Superhydrophobic Tipped Antimicrobial Photodynamic Therapy Device for the In Vivo Treatment of Periodontitis Using a Wistar Rat Model

Limited options exist for treatment of periodontitis; scaling and root planing (SRP) are not sufficient to eradicate P. gingivalis and the resulting inflammatory disease. Chlorhexidine (CHX), used as an adjuvant to SRP, may reduce bacterial loads but leads to pain and staining, while evidence for its efficacy is lacking. Antibiotics are effective but can lead to drug-resistance. The rising concern of antibiotic resistance limits the future use of this treatment approach. This study evaluates the efficacy of a novel superhydrophobic (SH) antimicrobial photodynamic therapy (aPDT) device as an adjuvant to SRP for the treatment of periodontitis induced in a Wistar rat in vivo model relative to CHX. The SH-aPDT device comprises an SH silicone rubber strip coated with verteporfin photosensitizer (PS), sterilized, and secured onto a tapered plastic optical fiber tip connected to a red diode laser. The superhydrophobic polydimethylsiloxane (PDMS) strips were fabricated by using a novel soluble template method that creates a medical-grade elastomer with hierarchical surface roughness without the use of nanoparticles. Superhydrophobicity minimizes direct contact of the PS-coated surface with bacterial biofilms. Upon insertion of the device tip into the pocket and energizing the laser, the device generates singlet oxygen that effectively targets and eliminates bacteria within the periodontal pocket. SH-aPDT treatment using 125 J/cm2 of red light on three consecutive days reduced P. gingivalis significantly more than SRP-CHX controls (p < 0.05). Clinical parameters significantly improved (p < 0.05), and histology and stereometry results demonstrated SH-aPDT to be the most effective treatment for improving healing and reducing inflammation, with an increase in fibroblast cells and extracellular matrix and a reduction in vascularization, inflammatory cells, and COX-2 expression. The SH-aPDT approach resulted in complete disease clearance assessed 30 days after treatment initiation with significant reduction of the periodontal pocket and re-formation of the junctional epithelium at the enamel-cementum junction. PS isolation on a SH strip minimizes the potential for bacteria to develop resistance, where the treatment may be aided by the oxygen supply retained within the SH surface.

Influence of Herbal Fillers Addition on Selected Properties of Silicone Subjected to Accelerated Aging

This work aims to assess the impact of the type and percentage of powdered herbs on selected properties of silicone-based composites. The matrix was an addition cross-linked platinum-cured polydimethylsiloxane. The fillers were powdered thyme and sage, which were introduced at 5, 10, and 15 wt.%. The introduced fillers differed in composition, morphology, and grain size. The grain morphology showed differences in the size and shape of the introduced fillers. The qualitative and quantitative assessment resulting from the incorporation was conducted based on tests of selected properties: density, wettability, rebound resilience, hardness, and tensile strength. The incorporation slightly affected the density and wettability of the silicone. Rebound resilience and hardness results differed depending on the filler type and fraction. However, tensile strength decreased, which may be due to the matrix's distribution of fillers and their chemical composition. Antibacterial activity evaluation against S. aureus proved the bacteriostatic properties of the composites. Accelerated aging in PBS solution further deteriorated the mechanical properties. FTIR and DSC have demonstrated the progressive aging of the materials. In addition, the results showed an overall minimal effect of fillers on the silicone chemical backbone and melting temperature. The developed materials can be used in applications that do not require high mechanical properties.

Self-Disinfecting Urethral Catheter to Overcome Urinary Infections: From Antimicrobial Photodynamic Action to Antibacterial Biochemical Entities

Medical-device-related infections are considered a worldwide public health problem. In particular, urinary catheters are responsible for 75% of cases of hospital urinary infections (a mortality rate of 2.3%) and present a high cost for public and private health systems. Some actions have been performed and described aiming to avoid it, including clinical guidelines for catheterization procedure, antibiotic prophylaxis, and use of antimicrobial coated-urinary catheters. In this review paper, we present and discuss the functionalization of urinary catheters surfaces with antimicrobial entities (e.g., photosensitizers, antibiotics, polymers, silver salts, oxides, bacteriophage, and enzymes) highlighting the immobilization of photosensitizing molecules for antimicrobial photodynamic applications. Moreover, the characterization techniques and (photo)antimicrobial effects of the coated-urinary catheters are described and discussed. We highlight the most significant examples in the last decade (2011-2021) concerning the antimicrobial coated-urinary catheter and their potential use, limitations, and future perspectives.

