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Farah N, Lim CW, Chin VK, Chong PP, Basir R, Yeo WWY, Tay ST, Choo S, Lee TY. Photoactivated riboflavin inhibits planktonic and biofilm growth of Candida albicans and non-albicans Candida species. Microb Pathog 2024; 191:106665. [PMID: 38685359 DOI: 10.1016/j.micpath.2024.106665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/02/2024]
Abstract
Fungal infections caused by Candida species pose a serious threat to humankind. Antibiotics abuse and the ability of Candida species to form biofilm have escalated the emergence of drug resistance in clinical settings and hence, rendered it more difficult to treat Candida-related diseases. Lethal effects of Candida infection are often due to inefficacy of antimicrobial treatments and failure of host immune response to clear infections. Previous studies have shown that a combination of riboflavin with UVA (riboflavin/UVA) light demonstrate candidacidal activity albeit its mechanism of actions remain elusive. Thus, this study sought to investigate antifungal and antibiofilm properties by combining riboflavin with UVA against Candida albicans and non-albicans Candida species. The MIC20 for the fluconazole and riboflavin/UVA against the Candida species tested was within the range of 0.125-2 μg/mL while the SMIC50 was 32 μg/mL. Present findings indicate that the inhibitory activities exerted by riboflavin/UVA towards planktonic cells are slightly less effective as compared to controls. However, the efficacy of the combination towards Candida species biofilms showed otherwise. Inhibitory effects exerted by riboflavin/UVA towards most of the tested Candida species biofilms points towards a variation in mode of action that could make it an ideal alternative therapeutic for biofilm-related infections.
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Affiliation(s)
- Nuratiqah Farah
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, UPM Serdang, Selangor, Malaysia
| | - Chee Woei Lim
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, UPM Serdang, Selangor, Malaysia
| | - Voon Kin Chin
- Faculty of Medicine, Nursing, and Health Sciences, SEGi University, Kota Damansara, 47810, Petaling Jaya, Selangor, Malaysia
| | - Pei Pei Chong
- School of Biosciences, Taylor's University, No 1, Jalan Taylor's, 47500, Subang Jaya, Selangor, Malaysia
| | - Rusliza Basir
- Department of Human Anatomy, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400, UPM Serdang, Selangor, Malaysia
| | - Wendy Wai Yeng Yeo
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - Sun Tee Tay
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Sulin Choo
- School of Biosciences, Taylor's University, No 1, Jalan Taylor's, 47500, Subang Jaya, Selangor, Malaysia
| | - Tze Yan Lee
- Perdana University School of Liberal Arts, Science and Technology (PUScLST), Suite 9.2, 9th Floor, Wisma Chase Perdana, Changkat Semantan, Damansara Heights, 50490, Kuala Lumpur, Malaysia.
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Najari E, Zamani S, Sheikh Arabi M, Ardebili A. Antimicrobial photodynamic effect of the photosensitizer riboflavin, alone and in combination with colistin, against pandrug-resistant Pseudomonas aeruginosa clinical isolates. J Infect Chemother 2024:S1341-321X(24)00075-8. [PMID: 38432556 DOI: 10.1016/j.jiac.2024.03.001] [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: 07/07/2023] [Revised: 02/05/2024] [Accepted: 03/01/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Development of multi-, extensively-, and pandrug-resistant (MDR, XDR, and PDR) strains of Pseudomonas aeruginosa remains a major problem in medical care. The present study evaluated the effect of antimicrobial photodynamic therapy (aPDT) as a monotherapy and in combination with colistin against P. aeruginosa isolates. METHODS Two P. aeruginosa isolates recovered from patients with respiratory tract infections were examined in this study. Minimum inhibitory concentration (MIC) of colistin was determined by the colistin broth disk elution (CBDE) and the reference broth microdilution (rBMD) methods. aPDT was performed using the photosensitizer (Ps) riboflavin at several concentrations and a light-emitting diode (LED) emitting blue light for different irradiation times with or without colistin at 1/2 × MIC concentration. RESULTS Both PA1 and PA2 isolates were identified as colistin-resistant P. aeruginosa with a MIC ≥4 μg/mL by the CBDE and MICs of 512 μg/mL and 256 μg/mL, respectively, by the rBMD. In aPDT, neither riboflavin nor LED light alone had antibacterial effects. The values of colony forming units per milliliter (CFU/mL) in both isolates were significantly reduced by LED + Ps treatments in a time-dependent manner (LED irradiation time) and dose-dependent manner (Ps concentration). In comparison with control, treatment with Ps (50 μM) + LED (120 s) and Ps (100 μM) + LED (120 s) resulted in 0.27 log10 CFU/mL and 0.43 log10 CFU/mL reductions in PA1, and 0.28 log10 CFU/mL and 0.34 log10 CFU/mL reductions in PA2, respectively, (P < 0.01). The best results were obtained after the combination of aPDT followed by colistin, which increased bacterial reduction, resulting in a 0.41-0.7 log10 CFU/mL reduction for PA1 and 0.35-0.83 log10 CFU/mL reduction for PA2 (P = 0.001). CONCLUSIONS This study suggests the potential implications of aPDT in combination with antibiotics, such as colistin for treatment of difficult-to-treat P. aeruginosa infections.
