing 400042, China
| | - Jingjing Wang
- Department of Laboratory Medicine, Xinqiao Hospital, The Army Medical University, Chongqing 400038, China
| | - Jin Li
- Department of Clinical Laboratory Medicine, Daping Hospital, The Army Medical University, Chongqing 400042, China
| | - Xia Lei
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing 400042, China.
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Shi L, Liu P, Liu J, Yang Y, Chen Q, Zhang Y, Zhang H, Wang X. Application of 5‐aminolevulinic acid‐photodynamic therapy in common skin diseases. TRANSLATIONAL BIOPHOTONICS 2020. [DOI: 10.1002/tbio.201900028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Lei Shi
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine Shanghai China
| | - Pei Liu
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine Shanghai China
| | - Jia Liu
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine Shanghai China
| | - Yuling Yang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine Shanghai China
| | - Qi Chen
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine Shanghai China
| | - Yunfeng Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine Shanghai China
| | - Haiyan Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine Shanghai China
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine Shanghai China
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Dong L, Li X, Shen X, Zhang W, Zhang J, Wang Y, Lu Y. Efficacy and safety of 5-aminolevulinic acid photodynamic therapy for the treatment of ulcerative squamous cell carcinoma. Photodiagnosis Photodyn Ther 2020; 30:101710. [PMID: 32142751 DOI: 10.1016/j.pdpdt.2020.101710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/14/2020] [Accepted: 03/02/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Photodynamic therapy is a nonsurgical alternative to conventional tumor excision for squamous cell carcinoma. In addition, photodynamic therapy has many advantages in improving wound healing, especially for diabetic foot lesions and infected ulcers. However, the effect of photodynamic therapy on ulcerative squamous cell carcinoma is not yet clear. In this study, we aimed to evaluate the effectiveness of photodynamic therapy in treating squamous cell carcinoma. METHODS A total of six cases of ulcerative squamous cell carcinoma were included in our study. Each ulcer region was irradiated with 120 J/cm2 using a 635-nm red light-emitting diode after application of 5-aminolevulinic acid solution at 1-week intervals. The number of treatment sessions depended on the healing of the lesions. RESULTS The ulcerative lesions showed complete clinical remission with an average 3.7 photodynamic therapy sessions. There was no recurrence during a follow-up of 8.5 months (range, 3 months to 1 year). The patients were able to complete the treatment protocol with good cosmetic results and no significant complications. In addition, most patients reported significant improvement in their quality of life. CONCLUSIONS Photodynamic therapy is a promising method for treating ulcerative squamous cell carcinoma. However, its effects need to be validated in larger patient samples in clinical trials.
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Affiliation(s)
- Liwen Dong
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Army Military Medical University, Chongqing 400042, PR China
| | - Xinying Li
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Army Military Medical University, Chongqing 400042, PR China
| | - Xiaoxiao Shen
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Army Military Medical University, Chongqing 400042, PR China
| | - Wanqi Zhang
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Army Military Medical University, Chongqing 400042, PR China
| | - Junbo Zhang
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Army Military Medical University, Chongqing 400042, PR China
| | - Yuanyuan Wang
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Army Military Medical University, Chongqing 400042, PR China
| | - Yuangang Lu
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Army Military Medical University, Chongqing 400042, PR China.
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Ucuncu M, Mills B, Duncan S, Staderini M, Dhaliwal K, Bradley M. Polymyxin-based photosensitizer for the potent and selective killing of Gram-negative bacteria. Chem Commun (Camb) 2020; 56:3757-3760. [DOI: 10.1039/d0cc00155d] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The methylene blue-polymyxin conjugate demonstrated high selectivity, sensitivity and phototoxicity against Gram-negative bacteria, including in early biofilm models.
