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Szymczak K, Woźniak-Pawlikowska A, Burzyńska N, Król M, Zhang L, Nakonieczna J, Grinholc M. Decrease of ESKAPE virulence with a cationic heme-mimetic gallium porphyrin photosensitizer: The Trojan horse strategy that could help address antimicrobial resistance. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2024; 256:112928. [PMID: 38723545 DOI: 10.1016/j.jphotobiol.2024.112928] [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: 11/17/2023] [Revised: 04/25/2024] [Accepted: 04/30/2024] [Indexed: 06/11/2024]
Abstract
INTRODUCTION Emerging antibiotic resistance among bacterial pathogens has forced an urgent need for alternative non-antibiotic strategies development that could combat drug resistant-associated infections. Suppression of virulence of ESKAPE pathogens' by targeting multiple virulence traits provides a promising approach. OBJECTIVES Here we propose an iron-blocking antibacterial therapy based on a cationic heme-mimetic gallium porphyrin (GaCHP), which antibacterial efficacy could be further enhanced by photodynamic inactivation. METHODS We used gallium heme mimetic porphyrin (GaCHP) excited with light to significantly reduce microbial viability and suppress both the expression and biological activity of several virulence traits of both Gram-positive and Gram-negative ESKAPE representatives, i.e., S. aureus and P. aeruginosa. Moreover, further improvement of the proposed strategy by combining it with routinely used antimicrobials to resensitize the microbes to antibiotics and provide enhanced bactericidal efficacy was investigated. RESULTS The proposed strategy led to substantial inactivation of critical priority pathogens and has been evidenced to suppress the expression and biological activity of multiple virulence factors in S. aureus and P. aeruginosa. Finally, the combination of GaCHP phototreatment and antibiotics resulted in promising strategy to overcome antibiotic resistance of the studied microbes and to enhance disinfection of drug resistant pathogens. CONCLUSION Lastly, considering high safety aspects of the proposed treatment toward host cells, i.e., lack of mutagenicity, no dark toxicity and mild phototoxicity, we describe an efficient alternative that simultaneously suppresses the functionality of multiple virulence factors in ESKAPE pathogens.
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Affiliation(s)
- Klaudia Szymczak
- Laboratory of Photobiology and Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland
| | - Agata Woźniak-Pawlikowska
- Laboratory of Photobiology and Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland
| | - Natalia Burzyńska
- Laboratory of Photobiology and Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland
| | - Magdalena Król
- Laboratory of Photobiology and Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland
| | - Lei Zhang
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), Tianjin University, Tianjin 300350, China
| | - Joanna Nakonieczna
- Laboratory of Photobiology and Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland.
| | - Mariusz Grinholc
- Laboratory of Photobiology and Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland.
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Chen J, Zhang H, Zhao T, Yu Y, Song J, Zhao Y, Alshawwa H, Zou X, Zhang Z. Oxygen Self-Supplied Nanoplatform for Enhanced Photodynamic Therapy against Enterococcus Faecalis within Root Canals. Adv Healthc Mater 2024; 13:e2302926. [PMID: 38273674 DOI: 10.1002/adhm.202302926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/10/2024] [Indexed: 01/27/2024]
Abstract
The successful treatment of persistent and recurrent endodontic infections hinges upon the eradication of residual microorganisms within the root canal system, which urgently needs novel drugs to deliver potent yet gentle antimicrobial effects. Antibacterial photodynamic therapy (aPDT) is a promising tool for root canal infection management. Nevertheless, the hypoxic microenvironment within the root canal system significantly limits the efficacy of this treatment. Herein, a nanohybrid drug, Ce6/CaO2/ZIF-8@polyethylenimine (PEI), is developed using a bottom-up strategy to self-supply oxygen for enhanced aPDT. PEI provides a positively charged surface, which enables precise targeting of bacteria. CaO2 reacts with H2O to generate O2, which alleviates the hypoxia in the root canal and serves as a substrate for Ce6 under 660 nm laser irradiation, leading to the successful eradication of planktonic Enterococcus faecalis (E. faecalis) and biofilm in vitro and, moreover, the effective elimination of mature E. faecalis biofilm in situ within the root canal system. This smart design offers a viable alternative for mitigating hypoxia within the root canal system to overcome the restricted efficacy of photosensitizers, providing an exciting prospect for the clinical management of persistent endodontic infection.
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Affiliation(s)
- Jiawen Chen
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Hong Zhang
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Tiancong Zhao
- College of Chemistry and Materials, Department of Chemistry and Laboratory of Advanced Materials, Shanghai Key Laboratory of Molecular Catalysis and Innovative Materials, State Key Laboratory of Molecular Engineering of Polymers, Collaborative Innovation Center of Chemistry for Energy Materials (2011-iChEM), Fudan University, Shanghai, 200433, P. R. China
| | - Yiyan Yu
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Jiazhuo Song
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Yuanhang Zhao
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Hamed Alshawwa
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Xinying Zou
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Zhimin Zhang
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
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Gu R, Fei S, Liu Z, Liu X, Fang X, Wu H, Zhang X, Xu G, Xu F. Effects of photodynamic therapy in patients with infected skin ulcers: A meta-analysis. Int Wound J 2024; 21:e14747. [PMID: 38445778 PMCID: PMC10915826 DOI: 10.1111/iwj.14747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 03/07/2024] Open
Abstract
The purpose of the meta-analysis was to evaluate and compare the photodynamic therapy's effectiveness in treating infected skin wounds. The results of this meta-analysis were analysed, and the odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were calculated using dichotomous or contentious random- or fixed-effect models. For the current meta-analysis, 6 examinations spanning from 2013 to 2021 were included, encompassing 154 patients with infected skin wounds were the used studies' starting point. Photodynamic therapy had a significantly lower wound ulcer size (MD, -4.42; 95% CI, -7.56--1.28, p = 0.006), better tissue repair (MD, -8.62; 95% CI, -16.76--0.48, p = 0.04) and lower microbial cell viability (OR, 0.13; 95% CI, 0.04-0.42, p < 0.001) compared with red light exposure in subjects with infected skin wounds. The examined data revealed that photodynamic therapy had a significantly lower wound ulcer size, better tissue repair and lower microbial cell viability compared with red light exposure in subjects with infected skin wounds. However, given that all examinations had a small sample size, consideration should be given to their values.
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Affiliation(s)
- Rui Gu
- Graduate School of Beijing University of Chinese Medicine, Beijing University of Chinese MedicineBeijingChina
| | - Sha'ni Fei
- Graduate School of Beijing University of Chinese Medicine, Beijing University of Chinese MedicineBeijingChina
| | - Zhaoyu Liu
- Graduate School of Beijing University of Chinese Medicine, Beijing University of Chinese MedicineBeijingChina
| | - Xiaoqi Liu
- Graduate School of Beijing University of Chinese Medicine, Beijing University of Chinese MedicineBeijingChina
| | - Xiaoxiao Fang
- Graduate School of Beijing University of Chinese Medicine, Beijing University of Chinese MedicineBeijingChina
| | - Hengjin Wu
- Graduate School of Beijing University of Chinese Medicine, Beijing University of Chinese MedicineBeijingChina
| | - Xia Zhang
- Department of NeurologyPeking University Aerospace School of Clinical MedicineBeijingChina
| | - Guomei Xu
- Department of DermatologyBeijing University of Chinese Medicine Third Affiliated HospitalBeijingChina
| | - Fengquan Xu
- Department of PsychosomaticsGuang'anmen Hospital, China Academy of Chinese Medical SciencesBeijingChina
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Maisch T, Scholz KJ, Forster EM, Wenzl V, Auer DL, Cieplik F, Hiller KA. Optimal effective concentration combinations (OPECCs) for binary application of membrane-targeting antiseptics and TMPyP-mediated antimicrobial photodynamic therapy. Photochem Photobiol Sci 2024; 23:189-196. [PMID: 38113026 DOI: 10.1007/s43630-023-00512-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/12/2023] [Indexed: 12/21/2023]
Abstract
The widespread occurrence of multi-resistant bacteria is a health problem of global dimension. Infections caused by multi-resistant pathogens are difficult to treat and often associated with high mortality. Therefore, new treatment strategies are of interest, such as the use of differently acting antibacterial concepts. One of these new concepts is the use of antiseptics in combination with the antibacterial photodynamic therapy (aPDT). Currently, no method has yet been established as a standard procedure for investigating combined effects and evaluating them in a generally valid and unambiguous manner. The focus of this study was on how cationic antiseptics benzalkonium chloride (BAC) and chlorhexidine digluconate (CHX) behave in a combined application with aPDT using the photosensitizer TMPyP. For this purpose, BAC and CHX were applied in combination with the aPDT using TMPyP in non-lethal concentrations to the three bacteria Escherichia coli, Staphylococcus aureus, and Enterococcus faecalis. The results of the combination experiments with sublethal concentrations of BAC or CHX with the aPDT showed that the binary application had a lethal effect. Irrespective of the bacteria, the reduction in concentrations in OPECC, compared to individual concentrations, was more than 50% for TMPyP, 23-40% for BAC, and 18-43% for CHX. Furthermore, the optimal effective concentration combinations (OPECCs) could be determined. The latter showed that the combined application allowed the reduction of both concentrations compared to the single application.
