Potassium Iodide Potentiates Broad-Spectrum Antimicrobial Photodynamic Inactivation Using Photofrin

Complete photodynamic inactivation of Pseudomonas aeruginosa biofilm with use of potassium iodide and its comparison with enzymatic pretreatment

Pseudomonas aeruginosa, a gram-negative bacterium, accounts for 7% of all hospital-acquired infections. Despite advances in medicine and antibiotic therapy, P. aeruginosa infection still results in high mortality rates of up to 62% in certain patient groups. This bacteria is also known to form biofilms, that are 10 to 1000 times more resistant to antibiotics compared to their free-floating counterparts. Photodynamic Inactivation (PDI) has been proved to be an effective antimicrobial technique for microbial control. This method involves the incubation of the pathogen with a photosensitizer (PS), then, a light at appropriated wavelength is applied, leading to the production of reactive oxygen species that are toxic to the microbial cells. Studies have focused on strategies to enhance the PDI efficacy, such as a pre-treatment with enzymes to degrade the biofilm matrix and/or an addition of inorganic salts to the PS. The aim of the present study is to evaluate the effectiveness of PDI against P. aeruginosa biofilm in association with the application of the enzymes prior to PDI (enzymatic pre-treatment) or the addition of potassium iodide (KI) to the photosensitizer solution, to increase the inactivation effectiveness of the treatment. First, a range of enzymes and PSs were tested, and the best protocols for combined treatments were selected. The results showed that the use of enzymes as a pre-treatment was effective to reduce the total biomass, however, when associated with PDI, mild bacterial reductions were obtained. Then, the use of KI in association with the PS was evaluated and the results showed that, PDI mediated by methylene blue (MB) in the presence of KI was able to completely eradicate the biofilm. However, when the PDI was performed with curcumin and KI, no additive reduction was observed. In conclusion, out of all strategies evaluated in the present study, the most promising strategy to improve PDI against P. aeruginosa biofilm was the use of KI in association with MB, resulting in eradication with 108 log bacterial inactivation.

Rose Bengal diacetate-mediated antimicrobial photodynamic inactivation: potentiation by potassium iodide and acceleration of wound healing in MRSA-infected diabetic mice

Previous studies have shown that antimicrobial photodynamic inactivation (aPDI) can be strongly potentiated by the addition of the non-toxic inorganic salt, potassium iodide (KI). This approach was shown to apply to many different photosensitizers, including the xanthene dye Rose Bengal (RB) excited by green light (540 nm). Rose Bengal diacetate (RBDA) is a lipophilic RB derivative that is easily taken up by cells and hydrolyzed to produce an active photosensitizer. Because KI is not taken up by microbial cells, it was of interest to see if aPDI mediated by RBDA could also be potentiated by KI. The addition of 100 mM KI strongly potentiated the killing of Gram-positive methicillin-resistant Staphylocccus aureus, Gram-negative Eschericia coli, and fungal yeast Candida albicans when treated with RBDA (up to 15 µM) for 2 hours followed by green light (540 nm, 10 J/cm2). Both RBDA aPDI regimens (400 µM RBDA with or without 400 mM KI followed by 20 J/cm2 green light) accelerated the healing of MRSA-infected excisional wounds in diabetic mice, without damaging the host tissue.

Potassium iodide enhances the killing effect of methylene blue mediated photodynamic therapy against F. monophora

BACKGROUND

Chromoblastomycosis (CMB) is a chronic granulomatous fungal infection that affect the skin and subcutaneous tissues. It is clinically problematic due to limited treatment options, low cure rates, and high rates of relapse. This underscores the necessity for innovative treatment approaches. In this study, potassium iodide (KI) combined with Methylene Blue (MB) mediated antimicrobial photodynamic therapy (PDT) were assessed in the treatment of Fonsecaea monophora (F. monophora) both in vitro and in vivo. And the underlying mechanism that contributes to the efficacy of this treatment approach was investigated.

METHODS

In vitro experiments were conducted using different combinations and concentrations of MB, KI, and 660 nm light (60 mW/cm2) to inhibit F. monophora. The study was carried out using colony-forming unit (CFU) counts and scanning electron microscopy (SEM). The production of singlet oxygen (1O2), free iodine (I2), hydrogen peroxide (H2O2), and superoxide anion during the KI combined MB-mediated antimicrobial PDT process was also detected. In vivo experiments were developed using a Balb/c mouse paw infection model with F. monophora and treated with PBS, 10 mM KI, 2 mM MB +100 J/cm² and 10 mM KI+2 mM MB +100 J/cm² respectively. Inflammatory swelling, fungal load and histopathological analyses of the mouse footpads were assessed.

RESULTS

KI enhanced the killing effect of MB-mediated antimicrobial PDT on the conidial spores of F. monophora at the cell and infected animal model level. During the process, the main antimicrobial agents in KI combined with MB- mediated antimicrobial PDT could produce stronger toxic active species including free I2 and H2O2. CONCLUSION: KI combined with MB-mediated antimicrobial PDT could be an effective adjunct therapy for treating CBM.

Laser fluorescence assessment of dental caries arrest with two silver fluoride agents in patients with special needs- a preliminary report

PURPOSE

While silver diamine fluoride has been used extensively for caries arrest and desensitising, silver fluoride (AgF) at neutral pH may also have value as a minimally invasive dental caries treatment. This study explored the effectiveness of two AgF products (AgF/KI and AgF/SnF2) when used in adult patients with special needs (SN) who had high caries risk and salivary gland hypofunction.

METHODS

This split-mouth clinical study, over two appointments 3-months apart, compared the impact of a single application of AgF/KI (Riva Star Aqua, SDI) and AgF/SnF2 (Creighton Dental CSDS, Whiteley) on matched carious lesions in the same arch, by clinical visual-tactile (cVT) assessment of caries status and laser fluorescence (LF, DIAGNOdent) evaluation of bacterial load in the lesions, using repeated measures analysis.

RESULTS

Twelve participants were recruited in the study. A total of 56 teeth (28 pairs) were included. Both AgF products gave a significant decrease in caries activity as measured by cVT (P < 0.0001) and LF (P = 0.0027). There were no statistically significant differences between the two AgF treatments, with response rates for improvements in active lesions of 92% in the AgF/KI arm, and 96% in the AgF/SnF2 arm. There was no effect of tooth type, lesion type, arch type, plaque metabolism and plaque area at the site level on outcomes, nor was there a clustering effect of sites in a patient level analysis. Overall, LF was superior to cVT for detecting lesions that still progressed despite treatment (P = 0.0027).

CONCLUSION

A single application of AgF/KI or AgF/SnF2 has high predictability (over 90%) for achieving arrest in active caries lesions in adult patients with SN and high caries risk. Clinical assessment should use visual-tactile examination combined with LF readings to detect lesions that are still progressing and that require additional treatments. Future studies should compare these AgF modalities with SDF and explore factors such as time between applications and the need for repeated applications.

TRIAL REGISTRATION

The study was registered with the Australian Clinical Trials Registry (ACTRN12621001139864p) on 23/08/2021.