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Affiliation(s)
- Muhammed Ucuncu
- School of Chemistry and the EPSRC IRC Proteus
- University of Edinburgh
- Joseph Black Building
- David Brewster Road
- Edinburgh
| | - Bethany Mills
- EPSRC Proteus Hub
- Centre of Inflammation Research
- Queen's Medical Research Institute
- University of Edinburgh
- 47 Little France Crescent
| | - Sheelagh Duncan
- EPSRC Proteus Hub
- Centre of Inflammation Research
- Queen's Medical Research Institute
- University of Edinburgh
- 47 Little France Crescent
| | - Matteo Staderini
- School of Chemistry and the EPSRC IRC Proteus
- University of Edinburgh
- Joseph Black Building
- David Brewster Road
- Edinburgh
| | - Kevin Dhaliwal
- EPSRC Proteus Hub
- Centre of Inflammation Research
- Queen's Medical Research Institute
- University of Edinburgh
- 47 Little France Crescent
| | - Mark Bradley
- School of Chemistry and the EPSRC IRC Proteus
- University of Edinburgh
- Joseph Black Building
- David Brewster Road
- Edinburgh
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Trevisan E, Menegazzi R, Zabucchi G, Troian B, Prato S, Vita F, Rapozzi V, Grandolfo M, Borelli V. Effect of methylene blue photodynamic therapy on human neutrophil functional responses. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2019; 199:111605. [PMID: 31473428 DOI: 10.1016/j.jphotobiol.2019.111605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/23/2019] [Accepted: 08/24/2019] [Indexed: 12/23/2022]
Abstract
Photodynamic therapy (PDT) has become an emerging novel therapeutic approach for treating localized microbial infections, particularly those sustained by multidrug-resistant strains. Given the irreplaceable role played by professional phagocytes in limiting infections, such as polymorphonuclear neutrophils, any newly designed antimicrobial therapeutic approach must not interfere with their function. The present investigation presents a detailed analysis of the effect of PDT on the viability and several functional responses of human polymorphonuclear neutrophils loaded with methylene blue (MB), one of the more commonly used photosensitizers in antimicrobial PDT. Taking advantage of the use of a specifically-designed optical LED array for illuminating MB-loaded human polymorphonuclear neutrophils, a number of cell functions have been assayed under miniaturized, strictly controlled and reproducible experimental conditions. The major findings of this study are the following: (1) MB-PDT increases human neutrophils adhesion and does not modify myeloperoxidase release; (2) MB-PDT markedly enhances reactive oxygen species generation that is independent of superoxide-forming phagocytic oxidase and very likely ascribable to LED-dependent excitation of accumulated methylene blue; (3) MB-PDT almost abolishes human neutrophils candidacidal activity by hindering the engulfing machinery. This in vitro study may represent a valuable reference point for future research on PDT applications for treating localized microbial infections.
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Affiliation(s)
- Elisa Trevisan
- Department of Life Sciences, University of Trieste, Trieste 34127, Italy
| | - Renzo Menegazzi
- Department of Life Sciences, University of Trieste, Trieste 34127, Italy.
| | - Giuliano Zabucchi
- Department of Life Sciences, University of Trieste, Trieste 34127, Italy
| | - Barbara Troian
- A.P.E. Research Srl, Area Science Park, Basovizza, Trieste 34012, Italy.
| | - Stefano Prato
- A.P.E. Research Srl, Area Science Park, Basovizza, Trieste 34012, Italy.
| | - Francesca Vita
- Department of Life Sciences, University of Trieste, Trieste 34127, Italy
| | - Valentina Rapozzi
- Department of Medicine, University of Udine, P.le Kolbe 4, 33100 Udine, Italy.
| | - Micaela Grandolfo
- International School for Advenced Studies, Neurobiology sector, Via Bonomea, 265, 34136 Trieste, Italy.
| | - Violetta Borelli
- Department of Life Sciences, University of Trieste, Trieste 34127, Italy.