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Affiliation(s)
- Tim Maisch
- Department of Dermatology, University Hospital Regensburg, 93053, Regensburg, Germany.
| | - Konstantin J Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053, Regensburg, Germany
| | - Eva-Maria Forster
- Department of Dermatology, University Hospital Regensburg, 93053, Regensburg, Germany
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053, Regensburg, Germany
| | - Verena Wenzl
- Department of Dermatology, University Hospital Regensburg, 93053, Regensburg, Germany
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053, Regensburg, Germany
| | - David L Auer
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053, Regensburg, Germany
| | - Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053, Regensburg, Germany
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053, Regensburg, Germany
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Ha HA, Al-Ansari MM, Al-Dahmash ND, Krishnan R, Shanmuganathan R. In vitro analyses of cerium oxide nanoparticles in degrading anthracene/fluorene and revealing the antibiofilm activity against bacteria and fungi. CHEMOSPHERE 2023; 345:140487. [PMID: 37875217 DOI: 10.1016/j.chemosphere.2023.140487] [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: 05/13/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 10/26/2023]
Abstract
A sol-gel method was used to synthesize the cerium dioxide nanoparticles. The nanoparticles formed were then characterized with UV-visible spectrophotometry, Fourier Transform Infrared Spectrophotometer (FTIR), SEM-EDAX, XRD, and Dynamic Light Scattering (DLS). The UV-visible absorbance at 282 nm and characteristic peak at 600-4000 cm-1 provided insight into the formation of cerium dioxide nanoparticles using a chemical method. SEM analysis and EDAX analysis confirmed nanoparticle formation and elements within the nanoparticles based on their irregular morphology. The hydrodynamic size obtained from the DLS analysis was 178.4 nm and the polydispersity was 0.275 nm. Furthermore, XRD results confirmed the crystalline nature of cerium dioxide nanoparticles. Using batch adsorption as a method, the effect of concentration of Polycyclic Aromatic Hydrocarbons (PAH), adsorbent concentration, pH, and irradiation source was investigated. Under UV light conditions, 10 μg/mL cerium dioxide nanoparticle at pH 5 degraded 2 μg/mL of PAH (anthracene and fluorene). Consequently, the synthesized cerium dioxide nanoparticles were effective photocatalysts. For anthracene and fluorene, kinetic studies showed the degradation process followed pseudo-second-order kinetics and Freundlich isotherms. Cerium oxide also exhibited significant antimicrobial and antibiofilm activity against bacteria and fungi. As a result, the cerium dioxide nanoparticle has proved to be a highly effective photocatalytic tool for the degradation of PAHs and exhibits strong antimicrobial activity.
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Affiliation(s)
- Hai-Anh Ha
- Faculty of Pharmacy, Duy Tan University, Da Nang 550000, Viet Nam.
| | - Mysoon M Al-Ansari
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Nora Dahmash Al-Dahmash
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Ramakrishnan Krishnan
- Department of Business, Harrisburg University of Science and Technology, Harrisburg, PA 17101, USA
| | - Rajasree Shanmuganathan
- Department of Biomaterials, Saveetha Dental College and Hospital, Saveetha Institute of Medical And Technical Sciences (SIMATS), Saveetha University, Chennai 600 077, India.
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Soares JM, Yakovlev VV, Blanco KC, Bagnato VS. Recovering the susceptibility of antibiotic-resistant bacteria using photooxidative damage. Proc Natl Acad Sci U S A 2023; 120:e2311667120. [PMID: 37729197 PMCID: PMC10523486 DOI: 10.1073/pnas.2311667120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/21/2023] [Indexed: 09/22/2023] Open
Abstract
Multidrug-resistant bacteria are one of the most serious threats to infection control. Few new antibiotics have been developed; however, the lack of an effective new mechanism of their action has worsened the situation. Photodynamic inactivation (PDI) can break antimicrobial resistance, since it potentiates the effect of antibiotics, and induces oxidative stress in microorganisms through the interaction of light with a photosensitizer. This paper addresses the application of PDI for increasing bacterial susceptibility to antibiotics and helping in bacterial persistence and virulence. The effect of photodynamic action on resistant bacteria collected from patients and bacteria cells with induced resistance in the laboratory was investigated. Staphylococcus aureus resistance breakdown levels for each antibiotic (amoxicillin, erythromycin, and gentamicin) from the photodynamic effect (10 µM curcumin, 10 J/cm2) and its maintenance in descendant microorganisms were demonstrated within five cycles after PDI application. PDI showed an innovative feature for modifying the degree of bacterial sensitivity to antibiotics according to dosages, thus reducing resistance and persistence of microorganisms from standard and clinical strains. We hypothesize a reduction in the degree of antimicrobial resistance through photooxidative action combats antibiotic failures.
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Affiliation(s)
- Jennifer M. Soares
- Institute of Physics of São Carlos, University of São Paulo, São Carlos13566-590, Brazil
- Biomedical Engineering, Texas A&M University, College Station, TX77840
| | | | - Kate C. Blanco
- Institute of Physics of São Carlos, University of São Paulo, São Carlos13566-590, Brazil
| | - Vanderlei S. Bagnato
- Institute of Physics of São Carlos, University of São Paulo, São Carlos13566-590, Brazil
- Biomedical Engineering, Texas A&M University, College Station, TX77840
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Li Z, Lei Z, Cai Y, Cheng DB, Sun T. MicroRNA therapeutics and nucleic acid nano-delivery systems in bacterial infection: a review. J Mater Chem B 2023; 11:7804-7833. [PMID: 37539650 DOI: 10.1039/d3tb00694h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Bacteria that have worked with humans for thousands of years pose a major threat to human health even today, as drug resistance has become a prominent problem. Compared to conventional drug therapy, nucleic acid-based therapies are a promising and potential therapeutic strategy for diseases in which nucleic acids are delivered through a nucleic acid delivery system to regulate gene expression in specific cells, offering the possibility of curing intractable diseases that are difficult to treat at this stage. Among the many nucleic acid therapeutic ideas, microRNA, a class of small nucleic acids with special properties, has made great strides in biology and medicine in just over two decades, showing promise in preclinical drug development. In this review, we introduce recent advances in nucleic acid delivery systems and their clinical applications, highlighting the potential of nucleic acid therapies, especially miRNAs extracted from traditional herbs, in combination with the existing set of nucleic acid therapeutic systems, to potentially open up a new line of thought in the treatment of cancer, viruses, and especially bacterial infectious diseases.
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Affiliation(s)
- Ze Li
- School of Chemistry, Chemical Engineering and Life Science, Hospital of Wuhan University of Technology, Wuhan University of Technology, 122 Luoshi Road, Wuhan 430070, China.
- Hubei Key Laboratory of Nanomedicine for Neurodegenerative Diseases, Wuhan University of Technology, 122 Luoshi Road, Wuhan 430070, China
| | - Zhixin Lei
- School of Chemistry, Chemical Engineering and Life Science, Hospital of Wuhan University of Technology, Wuhan University of Technology, 122 Luoshi Road, Wuhan 430070, China.
- Hubei Key Laboratory of Nanomedicine for Neurodegenerative Diseases, Wuhan University of Technology, 122 Luoshi Road, Wuhan 430070, China
| | - Yilun Cai
- School of Chemistry, Chemical Engineering and Life Science, Hospital of Wuhan University of Technology, Wuhan University of Technology, 122 Luoshi Road, Wuhan 430070, China.
| | - Dong-Bing Cheng
- School of Chemistry, Chemical Engineering and Life Science, Hospital of Wuhan University of Technology, Wuhan University of Technology, 122 Luoshi Road, Wuhan 430070, China.
- Hubei Key Laboratory of Nanomedicine for Neurodegenerative Diseases, Wuhan University of Technology, 122 Luoshi Road, Wuhan 430070, China
| | - Taolei Sun
- School of Chemistry, Chemical Engineering and Life Science, Hospital of Wuhan University of Technology, Wuhan University of Technology, 122 Luoshi Road, Wuhan 430070, China.
- Hubei Key Laboratory of Nanomedicine for Neurodegenerative Diseases, Wuhan University of Technology, 122 Luoshi Road, Wuhan 430070, China
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Babaeekhou L, Ghane M, Mohammad Rafiee M. Photodynamic Therapy and Its Synergism with Melittin Against Drug-Resistant Acinetobacter baumannii Isolates with High Biofilm Formation Ability. Curr Microbiol 2023; 80:324. [PMID: 37596435 DOI: 10.1007/s00284-023-03356-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 05/29/2023] [Indexed: 08/20/2023]
Abstract
Drug-resistant biofilm producer A. baumannii isolates are a global concern that warns researchers about the development of new treatments. This study was designed to analyze the effect of photodynamic therapy (PDT) as monotherapy and associated with melittin on multidrug-resistant A. baumannii isolates. Sub-lethal doses of photosensitizer, LED, and PDT were determined. The PDT effect on the biofilm and expression of biofilm-associated genes was evaluated by scanning electron microscopy and quantitative real-time PCR (qRT-PCR) methods, respectively. The synergistic effect of PDT and melittin on the survival of MDR/XDR strong biofilm producer isolates was evaluated by checkerboard assay. Survival rates were significantly decreased at the lowest concentration of 12.5-50 μg/ml in 4 min at an energy density of 93.75 J/cm2 (P < 0.05). The optimized PDT method had a bactericidal effect against all tested groups, and the mean expression levels of csu, abaI, bap, and ompA genes in the strong biofilm producers were decreased significantly compared to the control group. The combined effect of LED and melittin successfully reduced the MDR/XDR A. baumannii strong biofilm producers' growth from 3.1 logs. MB-mediated aPDT and combined treatment of PDT with melittin, which has been investigated for the first time in this study, can be an efficient strategy against MDR/XDR A. baumannii isolates with strong biofilm production capacity.
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Affiliation(s)
- Laleh Babaeekhou
- Department of Biology, Islamshahr Branch, Islamic Azad University, Sayyad Shirazi St., P.O. Box: 33135/369, Eslamshahr, Iran.
- Department of Biology, Islamshahr Branch, Islamic Azad University, Eslamshahr, Iran.
| | - Maryam Ghane
- Department of Biology, Islamshahr Branch, Islamic Azad University, Eslamshahr, Iran
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Li Y, Sun G, Xie J, Xiao S, Lin C. Antimicrobial photodynamic therapy against oral biofilm: influencing factors, mechanisms, and combined actions with other strategies. Front Microbiol 2023; 14:1192955. [PMID: 37362926 PMCID: PMC10288113 DOI: 10.3389/fmicb.2023.1192955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/16/2023] [Indexed: 06/28/2023] Open
Abstract
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.
