Photodynamic antimicrobial chemotherapy (PACT) using riboflavin inhibits the mono and dual species biofilm produced by antibiotic resistant Staphylococcus aureus and Escherichia coli

Photodynamic black phosphorus nanosheets functionalized with polymyxin B for targeted ablation of drug-resistant mixed-species biofilms

Biofilms, particularly those formed by multiple bacterial species, pose significant economic and environmental challenges, especially in the context of medical implants. Addressing the urgent need for effective treatment strategies that do not exacerbate drug resistance, we developed a novel nanoformulation, Ce6&PMb@BPN, based on black phosphorus nanosheets (BPN) for targeted treatment of mixed-species biofilms formed by Acinetobacter baumannii (A. baumannii) and methicillin-resistant Staphylococcus aureus (MRSA).The formulation leverages polymyxin B (PMb) for bacterial targeting and chlorin e6 (Ce6) for photodynamic action. Upon near-infrared (NIR) irradiation, Ce6&PMb@BPN efficiently eliminates biofilms by combining chemotherapy, photodynamic therapy (PDT) and photothermal therapy (PTT), reducing biofilm biomass significantly within 30 min. In vivo studies on mice infected with mixed-species biofilm-coated catheters demonstrated the formulation's potent antibacterial and biofilm ablation effects. Moreover, comprehensive biosafety evaluations confirmed the excellent biocompatibility of Ce6&PMb@BPN. Taken together, this intelligently designed nanoformulation holds potential for effectively treating biofilm-associated infections, addressing the urgent need for strategies to combat antibiotic-resistant biofilms, particularly mixed-species biofilm, in medical settings.

Evaluation of quantification methods to determine photodynamic action on mono- and dual-species bacterial biofilms

The effect of photodynamic inactivation (PDI) sensitized by 5,10,15,20-tetra(4-N,N,N-trimethylammoniophenyl)porphyrin (TMAP4+) on different components of mono- and dual-species biofilms of Staphylococcus aureus and Escherichia coli was determined by different methods. First, the plate count technique showed that TMAP4+-PDI was more effective on S. aureus than E. coli biofilm. However, crystal violet staining revealed no significant differences between before and after PDI biofilms of both bacteria. On the other hand, the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide method indicated a reduction in viable cells as the light exposure time increases in both, mono- and dual-species biofilms. Furthermore, it was determined that as the irradiation time increases, the amount of extracellular polymeric substances present in the biofilms decreased. This effect was presented in both strains and in the mixed biofilm, being more evident in S. aureus mono-specie biofilm. Finally, scanning electron microscopy analysis showed a decrease in the number of cells forming the biofilm after photosensitization treatments. This information makes it possible to determine whether the photodynamic action is based on damage to metabolic activity, extracellular matrix and/or biomass, which may be useful in establishing a fully effective PDI protocol for the treatment of microorganisms growing as biofilms.

Photoactivated riboflavin inhibits planktonic and biofilm growth of Candida albicans and non-albicans Candida species

Fungal infections caused by Candida species pose a serious threat to humankind. Antibiotics abuse and the ability of Candida species to form biofilm have escalated the emergence of drug resistance in clinical settings and hence, rendered it more difficult to treat Candida-related diseases. Lethal effects of Candida infection are often due to inefficacy of antimicrobial treatments and failure of host immune response to clear infections. Previous studies have shown that a combination of riboflavin with UVA (riboflavin/UVA) light demonstrate candidacidal activity albeit its mechanism of actions remain elusive. Thus, this study sought to investigate antifungal and antibiofilm properties by combining riboflavin with UVA against Candida albicans and non-albicans Candida species. The MIC20 for the fluconazole and riboflavin/UVA against the Candida species tested was within the range of 0.125-2 μg/mL while the SMIC50 was 32 μg/mL. Present findings indicate that the inhibitory activities exerted by riboflavin/UVA towards planktonic cells are slightly less effective as compared to controls. However, the efficacy of the combination towards Candida species biofilms showed otherwise. Inhibitory effects exerted by riboflavin/UVA towards most of the tested Candida species biofilms points towards a variation in mode of action that could make it an ideal alternative therapeutic for biofilm-related infections.

