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Montoya C, Roldan L, Yu M, Valliani S, Ta C, Yang M, Orrego S. Smart dental materials for antimicrobial applications. Bioact Mater 2023; 24:1-19. [PMID: 36582351 PMCID: PMC9763696 DOI: 10.1016/j.bioactmat.2022.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/17/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022] Open
Abstract
Smart biomaterials can sense and react to physiological or external environmental stimuli (e.g., mechanical, chemical, electrical, or magnetic signals). The last decades have seen exponential growth in the use and development of smart dental biomaterials for antimicrobial applications in dentistry. These biomaterial systems offer improved efficacy and controllable bio-functionalities to prevent infections and extend the longevity of dental devices. This review article presents the current state-of-the-art of design, evaluation, advantages, and limitations of bioactive and stimuli-responsive and autonomous dental materials for antimicrobial applications. First, the importance and classification of smart biomaterials are discussed. Second, the categories of bioresponsive antibacterial dental materials are systematically itemized based on different stimuli, including pH, enzymes, light, magnetic field, and vibrations. For each category, their antimicrobial mechanism, applications, and examples are discussed. Finally, we examined the limitations and obstacles required to develop clinically relevant applications of these appealing technologies.
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Affiliation(s)
- Carolina Montoya
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, PA, USA
| | - Lina Roldan
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, PA, USA
- Bioengineering Research Group (GIB), Universidad EAFIT, Medellín, Colombia
| | - Michelle Yu
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, PA, USA
| | - Sara Valliani
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, PA, USA
| | - Christina Ta
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, PA, USA
| | - Maobin Yang
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, PA, USA
- Department of Endodontology, Kornberg School of Dentistry, Temple University, Philadelphia, PA, USA
- Bioengineering Department, College of Engineering, Temple University, Philadelphia, PA, USA
| | - Santiago Orrego
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, PA, USA
- Bioengineering Department, College of Engineering, Temple University, Philadelphia, PA, USA
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2
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Gholami L, Shahabi S, Jazaeri M, Hadilou M, Fekrazad R. Clinical applications of antimicrobial photodynamic therapy in dentistry. Front Microbiol 2023; 13:1020995. [PMID: 36687594 PMCID: PMC9850114 DOI: 10.3389/fmicb.2022.1020995] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/30/2022] [Indexed: 01/07/2023] Open
Abstract
Given the emergence of resistant bacterial strains and novel microorganisms that globally threaten human life, moving toward new treatment modalities for microbial infections has become a priority more than ever. Antimicrobial photodynamic therapy (aPDT) has been introduced as a promising and non-invasive local and adjuvant treatment in several oral infectious diseases. Its efficacy for elimination of bacterial, fungal, and viral infections and key pathogens such as Streptococcus mutans, Porphyromonas gingivalis, Candida albicans, and Enterococcus faecalis have been investigated by many invitro and clinical studies. Researchers have also investigated methods of increasing the efficacy of such treatment modalities by amazing developments in the production of natural, nano based, and targeted photosensitizers. As clinical studies have an important role in paving the way towards evidence-based applications in oral infection treatment by this method, the current review aimed to provide an overall view of potential clinical applications in this field and summarize the data of available randomized controlled clinical studies conducted on the applications of aPDT in dentistry and investigate its future horizons in the dental practice. Four databases including PubMed (Medline), Web of Science, Scopus and Embase were searched up to September 2022 to retrieve related clinical studies. There are several clinical studies reporting aPDT as an effective adjunctive treatment modality capable of reducing pathogenic bacterial loads in periodontal and peri-implant, and persistent endodontic infections. Clinical evidence also reveals a therapeutic potential for aPDT in prevention and reduction of cariogenic organisms and treatment of infections with fungal or viral origins, however, the number of randomized clinical studies in these groups are much less. Altogether, various photosensitizers have been used and it is still not possible to recommend specific irradiation parameters due to heterogenicity among studies. Reaching effective clinical protocols and parameters of this treatment is difficult and requires further high quality randomized controlled trials focusing on specific PS and irradiation parameters that have shown to have clinical efficacy and are able to reduce pathogenic bacterial loads with sufficient follow-up periods.
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Affiliation(s)
- Leila Gholami
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Shiva Shahabi
- Dental Implants Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marzieh Jazaeri
- Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahdi Hadilou
- Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran,*Correspondence: Reza Fekrazad,
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Waingade M, Medikeri RS, Rathod P. Effectiveness of methylene blue photosensitizers compared to that of corticosteroids in the management of oral lichen planus: a systematic review and meta-analysis. J Dent Anesth Pain Med 2022; 22:175-186. [PMID: 35693351 PMCID: PMC9171335 DOI: 10.17245/jdapm.2022.22.3.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to systematically review the effectiveness of methylene blue (MB) photosensitizers in the management of symptomatic oral lichen planus (OLP). Electronic online databases and manual searches were performed for randomized controlled trials (RCTs) published in English between January 2010 and February 2022. RCTs comparing photodynamic therapy (PDT) and corticosteroid therapy at baseline and follow-up period were identified. The Cochrane risk of bias tool was used to assess the quality of the included studies. A meta-analysis was performed regarding visual analog scale (VAS) scores, Thongprasom sign scores, lesion size, response to treatment, and exacerbation of lesions after therapy. The clinical severity was analyzed qualitatively. Five RCTs consisting of 180 samples fulfilled the inclusion and exclusion criteria. All parameters of VAS score, Thongprasom sign score, lesion size, and response to treatment were statistically non-significant. Our results indicate that both MB-PDT and corticosteroid therapy are effective for the management of OLP. Moreover, MB-PDT is an effective alternative treatment option for OLP when corticosteroids are contraindicated. However, conclusive evidence cannot be ascertained owing to the heterogeneity among the studies.
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Affiliation(s)
- Manjushri Waingade
- Department of Oral Medicine and Radiology, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
| | - Raghavendra S Medikeri
- Department of Periodontics, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
| | - Pooja Rathod
- Department of Oral Medicine and Radiology, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
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Martins Antunes de Melo WDC, Celiešiūtė-Germanienė R, Šimonis P, Stirkė A. Antimicrobial photodynamic therapy (aPDT) for biofilm treatments. Possible synergy between aPDT and pulsed electric fields. Virulence 2021; 12:2247-2272. [PMID: 34496717 PMCID: PMC8437467 DOI: 10.1080/21505594.2021.1960105] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
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.
