Efficacy of photodynamic therapy against Streptococcus mutans biofilm: Role of singlet oxygen

Evaluation of treatment of methicillin-resistant Staphylococcus aureus biofilms with intermittent electrochemically generated H2O2 or HOCl

Chronic wound infections can be difficult to treat and may lead to impaired healing and worsened patient outcomes. Novel treatment strategies are needed. This study evaluated the effects of intermittently produced hydrogen peroxide (H2O2) and hypochlorous acid (HOCl), generated via an electrochemical bandage (e-bandage), against methicillin-resistant Staphylococcus aureus biofilms in an agar membrane biofilm model. By changing the working electrode potential, the e-bandage generated either HOCl (1.5 VAg/AgCl) or H2O2 (-0.6 VAg/AgCl). The degree of biocidal activity of intermittent treatment with HOCl and H2O2 correlated with HOCl treatment time; HOCl treatment durations of 0, 1.5, 3, 4.5, and 6 hours (with the rest of the 6-hour total treatment time devoted to H2O2 generation) resulted in mean biofilm reductions of 1.36 ± 0.2, 2.22 ± 0.16, 3.46 ± 0.38, 4.63 ± 0.74, and 7.66 ± 0.5 log CFU/cm2, respectively, vs. non-polarized controls, respectively. However, application of H2O2 immediately after HOCl treatment was detrimental to biofilm removal. For example, 3 hours HOCl treatment followed by 3 hours H2O2 resulted in a 1.90 ± 0.84 log CFU/cm2 lower mean biofilm reduction than 3 hours HOCl treatment followed by 3 hours non-polarization. HOCl generated over 3 hours exhibited biocidal activity for at least 7.5 hours after e-bandage operation ceased; 3 hours of HOCl generation followed by 7.5 hours of non-polarization resulted in a biofilm cell reduction of 7.92 ± 0.12 log CFU/cm2 vs. non-polarized controls. Finally, intermittent treatment with HOCl (i.e., interspersed with periods of e-bandage non-polarization) for various intervals showed similar effects (approximately 6 log CFU/cm2 reduction vs. non-polarized control) to continuous treatment with HOCl for 3 hours, followed by 3 hours of non-polarization. These findings suggest that timing and sequencing of HOCl and H2O2 treatments are crucial for maximizing biofilm control when using an e-bandage strategy.

A General Molecular Structural Design for Highly Efficient Photopyroptosis that can be Activated within 10 s Irradiation

Photopyroptosis is an emerging research branch of photodynamic therapy (PDT), whereas there remains a lack of molecular structural principles to fabricate photosensitizers for triggering a highly efficient pyroptosis. Herein, a general and rational structural design principle to implement this hypothesis, is proposed. The principle relies on the clamping of cationic moieties (e.g., pyridinium, imidazolium) onto one photosensitive core to facilitate a considerable mitochondrial targeting (both of the inner and the outer membranes) of the molecules, thus maximizing the photogenerated reactive oxygen species (ROS) at the specific site to trigger the gasdermin E-mediated pyroptosis. Through this design, the pyroptotic trigger can be achieved in a minimum of 10 s of irradiation with a substantially low light dosage (0.4 J cm⁻2), compared to relevant work reported (up to 60 J cm⁻2). Moreover, immunotherapy with high tumor inhibition efficiency is realized by applying the synthetic molecules alone. This structural paradigm is valuable for deepening the understanding of PDT (especially the mitochondrial-targeted PDT) from the perspective of pyroptosis, toward the future development of the state-of-the-art form of PDT.

Evaluation of Treatment of Methicillin-Resistant Staphylococcus aureus Biofilms with Intermittent Electrochemically-Generated H2O2 or HOCl

Chronic wound infections can be difficult to treat and may lead to impaired healing and worsened patient outcomes. Novel treatment strategies are needed. This study evaluated effects of intermittently produced H2O2 and HOCl, generated via an electrochemical bandage (e-bandage), against methicillin-resistant Staphylococcus aureus biofilms in an agar membrane biofilm model. By changing the working electrode potential, the e-bandage generated either HOCl (1.5 VAg/AgCl) or H2O2 (-0.6 VAg/AgCl). The degree of biocidal activity of intermittent treatment with HOCl and H2O2 correlated with HOCl treatment time; HOCl treatment durations of 0, 1.5, 3, 4.5, and 6 hours (with the rest of the 6 hour total treatment time devoted to H2O2 generation) resulted in mean biofilm reductions of 1.36±0.2, 2.22±0.16, 3.46±0.38, 4.63±0.74 and 7.66±0.5 log CFU/cm2, respectively vs. non-polarized controls, respectively. However, application of H2O2 immediately after HOCl treatment was detrimental to biofilm removal. For example, 3-hours HOCl treatment followed by 3-hours H2O2 resulted in a 1.90±0.84 log CFU/cm2 lower mean biofilm reduction than 3-hours HOCl treatment followed by 3-hours non-polarization. HOCl generated over 3-hours exhibited biocidal activity for at least 7.5-hours after e-bandage operation ceased; 3-hours of HOCl generation followed by 7.5-hours of non-polarization resulted in a biofilm cell reduction of 7.92±0.12 log CFU/cm2 vs. non polarized controls. Finally, intermittent treatment with HOCl (i.e., interspersed with periods of e-bandage non-polarization) for various intervals showed similar effects (approximately 6 log CFU/cm2 reduction vs. non-polarized control) to continuous treatment with HOCl for 3-hours, followed by 3-hours of non-polarization. These findings suggest that timing and sequencing of HOCl and H2O2 treatments are crucial for maximizing biofilm control.

Probiotic Lactobacillus plantarum Ln4 Showing Antimicrobial and Antibiofilm Effect against Streptococcus mutans KCTC 5124 Causing Dental Caries

Dental caries has known as an infectious disease that is considered a serious global public health problem. Recently, report indicate that probiotics play a vital role in maintaining oral health. Therefore, this study aimed to evaluate the prevention effects of Lactobacillus plantarum Ln4 against dental infection by the pathogenic bacterium Streptococcus mutans KCTC 5124 through biofilm formation inhibition. To evaluate such prevention effects against S. mutans KCTC 5124, antimicrobial activity, auto-aggregation, co-aggregation, cell surface hydrophobicity, total exopolysaccharide (EPS) production rate, and biofilm formation were analyzed. Results showed that L. plantarum Ln4 showed higher antimicrobial activity than L. rhamnosus GG (LGG). In the group treated with L. plantarum Ln4, the co-aggregation (58.85%), cell surface hydrophobicity (16.75%), and EPS production rate (73.29%) values were lower than those of LGG and the negative control. Additionally, crystal violet staining and confocal laser scanning microscopy (CLSM) revealed that L. plantarum Ln4 effectively inhibited biofilm formation in S. mutans KCTC 5124. Therefore, L. plantarum Ln4 could be used in the industry as a probiotics to prevent and improve oral health.