Evaluation of visible light and natural photosensitizers against Staphylococcus epidermidis and Staphylococcus saprophyticus planktonic cells and biofilm

Antimicrobial photoinactivation (API) has shown some promise in potentially treating different nosocomial bacterial infections, however, its application on staphylococci, especially other than Staphylococcus aureus or methicillin-resistant S. aureus (MRSA) species is still limited. Although S. aureus is a well-known and important nosocomial pathogen, several other species of the genus, particularly coagulase-negative Staphylococcus (CNS) species such as Staphylococcus epidermidis and Staphylococcus saprophyticus, can also cause healthcare-associated infections and foodborne intoxications. CNS are often involved in resilient biofilm formation on medical devices and can cause infections in patients with compromised immune systems or those undergoing invasive procedures. In this study, the effects of chlorophyllin and riboflavin-mediated API on S. epidermidis and S. saprophyticus planktonic cells and biofilm are demonstrated for the first time. Based on the residual growth determination and metabolic reduction ability changes, higher inactivating efficiency of chlorophyllin-mediated API was determined against the planktonic cells of both tested species of bacteria and against S. saprophyticus biofilm. Some insights on whether aqueous solutions of riboflavin and chlorophyllin, when illuminated with optimal exciting wavelength (440 nm and 402 nm, respectively) generate O2-•, are also provided in this work.

Photodynamic inactivation of bacteria: Why it is not enough to excite a photosensitizer

BACKGROUND

The development of multidrug resistance (MDR) in infectious agents is one of the most serious global problems facing humanity. Antimicrobial photodynamic therapy (APDT) shows encouraging results in the fight against MDR pathogens, including those in biofilms.

METHODS

Photosensitizers (PS), monocationic methylene blue, polycationic and polyanionic derivatives of phthalocyanines, electroneutral and polycationic derivatives of bacteriochlorin were used to study photodynamic inactivation of Gram-positive and Gram-negative planktonic bacteria and biofilms under LED irradiation. Zeta potential measurements, confocal fluorescence imaging, and coarse-grained modeling were used to evaluate the interactions of PS with bacteria. PS aggregation and photobleaching were studied using absorption and fluorescence spectroscopy.

RESULTS

The main approaches to ensure high efficiency of bacteria photosensitization are analyzed.

CONCLUSIONS

PS must maintain a delicate balance between binding to exocellular and external structures of bacterial cells and penetration through the cell wall so as not to get stuck on the way to photooxidation-sensitive structures of the bacterial cell.

Medicinal benefits, biological, and nanoencapsulation functions of riboflavin with its toxicity profile: A narrative review

Riboflavin is a precursor of the essential coenzymes flavin mononucleotide and flavin adenine dinucleotide. Both possess antioxidant properties and are involved in oxidation-reduction reactions, which have a significant impact on energy metabolism. Also, the coenzymes participate in metabolism of pyridoxine, niacin, folate, and iron. Humans must obtain riboflavin through their daily diet because of the lack of programmed enzymatic machineries for de novo riboflavin synthesis. Because of its physiological nature and fast elimination from the human body when in excess, riboflavin consumed is unlikely to induce any negative effects or develop toxicity in humans. The use of riboflavin in pharmaceutical and clinical contexts has been previously explored, including for preventing and treating oxidative stress and reperfusion oxidative damage, creating synergistic compounds to mitigate colorectal cancer, modulating blood pressure, improving diabetes mellitus comorbidities, as well as neuroprotective agents and potent photosensitizer in killing bloodborne pathogens. Thus, the goal of this review is to provide a comprehensive understanding of riboflavin's biological applications in medicine, key considerations of riboflavin safety and toxicity, and a brief overview on the nanoencapsulation of riboflavin for various functions including the treatment of a range of diseases, photodynamic therapy, and cellular imaging.

The Effect of Different Output Powers of Blue Diode Laser along with Curcumin and Riboflavin against Streptococcus mutans around Orthodontic Brackets: An In Vitro Study

OBJECTIVES

The aim of the present study was to determine the effects of antimicrobial photodynamic therapy (aPDT) using the blue diode laser (BDL) with different output powers and the photosensitizers riboflavin and curcumin on reducing the number of Streptococcus mutans around orthodontic brackets.

