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Zhong Q, Liao B, Liu J, Shen W, Wang J, Wei L, Ma Y, Dong PT, Bor B, McLean JS, Chang Y, Shi W, Cen L, Wu M, Liu J, Li Y, He X, Le S. Episymbiotic Saccharibacteria TM7x modulates the susceptibility of its host bacteria to phage infection and promotes their coexistence. Proc Natl Acad Sci U S A 2024; 121:e2319790121. [PMID: 38593079 PMCID: PMC11032452 DOI: 10.1073/pnas.2319790121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/21/2024] [Indexed: 04/11/2024] Open
Abstract
Bacteriophages (phages) play critical roles in modulating microbial ecology. Within the human microbiome, the factors influencing the long-term coexistence of phages and bacteria remain poorly investigated. Saccharibacteria (formerly TM7) are ubiquitous members of the human oral microbiome. These ultrasmall bacteria form episymbiotic relationships with their host bacteria and impact their physiology. Here, we showed that during surface-associated growth, a human oral Saccharibacteria isolate (named TM7x) protects its host bacterium, a Schaalia odontolytica strain (named XH001) against lytic phage LC001 predation. RNA-Sequencing analysis identified in XH001 a gene cluster with predicted functions involved in the biogenesis of cell wall polysaccharides (CWP), whose expression is significantly down-regulated when forming a symbiosis with TM7x. Through genetic work, we experimentally demonstrated the impact of the expression of this CWP gene cluster on bacterial-phage interaction by affecting phage binding. In vitro coevolution experiments further showed that the heterogeneous populations of TM7x-associated and TM7x-free XH001, which display differential susceptibility to LC001 predation, promote bacteria and phage coexistence. Our study highlights the tripartite interaction between the bacterium, episymbiont, and phage. More importantly, we present a mechanism, i.e., episymbiont-mediated modulation of gene expression in host bacteria, which impacts their susceptibility to phage predation and contributes to the formation of "source-sink" dynamics between phage and bacteria in biofilm, promoting their long-term coexistence within the human microbiome.
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Affiliation(s)
- Qiu Zhong
- Department of Microbiology, College of Basic Medical Sciences, Key Laboratory of Microbial Engineering Under the Educational Committee in Chongqing, Army Medical University, Chongqing400038, China
| | - Binyou Liao
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan610041, China
| | - Jiazhen Liu
- Department of Microbiology, College of Basic Medical Sciences, Key Laboratory of Microbial Engineering Under the Educational Committee in Chongqing, Army Medical University, Chongqing400038, China
| | - Wei Shen
- Department of Infectious Diseases, Institute for Viral Hepatitis, Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, the Second Affiliated Hospital of Chongqing Medical University, Chongqing401336, China
| | - Jing Wang
- Department of Microbiology, College of Basic Medical Sciences, Key Laboratory of Microbial Engineering Under the Educational Committee in Chongqing, Army Medical University, Chongqing400038, China
| | - Leilei Wei
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing400038, China
| | - Yansong Ma
- Department of Orthodontics, Capital Medical University, Beijing100050, China
| | - Pu-Ting Dong
- Department of Microbiology, The American Dental Association Forsyth Institute, Cambridge, MA02142
| | - Batbileg Bor
- Department of Microbiology, The American Dental Association Forsyth Institute, Cambridge, MA02142
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA02115
| | - Jeffrey S. McLean
- Department of Periodontics, University of Washington, Seattle, WA98119
- Department of Microbiology, University of Washington, Seattle, WA98195
| | - Yunjie Chang
- Department of Cell Biology, Zhejiang University School of Medicine, Hangzhou, Zhejiang310058, China
- Department of Infectious Disease of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang310058, China
| | - Wenyuan Shi
- Department of Microbiology, The American Dental Association Forsyth Institute, Cambridge, MA02142
| | - Lujia Cen
- Department of Microbiology, The American Dental Association Forsyth Institute, Cambridge, MA02142
| | - Miaomiao Wu
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan610041, China
| | - Jun Liu
- Department of Microbial Pathogenesis, Yale School of Medicine, New Haven, CT06536
| | - Yan Li
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan610041, China
| | - Xuesong He
- Department of Microbiology, The American Dental Association Forsyth Institute, Cambridge, MA02142
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA02115
| | - Shuai Le
- Department of Microbiology, College of Basic Medical Sciences, Key Laboratory of Microbial Engineering Under the Educational Committee in Chongqing, Army Medical University, Chongqing400038, China
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Dong PT, Tian J, Kobayashi-Kirschvink KJ, Cen L, McLean JS, Bor B, Shi W, He X. Episymbiotic Saccharibacteria induce intracellular lipid droplet production in their host bacteria. ISME J 2024; 18:wrad034. [PMID: 38366018 PMCID: PMC10939385 DOI: 10.1093/ismejo/wrad034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/07/2023] [Accepted: 12/20/2023] [Indexed: 02/18/2024]
Abstract
Saccharibacteria (formerly TM7) are a group of widespread and genetically diverse ultrasmall bacteria with highly reduced genomes that belong to Candidate Phyla Radiation, a large monophyletic lineage with poorly understood biology. Nanosynbacter lyticus type strain TM7x is the first Saccharibacteria member isolated from the human oral microbiome. With restrained metabolic capacities, TM7x lives on the surface of, and forms an obligate episymbiotic relationship with its bacterial host, Schaalia odontolytica strain XH001. The symbiosis allows TM7x to propagate but presents a burden to host bacteria by inducing stress response. Here, we employed super-resolution fluorescence imaging to investigate the physical association between TM7x and XH001. We showed that the binding with TM7x led to a substantial alteration in the membrane fluidity of XH001. We also revealed the formation of intracellular lipid droplets in XH001 when forming episymbiosis with TM7x, a feature that has not been reported in oral bacteria. The TM7x-induced lipid droplets accumulation in XH001 was confirmed by label-free Raman spectroscopy, which also unveiled additional phenotypical features when XH001 cells are physically associated with TM7x. Further exploration through culturing XH001 under various stress conditions showed that lipid droplets accumulation was a general response to stress. A survival assay demonstrated that the presence of lipid droplets plays a protective role in XH001, enhancing its survival under adverse conditions. In conclusion, our study sheds new light on the intricate interaction between Saccharibacteria and their host bacteria, highlighting the potential benefit conferred by TM7x to its host and further emphasizing the context-dependent nature of symbiotic relationships.