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Affiliation(s)
- Yijun Li
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen, China
| | - Guanwen Sun
- Department of Stomatology, Fujian Medical University Xiamen Humanity Hospital, Xiamen, China
| | - Jingchan Xie
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen, China
| | - Suli Xiao
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen, China
| | - Chen Lin
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen, China
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Sarabando SN, Palmeira A, Sousa ME, Faustino MAF, Monteiro CJP. Photomodulation Approaches to Overcome Antimicrobial Resistance. Pharmaceuticals (Basel) 2023; 16:682. [PMID: 37242465 PMCID: PMC10221556 DOI: 10.3390/ph16050682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 04/24/2023] [Accepted: 04/30/2023] [Indexed: 05/28/2023] Open
Abstract
Photopharmacology is an approach that aims to be an alternative to classical chemotherapy. Herein, the different classes of photoswitches and photocleavage compounds and their biological applications are described. Proteolysis targeting chimeras (PROTACs) containing azobenzene moieties (PHOTACs) and photocleavable protecting groups (photocaged PROTACs) are also mentioned. Furthermore, porphyrins are referenced as successful photoactive compounds in a clinical context, such as in the photodynamic therapy of tumours as well as preventing antimicrobial resistance, namely in bacteria. Porphyrins combining photoswitches and photocleavage systems are highlighted, taking advantage of both photopharmacology and photodynamic action. Finally, porphyrins with antibacterial activity are described, taking advantage of the synergistic effect of photodynamic treatment and antibiotic therapy to overcome bacterial resistance.
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Affiliation(s)
- Sofia N. Sarabando
- Laboratory of Organic and Pharmaceutical Chemistry, Chemical Sciences Department, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (S.N.S.); (A.P.)
- LAQV-Requimte and Department of Chemistry, University of Aveiro, 3010-193 Aveiro, Portugal;
| | - Andreia Palmeira
- Laboratory of Organic and Pharmaceutical Chemistry, Chemical Sciences Department, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (S.N.S.); (A.P.)
- CIIMAR—Interdisciplinary Centre of Marine and Environmental Research, 4450-208 Porto, Portugal
| | - Maria Emília Sousa
- Laboratory of Organic and Pharmaceutical Chemistry, Chemical Sciences Department, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (S.N.S.); (A.P.)
- CIIMAR—Interdisciplinary Centre of Marine and Environmental Research, 4450-208 Porto, Portugal
| | | | - Carlos J. P. Monteiro
- LAQV-Requimte and Department of Chemistry, University of Aveiro, 3010-193 Aveiro, Portugal;
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Hiller KA, Wenzl V, Forster EM, Cieplik F, Maisch T. The Optimal Effective Concentration Combination (OPECC) as a Novel Method for Evaluating the Effects of Binary Application of Antibacterial Compounds. Microorganisms 2023; 11:microorganisms11040830. [PMID: 37110251 PMCID: PMC10143449 DOI: 10.3390/microorganisms11040830] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
Combination therapies appear to be beneficial for preventing bacterial resistance to antibacterial approaches. The aim of this study was to define and determine an optimal effective concentration combination (OPECC) for binary application of antibacterial compounds. The antiseptics chlorhexidine (CHX), benzalkonium chloride (BAC), and cetylpyridinium chloride (CPC), as well as the antibiotic ciprofloxacin (CIP), were tested against planktonic Escherichia coli in binary combinations by applying a checkerboard assay, and then evaluated according to the established synergism principles. Extending the checkerboard method, the optical density (OD) of the wells was measured photometrically. On the borderline between effective (OD = 0) and non-effective (OD > 0) eradication of the bacterial cultures, the OPECC was determined. Binary combinations of CPC or CHX with BAC were assessed as either synergistic or indifferent, respectively, while there was no OPECC to calculate. For all other binary combinations, an OPECC was derivable, and these were assessed as either synergistic or indifferent. In conclusion, the evaluation of the binary combination application of antibacterial compounds based on the checkerboard method was refined to such an extent that it was possible to determine at least one concentration pair that could be defined and considered as an OPECC, independently of the evaluation of the system according to the different synergy principles. In general, the method presented herein for determining an OPECC can be applied to any conceivable method or system aimed at the eradication of a pathogen.
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Affiliation(s)
- Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Verena Wenzl
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany
- Department of Dermatology, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Eva-Maria Forster
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany
- Department of Dermatology, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Tim Maisch
- Department of Dermatology, University Hospital Regensburg, 93053 Regensburg, Germany
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Turzańska K, Adesanya O, Rajagopal A, Pryce MT, Fitzgerald Hughes D. Improving the Management and Treatment of Diabetic Foot Infection: Challenges and Research Opportunities. Int J Mol Sci 2023; 24:ijms24043913. [PMID: 36835330 PMCID: PMC9959562 DOI: 10.3390/ijms24043913] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/03/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
Diabetic foot infection (DFI) management requires complex multidisciplinary care pathways with off-loading, debridement and targeted antibiotic treatment central to positive clinical outcomes. Local administration of topical treatments and advanced wound dressings are often used for more superficial infections, and in combination with systemic antibiotics for more advanced infections. In practice, the choice of such topical approaches, whether alone or as adjuncts, is rarely evidence-based, and there does not appear to be a single market leader. There are several reasons for this, including a lack of clear evidence-based guidelines on their efficacy and a paucity of robust clinical trials. Nonetheless, with a growing number of people living with diabetes, preventing the progression of chronic foot infections to amputation is critical. Topical agents may increasingly play a role, especially as they have potential to limit the use of systemic antibiotics in an environment of increasing antibiotic resistance. While a number of advanced dressings are currently marketed for DFI, here we review the literature describing promising future-focused approaches for topical treatment of DFI that may overcome some of the current hurdles. Specifically, we focus on antibiotic-impregnated biomaterials, novel antimicrobial peptides and photodynamic therapy.
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Affiliation(s)
- Kaja Turzańska
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Education and Research Centre, Beaumont Hospital, D09 YD60 Dublin, Ireland
| | - Oluwafolajimi Adesanya
- School of Molecular and Cellular Biology, University of Illinois Urbana-Champaign, Champaign, IL 61801, USA
| | - Ashwene Rajagopal
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Education and Research Centre, Beaumont Hospital, D09 YD60 Dublin, Ireland
| | - Mary T. Pryce
- School of Chemical Sciences, Dublin City University, D09 V209 Dublin, Ireland
| | - Deirdre Fitzgerald Hughes
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Education and Research Centre, Beaumont Hospital, D09 YD60 Dublin, Ireland
- Correspondence: ; Tel.: +353-1-8093711
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Photodynamic therapy for treating infected skin wounds: A systematic review and meta-analysis from randomized clinical trials. Photodiagnosis Photodyn Ther 2022; 40:103118. [PMID: 36109003 DOI: 10.1016/j.pdpdt.2022.103118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/16/2022] [Accepted: 09/09/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Infected skin wounds represent a public health problem that effects 20 million people worldwide. Photodynamic therapy (PDT) is a treatment option with excellent results against several infections. OBJECTIVE This study aimed to perform a systematic review and meta-analysis on PDT efficacy for treating infected wounds based on randomized clinical trials (RCTs). METHODS PubMed, Scopus, Web of Science, SciELO, and the Cochrane library were searched. The Delphi List criteria and the Revised Cochrane risk-of-bias (Rob 2) were used for evaluating the quality of clinical trials. Meta-analyses were performed with the random-effect model. The odds ratio was the effect measure for binary outcomes, while the standard mean difference was used for continuous outcomes. The trim-and-fill method was used to detect small-study effects. The quality of evidence was verified for each outcome. RESULTS Only four out of 573 articles were selected for the qualitative and quantitative analyses. The most frequent cause of infected wounds was impaired venous circulation (75%). All studies used red LED light. PDT reduced healing time and improved the healing process and wound oxygenation. Patients treated with PDT showed 15% to 17% (p = 0.0003/ I2=0%) lower microbial cell viability in the wound and a significantly smaller wound size (0.72 cm2/p = 0.0187/I2=0%) than patients treated with placebo or red-light exposure. There was a high level of evidence for each meta-analysis outcome. CONCLUSION PDT can be an excellent alternative treatment for infected skin wounds, though larger trials are needed.
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14
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Machado CS, Seeger MG, Moreira KS, Burgo TAL, Iglesias BA, Vogel FSF, Cargnelutti JF. In vitro porphyrin-based photodynamic therapy against mono and polyculture of multidrug-resistant bacteria isolated from integumentary infections in animals. Photodiagnosis Photodyn Ther 2022; 40:103179. [PMID: 36334907 DOI: 10.1016/j.pdpdt.2022.103179] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/19/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022]
Abstract
Multidrug-resistant (MDR) organisms have been frequently isolated from integumentary lesions of animals, and these lesions are usually infected by more than one pathogen. This study evaluated an in vitro antimicrobial photodynamic therapy (aPDT) using two water-soluble tetra-cationic porphyrins (3-H2TMeP and 4-H2TMeP) against mono and polyculture of MDR bacteria isolated from dogs, cats, and horses. Ten isolates of MDR bacteria (two of each species: Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Serratia marcescens, and Staphylococcus pseudointermedius) were used to evaluate aPDT against the monoculture using a non-cytotoxic concentration of 3-H2TMeP and 4-H2TMeP porphyrins (40 µM), with 30 min of light irradiation in Gram-positive and 90 min for Gram-negative bacteria. The aPDT using the 4-H2TMeP porphyrin was also tested against five different polycultures (Coagulase positive Staphylococcus (CPS) and Pseudomonas sp.; E. coli and Proteus sp.; Pseudomonas sp. and Proteus sp.; CPS and E. coli; and CPS and Proteus sp.) for 90 min. The efficacy of both treatments was evaluated by plating the solution exposed to light or kept in the dark and counting the colonies forming units after 24 h of incubation at 37 °C. Atomic force microscope analysis was used to map bacteria morphological changes and extract adhesion force parameters from the bacteria membranes. Only the 4-H2TMeP porphyrin had antibacterial activity against MDR bacteria in monoculture, especially S. pseudointermedius and P. aeruginosa. In polyculture, the 4-H2TMeP porphyrin reduced bacterial concentrations (p < 0.05) in the associations of E. coli and S. pseudointermedius, P. aeruginosa and S. pseudointermedius, and P. aeruginosa and P. mirabilis. These results showed that aPDT using 4-H2TMeP is a good option for future associations of aPDT and other therapies or in vivo research.