Design and Synthesis of Metalloporphyrin Nanoconjugates for Dual Light-Responsive Antimicrobial Photodynamic Therapy

Antimicrobial photodynamic therapy (APDT) utilizes photosensitizers (PSs) that eradicate a broad spectrum of bacteria in the presence of light and molecular oxygen. On the other hand, some light sources such as ultraviolet (UVB and UVC) have poor penetration and high cytotoxicity, leading to undesired PDT of the PSs. Herein, we have synthesized conjugatable mesosubstituted porphyrins and extensively characterized them. Time-dependent density functional theory (TD-DFT) calculations revealed that metalloporphyrin EP (5) is a suitable candidate for further applications. Subsequently, the metalloporphyrin was conjugated with lignin-based zinc oxide nanocomposites (ZnOAL and ZnOKL) to develop hydrophilic nanoconjugates (ZnOAL@EP and ZnOKL@EP). Upon dual light (UV + green light) exposure, nanoconjugates showed enhanced singlet oxygen generation ability and also demonstrated pH responsiveness. These nanoconjugates displayed significantly improved APDT efficiency (4-7 fold increase) to treat bacterial infection under dual light irradiation.

Photodynamic therapy for ESKAPE pathogens: An emerging approach to combat antimicrobial resistance (AMR)

The increase in antimicrobial resistance, particularly in ESKAPE pathogens, has resulted in the dire need for new therapeutic approaches. ESKAPE is an acronym for a group of bacteria that are responsible for a majority of nosocomial and community acquired infections. The acronym stands for Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species. These pathogens are known for their ability to develop resistance to multiple antibiotics, making them difficult to treat thus posing a significant threat to public health. In light of the alarming consequences of antimicrobial resistance, it has been estimated that, in the absence of a substantial increase in the rate of development of new effective drugs, the number of casualties related to these infections will increase from about 700,000 in 2016 up to nearly 10,000,000 in 2050 [1]. One potential strategy to treat these pathogens is photodynamic therapy (PDT). In the early 20th century, Oscar Raab observed the phototoxicity of acridine red against Paramecium caudatum, while Tappenier and Jesionek demonstrated the photodynamic effects of eosin for treating cutaneous diseases. These discoveries laid the foundation for Photodynamic Therapy (PDT), which utilizes a non-toxic photosensitizer (PS) followed by targeted light irradiation for treatment [2]. PDT involves the use of a photosensitizer, a light source, and oxygen to eliminate highly active infectious pathogens such as bacteria, viruses, and fungi. PDT is known to possess several advantages including localized treatment and fewer side effects. Various photosensitizers and light sources have been assessed in different strains, showing promising results suggesting PDT to be a promising potential treatment option. PDT utilizes PS compounds with suitable light absorption that showcase effective results against the pathogens in vitro and in vivo, including BODIPY derivatives, Methylene Blue, and other dyes like porphyrin derivatives, phthalocyanines, indole derivatives, Photophrin, etc., inhibiting the growth of infections, for both in planktonic cells and in biofilms. Combination of PDT with other therapies like efflux pump inhibitors or quorum sensing inhibitors has also proven to be efficacious. However, this domain further needs to be assessed before it reaches the society.

Ultraefficient OG-Mediated Photodynamic Inactivation Mechanism for Ablation of Bacteria and Biofilms in Water Augmented by Potassium Iodide under Blue Light Irradiation

While photodynamic inactivation (PDI) has emerged as a novel sterilization strategy for drinking water treatment that recently attracted tremendous attention, its efficiency needs to be further improved. In this study, we aimed to clarify the ultraefficient mechanism by which potassium iodide (KI) potentiates octyl gallate (OG)-mediated PDI against bacteria and biofilms in water. When OG (0.15 mM) and bacteria were exposed to blue light (BL, 420 nm, 210 mW/cm2), complete sterilization (>7.5 Log cfu/mL of killing) was achieved by the addition of KI (250 mM) within only 5 min (63.9 J/cm2). In addition, at lower doses of OG (0.1 mM) with KI (100 mM), the biofilm was completely eradicated within 10 min (127.8 J/cm2). The KI-potentiated mechanism involves in situ rapid photogeneration of a multitude of reactive oxygen species, especially hydroxyl radicals (•OH), reactive iodine species, and new photocytocidal substances (quinone) by multiple photochemical pathways, which led to the destruction of cell membranes and membrane proteins, the cleavage of genomic DNA and extracellular DNA within biofilms, and the degradation of QS signaling molecules. This multitarget synergistic strategy provided new insights into the development of an environmentally friendly, safe, and ultraefficient photodynamic drinking water sterilization technology.

Effect of photodynamic therapy on multidrug-resistant Acinetobacter baumannii: A scoping review

BACKGROUND

Acinetobacter baumannii is a Gram-negative, non-fermenting coccobacillus of the Moraxellaceae family. It is an opportunistic pathogen responsible for several hospital-acquired infections (HAIs) associated with skin and tissue infections at surgical sites, catheter-associated urinary tract infections, and central line catheters. Multidrug-resistant (MDR) A. baumannii has caused hospital outbreaks that are difficult to eradicate and represent one of the leading producers of HAIs. MDR-A. baumannii presents a broad range of resistance to different antimicrobials, including carbapenems. Due to the low sensitivity to conventional antibiotic therapies, it is necessary to identify other therapeutic options. Antimicrobial photodynamic therapy (aPDT) is a promising alternative and complementary approach to address the shortage of antimicrobials in MDR-A. baumannii. APDT combines a photosensitizer agent, light, and oxygen to achieve a bactericidal/bacteriostatic effect. The effect is given by producing reactive oxygen species (ROS) that produce photooxidative stress over bacterial structures, such as the envelope and the DNA.

METHODS

This study aims to systematically collect bibliographic information from databases such as PubMed, Scopus, and google scholar to analyze the relevant articles critically.

RESULTS

An increasing body of evidence demonstrates the efficacy of photodynamic inactivation in eliminating A. baumannii strains, both in vitro and in vivo.

CONCLUSIONS

The evidence supports that photodynamic inactivation is an alternative capable of eliminating strains of Acinetobacter baumannii and may considerably improve the treatment of MDR strains. Although they do exist, aPDT studies on MDR strains of A. baumannii are scarce and should increase since it is on these strains that photodynamic therapy becomes attractive.

Combined bisdemethoxycurcumin and potassium iodide-mediated antimicrobial photodynamic therapy

Antimicrobial photodynamic therapy is emerging as a promising way to treat infections with minimal side effects. Typically, a single photosensitizer used in photodynamic therapy is capable of generating only one type of reactive oxygen species, which may have inadequate capability to eradicate certain types of microbes, especially Candida species. Thus, the use of combined photosensitizers is examined as a means of achieving superior antimicrobial results. We postulate that bisdemethoxycurcumin, a type I reactive oxygen species generator, combined with potassium iodide, an antimicrobial iodide molecule, might exhibit superior antimicrobial effects compared to a single photosensitizer-mediated photodynamic therapy. The effects of bisdemethoxycurcumin + potassium iodide + dental blue light on Candida albicans reduction were examined. Candida biofilms were treated with 20, 40 or 80 μM bisdemethoxycurcumin, 100 mM potassium iodide or a combination of these species for 20 min before irradiation with a dental blue light (90 J/cm²). The negative and positive controls were phosphate buffer saline and nystatin at 1 : 100,000 units/ml, respectively. Candidal numbers were quantified at 0, 1, 6 and 24 h. Hydroxyl radicals were spectrophotometrically measured using 2-[6-(4'amino phynoxyl-3H-xanthen-3-on-9-yl)] benzoic acid or APF probe-mediated fluorescence intensity (Varioskan) at 490/515 nm (excitation/emission). Candidal counts and hydroxyl radical comparisons were performed using the Kruskal-Wallis test and one-way ANOVA, respectively. Correlations between candidal numbers and hydroxyl radical levels were done with a Pearson correlation test. Forty μM bisdemethoxycurcumin+100 mM KI could provide a 3.5 log₁₀ CFU/ml reduction after 6 h. Bisdemethoxycurcumin alone generated OH levels that were strongly correlated with candidal reduction. In conclusion, 40 μM bisdemethoxycurcumin+100 mM KI could reduce C. albicans biofilm.