Antibacterial photodynamic properties of silver nanoparticles-loaded curcumin composite material in chitosan-based films

In order to cope with the increasingly severe food contamination and safety problems, a powerful sterilization of food packaging material is urgently needed. Chitosan (CS) has potential applications in food packaging due to its good film-forming properties, but its antibacterial activity is not sufficient to meet the needs in practical applications. Silver nanoparticles (AgNPs) have the problem of weak immediate antibacterial activity as a broad-spectrum antibacterial agent. Therefore, in this study, AgNPs@GA@Cur-POTS (AGCP) composite antibacterial system was prepared by combining AgNPs with antibacterial photodynamic therapy using gallic acid (GA) as a reducing agent, curcumin (Cur) as a photosensitizer and perfluorosilane (POTS) for surface modification. The results showed that AGCP could produce a large number of reactive oxygen species under blue light irradiation, killing >90 % of E. coli and S. aureus within 2 h. Subsequently, the composite film of CS loaded with AGCP (CS/AGCP) was prepared by the flow-delay method. The CS/AGCP composite film exhibited excellent barrier properties and antioxidant activity, while its antibacterial rates against E. coli and S. aureus reached 98.44 ± 1.27 % and 99.11 ± 0.24 %, respectively, while the OD630 values of the two groups of bacteria treated with it showed no significant increase in incubation for up to 132 h, exhibiting remarkable and sustained antibacterial effects. Taken together, this work will provide a new strategy for antibacterial food packaging.

Recent Progress in antibacterial hydrogel coatings for targeting biofilm to prevent orthopedic implant-associated infections

The application of orthopedic implants for bone tissue reconstruction and functional restoration is crucial for patients with severe bone fractures and defects. However, the abiotic nature of orthopedic implants allows bacterial adhesion and colonization, leading to the formation of bacterial biofilms on the implant surface. This can result in implant failure and severe complications such as osteomyelitis and septic arthritis. The emergence of antibiotic-resistant bacteria and the limited efficacy of drugs against biofilms have increased the risk of orthopedic implant-associated infections (OIAI), necessitating the development of alternative therapeutics. In this regard, antibacterial hydrogels based on bacteria repelling, contact killing, drug delivery, or external assistance strategies have been extensively investigated for coating orthopedic implants through surface modification, offering a promising approach to target biofilm formation and prevent OIAI. This review provides an overview of recent advancements in the application of antibacterial hydrogel coatings for preventing OIAI by targeting biofilm formation. The topics covered include: (1) the mechanisms underlying OIAI occurrence and the role of biofilms in exacerbating OIAI development; (2) current strategies to impart anti-biofilm properties to hydrogel coatings and the mechanisms involved in treating OIAI. This article aims to summarize the progress in antibacterial hydrogel coatings for OIAI prevention, providing valuable insights and facilitating the development of prognostic markers for the design of effective antibacterial orthopedic implants.

A Systematic Evaluation of Curcumin Concentrations and Blue Light Parameters towards Antimicrobial Photodynamic Therapy against Cariogenic Microorganisms

Dental caries is a highly preventable and costly disease. Unfortunately, the current management strategies are inadequate at reducing the incidence and new minimally invasive strategies are needed. In this study, a systematic evaluation of specific light parameters and aqueous curcumin concentrations for antimicrobial photodynamic therapy (aPDT) was conducted. Aqueous solutions of curcumin were first prepared and evaluated for their light absorbance after applying different ~56 mW/cm2 blue light treatments in a continuous application mode. Next, these same light treatments as well as different application modes were applied to the curcumin solutions and the molar absorptivity coefficient, reactive oxygen species (ROS) release, minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC) for Streptococcus mutans and the MIC and minimum fungicidal concentration (MFC) for Candida albicans were measured. After up to 1 min of light treatment, the molar absorptivity of curcumin when added to culture media was lower than that for water only; however, at higher energy levels, this difference was not apparent. There was a noted dependence on both ROS type and cariogenic microorganism species on the sensitivity to both blue light treatment and application mode. In conclusion, this study provides new information towards improving the agonistic potential of aPDT associated with curcumin against cariogenic microorganisms.

Domestic LED bulb induced photodynamic effect of Toluidine Blue O-embedded silicone catheters against urinary tract infection

BACKGROUND

Novel combination of Toluidine Blue O (TBO) embedded silicone catheter with domestic/household LED bulb has a potential in clinical infection such as prevention of multi drug resistant catheter-associated urinary tract infections (CAUTIs) through photodynamic therapy.

MATERIAL AND METHODS

Preliminarily, TBO was entrapped into silicone catheter by swell-encapsulation-shrink method. Further, in vitro study was carried out to check the antimicrobial photodynamic efficacy of TBO with domestic/household LED light. Antibiofilm activity was evaluated by scanning electron microscopy.

RESULTS

The results showed that these modified TBO embedded silicone catheters showed significant antimicrobial and antibiofilm activity against vancomycin resistant Staphylococcus aureus VRSA. Small piece (1 cm) of TBO-embedded silicone catheter (700 µM) showed 6 log₁₀ reduction in the viable count when exposed for only 5 min of domestic/household LED bulb, while 1 cm piece of 500 µM and 700 µM concentration of TBO-embedded catheter eradicated all bacterial load when exposed to 15 min of light. Segment of medical grade TBO-embedded silicone catheters were used to carry out investigation of reactive oxygen species generation mainly singlet oxygen that contributes to type II phototoxicity.

CONCLUSION

These modified catheter provides cost effective, easy to manage and less time consuming therapy to eliminate CAUTIs.

Photodynamic antimicrobial therapy (AmPDT) using 1,9-Dimethyl-Methylene Blue zinc chloride double salt - DMMB and λ640 ± 5ηm LED light in patients undertaking orthodontic treatment

Orthodontic treatment involves the use of apparatuses that impairs oral hygiene making patients susceptible to periodontal diseases and caries. To prevent increased antimicrobial resistance AmPDT has shown itself a feasible option. The aim of this investigation was to assess the efficiency of AmPDT employing 1,9-Dimethyl-Methylene Blue zinc chloride double salt - DMMB as a photosensitizing agent combined with red LED irradiation (λ640 ± 5 ηm) against oral biofilm of patients undertaking orthodontic treatment. Twenty-one patients agreed to participate. Four biofilm collections were carried out on brackets and gingiva around inferior central incisors; first was carried out before any treatment (Control); second followed five minutes of pre-irradiation, the third was immediately after the first AmPDT, and the last after a second AmPDT. Then, a microbiological routine for microorganism growth was carried out and, after 24-h, CFU counting was performed. There was significant difference between all groups. No significant difference was seen between Control and Photosensitizer and AmpDT1 and AmPDT2 groups. Significant differences were observed between Control and AmPDT1 and AmPDT2 groups, Photosensitizer and AmPDT1 and AmPDT2 groups. It was concluded that double AmPDT using DMBB in nano concentration and red LED was capable to meaningfully decrease the number of CFUs in orthodontic patients.

Potential Use of Brazilian Green Propolis Extracts as New Photosensitizers for Antimicrobial Photodynamic Therapy against Cariogenic Microorganisms

The synergic effect of Streptococcus mutans and Candida albicans increases dental caries severity. Antimicrobial photodynamic therapy (aPDT) is a non-invasive treatment for antimicrobial aspects. However, the current photosensitizers (PS) have many downsides for dental applications. This study aimed to evaluate the efficiency of two different Brazilian green propolis (BGP-AF and BGP-AG) as PS for aPDT against these microorganisms. A single-species biofilm was irradiated with crude extracts and their fractions and controls. Such extracts showed the best results and were evaluated in dual-species biofilms. Photodegradation, reactive oxygen species (ROS), cytotoxicity, and color stability assays were also investigated. Reductions higher than 3 log₁₀ CFU/mL (p < 0.0001) occurred for crude BGP in single- and dual-species biofilms. Singlet oxygen was produced in BGP (p < 0.0001). BGP-mediated aPDT delayed S. mutans and C. albicans regrowth after 24 h of treatment (p < 0.0001). Both BGP did not change the color of dental materials (p > 0.05). BGP-AF-mediated aPDT showed 72.41% of oral keratinocyte viability (p < 0.0001). BGP extracts may be used in aPDT against S. mutans and C. albicans. Specifically, BGP-AF may represent a promising PS for dental applications.