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Affiliation(s)
- Pu-Ting Dong
- Department of Microbiology, The ADA Forsyth Institute, Boston, MA 02142, United States
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
| | - Jing Tian
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Koseki J Kobayashi-Kirschvink
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA 02142, United States
- Laser Biomedical Research Center, G. R. Harrison Spectroscopy Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139, United States
| | - Lujia Cen
- Department of Microbiology, The ADA Forsyth Institute, Boston, MA 02142, United States
| | - Jeffrey S McLean
- Department of Periodontics, University of Washington, Seattle, WA 98195, United States
| | - Batbileg Bor
- Department of Microbiology, The ADA Forsyth Institute, Boston, MA 02142, United States
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
| | - Wenyuan Shi
- Department of Microbiology, The ADA Forsyth Institute, Boston, MA 02142, United States
| | - Xuesong He
- Department of Microbiology, The ADA Forsyth Institute, Boston, MA 02142, United States
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
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Jusuf S, Dong PT. Chromophore-Targeting Precision Antimicrobial Phototherapy. Cells 2023; 12:2664. [PMID: 37998399 PMCID: PMC10670386 DOI: 10.3390/cells12222664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/11/2023] [Accepted: 11/18/2023] [Indexed: 11/25/2023] Open
Abstract
Phototherapy, encompassing the utilization of both natural and artificial light, has emerged as a dependable and non-invasive strategy for addressing a diverse range of illnesses, diseases, and infections. This therapeutic approach, primarily known for its efficacy in treating skin infections, such as herpes and acne lesions, involves the synergistic use of specific light wavelengths and photosensitizers, like methylene blue. Photodynamic therapy, as it is termed, relies on the generation of antimicrobial reactive oxygen species (ROS) through the interaction between light and externally applied photosensitizers. Recent research, however, has highlighted the intrinsic antimicrobial properties of light itself, marking a paradigm shift in focus from exogenous agents to the inherent photosensitivity of molecules found naturally within pathogens. Chemical analyses have identified specific organic molecular structures and systems, including protoporphyrins and conjugated C=C bonds, as pivotal components in molecular photosensitivity. Given the prevalence of these systems in organic life forms, there is an urgent need to investigate the potential impact of phototherapy on individual molecules expressed within pathogens and discern their contributions to the antimicrobial effects of light. This review delves into the recently unveiled key molecular targets of phototherapy, offering insights into their potential downstream implications and therapeutic applications. By shedding light on these fundamental molecular mechanisms, we aim to advance our understanding of phototherapy's broader therapeutic potential and contribute to the development of innovative treatments for a wide array of microbial infections and diseases.
