High-resolution bimodal imaging and potent antibiotic/photodynamic synergistic therapy for osteomyelitis with a bacterial inflammation-specific versatile agent

Crosslinked hybrid polymer/ceramic composite coatings for the controlled release of clindamycin

A major risk associated with surgery, including bone tissue procedures, is surgical site infection. It is one of the most common as well as the most serious complications of modern surgery. A helpful countermeasure against infection is antibiotic therapy. In the present study, a methodology has been developed to obtain clindamycin-modified polymer-ceramic hybrid composite coatings for potential use in bone regenerative therapy. The coatings were prepared using a UV-light photocrosslinking method, and the drug was bound to a polymeric and/or ceramic phase. The sorption capacity of the materials in PBS was evaluated by determining the swelling ability and equilibrium swelling. The influence of the presence of ceramics on the amount of liquid bound was demonstrated. The results were correlated with the rate of drug release measured by high-performance liquid chromatography (HPLC). Coatings with higher sorption capacity released the drug more rapidly. Scanning electron microscopy (SEM) imaging was carried out comparing the surface area of the coatings before and after immersion in PBS, and the proportions of the various elements were also determined using the EDS technique. Changes in surface waviness were observed, and chlorine ions were also determined in the samples before incubation. This proves the presence of the drug in the material. The in vitro tests conducted indicated the release of the drug from the biomaterials. The antimicrobial efficacy of the coatings was tested against Staphylococcus aureus. The most promising material was tested for cytocompatibility (MTT reduction assay) against the mouse fibroblast cell line L929 as well as human osteoblast cells hFOB. It was demonstrated that the coating did not exhibit cytotoxicity. Overall, the results signaled the potential use of the developed polymer-ceramic hybrid coatings as drug carriers for the controlled delivery of clindamycin in bone applications. The studies conducted were the basis for directing samples for further in vivo experiments determining clinical efficacy.

3D Printed Photothermal Scaffold Sandwiching Bacteria Inside and Outside Improves The Infected Microenvironment and Repairs Bone Defects

Bone infection is one of the most devastating orthopedic outcomes, and overuse of antibiotics may cause drug-resistance problems. Photothermal therapy(PTT) is a promising antibiotic-free strategy for treating infected bone defects. Considering the damage to normal tissues and cells caused by high-temperature conditions in PTT, this study combines the antibacterial property of Cu to construct a multi-functional Cu2 O@MXene/alpha-tricalcium phosphate (α-TCP) scaffold support with internal and external sandwiching through 3D printing technology. On the "outside", the excellent photothermal property of Ti3 C2 MXene is used to carry out the programmed temperature control by the active regulation of 808 nm near-infrared (NIR) light. On the "inside", endogenous Cu ions gradually release and the release accumulates within the safe dose range. Specifically, programmed temperature control includes brief PTT to rapidly kill early bacteria and periodic low photothermal stimulation to promote bone tissue growth, which reduces damage to healthy cells and tissues. Meanwhile, Cu ions are gradually released from the scaffold over a long period of time, strengthening the antibacterial effect of early PTT, and promoting angiogenesis to improve the repair effect. PTT combined with Cu can deliver a new idea forinfected bone defects through in vitro and vivo application.

Cell membrane-coated biomimetic nanomedicines: productive cancer theranostic tools

As the second-leading cause of human death, cancer has drawn attention in the area of biomedical research and therapy from all around the world. Certainly, the development of nanotechnology has made it possible for nanoparticles (NPs) to be used as a carrier for delivery systems in the treatment of tumors. This is a biomimetic approach established to craft remedial strategies comprising NPs cloaked with membrane obtained from various natural cells like blood cells, bacterial cells, cancer cells, etc. Here we conduct an in-depth exploration of cell membrane-coated NPs (CMNPs) and their extensive array of applications including drug delivery, vaccination, phototherapy, immunotherapy, MRI imaging, PET imaging, multimodal imaging, gene therapy and a combination of photothermal and chemotherapy. This review article provides a thorough summary of the most recent developments in the use of CMNPs for the diagnosis and treatment of cancer. It critically assesses the state of research while recognizing significant accomplishments and innovations. Additionally, it indicates ongoing problems in clinical translation and associated queries that warrant deeper research. By doing so, this study encourages creative thinking for future projects in the field of tumor therapy using CMNPs while also educating academics on the present status of CMNP research.

Molecularly Engineered Room-Temperature Phosphorescence for Biomedical Application: From the Visible toward Second Near-Infrared Window

Phosphorescence, characterized by luminescent lifetimes significantly longer than that of biological autofluorescence under ambient environment, is of great value for biomedical applications. Academic evidence of fluorescence imaging indicates that virtually all imaging metrics (sensitivity, resolution, and penetration depths) are improved when progressing into longer wavelength regions, especially the recently reported second near-infrared (NIR-II, 1000-1700 nm) window. Although the emission wavelength of probes does matter, it is not clear whether the guideline of "the longer the wavelength, the better the imaging effect" is still suitable for developing phosphorescent probes. For tissue-specific bioimaging, long-lived probes, even if they emit visible phosphorescence, enable accurate visualization of large deep tissues. For studies dealing with bioimaging of tiny biological architectures or dynamic physiopathological activities, the prerequisite is rigorous planning of long-wavelength phosphorescence, being aware of the cooperative contribution of long wavelengths and long lifetimes for improving the spatiotemporal resolution, penetration depth, and sensitivity of bioimaging. In this Review, emerging molecular engineering methods of room-temperature phosphorescence are discussed through the lens of photophysical mechanisms. We highlight the roles of phosphorescence with emission from visible to NIR-II windows toward bioapplications. To appreciate such advances, challenges and prospects in rapidly growing studies of room-temperature phosphorescence are described.