Contributions of photochemistry to bio-based antibacterial polymer materials

Surgical site infections constitute a major health concern that may be addressed by conferring antibacterial properties to surgical tools and medical devices via functional coatings. Bio-sourced polymers are particularly well-suited to prepare such coatings as they are usually safe and can exhibit intrinsic antibacterial properties or serve as hosts for bactericidal agents. The goal of this Review is to highlight the unique contribution of photochemistry as a green and mild methodology for the development of such bio-based antibacterial materials. Photo-generation and photo-activation of bactericidal materials are illustrated. Recent efforts and current challenges to optimize the sustainability of the process, improve the safety of the materials and extend these strategies to 3D biomaterials are also emphasized.

Impact on Porphyromonas gingivalis of antimicrobial photodynamic therapy with blue light and Rose Bengal in plaque-disclosing solution

OBJECTIVES

Antimicrobial photodynamic therapy (aPDT) in periodontal pockets using lasers is difficult to perform in some cases because of the high cost of irradiation equipment and the narrow irradiation field. The purpose of the present study was to examine the effects of aPDT in combination with a plaque-disclosing solution and blue light-emitting diode (LED), which are used for composite resin polymerization.

METHODS

The reactive oxygen species generated by irradiating 0.001% RB or MB with blue light were analyzed using electron spin resonance spectroscopy. Blue-light exposure was performed at 6.92, 20.76 and 124.6 J. The microorganism to be sterilized was Porphyromonas gingivalis. After aPDT, colony-forming units (CFUs) were measured to estimate cell survival. Carbonylated protein (PC) levels were used to evaluate oxidative stress. All statistical analyses were performed with Tukey's multiple comparisons test or the unpaired t-test.

RESULTS

Singlet oxygen (¹O₂) generation was confirmed by RB+blue LED. ¹O₂ production was significantly greater with the blue LED irradiation of RB than that of MB (p < 0.0001). CFUs were significantly lower in the blue LED-irradiated group than in the non-LED-irradiated group (p < 0.01). The bactericidal effect increased in a time-dependent manner. aPDT increased PC levels. No morphological changes were observed in P. gingivalis.

CONCLUSIONS

The present results suggest that aPDT exerts bactericidal effects against P. gingivalis by increasing oxidative stress through the generation of ¹O₂ in cells. Periodontal disease may be treated by aPDT using the equipment available in dental offices.

Antibacterial Surfaces with Activity against Antimicrobial Resistant Bacterial Pathogens and Endospores

Hospital-acquired bacterial infections are a significant burden on healthcare systems worldwide causing an increased duration of hospital stays and prolonged patient suffering. We show that polyurethane containing crystal violet (CV) and 3-4 nm zinc oxide nanoparticles (ZnO NPs) possesses excellent bactericidal activity against hospital-acquired pathogens including multidrug resistant Escherichia coli (E. coli), Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA), and even highly resistant endospores of Clostridioides (Clostridium) difficile. Importantly, we used clinical isolates of bacterial strains, a protocol to mimic the environmental conditions of a real exposure in the healthcare setting, and low light intensity equivalent to that encountered in UK hospitals (∼500 lux). Our data shows that ZnO NPs enhance the photobactericidal activity of CV under low intensity light even with short exposure times, and we show that this involves both Type I and Type II photochemical pathways. Interestingly, polyurethane containing ZnO NPs alone showed significant bactericidal activity in the dark against one strain of E. coli, indicating that the NPs possess both light-activated synergistic activity with CV and inherent bactericidal activity that is independent of light. These new antibacterial polymers are potentially useful in healthcare facilties to reduce the transmission of pathogens between people and the environment.

Blue Light Disinfection in Hospital Infection Control: Advantages, Drawbacks, and Pitfalls

Hospital acquired infections (HAIs) are a serious problem that potentially affects millions of patients whenever in contact with hospital settings. Worsening the panorama is the emergence of antimicrobial resistance by most microorganisms implicated in HAIs. Therefore, the improvement of the actual surveillance methods and the discovery of alternative approaches with novel modes of action is vital to overcome the threats created by the emergence of such resistances. Light therapy modalities represent a viable and effective alternative to the conventional antimicrobial treatment and can be preponderant in the control of HAIs, even against multidrug resistant organisms (MDROs). This review will initially focus on the actual state of HAIs and MDROs and which methods are currently available to fight them, which is followed by the exploration of antimicrobial photodynamic therapy (aPDT) and antimicrobial blue light therapy (aBLT) as alternative approaches to control microorganisms involved in HAIs. The advantages and drawbacks of BLT relatively to aPDT and conventional antimicrobial drugs as well as its potential applications to destroy microorganisms in the healthcare setting will also be discussed.