Antimicrobial photodynamic therapy against oral biofilm: influencing factors, mechanisms, and combined actions with other strategies

Oral biofilms are a prominent cause of a wide variety of oral infectious diseases which are still considered as growing public health problems worldwide. Oral biofilms harbor specific virulence factors that would aggravate the infectious process and present resistance to some traditional therapies. Antimicrobial photodynamic therapy (aPDT) has been proposed as a potential approach to eliminate oral biofilms via in situ-generated reactive oxygen species. Although numerous types of research have investigated the effectiveness of aPDT, few review articles have listed the antimicrobial mechanisms of aPDT on oral biofilms and new methods to improve the efficiency of aPDT. The review aims to summarize the virulence factors of oral biofilms, the progress of aPDT in various oral biofilm elimination, the mechanism mediated by aPDT, and combinatorial approaches of aPDT with other traditional agents.

The role of the light source in antimicrobial photodynamic therapy

Antimicrobial photodynamic therapy (APDT) is a promising approach to fight the growing problem of antimicrobial resistance that threatens health care, food security and agriculture. APDT uses light to excite a light-activated chemical (photosensitiser), leading to the generation of reactive oxygen species (ROS). Many APDT studies confirm its efficacy in vitro and in vivo against bacteria, fungi, viruses and parasites. However, the development of the field is focused on exploring potential targets and developing new photosensitisers. The role of light, a crucial element for ROS production, has been neglected. What are the main parameters essential for effective photosensitiser activation? Does an optimal light radiant exposure exist? And finally, which light source is best? Many reports have described the promising antibacterial effects of APDT in vitro, however, its application in vivo, especially in clinical settings remains very limited. The restricted availability may partially be due to a lack of standard conditions or protocols, arising from the diversity of selected photosensitising agents (PS), variable testing conditions including light sources used for PS activation and methods of measuring anti-bacterial activity and their effectiveness in treating bacterial infections. We thus sought to systematically review and examine the evidence from existing studies on APDT associated with the light source used. We show how the reduction of pathogens depends on the light source applied, radiant exposure and irradiance of light used, and type of pathogen, and so critically appraise the current state of development of APDT and areas to be addressed in future studies. We anticipate that further standardisation of the experimental conditions will help the field advance, and suggest key optical and biological parameters that should be reported in all APDT studies. More in vivo and clinical studies are needed and are expected to be facilitated by advances in light sources, leading to APDT becoming a sustainable, alternative therapeutic option for bacterial and other microbial infections in the future.

Sulfonamide Porphyrins as Potent Photosensitizers against Multidrug-Resistant Staphylococcus aureus (MRSA): The Role of Co-Adjuvants

Sulfonamides are a conventional class of antibiotics that are well-suited to combat infections. However, their overuse leads to antimicrobial resistance. Porphyrins and analogs have demonstrated excellent photosensitizing properties and have been used as antimicrobial agents to photoinactivate microorganisms, including multiresistant Staphylococcus aureus (MRSA) strains. It is well recognized that the combination of different therapeutic agents might improve the biological outcome. In this present work, a novel meso-arylporphyrin and its Zn(II) complex functionalized with sulfonamide groups were synthesized and characterized and the antibacterial activity towards MRSA with and without the presence of the adjuvant KI was evaluated. For comparison, the studies were also extended to the corresponding sulfonated porphyrin TPP(SO₃H)₄. Photodynamic studies revealed that all porphyrin derivatives were effective in photoinactivating MRSA (>99.9% of reduction) at a concentration of 5.0 μM upon white light radiation with an irradiance of 25 mW cm^-2 and a total light dose of 15 J cm^-2. The combination of the porphyrin photosensitizers with the co-adjuvant KI during the photodynamic treatment proved to be very promising allowing a significant reduction in the treatment time and photosensitizer concentration by six times and at least five times, respectively. The combined effect observed for TPP(SO₂NHEt)₄ and ZnTPP(SO₂NHEt)₄ with KI seems to be due to the formation of reactive iodine radicals. In the photodynamic studies with TPP(SO₃H)₄ plus KI, the cooperative action was mainly due to the formation of free iodine (I₂).

Porphyrin Polymers Bearing N,N'-Ethylene Crosslinkers as Photosensitizers against Bacteria

The appearance of microbes resistant to antibiotics requires the development of alternative therapies for the treatment of infectious diseases. In this work two polymers, PTPPF₁₆-EDA and PZnTPPF₁₆-EDA, were synthesized by the nucleophilic aromatic substitution of 5,10,15,20-tetrakis(pentafluorophenyl)porphyrin and its Zn(II) complex with ethylenediamine, respectively. In these structures, the tetrapyrrolic macrocycles were N,N'-ethylene crosslinked, which gives them greater mobility. The absorption spectra of the polymers showed a bathochromic shift of the Soret band of ~10 nm with respect to the monomers. This effect was also found in the red fluorescence emission peaks. Furthermore, both polymeric materials produced singlet molecular oxygen with high quantum yields. In addition, they were capable of generating superoxide anion radicals. Photodynamic inactivation sensitized by these polymers was tested in Staphylococcus aureus and Escherichia coli bacteria. A decrease in cell viability greater than 7 log (99.9999%) was observed in S. aureus incubated with 0.5 μM photosensitizer upon 30 min of irradiation. Under these conditions, a low inactivation of E. coli (0.5 log) was found. However, when the cells were treated with KI, the elimination of the Gram-negative bacteria was achieved. Therefore, these polymeric structures are interesting antimicrobial photosensitizing materials for the inactivation of pathogens.

Antimicrobial Photodynamic Effect of Cross-Kingdom Microorganisms with Toluidine Blue O and Potassium Iodide

Streptococcus mutans (S. mutans) and Candida albicans (C. albicans) are prominent microbes associated with rapid and aggressive caries. In the present study, we investigated the antimicrobial efficacy, cytotoxicity, and mechanism of toluidine blue O (TBO)-mediated antimicrobial photodynamic therapy (aPDT) and potassium iodide (KI). The dependence of KI concentration, TBO concentration and light dose on the antimicrobial effect of aPDT plus KI was determined. The cytotoxicity of TBO-mediated aPDT plus KI was analyzed by cell counting kit-8 (CCK-8) assay. A singlet oxygen (1O2) probe test, time-resolved 1O2 detection, and a 1O2 quencher experiment were performed to evaluate the role of 1O2 during aPDT plus KI. The generation of iodine and hydrogen peroxide (H2O2) were analyzed by an iodine starch test and Amplex red assay. The anti-biofilm effect of TBO-mediated aPDT plus KI was also evaluated by counting forming unit (CFU) assay. KI could potentiate TBO-mediated aPDT against S. mutans and C. albicans in planktonic and biofilm states, which was safe for human dental pulp cells. 1O2 measurement showed that KI could quench 1O2 signals, implicating that 1O2 may act as a principal mediator to oxidize excess iodide ions to form iodine and H2O2. KI could highly potentiate TBO-mediated aPDT in eradicating S. mutans and C. albicans due to the synergistic effect of molecular iodine and H2O2.