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Affiliation(s)
- Sebastian Jusuf
- Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA;
| | - Pu-Ting Dong
- Department of Microbiology, The Forsyth Institute, Boston, MA 02142, USA
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA
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Dong PT, Tian J, Kobayashi-Kirschvink KJ, Cen L, McLean JS, Bor B, Shi W, He X. Episymbiotic bacterium induces intracellular lipid droplet production in its host bacteria. bioRxiv 2023:2023.09.06.556576. [PMID: 37732248 PMCID: PMC10508740 DOI: 10.1101/2023.09.06.556576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Saccharibacteria (formerly TM7) Nanosynbacter lyticus type strain TM7x exhibits a remarkably compact genome and an extraordinarily small cell size. This obligate epibiotic parasite forms a symbiotic relationship with its bacterial host, Schaalia odontolytica, strain XH001 (formerly Actinomyces odontolyticus strain XH001). Due to its limited genome size, TM7x possesses restrained metabolic capacities, predominantly living on the surface of its bacterial host to sustain this symbiotic lifestyle. To comprehend this intriguing, yet understudied interspecies interaction, a thorough understanding of the physical interaction between TM7x and XH001 is imperative. In this study, we employed super-resolution fluorescence imaging to investigate the physical association between TM7x and XH001. We found that the binding with TM7x led to a substantial alteration in the membrane fluidity of the host bacterium XH001. Unexpectedly, we revealed the formation of intracellular lipid droplets in XH001 when forming episymbiosis with TM7x, a feature not commonly observed in oral bacteria cells. The TM7x-induced LD accumulation in XH001 was further confirmed by label-free non-invasive Raman spectroscopy, which also unveiled additional phenotypical features when XH001 cells are physically associated with TM7x. Further exploration through culturing host bacterium XH001 alone under various stress conditions showed that LD accumulation was a general response to stress. Intriguingly, a survival assay demonstrated that the presence of LDs likely plays a protective role in XH001, enhancing its overall survival under adverse conditions. In conclusion, our study sheds new light on the intricate interaction between Saccharibacteria and its host bacterium, highlighting the potential benefit conferred by TM7x to its host, and further emphasizing the context-dependent nature of symbiotic relationships.
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Affiliation(s)
- Pu-Ting Dong
- Department of Microbiology, the Forsyth Institute, Boston, MA 02142, USA
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA
| | - Jing Tian
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Koseki J. Kobayashi-Kirschvink
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Laser Biomedical Research Center, G. R. Harrison Spectroscopy Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Lujia Cen
- Department of Microbiology, the Forsyth Institute, Boston, MA 02142, USA
| | - Jeffrey S. McLean
- Department of Periodontics, University of Washington, Seattle, WA 98195, USA
| | - Batbileg Bor
- Department of Microbiology, the Forsyth Institute, Boston, MA 02142, USA
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA
| | - Wenyuan Shi
- Department of Microbiology, the Forsyth Institute, Boston, MA 02142, USA
| | - Xuesong He
- Department of Microbiology, the Forsyth Institute, Boston, MA 02142, USA
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA
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Zhang M, Dong PT, Eldesouky HE, Zhan Y, Lin H, Wang Z, Salama EA, Jusuf S, Zong C, Chen Z, Seleem MN, Cheng JX. Fingerprint Stimulated Raman Scattering Imaging Unveils Ergosteryl Ester as a Metabolic Signature of Azole-Resistant Candida albicans. Anal Chem 2023. [PMID: 37310727 DOI: 10.1021/acs.analchem.3c00900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Candida albicans (C. albicans), a major fungal pathogen, causes life-threatening infections in immunocompromised individuals. Fluconazole (FLC) is recommended as first-line therapy for treatment of invasive fungal infections. However, the widespread use of FLC has resulted in increased antifungal resistance among different strains of Candida, especially C. albicans, which is a leading source of hospital-acquired infections. Here, by hyperspectral stimulated Raman scattering imaging of single fungal cells in the fingerprint window and pixel-wise spectral unmixing, we report aberrant ergosteryl ester accumulation in azole-resistant C. albicans compared to azole-susceptible species. This accumulation was a consequence of de novo lipogenesis. Lipid profiling by mass spectroscopy identified ergosterol oleate to be the major species stored in azole-resistant C. albicans. Blocking ergosterol esterification by oleate and suppressing sterol synthesis by FLC synergistically suppressed the viability of C. albicans in vitro and limited the growth of biofilm on mouse skin in vivo. Our findings highlight a metabolic marker and a new therapeutic strategy for targeting azole-resistant C. albicans by interrupting the esterified ergosterol biosynthetic pathway.
