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Surur AK, de Oliveira AB, De Annunzio SR, Ferrisse TM, Fontana CR. Bacterial resistance to antimicrobial photodynamic therapy: A critical update. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2024; 255:112905. [PMID: 38703452 DOI: 10.1016/j.jphotobiol.2024.112905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/06/2024] [Accepted: 04/04/2024] [Indexed: 05/06/2024]
Abstract
Bacterial antibiotic resistance is one of the most significant challenges for public health. The increase in bacterial resistance, mainly due to microorganisms harmful to health, and the need to search for alternative treatments to contain infections that cannot be treated by conventional antibiotic therapy has been aroused. An alternative widely studied in recent decades is antimicrobial photodynamic therapy (aPDT), a treatment that can eliminate microorganisms through oxidative stress. Although this therapy has shown satisfactory results in infection control, it is still controversial in the scientific community whether bacteria manage to develop resistance after successive applications of aPDT. Thus, this work provides an overview of the articles that performed successive aPDT applications in models using bacteria published since 2010, focusing on sublethal dose cycles, highlighting the main PSs tested, and addressing the possible mechanisms for developing tolerance or resistance to aPDT, such as efflux pumps, biofilm formation, OxyR and SoxRS systems, catalase and superoxide dismutase enzymes and quorum sensing.
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Affiliation(s)
- Amanda Koberstain Surur
- São Paulo State University (UNESP), School of Pharmaceutical Sciences, Department of Clinical Analysis, Araraquara, São Paulo, Brazil.
| | - Analú Barros de Oliveira
- São Paulo State University (UNESP), School of Dentistry, Department of Dental Materials and Prosthodontics, Araraquara, São Paulo, Brazil.
| | - Sarah Raquel De Annunzio
- São Paulo State University (UNESP), School of Pharmaceutical Sciences, Department of Clinical Analysis, Araraquara, São Paulo, Brazil.
| | - Túlio Morandin Ferrisse
- São Paulo State University (UNESP), School of Dentistry, Department of Dental Materials and Prosthodontics, Araraquara, São Paulo, Brazil.
| | - Carla Raquel Fontana
- São Paulo State University (UNESP), School of Pharmaceutical Sciences, Department of Clinical Analysis, Araraquara, São Paulo, Brazil.
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Cui Z, Zhang M, Geng S, Niu X, Wang X, Zhu Y, Ye F, Liu C. Antifungal Effect of Antimicrobial Photodynamic Therapy Mediated by Haematoporphyrin Monomethyl Ether and Aloe Emodin on Malassezia furfur. Front Microbiol 2021; 12:749106. [PMID: 34867868 PMCID: PMC8637056 DOI: 10.3389/fmicb.2021.749106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
Infectious dermatological diseases caused by Malassezia furfur are often chronic, recurrent, and recalcitrant. Current therapeutic options are usually tedious, repetitive, and associated with adverse effects. Alternatives that broaden the treatment options and reduce side effects for patients are needed. Antimicrobial photodynamic therapy (aPDT) is an emerging approach that is quite suitable for superficial infections. The aim of this study is to investigate the antimicrobial efficacy and effect of aPDT mediated by haematoporphyrin monomethyl ether (HMME) and aloe emodin (AE) on clinical isolates of M. furfur in vitro. The photodynamic antimicrobial efficacy of HMME and AE against M. furfur was assessed by colony forming unit (CFU) assay. The uptake of HMME and AE by M. furfur cells was investigated by fluorescence microscopy. Reactive oxygen species (ROS) probe and flow cytometry were employed to evaluate the intracellular ROS level. The effect of HMME and AE-mediated aPDT on secreted protease and lipase activity of M. furfur was also investigated. The results showed that HMME and AE in the presence of light effectively inactivated M. furfur cells in a photosensitizer (PS) concentration and light energy dose-dependent manner. AE exhibited higher antimicrobial efficacy against M. furfur than HMME under the same irradiation condition. HMME and AE-mediated aPDT disturbed the fungal cell envelop, significantly increased the intracellular ROS level, and effectively inhibited the activity of secreted protease and lipase of M. furfur cells. The results suggest that HMME and AE have potential to serve as PSs in the photodynamic treatment of dermatological diseases caused by M. furfur, but further ex vivo or in vivo experiments are needed to verify that they can meet the requirements for clinical practice.