Development of a Polymeric Film Entrapping Rose Bengal and Iodide Anion for the Light-Induced Generation and Release of Bactericidal Hydrogen Peroxide

A series of poly(2-hydroxyethyl methacrylate) (PHEMA) thin films entrapping photosensitizer Rose Bengal (RB) and tetrabutylammonium iodide (TBAI) have been synthetized. The materials have been characterized by means of Thermogravimetric Analysis (TGA), Attenuated Total Reflectance Fourier Transform Infrared Spectroscopy (ATR-FTIR) and UV-vis Absorption spectroscopy. Irradiation of the materials with white light led to the generation of several bactericidal species, including singlet oxygen (¹O₂), triiodide anion (I₃^-) and hydrogen peroxide (H₂O₂). ¹O₂ production was demonstrated spectroscopically by reaction with the chemical trap 2,2'-(anthracene-9,10-diylbis(methylene))dimalonic acid (ABDA). In addition, the reaction of iodide anion with ¹O₂ yielded I₃^- inside the polymeric matrix. This reaction is accompanied by the formation of H₂O₂, which diffuses out the polymeric matrix. Generation of both I₃^- and H₂O₂ was demonstrated spectroscopically (directly in the case of triiodide by the absorption at 360 nm and indirectly for H₂O₂ using the xylenol orange test). A series of photodynamic inactivation assays were conducted with the synthesized polymers against Gram-negative bacteria Escherichia coli and Pseudomonas aeruginosa. Complete eradication (7 log₁₀ CFU/mL) of both bacteria occurred after only 5 min of white light irradiation (400-700 nm; total energy dose 24 J/cm²) of the polymer containing both RB and TBAI. The control polymer without embedded iodide (only RB) showed only marginal reductions of ca. 0.5 log₁₀ CFU/mL. The main novelty of the present investigation is the generation of three bactericidal species (¹O₂, I₃^- and H₂O₂) at the same time using a single polymeric material containing all the elements needed to produce such a bactericidal cocktail, although the most relevant antimicrobial activity is shown by H₂O₂. This experimental approach avoids multistep protocols involving a final step of addition of I^-, as described previously for other assays in solution.

Photodynamic Inactivation of Bacteria in Ionic Environments Using the Photosensitizer SAPYR and the Chelator Citrate

Many studies show that photodynamic inactivation (PDI) is a powerful tool for the fight against pathogenic, multi-resistant bacteria and the closing of hygiene gaps. However, PDI studies have been frequently performed under standardized in vitro conditions comprising artificial laboratory settings. Under real life conditions, however, PDI encounters substances like ions, proteins, amino acids, and fatty acids, potentially hampering the efficacy PDI to an unpredictable extent. Thus, we investigated PDI with the phenalene-1-one based photosensitizer SAPYR against Escherichia coli and Staphylococcus aureus in the presence of calcium or magnesium ions, which are ubiquitous in potential fields of PDI applications like in tap water or on tissue surfaces. The addition of citrate should elucidate the potential as a chelator. The results indicate that PDI is clearly affected by such ubiquitous ions depending on its concentration and the type of bacteria. The application of citrate enhanced PDI especially for Gram-negative bacteria at certain ionic concentrations (e.g. CaCl₂ or MgCl₂ : 7.5 to 75 mmol l^-1 ). Citrate also improved PDI efficacy in tap water (especially for Gram-negative bacteria) and synthetic sweat solution (especially for Gram-positive bacteria). In conclusion, the use of chelating agents like citrate may facilitate the application of PDI under real life conditions.

Photodynamic therapy-a promising treatment of oral mucosal infections

The treatment of oral mucosal infections is increasingly challenging owing to antibiotic resistance. Therefore, alternative antimicrobial strategies are urgently required. Photodynamic therapy (PDT) has attracted attention for the treatment of oral mucosal infections because of its ability to effectively inactivate drug-resistant bacteria, completely heal clinical infectious lesions and usually offers only mild adverse reactions. This review briefly summarizes relevant scientific data and published papers and discusses the potential mechanism and application of PDT in the treatment of oral mucosal infections.

The Overlooked Photochemistry of Iodine in Aqueous Suspensions of Fullerene Derivatives

Fullerene's low water solubility was a serious challenge to researchers aiming to harness their excellent photochemical properties for aqueous applications. Cationic functionalization of the fullerene cage provided the most effective approach to increase water solubility, but common synthesis practices inadvertently complicated the photochemistry of these systems by introducing iodide as a counterion. This problem was overlooked until recent work noted a potentiation effect which occurred when photosensitizers were used to inactivate microorganisms with added potassium iodide. In this work, several photochemical pathways were explored to determine the extent and underlying mechanisms of iodide's interference in the photosensitization of singlet oxygen by cationic fulleropyrrolidinium ions and rose bengal. Triplet excited state sensitizer lifetimes were measured via laser flash photolysis to probe the role of I^- in triplet sensitizer quenching. Singlet oxygen production rates were compared across sensitizers in the presence or absence of I^-, SO₄^2-, and other anions. 3,5-Dimethyl-1H-pyrazole was employed as a chemical probe for iodine radical species, such as I·, but none were observed in the photochemical systems. Molecular iodine and triiodide, however, were found in significant quantities when photosensitizers were irradiated in the presence of I^- and O₂. The formation of I₂ in these photochemical systems calls into question the interpretations of prior studies that used I^- as a counterion for photosensitizer materials. As an example, MS2 bacteriophages were inactivated here by cationic fullerenes with and without I^- present, showing that I^- moderately accelerated the MS2 deactivation, likely by producing I₂. Production of I₂ did not appear to be directly correlated with estimates of ¹O₂ concentration, suggesting that the relevant photochemical pathways are more complex than direct reactions between ¹O₂ and I^- in the bulk solution. On the basis of the results here, iodine photochemistry may be underappreciated and misunderstood in other environmental systems.

A recyclable and light-triggered nanofibrous membrane against the emerging fungal pathogen Candida auris

The emerging "super fungus" Candida auris has become an important threat to human health due to its pandrug resistance and high lethality. Therefore, the development of novel antimicrobial strategy is essential. Antimicrobial photodynamic therapy (aPDT) has excellent performance in clinical applications. However, the relevant study on antifungal activity and the mechanism involved against C. auris remains scarce. Herein, a recyclable and biodegradable polylactic acid-hypocrellin A (PLA-HA) nanofibrous membrane is newly developed. In vitro PLA-HA-aPDT could significantly reduce the survival rate of C. auris plankton and its biofilms, and the fungicidal effect of the membrane is still significant after four repeated uses. Simultaneously, PLA-HA exhibits good biocompatibility and low hemolysis. In vivo experiments show that PLA-HA-aPDT can promote C. auris-infected wound healing, reduce inflammatory response, and without obvious toxic side-effects. Further results reveal that PLA-HA-aPDT could increase endogenous reactive oxygen species (ROS) levels, leading to mitochondrial dysfunction, release of cytochrome C, activation of metacaspase, and nuclear fragmentation, thereby triggering apoptosis of C. auris. Compared with HA, PLA-HA shows stronger controllability and reusability, which can greatly improve the utilization efficiency of HA alone. Taken together, the efficacy, safety and antifungal activity make PLA-HA-aPDT a highly promising antifungal candidate for skin or mucous membrane C. auris infection.