MATERIALS AND METHODS

A total of 36 orthodontic brackets were contaminated with S. mutans and randomly assigned to 12 groups as follows: control, riboflavin alone, riboflavin + BDL with an output power of 200, 300, 400, or 500 mW, and curcumin alone, curcumin + BDL with an output power of 200, 300, 400, or 500 mW, and 0.2% chlorhexidine (CHX-positive control). Orthodontic brackets were irradiated with a BDL (wavelength 445 nm) at a power density of 0.4-1.0 W/cm2 for 30 s. All orthodontic brackets were examined under a stereomicroscope at 10× magnification. Mean colony-forming units (CFUs)/mL were measured before and after treatment. A one-way analysis of variance with Tukey's post hoc test was performed to compare CFU/mL between groups.

RESULTS

CHX and curcumin plus BDL with an output power of 500 mW had the highest reduction in S. mutans colony numbers (p < 0.001). The curcumin groups were more effective than the riboflavin groups. Riboflavin alone and riboflavin + BDL with an output power of 200 mW showed no significant difference from the control group (p = 0.99 and 0.74, respectively).

CONCLUSION

Our results suggest that aPDT using curcumin as a photosensitizer plus BDL with an output power of 500 mW and a power density of 1.0 W/cm2 at a wavelength of 445 nm can effectively reduce colonies of S. mutans around stainless steel brackets.

The mixed biofilm formed by Listeria monocytogenes and other bacteria: Formation, interaction and control strategies

Listeria monocytogenes is an important foodborne pathogen. It can adhere to food or food contact surface for a long time and form biofilm, which will lead to equipment damage, food deterioration, and even human diseases. As the main form of bacteria to survive, the mixed biofilms often exhibit higher resistance to disinfectants and antibiotics, including the mixed biofilms formed by L. monocytogenes and other bacteria. However, the structure and interspecific interaction of the mixed biofilms are very complex. It remains to be explored what role the mixed biofilm could play in the food industry. In this review, we summarized the formation and influence factors of the mixed biofilm developed by L. monocytogenes and other bacteria, as well as the interspecific interactions and the novel control measures in recent years. Moreover, the future control strategies are prospected, in order to provide theoretical basis and reference for the research of the mixed biofilms and the targeted control measures.

Riboflavin Targets the Cellular Metabolic and Ribosomal Pathways of Candida albicans In Vitro and Exhibits Efficacy against Oropharyngeal Candidiasis

Oropharyngeal candidiasis (OPC), which has a high incidence in immunocompromised and denture stomatitis patients, is commonly caused by Candida albicans infection and in some cases develops into disseminated candidiasis throughout the throat and esophagus, resulting in high mortality. New drugs are needed to combat OPC because of the limited treatment options currently available and increasing resistance to existing drugs. Here, we confirmed that riboflavin (RF), a cofactor of flavin adenine mononucleotide and flavin adenine dinucleotide, has broad-spectrum anti-Candida activity. The formation of C. albicans hyphae and biofilm was inhibited by RF. Mechanistically, RF disrupted membrane and cell wall integrity, as well as promoting reactive oxygen species and pyruvate accumulation. Furthermore, RF targeted multiple essential pathways via functional disruption of thiamine and RF metabolic pathways, central carbon metabolism, and ribosome metabolism. Similar to the results in vitro, the inhibitory effect of RF on C. albicans hyphae was confirmed in a mouse model of OPC. Moreover, after 5 consecutive days of intraperitoneal injection, RF exhibited therapeutic efficacy, as demonstrated by phenotype investigation, the fungal burden, and histopathological analysis. These findings revealed that RF exerts a multifaceted anti-Candida effect and has potential benefits in the treatment of OPC. IMPORTANCE Candida species are common pathogens in fungal infections, causing mucosal infection and invasive infection in immunodeficient patients. Given the limited classes of drugs and resistance to these drugs, new antifungal agents need to be developed. Drug repurposing is a potential method for antifungal drug development. This study demonstrated that riboflavin (RF) exhibited broad-spectrum anti-Candida activity. RF affected multiple targets involving the membrane and cell wall integrity, the accumulation of reactive oxygen species and pyruvate, and the altered metabolic pathways in C. albicans. Moreover, RF exhibited efficacy in the treatment of C. albicans in an oropharyngeal candidiasis mouse model. Taken together, the antifungal activity and the promising clinical application of RF were highlighted.