Antibacterial photodynamic activity of carbon quantum dots/polydimethylsiloxane nanocomposites against Staphylococcus aureus, Escherichia coli and Klebsiella pneumoniae

Despite great efforts, the design of antibacterial surfaces is still a challenge. In this work, results of structural, mechanical, cytotoxic and antibacterial activities of hydrophobic carbon quantum dots/polydimethylsiloxane surfaces are presented. Antibacterial action of this surface is based on the generation of reactive oxygen species which cause bacteria damage by oxidative stress. At the same time, this surface was not cytotoxic towards the NIH/3T3 cells. Swelling-encapsulation-shrink method is applied for encapsulation of hydrophobic carbon quantum dots in medical grade silicone-polydimethylsiloxane. XPS and photoluminescence spectroscopy analyses confirm that hydrophobic carbon quantum dots have been encapsulated successfully into polydimethylsiloxane polymer matrix. Based on stress-strain test the improvement of mechanical properties of these nanocomposites is established. It is shown by electron paramagnetic resonance spectroscopy and luminescence method that nanocomposite generates singlet oxygen initiated by 470 nm blue light irradiation. Antibacterial testing shows the nanocomposite in the form of foil kills Staphylococcus aureus, Escherichia coli and Klebsiella pneumoniae and is very effective after only a 15 min irradiation.

Photoactivable Polymers Embedded with Cadmium-Free Quantum Dots and Crystal Violet: Efficient Bactericidal Activity against Clinical Strains of Antibiotic-Resistant Bacteria

The rising incidence of antibiotic-resistant infections from contaminated surfaces in hospitals or implanted medical devices has led to increasing interest in new antibacterial surfaces. Photoactivatable surfaces that can generate cytotoxic reactive oxygen species under exposure to ambient light is a promising approach to inactivation of surface-borne microorganisms. There is growing interest in the use of quantum dots (QDs) as light-harvesting agents for photobactericidal applications, but the cadmium in commonly used QDs will restrict clinical application. Herein, the photobactericidal activity of novel polyurethane substrates containing cadmium-free QDs was tested against clinical multidrug-resistant Gram-positive and Gram-negative bacterial strains: methicillin-resistant Staphylococcus aureus (MRSA) and a carbapenemase-producing strain of Escherichia coli ( E. coli). To enhance the capacity for reactive oxygen species generation, QDs were incorporated into the polymer with a photosensitizing dye, crystal violet. Close proximity between the QD and dye enables electron and energy transfer processes leading to generation of cytotoxic singlet oxygen and superoxide radicals. A QD solution in cyclohexane was premixed with a solution of CV in the more polar solvent, dichloromethane, to promote the formation of QD-CV nanocomposite complexes via CV adsorption. This solution was then used to embed the QDs and crystal violet into medical grade polyurethane via swell-encapsulation. The combination of QD and CV elicited significant synergistic antibacterial activity under visible light against MRSA within 1 h (99.98% reduction) and E. coli within 4 h (99.96% reduction). Photoluminescence lifetime and singlet oxygen phosphorescence measurements demonstrated that interaction between the QDs and the crystal violet occurs within the polymer and leads to enhanced generation of reactive oxygen species. Strong inhibition of kill was observed using the superoxide scavenger, superoxide dismutase. The efficacy of these QD-CV polymer substrates, that can harvest light across the visible spectrum, against multidrug-resistant bacteria demonstrates the feasibility of this approach.

Revisiting Current Photoactive Materials for Antimicrobial Photodynamic Therapy

Microbial infection is a severe concern, requiring the use of significant amounts of antimicrobials/biocides, not only in the hospital setting, but also in other environments. The increasing use of antimicrobial drugs and the rapid adaptability of microorganisms to these agents, have contributed to a sharp increase of antimicrobial resistance. It is obvious that the development of new strategies to combat planktonic and biofilm-embedded microorganisms is required. Photodynamic inactivation (PDI) is being recognized as an effective method to inactivate a broad spectrum of microorganisms, including those resistant to conventional antimicrobials. In the last few years, the development and biological assessment of new photosensitizers for PDI were accompanied by their immobilization in different supports having in mind the extension of the photodynamic principle to new applications, such as the disinfection of blood, water, and surfaces. In this review, we intended to cover a significant amount of recent work considering a diversity of photosensitizers and supports to achieve an effective photoinactivation. Special attention is devoted to the chemistry behind the preparation of the photomaterials by recurring to extensive examples, illustrating the design strategies. Additionally, we highlighted the biological challenges of each formulation expecting that the compiled information could motivate the development of other effective photoactive materials.