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Affiliation(s)
- Wanessa de Cassia Martins Antunes de Melo
- Department of Functional Materials and Electronics, Laboratory of Bioelectric, State Research Institute, Department of Functional Materials and Electronics, Center for Physical Sciences and Technology, Vilnius, Lithuania
| | - Raimonda Celiešiūtė-Germanienė
- Department of Functional Materials and Electronics, Laboratory of Bioelectric, State Research Institute, Department of Functional Materials and Electronics, Center for Physical Sciences and Technology, Vilnius, Lithuania
| | - Povilas Šimonis
- Department of Functional Materials and Electronics, Laboratory of Bioelectric, State Research Institute, Department of Functional Materials and Electronics, Center for Physical Sciences and Technology, Vilnius, Lithuania
| | - Arūnas Stirkė
- Department of Functional Materials and Electronics, Laboratory of Bioelectric, State Research Institute, Department of Functional Materials and Electronics, Center for Physical Sciences and Technology, Vilnius, Lithuania
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Thesnaar L, Bezuidenhout JJ, Petzer A, Petzer JP, Cloete TT. Methylene blue analogues: In vitro antimicrobial minimum inhibitory concentrations and in silico pharmacophore modelling. Eur J Pharm Sci 2021; 157:105603. [DOI: 10.1016/j.ejps.2020.105603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 01/05/2023]
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Warrier A, Mazumder N, Prabhu S, Satyamoorthy K, Murali TS. Photodynamic therapy to control microbial biofilms. Photodiagnosis Photodyn Ther 2020; 33:102090. [PMID: 33157331 DOI: 10.1016/j.pdpdt.2020.102090] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/29/2020] [Accepted: 10/30/2020] [Indexed: 01/09/2023]
Abstract
Microorganisms thrive in well-organized biofilm ecosystems. Biofilm-associated cells typically show increased resistance to antibiotics and contribute significantly to treatment failure. This has prompted investigations aimed at developing advanced and novel antimicrobial approaches that could effectively overcome the shortcomings associated with conventional antibiotic therapy. Studies are ongoing to develop effective curative strategies ranging from the use of peptides, small molecules, nanoparticles to bacteriophages, sonic waves, and light energy targeting various structural and physiological aspects of biofilms. In photodynamic therapy, a light source of a specific wavelength is used to irradiate non-toxic photosensitizers such as tetrapyrroles, synthetic dyes or, naturally occurring compounds to generate reactive oxygen species that can exert a lethal effect on the microbe especially by disrupting the biofilm. The photosensitizer preferentially binds to and accumulates in the microbial cells without causing any damage to the host tissue. Currently, photodynamic therapy is increasingly being used for the treatment of oral caries and dental plaque, chronic wound infections, infected diabetic foot ulcers, cystic fibrosis, chronic sinusitis, implant device-associated infections, etc. This approach is recognized as safe, as it is non-toxic and minimally invasive, making it a reliable, realistic, and promising therapeutic strategy for reducing the microbial burden and biofilm formation in chronic infections. In this review article, we discuss the current and future potential strategies of utilizing photodynamic therapy to extend our ability to impede and eliminate biofilms in various medical conditions.
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Affiliation(s)
- Anjali Warrier
- Department of Biotechnology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Nirmal Mazumder
- Department of Biophysics, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sudharshan Prabhu
- Department of Cell & Molecular Biology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Kapaettu Satyamoorthy
- Department of Cell & Molecular Biology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Thokur Sreepathy Murali
- Department of Biotechnology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
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Stájer A, Kajári S, Gajdács M, Musah-Eroje A, Baráth Z. Utility of Photodynamic Therapy in Dentistry: Current Concepts. Dent J (Basel) 2020; 8:E43. [PMID: 32392793 PMCID: PMC7345245 DOI: 10.3390/dj8020043] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 12/13/2022] Open
Abstract
The significant growth in scientific and technological advancements within the field of dentistry has resulted in a wide range of novel treatment modalities for dentists to use. Photodynamic therapy (PDT) is an emerging, non-invasive treatment method, involving photosensitizers, light of a specific wavelength and the generation of singlet oxygen and reactive oxygen species (ROS) to eliminate unwanted eukaryotic cells (e.g., malignancies in the oral cavity) or pathogenic microorganisms. The aim of this review article is to summarize the history, general concepts, advantages and disadvantages of PDT and to provide examples for current indications of PDT in various subspecialties of dentistry (oral and maxillofacial surgery, oral medicine, endodontics, preventive dentistry, periodontology and implantology), in addition to presenting some images from our own experiences about the clinical success with PDT.
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Affiliation(s)
- Anette Stájer
- Department of Periodontology, Faculty of Dentistry, University of Szeged, Tiszta Lajos körút 62-64, 6720 Szeged, Hungary;
| | - Szilvia Kajári
- Department of Periodontology, Faculty of Dentistry, University of Szeged, Tiszta Lajos körút 62-64, 6720 Szeged, Hungary;
| | - Márió Gajdács
- Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Eötvös utca 6, 6720 Szeged, Hungary;
| | - Aima Musah-Eroje
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tiszta Lajos körút 62-64, 6720 Szeged, Hungary; (A.M.-E.); (Z.B.)
| | - Zoltán Baráth
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tiszta Lajos körút 62-64, 6720 Szeged, Hungary; (A.M.-E.); (Z.B.)
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Photodynamic therapy in oral lichen planus: A prospective case-controlled pilot study. Sci Rep 2020; 10:1667. [PMID: 32015380 PMCID: PMC6997407 DOI: 10.1038/s41598-020-58548-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 01/09/2020] [Indexed: 12/21/2022] Open
Abstract
Oral lichen planus (OLP) is a common, chronic relapsing inflammatory disorder of the mucous membranes, which causes major discomfort. Current treatment includes topical/systemic glucocorticoids, immune modulators and systemic immunosuppressants, which may lead to considerable side-effects. The aim of this study was to determine the clinical and immunological efficacy of photodynamic therapy (PDT) in OLP as an alternative, easy-to-use, safe and non-invasive treatment. Twenty patients with OLP were treated with PDT in a prospective case-controlled pilot-study. PDT was performed on the most extensive oral lesion in 4 sessions (day 1, 3, 7, 14). Peripheral blood and lesional T cells were analysed before (day 1) and after PDT treatment (day 28). PDT led to a statistically significant reduction of clinical parameters (lesion size, ABSIS, Thongprasom-score) and improvement of all evaluated quality-of-life (QOL) items. The clinical improvement was accompanied by a significant decrease of the relative number of CD4+ and CD8+ T cells in mucosal OLP-lesions. Furthermore, CXCL10 plasma levels were decreased and the number of activated peripheral CD4 + CD137+ and CD8 + CD137+ T cells and IL-17-secreting T cells was diminished. PDT treatment in OLP leads to lesion reduction and improvement of QOL, and induces local and systemic anti-inflammatory effects. The study identifies PDT as a novel therapeutic option in OLP.
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Antimicrobial Photodynamic Therapy Protocols on Streptococcus mutans with Different Combinations of Wavelengths and Photosensitizing Dyes. Bioengineering (Basel) 2019; 6:bioengineering6020042. [PMID: 31083438 PMCID: PMC6631272 DOI: 10.3390/bioengineering6020042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 05/02/2019] [Accepted: 05/08/2019] [Indexed: 12/22/2022] Open
Abstract
The aim of the study is to test the application of different laser wavelengths, with and without different photosensitizing dyes on different types of cultures. Laser irradiation was realized on Streptococcus mutans in both solid and liquid culture media in continuous mode at three different fluences (10, 20, and 30 J/cm2) with a red diode (650 nm) with toluidine blue dye, a blue-violet diode (405 nm) with curcumin dye, and a green diode (532 nm) with erythrosine dye. Without a photosensitizer, no growth inhibition was obtained with the red diode at any fluence value. Inhibition rates of 40.7% and 40.2% were obtained with the blue diode and green diode. The blue diode laser used with curcumin obtained results in terms of growth inhibition up to 99.26% at a fluence of 30 J/cm2. The red diode laser used with toluidine blue obtained results in terms of growth inhibition up to 100% at fluences of 20 and 30 J/cm2. The KTP (potassium-titanyl-phosphate) laser used with erythrosine was able to determine a complete growth inhibition (100%) at the different fluence values. The combination of a laser and its proper color may dramatically change the results in terms of bactericidal effect. It will be interesting to confirm these data by further in vivo studies.