Antibacterial potential of riboflavin mediated blue diode laser photodynamic inactivation against Enterococcus faecalis: A laboratory investigation

OBJECTIVES

This study aimed to evaluate the inactivation potency of riboflavin-mediated blue diode laser photodynamic inactivation (PDI) against Enterococcus faecalis at planktonic and biofilm stages and also investigated its effect on the tooth color change.

MATERIALS AND METHODS

The antibacterial and antibiofilm activities of riboflavin mediated PDI against E. faecalis were investigated. The numbers of colony-forming units (CFUs)/mL were calculated. Teeth discoloration were evaluated using the CIE L*a*b* based color difference (ΔE).

RESULTS

Antibacterial analysis indicated that the blue diode laser irradiation at 12, 18, 24, and 30 J/cm² alone and different concentrations of riboflavin solution (6.25 to 100 μM) reduced the number of CFU/mL of E. faecalis, but the reduction was not statistically significant (P > 0.05). Depending on the riboflavin concentration and the light dose, there can be as much as a 1-log effect on CFU/mL. In addition, E. faecalis biofilm was more affected with 30 J/cm² irradiation dosage and 100 μM riboflavin than other groups. Meanwhile, bacterial suspensions treated with 5.25% sodium hypochlorite (NaOCl) showed maximum biofilm inhibition and colony number reduction, compared with the control. The teeth exhibited clinically acceptable color change after riboflavin treatment at concentration ranging from 6.25 to 50 μM (ΔE < 3.7).

CONCLUSIONS

The riboflavin mediated PDI process is somewhat less effective than NaOCl but perhaps less toxic to tissues. It might be feasible to repeat the riboflavin + light treatment to further promote efficacy.

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.

Highly Efficient Antibacterial Polymer Composites Based on Hydrophobic Riboflavin Carbon Polymerized Dots

Development of new types of antimicrobial coatings is of utmost importance due to increasing problems with pathogen transmission from various infectious surfaces to human beings. In this study, new types of highly potent antimicrobial polyurethane composite films encapsulated by hydrophobic riboflavin-based carbon polymer dots are presented. Detailed structural, optical, antimicrobial, and cytotoxic investigations of these composites were conducted. Low-power blue light triggered the composites to eradicate Escherichia coli in 30 min, whereas the same effect toward Staphylococcus aureus was reached after 60 min. These composites also show low toxicity against MRC-5 cells. In this way, RF-CPD composites can be used for sterilization of highly touched objects in the healthcare industry.

Photodynamic inactivation of multidrug-resistant bacteria in wastewater effluent using green phytochemicals as a natural photosensitizer

The control of multidrug-resistant bacteria (MDRB) is a great challenge in the 21st century. Photodynamic treatment (PDT) is one of the promising approaches to control MDRB. In the process, powerful oxidants such as reactive oxygen species (ROS) are produced, which cause cytotoxic damage and cell death of bacteria. This study examined a new and environment-friendly strategy for the photodynamic inactivation of two MDRB (Escherichia coli and Staphylococcus aureus) and total coliform (TC) in wastewater effluent using two phytochemicals, pyrogallol (PGL) and terpinolene (TPN), along with white and blue light-emitting diode (LED) light. Fourier-transform infrared spectroscopy (FTIR) of the phytochemicals confirmed the presence of different phenolic and aromatic compounds, which can enhance the generation of ROS alongside inactivating the bacterial cells. In the PDT process, white LED light was more active in controlling MDRB than blue LED light. After 80 min irradiation with white LED light (17 mW/cm²), the MDRB bacteria were eradicated completely at a minimum inhibitory concentration (MIC) dose (0.156 mg/mL for E. coli and 0.078 mg/mL for S. aureus) of PGL. In addition, light intensity was an important parameter in photodynamic disinfection. The TC in the secondary effluent was inactivated completely by both phytochemicals after 60 min of exposure to white LED light with an intensity of 80 mW/cm². The photosensitizing activity of phytochemicals was analyzed by a bactericidal and imidazole-RNO assay. These assays showed that PGL contributed to the generation of •OH radicals, whereas TPN produced ¹O₂ in the PDT process. Transmission electron microscopy (TEM) confirmed bacterial cell disruption after treatment. Overall, PDT using the phytochemicals as PS is a sustainable approach to control the MDRB and TC in wastewater successfully.