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Affiliation(s)
- Ehsan Najari
- Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran; Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
| | - Samin Zamani
- Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran; Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
| | - Mehdi Sheikh Arabi
- Medical Cellular and Molecular Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
| | - Abdollah Ardebili
- Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran; Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
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Osipyan GA, Khraistin H, Jourieh M. Collagen cross-linking beyond corneal ectasia: A comprehensive review. Indian J Ophthalmol 2024; 72:S191-S202. [PMID: 38271415 DOI: 10.4103/ijo.ijo_1507_23] [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: 06/08/2023] [Accepted: 11/19/2023] [Indexed: 01/27/2024] Open
Abstract
The history of corneal cross-linking (CXL) dates back to 2003 when some German scientists investigated possible treatments to harden the corneal structure to increase its resistance in ectatic corneal diseases. Nowadays, CXL is considered the most effective therapy in ectatic corneal diseases due to its proven efficacy in hardening the cornea, thus halting the development of the disease. Since 2003, CXL applications have dramatically expanded and have been implemented in several other areas such as infectious keratitis, corneal edema, and before performing keratoplasty for various purposes. Moreover, several irradiation patterns are being studied to correct refractive errors, taking into account the corneal refractive changes that occur after the procedure. Currently, scleral cross-linking is also being investigated as a potential therapy in cases of progressive myopia and glaucoma. In this article, we provide a comprehensive overview of the available applications of cross-linking in nonectatic ocular conditions and highlight the possible future indications of this procedure.
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Affiliation(s)
- Grigory A Osipyan
- Department of Corneal Pathology, Krasnov Research Institute of Eye Diseases, Moscow, Russia
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Arshad M, Joshan F, Chiniforush N, Afrasiabi S. Comparative study of the effect of different exposure parameters of 635nm diode laser and toluidine blue O in eliminating Aggregatibacter actinomycetemcomitans biofilm from titanium implant surfaces. Photodiagnosis Photodyn Ther 2024; 45:104012. [PMID: 38346465 DOI: 10.1016/j.pdpdt.2024.104012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND The aim of this study was to investigate the effects of antimicrobial photodynamic therapy (PDT) using 635 nm diode laser irradiation with an energy density of 6 to 30 J/cm2 and toluidine blue O (TBO) as a photosensitizer on the viability of Aggregatibacter actinomycetemcomitans attached to the surface of titanium implants. MATERIALS AND METHODS Titanium implants contaminated with A. actinomycetemcomitans were treated with TBO alone or in combination with different exposure parameters (light doses of 6 - 30 J/cm2 at 635 nm) and 0.2 % chlorhexidine (CHX). After treatment, colony forming units (CFUs)/ml were determined to assess PDT efficacy. The structure of the biofilm of A. actinomycetemcomitans was analyzed by field emission scanning electron microscopy (FESEM). RESULTS Under optimal conditions, the colony count was reduced by ∼90 %. Treatment with CHX was somewhat more effective (colony formation was reduced by ∼95 %), but this agent has adverse effects that can be avoided with PDT. CONCLUSION This study confirms the efficacy of PDT against A. actinomycetemcomitans depending on the light dose. Treatment with TBO + 635 nm diode laser has an effect that may be equivalent to that of CHX, but perhaps with fewer adverse effects.
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Affiliation(s)
- Mahnaz Arshad
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Prosthodontics, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Faraz Joshan
- International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Chiniforush
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Viale Benedetto XV, Genoa, Italy.
| | - Shima Afrasiabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Afrasiabi S, Entezari S, Etemadi A, Chiniforush N. The influence of different mode of power density during antimicrobial photodynamic therapy for photokilling of Streptococcus mutans. Photodiagnosis Photodyn Ther 2023; 44:103770. [PMID: 37640204 DOI: 10.1016/j.pdpdt.2023.103770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/21/2023] [Accepted: 08/25/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the inactivation potency of riboflavin and curcumin plus blue diode laser against Streptococcus mutans with different power densities. MATERIALS AND METHODS In this in vitro study, standard-strain S. mutans was exposed to curcumin and riboflavin plus blue diode laser with different power densities (0.4-1.0 W/cm2) as well as chlorhexidine (CHX). The colony forming units (CFUs)/mL was calculated. Data were analyzed by one-way ANOVA. RESULTS Antibacterial analysis indicated that the blue diode laser irradiation with curcumin and riboflavin provided a satisfactory reduction of the S. mutans level. In addition, S. mutans was more affected by curcumin + blue diode laser when the power density was set to 1.0 W/cm2 (P < 0.0001). Meanwhile, bacterial suspensions treated with CHX showed maximum colony number reduction, compared with the control (P < 0.0001). CONCLUSION This study showed the blue diode laser along with curcumin had strong bactericidal effect on S. mutans, and this effect improved by increasing the power density.