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Bui UT, Finlayson K, Edwards H. The diagnosis of infection in chronic leg ulcers: A narrative review on clinical practice. Int Wound J 2019; 16:601-620. [PMID: 30697930 PMCID: PMC7948879 DOI: 10.1111/iwj.13069] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 12/20/2018] [Accepted: 12/28/2018] [Indexed: 12/17/2022] Open
Abstract
This literature review aimed to provide a narrative review of evidence on validity of clinical and microbial indicators of infection and to gain insights into the diagnosis of infection in chronic leg ulcers (CLUs). A search was conducted in Cinahl, Medline, the Cochrane Library databases, Embase, Web of Science, ScienceDirect, Pubmed, PsycINFO, ProQuest dissertations, and Google Scholar from January 1990 to July 2017. The inclusion criteria were original studies, systematic reviews, and consensus documents focused on "infection" in CLUs, English language, clinical and community settings, and human. The reviewed studies were inconsistent in criteria for infection between investigated wound types and lack of specificity regarding wound types. There were few studies investigating the criteria for diagnosis of infection in leg ulcers. The identification of leg ulcer infection still remains problematic and relies on out-of-date and not uniform evidence. Literature in this area was mostly limited to level III and IV evidence based on The Australian National Health and Medical Research Council Levels of Evidence, or expert opinion. This literature review showed seven clinical signs and symptoms that could be diagnostic for infection in CLUs, including: new, increased, or altered ulcer pain; malodour; increased ulcer area; wound breakdown, delayed or non-healing; and erythema and increased local temperature, whilst the microbial indicators used to diagnose infected leg ulcers were varied and regarded as less important.
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Affiliation(s)
- Ut T. Bui
- School of Nursing, Institute of Health and Biomedical Innovation, Faculty of HealthQueensland University of TechnologyKelvin GroveQueenslandAustralia
| | - Kathleen Finlayson
- School of Nursing, Institute of Health and Biomedical Innovation, Faculty of HealthQueensland University of TechnologyKelvin GroveQueenslandAustralia
| | - Helen Edwards
- School of Nursing, Institute of Health and Biomedical Innovation, Faculty of HealthQueensland University of TechnologyKelvin GroveQueenslandAustralia
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Eduardo F, Bezinelli L, Gobbi M, Santos V, Maluf F, Corrêa L. Severe oral infection caused by Pseudomonas aeruginosa effectively treated with methylene blue-mediated photodynamic inactivation. Photodiagnosis Photodyn Ther 2019; 26:284-286. [DOI: 10.1016/j.pdpdt.2019.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 04/02/2019] [Accepted: 04/12/2019] [Indexed: 12/01/2022]
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Low concentrations of acetic and formic acids enhance the inactivation of Staphylococcus aureus and Pseudomonas aeruginosa with pulsed electric fields. BMC Microbiol 2019; 19:73. [PMID: 30943901 PMCID: PMC6448289 DOI: 10.1186/s12866-019-1447-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 03/28/2019] [Indexed: 02/07/2023] Open
Abstract
Background Skin infections, particularly caused by drug-resistant pathogens, represent a clinical challenge due to being a frequent cause of morbidity and mortality. The objectives of this study were to examine if low concentrations of acetic and formic acids can increase sensitivity of Staphylococcus aureus and Pseudomonas aeruginosa to pulsed electric field (PEF) and thus, promote a fast and efficient treatment methodology for wound treatment. Results We have shown that the combination of PEF (10–30 kV/cm) with organic acids (0.1% formic and acetic acids) increased the bactericidal properties of treatment. The effect was apparent for both acids. The proposed methodology allowed to reduce the energy of electrical pulses and the inhibitory concentrations of acids, while still maintain high efficiency of bacteria eradication. Conclusions Application of weak organic acids as bactericidal agents has many advantages over antibiotics because they do not trigger development of drug-resistance in bacteria. The combination with PEF can make the treatment effective even against biofilms. The results of this study are particularly useful for the development of new methodologies for the treatment of extreme cases of wound infections when the chemical treatment is no longer effective or hinders wound healing.
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Abstract
The emergence of antimicrobial drug resistance requires development of alternative therapeutic options. Multidrug-resistant strains of Enterococcus spp., Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa and Enterobacter spp. are still the most commonly identified antimicrobial-resistant pathogens. These microorganisms are part of the so-called 'ESKAPE' pathogens to emphasize that they currently cause the majority of hospital acquired infections and effectively 'escape' the effects of antibacterial drugs. Thus, alternative, safer and more efficient antimicrobial strategies are urgently needed, especially against 'ESKAPE' superbugs. Antimicrobial photodynamic inactivation is a therapeutic option used in the treatment of infectious diseases. It is based on a combination of a photosensitizer, light and oxygen to remove highly metabolically active cells.