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Affiliation(s)
- Carolina S Machado
- Programa de Pós-graduação em Medicina Veterinária (PPGMV) - Av. Roraima, Universidade Federal de Santa Maria (UFSM), 1000, prédio 97 - HVU, bairro Camobi, Santa Maria, RS CEP 97105-900, Brazil
| | - Marlane G Seeger
- Programa de Pós-graduação em Medicina Veterinária (PPGMV) - Av. Roraima, Universidade Federal de Santa Maria (UFSM), 1000, prédio 97 - HVU, bairro Camobi, Santa Maria, RS CEP 97105-900, Brazil
| | - Kelly S Moreira
- Coulomb Electrostatic and Mechanochemical Laboratory, Universidade Federal de Santa Maria (UFSM), Av. Roraima, 1000, Campus Camobi, Santa Maria, RS CEP 97105-900, Brazil
| | - Thiago A L Burgo
- Coulomb Electrostatic and Mechanochemical Laboratory, Universidade Federal de Santa Maria (UFSM), Av. Roraima, 1000, Campus Camobi, Santa Maria, RS CEP 97105-900, Brazil; Department of Chemistry and Environmental Sciences, Ibilce, São Paulo state University (Unesp), São José do Rio Preto, São Paulo, Brazil
| | - Bernardo A Iglesias
- Laboratório de Bioinorgânica e Materiais Porfirínicos - Departamento de Química, Universidade Federal de Santa Maria (UFSM), Av. Roraima, 1000, Campus Camobi, Santa Maria, RS CEP 97105-900, Brazil.
| | - Fernanda S F Vogel
- Departamento de Medicina Veterinária Preventiva (DMVP) - Av. Roraima, Universidade Federal de Santa Maria (UFSM), 1000, prédio 63D - bairro Camobi, Santa Maria, RS CEP 97105-900, Brazil
| | - Juliana F Cargnelutti
- Departamento de Medicina Veterinária Preventiva (DMVP) - Av. Roraima, Universidade Federal de Santa Maria (UFSM), 1000, prédio 63D - bairro Camobi, Santa Maria, RS CEP 97105-900, Brazil.
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15
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Antimicrobial and Photoantimicrobial Activities of Chitosan/CNPPV Nanocomposites. Int J Mol Sci 2022; 23:ijms232012519. [DOI: 10.3390/ijms232012519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/13/2022] [Accepted: 10/15/2022] [Indexed: 11/16/2022] Open
Abstract
Multidrug-resistant bacteria represent a global health and economic burden that urgently calls for new technologies to combat bacterial antimicrobial resistance. Here, we developed novel nanocomposites (NCPs) based on chitosan that display different degrees of acetylation (DAs), and conjugated polymer cyano-substituted poly(p-phenylene vinylene) (CNPPV) as an alternative approach to inactivate Gram-negative (E. coli) and Gram-positive (S. aureus) bacteria. Chitosan’s structure was confirmed through FT-Raman spectroscopy. Bactericidal and photobactericidal activities of NCPs were tested under dark and blue-light irradiation conditions, respectively. Hydrodynamic size and aqueous stability were determined by DLS, zeta potential (ZP) and time-domain NMR. TEM micrographs of NCPs were obtained, and their capacity of generating reactive oxygen species (ROS) under blue illumination was also characterized. Meaningful variations on ZP and relaxation time T2 confirmed successful physical attachment of chitosan/CNPPV. All NCPs exhibited a similar and shrunken spherical shape according to TEM. A lower DA is responsible for driving higher bactericidal performance alongside the synergistic effect from CNPPV, lower nanosized distribution profile and higher positive charged surface. ROS production was proportionally found in NCPs with and without CNPPV by decreasing the DA, leading to a remarkable photobactericidal effect under blue-light irradiation. Overall, our findings indicate that chitosan/CNPPV NCPs may constitute a valuable asset for the development of innovative strategies for inactivation and/or photoinactivation of bacteria.
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Combination of photodynamic antimicrobial chemotherapy and ciprofloxacin to combat S. aureus and E. coli resistant biofilms. Photodiagnosis Photodyn Ther 2022; 42:103142. [PMID: 36191747 DOI: 10.1016/j.pdpdt.2022.103142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/13/2022] [Accepted: 09/29/2022] [Indexed: 11/21/2022]
Abstract
Photodynamic antimicrobial chemotherapy (PACT) coupled with an antibiotic, ciprofloxacin (CIP), was investigated using two indium metallated cationic photosensitizers, a porphyrin (1) and a phthalocyanine (2). Applying PACT followed by the antibiotic treatment led to a remarkable reduction in the biofilm cell survival of two antibiotic-resistant bacterial strains, S. aureus (Gram-positive) and E. coli (Gram-nenative). Treating both bacteria strains with PACT alone showed no significant activity at 32 µM with 15 min irradiation, while CIP alone exhibited a minimum biofilm inhibition concentration (MBIC) at 4 and 8 µg/mL on S. aureus and E. coli, respectively following 24 h incubation. The combined treatment resulted in the complete eradication of the matured biofilms with high log10 reduction values of 7.05 and 7.20 on S. aureus and E. coli, respectively, at low concentrations. It was found that 15 min PACT irradiation of 8 µM of complexes (1 and 2) combined with 2 µg/mL of CIP have a 100% reduction of the resistant S. aureus biofilms. Whereas the total killing of E. coli was obtained when combining 8 µM of complex 1 and 16 µM of complex 2 both combined with 4 µg/mL of CIP.
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17
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Woźniak A, Grinholc M. Combined Antimicrobial Blue Light and Antibiotics as a Tool for Eradication of Multidrug-Resistant Isolates of Pseudomonas aeruginosa and Staphylococcus aureus: In Vitro and In Vivo Studies. Antioxidants (Basel) 2022; 11:antiox11091660. [PMID: 36139734 PMCID: PMC9495928 DOI: 10.3390/antiox11091660] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 11/16/2022] Open
Abstract
Increased development of resistance to antibiotics among microorganisms promotes the evaluation of alternative approaches. Within this study, we examined the efficacy of antimicrobial blue light (aBL) with routinely used antibiotics against multidrug-resistant isolates of Pseudomonas aeruginosa and Staphylococcus aureus as combined alternative treatment. In vitro results of this study confirm that both S. aureus and P. aeruginosa can be sensitized to antibiotics, such as chloramphenicol, linezolid, fusidic acid or colistin, fosfomycin and ciprofloxacin, respectively. The assessment of increased ROS production upon aBL exposure and the changes in cell envelopes permeability were also goals that were completed within the current study. Moreover, the in vivo experiment revealed that, indeed, the synergy between aBL and antibiotic (chloramphenicol) occurs, and the results in the reduced bioluminescence signal of the S. aureus Xen31 strain used to infect the animal wounds. To conclude, we are the first to present the possible mechanism explaining the observed synergies among photoinactivation with blue light and antibiotics in the term of Gram-positive and Gram-negative representatives.
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Felix L, Mishra B, Khader R, Ganesan N, Mylonakis E. In Vitro and In Vivo Bactericidal and Antibiofilm Efficacy of Alpha Mangostin Against Staphylococcus aureus Persister Cells. Front Cell Infect Microbiol 2022; 12:898794. [PMID: 35937701 PMCID: PMC9353584 DOI: 10.3389/fcimb.2022.898794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/23/2022] [Indexed: 11/23/2022] Open
Abstract
The formation of persister cells is associated with recalcitrance and infections. In this study, we examined the antimicrobial property of alpha mangostin, a natural xanthone molecule, against methicillin-resistant Staphylococcus aureus (MRSA) persisters and biofilm. The MIC of alpha mangostin against MRSA persisters was 2 µg/ml, and activity was mediated by causing membrane permeabilization within 30 min of exposure. The membrane activity of alpha mangostin was further studied by fast-killing kinetics of MRSA persiste r cells and found that the compound exhibited 99.99% bactericidal activity within 30 min. Furthermore, alpha mangostin disrupted established MRSA biofilms and inhibited bacterial attachment as biofilm formation. Alpha mangostin down-regulated genes associated with the formation of persister cells and biofilms, such as norA, norB, dnaK, groE, and mepR, ranging from 2 to 4-folds. Alpha mangostin at 16 μg/ml was non-toxic (> 95% cell survival) to liver-derived HepG2 and lung-derived A549 cells, similarly. Still, alpha mangostin exhibited 50% cell lysis of human RBC at 16 μg/ml. Interestingly, alpha mangostin was effective in vivo at increasing the survival up to 75% (p<0.0001) of Galleria mellonella larvae infected with MRSA persister for 120 h. In conclusion, we report that alpha mangostin is active against MRSA persisters and biofilms, and these data further our understanding of the antistaphylococcal activity and toxicity of this natural compound.
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19
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Xu X, Liu B, Wu H, Zhang Y, Tian X, Tian J, Liu T. Poly Lactic- co-Glycolic Acid-Coated Toluidine Blue Nanoparticles for the Antibacterial Therapy of Wounds. NANOMATERIALS (BASEL, SWITZERLAND) 2021; 11:3394. [PMID: 34947743 PMCID: PMC8708285 DOI: 10.3390/nano11123394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/03/2021] [Accepted: 12/09/2021] [Indexed: 12/03/2022]
Abstract
Bacterial infections in wounded skin are associated with high mortality. The emergence of drug-resistant bacteria in wounded skin has been a challenge. Toluidine blue (TB) is a safe and inexpensive photosensitizer that can be activated and used in near-infrared photodynamic therapy to effectively kill methicillin-resistant Staphylococcus aureus (MRSA). However, its aggregation-induced quenching effect largely affects its clinical applications. In this study, TB nanoparticles (NPs) were synthesized using an ultrasound-assisted coating method. Their physicochemical and biological properties were studied and evaluated by scanning electron microscopy and Fourier-transform infrared spectroscopy. The TBNPs had a broad-spectrum antibacterial activity against Gram-positive bacteria (MRSA) and Gram-negative bacteria (E. coli). In addition, MTT, hemolysis, and acute toxicity tests confirmed that TBNPs had good biocompatibility. The TBNPs exhibited a high photodynamic performance under laser irradiation and efficiently killed E. coli and MRSA through generated reactive oxygen species, which destroyed the cell wall structure. The potential application of TBNPs in vivo was studied using an MRSA-infected wound model. The TBNPs could promote wound healing within 7 days, mainly by reducing the inflammation and promoting collagen deposition and granulation tissue formation. In conclusion, the TBNPs offer a promising strategy for clinical applications against multiple-drug resistance.