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Mahmoudi H, Bahador A, Pourhajibagher M, Alikhani MY. Antimicrobial Photodynamic Therapy: An Effective Alternative Approach to Control Bacterial Infections. J Lasers Med Sci 2018; 9:154-160. [PMID: 30809325 PMCID: PMC6378356 DOI: 10.15171/jlms.2018.29] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Introduction: The purpose of this review was to evaluate the available literature for in vitro and in vivo effectiveness of antimicrobial Photodynamic therapy (aPDT) in the field of bacteriology. Methods: A review of the relevant articles carried out in PubMed and Scopus to determine the efficiency of aPDT used in the reduction of microbial infection. Thirty-one relevant documents retrieved from PubMed, Scopus by inserting "antimicrobial photodynamic therapy" and "bacterial infection" and "photodynamic therapy" keywords. Results: According to different results, aPDT can be used as an adjuvant for the treatment of infectious diseases. The use of photosensitizer methylene blue, toluidine blue O (TBO), indocyanine green with light diode laser centered at (630±10 nm) and (650±10 nm) wavelengths have been shown to have significant results for the treatment of infectious diseases and bactericidal properties Conclusion: These findings suggest that, aPDT can be an efficient method in the treatment of localized and superficial infections.
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Affiliation(s)
- Hassan Mahmoudi
- Microbiology Department, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abbas Bahador
- Microbiology Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Pourhajibagher
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Salva KA, Kim YH, Rahbar Z, Wood GS. Epigenetically Enhanced PDT Induces Significantly Higher Levels of Multiple Extrinsic Pathway Apoptotic Factors than Standard PDT, Resulting in Greater Extrinsic and Overall Apoptosis of Cutaneous T-cell Lymphoma. Photochem Photobiol 2018; 94:1058-1065. [PMID: 29675945 DOI: 10.1111/php.12925] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 03/26/2018] [Indexed: 11/27/2022]
Abstract
Aminolevulinate-based photodynamic therapy (ALA-PDT) selectively eliminates diseased tissues primarily through the induction of intrinsic apoptotic pathway. ALA-PDT is a first-line therapy for actinic keratosis, however, it is less effective for cutaneous T-cell lymphoma (CTCL). We have previously demonstrated that the resistance of CTCL to apoptosis correlates with decreased expression of death receptors such as FAS, and that methotrexate functions as an epigenetic regulator that reestablishes the susceptibility of CTCL to extrinsic pathway apoptosis. We showed previously that MTX augments the effectiveness of PDT by sensitizing cells to apoptosis by induction of apoptotic factors, a process we call "epigenetically enhanced" PDT (ePDT). Here, in CTCL cell lines, leukemic CTCL cells, and normal blood T cells, we analyzed multiple components of the FAS, TRAIL, and TNF families using multispectral imaging of immunostained cytopreparations, a quantitative technique with five-fold greater sensitivity than standard immunocytology. ePDT induced significantly greater FAS, FASL, TRAIL-R1 & -R2, and TNFα levels than standard PDT. This correlated with significantly greater induction of extrinsic pathway apoptosis and/or overall apoptosis in all CTCL samples. There was no appreciable effect on normal T cells. These data set the stage for clinical trials of ePDT as a novel localized treatment of CTCL.
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Affiliation(s)
- Katrin A Salva
- Department of Dermatology, University of Wisconsin, Madison, WI
| | - Youn H Kim
- Department of Dermatology, Stanford University, Stanford, CA
| | - Ziba Rahbar
- Department of Dermatology, Stanford University, Stanford, CA
| | - Gary S Wood
- Department of Dermatology, University of Wisconsin, Madison, WI.,VA Medical Center, Madison, WI
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Mercuri SR, Brianti P, Foti A, Bartolucci M, Dattola A, Nisticò SP. Penile Lichen Sclerosus Treated with 1927 nm Thulium Fiber Laser and Photodynamic Therapy: A New Possible Therapeutic Approach. Photomed Laser Surg 2018; 36:333-336. [PMID: 29298401 DOI: 10.1089/pho.2017.4386] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE We treated two patients with recalcitrant lichen sclerosus (LS) of the penis with a combination of 1927 nm thulium fiber laser and methyl-aminolevulinate (MAL) photodynamic therapy (PDT). BACKGROUND DATA Therapy of LS is based on topical potent steroids, emollients, and topical calcineurin inhibitors. Circumcision is effective, but not always accepted. PDT represents a valid therapeutic option in refractory cases, but there are no reports about the association with 1927 nm thulium laser in the treatment of this pathology. MATERIALS AND METHODS We used to treat the affected areas with a combination of 1927 nm thulium fiber laser and MAL PDT in the same section. The same protocol was repeated after 1 month. RESULTS An improvement of lesions after the first treatment and complete cleaning after 3 months of therapy were noted. Results were maintained in the follow-up after 2 years. CONCLUSIONS Association with 1927 nm thulium laser was able to amplify the effectiveness of PDT and to promote tissue remodeling. Despite the positive response to our case, clinical studies are lacking and further analysis could be performed on a wider population to better define correct dosage and safety profile. Further, it is necessary to compare this procedure with other treatments to establish the real effectiveness.
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Affiliation(s)
| | - Pina Brianti
- 1 Dermatology and Cosmetology Unit, IRCCS San Raffaele Hospital , Milan, Italy
| | - Antonio Foti
- 1 Dermatology and Cosmetology Unit, IRCCS San Raffaele Hospital , Milan, Italy
| | - Marco Bartolucci
- 1 Dermatology and Cosmetology Unit, IRCCS San Raffaele Hospital , Milan, Italy
| | - Annunziata Dattola
- 2 Department of Dermatology, University of Rome "Tor Vergata ," Rome, Italy
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Nagai Y, Suzuki A, Katsuragi H, Shinkai K. Effect of antimicrobial photodynamic therapy (aPDT) on the sterilization of infected dentin in vitro. Odontology 2017; 106:154-161. [PMID: 29071451 DOI: 10.1007/s10266-017-0321-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/09/2017] [Indexed: 10/18/2022]
Abstract
The aim of this study was to evaluate the bactericidal effect of antimicrobial photodynamic therapy (aPDT) on an infected dentin model. Dentin plates were prepared from extracted human molars and infected through immersion in a solution of Streptococcus mutans. The nine experimental groups consisted of two laser irradiation groups (650 nm laser: 650 laser and 940 nm laser: 940 laser), two photosensitizer groups (methylene blue: MB, and azulenocyanine: Azc), four aPDT groups (650 nm laser irradiation of MB: 650 laser-MB, 650 nm laser irradiation of Azc: 650 laser-Azc, 940 nm laser irradiation of MB: 940 laser-MB and 940 nm laser irradiation of Azc: 940 laser-Azc) and a control. The bactericidal effects on each group were evaluated by colony count and adenosine triphosphate (ATP) assays. Based on the results of the colony count assay, the 650 laser-MB and 940 laser-MB groups formed significantly fewer colonies than the other experimental groups. Significantly fewer colonies were observed in the 940 laser-Azc group than in the control, but significant differences in the numbers of colonies were not observed between the 650 laser-Azc and control groups. The 940 laser group formed slightly fewer colonies than the 650 laser group, but the difference was not significant. In addition, the number of colonies in the MB group was significantly less than the number in the Azc group. The results of the ATP assay were similar to those of the colony count assay. aPDT with MB showed a significant bactericidal effect on dentin plates infected with S. mutans.