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Tan Y, Cheng Q, Yang H, Li H, Gong N, Liu D, Wu J, Lei X. Effects of ALA-PDT on biofilm structure, virulence factor secretion, and QS in Pseudomonas aeruginosa. Photodiagnosis Photodyn Ther 2018; 24:88-94. [DOI: 10.1016/j.pdpdt.2018.07.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 06/05/2018] [Accepted: 07/06/2018] [Indexed: 10/28/2022]
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Schreiner M, Bäumler W, Eckl D, Späth A, König B, Eichner A. Photodynamic inactivation of bacteria to decolonize meticillin-resistant Staphylococcus aureus
from human skin. Br J Dermatol 2018; 179:1358-1367. [DOI: 10.1111/bjd.17152] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2018] [Indexed: 12/18/2022]
Affiliation(s)
- M. Schreiner
- Department of Dermatology; University Hospital Regensburg; Franz-Josef-Strauss-Allee 11 93053 Regensburg Germany
| | - W. Bäumler
- Department of Dermatology; University Hospital Regensburg; Franz-Josef-Strauss-Allee 11 93053 Regensburg Germany
| | - D.B. Eckl
- Institute of Microbiology; University of Regensburg; Regensburg Germany
| | - A. Späth
- TriOptoTec GmbH; Am Biopark 13 Regensburg Germany
| | - B. König
- Department of Organic Chemistry; University of Regensburg; Regensburg Germany
| | - A. Eichner
- Department of Dermatology; University Hospital Regensburg; Franz-Josef-Strauss-Allee 11 93053 Regensburg Germany
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da Collina GA, Freire F, Santos TPDC, Sobrinho NG, Aquino S, Prates RA, da Silva DDFT, Tempestini Horliana ACR, Pavani C. Controlling methylene blue aggregation: a more efficient alternative to treat Candida albicans infections using photodynamic therapy. Photochem Photobiol Sci 2018; 17:1355-1364. [PMID: 30183793 DOI: 10.1039/c8pp00238j] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Methylene Blue (MB) has been widely used in antimicrobial Photodynamic Therapy (aPDT), however, the mechanisms of action (Type I or Type II) are defined by its state of aggregation. In this sense, the identification of the relationships between aggregation, the mechanisms of action and the effectiveness against microorganisms, as well as the establishment of the means and the formulations that may favor the most effective mechanisms, are essential. Thus, the objective of this study was to assess the in vitro aPDT efficacies against Candida albicans, by using MB in vehicles which may influence the aggregation and present an oral formulation (OF) containing MB, to be used in clinical aPDT procedures. The efficacy of MB at 20 mg L-1 was tested in a range of vehicles (water, physiological solution - NaCl 0.9%, phosphate saline buffer - PBS, sodium dodecyl sulfate 0.25% - SDS and urea 1 mol L-1) in a C. albicans planktonic culture, when using 4.68 J cm-2 of 640 ± 12 nm LED for the irradiations, as well as 5 minutes of pre-irradiation time, together with measuring the UFC mL-1. Based upon these analyses, an OF containing MB in the most effective vehicle was tested in the biofilms, as a proposal for clinical applications. When comparing some of the vehicles, sodium dodecyl sulfate was the only one that enhanced an MB aPDT efficacy in a planktonic C. albicans culture. This OF was tested in the biofilms and 50 mg L-1 MB was necessary, in order to achieve some reduction in the cell viabilities after the various treatments. The light dosimetries still need further adaptations, in order for this formulation to be used in clinical applications. The present research has indicated that the development of this formulation for the control of MB aggregations may result in more effective clinical protocols.
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Affiliation(s)
- Gabriela Alves da Collina
- Post-Graduation Program of Biophotonics Applied to Health Sciences, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil.
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Photodynamic therapy as an alternative to antibiotic therapy for the treatment of infected leg ulcers. Photodiagnosis Photodyn Ther 2018; 23:132-143. [DOI: 10.1016/j.pdpdt.2018.05.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 03/25/2018] [Accepted: 05/02/2018] [Indexed: 12/29/2022]
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