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Affiliation(s)
| | | | | | | | | | - Jijing Tian
- Laboratory of Veterinary Pathology and Nanopathology, College of Veterinary Medicine, China Agricultural University, No. 2 West Road Yuanmingyuan, Beijing 100193, China; (X.X.); (B.L.); (H.W.); (Y.Z.); (X.T.)
| | - Tianlong Liu
- Laboratory of Veterinary Pathology and Nanopathology, College of Veterinary Medicine, China Agricultural University, No. 2 West Road Yuanmingyuan, Beijing 100193, China; (X.X.); (B.L.); (H.W.); (Y.Z.); (X.T.)
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20
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Wang D, Kuzma ML, Tan X, He TC, Dong C, Liu Z, Yang J. Phototherapy and optical waveguides for the treatment of infection. Adv Drug Deliv Rev 2021; 179:114036. [PMID: 34740763 PMCID: PMC8665112 DOI: 10.1016/j.addr.2021.114036] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/11/2021] [Accepted: 10/28/2021] [Indexed: 02/07/2023]
Abstract
With rapid emergence of multi-drug resistant microbes, it is imperative to seek alternative means for infection control. Optical waveguides are an auspicious delivery method for precise administration of phototherapy. Studies have shown that phototherapy is promising in fighting against a myriad of infectious pathogens (i.e. viruses, bacteria, fungi, and protozoa) including biofilm-forming species and drug-resistant strains while evading treatment resistance. When administered via optical waveguides, phototherapy can treat both superficial and deep-tissue infections while minimizing off-site effects that afflict conventional phototherapy and pharmacotherapy. Despite great therapeutic potential, exact mechanisms, materials, and fabrication designs to optimize this promising treatment option are underexplored. This review outlines principles and applications of phototherapy and optical waveguides for infection control. Research advances, challenges, and outlook regarding this delivery system are rigorously discussed in a hope to inspire future developments of optical waveguide-mediated phototherapy for the management of infection and beyond.
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Affiliation(s)
- Dingbowen Wang
- Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA
| | - Michelle Laurel Kuzma
- Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA
| | - Xinyu Tan
- Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA; Academy of Orthopedics, Provincial Key Laboratory of Bone and Joint Degenerative Diseases, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong Province 510280, China
| | - Tong-Chuan He
- Molecular Oncology Laboratory, Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago Medical Center, Chicago, IL 60637, USA; Department of Surgery, The University of Chicago Medical Center, Chicago, IL 60637, USA
| | - Cheng Dong
- Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA
| | - Zhiwen Liu
- Department of Electrical Engineering, Materials Research Institute, The Pennsylvania State University, University Park, PA 16802, USA
| | - Jian Yang
- Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA.
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Feng Y, Coradi Tonon C, Ashraf S, Hasan T. Photodynamic and antibiotic therapy in combination against bacterial infections: efficacy, determinants, mechanisms, and future perspectives. Adv Drug Deliv Rev 2021; 177:113941. [PMID: 34419503 DOI: 10.1016/j.addr.2021.113941] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/23/2021] [Accepted: 08/17/2021] [Indexed: 12/12/2022]
Abstract
Antibiotic treatment, the mainstay for the control of bacterial infections, is greatly hampered by the global prevalence of multidrug-resistant (MDR) bacteria. Photodynamic therapy (PDT) is effective against MDR infections, but PDT-induced bacterial inactivation is often incomplete, causing the relapse of infections. Combination of PDT and antibiotics is a promising strategy to overcome the limitation of both antibiotic treatment and PDT, exerting increased disinfection efficacy on MDR bacterial pathogens versus either of the monotherapies alone. In this review, we present an overview of the therapeutic effects of PDT/antibiotic combinations that have been developed. We further summarize the influencing factors and the governing molecular mechanisms of the therapeutic outcomes of PDT/antibiotic combinations. In the end, we provide concluding remarks on the strengths, limitations, and future research directions of PDT/antibiotic combination therapy to guide its appropriate usage and further development.
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Affiliation(s)
- Yanfang Feng
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Caroline Coradi Tonon
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Shoaib Ashraf
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Tayyaba Hasan
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Health Sciences and Technology (Harvard-MIT), Cambridge, MA, USA.
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22
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Photodynamic Therapy Combined with Antibiotics or Antifungals against Microorganisms That Cause Skin and Soft Tissue Infections: A Planktonic and Biofilm Approach to Overcome Resistances. Pharmaceuticals (Basel) 2021; 14:ph14070603. [PMID: 34201530 PMCID: PMC8308592 DOI: 10.3390/ph14070603] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 12/18/2022] Open
Abstract
The present review covers combination approaches of antimicrobial photodynamic therapy (aPDT) plus antibiotics or antifungals to attack bacteria and fungi in vitro (both planktonic and biofilm forms) focused on those microorganisms that cause infections in skin and soft tissues. The combination can prevent failure in the fight against these microorganisms: antimicrobial drugs can increase the susceptibility of microorganisms to aPDT and prevent the possibility of regrowth of those that were not inactivated during the irradiation; meanwhile, aPDT is effective regardless of the resistance pattern of the strain and their use does not contribute to the selection of antimicrobial resistance. Additive or synergistic antimicrobial effects in vitro are evaluated and the best combinations are presented. The use of combined treatment of aPDT with antimicrobials could help overcome the difficulty of fighting high level of resistance microorganisms and, as it is a multi-target approach, it could make the selection of resistant microorganisms more difficult.
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Towards effective cutaneous leishmaniasis treatment with light-based technologies. A systematic review and meta-analysis of preclinical studies. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2021; 221:112236. [PMID: 34090038 DOI: 10.1016/j.jphotobiol.2021.112236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/12/2021] [Accepted: 05/29/2021] [Indexed: 02/02/2023]
Abstract
Cutaneous leishmaniasis (CL) is a neglected disease that represents a serious global public health concern. We performed a systematic review with meta-analysis targeting the use of light-based therapies on CL in preclinical studies since they are essential to identify the benefits, challenges, and limitations of proposing new technologies to fight CL. We searched Pubmed and Web of Science to include original preclinical researches in English that used light-based technologies to fight CL. Inclusion criteria encompassed any animal model for CL induction, an untreated infected group as the comparator, reliable and consistent methodology to develop and treat CL, focus on an antimicrobial therapeutic approach, and data for lesion size and/or parasite load in the infection site. We identified eight eligible articles, and all of them used photodynamic therapy (PDT). For the meta-analysis, three studies were included regarding the parasite load in the infection site and four comprised the lesion size. No overall statistically significant differences were observed between untreated control and PDT groups for parasite load. Differently, PDT significantly reduced the lesion size regardless of the protocol used to treat CL (in mm, SMD: -1.90; 95% CI: -3.74 to -0.07, p = 0.04). This finding is particularly encouraging since CL promotes disfiguring lesions that profoundly affect the quality of life of patients. We conclude that PDT is a new promising technology able to be topically used against CL if applied in more than one session, making it a promising ally for the management of CL.
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Wang S, Wang X, Yu L, Sun M. Progress and trends of photodynamic therapy: From traditional photosensitizers to AIE-based photosensitizers. Photodiagnosis Photodyn Ther 2021; 34:102254. [PMID: 33713845 DOI: 10.1016/j.pdpdt.2021.102254] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/16/2021] [Accepted: 03/05/2021] [Indexed: 02/06/2023]
Abstract
Photodynamic therapy (PDT) is an established clinical treatment technology which utilizes excitation light of a specific wavelength to activate photosensitizers (PSs) to generate reactive oxygen species (ROS), which leads to cancer cell death. Over the past decades of PDT research, progress have been made in the development of PSs. However, many inherent characteristics of traditional PSs have caused various problems in PDT, such as low treatment efficiency at aggregation state and shallow treatment depth. In solution to these problems, aggregation-induced emission (AIE)-based PSs have been reported in recent years. Here, this article reviews the design strategy and the biomedical applications of AIE PSs in detail, which begins with a summary of traditional PSs for a comparison between traditional PSs and AIE PSs. Subsequently, the different functional AIE PSs in photodynamic cancer cells ablation and image-guided therapy are discussed in detail taking controllable excitation wavelength, stimulus response and PDT/photothermal therapy synergistic effect as examples. These studies have demonstrated the great potential of AIE PSs as effective theranostic agents. And the review provides references for the development of new PSs and hopefully spur research interest in AIE PSs for future clinical application.
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Affiliation(s)
- Shuai Wang
- School of Materials Science and Engineering, Ocean University of China, Qingdao, 266100, PR China
| | - Xiao Wang
- State Key Laboratory of Marine Coatings, Marine Chemical Research Institute Co., Ltd., Qingdao, 266071, PR China
| | - Liangmin Yu
- Key Laboratory of Marine Chemistry Theory and Technology, Ministry of Education, Ocean University of China, Qingdao, 266100, PR China
| | - Mingliang Sun
- School of Materials Science and Engineering, Ocean University of China, Qingdao, 266100, PR China; State Key Laboratory of Marine Coatings, Marine Chemical Research Institute Co., Ltd., Qingdao, 266071, PR China; Institute of Polymer Optoelectronic Materials and Devices, State Key Laboratory of Luminescent Materials and Devices, South China University of Technology, Guangzhou 510640, China.