Biocompatible copper formate-based nanoparticles with strong antibacterial properties for wound healing

Copper-based antibacterial materials have emerged as a potential alternative for combating bacterial infections, which continue to pose significant health risks. Nevertheless, the use of copper-based nanoparticles as antibacterial agents has faced challenges due to their toxicity towards cells and tissues. To overcome this obstacle, we propose a new approach using a contact-active copper-based nanoparticles called polydopamine (PDA)-coated copper-amine (Cuf-TMB@PDA). The positively charged surface of Cuf-TMB@PDA enables efficient targeting of negatively charged bacteria, allowing controlled release of Cu(II) into the bacterial cell membrane. Moreover, Cuf-TMB@PDA exhibits similar ·OH signals as Cuf-TMB suspensions in previous work. In cytotoxicity assays conducted over 72 h, Cuf-TMB@PDA demonstrated an efficacy of 98.56%, while releasing lower levels of Cu(II) that were less harmful to cells, resulting in enhanced antimicrobial effects. These antimicrobial properties are attributed to the synergistic effects of charge-contact activity of PDA, controlled release of Cu(II), and free radicals. Subsequent in vivo experiments confirmed the strong antimicrobial potency of Cuf-TMB@PDA and its ability to promote wound healing.

Stimuli-Actuated Turn-On Theranostic Nanoplatforms for Imaging-Guided Antibacterial Treatment

Antibacterial theranostic nanoplatforms, which integrate diagnostic and therapeutic properties, exhibit gigantic application prospects in precision medicine. However, traditional theranostic nanoplatforms usually present an always-on signal output, which leads to poor specificity or selectivity in the treatment of bacterial infections. To address this challenge, stimuli-actuated turn-on nanoplatforms are developed for simultaneous activation of diagnostic signals (e.g., fluorescent, photoacoustic, magnetic signals) and initiation of antibacterial treatment. Specifically, by combining the infection microenvironment-responsive activation of visual signals and antibacterial activity, these theranostic nanoplatforms exert both higher accurate diagnosis rates and more effective treatment effects. In this review, the imaging and treatment strategies that are commonly used in the clinic are first briefly introduced. Next, the recent progress of stimuli-actuated turn-on theranostic nanoplatforms for treating bacterial infectious diseases is summarized in detail. Finally, current bottlenecks and future opportunities of antibacterial theranostic nanoplatforms are also outlined and discussed.

One-pot synthesis of ultra-stable polyvinylpyrrolidone-modified MnO2 nanoparticles for efficient radiation protection

Radiobiological damage can be caused by radiation, and easy preparation of long-term stable radioprotectors is helpful for timely and efficient response to radiation emergencies. This study develops an ultra-stable radioprotector for rapid nuclear emergency with a simple preparing method. First of all, polyvinylpyrrolidone-modified MnO2 nanoparticles (PVP-MnO2 NPs) are obtained by one-pot synthesis with ultra-stability (remaining for at least three years) and multiple free radical scavenging activities. In the synthesis process, PVP acts as a reducing agent, a surfactant (soft template), and a steric stabilizer. PVP-MnO2 NPs can improve the survival rates of irradiated cells by effectively scavenging free radicals and protecting DNA from radiation damage. Besides, PVP-MnO2 NPs can also prevent peripheral blood cell and organ damage induced by radiation, and improve the survival rate of irradiated mice. Finally, PVP-MnO2 NPs are mainly metabolized by liver and kidney in mice, and basically excreted 72 h after administration. These results indicate that PVP-MnO2 NPs exhibit good biosafety and radioprotection activity, which is significant for the development of radioprotection agents.

Therapeutic application of manganese-based nanosystems in cancer radiotherapy

Radiotherapy is an important therapeutic modality in the treatment of cancers. Nevertheless, the characteristics of the tumor microenvironment (TME), such as hypoxia and high glutathione (GSH), limit the efficacy of radiotherapy. Manganese-based (Mn-based) nanomaterials offer a promising prospect for sensitizing radiotherapy due to their good responsiveness to the TME. In this review, we focus on the mechanisms of radiosensitization of Mn-based nanosystems, including alleviating tumor hypoxia, increasing reactive oxygen species production, increasing GSH conversion, and promoting antitumor immunity. We further illustrate the applications of these mechanisms in cancer radiotherapy, including the development and delivery of radiosensitizers, as well as their combination with other therapeutic modalities. Finally, we summarize the application of Mn-based nanosystems as contrast agents in realizing precision therapy. Hopefully, the present review will provide new insights into the biological mechanisms of Mn-based nanosystems, as well as their applications in radiotherapy, in order to address the difficulties and challenges that remain in their clinical application in the future.

Magnetic Resonance Diagnosis of Early Triple-Negative Breast Cancer Based on the Ionic Covalent Organic Framework with High Relaxivity and Long Retention Time

Patients with triple-negative breast cancer (TNBC) have dismal prognoses due to the lack of therapeutic targets and susceptibility to lymph node (LN) metastasis. Therefore, it is essential to develop more effective approaches to identify early TNBC tissues and LNs. In this work, a magnetic resonance imaging (MRI) contrast agent (Mn-iCOF) was constructed based on the Mn(II)-chelated ionic covalent organic framework (iCOF). Because of the porous structure and hydrophilicity, the Mn-iCOF has a high longitudinal relaxivity (r₁) of 8.02 mM^-1 s^-1 at 3.0 T. For the tumor-bearing mice, a lower dose (0.02 mmol [Mn]/kg) of Mn-iCOF demonstrated a higher signal-to-noise ratio (SNR) value (1.8) and longer retention time (2 h) compared to a 10-fold dose of commercial Gd-DOTA (0.2 mmol [Gd]/kg). Moreover, the Mn-iCOF can provide continuous and significant MR contrast for the popliteal LNs within 24 h, allowing for accurate evaluation and dissection of LNs. These excellent MRI properties of the Mn-iCOF may open new avenues for designing more biocompatible MRI contrast agents with higher resolutions, particularly in the diagnosis of TNBC.