Comparing proteome changes involved in biofilm formation by Streptococcus mutans after exposure to sucrose and starch

Streptococcus mutans is a main organism of tooth infections including tooth decay and periodontitis. The aim of this study was to assess the influence of sucrose and starch on biofilm formation and proteome profile of S. mutans ATCC 35668 strain. The biofilm formation was assessed by microtiter plating method. Changes in bacterial proteins after exposure to sucrose and starch carbohydrates were analyzed using matrix-assisted laser desorption/ionization mass spectrometry. The biofilm formation of S. mutans was increased to 391.76% in 1% sucrose concentration, 165.76% in 1% starch, and 264.27% in the 0.5% sucrose plus 0.5% starch in comparison to biofilm formation in the media without sugars. The abundance of glutamines, adenylate kinase, and 50S ribosomal protein L29 was increased under exposure to sucrose. Upregulation of lactate utilization protein C, 5-hydroxybenzimidazole synthase BzaA, and 50S ribosomal protein L16 was formed under starch exposure. Ribosome-recycling factor, peptide chain release factor 1, and peptide methionine sulfoxide reductase MsrB were upregulated under exposure to sucrose in combination with starch. The results demonstrated that the carbohydrates increase microbial pathogenicity. In addition, sucrose and starch carbohydrates can induce biofilm formation of S. mutans via various mechanisms such as changes in the expression of special proteins.

Application of Antimicrobial Photodynamic Therapy for Inactivation of Acinetobacter baumannii Biofilms

Acinetobacter baumannii is a dangerous hospital pathogen primarily due to its ability to form biofilms on different abiotic and biotic surfaces. The present study investigated the effect of riboflavin- and chlorophyllin-based antimicrobial photodynamic therapy, performed with near-ultraviolet or blue light on the viability of bacterial cells in biofilms and their structural stability, also determining the extent of photoinduced generation of intracellular reactive oxygen species as well as the ability of A. baumannii to form biofilms after the treatment. The efficacy of antimicrobial photodynamic therapy was compared with that of light alone and the role of the photosensitizer type on the photosensitization mechanism was demonstrated. We found that the antibacterial effect of riboflavin-based antimicrobial photodynamic therapy depends on the ability of photoactivated riboflavin to generate intracellular reactive oxygen species but does not depend on the concentration of riboflavin and pre-incubation time before irradiation. Moreover, our results suggest a clear interconnection between the inactivation efficiency of chlorophyllin-based antimicrobial photodynamic therapy and the sensitivity of A. baumannii biofilms to used light. In summary, all the analyzed results suggest that riboflavin-based antimicrobial photodynamic therapy and chlorophyllin-based antimicrobial photodynamic therapy have the potential to be applied as an antibacterial treatment against A. baumannii biofilms or as a preventive measure against biofilm formation.

Research progress of stimulus-responsive antibacterial materials for bone infection

Infection is one of the most serious complications harmful to human health, which brings a huge burden to human health. Bone infection is one of the most common and serious complications of fracture and orthopaedic surgery. Antibacterial treatment is the premise of bone defect healing. Among all the antibacterial strategies, irritant antibacterial materials have unique advantages and the ability of targeted therapy. In this review, we focus on the research progress of irritating materials, the development of antibacterial materials and their advantages and disadvantages potential applications in bone infection.

Does potassium iodide help in the microbial reduction of oral microcosm biofilms after photodynamic therapy with methylene blue and red laser?

OBJECTIVE

To evaluate the efficacy of methylene blue (MB)-mediated antimicrobial photodynamic therapy (aPDT) doped with potassium iodide (KI) against oral microcosms biofilms cultured in dentin.

METHODS

A saliva-glycerol stock formed from pooled human saliva was diluted in McBain artificial saliva with 1% sucrose (1:1), inoculated on bovine dentin blocks, and refreshed daily for 5 days. The biofilms were divided (n = 9/group) and treated with 0.9% NaCl (C), 0.2% chlorhexidine (CX), 0.01% MB + low-power laser 15 J, 88 mW, 180 s (PL), and 0.01% MB + 50 mM KI + laser (PKIL). Serial dilution was performed, and cellular viability (CFU/mL) was evaluated for total microorganisms, total lactobacilli, total streptococci, and S. mutans. Additional biofilms were cultured and treated (n = 4) for biomass determination (%BMR). The microscopic structure of the biofilms was observed by SEM. One-way ANOVA and Tukey tests were conducted (α=5%).

RESULTS

Total microorganisms and total streptococci significantly reduced in biofilms treated with CX and PKIL when compared to C, but the CX, PKIL, and PL treatments did not differ from each other. Total lactobacilli and S. mutans showed a significant reduction in the CX, PL, and PKIL groups when compared to C, but with no difference between them. Biomass analysis showed a significantly reduction for CX and PKIL compared to C. SEM micrographs showed noticeable changes in bacterial membrane integrity for the PKIL and CX groups.

CONCLUSION

The addition of KI to methylene blue-mediated aPDT in microcosm biofilms was effective in reducing oral microorganisms, but the effect was group dependent.

Gold nanoparticle decoration potentiate the antibacterial enhancement of TiO2 nanotubes via sonodynamic therapy against peri-implant infections

Inflammatory damage from bacterial biofilms usually causes the failure of tooth implantation. A promising solution for this challenge is to use an implant surface with a long-term, in-depth and efficient antibacterial feature. In this study, we developed an ultrasound-enhanced antibacterial implant surface based on Au nanoparticle modified TiO2 nanotubes (AuNPs-TNTs). As an artificial tooth surface, films based on AuNPs-TNTs showed excellent biocompatibility. Importantly, compared to bare titania surface, a larger amount of reactive oxygen radicals was generated on AuNPs-TNTs under an ultrasound treatment. For a proof-of-concept application, Porphyromonas gingivalis (P. gingivalis) was used as the model bacteria; the as-proposed AuNPs-TNTs exhibited significantly enhanced antibacterial activity under a simple ultrasound treatment. This antibacterial film offers a new way to design the surface of an artificial implant coating for resolving the bacterial infection induced failure of dental implants.

Simultaneous Photodynamic Eradication of Tooth Biofilm and Tooth Whitening with an Aggregation-Induced Emission Luminogen

Dental caries is among the most prevalent dental diseases globally, which arises from the formation of microbial biofilm on teeth. Besides, tooth whitening represents one of the fastest-growing areas of cosmetic dentistry. It will thus be great if tooth biofilm eradication can be combined with tooth whitening. Herein, a highly efficient photodynamic dental therapy strategy is reported for tooth biofilm eradication and tooth discoloration by employing a photosensitizer (DTTPB) with aggregation-induced emission characteristics. DTTPB can efficiently inactivate S. mutans, and inhibit biofilm formation by suppressing the expression of genes associated with extracellular polymeric substance synthesis, bacterial adhesion, and superoxide reduction. Its inhibition performance can be further enhanced through combined treatment with chlorhexidine. Besides, DTTPB exhibits an excellent tooth-discoloration effect on both colored saliva-coated hydroxyapatite and clinical teeth, with short treatment time (less than 1 h), better tooth-whitening performance than 30% hydrogen peroxide, and almost no damage to the teeth. DTTPB also demonstrates excellent biocompatibility with neglectable hemolysis effect on mouse red blood cells and almost no killing effect on mammalian cells, which enables its potential applications for simultaneous tooth biofilm eradication and tooth whitening in clinical dentistry.