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Pieranski M, Sitkiewicz I, Grinholc M. Increased photoinactivation stress tolerance of Streptococcus agalactiae upon consecutive sublethal phototreatments. Free Radic Biol Med 2020; 160:657-669. [PMID: 32916279 DOI: 10.1016/j.freeradbiomed.2020.09.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/24/2020] [Accepted: 09/02/2020] [Indexed: 02/08/2023]
Abstract
Streptococcus agalactiae (Group B Streptococcus, GBS) is a common commensal bacterium in adults but remains a leading source of invasive infections in newborns, pregnant women, and the elderly, and more recently, causes an increased incidence of invasive disease in nonpregnant adults. Reduced penicillin susceptibility and emerging resistance to non-β-lactams pose challenges for the development and implementation of novel, nonantimicrobial strategies to reduce the burden of GBS infections. Antimicrobial photodynamic inactivation (aPDI) via the production of singlet oxygen or other reactive oxygen species leads to the successful eradication of pathogenic bacteria, affecting numerous cellular targets of microbial pathogens and indicating a low risk of resistance development. Nevertheless, we have previously reported possible aPDI tolerance development upon repeated sublethal aPDI applications; thus, the current work was aimed at investigating whether aPDI tolerance could be observed for GBS and what mechanisms could cause it. To address this problem, 10 cycles of sublethal aPDI treatments employing rose bengal as a photosensitizer, were applied to the S. agalactiae ATCC 27956 reference strain and two clinical isolates (2306/02 and 2974/07, serotypes III and V, respectively). We demonstrated aPDI tolerance development and stability after 5 cycles of subculturing with no aPDI exposure. Though the treatment resulted in a stable phenotype, no increases in mutation rate or accumulated genetic alterations were observed (employing a RIF-, CIP-, STR-resistant mutant selection assay and cyl sequencing, respectively). qRT-PCR analysis demonstrated that 10 sublethal aPDI exposures led to increased expression of all tested major oxidative stress response elements; changes in sodA, ahpC, npx, cylE, tpx and recA expression indicate possible mechanisms of developed tolerance. Increased expression upon sublethal aPDI treatment was reported for all but two genes, namely, ahpC and cylE. aPDI targeting cylE was further supported by colony morphology changes induced with 10 cycles of aPDI (increased SCV population, increased hemolysis, increased numbers of dark- and unpigmented colonies). In oxidant killing assays, aPDI-tolerant strains demonstrated no increased tolerance to hypochlorite, superoxide (paraquat), singlet oxygen (new methylene blue) or oxidative stress induced by aPDI employing a structurally different photosensitizer, i.e., zinc phthalocyanine, indicating a lack of cross resistance. The results indicate that S. agalactiae may develop stable aPDI tolerance but not resistance when subjected to multiple sublethal phototreatments, and this risk should be considered significant when defining efficient anti-S. agalactiae aPDI protocols.
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Affiliation(s)
- Michal Pieranski
- Intercollegiate Faculty of Biotechnology, Laboratory of Molecular Diagnostics, University of Gdansk and Medical University of Gdansk, Abrahama 58, 80-307, Gdansk, Poland
| | - Izabela Sitkiewicz
- Department of Drug Biotechnology and Bioinformatics, National Medicines Institute, Chelmska 30/34, 00-725, Warszawa, Poland
| | - Mariusz Grinholc
- Intercollegiate Faculty of Biotechnology, Laboratory of Molecular Diagnostics, University of Gdansk and Medical University of Gdansk, Abrahama 58, 80-307, Gdansk, Poland.
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Klausen M, Ucuncu M, Bradley M. Design of Photosensitizing Agents for Targeted Antimicrobial Photodynamic Therapy. Molecules 2020; 25:E5239. [PMID: 33182751 PMCID: PMC7696090 DOI: 10.3390/molecules25225239] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/18/2022] Open
Abstract
Photodynamic inactivation of microorganisms has gained substantial attention due to its unique mode of action, in which pathogens are unable to generate resistance, and due to the fact that it can be applied in a minimally invasive manner. In photodynamic therapy (PDT), a non-toxic photosensitizer (PS) is activated by a specific wavelength of light and generates highly cytotoxic reactive oxygen species (ROS) such as superoxide (O2-, type-I mechanism) or singlet oxygen (1O2*, type-II mechanism). Although it offers many advantages over conventional treatment methods, ROS-mediated microbial killing is often faced with the issues of accessibility, poor selectivity and off-target damage. Thus, several strategies have been employed to develop target-specific antimicrobial PDT (aPDT). This includes conjugation of known PS building-blocks to either non-specific cationic moieties or target-specific antibiotics and antimicrobial peptides, or combining them with targeting nanomaterials. In this review, we summarise these general strategies and related challenges, and highlight recent developments in targeted aPDT.
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Affiliation(s)
- Maxime Klausen
- School of Chemistry and the EPSRC IRC Proteus, University of Edinburgh, Joseph Black Building, David Brewster Road, Edinburgh EH9 3FJ, UK;
| | - Muhammed Ucuncu
- School of Chemistry and the EPSRC IRC Proteus, University of Edinburgh, Joseph Black Building, David Brewster Road, Edinburgh EH9 3FJ, UK;
- Department of Analytical Chemistry, Faculty of Pharmacy, Izmir Katip Celebi University, Izmir 35620, Turkey
| | - Mark Bradley
- School of Chemistry and the EPSRC IRC Proteus, University of Edinburgh, Joseph Black Building, David Brewster Road, Edinburgh EH9 3FJ, UK;
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Schramm S, Hiller KA, Cantzler S, Weilemann H, Cantzler M, Zimmermann JL, Cieplik F, Maisch T. The Latest Time Point of Retreatment (LTPR) as a Novel Method to Determine Antibacterial Effects for Binary Use of Cold Atmospheric Plasma and Conventional Agents. Front Microbiol 2020; 11:576500. [PMID: 33193191 PMCID: PMC7658100 DOI: 10.3389/fmicb.2020.576500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/07/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sandra Schramm
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | | | | | | | | | - Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Tim Maisch
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
- *Correspondence: Tim Maisch,
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Afrasiabi S, Pourhajibagher M, Chiniforush N, Bahador A. Propolis nanoparticle enhances the potency of antimicrobial photodynamic therapy against Streptococcus mutans in a synergistic manner. Sci Rep 2020; 10:15560. [PMID: 32968097 PMCID: PMC7511362 DOI: 10.1038/s41598-020-72119-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 08/20/2020] [Indexed: 01/28/2023] Open
Abstract
Less invasive removal approaches have been recommended for deep caries lesions. Antimicrobial photodynamic therapy (aPDT) and propolis nanoparticle (PNP) are highlighted for the caries management plan. Evidence is lacking for an additive effect of combination PNP with photosensitizer (PS) in aPDT. This study aimed to investigate the individual and synergistic effects of chlorophyllin-phycocyanin mixture (PhotoActive+) and toluidine blue O (TBO) as PSs in combination with PNP in the aPDT process (aPDTplus) against major important virulence factors of Streptococcus mutans. Following characterization, biocompatibility of the PSs alone, or in combination with PNP were investigated on human gingival fibroblast cell. The in vitro synergy of PhotoActive+ or TBO and PNP was evaluated by the checkerboard method. The bacteria's virulence properties were surveyed in the presence of the PSs, individually as well as in combination. When the PSs were examined in combination (synergistic effect, FIC Index < 0.5), a stronger growth inhibitory activity was exhibited than the individual PSs. The biofilm formation, as well as genes involved in biofilm formation, showed greater suppression when the PSs were employed in combination. Overall, the results of this study suggest that the combination of PhotoActive+ or TBO with PNP with the least cytotoxicity effects and the highest antimicrobial activites would improve aPDT outcomes, leading to synergistic effects and impairing the virulence of S. mutans.
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Affiliation(s)
- Shima Afrasiabi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Pourhajibagher
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Chiniforush
- Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Abbas Bahador
- Oral Microbiology Laboratory, Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Keshavarz Blvd, 100 Poursina Ave., 14167-53955, Tehran, Iran.
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Martínez SR, Ibarra LE, Ponzio RA, Forcone MV, Wendel AB, Chesta CA, Spesia MB, Palacios RE. Photodynamic Inactivation of ESKAPE Group Bacterial Pathogens in Planktonic and Biofilm Cultures Using Metallated Porphyrin-Doped Conjugated Polymer Nanoparticles. ACS Infect Dis 2020; 6:2202-2213. [PMID: 32538610 DOI: 10.1021/acsinfecdis.0c00268] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Photodynamic inactivation (PDI) protocols using photoactive metallated porphyrin-doped conjugated polymer nanoparticles (CPNs) and blue light were developed to eliminate multidrug-resistant pathogens. CPNs-PDI protocols using varying particle concentrations and irradiation doses were tested against nine pathogenic bacterial strains including antibiotic-resistant bacteria of the ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) pathogens group. The bactericidal effect was achieved in methicillin-resistant Staphylococus aureus (S. aureus) strains using low light doses (9.6-14.4 J/cm2), while Gram-negative bacteria required a higher light dose (28.8 J/cm2). The bacteria-CPN interaction was studied through flow cytometry, taking advantage of the intrinsic CPN fluorescence, demonstrating that CPNs efficiently bind to the bacterial envelope. Finally, the performance of CPNs-PDI was explored in biofilms; good antibiofilm ability and almost complete eradication were observed for S. aureus and Escherichia coli biofilms, respectively, using confocal microscopy. Overall, we demonstrated that CPNs-PDI is an efficient tool not only to kill superbugs as sessile cells but also to disrupt and eradicate biofilms of highly relevant pathogenic bacterial species.