NIR-II xanthene dyes with structure-inherent bacterial targeting for efficient photothermal and broad-spectrum antibacterial therapy

Development of novel broad-spectrum sterilization is an efficient strategy that can overcome drug resistance and avoid antibiotics abuse toward bacterial-infected diseases. Photothermal therapy (PTT) in the second near-infrared (NIR-II) therapeutic window with an increased tissue penetration and elevated maximal permissible exposure has attracted considerable attention in antibacterial applications. However, the lack of bacterial-targeted photothermal agents limits their further development. Herein, we developed three xanthene derivatives (CNs) with intense light harvesting ability around 1180 nm. Their bulky planar conformations facilitated the formation of H-aggregates with outstanding photothermal conversion ability and good photostability in the NIR-II therapeutic bio window. By manipulating side chains of CNs, their liposomes exhibited different surface charges, ranging from negative to positive. Remarkably, the intermolecular hydrogen bonding of CN3 dimer drived the positively charged xanthene skeleton exposed to the periphery, which endowed it natural bacterial targeting potency. Therefore, CN3 possessed a good NIR-II photothermal and broad-spectrum sterilization against Gram-positive and Gram-negative bacteria. The photothermal antibacterial activities for S. aureus and E. coli were 99.4% and 99.2%, respectively, promoting significant wound healing in bacteria-infected mice with superior biocompatibility. This structure-inherent bacterial targeting strategy as a proof-of-concept shows an efficient broad-spectrum bacterial inactivation, indicating more encouraging NIR-II photothermal antibacterial therapy. STATEMENT OF SIGNIFICANCE: Photothermal therapy (PTT) in the second near-infrared region (NIR-II, 1000-1700 nm) enables the treatment of deep inflammation more satisfactory due to higher tissue penetration depth. In this work, three new NIR-II xanthene derivatives (CNs) with intense light harvesting ability around 1180 nm were developed. CNs showed typical H-aggregated performance with bulky planar conformations and outstanding photothermal conversion ability. Density functional theory calculations revealed that the intermolecular hydrogen bonding of CN3 dimer drived the exposure of positively charged xanthene skeleton to periphery of dimer. Therefore, CN3 NPs possessed natural bacterial targeting potency and excellent NIR-II photothermal and broad-spectrum sterilization, and so as to significantly promote the wound healing of Gram-positive / negative bacteria infected mice.

Recent Advances in Contrast-Enhanced Photoacoustic Imaging: Overcoming the Physical and Practical Challenges

For decades now, photoacoustic imaging (PAI) has been investigated to realize its potential as a niche biomedical imaging modality. Despite its highly desirable optical contrast and ultrasonic spatiotemporal resolution, PAI is challenged by such physical limitations as a low signal-to-noise ratio (SNR), diminished image contrast due to strong optical attenuation, and a lower-bound on spatial resolution in deep tissue. In addition, contrast-enhanced PAI has faced practical limitations such as insufficient cell-specific targeting due to low delivery efficiency and difficulties in developing clinically translatable agents. Identifying these limitations is essential to the continuing expansion of the field, and substantial advances in developing contrast-enhancing agents, complemented by high-performance image acquisition systems, have synergistically dealt with the challenges of conventional PAI. This review covers the past four years of research on pushing the physical and practical challenges of PAI in terms of SNR/contrast, spatial resolution, targeted delivery, and clinical application. Promising strategies for dealing with each challenge are reviewed in detail, and future research directions for next generation contrast-enhanced PAI are discussed.

Immunomodulatory activity of manganese dioxide nanoparticles: Promising for novel vaccines and immunotherapeutics

Manganese (Mn), a nutrient inorganic trace element, is necessary for a variety of physiological processes of animal body due to their important roles in oxidative regulation effects and other aspects of activities. Moreover, manganese ion (Mn²⁺) has widely reported to be crucial for the regulations of different immunological responses, thus showing promising application as potential adjuvants and immunotherapeutics. Taking the advantages of Mn-based biological and immunological activities, Manganese dioxide nanoparticles (MnO₂ NPs) are a new type of inorganic nanomaterials with numerous advantages, including simple preparation, low cost, environmental friendliness, low toxicity, biodegradable metabolism and high bioavailability. MnO₂ NPs, as a kind of drug carrier, have also shown the ability to catalyze hydrogen peroxide (H₂O₂) to produce oxygen (O₂) under acidic conditions, which can enhance the efficacy of radiotherapy, chemotherapy and other therapeutics for tumor treatment by remodeling the tumor microenvironment. More importantly, MnO₂ NPs also play important roles in immune regulations both in innate and adaptive immunity. In this review, we summarize the biological activities of Manganese, followed by the introduction for the biological and medical functions and mechanisms of MnO₂ NPs. What's more, we emphatically discussed the immunological regulation effects and mechanisms of MnO₂ NPs, as well as their potentials to serve as adjuvants and immunomodulators, which might benefit the development of novel vaccines and immunotherapies for more effective disease control.