It is urgent to develop new antifungal strategies to address the problem of Candida auris infection and drug resistance. Previous studies have revealed that antimicrobial photodynamic therapy (aPDT) based on natural products, such as hypocrellin A (HA), is a promising method in clinical applications. However, equivalent studies of aPDT on antifungal activity and its mechanism against C. auris remain scarce. Herein, we successfully prepared a recyclable, biodegradable, and light-driven antifungal PLA-HA nanofibrous membrane through the electrospinning technique. C. auris infection has been treated by aPDT in vitro and in vivo for the first time, especially HA-mediated aPDT. In vitro and in vivo experiments have provided sufficient lines of evidence that PLA-HA is a promising antifungal material for superficial C. auris infections due to its antifungal effect and excellent biocompatibility. Notably, there still remains a very high antifungal activity after utilizing PLA-HA four times. In addition, this study clarifies that the anti-C. auris mechanism of PLA-HA, namely, PLA-HA-mediated aPDT, is attributed to the formation of intracellular ROS, resulting in mitochondrial dysfunction and a decline in the mitochondrial transmembrane potential, releasing cytochrome C from mitochondria to the cytoplasm, promoting the activation of metacaspase, and inducing nuclear condensation and fragmentation of C. auris, thus triggering yeast cell apoptosis. This study lays a foundation for developing new antimicrobial nanofibrous dressings mediated by aPDT and provides an alternative strategy for the treatment of local fungal infectious diseases.

Synergistic Effect of Combination of a Temoporfin-Based Photodynamic Therapy with Potassium Iodide or Antibacterial Agents on Oral Disease Pathogens In Vitro

5, 10, 15, 20-Tetrakis(3-hydroxyphenyl)chlorin (temoporfin) is a photosensitizer used in photodynamic therapy for oral cancer and periodontal disease treatment. This study determined the minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of temoporfin. Additionally, the combination of potassium iodide (KI) or antimicrobial agents in oral pathogens under hypoxic or normoxic conditions were determined. We also evaluated the biofilm removal effect and detected the expressions of the antibiotic resistance-related genes and biofilm formation-related genes of methicillin-resistant staphylococcus aureus (MRSA). The results provided reveal that the combination of the temoporfin and KI had a synergistic effect of reducing the MICs and MBCs of Lactobacillus acidophilus and Lactobacillus paracasei under normoxic and hypoxic conditions due to increasing H₂O₂ production. Temoporfin increased the biofilm removal of Aggregatibacter actinomycetemcomitans, Enterococcus faecalis, and Staphylococcus aureus under normoxic condition, and it reduced the antibiotic resistance-related genes expression of MRSA. The combination of temoporfin with ampicillin or chlorhexidine significantly enhanced the bactericidal effect on MRSA. This study provides a potential application of temoporfin on the clinical side against oral pathogens and the prevention of oral diseases.

Biofilms in Surgical Site Infections: Recent Advances and Novel Prevention and Eradication Strategies

Surgical site infections (SSIs) are common postoperative occurrences due to contamination of the surgical wound or implanted medical devices with community or hospital-acquired microorganisms, as well as other endogenous opportunistic microbes. Despite numerous rules and guidelines applied to prevent these infections, SSI rates are considerably high, constituting a threat to the healthcare system in terms of morbidity, prolonged hospitalization, and death. Approximately 80% of human SSIs, including chronic wound infections, are related to biofilm-forming bacteria. Biofilm-associated SSIs are extremely difficult to treat with conventional antibiotics due to several tolerance mechanisms provided by the multidrug-resistant bacteria, usually arranged as polymicrobial communities. In this review, novel strategies to control, i.e., prevent and eradicate, biofilms in SSIs are presented and discussed, focusing mainly on two attractive approaches: the use of nanotechnology-based composites and natural plant-based products. An overview of new therapeutic agents and strategic approaches to control epidemic multidrug-resistant pathogenic microorganisms, particularly when biofilms are present, is provided alongside other combinatorial approaches as attempts to obtain synergistic effects with conventional antibiotics and restore their efficacy to treat biofilm-mediated SSIs. Some detection and real-time monitoring systems to improve biofilm control strategies and diagnosis of human infections are also discussed.

In Vivo Potentiation of Antimicrobial Photodynamic Therapy in a Mouse Model of Fungal Infection by Addition of Potassium Iodide

Antimicrobial photodynamic inactivation (aPDI) involves the use of a nontoxic dye or photosensitizer excited with visible light to produce reactive oxygen species that can kill all classes of microorganisms. Antimicrobial photodynamic therapy (aPDT) can be used in vivo as an alternative therapeutic strategy to treat localized infections due to its ability to selectively kill microbes while preserving host mammalian cells. aPDI can be potentiated by the addition of the nontoxic inorganic salt potassium iodide (KI). KI is an approved drug for antifungal therapy. The mechanism of potentiation with iodide is likely to be singlet oxygen addition to iodide to form iodine radicals, hydrogen peroxide, and molecular iodine. A previous chapter in this volume described potentiation of aPDI in vitro by addition of KI, while in this chapter we address the ability of KI to potentiate aPDT in vivo using an animal model of localized fungal infection. We employed oral candidiasis in immunosuppressed mice caused by a bioluminescent strain of Candida albicans and monitored by bioluminescence imaging.

In Vitro Potentiation of Antimicrobial Photodynamic Inactivation by Addition of Potassium Iodide

The current increase in antibiotic resistance worldwide and the emergence of microbial strains that are resistant to all known antibiotics have stimulated research into novel strategies such as aPDI that are thought to be unlikely to lead to the development of resistance. Although many studies have reported in vitro aPDI killing of microorganisms by a range of different photosensitizers, there are still limitations to the effectiveness of aPDI, and recurrence of bacterial growth may occur in animal studies after completion of the illumination. In this chapter we cover a novel and relatively simple method to improve the efficacy of aPDI against Gram-positive Staphylococcus aureus, Gram-negative Escherichia coli, and fungal yeast Candida albicans by the addition of potassium iodide, a nontoxic inorganic salt. Under some circumstances up to six-logs additional killing can be obtained.

Recent progress in Tannic Acid-driven antimicrobial/antifouling surface coating strategies

Medical devices and surgical implants are a necessary part of tissue engineering and regenerative medicines. However, the biofouling and microbial colonization on the implant surface continues to be a major...

Potentiation Effect of Iodine Species on the Antimicrobial Capability of Surfaces Coated with Electroactive Phthalocyanines

The spreading of different infections can occur through direct contact with glass surfaces in commonly used areas. Incorporating the use of alternative therapies in these materials seems essential to reduce and also avoid bacterial resistance. In this work, the capability to kill microbes of glass surfaces coated with two electroactive metalated phthalocyanines (ZnPc-EDOT and CuPc-EDOT) is assessed. The results show that both of these materials are capable of producing reactive oxygen species; however, the polymer with Zn(II) (ZnPc-PEDOT) has a singlet oxygen quantum yield 8-fold higher than that of the Cu(II) containing analogue. This was reflected in the in vitro experiments where the effectiveness of the surfaces was tested in bacterial suspensions, monitoring single microbe inactivation upon attachment to the polymers, and eliminating mature biofilms. Furthermore, we evaluated the use of an inorganic salt (KI) to potentiate the photodynamic inactivation mediated by an electropolymerized surface. The addition of the salt improved the efficiency of phototherapy at least two times for both polymers; nevertheless, the material coated with ZnPc-PEDOT was the only one capable of eliminating >99.98% of the initial microbes loading under different circumstances.