Photodynamic antibacterial and antibiofilm activity of riboflavin against Xanthomonas oryzae pv oryzae: an ecofriendly strategy to combat bacterial leaf blight (BLB) rice disease

Bacterial leaf blight (BLB), caused by Xanthomonas oryzae pv oryzae (Xoo), is one of the most damaging rice diseases, causing severe production losses depending on the rice variety. The purpose of this study was to develop an antibacterial photodynamic treatment (aPDT) using riboflavin for the treatment of BLB disease. Combining light and riboflavin (RF) therapy significantly reduced bacterial planktonic cells compared to RF alone. Photoactivated riboflavin also decreased biofilm biomass by reducing the number of viable sessile cells and the production of extracellular polymeric substances (EPS). Reactive oxygen species (ROS) levels in Xoo cells treated with photoactivated riboflavin were found to be significantly higher than in cells treated with riboflavin and light individually. Malondialdehyde (MDA) increased greatly in photoactivated riboflavin treated cells, indicating that severe oxidative damage was induced. Subsequently, a reduction in lactate dehydrogenase (LDH) activity in photoactivated riboflavin treated Xoo cells indicates that oxidative stress has disrupted the respiratory system, leading to bacterial cell death. In an ex vivo aPDT assay, photoactivated riboflavin successfully eradicated Xoo on the surface of rice leaves. Photoactivated riboflavin had no side effects on rice seed germination in subsequent trials, indicating that it is safe for agricultural applications. Therefore, all these findings suggest that aPDT is a potential alternative management strategy for BLB disease.

Control Measurements of Escherichia coli Biofilm: A Review

Escherichia coli (E. coli) is a common pathogen that causes diarrhea in humans and animals. In particular, E. coli can easily form biofilm on the surface of living or non-living carriers, which can lead to the cross-contamination of food. This review mainly summarizes the formation process of E. coli biofilm, the prevalence of biofilm in the food industry, and inhibition methods of E. coli biofilm, including chemical and physical methods, and inhibition by bioactive extracts from plants and animals. This review aims to provide a basis for the prevention and control of E. coli biofilm in the food industry.

In vitro effect of farnesol on planktonic cells and dual biofilm formed by Candida albicans and Escherichia coli

Many biofilm studies have focused on axial biofilms, however biofilms in nature and in vivo environment are multi-species. Farnesol is a sesquiterpene alcohol found in many essential oils. This study investigated the in vitro effects of farnesol on planktonic cells and biofilms of Candida albicans and Escherichia coli. The ultrastructural morphology of farnesol treated cells was evaluated by TEM. According to the XTT results, farnesol caused a significant decrease in metabolic activity and scanning electron microscope images confirmed a reduction in the preformed biofilm as a result of farnesol treatment for single species C. albicans and E. coli biofilms. Although farnesol has less effect on dual species biofilm compared to the single species biofilms, its effect on the dual biofilm was found to be stronger than amphotericin B or ampicillin. Further studies are needed to clarify the role of farnesol on fungal-bacterial biofilms.

Orange-red to NIR emissive carbon dots for antimicrobial, bioimaging and bacteria diagnosis

Antimicrobial photodynamic therapy (aPDT) has become a popular technology for the treatment of bacterial infections. The development of antimicrobial agents combining diagnosis and treatment remains a major challenge. Herein, curcumin carbon quantum dots (Cur-NRCQDs) with antibacterial and imaging effects were synthesized using a hydrothermal method. The fluorescence absorption range of the Cur-NRCQDs in aqueous solution was 555 to 850 nm, showing orange-red to near infrared (NIR) fluorescence, and its maximum emission wavelength was 635 nm. At the same time, Cur-NRCQDs improved the efficiency of Cur as the photosensitizer (PS), showed good storage and light stability, and enhanced the efficiency of reactive oxygen (ROS) generation and antibacterial activity. Under the irradiation of a xenon lamp, Cur-NRCQDs inactivated 100% Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) at concentrations of 10 and 15 μM, respectively. The possible reason for this was that under PDT, the ROS produced by the Cur-NRCQDs destroyed the integrity of the cell membrane, resulting in leakage of the contents. In addition, the Cur-NRCQDs showed good cell compatibility, as they can also enter bacteria and cells for imaging, so they can be employed for the detection of bacteria and cell tissues. Therefore, Cur-NRCQDs are an ideal candidate material for aPDT treatment and fluorescent bioimaging.