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Affiliation(s)
- Yuta Nagai
- Advanced Operative Dentistry-Endodontics, The Nippon Dental University Graduate School of Life Dentistry at Niigata, Niigata, Japan
| | - Anri Suzuki
- Department of Microbiology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Hiroaki Katsuragi
- Department of Microbiology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Koichi Shinkai
- Department of Operative Dentistry, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamaura-cho, Chuo-ku, Niigata, 951-8580, Japan.
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Maździarz A, Osuch B, Kowalska M, Nalewczyńska A, Śpiewankiewicz B. Photodynamic therapy in the treatment of vulvar lichen sclerosus. Photodiagnosis Photodyn Ther 2017; 19:135-139. [PMID: 28526592 DOI: 10.1016/j.pdpdt.2017.05.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 04/29/2017] [Accepted: 05/14/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Vulvar lichen sclerosus is a chronic and incurable disease that causes various unpleasant symptoms and serious consequences. OBJECTIVE The purpose of the study was to assess the effectiveness of photodynamic therapy in the treatment of vulvar lichen sclerosus. METHODS Participants in the study included 102 female patients aged 19-85 suffer from vulvar lichen sclerosus. The patients underwent photodynamic therapy (PDT). In the course of PDT the 5% 5- aminolevulinic acid was used in gel form. The affected areas were irradiated with a halogenic lamp PhotoDyn 501 (590-760nm) during a 10-min radiation treatment. The treatment was repeated weekly for 10 weeks. RESULT PDT has brought about a good therapeutic effect (complete or partial clinical remission), with 87.25% improvement rate in patients suffering from lichen sclerosus. The greatest vulvoscopic response was observed in the reduction of subepithelial ecchymoses and teleangiectasia (78.95%), and the reduction of erosions and fissures (70.97%). A partial remission of lichenification with hyperkeratosis was observed in 51.61% of cases. The least response was observed in the atrophic lesions reduction (improvement in 37.36% of cases). CONCLUSION Our patients suffering from vulvar lichen sclerosus demonstrated positive responses to photodynamic therapy and the treatment was well tolerated. Photodynamic therapy used to treat lichen sclerosus yields excellent cosmetic results.
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Affiliation(s)
- Agnieszka Maździarz
- Department of Gynecologic Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology in Warsaw, Roentgena Street 5, 02-781 Warsaw, Poland.
| | - Beata Osuch
- Department of Gynecologic Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology in Warsaw, Roentgena Street 5, 02-781 Warsaw, Poland
| | - Magdalena Kowalska
- Department of Gynecologic Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology in Warsaw, Roentgena Street 5, 02-781 Warsaw, Poland
| | - Agnieszka Nalewczyńska
- Department of Gynecologic Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology in Warsaw, Roentgena Street 5, 02-781 Warsaw, Poland
| | - Beata Śpiewankiewicz
- Department of Gynecologic Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology in Warsaw, Roentgena Street 5, 02-781 Warsaw, Poland.
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Merigo E, Conti S, Ciociola T, Fornaini C, Polonelli L, Lagori G, Manfredi M, Vescovi P. Effect of different wavelengths and dyes on Candida albicans: In vivo study using Galleria mellonella as an experimental model. Photodiagnosis Photodyn Ther 2017; 18:34-38. [PMID: 28130177 DOI: 10.1016/j.pdpdt.2017.01.181] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 01/03/2017] [Accepted: 01/22/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Studies on photodynamic inactivation against microorganisms had a great development in recent years. The aim of this work was to test the application of different laser wavelengths with or without different photosensitizing dyes on Candida albicans cells in vitro and in photodynamic therapy protocols in vivo in larvae of Galleria mellonella. METHODS Laser application was realized on C. albicans cells suspended in saline solution or cultured on solid medium for the in vitro study, and in a model of G. mellonella candidal infection for the in vivo study. Three wavelengths (650, 405, and 532nm) were used in continuous mode with different values of applied fluences: 10, 20 and 30J/cm2 for the in vitro study and 10J/cm2 for the in vivo study, without and with photosensitizing dyes. RESULTS No growth inhibition was obtained on yeast cells in saline solution without photosensitizers. The maximum inhibition of growth (100%) was obtained with 405nm diode laser and curcumin at any used fluence. No growth inhibition was observed for yeast cells cultured on solid medium after laser application without dyes. An inhibition was observed after laser application when curcumin and erythrosine were added to the medium. The survival curves of G. mellonella larvae infected with C. albicans with or without the different dyes and after laser application showed a statistically significant difference (p<0.001) in comparison with the proper control groups. CONCLUSIONS These results show the efficacy of photodynamic inactivation exploiting a suitable combination of light and dyes against C. albicans and the potential of photodynamic therapy for the treatment of candidal infections.
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Affiliation(s)
- Elisabetta Merigo
- Unit of Oral Pathology, Medicine and Laser Surgery, Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T.), University of Parma, Parma, Italy; MicOralIS Laboratory EA7354 - UFR of Odontology, University of Nice-Sophia Antipolis, Nice, France.
| | - Stefania Conti
- Unit of Microbiology and Virology, Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T.), University of Parma, Parma, Italy
| | - Tecla Ciociola
- Unit of Microbiology and Virology, Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T.), University of Parma, Parma, Italy
| | - Carlo Fornaini
- Unit of Oral Pathology, Medicine and Laser Surgery, Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T.), University of Parma, Parma, Italy; MicOralIS Laboratory EA7354 - UFR of Odontology, University of Nice-Sophia Antipolis, Nice, France
| | - Luciano Polonelli
- Unit of Microbiology and Virology, Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T.), University of Parma, Parma, Italy
| | - Giuseppe Lagori
- Unit of Oral Pathology, Medicine and Laser Surgery, Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T.), University of Parma, Parma, Italy; MicOralIS Laboratory EA7354 - UFR of Odontology, University of Nice-Sophia Antipolis, Nice, France
| | - Maddalena Manfredi
- Unit of Oral Pathology, Medicine and Laser Surgery, Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T.), University of Parma, Parma, Italy
| | - Paolo Vescovi
- Unit of Oral Pathology, Medicine and Laser Surgery, Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T.), University of Parma, Parma, Italy
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Abstract
Photodynamic therapy (PDT), also known as photoradiation therapy, phototherapy, or photochemo-therapy, involves the use of a photoactive dye (photosensitizer) that is activated by exposure to light of a specific wavelength in the presence of oxygen. The transfer of energy from the activated photosensitizer to available oxygen results in the formation of toxic oxygen species, such as singlet oxygen and free radicals. These very reactive chemical species can damage proteins, lipids, nucleic acids, and other cellular components. Applications of PDT in dentistry are growing rapidly: the treatment of oral cancer, bacterial and fungal infection therapies, and the photodynamic diagnosis (PDD) of the malignant transformation of oral lesions. PDT has shown potential in the treatment of oral leukoplakia, oral lichen planus, and head and neck cancer. Photodynamic antimicrobial chemotherapy (PACT) has been efficacious in the treatment of bacterial, fungal, parasitic, and viral infections. The absence of genotoxic and mutagenic effects of PDT is an important factor for long-term safety during treatment. PDT also represents a novel therapeutic approach in the management of oral biofilms. Disruption of plaque structure has important consequences for homeostasis within the biofilm. Studies are now leading toward selective photosensitizers, since killing the entire flora leaves patients open to opportunistic infections. Dentists deal with oral infections on a regular basis. The oral cavity is especially suitable for PACT, because it is relatively accessible to illumination.