Advances in image-guided drug delivery for antibacterial therapy

The emergence of antibiotic-resistant bacterial strains is seriously endangering the global healthcare system. There is an urgent need for combining imaging with therapies to realize the real-time monitoring of pathological condition and treatment progress. It also provides guidance on exploring new medicines and enhance treatment strategies to overcome the antibiotic resistance of existing conventional antibiotics. In this review, we provide a thorough overview of the most advanced image-guided approaches for bacterial diagnosis (e.g., computed tomography imaging, magnetic resonance imaging, photoacoustic imaging, ultrasound imaging, fluorescence imaging, positron emission tomography, single photon emission computed tomography imaging, and multiple imaging), and therapies (e.g., photothermal therapy, photodynamic therapy, chemodynamic therapy, sonodynamic therapy, immunotherapy, and multiple therapies). This review focuses on how to design and fabricate photo-responsive materials for improved image-guided bacterial theranostics applications. We present a potential application of different image-guided modalities for both bacterial diagnosis and therapies with representative examples. Finally, we highlighted the current challenges and future perspectives image-guided approaches for future clinical translation of nano-theranostics in bacterial infections therapies. We envision that this review will provide for future development in image-guided systems for bacterial theranostics applications.

Photoacoustic imaging for the study of oxygen saturation and total hemoglobin in bone healing and non-union formation

Non-union formation represents a major complication in trauma surgery. Adequate vascularization has been recognized as vital for bone healing. However, the role of vascularization in the pathophysiology of non-union formation remains elusive. This is due to difficulties in studying bone microcirculation in vivo. Therefore, we herein studied in a murine osteotomy model whether photoacoustic imaging may be used to analyze vascularization in bone healing and non-union formation. We found that oxygen saturation within the callus tissue is significantly lower in non-unions compared to unions and further declines over time. Moreover, the amount of total hemoglobin (HbT) within the callus tissue was markedly reduced in non-unions. Correlation analyses showed a strong positive correlation between microvessel density and HbT, indicating that photoacoustically determined HbT is a valid parameter to assess vascularization during bone healing. In summary, photoacoustic imaging is a promising approach to study vascular function and tissue oxygenation in bone regeneration.

Magnetic Composite Rapidly Treats Staphylococcus aureus-Infected Osteomyelitis through Microwave Strengthened Thermal Effects and Reactive Oxygen Species

It is difficult to effectively treat bacterial osteomyelitis using photothermal therapy or photodynamic therapy due to poor penetration of light. Here, a microwave (MW)-excited magnetic composite of molybdenum disulfide (MoS₂ ) / iron oxide (Fe₃ O₄ ) is reported for the treatment of bacteria-infected osteomyelitis. In in vitro and in vivo experiments, MoS₂ /Fe₃ O₄ is shown to effectively eradicate bacteria-infected mouse tibia osteomyelitis, due to MW thermal enhancement and reactive oxygen species (ROS) (¹ O₂ and ·O₂ ^- ) production under MW radiation. In addition, the mechanism of MW heat generation is proposed by MW network vector analysis. By the density functional theory and finite element method, the ROS generation mechanism is proposed. The synergy or conductive network between dielectric MoS₂ and magnetic Fe₃ O₄ can reach both enhancement of the dielectric and magnetic attenuation capability. In addition, abundant interfaces are generated to enhance the attenuation of electromagnetic waves by MoS₂ and Fe₃ O_4, introducing multiple reflections and interfacial polarization. Therefore, MoS₂ /Fe₃ O₄ has excellent MW absorption ability based on the synergy or conductive network between MoS₂ and magnetic Fe₃ O₄ as well as multiple dielectric reflections and interfacial polarization.

Water-Enabled H2 Generation from Hydrogenated Silicon Nanosheets for Efficient Anti-Inflammation

As an emerging therapeutic gas, hydrogen (H₂) is gifted with excellent biosafety, high tissue permeability, and radical-trapping capacity and is extensively considered as a highly promising antioxidant in clinics. However, a facile and effective strategy of H₂ production for major inflammatory disease treatments is still lacking. In this study, by a facile wet-chemical exfoliation synthesis, a hydrogen-terminated silicon nanosheet (H-silicene) has been synthesized, which can favorably react with environmental water to generate H₂ rapidly and continuously without any external energy input. Furthermore, theoretical calculations were employed to reveal the mechanism of enhanced H₂ generation efficacy of H-silicene nanosheets. The as-synthesized H-silicene has been explored as a flexible hydrogen gas generator for efficient antioxidative stress application for the first time, which highlights a promising prospect of this two-dimensional H-silicene nanomaterial for acute inflammatory treatments by on-demand H₂ production-enabled reactive oxygen species scavenging. This study provides a novel and efficient modality for nanomaterial-mediated H₂ therapy.

NIR-PTT/ROS-Scavenging/Oxygen-Enriched Synergetic Therapy for Rheumatoid Arthritis by a pH-Responsive Hybrid CeO2-ZIF-8 Coated with Polydopamine

Rheumatoid arthritis (RA) is an inflammatory type of arthritis that causes joint pain and damage. The inflammatory cell infiltration (e.g., M1 macrophages), the poor O₂ supply at the joint, and the excess reactive oxygen species (ROS)-induced oxidative injury are the main causes of RA. We herein report a polydopamine (PDA)-coated CeO₂-dopped zeolitic imidazolate framework-8 (ZIF-8) nanocomposite CeO₂-ZIF-8@PDA (denoted as CZP) that can synergistically treat RA. Under near-infrared (NIR) light irradiation, PDA efficiently scavenges ROS and results in an increased temperature in the inflamed area because of its good light-to-heat conversion efficiency. The rise of temperature serves to obliterate hyper-proliferative inflammatory cells accumulated in the diseased area while vastly promoting the collapse of the acidic-responsive skeleton of ZIF-8 to release the encapsulated CeO₂. The released CeO₂ exerts its catalase-like activity to relieve hypoxia by generating oxygen via the decomposition of H₂O₂ highly expressed in the inflammatory sites. Thus, the constructed CZP composite can treat RA through NIR-photothermal/ROS-scavenging/oxygen-enriched combinative therapy and show good regression of pro-inflammatory cytokines and hypoxia-inducible factor-1α (HIF-1α) in vitro and promising therapeutic effect on RA in rat models. The multimodal nano-platform reported herein is expected to shed light on the design of synergistic therapeutic nanomedicine for effective RA therapy.