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Affiliation(s)
- Meng Zhang
- Department of Electrical & Computer Engineering, Boston, Massachusetts 02215, United States
- Boston University Photonics Center, Boston University, Boston, Massachusetts 02215, United States
| | - Pu-Ting Dong
- Boston University Photonics Center, Boston University, Boston, Massachusetts 02215, United States
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, United States
| | - Hassan E Eldesouky
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, United States
| | - Yuewei Zhan
- Boston University Photonics Center, Boston University, Boston, Massachusetts 02215, United States
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, United States
| | - Haonan Lin
- Boston University Photonics Center, Boston University, Boston, Massachusetts 02215, United States
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, United States
| | - Zian Wang
- Boston University Photonics Center, Boston University, Boston, Massachusetts 02215, United States
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, United States
| | - Ehab A Salama
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, United States
| | - Sebastian Jusuf
- Boston University Photonics Center, Boston University, Boston, Massachusetts 02215, United States
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, United States
| | - Cheng Zong
- Department of Electrical & Computer Engineering, Boston, Massachusetts 02215, United States
- Boston University Photonics Center, Boston University, Boston, Massachusetts 02215, United States
| | - Zhicong Chen
- Department of Electrical & Computer Engineering, Boston, Massachusetts 02215, United States
- Boston University Photonics Center, Boston University, Boston, Massachusetts 02215, United States
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, United States
| | - Mohamed N Seleem
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, United States
| | - Ji-Xin Cheng
- Department of Electrical & Computer Engineering, Boston, Massachusetts 02215, United States
- Boston University Photonics Center, Boston University, Boston, Massachusetts 02215, United States
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, United States
- Department of Chemistry, Boston University, Boston, Massachusetts 02215, United States
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Yang M, Dong PT, Cen L, Shi W, He X, Li J. Targeting Fusobacterium nucleatum through chemical modifications of host-derived transfer RNA fragments. ISME J 2023; 17:880-890. [PMID: 37005460 PMCID: PMC10202947 DOI: 10.1038/s41396-023-01398-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/13/2023] [Accepted: 03/17/2023] [Indexed: 04/04/2023]
Abstract
Host mucosal barriers possess an arsenal of defense molecules to maintain host-microbe homeostasis such as antimicrobial peptides and immunoglobulins. In addition to these well-established defense molecules, we recently reported small RNAs (sRNAs)-mediated interactions between human oral keratinocytes and Fusobacterium nucleatum (Fn), an oral pathobiont with increasing implications in extra-oral diseases. Specifically, upon Fn infection, oral keratinocytes released Fn-targeting tRNA-derived sRNAs (tsRNAs), an emerging class of noncoding sRNAs with gene regulatory functions. To explore potential antimicrobial activities of tsRNAs, we chemically modify the nucleotides of the Fn-targeting tsRNAs and demonstrate that the resultant tsRNA derivatives, termed MOD-tsRNAs, exhibit growth inhibitory effect against various Fn type strains and clinical tumor isolates without any delivery vehicle in the nanomolar concentration range. In contrast, the same MOD-tsRNAs do not inhibit other representative oral bacteria. Further mechanistic studies uncover the ribosome-targeting functions of MOD-tsRNAs in inhibiting Fn. Taken together, our work provides an engineering approach to targeting pathobionts through co-opting host-derived extracellular tsRNAs.
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Affiliation(s)
- Mengdi Yang
- Department of Bioengineering, Northeastern University, Boston, MA, 02115, USA
| | - Pu-Ting Dong
- Department of Microbiology, The Forsyth Institute, Cambridge, MA, 02142, USA
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, 02115, USA
| | - Lujia Cen
- Department of Microbiology, The Forsyth Institute, Cambridge, MA, 02142, USA
| | - Wenyuan Shi
- Department of Microbiology, The Forsyth Institute, Cambridge, MA, 02142, USA
| | - Xuesong He
- Department of Microbiology, The Forsyth Institute, Cambridge, MA, 02142, USA.
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, 02115, USA.
| | - Jiahe Li
- Department of Bioengineering, Northeastern University, Boston, MA, 02115, USA.
- Department of Biomedical Engineering, College of Engineering and School of Medicine, University of Michigan, Ann Arbor, MI, 48109-5622, USA.
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Xiang D, Dong PT, Cen L, Bor B, Lux R, Shi W, Yu Q, He X, Wu T. Antagonistic interaction between two key endodontic pathogens Enterococcus faecalis and Fusobacterium nucleatum. J Oral Microbiol 2023; 15:2149448. [DOI: 10.1080/20002297.2022.2149448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Doudou Xiang
- Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, Shaanxi, China
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Pu-Ting Dong
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts, USA
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Lujia Cen
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Batbileg Bor
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts, USA
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Renate Lux
- School of Dentistry, UCLA, Los Angeles, California, USA
| | - Wenyuan Shi
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Qing Yu
- Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Xuesong He
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts, USA
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Tingxi Wu
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts, USA
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Dong PT, Jusuf S, Hui J, Zhan Y, Zhu Y, Liu GY, Cheng JX. Photoinactivation of catalase sensitizes wide-ranging bacteria to ROS-producing agents and immune cells. JCI Insight 2022; 7:153079. [PMID: 35446788 PMCID: PMC9220836 DOI: 10.1172/jci.insight.153079] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 04/20/2022] [Indexed: 11/17/2022] Open
Abstract
Bacteria have evolved to cope with the detrimental effects of ROS using their essential molecular components. Catalase, a heme-containing tetramer protein expressed universally in most aerobic bacteria, plays an indispensable role in scavenging excess hydrogen peroxide (H2O2). Here, through use of wild-type and catalase-deficient mutants, we identified catalase as an endogenous therapeutic target of 400–420 nm blue light. Catalase residing inside bacteria could be effectively inactivated by blue light, subsequently rendering the pathogens extremely vulnerable to H2O2 and H2O2-producing agents. As a result, photoinactivation of catalase and H2O2 synergistically eliminated a wide range of catalase-positive planktonic bacteria and P. aeruginosa inside biofilms. In addition, photoinactivation of catalase was shown to facilitate macrophage defense against intracellular pathogens. The antimicrobial efficacy of catalase photoinactivation was validated using a Pseudomonas aeruginosa–induced mouse abrasion model. Taken together, our findings offer a catalase-targeting phototherapy approach against multidrug-resistant bacterial infections.