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Affiliation(s)
- K Konopka
- Department of Microbiology, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA.
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Annaji S, Sarkar I, Rajan P, Pai J, Malagi S, Bharmappa R, Kamath V. Efficacy of Photodynamic Therapy and Lasers as an Adjunct to Scaling and Root Planing in the Treatment of Aggressive Periodontitis - A Clinical and Microbiologic Short Term Study. J Clin Diagn Res 2016; 10:ZC08-12. [PMID: 27042576 DOI: 10.7860/jcdr/2016/13844.7165] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 08/05/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Aggressive periodontitis comprises a group of rare, severe, rapidly progressive form of periodontitis. Conventional treatment includes mechanical debridement augmented with adjunctive antimicrobial therapy. Development of antibiotic resistance has led to use of lasers. Photodynamic therapy (PDT) is a novel non-invasive therapeutic approach with increased site and pathogen specificity. This study compares PDT and Lasers as an adjunct to conventional Scaling in the treatment of patients with aggressive periodontitis. MATERIALS AND METHODS Fifteen untreated aggressive periodo-ntitis patients were randomly assigned in a split mouth design for one of the following treatment modalities: 1) SRP alone; (2) SRP + Diode Laser irradiation with 810 nm at 1W, continuous mode for 30 sec per tooth; (3) SRP + PDT on "0" day; (4) SRP + PDT on "0", 7(th) and 21(st) day. The clinical parameters included PI, BOP, PPD, CAL recorded at the baseline & 3(rd) month. The site with greatest probing pocket depth (PPD) was selected from each quadrant for bacterial sampling and cultured for Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis & Prevotella intermedia. RESULTS Statistically significant reduction in clinical & microbial parameters was seen. Sites 4 showed a greater reduction compared to other groups. CONCLUSION Photodynamic therapy is a valuable treatment modality adjunctive to conventional scaling and root planing.
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Affiliation(s)
- Sreedhar Annaji
- Reader, Department of Periodontics, Coorg Institute of Dental Sciences , Virajpet, India
| | - Indranil Sarkar
- Post Graduate Student, Department of Periodontics, Coorg institute of Dental Sciences , Virajpet, India
| | - Padma Rajan
- Professor and Head of Department, Department of Periodontics, Coorg institute of Dental Sciences , Virajpet, India
| | - Jagdish Pai
- Professor, Department of Periodontics, Coorg institute of Dental Sciences , Virajpet, India
| | - Sachin Malagi
- Reader, Department of Periodontics, Coorg institute of Dental Sciences , Virajpet, India
| | - Radhika Bharmappa
- Senior Lecturer, Department of Periodontics, Coorg institute of Dental Sciences , Virajpet, India
| | - Vinesh Kamath
- Senior Lecturer, Department of Periodontics, Coorg institute of Dental Sciences , Virajpet, India
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Chiniforush N, Pourhajibagher M, Shahabi S, Bahador A. Clinical Approach of High Technology Techniques for Control and Elimination of Endodontic Microbiota. J Lasers Med Sci 2015; 6:139-50. [PMID: 26705458 DOI: 10.15171/jlms.2015.09] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The main goal in endodontic treatment is to eradicate or at least reduce intraradicular microbial population to levels that are more compatible with periapical lesions healing process. Since endodontic infections are polymicrobial in nature, intraradicular survival of endodontic microbiota and their pathogenic properties are influenced by a combination of their virulence factors. The purpose of this article is to review the endodontic microbiota and their respective virulence attributes, as well as perform a literature review of the effects of disinfection procedures in the treatment of endodontic infections to gain best practices. Conventional technique for root canal preparation includes mechanical debridement and application of antimicrobial irrigants. Recently, laser irradiation has been used to enhance the results of root canal treatment through its thermal effect. To reduce thermal side effects, laser activated irrigation (LAI) and photon induced photoacoustic streaming (PIPS) were introduced. Antimicrobial photodynamic therapy (aPDT) by photochemical reaction uses light at a specific wavelength to activate a nontoxic photosensitizer (PS) in the presence of oxygen to produce cytotoxic products. Different PSs are used in dentistry including methylene blue (MB), toluidine blue O (TBO), indocyanine green (ICG) and curcumin. Among different options, ICG could be the best choice due to its peak absorption at wavelength of 808 nm, which coincides with the commercial diode laser devices. Also, this wavelength has more penetration depth compared to other wavelengths used in aPDT.
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Affiliation(s)
- Nasim Chiniforush
- Laser Research Center of Dentistry (LRCD), Dental Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Pourhajibagher
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sima Shahabi
- Dental Biomaterials Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Bahador
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Salva KA, Wood GS. Epigenetically Enhanced Photodynamic Therapy (ePDT) is Superior to Conventional Photodynamic Therapy for Inducing Apoptosis in Cutaneous T-Cell Lymphoma. Photochem Photobiol 2015; 91:1444-51. [PMID: 26302991 DOI: 10.1111/php.12521] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 08/01/2015] [Indexed: 11/26/2022]
Abstract
Conventional photodynamic therapy with aminolevulinate (ALA-PDT) selectively induces apoptosis in diseased cells and is highly effective for treating actinic keratoses. However, similar results are achieved only in a subset of patients with cutaneous T-cell lymphoma (CTCL). Our previous work shows that the apoptotic resistance of CTCL correlates with low expression of death receptors like Fas cell surface death receptor (FAS), and that methotrexate upregulates FAS by inhibiting the methylation of its promoter, acting as an epigenetic derepressor that restores the susceptibility of FAS-low CTCL to caspase-8-mediated apoptosis. Here, we demonstrate that methotrexate increases the response of CTCL to ALA-PDT, a concept we refer to as epigenetically enhanced PDT (ePDT). Multiple CTCL cell lines were subjected to conventional PDT versus ePDT. Apoptotic biomarkers were analyzed in situ with multispectral imaging analysis of immunostained cells, a method that is quantitative and 5× more sensitive than standard immunohistology for antigen detection. Compared to conventional PDT or methotrexate alone, ePDT led to significantly greater cell death in all CTCL cell lines tested by inducing greater activation of caspase-8-mediated extrinsic apoptosis. Upregulation of FAS and/or tumor necrosis factor-related apoptosis-inducing ligand pathway components was observed in different CTCL cell lines. These findings provide a rationale for clinical trials of ePDT for CTCL.