Investigation of powerful fungicidal activity of tetra-cationic platinum(II) and palladium(II) porphyrins by antimicrobial photodynamic therapy assays

This manuscript reports enhanced antimicrobial photoinactivation using tetra-cationic porphyrins with peripheral platinum(II) and palladium(II) complexes against fungal dermatophyte strains. Six different positively charged porphyrins were used and applied in antimicrobial photodynamic therapy experiments (aPDT) against dermatophyte fungi colonies. The microbiological tests were conducted with an adequate concentration of photosensitizer (PS) under white-light irradiation for 120 min and the most effective PS meta isomer 3PtP significantly reduced the concentration of viable fungal colony. In this way, tetra-cationic porphyrins containing platinum(II)-bipyridyl complexes may be promising fungicidal aPDT agents with potential applications in future clinical cases.

Porphyrin-Schiff Base Conjugates Bearing Basic Amino Groups as Antimicrobial Phototherapeutic Agents

New porphyrin–Schiff base conjugates bearing one (6) and two (7) basic amino groups were synthesized by condensation between tetrapyrrolic macrocycle-containing amine functions and 4-(3-(N,N-dimethylamino)propoxy)benzaldehyde. This approach allowed us to easily obtain porphyrins substituted by positive charge precursor groups in aqueous media. These compounds showed the typical Soret and four Q absorption bands with red fluorescence emission (Φ_F ~ 0.12) in N,N-dimethylformamide. Porphyrins 6 and 7 photosensitized the generation of O₂(¹Δ_g) (Φ_Δ ~ 0.44) and the photo-oxidation of L-tryptophan. The decomposition of this amino acid was mainly mediated by a type II photoprocess. Moreover, the addition of KI strongly quenched the photodynamic action through a reaction with O₂(¹Δ_g) to produce iodine. The photodynamic inactivation capacity induced by porphyrins 6 and 7 was evaluated in Staphylococcus aureus, Escherichia coli, and Candida albicans. Furthermore, the photoinactivation of these microorganisms was improved using potentiation with iodide anions. These porphyrins containing basic aliphatic amino groups can be protonated in biological systems, which provides an amphiphilic character to the tetrapyrrolic macrocycle. This effect allows one to increase the interaction with the cell wall, thus improving photocytotoxic activity against microorganisms.

Biodegradable supramolecular micelles via host-guest interaction of cyclodextrin-terminated polypeptides and adamantane-terminated polycaprolactones

Biodegradable supramolecular micelles were prepared exploiting the host-guest interaction of cyclodextrin and adamantane. Cyclodextrin-initiated polypeptides acted as the hydrophilic corona, whereas adamantane-terminated polycaprolactones served as the hydrophobic core.

Tetracationic porphyrin derivatives against human breast cancer

Photodynamic therapy (PDT) is an approved therapeutic approach and an alternative to conventional chemotherapy for the treatment of several types of cancer with the advantages of reducing the side effects and developing resistance mechanisms. Here, was evaluated the photosensitization capabilities of 5,10,15,20-tetrakis[4-(pyridinium-1-yl-methyl)phenyl]porphyrin (3), its N-confused isomer (4) and of the neutral precursors (1) and (2) and the results were compared with the ones obtained with the cationic 5,10,15,20-tetrakis(1-methylpyridinium-4-yl)porphyrin (TMPyP). Both regular porphyrin derivatives 1 and 3 showed higher efficiency to generate singlet oxygen than TMPyP. The PDT assays towards MCF-7 cells under red light irradiation (λ > 640 nm, 23.7 mW cm^-2) demonstrated that the cationic porphyrin 3 is an efficient photosensitizer to kill MCF-7 breast cancer cells. The study of the cell death mechanisms induced by the photodynamic process showed that the studied porphyrin 3 and TMPyP caused cell death by autophagic flux and necrosis.

Photodynamic Inactivation of Pseudomonas aeruginosa by PHEMA Films Loaded with Rose Bengal: Potentiation Effect of Potassium Iodide

Four formulations have been used to produce different poly(2-hydroxyethyl methacrylate) (PHEMA) thin films, containing singlet oxygen photosensitizer Rose Bengal (RB). The polymers have been characterized employing Thermogravimetric Analysis (TGA), Attenuated Total Reflectance Fourier Transform Infrared Spectroscopy (ATR-FTIR) and UV-vis Absorption Spectroscopy. When irradiated with white light (400-700 nm) films generated singlet oxygen (1O2), as demonstrated by the reactivity with 1O2 trap 9,10-dimethylanthracene (DMA). Material with the highest RB loading (polymer A4, 835 nmol RB/g polymer) was able to perform up to ten cycles of DMA oxygenation reactions at high conversion rates (ca. 90%). Polymer A4 was also able to produce the complete eradication of a Pseudomonas aeruginosa planktonic suspension of 8 log10 CFU/mL, when irradiated with white light (total dose 72 J/cm2). The antimicrobial photodynamic effect was remarkably enhanced by adding potassium iodide (100 mM). In such conditions the complete bacterial reduction occurred with a total light dose of 24 J/cm2. Triiodide anion (I3-) generation was confirmed by UV-vis absorption spectroscopy. This species was detected inside the PHEMA films after irradiation and at concentrations ca. 1 M. The generation of this species and its retention in the matrix imparts long-lasting bactericidal effects to the RB@PHEMA polymeric hydrogels. The polymers here described could find potential applications in the medical context, when optimized for their use in everyday objects, helping to prevent bacterial contagion by contact with surfaces.

Antimicrobial Photodynamic Approach in the Inactivation of Viruses in Wastewater: Influence of Alternative Adjuvants

Pathogenic viruses are frequently present in marine and estuarine waters, due to poor wastewater (WW) treatments, which consequently affect water quality and human health. Chlorination, one of the most common methods used to ensure microbiological safety in tertiarily treated effluents, may lead to the formation of toxic chemical disinfection by-products on reaction with organic matter present in the effluents. Antimicrobial photodynamic therapy (aPDT) can be a promising disinfecting approach for the inactivation of pathogens, without the formation of known toxic by-products. Additionally, some studies have reported the potentiator effect on aPDT of some compounds, such as potassium iodide (KI) and hydrogen peroxide (H2O2). In the present study, the aPDT efficiency of a PS formulation constituted of five cationic porphyrins (Form) in the inactivation of E. coli T4-like bacteriophage, a model of mammalian viruses, in different aqueous matrices with different organic matter content, was evaluated. Photoinactivation studies were performed at different concentrations of Form and in the presence of the adjuvants KI and H2O2. The results showed that the efficiency of bacteriophage photoinactivation is correlated with the Form concentration, the amount of the organic matter in WW, and the adjuvant type. Form can be an effective alternative to controlling viruses in WW, particularly if combined with H2O2, allowing to significantly reduce PS concentration and treatment time. When combined with KI, the Form is less effective in inactivating T4-like bacteriophage in WW.