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Affiliation(s)
- Pu-Ting Dong
- Department of Biomedical Engineering, Boston University, Boston, United States of America
| | - Sebastian Jusuf
- Department of Biomedical Engineering, Boston University, Boston, United States of America
| | - Jie Hui
- Department of Biomedical Engineering, Boston University, Boston, United States of America
| | - Yuewei Zhan
- Department of Biomedical Engineering, Boston University, Boston, United States of America
| | - Yifan Zhu
- Department of Chemistry, Boston University, Boston, United States of America
| | - George Y Liu
- Department of Pediatrics, University of California, San Diego, San Diego, United States of America
| | - Ji-Xin Cheng
- Boston University, Boston, United States of America
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9
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Jusuf S, Dong PT, Hui J, Ulloa ER, Liu GY, Cheng JX. Granadaene Photobleaching Reduces the Virulence and Increases Antimicrobial Susceptibility of Streptococcus agalactiae. Photochem Photobiol 2021; 97:816-825. [PMID: 33502005 DOI: 10.1111/php.13389] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 01/20/2021] [Indexed: 12/14/2022]
Abstract
Streptococcus agalactiae, also known as Group B Streptococcus (GBS), is increasingly recognized as a major cause of soft tissue and invasive diseases in the elderly and diabetic populations. Antibiotics like penicillin are used with great frequency to treat these infections, although antimicrobial resistance is increasing among GBS strains and underlines a need for alternative methods not reliant on traditional antibiotics. GBS granadaene pigment is related to the hemolysin/cytolysin of GBS, which is critical for the pathogenesis of GBS diseases. Here, we show that photobleaching granadaene dampens the hemolytic activity of GBS. Furthermore, photobleaching of this antioxidant was found to increase GBS susceptibility to killing by reactive oxygen species like hydrogen peroxide. Treatment with light was also shown to affect GBS membrane permeability and contribute to increased susceptibility to the cell membrane-targeting antibiotic daptomycin. Overall, our study demonstrates dual effects of photobleaching on the virulence and antimicrobial susceptibility of GBS and suggests a novel approach for the treatment of GBS infection.
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Affiliation(s)
- Sebastian Jusuf
- Department of Biomedical Engineering, Boston University, Boston, MA
| | - Pu-Ting Dong
- Department of Chemistry, Boston University, Boston, MA
| | - Jie Hui
- Department of Electrical & Computer Engineering, Boston University, Boston, MA
| | - Erlinda R Ulloa
- Department of Pediatrics, University of California Irvine School of Medicine, Irvine, CA
| | - George Y Liu
- Division of Pediatric Infectious Diseases, University of California San Diego School of Medicine, La Jolla, CA
| | - Ji-Xin Cheng
- Department of Biomedical Engineering, Boston University, Boston, MA.,Department of Chemistry, Boston University, Boston, MA.,Department of Electrical & Computer Engineering, Boston University, Boston, MA.,Photonics Center, Boston University, Boston, MA
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10
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Dong PT, Zong C, Dagher Z, Hui J, Li J, Zhan Y, Zhang M, Mansour MK, Cheng JX. Polarization-sensitive stimulated Raman scattering imaging resolves amphotericin B orientation in Candida membrane. Sci Adv 2021; 7:7/2/eabd5230. [PMID: 33523971 PMCID: PMC7787481 DOI: 10.1126/sciadv.abd5230] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 11/11/2020] [Indexed: 05/10/2023]
Abstract
Ergosterol-targeting amphotericin B (AmB) is the first line of defense for life-threatening fungal infections. Two models have been proposed to illustrate AmB assembly in the cell membrane; one is the classical ion channel model in which AmB vertically forms transmembrane tunnel and the other is a recently proposed sterol sponge model where AmB is laterally adsorbed onto the membrane surface. To address this controversy, we use polarization-sensitive stimulated Raman scattering from fingerprint C═C stretching vibration to visualize AmB, ergosterol, and lipid in single fungal cells. Intracellular lipid droplet accumulation in response to AmB treatment is found. AmB is located in membrane and intracellular droplets. In the 16 strains studied, AmB residing inside cell membrane was highly ordered, and its orientation is primarily parallel to phospholipid acyl chains, supporting the ion channel model. Label-free imaging of AmB and chemical contents offers an analytical platform for developing low-toxicity, resistance-refractory antifungal agents.
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Affiliation(s)
- Pu-Ting Dong
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
- Photonics Center, Boston University, Boston, MA 02215, USA
| | - Cheng Zong
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
- Photonics Center, Boston University, Boston, MA 02215, USA
| | - Zeina Dagher
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Jie Hui
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
- Photonics Center, Boston University, Boston, MA 02215, USA
| | - Junjie Li
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
- Photonics Center, Boston University, Boston, MA 02215, USA
| | - Yuewei Zhan
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
- Photonics Center, Boston University, Boston, MA 02215, USA
| | - Meng Zhang
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
- Photonics Center, Boston University, Boston, MA 02215, USA
| | - Michael K Mansour
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Ji-Xin Cheng
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA.