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Affiliation(s)
- Katrin Agnes Salva
- Department of Dermatology, Wisconsin Institutes for Medical Research, University of Wisconsin, Madison, WI
| | - Gary S Wood
- Department of Dermatology, Wisconsin Institutes for Medical Research, University of Wisconsin, Madison, WI.,VA Medical Center, Madison, WI
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Yu J, Hsu CH, Huang CC, Chang PY. Development of therapeutic Au-methylene blue nanoparticles for targeted photodynamic therapy of cervical cancer cells. ACS APPLIED MATERIALS & INTERFACES 2015; 7:432-41. [PMID: 25494339 DOI: 10.1021/am5064298] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Photodynamic therapy (PDT) involves the cellular uptake of a photosensitizer (PS) combined with oxygen molecules and light at a specific wavelength to be able to trigger cancer cell death via the apoptosis pathway, which is less harmful and has less inflammatory side effect than necrosis. However, the traditional PDT treatment has two main deficiencies: the dark toxicity of the PS and the poor selectivity of the cellular uptake of PS between the target cells and normal tissues. In this work, methylene blue (MB), a known effective PS, combined with Au nanoparticles (NPs) was prepared using an intermolecular interaction between a polystyrene-alt-maleic acid (PSMA) layer on the Au NPs and MB. The Au@polymer/MB NPs produced a high quantum yield of singlet oxygen molecules, over 50% as much as that of free MB, when they were excited by a dark red light source at 660 nm, but without significant dark toxicity. Furthermore, transferrin (Tf) was conjugated on the Au@polymer/MB NPs via an EDC/NHS reaction to enhance the selectivity to HeLa cells compared to 3T3 fibroblasts. With a hand-held single laser treatment (32 mW/cm) for 4 min, the new Au@polymer/MB-Tf NPs showed a 2-fold enhancement of PDT efficiency toward HeLa cells over the use of free MB at 4 times dosage. Cellular staining examinations showed that the HeLa cells reacted with Au@polymer/MB-Tf NPs and the 660 nm light excitation triggered PDT, which caused the cells to undergo apoptosis ("programmed" cell death). We propose that applying this therapeutic Au@polymer/MB-Tf nanoagent is facile and safe for delivery and cancer cell targeting to simultaneously minimize side effects and accomplish a significant enhancement in photodynamic therapeutic efficiency toward next-generation nanomedicine development.
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Affiliation(s)
- Jiashing Yu
- Department of Chemical Engineering, National Taiwan University , Taipei 106, Taiwan
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21
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Singh S, Nagpal R, Manuja N, Tyagi SP. Photodynamic therapy: An adjunct to conventional root canal disinfection strategies. AUST ENDOD J 2014; 41:54-71. [PMID: 25404404 DOI: 10.1111/aej.12088] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Although chemical-based root canal disinfectants are important to reduce microbial loads and remove infected smear layer from root dentin, they have only a limited ability to eliminate biofilm bacteria, especially from root complexities. This paper explores the novel photodynamic therapy (PDT) for antimicrobial disinfection of root canals. The combination of an effective photosensitizer, the appropriate wavelength of light and ambient oxygen is the key factor in PDT. PDT uses a specific wavelength of light to activate a non-toxic dye (photosensitizer), leading to the formation of reactive oxygen species. These reactive oxygen molecules can damage bacterial proteins, membrane lipids and nucleic acids, which promote bacterial cell death. In, addition PDT may enhance cross-linking of collagen fibrils in the dentin matrix and thereby improving dentin stability. The concept of PDT is plausible and could foster new therapy concepts for endodontics. The available knowledge should enable and encourage steps forward into more clinical-oriented research and development. This article discusses PDT as related to root canal disinfection, including its components, mechanism of action, reviews the current endodontic literature and also highlights the shortcomings and advancements in PDT techniques.
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Affiliation(s)
- Shipra Singh
- Department of Conservative Dentistry and Endodontics, Kothiwal Dental College and Research Centre, Moradabad, India
| | - Rajni Nagpal
- Department of Conservative Dentistry and Endodontics, Kothiwal Dental College and Research Centre, Moradabad, India
| | - Naveen Manuja
- Department of Pediatric Dentistry, Kothiwal Dental College and Research Centre, Moradabad, India
| | - Sashi Prabha Tyagi
- Department of Conservative Dentistry and Endodontics, Kothiwal Dental College and Research Centre, Moradabad, India
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Muhammad OH, Chevalier M, Rocca JP, Brulat-Bouchard N, Medioni E. Photodynamic therapy versus ultrasonic irrigation: interaction with endodontic microbial biofilm, an ex vivo study. Photodiagnosis Photodyn Ther 2014; 11:171-81. [PMID: 24583092 DOI: 10.1016/j.pdpdt.2014.02.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 02/08/2014] [Accepted: 02/10/2014] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Photodynamic therapy was introduced as an adjuvant to conventional chemo-mechanical debridement during endodontic treatment to overcome the persistence of biofilms. The aim of this study was to evaluate the ability of photodynamic therapy (PDT) to disrupt an experimental microbial biofilm inside the root canal in a clinically applicable working time. MATERIALS AND METHODS Thirty extracted teeth were prepared and then divided in three groups. All samples were infected with an artificially formed biofilm made of Enterococcus faecalis, Streptococcus salivarius, Porphyromonas gingivalis and Prevotella intermedia bacteria. First group was treated with Aseptim Plus® photo-activated (LED) disinfection system, second group by a 650 nm Diode Laser and Toluidine blue as photosensitizer, and the third group, as control group, by ultrasonic irrigation (PUI) using EDTA 17% and NaOCl 2.6% solutions. The working time for all three groups was fixed at 3 min. Presence or absence of biofilm was assessed by aerobic and anaerobic cultures. RESULTS There was no statistically significant difference between results obtained from groups treated by Aseptim Plus® and Diode Laser (P<0.6267). In cultures of both groups there was a maximal bacterial growth. The group that was treated by ultrasonic irrigation and NaOCl and EDTA solutions had the best results (P<0.0001): there was a statistically significant reduction of bacterial load and destruction of microbial biofilm. CONCLUSION Under the condition of this study, Photodynamic therapy could not disrupt endodontic artificial microbial biofilm and could not inhibit bacterial growth in a clinically favorable working time.
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Affiliation(s)
- Omid H Muhammad
- Laboratory of Oral Health and Aging, URE 001, Faculty of Dentistry, 24, Avenue des Diables Bleus, 06357 Nice Cedex 4, France
| | - Marlene Chevalier
- Laboratory of Oral Health and Aging, URE 001, Faculty of Dentistry, 24, Avenue des Diables Bleus, 06357 Nice Cedex 4, France
| | - Jean-Paul Rocca
- Laboratory of Oral Health and Aging, URE 001, Faculty of Dentistry, 24, Avenue des Diables Bleus, 06357 Nice Cedex 4, France; Restorative Dentistry and Endodontics Department, Faculty of Dentistry, University of Nice-Sophia Antipolis, 24, Avenue des Diables Bleus, 06357 Nice Cedex 4, France; Pôle Odontologie, CHU Nice Saint Roch, 5 rue Pierre Devoluy, 06000 Nice, France
| | - Nathalie Brulat-Bouchard
- Laboratory of Oral Health and Aging, URE 001, Faculty of Dentistry, 24, Avenue des Diables Bleus, 06357 Nice Cedex 4, France; Restorative Dentistry and Endodontics Department, Faculty of Dentistry, University of Nice-Sophia Antipolis, 24, Avenue des Diables Bleus, 06357 Nice Cedex 4, France; Pôle Odontologie, CHU Nice Saint Roch, 5 rue Pierre Devoluy, 06000 Nice, France
| | - Etienne Medioni
- Laboratory of Oral Health and Aging, URE 001, Faculty of Dentistry, 24, Avenue des Diables Bleus, 06357 Nice Cedex 4, France; Restorative Dentistry and Endodontics Department, Faculty of Dentistry, University of Nice-Sophia Antipolis, 24, Avenue des Diables Bleus, 06357 Nice Cedex 4, France; Pôle Odontologie, CHU Nice Saint Roch, 5 rue Pierre Devoluy, 06000 Nice, France.