Riboflavin as a promising antimicrobial agent? A multi-perspective review

•

Riboflavin demonstrates antioxidant and photosensitizing properties.

•

Riboflavin is able to induce ROS and modulate immune response.

•

Riboflavin possesses potent antimicrobial activity when used alone or combined with other anti-infectives.

•

The riboflavin biosynthesis pathway serves as an ideal drug target against microbes.

•

UVA combination with riboflavin exhibits remarkable antimicrobial effects.

Riboflavin, or more commonly known as vitamin B2, forms part of the component of vitamin B complex. Riboflavin consisting of two important cofactors, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD), which are involved in multiple oxidative-reduction processes and energy metabolism. Besides maintaining human health, different sources reported that riboflavin can inhibit or inactivate the growth of different pathogens including bacteria, viruses, fungi and parasites, highlighting the possible role of riboflavin as an antimicrobial agent. Moreover, riboflavin and flavins could produce reactive oxygen species (ROS) when exposed to light, inducing oxidative damage in cells and tissues, and thus are excellent natural photosensitizers. Several studies have illustrated the therapeutic efficacy of photoactivated riboflavin against nosocomial infections and multidrug resistant bacterial infections as well as microbial associated biofilm infections, revealing the potential role of riboflavin as a promising antimicrobial candidate, which could serve as one of the alternatives in fighting the global crisis of the emergence of antimicrobial resistance seen in different pathogenic microbes. Riboflavin could also be involved in modulating host immune responses, which might increase the pathogen clearance from host cells and increase host defense against microbial infections. Thus, the dual effects of riboflavin on both pathogens and host immunity, reflected by its potent bactericidal effect and alleviation of inflammation in host cells further imply that riboflavin could be a potential candidate for therapeutic intervention in resolving microbial infections. Hence, this review aimed to provide some insights on the promising role of riboflavin as an antimicrobial candidate and also a host immune-modulator from a multi-perspective view as well as to discuss the application and challenges on using riboflavin in photodynamic therapy against various pathogens and microbial biofilm-associated infections.

Hydrogen peroxide potentiates antimicrobial photodynamic therapy in eliminating Candida albicans and Streptococcus mutans dual-species biofilm from denture base

BACKGROUND

Candida albicans (C.albicans) is the primary pathogen of denture biofilm. Moreover, it could establish a cross-kingdom relationship with bacteria to enhance its virulence and resistance to antifungal drugs. This study aimed to investigate the efficacy of antimicrobial photodynamic therapy (aPDT) in combination with hydrogen peroxide (H₂O₂) against C.albicans and Streptococcus mutans (S.mutans) dual-species biofilm formed on polymethyl methacrylate (PMMA) disk, and explore its involved mechanisms.

METHODS

C.albicans and S.mutans were grown on PMMA disk for 48 h to form biofilm and received different treatments. The treatments included:1) phosphate-buffered saline (PBS) group,2) 100 mM H₂O₂ group,3) aPDT group,4) aPDT+ H₂O₂ and 5) H₂O₂+aPDT group. Colony forming units (CFU), 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), and scanning electron microscope (SEM) were used to evaluate the antimicrobial effects. Extracellular polysaccharide substance (EPS) production and observation, cell permeability of biofilm, and uptake of toluidine blue O (TBO) by biofilm were assessed to investigate the involved mechanism.

RESULTS

There was no significant difference between PBS group and H₂O₂ group in viable microorganisms and metabolic activity of biofilm. The treatment protocols containing aPDT group reduced microorganism numbers and metabolic activity when compared to PBS group or H₂O₂ group (P<0.05). H₂O₂+aPDT treatment showed the highest antimicrobial efficacy in comparison with other treatments (P<0.05). Pretreatment with H₂O₂ could decrease EPS production and enhance cell permeability, leading to increased TBO uptake in biofilm.

CONCLUSION

Pretreatment with H₂O₂ improved aPDT efficiency in eliminating dual-species biofilm from PMMA disk by reducing EPS amount, enhancing cell permeability, and increasing TBO uptake.

