Twice-daily red and blue light treatment for Candida albicans biofilm matrix development control

DNase enhances photodynamic therapy against fluconazole-resistant Candida albicans biofilms

OBJECTIVE

This study evaluated the effectiveness of DNase I combined with antimicrobial photodynamic therapy, mediated by Photodithazine^® and light-emitting diode light, against biofilms formed by a fluconazole-resistant Candida albicans strain (ATCC 96901) and two clinical isolates (R14 and R70).

MATERIALS AND METHODS

Biofilms were grown for 48 h and exposed to DNase for 5 min, followed by application of a photosensitizer (P) and light (L), either singly or combined (P+L+, P-L+, P+L-, P-L-, P-L-DNase, P+L+DNase, P+L-DNase, and P-L+DNase; n = 12). Biofilm analysis included quantification of extracellular matrix components (water-soluble and insoluble proteins and polysaccharides, and extracellular DNA), and biomass (total and insoluble), as well as enumeration of colony-forming units. The data were analyzed using three-way analysis of variance with Bonferroni's post-hoc test.

RESULTS

The DNase treatment combined with aPDT showed a reduction of 1.92, 1.65, and 1.29 log₁₀ of cell viability compared with untreated controls for ATCC 96901, R14, and R70 strains, respectively. It also reduced extracellular matrix contents of water-soluble polysaccharides (36.3%) and extracellular DNA (72.3%), as well as insoluble biomass content (43.3%).

CONCLUSION

The three strains showed similar behavior when treated with DNase, and the extracellular matrix components were affected, improving the effectiveness of antimicrobial photodynamic therapy.

Candida biofilm matrix as a resistance mechanism against photodynamic therapy

BACKGROUND

Antimicrobial photodynamic therapy (aPDT) efficiency on Candida albicans is recognized in free-floating cultures. Though, the lack of aPDT effectiveness against C. albicans organized in biofilms is still unclear. This study aimed to explore the role of the extracellular matrix (ECM) in the protection against aPDT in C. albicans biofilms.

METHODS

C. albicans SN 425 wild-type and two mutant strains CNJ 2302; Δ/Δefg1 and CJN 2330; Δ/Δtec1 (ECM deficient) were used. Biofilms were grown on 24-well plates and exposed twice-daily to aPDT with 44 μM toluidine blue-O (TBO) for 5 min followed by red light (635 nm) for 1 min (87.6 J/cm²) or 2 min (175.2 J/cm²). Application of just TBO, light, 0.12% chlorhexidine, and ultrapure water were used as controls. After 48 h, biofilms were assessed for dry-weight (DW), colony forming units (CFU), extracellular DNA (eDNA), soluble and insoluble protein (SP/IP), water-insoluble (alkali-soluble) polysaccharide (ASP), water-soluble polysaccharides (WSP), and confocal scanning laser microscopy.

RESULTS

The strains with ECM deficient were affected by aPDT. For the mutant strain Δ/Δefg1, aPDT significantly reduced CFU, ASP, DW, eDNA, WSP and IP when compared to NC (p<0.001) and for the Δ/Δtec1, aPDT significantly reduced CFU, eDNA, IP and SP. Whereas CFU, DW, ASP of the wild-type strain biofilms were not reduced (p>0.05).

CONCLUSIONS

C. albicans strains with reduced ECM compounds were more sensitive to aPDT suggesting that the ECM may have a significant protection role from aPDT in C. albicans biofilms.

Blue light & chlorhexidine therapies on Streptococcus mutans biofilm and its regrowth on an in vitro orthodontic model

INTRODUCTION

Fixed orthodontic appliances create areas of stagnation for dental biofilms and make it difficult to clean the teeth; therefore, there is a risk of developing incipient caries lesions during the orthodontic treatment. The objective of this study is to determine if the combination of 2 different therapies, phototherapy by blue light (BL) and the antimicrobial 0.12% chlorhexidine (CHX) on enamel, orthodontic brackets, and elastics, would reduce or inhibit mature Streptococcus mutans biofilms and their regrowth on these substrates 24 hours after the application of the treatment; and if this treatment would interfere with bracket adhesion to the enamel.