Antimicrobial Photodynamic Therapy Involving a Novel Photosensitizer Combined With an Antibiotic in the Treatment of Rabbit Tibial Osteomyelitis Caused by Drug-Resistant Bacteria

Osteomyelitis is deep tissue inflammation caused by bacterial infection. If such an infection persists, it can lead to dissolution and necrosis of the bone tissue. As a result of the extensive use of antibiotics, drug-resistant bacteria are an increasingly common cause of osteomyelitis, limiting the treatment options available to surgeons. Photodynamic antibacterial chemotherapy has attracted increasing attention as a potential alternative treatment. Its advantages are a broad antibacterial spectrum, lack of drug resistance, and lack of toxic side effects. In this study, we explored the impact of the new photosensitizer LD4 in photodynamic antimicrobial chemotherapy (PACT), both alone and in combination with an antibiotic, on osteomyelitis. A rabbit tibial osteomyelitis model was employed and microbiological, histological, and radiological studies were performed. New Zealand white rabbits (n = 36) were randomly divided into a control group, antibiotic group, PACT group and PACT + antibiotic group for treatment. In microbiological analysis, a reduction in bacterial numbers of more than 99.9% was recorded in the PACT group and the PACT + antibiotic group 5 weeks after treatment (p < 0.01). In histological analysis, repair of the damaged bone tissue was observed in the PACT group, and bone repair in the PACT + antibiotic group was even more significant. In radiological analysis, the X-ray Norden score showed that the severity of bone tissue defects or destruction followed the pattern: PACT + antibiotic group < PACT group < antibiotic group < control group.

Recent advances in nanoparticle-based targeting tactics for antibacterial photodynamic therapy

Abstract

The rise of antibacterial drug resistance means treatment options are becoming increasingly limited. We must find ways to tackle these hard-to-treat drug-resistant and biofilm infections. With the lack of new antibacterial drugs (such as antibiotics) reaching the clinics, research has switched focus to exploring alternative strategies. One such strategy is antibacterial photodynamic therapy (aPDT), a system that relies on light, oxygen, and a non-toxic dye (photosensitiser) to generate cytotoxic reactive oxygen species. This technique has already been shown capable of handling both drug-resistant and biofilm infections but has limited clinical approval to date, which is in part due to the low bioavailability and selectivity of hydrophobic photosensitisers. Nanotechnology-based techniques have the potential to address the limitations of current aPDT, as already well-documented in anti-cancer PDT. Here, we review recent advances in nanoparticle-based targeting tactics for aPDT.

Graphical Abstract

A Dual-Modal Magnetic Resonance/Photoacoustic Imaging Tracer for Long-Term High-Precision Tracking and Facilitating Repair of Peripheral Nerve Injuries

Neuroanatomical tracing is considered a crucial technique to assess the axonal regeneration level after injury, but traditional tracers do not meet the needs of in vivo neural tracing in deep tissues. Magnetic resonance (MR) and photoacoustic (PA) imaging have high spatial resolution, great penetration depth, and rich contrast. Fe₃ O₄ nanoparticles may work well as a dual-modal diagnosis probe for neural tracers, with the potential to improve nerve regeneration. The present study combines antegrade neural tracing imaging therapy for the peripheral nervous system. Fe₃ O₄ @COOH nanoparticles are successfully conjugated with biotinylated dextran amine (BDA) to produce antegrade nano-neural tracers, which are encapsulated by microfluidic droplets to control leakage and allow sustained, slow release. They have many notable advantages over traditional tracers, including dual-modal real-time MR/PA imaging in vivo, long-duration release effect, and limitation of uncontrolled leakage. These multifunctional anterograde neural tracers have potential neurotherapeutic function, are reliable and may be used as a new platform for peripheral nerve injury imaging and treatment integration.

Manganese oxide nanomaterials for bacterial infection detection and therapy

Bacterial infection has received substantial attention and poses a serious threat to human health. Although antibiotics can effectively fight against bacterial infection, the occurrence of antibiotic resistance has become increasingly serious in recent years, which tremendously hinders its clinical application. Consequently, it is urgent to explore novel strategies to achieve efficacious treatment of bacterial diagnosis and detection. Manganese dioxide (MnO₂) nanomaterial has been extensively reported in tumor therapy. Nevertheless, there are few antibacterial reviews of MnO₂. Herein, we will discuss the applications of MnO₂ in the detection and treatment of bacterial infection, including photodynamic therapy, immunotherapy, improvement of hypoxia, dual-modal combination therapy, reactive oxygen species scavenging, magnetic resonance imaging, optical application of acoustic imaging, and so forth. This review is expected to provide meaningful guidance on further research of MnO₂ nanomaterial for antibacterial applications.

Ultrasonic Interfacial Engineering of MoS2 -Modified Zn Single-Atom Catalysts for Efficient Osteomyelitis Sonodynamic Ion Therapy

Osteomyelitis is considered as the most serious bone infection, which can lead to the bone destruction or fatal sepsis. Clinical treatments through frequent antibiotics administration and surgical debridement bring inevitable side effects including drug-resistance and disfigurements. It is urgent to develop an antibiotics-free and rapid strategy to treat osteomyelitis. Herein, a bifunctional sonosensitizer that consists of porphyrin-like Zn single-atom catalysts (g-ZnN₄ ) and MoS₂ quantum dots is developed, which exhibits excellent sonodynamic antibacterial efficiency and osteogenic ability. It is found that the construction of heterogeneous interfaces of g-ZnN₄ -MoS₂ fully activates the adsorbed O₂ due to the increased interface charge transfer, enhanced spin-flip, and reduced activation energy of O₂ . The generated ¹ O₂ can kill methicillin-resistant Staphylococcus aureus (MRSA) with an antibacterial efficiency of 99.58% under 20 min of ultrasound (US) irradiation. The Zn single atoms immobilized in g-ZnN₄ can be released steadily in the form of Zn²⁺ for 28 days within safe concentration, realizing the great osteoinductive ability of such a sonosensitizer. For the treatment of MRSA-infected osteomyelitis, the inflammation and bone loss can be significantly suppressed through sonodynamic ion therapy. This work provides another strategy for developing high efficiency sonosensitizer through ultrasound interfacial engineering.