- Photonics Center, Boston University, Boston, MA 02215, USA
- Department of Electrical and Computer Engineering, Boston University, Boston, MA 02215, USA
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11
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Wu J, Zhu Y, You L, Dong PT, Mei J, Cheng JX. Polymer Electrochromism Driven by Metabolic Activity Facilitates Rapid and Facile Bacterial Detection and Susceptibility Evaluation. Adv Funct Mater 2020; 30:2005192. [PMID: 33708032 PMCID: PMC7941207 DOI: 10.1002/adfm.202005192] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Indexed: 05/19/2023]
Abstract
The electrochromism of a water-soluble naturally oxidized electrochromic polymer, ox-PPE, is harnessed for rapid and facile bacterial detection, discrimination, and susceptibility testing. The ox-PPE solution shows distinct colorimetric and spectroscopic changes within 30 min when mixed with live bacteria. For the underlying mechanism, it is found that ox-PPE responds to the reducing species (e.g. cysteine and glutathione) released by metabolically active bacteria. This reduction reaction is ubiquitous among various bacterial strains, with a noticeable difference that enables discrimination of Gram-negative and Gram-positive bacterial strains. Combining ox-PPE with antibiotics, methicillin-susceptible and -resistant S. aureus can be differentiated within 2.5 h. Proof-of-concept demonstration of ox-PPE for antimicrobial susceptibility testing is carried out by incubating E. coli with various antibiotics. The obtained minimum inhibition concentrations are consistent with the conventional culture-based methods, but with the procedure time significantly shortened to 3 h.
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Affiliation(s)
- Jiayingzi Wu
- Department of Chemistry, Purdue University, West Lafayette, Indiana 47907, USA
| | - Yifan Zhu
- Department of Chemistry, Department of Electrical and Computer Engineering, Boston University, Boston, Massachusetts 02215, USA
| | - Liyan You
- Department of Chemistry, Purdue University, West Lafayette, Indiana 47907, USA
| | - Pu-Ting Dong
- Department of Chemistry, Department of Electrical and Computer Engineering, Boston University, Boston, Massachusetts 02215, USA
| | - Jianguo Mei
- Department of Chemistry, Purdue University, West Lafayette, Indiana 47907, USA
| | - Ji-Xin Cheng
- Department of Chemistry, Department of Electrical and Computer Engineering, Boston University, Boston, Massachusetts 02215, USA; Department of Physics, Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, USA
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12
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Leanse LG, Dong PT, Goh XS, Lu M, Cheng JX, Hooper DC, Dai T. Quinine Enhances Photo-Inactivation of Gram-Negative Bacteria. J Infect Dis 2020; 221:618-626. [PMID: 31565732 DOI: 10.1093/infdis/jiz487] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 09/24/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Antimicrobial resistance is a significant concern to public health, and there is a pressing need to develop novel antimicrobial therapeutic modalities. METHODS In this study, we investigated the capacity for quinine hydrochloride (Q-HCL) to enhance the antimicrobial effects of antimicrobial blue light ([aBL] 405 nm wavelength) against multidrug-resistant (MDR) Gram-negative bacteria in vitro and in vivo. RESULTS Our findings demonstrated the significant improvement in the inactivation of MDR Pseudomonas aeruginosa and Acinetobacter baumannii (planktonic cells and biofilms) when aBL was illuminated during Q-HCL exposure. Furthermore, the addition of Q-HCL significantly potentiated the antimicrobial effects of aBL in a mouse skin abrasion infection model. In addition, combined exposure of aBL and Q-HCL did not result in any significant apoptosis when exposed to uninfected mouse skin. CONCLUSIONS In conclusion, aBL in combination with Q-HCL may offer a novel approach for the treatment of infections caused by MDR bacteria.
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Affiliation(s)
- Leon G Leanse
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Vaccine and Immunotherapy Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Pu-Ting Dong
- Department of Chemistry, Boston University, Boston, Massachusetts, USA
| | - Xueping S Goh
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Vaccine and Immunotherapy Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Min Lu
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ji-Xin Cheng
- Department of Chemistry, Boston University, Boston, Massachusetts, USA.,Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA
| | - David C Hooper
- Division of Infectious Disease, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Tianhong Dai
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Vaccine and Immunotherapy Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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13
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Hui J, Dong PT, Liang L, Mandal T, Li J, Ulloa ER, Zhan Y, Jusuf S, Zong C, Seleem MN, Liu GY, Cui Q, Cheng JX. Photo-Disassembly of Membrane Microdomains Revives Conventional Antibiotics against MRSA. Adv Sci (Weinh) 2020; 7:1903117. [PMID: 32195102 PMCID: PMC7080515 DOI: 10.1002/advs.201903117] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 12/29/2019] [Indexed: 05/21/2023]
Abstract
Confronted with the rapid evolution and dissemination of antibiotic resistance, there is an urgent need to develop alternative treatment strategies for drug-resistant pathogens. Here, an unconventional approach is presented to restore the susceptibility of methicillin-resistant S. aureus (MRSA) to a broad spectrum of conventional antibiotics via photo-disassembly of functional membrane microdomains. The photo-disassembly of microdomains is based on effective photolysis of staphyloxanthin, the golden carotenoid pigment that gives its name. Upon pulsed laser treatment, cell membranes are found severely disorganized and malfunctioned to defense antibiotics, as unveiled by membrane permeabilization, membrane fluidification, and detachment of membrane protein, PBP2a. Consequently, the photolysis approach increases susceptibility and inhibits development of resistance to a broad spectrum of antibiotics including penicillins, quinolones, tetracyclines, aminoglycosides, lipopeptides, and oxazolidinones. The synergistic therapy, without phototoxicity to the host, is effective in combating MRSA both in vitro and in vivo in a mice skin infection model. Collectively, this endogenous chromophore-targeted phototherapy concept paves a novel platform to revive conventional antibiotics to combat drug-resistant S. aureus infections as well as to screen new lead compounds.