Photodynamic therapy and combinatory treatments for the control of biofilm-associated infections

The advent of antimicrobial resistance has added considerable impact to infectious diseases both in the number of infections and healthcare costs. Furthermore, the relentless emergence of multidrug-resistant bacteria, particularly in the biofilm state, has made mandatory the discovery of new alternative antimicrobial therapies that are capable to eradicate resistant bacteria and impair the development of new forms of resistance. Amongst the therapeutic strategies for treating biofilms, antimicrobial photodynamic therapy (aPDT) has shown great potential in inactivating several clinically relevant micro-organisms, including antibiotic-resistant 'priority bacteria' declared by the WHO as critical pathogens. Its antimicrobial effect is centred on the basis that harmless low-intensity light stimulates a non-toxic dye named photosensitizer, triggering the production of reactive oxygen species upon photostimulation. In addition, combination therapies of aPDT with other antimicrobial agents (e.g. antibiotics) have also drawn considerable attention, as it is a multi-target strategy. Therefore, the present review highlights the recent advances of aPDT against biofilms, also covering progress on combination therapy.

Influence of antimicrobial photodynamic therapy with different pre-irradiation times on children's dental biofilm: randomized clinical trial

PURPOSE

Photodynamic therapy (PDT) is effective in reducing pathogenic microorganisms in the oral cavity and in preventing dental diseases. This study evaluated the pre-irradiation time using PDT (diode laser associated with 0.01% methylene blue) to decrease the number of microorganisms in the visible plaque in permanent teeth.

METHODS

This randomized clinical trial included 108 homologous lower permanent first molars (36 and 46) with biofilm from 54 children aged six to 12 years. PDT was performed (0.01% methylene blue photosensitizer/therapeutic laser-InGaAIP), according to the following protocols: Group 1, biofilm collection of the distal area of the lingual surface of 36 µm before PDT; group 2, mesial area of the lingual surface of 36 µm 1 min after PDT; group 3, area of the lingual surface of 46 µm before PDT; and group 4, mesial area of the lingual surface of 46 µm 5 min after PDT.

RESULTS

After statistical analysis, significant differences were observed between the groups (p = 0.000). In groups 2 and 4, the number of bacteria tended to decrease, with a more evident bacterial reduction in group 4.

CONCLUSIONS

Pre-irradiation reduced the number of colony-forming units of mature bacterial biofilms in vivo. A time of 5 min resulted in a greater reduction in the number of colony-forming units.

CLINICAL TRIAL REGISTRATION

ReBEC Identifier: RBR-6bqfp3; Date of Register: March 2nd, 2020. Retrospectively Registered.

In vitro evaluation of the cis-[Ru(phen)2(pPDIp)]2+⁎⁎ complex for antimicrobial photodynamic therapy against Sporothrix brasiliensis and Candida albicans

BACKGROUND

Photodynamic therapy (PDT) activates a photosensitizer by visible light to generate cytotoxic oxygen species that lead to cell death. With proper illumination, PDT is often used in applications on superficial and sub-surface lesions. Sporotrichosis infection occurs by Sporothrix fungi which causes a skin wound, worsened by Candida albicans infections. This study investigated the photosensitizing efficiency of the Ru(phen)₂(pPDIp)(PF₆)₂ complex, RupPDIp, against S. brasiliensis and C. albicans.

MATERIAL AND METHODS

RupPDIp efficiency against these fungi was tested using 450 nm (blue light and 36 J/cm²) and 525 nm (green light, 25.2 J/cm²) at 0.05-20 μM concentrations. To ensure PDT effectiveness, control groups were tested in the absence and in the presence of RupPDIp under light irradiation and in the dark.

RESULTS

RupPDIp eliminated both fungi at ≤5.0 μM. Green light showed the best results, eliminating S. brasiliensis and C. albicans colonies at RupPDIp 0.5 μM and 0.05 μM, respectively.

CONCLUSION

RupPDIp is a promising photosensitizer in aPDT, eliminating 10⁶ CFU/mL of both fungi at 450 nm and 525 nm, with lower light doses and concentrations when treated with the green light compared to the blue light.

Photodynamic Therapy (PDT) in Prosthodontics: Disinfection of Human Teeth Exposed to Streptococcus mutans and the Effect on the Adhesion of Full Ceramic Veneers, Crowns, and Inlays: An In Vitro Study

The use of PDT in prosthodontics as a disinfection protocol can eradicate bacteria from tooth surfaces by causing the death of the microorganisms to which the photosensitizer binds, absorbing the energy of laser light during irradiation. The aim of the study was to investigate the capacity of PDT to increase the bond strength of full ceramic restorations. In this study, 45 extracted human teeth were prepared for veneers, crowns, and inlays and contaminated with Streptococcus mutans. Tooth surfaces decontamination was performed using a diode laser and methylene blue as a photosensitizer. The disinfection effect and the impact on tensile bond strength were evaluated by scanning electron microscopy (SEM) and pull-out tests of the cemented ceramic prosthesis. Results show that the number of bacteria was reduced from colonized prepared tooth surfaces, and the bond strength was increased when PDT was used. In conclusion, the present study indicates that using PDT as a protocol before the final adhesive cementation of ceramic restorations could be a promising approach, with outstanding advantages over conventional methods.

Multifunctional Photoactive Hydrogels for Wound Healing Acceleration

Light is an attractive tool that has a profound impact on modern medicine. Particularly, light-based photothermal therapy (PTT) and photodynamic therapy (PDT) show great application prospects in the prevention of wound infection and promoting wound healing. In addition, hydrogels have shown attractive advantages in the field of wound dressings due to their excellent biochemical effects. Therefore, multifunctional photoresponsive hydrogels (MPRHs) that integrate the advantages of light and hydrogels are increasingly used in biomedicine, especially in the field of wound repair. However, a comprehensive review of MPRHs for wound regeneration is still lacking. This review first focuses on various types of MPRHs prepared by diverse photosensitizers, photothermal agents (PHTAs) including transition metal sulfide/oxides nanomaterials, metal nanostructure-based PHTAs, carbon-based PHTAs, conjugated polymer or complex-based PHTAs, and/or photodynamic agents (PHDAs) such as ZnO-based, black-phosphorus-based, TiO₂-based, and small organic molecule-based PHDAs. We also then discuss how PTT, PDT, and photothermal/photodynamic synergistic therapy can modulate the microenvironments of bacteria to inhibit infection. Overall, multifunctional hydrogels with both therapeutic and tissue regeneration capabilities have been discussed and existing challenges, as well as future research directions in the field of MPRHs and their application in wound management are argued.

Recent Strategies to Develop Innovative Photosensitizers for Enhanced Photodynamic Therapy

This review presents a robust strategy to design photosensitizers (PSs) for various species. Photodynamic therapy (PDT) is a photochemical-based treatment approach that involves the use of light combined with a light-activated chemical, referred to as a PS. Attractively, PDT is one of the alternatives to conventional cancer treatment due to its noninvasive nature, high cure rates, and low side effects. PSs play an important factor in photoinduced reactive oxygen species (ROS) generation. Although the concept of photosensitizer-based photodynamic therapy has been widely adopted for clinical trials and bioimaging, until now, to our surprise, there has been no relevant review article on rational designs of organic PSs for PDT. Furthermore, most of published review articles in PDT focused on nanomaterials and nanotechnology based on traditional PSs. Therefore, this review aimed at reporting recent strategies to develop innovative organic photosensitizers for enhanced photodynamic therapy, with each example described in detail instead of providing only a general overview, as is typically done in previous reviews of PDT, to provide intuitive, vivid, and specific insights to the readers.