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Affiliation(s)
- Sol R. Martínez
- Instituto de Investigaciones en Tecnologı́as Energéticas y Materiales Avanzados (IITEMA), Universidad Nacional de Rı́o Cuarto, Consejo Nacional de Investigaciones Cientı́ficas y Tecnológicas (CONICET), Rı́o Cuarto, Córdoba X5804BYA, Argentina
| | - Luis E. Ibarra
- Instituto de Biotecnologı́a Ambiental y Salud (INBIAS), Universidad Nacional de Rı́o Cuarto, Consejo Nacional de Investigaciones Cientı́ficas y Tecnológicas (CONICET), Rı́o Cuarto, Córdoba X5804BYA, Argentina
| | - Rodrigo A. Ponzio
- Instituto de Investigaciones en Tecnologı́as Energéticas y Materiales Avanzados (IITEMA), Universidad Nacional de Rı́o Cuarto, Consejo Nacional de Investigaciones Cientı́ficas y Tecnológicas (CONICET), Rı́o Cuarto, Córdoba X5804BYA, Argentina
| | | | | | - Carlos A. Chesta
- Instituto de Investigaciones en Tecnologı́as Energéticas y Materiales Avanzados (IITEMA), Universidad Nacional de Rı́o Cuarto, Consejo Nacional de Investigaciones Cientı́ficas y Tecnológicas (CONICET), Rı́o Cuarto, Córdoba X5804BYA, Argentina
| | - Mariana B. Spesia
- Instituto de Desarrollo Agroindustrial y de la Salud (IDAS), Universidad Nacional de Rı́o Cuarto, Consejo Nacional de Investigaciones Cientı́ficas y Tecnológicas (CONICET), Rı́o Cuarto, Córdoba X5804BYA, Argentina
| | - Rodrigo E. Palacios
- Instituto de Investigaciones en Tecnologı́as Energéticas y Materiales Avanzados (IITEMA), Universidad Nacional de Rı́o Cuarto, Consejo Nacional de Investigaciones Cientı́ficas y Tecnológicas (CONICET), Rı́o Cuarto, Córdoba X5804BYA, Argentina
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Modelling the Anti-Methicillin-Resistant Staphylococcus Aureus (MRSA) Activity of Cannabinoids: A QSAR and Docking Study. CRYSTALS 2020. [DOI: 10.3390/cryst10080692] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Twenty-four cannabinoids active against MRSA SA1199B and XU212 were optimized at WB97XD/6-31G(d,p), and several molecular descriptors were obtained. Using a multiple linear regression method, several mathematical models with statistical significance were obtained. The robustness of the models was validated, employing the leave-one-out cross-validation and Y-scrambling methods. The entire data set was docked against penicillin-binding protein, iso-tyrosyl tRNA synthetase, and DNA gyrase. The most active cannabinoids had high affinity to penicillin-binding protein (PBP), whereas the least active compounds had low affinities for all of the targets. Among the cannabinoid compounds, Cannabinoid 2 was highlighted due to its suitable combination of both antimicrobial activity and higher scoring values against the selected target; therefore, its docking performance was compared to that of oxacillin, a commercial PBP inhibitor. The 2D figures reveal that both compounds hit the protein in the active site with a similar type of molecular interaction, where the hydroxyl groups in the aromatic ring of cannabinoids play a pivotal role in the biological activity. These results provide some evidence that the anti-Staphylococcus aureus activity of these cannabinoids may be related to the inhibition of the PBP protein; besides, the robustness of the models along with the docking and Quantitative Structure–Activity Relationship (QSAR) results allow the proposal of three new compounds; the predicted activity combined with the scoring values against PBP should encourage future synthesis and experimental testing.
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31
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Fonseca G, Dourado D, Barreto M, Cavalcanti M, Pavelski M, Ribeiro L, Frigo L. Antimicrobial Photodynamic Therapy (aPDT) for decontamination of high-speed handpieces: A comparative study. Photodiagnosis Photodyn Ther 2020; 30:101686. [DOI: 10.1016/j.pdpdt.2020.101686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 02/05/2020] [Accepted: 02/14/2020] [Indexed: 12/28/2022]
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Dharmaratne P, Sapugahawatte DN, Wang B, Chan CL, Lau KM, Lau CB, Fung KP, Ng DK, Ip M. Contemporary approaches and future perspectives of antibacterial photodynamic therapy (aPDT) against methicillin-resistant Staphylococcus aureus (MRSA): A systematic review. Eur J Med Chem 2020; 200:112341. [PMID: 32505848 DOI: 10.1016/j.ejmech.2020.112341] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/15/2020] [Accepted: 04/15/2020] [Indexed: 11/19/2022]
Abstract
The high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) causing skin and soft tissue infections in both the community and healthcare settings challenges the limited options of effective antibiotics and motivates the search for alternative therapeutic solutions, such as antibacterial photodynamic therapy (aPDT). While many publications have described the promising anti-bacterial activities of PDT in vitro, its applications in vivo and in the clinic have been very limited. This limited availability may in part be due to variabilities in the selected photosensitizing agents (PS), the variable testing conditions used to examine anti-bacterial activities and their effectiveness in treating MRSA infections. We thus sought to systematically review and examine the evidence from existing studies on aPDT associated with MRSA and to critically appraise its current state of development and areas to be addressed in future studies. In 2018, we developed and registered a review protocol in the International Prospective Register of Systematic Reviews (PROSPERO) with registration No: CRD42018086736. Three bibliographical databases were consulted (PUBMED, MEDLINE, and EMBASE), and a total of 113 studies were included in this systematic review based on our eligibility criteria. Many variables, such as the use of a wide range of solvents, pre-irradiation times, irradiation times, light sources and light doses, have been used in the methods reported by researchers, which significantly affect the inter-study comparability and results. On another note, new approaches of linking immunoglobulin G (IgG), antibodies, efflux pump inhibitors, and bacteriophages with photosensitizers (PSs) and the incorporation of PSs into nano-scale delivery systems exert a direct effect on improving aPDT. Enhanced activities have also been achieved by optimizing the physicochemical properties of the PSs, such as the introduction of highly lipophilic, poly-cationic and site-specific modifications of the compounds. However, few in vivo studies (n = 17) have been conducted to translate aPDT into preclinical studies. We anticipate that further standardization of the experimental conditions and assessing the efficacy in vivo would allow this technology to be further applied in preclinical trials, so that aPDT would develop to become a sustainable, alternative therapeutic option against MRSA infection in the future.
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Affiliation(s)
- Priyanga Dharmaratne
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong (SAR), China.
| | | | - Baiyan Wang
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong (SAR), China.
| | - Chung Lap Chan
- Institute of Chinese Medicine and State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, The Chinese University of Hong Kong, China.
| | - Kit-Man Lau
- Institute of Chinese Medicine and State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, The Chinese University of Hong Kong, China.
| | - Clara Bs Lau
- Institute of Chinese Medicine and State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, The Chinese University of Hong Kong, China.
| | - Kwok Pui Fung
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong (SAR), China; CUHK-Zhejiang University Joint Laboratory on Natural Products and Toxicology Research, China.
| | - Dennis Kp Ng
- Department of Chemistry, Faculty of Science, The Chinese University of Hong Kong, Hong Kong (SAR), China
| | - Margaret Ip
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong (SAR), China; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China.
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33
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Malik Z. Photodynamic inactivation of antibiotic‐resistant Gram‐positive bacteria: Challenges and opportunities. TRANSLATIONAL BIOPHOTONICS 2020. [DOI: 10.1002/tbio.201900030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Zvi Malik
- Faculty of Life ScienceBar‐Ilan University Ramat‐Gan Israel
- Zefat Academic College Zefat Israel
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Costa Magacho C, Guerra Pinto J, Müller Nunes Souza B, Correia Pereira AH, Ferreira-Strixino J. Comparison of photodynamic therapy with methylene blue associated with ceftriaxone in gram-negative bacteria; an in vitro study. Photodiagnosis Photodyn Ther 2020; 30:101691. [PMID: 32109621 DOI: 10.1016/j.pdpdt.2020.101691] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 01/22/2020] [Accepted: 02/21/2020] [Indexed: 12/11/2022]
Abstract
The resistance of microorganisms increases the need for new antimicrobial therapies. The aim of this study was to evaluate the in vitro action of photodynamic therapy and its combination with ceftriaxone in third generation cephalosporin resistant gram-negative bacteria. Clinical strains of Klebsiella pneumoniae, Enterobacter aerogenes and Escherichia coli were obtained, incubated with MB for 15 min combined or not with ceftriaxone and irradiated with fluence of 10 and 25 J/cm². MB internalization was evaluated by confocal microscopy. Cell viability was assessed by counting colony forming units and bacterian metabolism by the resazurin test. MB has been observed within cells, although not in all bacteria. PDT-MB alone and combined with Ceftriaxone reduced bacterial growth by approximately 1 log at 10 J/cm² of fluence and 4 logs by 25 J/cm², with a significant difference from the control group. The reduction in bacterial growth between the treated groups was similar, without significant difference between them. The Resazurin test showed lower bacterial metabolic activity in the treated groups, but it did not allow to observe difference between fluences. It was concluded with this study that the internalization of MB was not observed in all cells of K. pneumoniae, E. aerogenes and E. coli strains. There was less bacterial metabolic activity in the treated groups, with no variation between different fluences. PDT-MB 25 J/cm² alone and combined with Ceftriaxone showed antimicrobial action, but the PDT-MB/Ceftriaxone combination had no potentiating effect.
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Affiliation(s)
- Christiane Costa Magacho
- Laboratório de Fotobiologia Aplicada à Saúde (FOTOBIOS), Instituto de Pesquisa e Desenvolvimento, Universidade do Vale do Paraíba, São José dos Campos, São Paulo, Brazil
| | - Juliana Guerra Pinto
- Laboratório de Fotobiologia Aplicada à Saúde (FOTOBIOS), Instituto de Pesquisa e Desenvolvimento, Universidade do Vale do Paraíba, São José dos Campos, São Paulo, Brazil
| | - Beatriz Müller Nunes Souza
- Laboratório de Fotobiologia Aplicada à Saúde (FOTOBIOS), Instituto de Pesquisa e Desenvolvimento, Universidade do Vale do Paraíba, São José dos Campos, São Paulo, Brazil
| | - André Henrique Correia Pereira
- Laboratório de Fotobiologia Aplicada à Saúde (FOTOBIOS), Instituto de Pesquisa e Desenvolvimento, Universidade do Vale do Paraíba, São José dos Campos, São Paulo, Brazil
| | - Juliana Ferreira-Strixino
- Laboratório de Fotobiologia Aplicada à Saúde (FOTOBIOS), Instituto de Pesquisa e Desenvolvimento, Universidade do Vale do Paraíba, São José dos Campos, São Paulo, Brazil.