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Affiliation(s)
- Jie Hui
- Department of Electrical and Computer Engineering Boston University Boston MA 02215 USA
- Boston University Photonics Center Boston MA 02215 USA
| | - Pu-Ting Dong
- Boston University Photonics Center Boston MA 02215 USA
- Department of Chemistry Boston University Boston MA 02215 USA
| | - Lijia Liang
- Department of Electrical and Computer Engineering Boston University Boston MA 02215 USA
- State Key Laboratory of Supramolecular Structure and Materials Institute of Theoretical Chemistry Jilin University Changchun 130012 China
| | | | - Junjie Li
- Department of Electrical and Computer Engineering Boston University Boston MA 02215 USA
- Boston University Photonics Center Boston MA 02215 USA
| | - Erlinda R Ulloa
- Collaborative to Halt Antibiotic-Resistant Microbes (CHARM) Department of Pediatrics University of California San Diego School of Medicine La Jolla CA 92093 USA
- Division of Infectious Disease Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
| | - Yuewei Zhan
- Department Biomedical Engineering Boston University Boston MA 02215 USA
| | - Sebastian Jusuf
- Department Biomedical Engineering Boston University Boston MA 02215 USA
| | - Cheng Zong
- Department of Electrical and Computer Engineering Boston University Boston MA 02215 USA
- Boston University Photonics Center Boston MA 02215 USA
| | - Mohamed N Seleem
- College of Veterinary Medicine Purdue University West Lafayette IN 47907 USA
| | - George Y Liu
- Collaborative to Halt Antibiotic-Resistant Microbes (CHARM) Department of Pediatrics University of California San Diego School of Medicine La Jolla CA 92093 USA
- Division of Infectious Diseases Rady Children's Hospital San Diego CA 92123 USA
| | - Qiang Cui
- Department of Chemistry Boston University Boston MA 02215 USA
- Department Biomedical Engineering Boston University Boston MA 02215 USA
| | - Ji-Xin Cheng
- Department of Electrical and Computer Engineering Boston University Boston MA 02215 USA
- Boston University Photonics Center Boston MA 02215 USA
- Department of Chemistry Boston University Boston MA 02215 USA
- Department Biomedical Engineering Boston University Boston MA 02215 USA
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14
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Dong PT, Lin H, Huang KC, Cheng JX. Label-free quantitation of glycated hemoglobin in single red blood cells by transient absorption microscopy and phasor analysis. Sci Adv 2019; 5:eaav0561. [PMID: 31093524 PMCID: PMC6510558 DOI: 10.1126/sciadv.aav0561] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 03/27/2019] [Indexed: 06/09/2023]
Abstract
As a stable and accurate biomarker, glycated hemoglobin (HbA1c) is clinically used to diagnose diabetes with a threshold of 6.5% among total hemoglobin (Hb). Current methods such as boronate affinity chromatography involve complex processing of large-volume blood samples. Moreover, these methods cannot measure HbA1c fraction at single-red blood cell (RBC) level, thus unable to separate the contribution from other factors such as RBC lifetime. Here, we demonstrate a spectroscopic transient absorption imaging approach that is able to differentiate HbA1c from Hb on the basis of their distinct excited-state dynamics. HbA1c fraction inside a single RBC is derived quantitatively through phasor analysis. HbA1c fraction distribution of diabetic blood is apparently different from that of healthy blood. A mathematical model is developed to derive the long-term blood glucose concentration. Our technology provides a unique way to study heme modification and to derive clinically important information void of bloodstream glucose fluctuation.