Antimicrobial Effect of Phytochemicals from Edible Plants

Current strategies of combating bacterial infections are limited and involve the use of antibiotics and preservatives. Each of these agents has generally inadequate efficacy and a number of serious adverse effects. Thus, there is an urgent need for new antimicrobial drugs and food preservatives with higher efficacy and lower toxicity. Edible plants have been used in medicine since ancient times and are well known for their successful antimicrobial activity. Often photosensitizers are present in many edible plants; they could be a promising source for a new generation of drugs and food preservatives. The use of photodynamic therapy allows enhancement of antimicrobial properties in plant photosensitizers. The purpose of this review is to present the verified data on the antimicrobial activities of photodynamic phytochemicals in edible species of the world’s flora, including the various mechanisms of their actions.

New Perspectives on Old and New Therapies of Staphylococcal Skin Infections: The Role of Biofilm Targeting in Wound Healing

Among the most common complications of both chronic wound and surgical sites are staphylococcal skin infections, which slow down the wound healing process due to various virulence factors, including the ability to produce biofilms. Furthermore, staphylococcal skin infections are often caused by methicillin-resistant Staphylococcus aureus (MRSA) and become a therapeutic challenge. The aim of this narrative review is to collect the latest evidence on old and new anti-staphylococcal therapies, assessing their anti-biofilm properties and their effect on skin wound healing. We considered antibiotics, quorum sensing inhibitors, antimicrobial peptides, topical dressings, and antimicrobial photo-dynamic therapy. According to our review of the literature, targeting of biofilm is an important therapeutic choice in acute and chronic infected skin wounds both to overcome antibiotic resistance and to achieve better wound healing.

Photodynamic disinfection and its role in controlling infectious diseases

Photodynamic therapy is witnessing a revival of its origins as a response to the rise of multi-drug resistant infections and the shortage of new classes of antibiotics. Photodynamic disinfection (PDDI) of microorganisms is making progresses in preclinical models and in clinical cases, and the perception of its role in the clinical armamentarium for the management of infectious diseases is changing. We review the positioning of PDDI from the perspective of its ability to respond to clinical needs. Emphasis is placed on the pipeline of photosensitizers that proved effective to inactivate biofilms, showed efficacy in animal models of infectious diseases or reached clinical trials. Novel opportunities resulting from the COVID-19 pandemic are briefly discussed. The molecular features of promising photosensitizers are emphasized and contrasted with those of photosensitizers used in the treatment of solid tumors. The development of photosensitizers has been accompanied by the fabrication of a variety of affordable and customizable light sources. We critically discuss the combination between photosensitizer and light source properties that may leverage PDDI and expand its applications to wider markets. The success of PDDI in the management of infectious diseases will ultimately depend on the efficacy of photosensitizers, affordability of the light sources, simplicity of the procedures, and availability of fast and efficient treatments.

The promise of endogenous and exogenous riboflavin in anti-infection

To resolve the growing problem of drug resistance in the treatment of bacterial and fungal pathogens, specific cellular targets and pathways can be used as targets for new antimicrobial agents. Endogenous riboflavin biosynthesis is a conserved pathway that exists in most bacteria and fungi. In this review, the roles of endogenous and exogenous riboflavin in infectious disease as well as several antibacterial agents, which act as analogues of the riboflavin biosynthesis pathway, are summarized. In addition, the effects of exogenous riboflavin on immune cells, cytokines, and heat shock proteins are described. Moreover, the immune response of endogenous riboflavin metabolites in infectious diseases, recognized by MHC-related protein-1, and then presented to mucosal associated invariant T cells, is highlighted. This information will provide a strategy to identify novel drug targets as well as highlight the possible clinical use of riboflavin.

Mechanical and antimicrobial effects of riboflavin-mediated photosensitization of in vitro C. albicans formed on polymethyl methacrylate resin

PURPOSE

This study assessed the potential of riboflavin-mediated photodynamic therapy (RF-PDT) against Candida albicans (C. albicans) and compared the effects of RF-PDT with other therapeutic modalities in terms of mechanical and surface characteristics of acrylic denture base material.

MATERIALS AND METHODS

Molds (10 × 10 × 2 mm) of acrylic resin specimens were prepared and underwent artificial ageing. C. albicans were grown aerobically over the specimens and divided into four groups (n = 10/group); Group-I: no decontamination; Group-II: nystatin suspension; Group-III: riboflavin 0.1% in darkness, Group-IV: blue LED light only, and Group-V: riboflavin 0.1% for 10 minutes (pre-irradiation time) and photoactivated by the blue LED light (light dose). Fungal viability was assessed using MTT assay and characterized using scanning electron microscopy and confocal laser microscopy (CLSM). Treated specimens were subjected to surface roughness (R_a), flexural strength (FS), and flexural modulus (FM).