Antimicrobial photodynamic therapy (aPDT) for biofilm treatments. Possible synergy between aPDT and pulsed electric fields

Currently, microbial biofilms have been the cause of a wide variety of infections in the human body, reaching 80% of all bacterial and fungal infections. The biofilms present specific properties that increase the resistance to antimicrobial treatments. Thus, the development of new approaches is urgent, and antimicrobial photodynamic therapy (aPDT) has been shown as a promising candidate. aPDT involves a synergic association of a photosensitizer (PS), molecular oxygen and visible light, producing highly reactive oxygen species (ROS) that cause the oxidation of several cellular components. This therapy attacks many components of the biofilm, including proteins, lipids, and nucleic acids present within the biofilm matrix; causing inhibition even in the cells that are inside the extracellular polymeric substance (EPS). Recent advances in designing new PSs to increase the production of ROS and the combination of aPDT with other therapies, especially pulsed electric fields (PEF), have contributed to enhanced biofilm inhibition. The PEF has proven to have antimicrobial effect once it is known that extensive chemical reactions occur when electric fields are applied. This type of treatment kills microorganisms not only due to membrane rupture but also due to the formation of reactive compounds including free oxygen, hydrogen, hydroxyl and hydroperoxyl radicals. So, this review aims to show the progress of aPDT and PEF against the biofilms, suggesting that the association of both methods can potentiate their effects and overcome biofilm infections.

Photo-damage promoted by tetra-cationic palladium(II) porphyrins in rapidly growing mycobacteria

Antimicrobial photodynamic therapy (aPDT) has gained prominence in microbiology, especially in treating non-invasive infections. Diseases such as mycobacteriosis, which causes localized infections and has a slow treatment, tend to be future targets for this type of technology. Therefore, this study aimed to explore the action of two isomeric Pd(II)-porphyrins on fast-growing mycobacterial strains (RGM). Tetra-cationic porphyrins (4-PdTPyP and 3-PdTPyP) were synthesized and applied against standard strains of Mycobacteroides abscessus subsp. abscessus (ATCC 19977), Mycolicibacterium fortuitum (ATCC 6841), Mycolicibacterium smegmatis (ATCC 700084), and Mycobacteroides abscessus subsp. massiliense (ATCC 48898). Reactive oxygen species (ROS) scavengers were used in an attempt to determine possible ROS produced by the photosensitizers (PS) under study. Moreover, the impact of porphyrin on the mycobacterial surface was further evaluated by atomic force microscopy (AFM), and we observed significant damage on cells walls and altered nanomechanical and electrostatic adhesion properties. The results presented herein show that the positively charged porphyrin at the meta position (3-PdTPyP) was the most efficient PS against the RGM strains, and its bactericidal activity was proven in two irradiation sessions, with singlet oxygen species being the main ROS involved in this process. This study demonstrated the therapeutic potential of porphyrins, especially the 3-PdTPyP derivative.

A New Insight into the Bactericidal Mechanism of 405 nm Blue Light-Emitting-Diode against Dairy Sourced Cronobacter sakazakii

(1) Background: Limited evidence exists addressing the action of antimicrobial visible light against Cronobacter sakazakii. Here, we investigated the antimicrobial effects of blue-LED (light emitting diode) at 405 nm against two persistent dairy environment sourced strains of C. sakazakii (ES191 and AGRFS2961). (2) Methods: Beside of investigating cell survival by counts, the phenotypic characteristics of the strains were compared with a reference strain (BAA894) by evaluating the metabolic rate, cell membrane permeability, and ROS level. (3) Results: The two environment isolates (ES191 and AGRFS2961) were more metabolic active and ES191 showed dramatic permeability change of the outer membrane. Notably, we detected varied impacts of different ROS scavengers (catalase > thiourea > superoxide dismutase) during light application, suggesting that hydrogen peroxide (H₂O₂₎, the reducing target of catalase, has a key role during blue light inactivation. This finding was further strengthened, following the observation that the combined effect of external H₂O₂ (sublethal concentration) and 405 nm LED, achieved an additional 2–4 log CFU reduction for both stationary phase and biofilm cells. (4) Conclusions: H₂O₂ could be used in combination with blue light to enhance bactericidal efficacy and form the basis of a new hurdle technology for controlling C. sakazakii in dairy processing plants.

Antibacterial Photodynamic Inactivation of Fagopyrin F from Tartary Buckwheat (Fagopyrum tataricum) Flower against Streptococcus mutans and Its Biofilm

The objective of this study was to determine reactive oxygen species (ROS) produced by fagopyrin F-rich fraction (FFF) separated from Tartary buckwheat flower extract exposed to lights and to investigate its antibacterial photodynamic inactivation (PDI) against Streptococcus mutans and its biofilm. ROS producing mechanisms involving FFF with light exposure were determined using a spectrophotometer and a fluorometer. S. mutans and its biofilm inactivation after PDI treatment of FFF using blue light (BL; 450 nm) were determined by plate count method and crystal violet assay, respectively. The biofilm destruction by ROS produced from FFF after exposure to BL was visualized using confocal laser scanning microscopy (CLSM) and field emission scanning electron microscope (FE-SEM). BL among 3 light sources produced type 1 ROS the most when applying FFF as a photosensitizer. FFF exposed to BL (5 and 10 J/cm2) significantly more inhibited S. mutans viability and biofilm formation than FFF without the light exposure (p < 0.05). In the PDI of FFF exposed to BL (10 J/cm2), an apparent destruction of S. mutans and its biofilm were observed by the CLSM and FE-SEM. Antibacterial PDI effect of FFF was determined for the first time in this study.

Rational design of type I photosensitizers based on Ru(ii) complexes for effective photodynamic therapy under hypoxia

Photodynamic therapy (PDT) has been widely used in conjunction with molecular oxygen to cause cancer cell death. Hypoxia, the inherent property in solid tumors, is the obstacle during the process of PDT. It is urgent to develop PDT photosensitizers independent of the oxygen concentration. Herein, triphenylamine-modified Ru(ii) complexes have been used as photosensitizers to produce superoxide anions (O2-˙) and hydroxyl radicals (˙OH) through a type I photochemical process. Ru(ii) complexes with triphenylamine can provide a possibility to drive the reactive oxygen species production through low oxidation potential and good light-harvesting abilities. The investigation on light-mediated radical production showed that Ru4 could produce abundant ˙OH and O2-˙ compared to Ru1-Ru3 under hypoxic environments owing to the strong absorption. These radicals exhibit potent toxicity, which can damage the neighbouring biomolecules and cause the apoptosis of cancer cells. The PDT effect was evaluated in vitro under hypoxia, suggesting that Ru4 could maintain excellent performance in inducing a sharp decrease in the activity of cancer cells.