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Affiliation(s)
- Zixin Cui
- Department of Infection, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Miaomiao Zhang
- Department of Pathogenic Microbiology and Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Songmei Geng
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xinwu Niu
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaopeng Wang
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yanyan Zhu
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Feng Ye
- Department of Infection, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Chengcheng Liu
- Department of Pathogenic Microbiology and Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China
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Ma W, Zhang M, Cui Z, Wang X, Niu X, Zhu Y, Yao Z, Ye F, Geng S, Liu C. Aloe-emodin-mediated antimicrobial photodynamic therapy against dermatophytosis caused by Trichophyton rubrum. Microb Biotechnol 2021; 15:499-512. [PMID: 34165875 PMCID: PMC8867962 DOI: 10.1111/1751-7915.13875] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 05/31/2021] [Accepted: 06/10/2021] [Indexed: 01/03/2023] Open
Abstract
Trichophyton rubrum is responsible for the majority of dermatophytosis. Current systemic and topical antifungals against dermatophytosis are often tedious and sometimes unsatisfactory. Antimicrobial photodynamic therapy (aPDT) is a non‐invasive alternative suitable for the treatment of superficial fungal infections. This work investigated the photodynamic inactivation efficacy and effects of aloe‐emodin (AE), a natural photosensitizer (PS) against T. rubrum microconidia in vitro, and evaluated the treatment effects of AE‐mediated aPDT for T. rubrum‐caused tinea corporis in vivo and tinea unguium ex vivo. The photodynamic antimicrobial efficacy of AE on T. rubrum microconidia was evaluated by MTT assay. The inhibition effect of AE‐mediated aPDT on growth of T. rubrum was studied. Intracellular location of AE, damage induced by AE‐mediated aPDT on cellular structure and surface of microconidia and generation of intracellular ROS were investigated by microscopy and flow cytometry. The therapeutic effects of AE‐mediated aPDT against dermatophytosis were assessed in T. rubrum‐caused tinea corporis guinea pig model and tinea unguium ex vivo model. AE‐mediated aPDT effectively inactivated T. rubrum microconidia in a light energy dose‐dependent manner and exhibited strong inhibitory effect on growth of T. rubrum. Microscope images indicated that AE is mainly targeted to the organelles and caused damage to the cytoplasm of microconidia after irradiation through generation of abundant intracellular ROS. AE‐mediated aPDT demonstrated effective therapeutic effects for T. rubrum‐caused tinea corporis on guinea pig model and tinea unguium in ex vivo model. The results obtained suggest that AE is a potential PS for the photodynamic treatment of dermatophytosis caused by T. rubrum, but its permeability in skin and nails needs to be improved.
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Affiliation(s)
- Wenpeng Ma
- Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiao Tong University Health Science Center, 76 West Yanta Road, Xi'an, 710061, China.,Clinical Laboratory, The Second Hospital of Weinan, 2 East Chaoyang Street, Weinan, 714000, China
| | - Miaomiao Zhang
- Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiao Tong University Health Science Center, 76 West Yanta Road, Xi'an, 710061, China
| | - Zixin Cui
- Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiao Tong University Health Science Center, 76 West Yanta Road, Xi'an, 710061, China.,Department of Infection, The First Affiliated Hospital of College of Medicine, Xi'an Jiao Tong University, 227 West Yanta Road, Xi'an, 710061, China
| | - Xiaopeng Wang
- Department of Dermatology, The Second Affiliated Hospital of College of Medicine, Xi'an Jiao Tong University, 157 Xi Wu Road, Xi'an, 710004, China
| | - Xinwu Niu
- Department of Dermatology, The Second Affiliated Hospital of College of Medicine, Xi'an Jiao Tong University, 157 Xi Wu Road, Xi'an, 710004, China
| | - Yanyan Zhu
- Department of Dermatology, The Second Affiliated Hospital of College of Medicine, Xi'an Jiao Tong University, 157 Xi Wu Road, Xi'an, 710004, China
| | - Zhihong Yao
- Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiao Tong University Health Science Center, 76 West Yanta Road, Xi'an, 710061, China.,Department of Clinical Medicine, Hanzhong Vocational and Technical College, 81 Zongying Town, Hanzhong, 723002, China
| | - Feng Ye
- Department of Infection, The First Affiliated Hospital of College of Medicine, Xi'an Jiao Tong University, 227 West Yanta Road, Xi'an, 710061, China
| | - Songmei Geng
- Department of Dermatology, The Second Affiliated Hospital of College of Medicine, Xi'an Jiao Tong University, 157 Xi Wu Road, Xi'an, 710004, China
| | - Chengcheng Liu
- Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiao Tong University Health Science Center, 76 West Yanta Road, Xi'an, 710061, China
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