RESULTS

Group-I showed the highest C. albicans viability followed by Group-III. Nystatin group (Group-II) showed ∼50% of the viability while RF-PDT showed the least C. albicans viability among the four groups (p<0.05). On SEM, specimens treated with Group-IV and V showed almost clear and free from C. albicans that was evidenced on CLSM. Post-treated specimens and storage after 72 h revealed that FS was significantly higher for RF-PDT group as compared to any other group (>105.82 MPa) (p<0.05). The FM and Ra showed statistically no significant difference between the groups (p>0.05).

CONCLUSION

RF-PDT showed the highest anti-fungal capacity against C. albicans over acrylic denture surface without any surface deterioration.

Staphylococcal Biofilms: Challenges and Novel Therapeutic Perspectives

Staphylococci, like Staphylococcus aureus and S. epidermidis, are common colonizers of the human microbiota. While being harmless in many cases, many virulence factors result in them being opportunistic pathogens and one of the major causes of hospital-acquired infections worldwide. One of these virulence factors is the ability to form biofilms-three-dimensional communities of microorganisms embedded in an extracellular polymeric matrix (EPS). The EPS is composed of polysaccharides, proteins and extracellular DNA, and is finely regulated in response to environmental conditions. This structured environment protects the embedded bacteria from the human immune system and decreases their susceptibility to antimicrobials, making infections caused by staphylococci particularly difficult to treat. With the rise of antibiotic-resistant staphylococci, together with difficulty in removing biofilms, there is a great need for new treatment strategies. The purpose of this review is to provide an overview of our current knowledge of the stages of biofilm development and what difficulties may arise when trying to eradicate staphylococcal biofilms. Furthermore, we look into promising targets and therapeutic methods, including bacteriocins and phage-derived antibiofilm approaches.

Antimicrobial capacity and physico-chemical characteristics of adhesive resin containing riboflavin after photodynamic therapy

PURPOSE

To assess the micro-tensile bond strength (μ-TBS), degree of conversion, and antimicrobial capacity of modified dentin adhesive using riboflavin photoinitiators.

MATERIALS AND METHODS

Three groups of adhesives (control; 0.1 % riboflavin-PDT and 0.5 % riboflavin PDT) were prepared and tested on 70 sound molar teeth. Fourier-transformed infrared spectroscopy (FTIR) was performed for riboflavin and riboflavin-modified adhesives to calculate the degree of conversion. Contact angle measurement was performed by dropping a 5 μL droplet of the adhesives onto polished dentin disk. For μ-TBS testing, the dentin beams were fixed on a micro-tensile tester and were loaded in tension at a cross-head speed of 1 mm per min until fracture. The viability of Streptococcus mutans biofilm was tested using MTT assay.

RESULTS

The spectrum at 1728 cm-1 indicates CO stretching frequency of riboflavin. The groups control and 0.1 % riboflavin PDT showed the highest degree of conversion followed by lowest degree of conversion of 0.5 % riboflavin adhesive after PDT. The control adhesive exhibited the highest contact angle over the dentin surface compared to the riboflavin-modified adhesive groups (p < 0.05). The lowest contact angle was observed for 0.1 % riboflavin that showed increased permeability of the adhesive onto the dentin surface (p < 0.05). The variables of immediate bonding (F = 12.328, p = 0.000) and ageing in artificial saliva (F = 41.559, p = 0.000) significantly affected the bond strength. For aged μ-TBS testing, the scores for 0.1 % riboflavin PDT was significantly higher as compared to the 0.5 % riboflavin PDT samples. The MTT resulted in a lower S. mutans viability for 0.5 % riboflavin PDT compared to 0.1 % riboflavin PDT and control adhesive (p < 0.05), irrespective of any time point, that is, after 24 h and 30 days ageing.

CONCLUSIONS

The addition of riboflavin as photosensitizer in dentin adhesive demonstrated higher bond strength, excellent antimicrobial capability, and degree of conversion following PDT. The addition of riboflavin in dentin adhesive for PDT could be used as a potential restorative material in adhesive dentistry.