Interplay of phosphate and carbonate ions with flavin photosensitizers in photodynamic inactivation of bacteria

Photodynamic inactivation (PDI) of pathogenic bacteria is a promising technology in different applications. Thereby, a photosensitizer (PS) absorbs visible light and transfers the energy to oxygen yielding reactive oxygen species (ROS). The produced ROS are then capable of killing microorganisms via oxidative damage of cellular constituents. Among other PS, some flavins are capable of producing ROS and cationic flavins are already successfully applied in PDI. When PDI is used for example on tap water, PS like flavins will encounter various ions and other small organic molecules which might hamper the efficacy of PDI. Thus, the impact of carbonate and phosphate ions on PDI using two different cationic flavins (FLASH-02a, FLASH-06a) was investigated using Staphylococcus aureus and Pseudomonas aeruginosa as model organisms. Both were inactivated in vitro at a low light exposure of 0.72 J cm-2. Upon irradiation, FLASH-02a reacts to single substances in the presence of carbonate or phosphate, whereas the photochemical reaction for FLASH-06a was more unspecific. DPBF-assays indicated that carbonate and phosphate ions decreased the generation of singlet oxygen of both flavins. Both microorganisms could be easily inactivated by at least one PS with up to 6 log10 steps of cell counts in low ion concentrations. Using the constant radiation exposure of 0.72 J cm-2, the inactivation efficacy decreased somewhat at medium ion concentrations but reached almost zero for high ion concentrations. Depending on the application of PDI, the presence of carbonate and phosphate ions is unavoidable. Only upon light irradiation such ions may attack the PS molecule and reduce the efficacy of PDI. Our results indicate concentrations for carbonate and phosphate, in which PDI can still lead to efficient reduction of bacterial cells when using flavin based PS.

Light-assisted anticancer photodynamic therapy using porphyrin-doped nanoencapsulates

Light activatable porphyrinic photosensitizers (PSs) are essential components of anticancer and antimicrobial therapy and diagnostic imaging. However, their biological applications are quite challenging due to the lack of hydrophilicity and biocompatibility. To overcome such drawbacks, photosensitizers can be doped into a biocompatible polymer such as gelatin and further can be used for biomedical applications. Herein, first, a novel A4 type porphyrin PS [5,10,15,20-tetrakis(4-pyridylamidephenyl)porphyrin; TPyAPP] was synthesized via a rational route with good yield. Further, this porphyrin was encapsulated into the gelatin nanoparticles (GNPs) to develop hydrophilic phototherapeutic nanoagents (PTNAs, A4por-GNPs). Notably, the synthesis of such porphyrin-doped GNPs avoids the use of any toxic chemicals or solvents. The nanoprobes have also shown good fluorescence quantum yield demonstrating their applicability in bioimaging. Further, the mechanistic aspects of the anticancer and antimicrobial efficacy of the developed A4por-GNPs were evaluated via singlet oxygen generation studies. Overall, our results indicated porphyrin-doped biodegradable polymeric nanoparticles act as effective phototherapeutic agents against a broad range of cancer cell lines and microbes upon activation by the low-cost LED light.

Antimicrobial photodynamic therapy for oral Candida infection in adult AIDS patients: A pilot clinical trial

BACKGROUND

Antimicrobial photodynamic therapy (aPDT) using methylene blue (MB) plus potassium iodide (KI) has been shown to be effective in killing Candida albicans in many in vitro and in vivo studies, however, there are limited reports of clinical investigations. This study aimed to explore the clinical application of aPDT with MB plus KI for the treatment of oral infection caused by C. albicans in adult acquired immune deficiency syndrome (AIDS) patients.

METHODS

A total of 21 adult AIDS patients with C. albicans oral candidiasis were divided into two groups according to MB concentration and received two consecutive aPDT treatments. Immediately before and after the aPDT treatments, C. albicans yeast isolates were recovered to measure the colony-forming units per mL (CFU/mL), biofilm formation, and to analyze the 25S rDNA genotype. Patients were assessed for the clinical recovery of oral lesions and improvement of symptoms.

RESULTS

The Log₁₀ CFU/mL of C. albicans decreased significantly after the second aPDT but not the first aPDT. There was no significant difference between the two MB concentrations. Both aPDT protocols decreased the oral lesions and clinical symptoms with no significant difference after 2-fraction aPDT. The biofilm formation of C. albicans isolates did not change before and after aPDT. The killing efficiency of 2-fraction-aPDT was not associated with either biofilm formation or 25S rDNA genotype.

CONCLUSIONS

Two-fraction-aPDT with MB plus KI could reduce the number of viable C. albicans fungal cells and improve the clinical symptoms of oral candidiasis in adult AIDS patients, regardless of the biofilm formation or 25S rDNA genotype of infected C. albicans isolates.

A novel tricationic fullerene C60 as broad-spectrum antimicrobial photosensitizer: mechanisms of action and potentiation with potassium iodide

A novel amphiphilic photosensitizing agent based on a tricationic fullerene C₆₀ (DMC₆₀³⁺) was efficiently synthesized from its non-charged analogue MMC₆₀. These fullerenes presented strong UV absorptions, with a broad range of less intense absorption up to 710 nm. Both compounds showed low fluorescence emission and were able to photosensitize the production of reactive oxygen species. Furthermore, photodecomposition of L-tryptophan sensitized by both fullerenes indicated an involvement of type II pathway. DMC₆₀³⁺ was an effective agent to produce the photodynamic inactivation (PDI) of Staphylococcus aureus, Escherichia coli and Candida albicans. Mechanistic insight indicated that the photodynamic action sensitized by DMC₆₀³⁺ was mainly mediated by both photoprocesses in bacteria, while a greater preponderance of the type II pathway was found in C. albicans. In presence of potassium iodide, a potentiation of PDI was observed due to the formation of reactive iodine species. Therefore, the amphiphilic DMC₆₀³⁺ can be used as an effective potential broad-spectrum antimicrobial photosensitizer.

The Photosensitizing Efficacy of Micelles Containing a Porphyrinic Photosensitizer and KI against Resistant Melanoma Cells

Photodynamic therapy (PDT) is a promising alternative to overcome the resistance of melanoma to conventional therapies. Currently applied photosensitizers (PS) are often based on tetrapyrrolic macrocycles like porphyrins. Unfortunately, in some cases the use of this type of derivative is limited due to their poor solubility in the biological environment. Feasible approaches to surpass this drawback are based on lipid formulations. Besides that, and inspired in the efficacy of potassium iodide (KI) for antimicrobial photodynamic therapy (aPDT), the combined effect of singlet oxygen (1 O2 ) with KI was assessed in this work, as an alternative strategy to potentiate the effect of PDT against resistant melanoma cells.

Highly cytotoxic gold(i)-phosphane dithiocarbamate complexes trigger an ER stress-dependent immune response in ovarian cancer cells

Ovarian cancer is a highly aggressive disease which is treated by surgery and platinum chemotherapy. However, a significant proportion of treated patients develop resistance to platinum treatment resulting in tumor relapse. Acquired platinum resistance has been recently correlated with activation of pro-survival endoplasmic reticulum (ER) stress responses. We hypothesized that Au complexes that induce severe ER stress might counteract pro-survival cellular attempts leading to the ER stress-mediated apoptosis and reduced platinum resistance. In this work, we prepared a series of highly cytotoxic AuI-dialkyldithiocarbamate complexes and investigated their anticancer potential in ovarian cancer cells. Complexes demonstrated surprisingly low stability in chloroform, resulting in the formation of an Au chain polymer, which also displayed excellent cytotoxicity. Lead complex 2 induced oxidative stress and ER stress-mediated p53-independent apoptosis associated with PARP cleavage and cell cycle arrest at G2/M phase. Importantly, 2 caused the surface exposure of calreticulin (CRT), which is the first step in the activation of cellular immunogenic response.