Photo-Sono Interfacial Engineering Exciting the Intrinsic Property of Herbal Nanomedicine for Rapid Broad-Spectrum Bacteria Killing

Large doses and long duration are often required for herbal medicines to kill bacteria effectively. Herein, a photoacoustic interfacial engineering strategy was utilized to endow curcumin (Cur, a kind of herbal medicine) with rapid and highly effective bacteria-killing efficacy, in which Cur was combined with CuS to form a hybrid material of CuS/Cur with tight contact through in situ nucleation and growth on the petaloid CuS surface. Due to the different work functions of CuS and Cur, the interfacial electrons were redistributed, i.e., a large number of electrons gathered on the side of CuS. In contrast, the holes gathered on the side of Cur after contact. An internal electric field was formed to drive the excited electrons to transfer from CuS to Cur, thus enhancing the separation of electron-hole pairs. Besides exerting the drug nature of Cur itself, the CuS/Cur hybrid also had photo-sono responsive ability, which endowed the hybrid with photothermal, photodynamic, and sonodynamic effects. Therefore, this Cur-based hybrid killed 99.56% of Staphylococcus aureus and 99.48% of Escherichia coli under 808 nm near-infrared light irradiation and ultrasound successively for 15 min, which was ascribed to the synergy of ROS, hyperthermia, and released Cu²⁺ together with the drug properties of Cur. This work provides a strategy to enhance the therapeutic effects of herbal medicines against pathogenic bacterial infections by exciting the intrinsic properties of herbal medicines as materials through a photo-sono interfacial engineering strategy.

Progress on photocatalytic semiconductor hybrids for bacterial inactivation

Due to its use of green and renewable energy and negligible bacterial resistance, photocatalytic bacterial inactivation is to be considered a promising sterilization process. Herein, we explore the relevant mechanisms of the photoinduced process on the active sites of semiconductors with an emphasis on the active sites of semiconductors, the photoexcited electron transfer, ROS-induced toxicity and interactions between semiconductors and bacteria. Pristine semiconductors such as metal oxides (TiO₂ and ZnO) have been widely reported; however, they suffer some drawbacks such as narrow optical response and high photogenerated carrier recombination. Herein, some typical modification strategies will be discussed including noble metal doping, ion doping, hybrid heterojunctions and dye sensitization. Besides, the biosafety and biocompatibility issues of semiconductor materials are also considered for the evaluation of their potential for further biomedical applications. Furthermore, 2D materials have become promising candidates in recent years due to their wide optical response to NIR light, superior antibacterial activity and favorable biocompatibility. Besides, the current research limitations and challenges are illustrated to introduce the appealing directions and design considerations for the future development of photocatalytic semiconductors for antibacterial applications.

Stimuli-Responsive Nanoplatform-Assisted Photodynamic Therapy Against Bacterial Infections

Bacterial infections are common diseases causing tremendous deaths in clinical settings. It has been a big challenge to human beings because of the antibiotics abuse and the newly emerging microbes. Photodynamic therapy (PDT) is a reactive oxygen species-based therapeutic technique through light-activated photosensitizer (PS). Recent studies have highlighted the potential of PDT as an alternative method of antibacterial treatment for its broad applicability and high efficiency. However, there are some shortcomings due to the low selectivity and specificity of PS. Growing evidence has shown that drug delivery nanoplatforms have unique advantages in enhancing therapeutic efficacy of drugs. Particularly, stimuli-responsive nanoplatforms, as a promising delivery system, provide great opportunities for the effective delivery of PS. In the present mini-review, we briefly introduced the unique microenvironment in bacterial infection tissues and the application of PDT on bacterial infections. Then we review the stimuli-responsive nanoplatforms (including pH-, enzymes-, redox-, magnetic-, and electric-) used in PDT against bacterial infections. Lastly, some perspectives have also been proposed to further promote the future developments of antibacterial PDT.

In vivo optical molecular imaging of inflammation and immunity

Inflammation is the phenotypic form of various diseases. Recent development in molecular imaging provides new insights into the diagnostic and therapeutic evaluation of different inflammatory diseases as well as diseases involving inflammation such as cancer. While conventional imaging techniques used in the clinical setting provide only indirect measures of inflammation such as increased perfusion and altered endothelial permeability, optical imaging is able to report molecular information on diseased tissue and cells. Optical imaging is a quick, noninvasive, nonionizing, and easy-to-use diagnostic technology which has been successfully applied for preclinical research. Further development of optical imaging technology such as optoacoustic imaging overcomes the limitations of mere fluorescence imaging, thereby enabling pilot clinical applications in humans. By means of endogenous and exogenous contrast agents, sites of inflammation can be accurately visualized in vivo. This allows for early disease detection and specific disease characterization, enabling more rapid and targeted therapeutic interventions. In this review, we summarize currently available optical imaging techniques used to detect inflammation, including optical coherence tomography (OCT), bioluminescence, fluorescence, optoacoustics, and Raman spectroscopy. We discuss advantages and disadvantages of the different in vivo imaging applications with a special focus on targeting inflammation including immune cell tracking.