Effects of geometry and composition of soft polymer films embedded with nanoparticles on rates for optothermal heat dissipation

Embedding soft matter with nanoparticles (NPs) can provide electromagnetic tunability at sub-micron scales for a growing number of applications in healthcare, sustainable energy, and chemical processing. However, the use of NP-embedded soft material in temperature-sensitive applications has been constrained by difficulties in validating the prediction of rates for energy dissipation from thermally insulating to conducting behavior. This work improved the embedment of monodisperse NPs to stably decrease the inter-NP spacings in polydimethylsiloxane (PDMS) to nano-scale distances. Lumped-parameter and finite element analyses were refined to apportion the effects of the structure and composition of the NP-embedded soft polymer on the rates for conductive, convective, and radiative heat dissipation. These advances allowed for the rational selection of PDMS size and NP composition to optimize measured rates of internal (conductive) and external (convective and radiative) heat dissipation. Stably reducing the distance between monodisperse NPs to nano-scale intervals increased the overall heat dissipation rate by up to 29%. Refined fabrication of NP-embedded polymer enabled the tunability of the dynamic thermal response (the ratio of internal to external dissipation rate) by a factor of 3.1 to achieve a value of 0.091, the largest reported to date. Heat dissipation rates simulated a priori were consistent with 130 μm resolution thermal images across 2- to 15-fold changes in the geometry and composition of NP-PDMS. The Nusselt number was observed to increase with the fourth root of the Rayleigh number across thermally insulative and conductive regimes, further validating the approach. These developments support the model-informed design of soft media embedded with nano-scale-spaced NPs to optimize the heat dissipation rates for evolving temperature-sensitive diagnostic and therapeutic modalities, as well as emerging uses in flexible bioelectronics, cell and tissue culture, and solar-thermal heating.

White-Light-Activated Antibacterial Surfaces Generated by Synergy between Zinc Oxide Nanoparticles and Crystal Violet

The prevalence of hospital-acquired infections (HAIs) caused by multidrug-resistant bacteria is a growing public health concern worldwide. Herein, a facile, easily scalable technique is reported to fabricate white-light-activated bactericidal surfaces by incorporating zinc oxide (ZnO) nanoparticles and crystal violet (CV) dye into poly(dimethylsiloxane). The effect of ZnO concentration on photobactericidal activity of CV is investigated, and we show that there is synergy between ZnO and CV. These materials showed highly significant antibacterial activity when tested against Staphylococcus aureus and Escherichia coli under white light conditions. These surfaces have potential to be used in healthcare environments to decrease the impact of HAIs.

Covalently Attached Antimicrobial Surfaces Using BODIPY: Improving Efficiency and Effectiveness

The development of photoactivated antimicrobial surfaces that kill pathogens through the production of singlet oxygen has proved very effective in recent years, with applications in medical devices and hospital touch surfaces, to improve patient safety and well being. However, many of these surfaces require a swell-encapsulation-shrink strategy to incorporate the photoactive agents in a polymer matrix, and this is resource intensive, given that only the surface fraction of the agent is active against bacteria. Furthermore, there is a risk that the agent will leach from the polymer and thus raises issues of biocompatibility and patient safety. Here, we describe a more efficient method of fabricating a silicone material with a covalently attached monolayer of photoactivating agent that uses heavy-atom triplet sensitization for improved singlet oxygen generation and corresponding antimicrobial activity. We use boron-dipyrromethane with a reactive end group and incorporated Br atoms, covalently attached to poly(dimethylsiloxane). We demonstrate the efficacy of this material in producing singlet oxygen and killing Staphylococcus aureus and suggest how it might be easily modifiable for future antimicrobial surface development.

Antimicrobial Properties of Copper-Doped ZnO Coatings under Darkness and White Light Illumination

We report the first antimicrobial study of transparent and robust Cu-doped ZnO coatings that displayed potent antimicrobial activity that resulted in bacterial (Escherichia coli) reduction below detection limits within 6 h of illumination via a white light source that is found in hospital environments. The same bacterial reduction rate was observed even under darkness for 4.0 atom % Cu-doped ZnO films thus providing an efficient 24 h disinfection. All films were produced via a novel, inexpensive, and easily scalable route and were also thoroughly analyzed for their material properties.