METHODS

Biofilms of S. mutans UA159 were formed for 5-days over samples composed of a bovine enamel, orthodontic bracket, and orthodontic elastic. Then, the specimens were treated with 0.89% NaCl for 1 minute, BL for 12 minutes (72 J/cm²), 0.12% CHX for 1 minute, and BL for 12 minutes, followed by 0.12% CHX for 1 minute (BL+CHX). Biofilm was evaluated by colonies forming units and dry weight immediately after treatments and 24 hours after treatments (regrowth). The pH of the spent media was measured on the fifth and sixth days. Biofilm formation on the samples after the treatments and regrowth was visually evaluated by confocal laser scanning microscopy. Shear bond strength (SBS) between bracket and enamel was evaluated using a universal testing machine at a crosshead speed of 1 mm/min. After bonding, specimens were thermocycled (500× at 5-55°C), treated, and thermocycled again.

RESULTS

After 5 days of biofilm formation, BL+CHX significantly reduced the bacterial viability on enamel compared with NaCl (P = 0.004) and BL (P = 0.014). For bracket and elastic, all the treatments resulted in similar bacterial viability (P ≥0.081). In the regrowth, CHX and BL+CHX significantly reduced the bacterial viability in the enamel compared with the NaCl (P ≤0.015) and BL (P ≤0.013). For bracket, BL+CHX significantly reduced the bacterial viability compared with NaCl (P = 0.008) and BL (P = 0.009). For the elastic, BL+CHX eliminated the biofilms from the substrate. CHX and BL+CHX significantly reduced the bacterial viability 24 hours after treatment for all substrates (P ≤0.05). The media pH significantly increased when samples were treated with CHX and BL+CHX (P ≤0.001). Confocal laser scanning microscopy images visually showed an abundant quantity of red cells in the samples treated with BL+CHX. There was no difference in the SBS between the treatments (P ≥0.932).

CONCLUSIONS

The association between BL and CHX reduced S. mutans biofilm and its regrowth on an in vitro orthodontic model and did not influence the bonding strength between bracket and enamel.

Light Signaling Regulates Aspergillus niger Biofilm Formation by Affecting Melanin and Extracellular Polysaccharide Biosynthesis

Light is an important signal source in nature, which regulates the physiological cycle, morphogenetic pathways, and secondary metabolites of fungi. As an external pressure on Aspergillus niger, light signaling transmits stress signals into the cell via the mitogen-activated protein kinase (MAPK) signaling pathway. Studying the effect of light on the biofilm of A. niger will provide a theoretical basis for light in the cultivation of filamentous fungi and industrial applications. Here, the characterization of A. niger biofilm under different light intensities confirmed the effects of light signaling. Our results indicated that A. niger intensely accumulated protective mycelial melanin under light illumination. We also discovered that the RlmA transcription factor in the MAPK signaling pathway is activated by light signaling to promote the synthesis of melanin, chitin, and other exopolysaccharides. However, the importance of melanin to A. niger biofilm is rarely reported; therefore, we knocked out key genes of the melanin biosynthetic pathway—Abr1 and Ayg1. Changes in hydrophobicity and electrostatic forces resulted in the decrease of biofilm caused by the decrease of melanin in mutants.

Consecutive treatments with photodynamic therapy and nystatin altered the expression of virulence and ergosterol biosynthesis genes of a fluconazole-resistant Candida albicans in vivo

This investigation assessed the effect of five consecutive daily topical treatments of antimicrobial photodynamic therapy (aPDT), nystatin (NYS), and an association of treatments on a fluconazole-resistant strain of Candida albicans colonizing the tongues of mice. After the last treatments application, colonies of C. albicans were recovered from the tongues and used to determine their fluconazole susceptibility. After 24 hours of the last treatment, the mice tongues were processed to evaluate the expression of C. albicans genes related to the virulence and ergosterol production. The fluconazole susceptibility test yielded a resistance profile similar for all treatment groups and the control group (no treatment). The treatments aPDT, NYS, NYS+aPDT, and aPDT+NYS promoted a reduction in ALS1, EFG1, CAP1, SOD1, SAP1, and LIP3 expression. The expression of HWP1 was higher in the three groups containing nystatin. In contrast, the treatments produced a significative increase in CAT1 gene expression, mainly in the groups in which aPDT was performed. The expression of genes related to ergosterol production was significantly reduced by the treatments evaluated (aPDT, NYS, NYS+aPDT, and aPDT+NYS). Thus, the consecutive topical treatments performed on mice tongues promoted a reduction in the expression of virulence and ergosterol biosynthesis genes of a fluconazole-resistant C. albicans.