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Affiliation(s)
- Pu-Ting Dong
- Department of Chemistry, Boston University, Boston, MA 02215, USA
| | - Haonan Lin
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
| | - Kai-Chih Huang
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
| | - Ji-Xin Cheng
- Department of Chemistry, Boston University, Boston, MA 02215, USA
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
- Department of Electrical and Computer Engineering, Boston University, Boston, MA 02215, USA
- Photonics Center, Boston University, Boston, MA 02215, USA
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15
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Wang CG, Wu XZ, Di D, Dong PT, Xiao R, Wang SQ. Orientation-dependent nanostructure arrays based on anisotropic silicon wet-etching for repeatable surface-enhanced Raman scattering. Nanoscale 2016; 8:4672-4680. [PMID: 26853057 DOI: 10.1039/c5nr04750a] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Repeatable fabrication of sensitive plasmonic substrates through a simple procedure has become a major challenge for SERS-based sensing and imaging. Herein, a new class of high-performance SERS substrates, including pyramid, ridged-hexagon, and quasi-triangle nanostructures, is successfully fabricated based on the nanosphere lithography technique and anisotropic wet etching. Using the wafer-scale Cr-hole array as the etching mask, cavity-templates of various configurations are fabricated by the orientation-dependent wet etching technique, from where the nanostructure arrays are finally peeled-off. The anisotropic wet etching on (100), (110), and (111) silicon wafers has been systematically studied at the nanoscale revealing the formation mechanism of these cavity-templates. The peeled-off nanostructure arrays provide high-density tips and/or gaps (about 2.5 × 10(7) mm(-2)) and thus facilitate the generation of "hot spots". The distribution of the electromagnetic field is visualized by the finite difference time domain calculation. And the calculation results are validated by SERS characterization. The SERS enhancement factors of these substrates are in the order of 10(6)-10(7), with the maximum enhancement factor of 1.32 × 10(7) yielded by the ridged-hexagon arrays. The proposed nanostructure arrays present excellent homogeneity and reproducibility (with the largest relative standard deviation of 16.43%) for the reason that the SERS-active substrates are peeled-off from an identical template. The cost-effective fabrication, high sensitivity, good homogeneity and well-performed reproducibility demonstrate that these orientation-dependent NSs are good candidates for SERS-based in vitro and in situ detection and biosensing.
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Affiliation(s)
- C G Wang
- College of Mechatronics Engineering and Automation, National University of Defense Technology, Changsha, Hunan Province 410073, P. R. China. and Key Laboratory of New Molecular Diagnosis Technologies for Infectious Diseases, Institute of Radiation Medicine, Academy of Military Medical Sciences, Beijing 100850, P. R. China.
| | - X Z Wu
- College of Mechatronics Engineering and Automation, National University of Defense Technology, Changsha, Hunan Province 410073, P. R. China.
| | - D Di
- College of Mechatronics Engineering and Automation, National University of Defense Technology, Changsha, Hunan Province 410073, P. R. China. and Dingyuan Automotive Proving Ground, Nanjing, Jiangsu Province 210028, P.R. China
| | - P T Dong
- College of Mechatronics Engineering and Automation, National University of Defense Technology, Changsha, Hunan Province 410073, P. R. China.
| | - R Xiao
- Key Laboratory of New Molecular Diagnosis Technologies for Infectious Diseases, Institute of Radiation Medicine, Academy of Military Medical Sciences, Beijing 100850, P. R. China.
| | - S Q Wang
- Key Laboratory of New Molecular Diagnosis Technologies for Infectious Diseases, Institute of Radiation Medicine, Academy of Military Medical Sciences, Beijing 100850, P. R. China.
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16
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Kato Y, Sano H, Dong PT, Panji N, Itezawa Y, Hayashi J, Kanno T. The Effect of Clipping and Coiling in Acute Severe Subarachnoid Hemorrhage after International Subarachnoid Aneurysmal Trial (ISAT) Results. ACTA ACUST UNITED AC 2005; 48:224-7. [PMID: 16172968 DOI: 10.1055/s-2005-870930] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Cerebral aneurysms are treated by two methods: direct microsurgical clipping and endovascular coiling. Both are selected based on definite guidelines for clinicoradiological criteria as follows: Endovascular therapy comprising of GDC embolization, CSF wash-out with UK or TP A were performed in cases with Hunt and Kosnik grade 4 (GCS 7, 8), and grade 5 (without hydrocephalus or intracranial hemorrhage), age>70 years, subacute stage (4--14 days of vasospasm), basilar aneurysm and peripheral MCA/PCA aneurysms. Microsurgical clipping with a drainage procedure was performed in cases with Hunt and Kosnik grades 0--3, grade 4 (GCS 9--12), age less than 70 years, grade 5 with hydrocephalus or intracerebral hematoma and acute stage (0--3 days after bleed). The patient's outcome was measured using GOS (Glasgow outcome score) at the time of discharge. In our series of severe (poor grade) SAH cases, 120 cases underwent clipping and 59 cases underwent coiling. Although they accounted for 37.8 % and 48 % of total SAH cases, respectively, the outcome was satisfactory. Good recovery and moderate disability, together termed "favorable outcome" was found in 69.16 % of clipping cases and 44.06 % of coiling cases. Clipping had a better outcome than coiling in cases of acute severe SAH in our series. The golden hour resuscitation, pre-hospital care and the adjunctive treatment strategies like hypothermia are discussed. A critical appraisal of the ISAT of microsurgical clipping versus coiling is used for comparison of our results.
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Affiliation(s)
- Y Kato
- Department of Neurosurgery, Fujita Health University, Toyoake, Aichi, Japan.
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