Single-Atom Catalysis for Efficient Sonodynamic Therapy of Methicillin-Resistant Staphylococcus aureus-Infected Osteomyelitis

Osteomyelitis, as a severe bone disease caused by bacterial infection, can result in lifelong disability or fatal sepsis. Considering that the infection is stubborn and deep-sited in bone tissue, in situ and rapid treatments for osteomyelitis remain a significant challenge. Herein, we prepare an ultrasound (US)-activated single-atom catalyst that consists of a Au nanorod (NRs)-actuated single-atom-doped porphyrin metal-organic framework (HNTM-Pt@Au) and red cell membrane (RBC), which can efficiently treat methicillin-resistant Staphylococcus aureus (MRSA)-infected osteomyelitis under US. Besides the outstanding performance in the field of photocatalysis, we find that single atoms (such as Pt, Au, Cu) also improve the sonocatalytic ability of the sonosensitizer. Due to the strong electron-trapping and oxygen adsorption capacity, the Pt single atom endows RBC-HNTM-Pt@Au with an excellent sonocatalytic activity. It shows an excellent antibacterial performance with an antibacterial efficiency of 99.9% toward MRSA under 15 min of US irradiation. Meanwhile, the RBC-HNTM-Pt@Au can be propelled directionally under US and thus dynamically neutralize the secreted toxins. The MRSA-infected osteomyelitis in rat tibia was successfully treated, which shows negligible bone loss, reduced inflammation response, and great biocompatibility. This work presents an efficient sonodynamic therapy for the treatment of deep tissue infections via a multifunctional single-atom catalyst.

Maltodextrin-Conjugated Gd-Based MRI Contrast Agents for Specific Diagnosis of Bacterial Infections

Bacterial infections are one of the most serious health risks worldwide, and their rapid diagnosis remains a major challenge in clinic. To enhance the relaxivity and bacterial specificity of magnetic resonance imaging (MRI) contrast agents, here, a kind of gadolinium-based nanoparticles (NPs) of impressive biocompatibility is constructed as a contrast agent for maltodextrin-mediated bacteria-targeted diagnosis. To realize this, positively charged ultrasmall gadolinium oxide (Gd₂O₃, 2-3 nm) NPs are embedded in mesoporous silica NPs (MSN) with pore size around 6.38 nm. The resulting Gd₂O₃@MSN exhibits enhanced r₁ value and T₁-weighted MRI performance. Interestingly, upon conjugation of Gd₂O₃@MSN with maltodextrin to produce Gd₂O₃@MSN-Malt NPs, a remarkable decrease in internalization by osteosarcoma cells, alongside an increased adsorption toward E. coli and S. aureus, is achieved. It is therefore conceivable that the bacteria-targeted Gd₂O₃@MSN-Malt might be a promising MRI contrast agent for effective discrimination of bacterial infections from tumor.

Photodynamic therapy for treatment of Staphylococcus aureus infections

BACKGROUND

Staphylococcus aureus is a Gram-positive spherical bacterium that commonly causes various infections which can range from superficial to life-threatening. Hospital strains of S. aureus are often resistant to antibiotics, which has made their treatment difficult in recent decades. Other therapeutic alternatives have been postulated to overcome the drawbacks of antibiotic multi-resistance. Of these, photodynamic therapy (PDT) is a promising approach to address the notable shortage of new active antibiotics against multidrug-resistant S. aureus. PDT combines the use of a photosensitizer agent, light, and oxygen to eradicate pathogenic microorganisms. Through a systematic analysis of published results, this work aims to verify the usefulness of applying PDT in treating multidrug-resistant S.aureus infections.

METHODS

This review was based on a bibliographic search in various databases and the analysis of relevant publications.

RESULTS

There is currently a large body of evidence demonstrating the efficacy of photodynamic therapy in eliminating S.aureus strains. Both biofilm-producing strains, as well as multidrug-resistant strains.

CONCLUSION

We conclude that there is sufficient scientific evidence that PDT is a useful adjunct to traditional antibiotic therapy for treating S. aureus infections. Clinical application through appropriate trials should be introduced to further define optimal treatment protocols, safety and efficay.

Antibacterial and anti-inflammatory ultrahigh molecular weight polyethylene/tea polyphenol blends for artificial joint applications

Periprosthetic joint infection (PJI) is one of the main causes for the failure of joint arthroplasty. In view of the limited clinical effect of oral/injectable antibiotics and the drug resistance problem, there is a pressing need to develop antibacterial implants with therapeutic antimicrobial properties. In this work, we prepared a highly antibacterial ultrahigh molecular weight polyethylene (UHMWPE) implant by incorporating tea polyphenols. The presence of tea polyphenols not only improved the oxidation stability of irradiated UHMWPE, but also gave it the desirable antibacterial property. The potent antibacterial activity was attributed to the tea polyphenols that produced excess intracellular reactive oxygen species and destroyed the bacterial membrane structure. The tea polyphenol-blended UHMWPE had no biological toxicity to human adipose-derived stem cells and effectively reduced bacteria-induced inflammation in vivo. These results indicate that tea polyphenol-blended UHMWPE is promising for joint replacement prostheses with multifunctionality to meet patient satisfaction.