Evidence-Based Review of Antibiofilm Agents for Wound Care

Significance: Biofilms in vivo are small densely packed aggregations of microbes that are highly resistant to host immune responses and treatment. They attach to each other and to nearby surfaces. Biofilms are difficult to study and identify in a clinical setting as their quantification necessitates the use of advanced microscopy techniques such as confocal laser scanning microscopy. Nonetheless, it is likely that biofilms contribute to the pathophysiology of chronic skin wounds. Reducing, removing, or preventing biofilms is thus a logical approach to help clinicians heal chronic wounds. Recent Advances: Wound care products have demonstrated varying degrees of efficacy in destroying biofilms in in vitro and preclinical models, as well as in some clinical studies. Critical Issues: Controlled studies exploring the beneficial role of biofilm eradication and its relationship to healing in patients with chronic wounds are limited. This review aims to discuss the mode of action and clinical significance of currently available antibiofilm products, including surfactants, dressings, and others, with a focus on levels of evidence for efficacy in disrupting biofilms and ability to improve wound healing outcomes. Future Directions: Few available products have good evidence to support antibiofilm activity and wound healing benefits. Novel therapeutic strategies are on the horizon. More high-quality clinical studies are needed. The development of noninvasive techniques to quantify biofilms will facilitate increased ease of research about biofilms in wounds and how to combat them.

Regimen and different surfaces interfere with photodynamic therapy on Candida albicans biofilms

The aim of this study is to compare antimicrobial photodynamic therapy (aPDT) against Candida albicans biofilms formed on two different substrates - acrylic resin or bottom of polystyrene plate; and two aPDT application regimens - twice-daily over the course of 48 h or single treatment after 48 h biofilm formation. C. albicans SN425 biofilms cultivated on Roswell Park Memorial Institute medium were incubated for 5 min with toluidine blue O (44 μM) used as a photosensitizer before red light (635 nm; 175.2 J/cm2) exposure for 2 min. As negative control, ultrapure water, and as positive control 0.12% chlorhexidine (CHX) were used. Biofilms were analyzed for colony forming units (CFU) and cells morphology by confocal scanning laser microscopy. Single treatment and twice-daily aPDT on polystyrene plate and single treatment on acrylic resin did not significantly reduce the CFU (p > 0.05); in contrast, twice-daily aPDT on acrylic resin has reduced C. albicans below the detection limit, similarly to CHX treatment. Single aPDT treatment on polystyrene plate and on the resin presented a bulky and homogeneous biofilm predominantly formed by pseudohyphae. In contrast, in the resin group, the biofilm treated twice-daily with aPDT was predominantly formed by yeast cells, whilst pseudohyphae were occasionally visible. In conclusion, biofilms formed on polystyrene plates are more resistant to aPDT than biofilms formed on acrylic resin. Moreover, applying aPDT twice-daily reduces C. albicans biofilm development on acrylic resin and is a better approach against C. albicans biofilms than one single application on the mature biofilm.

Antimicrobial photodynamic therapy reduces gene expression of Candida albicans in biofilms

The present study evaluated whether the oxidative stress caused by antimicrobial photodynamic therapy (aPDT) affects the expression of C. albicans genes related to adhesion and biofilm formation (ALS1 and HPW1) and oxidative stress response (CAP1, CAT1, and SOD1). The aPDT was mediated by two photosensitizing agents (PSs) Photodithazine® (PDZ at 100 and 200 mg/L) or Curcumin (CUR at 40 and 80 μM) and LED (37.5 J/cm² or 50 J/cm²). The quantification of the expression was performed by Reverse Transcription-Quantitative Polymerase Chain Reaction (RT-qPCR) using specific primers for the target genes. The data were analyzed by Analysis of Variance (α = 0.05), followed by Tukey's post-test. It was observed reduction in the expression of ALS1, HWP1, CAP1, CAT1, and SOD1 when aPDT was performed using 200 mg/L PDZ and 80 μM CUR associated to LED (37.7 and 50 J/cm², respectively) and using 100 mg/L PDZ and 40 μM CUR with LED of 50 J/cm² (versus control). Also, the expression of CAP1 and SOD1 genes was reduced after aPDT using 100 mg/L PDZ and LED of 37.5 J/cm². There was a significant reduction in the expression of genes HWP1, CAP1, and SOD1 after aPDT using 40 μM CUR and 37.5 J/cm² (versus the control group). The application of LED only at 37.5 and 50 J/cm² promoted down-regulation of ALS1, CAP1, CAT1, and SOD1 genes (versus the control group). Therefore, aPDT mediated by LED -associated PSs PDZ and CUR promoted a reduction in the expression of the five C. albicans genes evaluated.