Microbicidal effect of 405-nm blue LED light on Candida albicans and Streptococcus mutans dual-species biofilms on denture base resin

This study investigated: (1) the microbicidal effect of 405-nm blue LED light irradiation on biofilm formed by Candida albicans hyphae and Streptococcus mutans under dual-species condition on denture base resin, (2) the generation of intracellular reactive oxygen species (ROS) induced by irradiation, and (3) the existence of intracellular porphyrins, which act as a photosensitizer. Denture base resin specimens were prepared and C. albicans and S. mutans dual-species biofilms were allowed to form on the specimens. The biofilms were irradiated with 405-nm blue LED light and analyzed using the colony-forming unit assay, fluorescence microscopy, and scanning electron microscopy (SEM). Single-species biofilms of C. albicans and S. mutans formed on the specimens were irradiated with 405-nm blue LED light. After the irradiation, the intracellular ROS levels in C. albicans and S. mutans cells were measured. In addition, the level of intracellular porphyrins in C. albicans and S. mutans were measured. Irradiation for more than 30 min significantly inhibited the colony formation ability of C. albicans and S. mutans. Fluorescence microscopy revealed that almost all C. albicans and S. mutans cells were killed by irradiation. SEM images showed various cell damage patterns. Irradiation led to the generation of intracellular ROS and porphyrins were present in both C. albicans and S. mutans cells. In conclusion, irradiation with 405-nm blue light-emitting diode light for 40 min effectively disinfect C. albicans hyphae and S. mutans dual-species biofilms and possibly react with intracellular porphyrins resulting in generation of ROS in each microorganism.

Antimicrobial photodynamic therapy mediated by methylene blue coupled to β-cyclodextrin reduces early colonizing microorganisms from the oral biofilm

OBJECTIVE

To test the effect of antimicrobial photodynamic therapy (A-PDT) on the oral biofilm formed with early colonizing microorganisms, using the photosensitizer methylene blue coupled with β-cyclodextrin nanoparticles and red light sources laser or LED (λ =660 nm).

METHODS

The groups were divided into (n = 3, in triplicate): C (negative control, 0.9 % NaCl), CX (positive control, 0.2 % chlorhexidine), P (Photosensitizer/Nanoparticle), L (Laser), LED (light-emitting diode), LP (Laser + Photosensitizer/Nanoparticle) and LEDP (LED + Photosensitizer/Nanoparticle). A multispecies biofilm composed ofS. gordonii, S. oralis, S. mitis, and S. sanguinis was grown in microplates containing BHI supplemented with 1% sucrose (w/v) for 24 h. Light irradiations were applied with a laser at 9 J for 90 s (320 J/cm²), or with LED, at 8.1 J for 90 s (8.1 J/cm²). The microbial reduction was assessed by counting viable biofilm microorganisms in selective culture media, before and after the treatments. Data normality was assessed by the Shapiro-Wilk test, and the results were submitted to Kruskal-Wallis analysis, followed by Dunn's test, with a significance level of 5%.

RESULTS

The groups LP and LEDP were able to significantly reduce the biofilm microorganism counts by as much as 4 log₁₀ times compared to the negative control group (p < 0.05) and did not statistically differ from the positive control group (CX) (p > 0.05).

CONCLUSION

The A-PDT mediated by encapsulated β-cyclodextrin methylene blue irradiated by Laser or LED was effective in the microbial reduction of multispecies biofilm composed of early colonizing microorganisms.

Photodynamic optimization by combination of xanthene dyes on different forms of Streptococcus mutans: An in vitro study

OBJECTIVE

The photokilling rate in antimicrobial photodynamic therapy (a-PDT) is highly related to interaction of reactive oxygen species (ROS) produced, ability of photosensitizers (PS) in incorporating into microorgansims and light devices/microorganism type. Since xanthene dyes (Rose Bengal and Erythrosine) are present in the dental practice as PS, have high quantum yield of singlet oxygen and are efficiently incorporated into bacterial cells, the additive bactericidal ability of a combination of xanthene dyes was tested on planktonic cultures and biofilms of Streptococcus mutans when irradiated by a hand-held LED photopolymerizer unit.

METHODS

Planktonic cultures of S. mutans (UA 159 ATCC 700610) were grown in BHI broth with 1 % sucrose. This culture was exposed to a concentrations of Rose Bengal (RB) and Erythrosine (ER) at 1.5, 3.5 μM, in combination (RB + ER + L+) / alone (RB + L+/ ER + L+) and irradiated with a blue LED high light intensity (L). Accordingly, concentrations of dyes and time irradiation were increased in 10 times and applied on 120 h - biofilms of S. mutans and compared with a 0.12 % Chlorhexidine solution (0.12 % - CHX). For statistical analysis, parametrical procedures were applied (n = 6; ANOVA test and Tukey post hoc test; α = 0.05) and data transformed into log ₁₀.

RESULTS

Substantial antimicrobial reduction was verified in planktonic cultures (∼ 7 log reduction) and biofilm (∼ 1 log reduction) for combined a-PDT group (RB + ER + L+) presenting a significant statistical difference to control group (p < 0.05) with similar effect to CHX group (p > 0.05).

CONCLUSION

Different forms of S. mutans can be effectively controlled by photodynamic therapy and optimized when in combination of xanthene dyes.

Photosensitizers attenuate LPS-induced inflammation: implications in dentistry and general health

Antimicrobial photodynamic therapy (aPDT) is a complementary therapeutic modality for periodontal and endodontic diseases, in which Gram-negative bacteria are directly involved. Currently, there are few evidences regarding the effects of aPDT on bacterial components such as lipopolysaccharide (LPS) and it would represent a major step forward in the clinical use of this therapy. In this context, this study aimed to evaluate the efficacy of different photosensitizers (PSs) used in aPDT in LPS inhibition. Four PSs were used in this study: methylene blue (MB), toluidine blue (TBO), new methylene blue (NMB), and curcumin (CUR). Different approaches to evaluate LPS interaction with PSs were used, such as spectrophotometry, Limulus amebocyte lysate (LAL) test, functional assays using mouse macrophages, and an in vivo model of LPS injection. Spectrophotometry showed that LPS decreased the absorbance of all PSs used, indicating interactions between the two species. LAL assay revealed significant differences in LPS concentrations upon pre-incubation with the different PSs. Interestingly, the inflammatory potential of LPS decreased after previous treatment with the four PSs, resulting in decreased secretion of inflammatory cytokines by macrophages. In vivo, pre-incubating curcumin with LPS prevented animals from undergoing septic shock within the established time. Using relevant models to study the inflammatory activity of LPS, we found that all PSs used in this work decreased LPS-induced inflammation, with a more striking effect observed for NMB and curcumin. These data advance the understanding of the mechanisms of LPS inhibition by PSs.

The central role of the SOS DNA repair system in antibiotics resistance: A new target for a new infectious treatment strategy

Bacteria have a considerable ability and potential to acquire resistance against antimicrobial agents by acting diverse mechanisms such as target modification or overexpression, multidrug transporter systems, and acquisition of drug hydrolyzing enzymes. Studying the mechanisms of bacterial cell physiology is mandatory for the development of novel strategies to control the antimicrobial resistance phenomenon, as well as for the control of infections in clinics. The SOS response is a cellular DNA repair mechanism that has an essential role in the bacterial biologic process involved in resistance to antibiotics. The activation of the SOS network increases the resistance and tolerance of bacteria to stress and, as a consequence, to antimicrobial agents. Therefore, SOS can be an applicable target for the discovery of new antimicrobial drugs. In the present review, we focus on the central role of SOS response in bacterial resistance mechanisms and its potential as a new target for control of resistant pathogens.

The Impact of Photosensitizer Selection on Bactericidal Efficacy Of PDT against Cariogenic Biofilms: A Systematic Review and Meta-Analysis

BACKGROUND

There are investigations on multiple photosensitizers for modulation of caries-related biofilms using PDT. However, much controversy remains about recommended parameters mostly on the selection of an efficient photosensitizer.