Near-Infrared Plasmon-Boosted Heat/Oxygen Enrichment for Reversing Rheumatoid Arthritis with Metal/Semiconductor Composites

Rheumatoid arthritis (RA) is an autoimmune disease that often causes progressive joint dysfunction, even disability and death in severe cases. The radical improvement of inflammatory cell infiltration and the resulting disorder in oxygen supply is a novel therapeutic direction for RA. Herein, a near-infrared-absorbing metal/semiconductor composite, polyethylene glycol-modified ceria-shell-coated gold nanorod (Au@CeO₂), is fabricated for topical photothermal/oxygen-enriched combination therapy for RA in a mouse model. Upon laser irradiation, the photothermal conversion of Au@CeO₂ is exponentially enhanced by the localized surface plasma resonance-induced light focusing. The elevated temperature can not only remarkably obliterate hyperproliferative inflammatory cells gathered in diseased joints but also vastly increase the catalase-like activity of ceria to accelerate the decomposition of H₂O₂ to produce much oxygen, which relieves hypoxia. Significantly, RA-induced lesions are improved, and the expression of proinflammatory cytokines and hypoxia-inducible factors is effectively repressed under the cooperation of heat and oxygen. Overall, the core/shell-structured Au@CeO₂ is a promising nanotherapeutic platform that can well realize light-driven heat/oxygen enrichment to completely cure RA from the perspective of pathogenesis.

Beyond Antibiotics: Photo/Sonodynamic Approaches for Bacterial Theranostics

Rapid evolution and propagation of multidrug resistance among bacterial pathogens are outpacing the development of new antibiotics, but antimicrobial photodynamic therapy (aPDT) provides an excellent alternative. This treatment depends on the interaction between light and photoactivated sensitizer to generate reactive oxygen species (ROS), which are highly cytotoxic to induce apoptosis in virtually all microorganisms without resistance concern. When replacing light with low-frequency ultrasonic wave to activate sensitizer, a novel ultrasound-driven treatment emerges as antimicrobial sonodynamic therapy (aSDT). Recent advances in aPDT and aSDT reveal golden opportunities for the management of multidrug resistant bacterial infections, especially in the theranostic application where imaging diagnosis can be accomplished facilely with the inherent optical characteristics of sensitizers, and the generated ROS by aPDT/SDT cause broad-spectrum oxidative damage for sterilization. In this review, we systemically outline the mechanisms, targets, and current progress of aPDT/SDT for bacterial theranostic application. Furthermore, potential limitations and future perspectives are also highlighted.

Biomaterials against Bone Infection

Chronic bone infection is considered as one of the most problematic biofilm-related infections. Its recurrent and resistant nature, high morbidity, prolonged hospitalization, and costly medical care expenses have driven the efforts of the scientific community to develop new therapies to improve the standards used today. There is great debate on the management of this kind of infection in order to establish consistent and agreed guidelines in national health systems. The scientific research is oriented toward the design of anti-infective biomaterials both for prevention and cure. The properties of these materials must be adapted to achieve better anti-infective performance and good compatibility, which allow a good integration of the implant with the surrounding tissue. The objective of this review is to study in-depth the antibacterial biomaterials and the strategies underlying them. In this sense, this manuscript focuses on antimicrobial coatings, including the new technological advances on surface modification; scaffolding design including multifunctional scaffolds with both antimicrobial and bone regeneration properties; and nanocarriers based on mesoporous silica nanoparticles with advanced properties (targeting and stimuli-response capabilities).

Epothilone B prevents lipopolysaccharide-induced inflammatory osteolysis through suppressing osteoclastogenesis via STAT3 signaling pathway

Inflammatory osteolysis is a common osteolytic specificity that occurs during infectious orthopaedic surgery and is characterized by an imbalance in bone homeostasis due to excessive osteoclast bone resorption activity. Epothilone B (Epo B) induced α-tubulin polymerization and enhanced microtubule stability, which also played an essential role in anti-inflammatory effect on the regulation of many diseases. However, its effects on skeletal system have rarely been investigated. Our study demonstrated that Epo B inhibited osteoclastogenesis in vitro and prevented inflammatory osteolysis in vivo. Further analysis showed that Epo B also markedly induced mature osteoclasts apoptosis during osteoclastogenesis. Mechanistically, Epo B directly suppressed osteoclastogenesis by the inhibitory regulation of the phosphorylation and activation of PI3K/Akt/STAT3 signaling directly, and the suppressive regulation of the CD9/gp130/STAT3 signaling pathway indirectly. The negative regulatory effect on STAT3 signaling further restrained the translocation of NF-κB p65 and NFATc1 from the cytosol to the nuclei during RANKL stimulation. Additionally, the expression of osteoclast specific genes was also significantly attenuated during osteoclast fusion and differentiation. Taken together, these findings illustrated that Epo B protected against LPS-induced bone destruction through inhibiting osteoclastogenesis via regulating the STAT3 dependent signaling pathway.

In vivo assessment of inflammation in carotid atherosclerosis by noninvasive photoacoustic imaging

Objectives: The objective of this study was to demonstrate the feasibility of using noninvasive photoacoustic imaging technology along with novel semiconducting polymer nanoparticles for in vivo identifying inflammatory components in carotid atherosclerosis and assessing the severity of inflammation using mouse models.

Methods and Results: Healthy carotid arteries and atherosclerotic carotid arteries were imaged in vivo by the noninvasive photoacoustic imaging system. Molecular probes PBD-CD36 were used to label the inflammatory cells to show the inflammation information by photoacoustic imaging. In in vivo imaging experiments, we observed the maximum photoacoustic signal enhancement of 4.3, 5.2, 8 and 16.3 times between 24 h post probe injection and that before probe injection in four carotid arteries belonging to three atherosclerotic mice models. In the corresponding carotid arteries stained with CD36, the ratio of 0.043, 0.061, 0.082 and 0.113 was found between CD36 positive (CD36(+)) expression area and intima-media area (P < 0.05). For the CD36(+) expression less than 0.008 in eight arteries, no photoacoustic signal enhancement was found due to the limited system sensitivity. The photoacoustic signal reflects CD36(+) expression in plaques, which shows the feasibility of using photoacoustic imaging for in vivo assessment of carotid atherosclerosis.

Conclusion: This research demonstrates a semiconducting polymer nanoparticle along with photoacoustic technology for noninvasive imaging and assessment of inflammation of carotid atherosclerotic plaques in vivo.