Nanosecond time-resolved characterization of a pentacene-based room-temperature MASER

The performance of a room temperature, zero-field MASER operating at 1.45 GHz has been examined. Nanosecond laser pulses, which are essentially instantaneous on the timescale of the spin dynamics, allow the visible-to-microwave conversion efficiency and temporal response of the MASER to be measured as a function of excitation energy. It is observed that the timing and amplitude of the MASER output pulse are correlated with the laser excitation energy: at higher laser energy, the microwave pulses have larger amplitude and appear after shorter delay than those recorded at lower laser energy. Seeding experiments demonstrate that the output variation may be stabilized by an external source and establish the minimum seeding power required. The dynamics of the MASER emission may be modeled by a pair of first order, non-linear differential equations, derived from the Lotka-Volterra model (Predator-Prey), where by the microwave mode of the resonator is the predator and the spin polarization in the triplet state of pentacene is the prey. Simulations allowed the Einstein coefficient of stimulated emission, the spin-lattice relaxation and the number of triplets contributing to the MASER emission to be estimated. These are essential parameters for the rational improvement of a MASER based on a spin-polarized triplet molecule.

Thiol-Capped Gold Nanoparticles Swell-Encapsulated into Polyurethane as Powerful Antibacterial Surfaces Under Dark and Light Conditions

A simple procedure to develop antibacterial surfaces using thiol-capped gold nanoparticles (AuNPs) is shown, which effectively kill bacteria under dark and light conditions. The effect of AuNP size and concentration on photo-activated antibacterial surfaces is reported and we show significant size effects, as well as bactericidal activity with crystal violet (CV) coated polyurethane. These materials have been proven to be powerful antibacterial surfaces against both Gram-positive and Gram-negative bacteria. AuNPs of 2, 3 or 5 nm diameter were swell-encapsulated into PU before a coating of CV was applied (known as PU-AuNPs-CV). The antibacterial activity of PU-AuNPs-CV samples was tested against Staphylococcus aureus and Escherichia coli as representative Gram-positive and Gram-negative bacteria under dark and light conditions. All light conditions in this study simulated a typical white-light hospital environment. This work demonstrates that the antibacterial activity of PU-AuNPs-CV samples and the synergistic enhancement of photoactivity of triarylmethane type dyes is highly dependent on nanoparticle size and concentration. The most powerful PU-AuNPs-CV antibacterial surfaces were achieved using 1.0 mg mL-1 swell encapsulation concentrations of 2 nm AuNPs. After two hours, Gram-positive and Gram-negative bacteria were reduced to below the detection limit (>4 log) under dark and light conditions.

Enhancing the Antibacterial Activity of Light-Activated Surfaces Containing Crystal Violet and ZnO Nanoparticles: Investigation of Nanoparticle Size, Capping Ligand, and Dopants

Healthcare-associated infections pose a serious risk for patients, staff, and visitors and are a severe burden on the National Health Service, costing at least £1 billion annually. Antimicrobial surfaces significantly contribute toward reducing the incidence of infections as they prevent bacterial adhesion and cause bacterial cell death. Using a simple, easily upscalable swell-encapsulation-shrink method, novel antimicrobial surfaces have been developed by incorporating metal oxide nanoparticles (NPs) and crystal violet (CV) dye into medical-grade polyurethane sheets. This study compares the bactericidal effects of polyurethane incorporating ZnO, Mg-doped ZnO, and MgO. All metal oxide NPs are well defined, with average diameters ranging from 2 to 18 nm. These materials demonstrate potent bactericidal activity when tested against clinically relevant bacteria such as Escherichia coli and Staphylococcus aureus. Additionally, these composites are tested against an epidemic strain of methicillin-resistant Staphylococcus aureus (MRSA) that is rife in hospitals throughout the UK. Furthermore, we have tested these materials using a low light intensity (∼500 lx), similar to that present in many clinical environments. The highest activity is achieved from polymer composites incorporating CV and ∼3 nm ZnO NPs, and the different performances of the metal oxides have been discussed.

Materials for selective photo-oxygenation vs. photocatalysis: preparation, properties and applications in environmental and health fields

Photosensitizing materials made of organic dyes embedded in various supports are compared to usual supported TiO₂-based photocatalysts.

Development of photoactivable glycerol-based coatings containing quercetin for antibacterial applications

Synthesis of antibacterial coatings derived from glycerol and quercetin for the inhibition of bacteria proliferation.

Comparative study of singlet oxygen production by photosensitiser dyes encapsulated in silicone: towards rational design of anti-microbial surfaces

Theoretical and experimental toolbox for the rational design of light-activated antimicrobial surfaces.