OBJECTIVE

The study performed a systematic review to identify the answer to the following question: What photosensitizers present high bactericidal efficacy against cariogenic biofilms?

METHODS

Systematic review with meta-analyses were carried out for English language articles from October to December 2019 (PRISMA standards) using MEDLINE, Scopus, Biomed Central, EMBASE, LILACS, and Web of Science. Information on study design, biofilm model, photosensitizer, light source, energy delivery, the incubation time for photosensitizer, and bacterial reduction outcomes were recorded. We performed two meta-analyses to compare bacterial reduction, data was expressed by (1) base 10 Logarithm values and (2) Log reduction RESULTS: After the eligibility criteria were applied (PEDro scale), the selected studies showed that toluidine Blue Ortho (TBO) and methylene blue (MBO) (5-min incubation time and 5-min irradiation) demonstrated better bacterial reduction outcomes. For the data expressed by Log TBO, MBO, curcumin, and Photogem® presented a significant bacterial decrease in comparison to the control (p = 0.042). For the data represented by Log reduction, the bacterial reduction toward S.mutans was not significant for any photosensitizer (p = 0.679).

CONCLUSION

The lack of methodological standardization among the studies still hinders the establishment of photosensitizer and bactericidal efficiency. TBO, MBO, curcumin, and photogem generate greater PDT-based bacterial reduction on caries-related bacteria.. Further clinical studies are necessary in order to obtain conclusive results.

Validation of stable reference genes in Staphylococcus aureus to study gene expression under photodynamic treatment: a case study of SEB virulence factor analysis

Staphylococcal enterotoxin B (SEB), encoded by the seb gene, is a virulence factor produced by Staphylococcus aureus that is involved mainly in food poisoning and is known to act as an aggravating factor in patients with atopic dermatitis. Research results in animal infection models support the concept that superantigens, including SEB contribute to sepsis and skin and soft tissue infections. In contrast to antibiotics, antimicrobial photodynamic inactivation (aPDI) is a promising method to combat both bacterial cells and virulence factors. The main aims of this research were to (1) select the most stable reference genes under sublethal aPDI treatments and (2) evaluate the impact of aPDI on seb. Two aPDI combinations were applied under sublethal conditions: rose bengal (RB) and green light (λ_max = 515 nm) and new methylene blue (NMB) and red light (λ_max = 632 nm). The stability of ten candidate reference genes (16S rRNA, fabD, ftsZ, gmk, gyrB, proC, pyk, rho, rpoB and tpiA) was evaluated upon aPDI using four software packages—BestKeeper, geNorm, NormFinder and RefFinder. Statistical analyses ranked ftsZ and gmk (RB + green light) and ftsZ, proC, and fabD (NMB + red light) as the most stable reference genes upon photodynamic treatment. Our studies showed downregulation of seb under both aPDI conditions, suggesting that aPDI could decrease the level of virulence factors.

Smart Hydrogel-Based DVDMS/bFGF Nanohybrids for Antibacterial Phototherapy with Multiple Damaging Sites and Accelerated Wound Healing

Burn infection is one of the commonest causes of death in severely burned patients. Developing multifunctional biological nanomaterials has a great significance for the comprehensive treatment of burn infection. In this paper, we developed a hydrogel-based nanodelivery system with antibacterial activity and skin regeneration function, which was used for photodynamic antimicrobial chemotherapy (PACT) in the treatment of burns. The treatment system is mainly composed of porphyrin photosensitizer sinoporphyrin sodium (DVDMS) and poly(lactic-co-glycolic acid) (PLGA)-encapsulated basic fibroblast growth factor (bFGF) nanospheres that are embedded in carboxymethyl chitosan (CMCS)-sodium alginate to form CSDP hybrid hydrogel. We systematically evaluated the inherent antibacterial performance, rheological properties, fluorescence imaging, and biocompatibility of the CSDP nanosystem. Under mild photoirradiation (30 J/cm², 5 min), 10 μg/mL CSDP showed excellent antibacterial and anti-biofilm activities, which eradicated almost 99.99% of Staphylococcus aureus and multidrug-resistant (MDR) S. aureus in vitro. KEGG analysis identified that multiple signaling pathways were changed in MDR S. aureus after PACT. In the burn-infection model, CSDP-PACT successfully inhibited bacteria growth and concurrently promoted wound healing. Moreover, several regenerative factors were increased and some proinflammatory factors were reduced in the burn wounds of CSDP hydrogel treatment. These results suggest that the multifunctional CSDP hydrogel is a portable, light-triggered, antibacterial theranostic-platform and CSDP-PACT provides a promising strategy or the mechanically based synergistic treatment of burn infections.

Curcumin induced photodynamic therapy mediated suppression of quorum sensing pathway of Pseudomonas aeruginosa: An approach to inhibit biofilm in vitro

OBJECTIVE

The objective of this study was to inhibit the Pseudomonas aeruginosa biofilm through curcumin-mediated antimicrobial photodynamic therapy (A-PDT).

BACKGROUND

The mechanism behind A-PDT mediated photoinactivation depend upon reactive oxygen species (ROS) production, like singlet oxygen and free radicals.

METHODS

To evaluate the antibacterial efficacy of curcumin induced A-PDT on P. aeruginosa by colony forming unit (CFU) while antibiofilm action was determined by the use of crystal violet, XTT, congored binding assay and confocal laser scanning microscope (CLSM).

RESULTS

We found that curcumin with 10 J/cm² of light reduces P. aeruginosa biofilm more efficiently than without light. Extracellular polymeric substances (EPS) production was also reduced by approx 94 % with 10 J/cm² of light dose. CLSM images showed that the thickness of biofilms were reduced from >30 μm to <5 μm after treatment with curcumin followed by 10 J/cm² of light irradiation. Curcumin showed better bacteriostatic activity than bactericidal activity. Singlet oxygen is primarily responsible for photodamage and cytotoxic reactions caused by curcumin-mediated APDT. Genes involved in quorum sensing (QS) pathway was also found to be inhibited after APDT. Curcumin with 5 J/cm² light inhibits QS genes and on increasing light dose i.e10 J/cm², we found a drastic reduction in gene expression.

CONCLUSION

We conclude that the curcumin mediated A-PDT inhibits biofilm formation ofP. aeruginosa through QS pathway by the action of singlet oxygen generation which in turn reduced EPS of the biofilm.

Effects of Ag/ZnO nanocomposite at sub-minimum inhibitory concentrations on virulence factors of Streptococcus mutans

OBJECTIVE

Streptococcus mutans (S. mutans), the main pathogen of dental caries, could be well killed by Ag/ZnO nanocomposite. However, effects on virulence factors remain to be elucidated. This study investigated effects of Ag/ZnO at sub-minimum inhibitory concentrations (sub-MICs) on virulence factors of S. mutans and related genes expressions.

DESIGN

Effects of Ag/ZnO on the growth of S. mutans was investigated by growth curves and MTT staining method. The influence of Ag/ZnO at sub-MICs on biofilm formation was measured by the crystal violet staining method and observed by a scanning electron microscopy. Adherence, cell-surface hydrophobicity, acidogenicity and extracellular polysaccharides (EPS) of S. mutans after treatment by Ag/ZnO at sub-MICs were also investigated. Virulence factors related genes expressions after treated by Ag/ZnO at 1/2 MIC was conducted by the quantitative real-time PCR (qRT-PCR) method.