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Gao Z, Van Nostrand JD, Zhou J, Zhong W, Chen K, Guo J. Anti-listeria Activities of Linalool and Its Mechanism Revealed by Comparative Transcriptome Analysis. Front Microbiol 2019; 10:2947. [PMID: 31921091 PMCID: PMC6938037 DOI: 10.3389/fmicb.2019.02947] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 12/06/2019] [Indexed: 01/17/2023] Open
Abstract
Listeria monocytogenes, which causes serious foodborne infections and public health problems worldwide, is one of the most important foodborne pathogens. Linalool has been identified as an antimicrobial agent against some microorganism, but its mechanism of action is currently unclear. Here, we investigated the efficacy of linalool against L. monocytogenes while planktonic and as a biofilm and explored potential mechanisms of action. Linalool exhibited strong anti-listeria activity in the planktonic stage. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) observations revealed seven stages were classified of cells at microscopic level. Mesosome-like structures were observed for the first time in L. monocytogenes after linalool treatment. Linalool also showed significant anti-biofilm activity through both dispersal and killing of cells in the biofilm based on confocal scanning laser microscopy (CLSM) and SEM imaging, crystal violet staining, XTT and COMSTAT assays. Moreover, comparative transcriptome analysis demonstrated many potential mechanisms of action for linalool and some important pathways were screened out through the analysis of GO enrichment and KEGG. Our study provides evidence that linalool exhibits a strong antimicrobial activity against both the planktonic and biofilm forms of L. monocytogenes and gives insight into its mechanism of action.
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Affiliation(s)
- Zhipeng Gao
- Hunan Engineering Technology Research Center of Featured Aquatic Resources Utilization, College of Animal Science and Technology, Hunan Agricultural University, Changsha, China
| | - Joy D Van Nostrand
- Institute for Environmental Genomics, University of Oklahoma, Norman, OK, United States
| | - Jizhong Zhou
- Institute for Environmental Genomics, University of Oklahoma, Norman, OK, United States
| | - Weiming Zhong
- Hunan Engineering Technology Research Center of Featured Aquatic Resources Utilization, College of Animal Science and Technology, Hunan Agricultural University, Changsha, China
| | - Kangyong Chen
- Hunan Engineering Technology Research Center of Featured Aquatic Resources Utilization, College of Animal Science and Technology, Hunan Agricultural University, Changsha, China
| | - Jiajing Guo
- International Joint Lab on Fruits and Vegetables Processing, Quality and Safety, Hunan Key Lab of Fruits and Vegetables Storage, Processing, Quality and Safety, Hunan Agriculture Product Processing Institute, Hunan Academy of Agricultural Sciences, Changsha, China
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36
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Calixto GMF, de Annunzio SR, Victorelli FD, Frade ML, Ferreira PS, Chorilli M, Fontana CR. Chitosan-Based Drug Delivery Systems for Optimization of Photodynamic Therapy: a Review. AAPS PharmSciTech 2019; 20:253. [PMID: 31309346 DOI: 10.1208/s12249-019-1407-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 04/26/2019] [Indexed: 02/08/2023] Open
Abstract
Drug delivery systems (DDS) can be designed to enrich the pharmacological and therapeutic properties of several drugs. Many of the initial obstacles that impeded the clinical applications of conventional DDS have been overcome with nanotechnology-based DDS, especially those formed by chitosan (CS). CS is a linear polysaccharide obtained by the deacetylation of chitin, which has potential properties such as biocompatibility, hydrophilicity, biodegradability, non-toxicity, high bioavailability, simplicity of modification, aqueous solubility, and excellent chemical resistance. Furthermore, CS can prepare several DDS as films, gels, nanoparticles, and microparticles to improve delivery of drugs, such as photosensitizers (PS). Thus, CS-based DDS are broadly investigated for photodynamic therapy (PDT) of cancer and fungal and bacterial diseases. In PDT, a PS is activated by light of a specific wavelength, which provokes selective damage to the target tissue and its surrounding vasculature, but most PS have low water solubility and cutaneous photosensitivity impairing the clinical use of PDT. Based on this, the application of nanotechnology using chitosan-based DDS in PDT may offer great possibilities in the treatment of diseases. Therefore, this review presents numerous applications of chitosan-based DDS in order to improve the PDT for cancer and fungal and bacterial diseases.
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Indocyanine Green-Mediated Photodynamic Therapy Reduces Methicillin-Resistant Staphylococcus aureus Drug Resistance. J Clin Med 2019; 8:jcm8030411. [PMID: 30934605 PMCID: PMC6463108 DOI: 10.3390/jcm8030411] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/10/2019] [Accepted: 03/21/2019] [Indexed: 02/05/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) skin-wound infections are associated with considerable morbidity and mortality. Indocyanine green (ICG), a safe and inexpensive dye used in clinical imaging, can be activated by near-infrared in photodynamic therapy (PDT) and photothermal therapy (PTT) to effectively kill MRSA. However, how this treatment affects MRSA drug sensitivity remains unknown. The drug-sensitivity phenotypes, bacterial growth rate, and cell-wall thickness of three MRSA strains were analyzed after ICG-PDT. Drug-resistant gene expressions were determined by polymerase chain reaction (PCR) and quantitative reverse transcription (qRT)-PCR. Related protein expressions were examined with immunoblotting. Drug sensitivity was further evaluated in animal models. MRSA that survived the treatment grew faster, and the cell wall became thinner compared to parental cells. These cells became more sensitive to oxacillin, which was partly related to mecA complex gene deletion. Skin necrosis caused by ICG-PDT-treated MRSA infection was smaller and healed faster than that infected with parental cells. With oxacillin therapy, no bacteria could be isolated from mouse lung tissue infected with ICG-PDT-treated MRSA. ICG-PDT drives MRSA toward an oxacillin-sensitive phenotype. It has the potential to develop into an alternative or adjuvant clinical treatment against MRSA wound infections.
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Abstract
Staphylococcus aureus is one of the most important human pathogens that is responsible for a variety of diseases ranging from skin and soft tissue infections to endocarditis and sepsis. In recent decades, the treatment of staphylococcal infections has become increasingly difficult as the prevalence of multi-drug resistant strains continues to rise. With increasing mortality rates and medical costs associated with drug resistant strains, there is an urgent need for alternative therapeutic options. Many innovative strategies for alternative drug development are being pursued, including disruption of biofilms, inhibition of virulence factor production, bacteriophage-derived antimicrobials, anti-staphylococcal vaccines, and light-based therapies. While many compounds and methods still need further study to determine their feasibility, some are quickly approaching clinical application and may be available in the near future.
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Wozniak A, Grinholc M. Combined Antimicrobial Activity of Photodynamic Inactivation and Antimicrobials-State of the Art. Front Microbiol 2018; 9:930. [PMID: 29867839 PMCID: PMC5952179 DOI: 10.3389/fmicb.2018.00930] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 04/20/2018] [Indexed: 11/13/2022] Open
Abstract
Antimicrobial photodynamic inactivation (aPDI) is a promising tool for the eradication of life-threatening pathogens with different profiles of resistance. This study presents the state-of-the-art published studies that have been dedicated to analyzing the bactericidal effects of combining aPDI and routinely applied antibiotics in in vitro (using biofilm and planktonic cultures) and in vivo experiments. Furthermore, the current paper reviews the methodology used to obtain the published data that describes the synergy between these antimicrobial approaches. The authors are convinced that even though the combined efficacy of aPDI and antimicrobials could be investigated with the wide range of methods, the use of a unified experimental methodology that is in agreement with antimicrobial susceptibility testing (AST) is required to investigate possible synergistic cooperation between aPDI and antimicrobials. Conclusions concerning the possible synergistic activity between the two treatments can be drawn only when appropriate assays are employed. It must be noticed that some of the described papers were just aimed at determination if combined treatments exert enhanced antibacterial outcome, without following the standard methodology to evaluate the synergistic effect, but in most of them (18 out of 27) authors indicated the existence of synergy between described antibacterial approaches. In general, the increase in bacterial inactivation was observed when both therapies were used in combination.
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Affiliation(s)
- Agata Wozniak
- Laboratory of Molecular Diagnostics, Department of Biotechnology, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Gdansk, Poland
| | - Mariusz Grinholc
- Laboratory of Molecular Diagnostics, Department of Biotechnology, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Gdansk, Poland
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Pérez-Laguna V, García-Malinis AJ, Aspiroz C, Rezusta A, Gilaberte Y. Antimicrobial effects of photodynamic therapy. GIORN ITAL DERMAT V 2018; 153:833-846. [PMID: 29683289 DOI: 10.23736/s0392-0488.18.06007-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The microorganisms that cause infections are increasing their resistance to antibiotics. In this context, alternative treatments are necessary. The antimicrobial photodynamic therapy (aPDT) is a therapeutic modality based on photosensitizing molecules that end up generating reactive oxygen species that induce the destruction of the target cells when are irradiated with light of a suitable wavelength and at a proper dose. The cells targeted by aPDT are all types of microorganisms (bacteria, fungi and parasites) including viruses and has been proven effective against representative members of all of them. In the field of dermatology, aPDT has been tested with promising results in different infections such as chronic ulcers, acne, onychomycosis and other cutaneous mycoses, as well as in leishmaniasis. Therefore, it is presented as a possible treatment option against the agents that cause skin and/or mucous infections.
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Affiliation(s)
| | | | - Carmen Aspiroz
- Unit of Microbiology, Hospital Royo Villanova, Zaragoza, Spain
| | - Antonio Rezusta
- IIS Aragón, Zaragoza, Spain.,Department of Microbiology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Yolanda Gilaberte
- IIS Aragón, Zaragoza, Spain - .,Department of Dermatology, Hospital Universitario Miguel Servet, Zaragoza, Spain
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