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Mallidi S, Anbil S, Lee S, Manstein D, Elrington S, Kositratna G, Schoenfeld D, Pogue B, Davis SJ, Hasan T. Photosensitizer fluorescence and singlet oxygen luminescence as dosimetric predictors of topical 5-aminolevulinic acid photodynamic therapy induced clinical erythema. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:028001. [PMID: 24503639 PMCID: PMC3915169 DOI: 10.1117/1.jbo.19.2.028001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 12/05/2013] [Accepted: 12/05/2013] [Indexed: 05/19/2023]
Abstract
The need for patient-specific photodynamic therapy (PDT) in dermatologic and oncologic applications has triggered several studies that explore the utility of surrogate parameters as predictive reporters of treatment outcome. Although photosensitizer (PS) fluorescence, a widely used parameter, can be viewed as emission from several fluorescent states of the PS (e.g., minimally aggregated and monomeric), we suggest that singlet oxygen luminescence (SOL) indicates only the active PS component responsible for the PDT. Here, the ability of discrete PS fluorescence-based metrics (absolute and percent PS photobleaching and PS re-accumulation post-PDT) to predict the clinical phototoxic response (erythema) resulting from 5-aminolevulinic acid PDT was compared with discrete SOL (DSOL)-based metrics (DSOL counts pre-PDT and change in DSOL counts pre/post-PDT) in healthy human skin. Receiver operating characteristic curve (ROC) analyses demonstrated that absolute fluorescence photobleaching metric (AFPM) exhibited the highest area under the curve (AUC) of all tested parameters, including DSOL based metrics. The combination of dose-metrics did not yield better AUC than AFPM alone. Although sophisticated real-time SOL measurements may improve the clinical utility of SOL-based dosimetry, discrete PS fluorescence-based metrics are easy to implement, and our results suggest that AFPM may sufficiently predict the PDT outcomes and identify treatment nonresponders with high specificity in clinical contexts.
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Affiliation(s)
- Srivalleesha Mallidi
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, Massachusetts 02114
| | - Sriram Anbil
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, Massachusetts 02114
| | - Seonkyung Lee
- Physical Sciences Inc., Andover, Massachusetts 01810
| | - Dieter Manstein
- Massachusetts General Hospital, Department of Dermatology, Boston, Massachusetts 02114
| | - Stefan Elrington
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, Massachusetts 02114
| | - Garuna Kositratna
- Massachusetts General Hospital, Department of Dermatology, Boston, Massachusetts 02114
| | - David Schoenfeld
- Massachusetts General Hospital, Biostatistics Department, Boston, Massachusetts 02114
| | - Brian Pogue
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire 03755
| | | | - Tayyaba Hasan
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, Massachusetts 02114
- Address all correspondence to: Tayyaba Hasan, E-mail:
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Ronay V, Buchalla W, Sahrmann P, Attin T, Schmidlin PR. In vitro evaluation of the oxidation efficacy of transgingival photodynamic therapy. Acta Odontol Scand 2013; 71:1216-20. [PMID: 23320555 DOI: 10.3109/00016357.2012.757639] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the capability of soft laser light to penetrate blood, serum, gingival connective tissue and pure collagen type I. MATERIALS AND METHODS A 1:1 mixture of methylene blue (MB) and diphenylisobenzofuran (DPBF) was irradiated for 60 s with a diode laser (670 nm, 0.3 W) through blood, serum, gingival connective tissue and collagen type I (2 mm transillumination thickness). The oxidation of DPBF by MB was determined spectrophotometrically by measuring the optical density (oD) at 410 nm. The absorption spectra of DPBF/MB irradiated through MB (1%) and strawberry red solution (3%) served as control. RESULTS The mean oD of non-irradiated DPBF/MB was 1.98 ± 0.04. Irradiation through MB showed no oxidation of DPBF (1.98 ± 0.02; p > 0.05), while interposition of strawberry red and serum resulted in almost complete oxidation of DPBF (0.13 ± 0.09, 0.06 ± 0.03; p ≤ 0.0001). Irradiation through gingiva and collagen reduced the oxidation of DPBF significantly (1.0 ± 0.04, 0.7 ± 0.04; p ≤ 0.0001), accounting for 50% to 35% of the non-irradiated DPBF/MB solution. CONCLUSION Red light from a diode laser can penetrate blood and gingival tissues. However, light absorption for collagen and connective tissue can hamper the oxidation process.
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Affiliation(s)
- Valerie Ronay
- Clinic for Preventive Dentistry, Cariology and Periodontology, Center for Dental Medicine, University of Zurich, Switzerland
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Nagata JY, Hioka N, Kimura E, Batistela VR, Terada RSS, Graciano AX, Baesso ML, Hayacibara MF. Antibacterial photodynamic therapy for dental caries: Evaluation of the photosensitizers used and light source properties. Photodiagnosis Photodyn Ther 2012; 9:122-31. [DOI: 10.1016/j.pdpdt.2011.11.006] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 11/19/2011] [Accepted: 11/28/2011] [Indexed: 11/16/2022]
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Rajesh S, Koshi E, Philip K, Mohan A. Antimicrobial photodynamic therapy: An overview. J Indian Soc Periodontol 2011; 15:323-7. [PMID: 22368354 PMCID: PMC3283927 DOI: 10.4103/0972-124x.92563] [Citation(s) in RCA: 123] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Accepted: 11/29/2011] [Indexed: 01/22/2023] Open
Abstract
Inflammatory periodontal disease caused by dental plaque is characterized by the clinical signs of inflammation and loss of periodontal tissue support. The mechanical removal of this biofilm and adjunctive use of antibacterial disinfectants and antibiotics have been the conventional methods of periodontal therapy. But the removal of plaque and the reduction in the number of infectious organisms can be impaired in sites with difficult access. The possibility of development of resistance to antibiotics by the target organism has led to the development of a new antimicrobial concept with fewer complications. Photodynamic therapy (PDT) involves the use of low power lasers with appropriate wavelength to kill micro organisms treated with a photosensitizer drug. PDT could be a useful adjunct to mechanical as well as antibiotics in eliminating periopathogenic bacteria.
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Affiliation(s)
- S. Rajesh
- Department of Conservative Dentistry, Sree Mookambika Institute of Dental Sciences, Kulasekharam, K.K. Dist, India
| | - Elizabeth Koshi
- Department of Periodontics, Sree Mookambika Institute of Dental Sciences, Kulasekharam, K.K. Dist, India
| | - Koshi Philip
- Department of Orthodontics, GDC, Kottayam, India
| | - Aparna Mohan
- PG, Department of Prosthodontics, SMIDS, Kulasekharam, Kerala, India
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Extracts from Alternanthera maritima as natural photosensitizers in photodynamic antimicrobial chemotherapy (PACT). JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2010; 99:15-20. [DOI: 10.1016/j.jphotobiol.2010.01.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Revised: 01/16/2010] [Accepted: 01/18/2010] [Indexed: 11/22/2022]
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Raghavendra M, Koregol A, Bhola S. Photodynamic therapy: a targeted therapy in periodontics. Aust Dent J 2010; 54 Suppl 1:S102-9. [PMID: 19737261 DOI: 10.1111/j.1834-7819.2009.01148.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The oral cavity is colonized by a large number and highly diversified communities of micro-organisms. Bacterial biofilm present on tooth or root surface is a major cause of gingivitis and periodontitis. Chemical antimicrobial agents are widely used in prophylactic and therapeutic regimens for dental plaque related diseases, which are among the most common human infections. As these agents are difficult to maintain at therapeutic concentrations in the oral cavity and can be rendered ineffective by resistance development in target organisms, there is a need for an alternative antimicrobial approach. A novel approach, photodynamic therapy (PDT), could be a solution to these problems. Lethal photosensitization of many bacteria, both Gram positive and Gram negative was found in many studies. The advantage of this new approach includes rapid bacterial elimination, minimal chance of resistance development and safety of adjacent host tissue and normal microflora. Thus, the available knowledge of photodynamic therapy should encourage a more clinically oriented application of this technique.