RESULTS

Sub-MICs of Ag/ZnO exhibited a dose-dependent inhibition on the virulence factors of S. mutans. Specially, Ag/ZnO at 1/2 MIC decreased 69.00 % biofilm formation, 31.78 % sucrose-independent and 48.08 % sucrose-dependent adherence, 69.44 % cell-surface hydrophobicity and 72.45 % water-soluble and 90.60 % water-insoluble EPS. Furthermore, the expression of virulence factors related genes was significantly suppressed by Ag/ZnO at 1/2 MIC.

CONCLUSIONS

Ag/ZnO at sub-MICs inhibited multiple virulence factors of S. mutans through downregulating the related genes. Ag/ZnO nanocomposite could be used for prevention of dental caries at low dosage.

Anti-biofilm and anti-metabolic effects of antimicrobial photodynamic therapy using chlorophyllin-phycocyanin mixture against Streptococcus mutans in experimental biofilm caries model on enamel slabs

BACKGROUND

Partial (selective) removal of dental caries is a suitable manner to treat deep carious lesions in vital teeth with asymptomatic pulps. Antimicrobial photodynamic therapy (aPDT) was proposed as a promising ancillary approach for reduction of the residual bacteria from the cavity. Therefore, the focus of this study was to investigate the influence of aPDT using diode laser (DL) plus PhotoActive+ (chlorophyllin-phycocyanin mixture [CHL-PC]) as photosensitizer (PS) on metabolic activity and the reduction in the number of living bacteria within the preformed biofilm caries model on enamel slabs of Streptococcus mutans.

MATERIALS AND METHODS

The lethal and sub-significant inhibitory (SSI) potential of aPDT using CHL-PC and 635 nm DL against experimental biofilm caries model on enamel slabs and metabolic activity of S. mutans was analyzed using crystal violet and XTT reduction assays, respectively. Intracellular ROS formation by DCFH-DA assay was measured in CHL-PC mediated aPDT treated bacterial samples. Tooth discoloration and cell cytotoxicity of CHL-PC were assessed in the CIEL*a*b* color space and neutral red assay, respectively.

RESULTS

In this study aPDT at a maximum concentration level of CHL-PC (5000 μg/mL) with 3 min DL irradiation time (103.12 J/cm²) reduced the ex-vivo cariogenic biofilm of S. mutans by 36.93 % (P <  0.05). Although chlorhexidine (CHX) had an anti-biofilm effect about 1.7 fold compared to CHL-PC mediated aPDT, this difference was not significant (36.93 in comparison to 63.05 %; P >  0.05). CHL-PC mediated aPDT demonstrated a significant reduction in bacterial metabolic activity, with rates of 77 % at a SSI dose (using 156 μg/mL of CHL-PC and 3 min DL irradiation time with the energy density of 103.12 J/cm²). The treated bacterial cells exhibited significant (P < 0.05) increment in the ROS generation. The least color change (ΔE) was found using CHL-PC at a concentration of 156 μg/mL (ΔE = 2.74). CHL-PC in different concentrations showed no significant reduction in human gingival fibroblasts (HGFs) cell survival (P >  0.05).

CONCLUSION

CHL-PC mediated aPDT not only reduces the number of living bacteria within the biofilms of S. mutans in an experimental biofilm caries model on enamel slabs but also its influences microbial virulence by reducing the metabolic activity of the S. mutants.

Photonic Therapy in Periodontal Diseases an Overview with Appraisal of the Literature and Reasoned Treatment Recommendations

Recent reviews and meta-analyses of the literature over the past quarter-century have failed to provide enough evidence to prove or disprove the actual utility of photonic therapy in periodontitis, alone or adjunctive to conventional approaches. This apparent paradox has been explained by the many physical, molecular, biological, anatomical, and technical variables of photonic treatments, which can differ in light-emitting devices (laser or LED), wavelengths, irradiation power and modes, clinical objectives, follow-up times, disease grading, and assessment methods. This multi-faceted, controversial scenario has led practitioners to underestimate the actual potential of photonic therapy in periodontal diseases. In this critical appraisal of the literature, we have briefly summarized the main photonic therapies and instruments used in Periodontology, highlighting their main characteristics and limitations. Then, we have tried to identify and discuss the key methodological issues which can have an impact on the outcome of photonic therapies. Our main goal was to identify the best parameters, settings, and methodologies to perform effective periodontal photonic treatments and to extrapolate some recommendations for clinical use. Should these recommendations find a consensus among periodontologists and be adopted in future clinical studies, they will hopefully contribute to dissipate the present confusion and uncertainty on this complex matter.

Oral microbiological control by photodynamic action in orthodontic patients

BACKGROUND

Orthodontics involves diagnosis and treatment of dental and skeletal malocclusions. Orthodontic apparatus may repair these malocclusions but may also impair oral hygiene making patients prone to develop both periodontal diseases and caries. Antimicrobial agents may be used to prevent this.To avoid increased antimicrobial resistance to available drugs, A-PDT (Antimicrobial Photodynamic Therapy) appears as a viable alternative.

OBJECTIVE

This work aimed to evaluate the efficacy of A-PDT on reducing the number of colony forming units (CFU) through the use of phenothiazine compound (methylene blue+ toluidine blue) as a photosensitizer, associated with red LED (λ640±5ηm) irradiation in orthodontic patients.

METHODOLOGY

Twenty-one patients consented to participate in the study. Three biofilm collections were performed around the brackets and gums of the inferior central incisors; first before any intervention (Control); second after 5min of pre-irradiation and the last one immediately after AmPDT. Subsequently, a microbiological routine for microorganism growth period were performed and CFU counting after a 24h done.

RESULTS

The data showed that the AmPDT was able to reduce CFU count around 90% when compared to Control group (p=0.007) and also between the A-PDT and Photosensitizer groups (p=0.010). However, there were no differences between the Control and Photosensitizer groups.

CONCLUSION

A-PDT associated with the use of phenothiazine compounds and red LED was able to significantly reduce the number of CFUs in orthodontic patients.

Anti-Biofilm Property of Bioactive Upconversion Nanocomposites Containing Chlorin e6 against Periodontal Pathogens

Photodynamic therapy (PDT) based periodontal disease treatment has received extensive attention. However, the deep tissue location of periodontal plaque makes the conventional PDT encounter a bottleneck. Herein, upconversion fluorescent nanomaterial with near-infrared light excitation was introduced into the treatment of periodontal disease, overcoming the limited tissue penetration depth of visible light in PDT. Photosensitizer Ce6 molecules were combined with upconversion nanoparticles (UCNPs) NaYF4:Yb,Er with a novel strategy. The hydrophobic UCNPs were modified with amphiphilic silane, utilizing the hydrophobic chain of the silane to bind to the hydrophobic groups of the UCNPs through a hydrophobic-hydrophobic interaction, and the Ce6 molecules were loaded in this hydrophobic layer. This achieves both the conversion of the hydrophobic to the hydrophilic surface and the loading of the oily photosensitizer molecules. Because the excitation position of the Ce6 molecule is in the red region, Mn ions were doped to enhance red light, and thus the improved PDT function. This Ce6 loaded UCNPs composites with efficient red upconversion luminescence show remarkable bacteriological therapeutic effect on Porphyromonas gingivalis, Prevotella intermedia and Fusobacterium nucleatum and the corresponding biofilms under 980 nm irradiation, indicating a high application prospect in the treatment of periodontal diseases.