Cationic Pyrrolidine/Pyrroline-Substituted Porphyrins as Efficient Photosensitizers against E. coli

New porphyrin–pyrrolidine/pyrroline conjugates were prepared by revisiting 1,3-dipolar cycloaddition reactions between a porphyrinic azomethine ylide and a series of dipolarophiles. Cationic conjugates obtained by alkylation of the pyrrolidine/pyrroline cycloadducts showed ability to generate singlet oxygen and to produce iodine in presence of KI when irradiated with visible light. Some of the cationic derivatives showed photobactericidal properties towards a Gram-negative bioluminescent E. coli. In all cases, these features were significantly improved using KI as coadjutant, allowing, under the tested conditions, the photoinactivation of the bacterium until the detection limit of the method with a drastic reduction of the required photosensitizer concentration and irradiation time. The obtained results showed a high correlation between the ability of the cationic porphyrin derivative to produce singlet oxygen and iodine and its E. coli photoinactivation profile.

Antimicrobial Blue Light versus Pathogenic Bacteria: Mechanism, Application in the Food Industry, Hurdle Technologies and Potential Resistance

Blue light primarily exhibits antimicrobial activity through the activation of endogenous photosensitizers, which leads to the formation of reactive oxygen species that attack components of bacterial cells. Current data show that blue light is innocuous on the skin, but may inflict photo-damage to the eyes. Laboratory measurements indicate that antimicrobial blue light has minimal effects on the sensorial and nutritional properties of foods, although future research using human panels is required to ascertain these findings. Food properties also affect the efficacy of antimicrobial blue light, with attenuation or enhancement of the bactericidal activity observed in the presence of absorptive materials (for example, proteins on meats) or photosensitizers (for example, riboflavin in milk), respectively. Blue light can also be coupled with other treatments, such as polyphenols, essential oils and organic acids. While complete resistance to blue light has not been reported, isolated evidence suggests that bacterial tolerance to blue light may occur over time, especially through gene mutations, although at a slower rate than antibiotic resistance. Future studies can aim at characterizing the amount and type of intracellular photosensitizers across bacterial species and at assessing the oxygen-independent mechanism of blue light-for example, the inactivation of spoilage bacteria in vacuum-packed meats.

A cost-effective combination of Rose Bengal and off-the-shelf cationic polystyrene for the photodynamic inactivation of Pseudomonas aeruginosa

Two new photoactive materials have been prepared, characterized and tested against Pseudomonas aeruginosa bacteria (planktonic suspension). The synthesis of the polymeric photosensitizers can be made at a multigram scale, in few minutes, starting from inexpensive and readily available materials, such as Rose Bengal (photosensitizer) and ion exchange resins Amberlite® IRA 900 (macroporous) or IRA 400 (gel-type) as cationic polystyrene supports. The most notable feature of these systems is their notable bactericidal activity in the dark (4-5 log₁₀ CFU/mL reduction of the population of P. aeruginosa) which becomes enhanced upon irradiation with visible light (to reach a total reduction of 8 log₁₀ CFU/mL for the macroporous polymer at a fluence of 120 J/cm² using green light of 515 nm).

Antimicrobial Photodynamic Therapy in the Control of Pseudomonas syringae pv. actinidiae Transmission by Kiwifruit Pollen

Pseudomonas syringae pv. actinidiae (Psa) is a phytopathogen responsible for bacterial canker in kiwifruit plants and can be disseminated through pollen. This study aimed to evaluate the effectiveness of antimicrobial photodynamic therapy (aPDT) in the inactivation of Psa on kiwifruit pollen using New Methylene Blue (NMB) and Methylene Blue (MB) in the presence/absence of potassium iodide (KI). Pollen germination assays were also performed to evaluate if it was affected by aPDT. Higher reduction of Psa was achieved using NMB (5.0 μM) combined with KI (100 mM) in vitro (ca. 8 log CFU mL⁻¹ after 90 min of irradiation), while NMB alone promoted a lower reduction (3.7 log CFU mL⁻¹). The most efficient NMB concentration with KI was used to study the photodynamic efficiency of MB (5.0 μM). MB with KI photo-inactivated Psa more efficiently than NMB, causing the same bacterial reduction (ca. 8 log CFU mL⁻¹) in half the irradiation time (45 min). Therefore, MB was selected for the subsequent ex vivo aPDT assays in pollen. Almost all the Psa cells added artificially to the pollen (3.2 log CFU mL⁻¹) were photo-inactivated (3.1 log CFU mL⁻¹), whereas aPDT had a low effect on pollen natural microorganisms. When KI was added, a significant increase in aPDT effectiveness was observed (4.5 log CFU mL⁻¹). No negative effects were observed in the pollen germination after aPDT. The results show aPDT is an effective and safe method to Psa inactivation on kiwifruit pollen, and MB use is a promising alternative in the control of Psa transmission.

Efficient photodynamic inactivation of Candida albicans by porphyrin and potassium iodide co-encapsulation in micelles

Photodynamic inactivation of bacterial and fungal pathogens is a promising alternative to the extensive use of conventional single-target antibiotics and antifungal agents. The combination of photosensitizers and adjuvants can improve the photodynamic inactivation efficiency. In this regard, it has been shown that the use of potassium iodide (KI) as adjuvant increases pathogen killing. Following our interest in this topic, we performed the co-encapsulation of a neutral porphyrin photosensitizer (designated as P1) and KI into micelles and tested the obtained nanoformulations against the human pathogenic fungus Candida albicans. The results of this study showed that the micelles containing P1 and KI displayed a better photodynamic performance towards C. albicans than P1 and KI in solution. It is noteworthy that higher concentrations of KI within the micelles resulted in increased killing of C. albicans. Subcellular localization studies by confocal fluorescence microscopy revealed that P1 was localized in the cell cytoplasm, but not in the nuclei or mitochondria. Overall, our results show that a nanoformulation containing a photosensitizer plus an adjuvant is a promising approach for increasing the efficiency of photodynamic treatment. Actually, the use of this strategy allows a considerable decrease in the amount of both photosensitizer and adjuvant required to achieve pathogen killing.

Biofunctionalization of Textile Materials. 3. Fabrication of Poly(lactide)-Potassium Iodide Composites with Antifungal Properties

The paper presents a method of obtaining poly(lactide) (PLA) nonwoven fabrics with antifungal properties using potassium iodide as a nonwoven modifying agent. PLA nonwoven fabrics were obtained by the melt-blown technique and subsequently surface modified (PLA→PLA-SM-KI) by the dip-coating method. The analysis of these PLA-SM-KI (0.1%–2%) composites included Scanning Electron Microscopy (SEM), UV/VIS transmittance, FTIR spectrometry and air permeability. The nonwovens were subjected to microbial activity tests against Aspergillus niger fungal mold species, exhibiting substantial antifungal activity. The studies showed that PLA-KI hybrids containing 2% KI have appropriate mechanical properties, morphology and demanded antimicrobial properties to be further developed as a potential antimicrobial, biodegradable material.