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Affiliation(s)
- M Raghavendra
- PMNM Dental College and Hospital, Bagalkot, Karnataka, India.
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Spatial regulation of specific gene expression through photoactivation of RNAi. J Control Release 2009; 137:241-5. [DOI: 10.1016/j.jconrel.2009.04.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 04/08/2009] [Accepted: 04/12/2009] [Indexed: 12/13/2022]
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Abstract
ALA-PDT is a safe, well-tolerated, and effective treatment for many dermatologic conditions. Current data most strongly support its use in the treatment of actinic damage, but further investigation into alternative uses continues. Current efficacy is limited primarily by the depth of penetration of the photosensitizing agent and the activating light source. Even with this limitation, the potential applications of PDT are numerous. As new technology is developed to overcome current restraints, the future of PDT is wide open.
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Thompson MS, Johansson A, Johansson T, Andersson-Engels S, Svanberg S, Bendsoe N, Svanberg K. Clinical system for interstitial photodynamic therapy with combined on-line dosimetry measurements. APPLIED OPTICS 2005; 44:4023-31. [PMID: 16004049 DOI: 10.1364/ao.44.004023] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
A system for interstitial photodynamic therapy with delta-aminolaevulinic acid and multiple optical fibers has been developed. The system enables photodynamic treatment of large embedded tumor volumes and utilizes real-time measurements to allow on-line dosimetry. Important parameters such as light fluence rate, sensitizer fluorescence intensity, and changes in local blood oxygen saturation are measured with the same fibers that deliver the therapeutic light. Data from the first clinical treatments on nodular basal cell carcinomas indicate a major treatment-induced light absorption increase, rapid sensitizer photobleaching, and a relatively constant global tissue oxygen saturation level during the treatment.
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Affiliation(s)
- Marcelo Soto Thompson
- Department of Physics, Lund Institute of Technology, PO Box 118, SE-221 00 Lund, Sweden.
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Brezová V, Dvoranová D, Kost'álová D. Oxygen activation by photoexcited protoberberinium alkaloids fromMahonia aquifolium. Phytother Res 2004; 18:640-6. [PMID: 15476305 DOI: 10.1002/ptr.1512] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Protoberberinium salts, i.e. berberine (I), palmatine (II) and jatrorrhizine (III) prepared from Mahonia aquifolium (Pursh) Nutt. belong to isoquinoline alkaloids possessing interesting biological activity (e.g. antibacterial, antimalarial, antitumor). The characteristic UV/Vis absorption band maxima of I-III iodide salts were found in regions 350 and 425 nm in dimethylsulfoxide (DMSO) and ethanol solvents, and were only negligibly influenced by substitution changes on the C-2 and C-3 positions. The fluorescence intensity of protoberberinium salts monitored in ethanol solutions was significantly lowered by iodide counter-ions, and decreased in the order berberine > palmatine > jatrorrhizine. EPR spectroscopy supplied evidence of the formation of super-oxide anion radicals and singlet oxygen upon irradiation of berberine in oxygenated DMSO solvent. The photochemical generation of O(2) (.-) and (1)O(2) in DMSO solutions of palmatine and jatrorrhizine was substantially lower, and probably reflected the replacement of a photolabile methylenedioxy group at C-2 and C-3 positions in the berberine molecule by two methoxy groups in palmatine, and methoxyl (C-2) and hydroxyl (C-3) substitution in jatrorrhizine. Additionally, the powder EPR spectra of protoberberinium iodides I-III measured at 290 K revealed the presence of single-line EPR signals (g(eff) = 2.0044), which were attributed to hydroperoxidic structures produced by the autoxidation process. The photochemical reactions of protoberbenium salts producing reactive oxygen species after UVA excitation should be integrated in biological activity investigations, as well as in their applications in skin disorder treatment.
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Affiliation(s)
- Vlasta Brezová
- Department of Physical Chemistry, Faculty of Chemical and Food Technology, Slovak University of Technology in Bratislava, Radlinského 9, SK-812 37 Bratislava, Slovak Republic.
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Chen X, Hui L, Foster DA, Drain CM. Efficient synthesis and photodynamic activity of porphyrin-saccharide conjugates: targeting and incapacitating cancer cells. Biochemistry 2004; 43:10918-29. [PMID: 15323552 PMCID: PMC6180334 DOI: 10.1021/bi049272v] [Citation(s) in RCA: 169] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Since the role of saccharides in cell recognition, metabolism, and cell labeling is well-established, the conjugation of saccharides to drugs is an active area of research. Thus, one goal in the use of saccharide-drug conjugates is to impart a greater specificity toward a given cell type or other targets. Although widely used to treat some cancers and age related macular degeneration, the drugs used in photodynamic therapy (PDT) display poor chemical selectivity toward the intended targets, and uptake by cells most likely arises from passive, diffusional processes. Instead, the specific irradiation of the target tissues, and the formation of the toxic species in situ, are the primary factors that modulate the selectivity in the present mode of PDT. We report herein a two-step method to make nonhydrolyzable saccharide-porphyrin conjugates in high yields using a tetra(pentafluorophenyl)porphyrin and the thio derivative of the sugar. As a demonstration of their properties, the selective uptake (and/or binding) of these compounds to several cancer cell types was examined, followed by an investigation of their photodynamic properties. As expected, different malignant cell types take up one type of saccharide-porphyrin conjugate preferentially over others; for example, human breast cancer cells (MDA-MB-231) absorb a tetraglucose-porphyrin conjugate over the corresponding galactose derivative. Doseametric studies reveal that these saccharide-porphyrin conjugates exhibit varying PDT responses depending on drug concentration and irradiation energy. (1) Using 20 microM conjugate and greater irradiation energy induces cell death by necrosis. (2) When 10-20 microM conjugate and less irradiation energy are used, both necrosis and apoptosis are observed. (3) Using 10 microM and the least irradiation energy, a significant reduction in cell migration is observed, which indicates a reduction in aggressiveness of the cancer cells.
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Affiliation(s)
- Xin Chen
- Department of Chemistry and Biochemistry, Hunter College and the Graduate Center of the City University of New York, 695 Park Avenue, New York, New York 10021
| | - Li Hui
- Department of Biological Science, Hunter College and the Graduate Center of the City University of New York, 695 Park Avenue, New York, New York 10021
| | - David A. Foster
- Department of Biological Science, Hunter College and the Graduate Center of the City University of New York, 695 Park Avenue, New York, New York 10021
| | - Charles Michael Drain
- Department of Chemistry and Biochemistry, Hunter College and the Graduate Center of the City University of New York, 695 Park Avenue, New York, New York 10021
- Department of Chemistry and Biochemistry and Biological Science, The Rockefeller University, 1230 York Avenue, New York, New York 10021
- To whom correspondence should be addressed. . Phone: (212) 650-3791. Fax: (212) 772-5332
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