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Affiliation(s)
- Shima Afrasiabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sarvin Entezari
- Dentist, Faculty of Dentistry, Tehran Medical Sciences. Islamic Azad University, Tehran, Iran
| | - Ardavan Etemadi
- Department of Periodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Laser Research Center of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Dahshan NA, Abu-Dahab R, Khalil EA, Al-Bakri AG. Bactericidal effect of Iberin combined with photodynamic antimicrobial chemotherapy against Pseudomonas aeruginosa biofilm cultured on ex vivo wound model. Photodiagnosis Photodyn Ther 2023; 44:103841. [PMID: 37832710 DOI: 10.1016/j.pdpdt.2023.103841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 10/15/2023]
Abstract
Wounds infected by Pseudomonas aeruginosa (P. aeruginosa) biofilms are characterized by poor healing and by being long lasting. Pyocyanin and pyoverdine are exotoxins that contribute to P. aeruginosa pathogenicity in wound infections and are known as virulence factors. Despite the usefulness of antimicrobial photodynamic therapy (PDT) in the management of wound infections, biofilms are hurdle for microbial photoinactivation. Quorum sensing (QS) is a cell density-dependent chemical signaling system P. aeruginosa uses to regulate biofilm formation and virulence factors production. In the current study, QS attenuation was used in combination with PDT against P. aeruginosa biofilm cultured on skin explant. Iberin is a QS inhibitor that attenuates P. aeruginosa virulence and affects biofilm integrity. The antibiofilm and QS inhibitory activities of iberin in combination with either riboflavin or 5,10,15,20-Tetrakis(1-methyl-4-pyridinio) porphyrin tetra p-toluenesulfonate (TMP) mediated PDT were investigated using viable count method and pyocyanin and pyoverdine assays, respectively. No bactericidal activity was reported when iberin was added to a mature biofilm (24 h) followed by PDT. When added to a growing biofilm at multiple time points (0 h, 24 h and 48 h), iberin inhibited P. aeruginosa biofilm QS signaling system. This inhibitory effect resulted in an observable decrease in the levels of the QS-regulated virulence factors, pyocyanin and pyoverdine, without any effect on the growth of the biofilm cultures. These changes in biofilm virulence were associated with a decrease in biofilm resistance to PDT and caused bactericidal effect upon photosensitizers treatment and irradiation. Iberin-treated-riboflavin-mediated PDT resulted in a significant 1.3 log reduction in biofilm population. Similarly, iberin-treated-TMP-mediated PDT caused a significant 1.8 log reduction in biofilm population. The combination of QS inhibitor with PDT is a promising alternative antimicrobial therapy for the management of biofilms.
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Affiliation(s)
- Nisreen A Dahshan
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Rana Abu-Dahab
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Enam A Khalil
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Amal G Al-Bakri
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, Jordan.
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Kowalska M, Mischi E, Stoma S, Nørrelykke SF, Hartnack S, Pot SA. How Modifications of Corneal Cross-Linking Protocols Influence Corneal Resistance to Enzymatic Digestion and Treatment Depth. Transl Vis Sci Technol 2023; 12:18. [PMID: 37191620 DOI: 10.1167/tvst.12.5.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
Purpose The purpose of this study was to determine the effects of the Photoactivated Chromophore for Keratitis Corneal Cross-Linking (PACK-CXL) protocol modifications on corneal resistance to enzymatic digestion and treatment depth. Methods Eight hundred one ex vivo porcine eyes were randomly divided into groups of 12 to 86 corneas, treated with various epi-off PACK-CXL modifications, including acceleration (30 > 2 minutes, 5.4 J/cm2), increased fluence (5.4 > 32.4 J/cm2), deuterium oxide (D2O) supplementation, different carrier types (dextran versus hydroxypropyl methylcellulose [HPMC]), increased riboflavin concentration (0.1 > 0.4%), and riboflavin replenishment during irradiation (yes/no). Control group eyes did not receive PACK-CXL. A pepsin digestion assay was used to determine corneal resistance to enzymatic digestion. A phalloidin fluorescent imaging assay was used to determine the PACK-CXL treatment effect depth. Differences between groups were evaluated using a linear model and a derivative method, respectively. Results PACK-CXL significantly increased corneal resistance to enzymatic digestion compared to no treatment (P < 0.03). When compared to a 10 minute, 5.4 J/cm2 PACK-CXL protocol, fluences of 16.2 J/cm2 and higher increased corneal resistance to enzymatic digestion by 1.5- to 2-fold (P < 0.001). Other protocol modifications did not significantly change corneal resistance. A 16.2 J/cm2 fluence also increased collagen compaction in the anterior stroma, whereas omitting riboflavin replenishment during irradiation increased PACK-CXL treatment depth. Conclusions Increasing fluence will likely optimize PACK-CXL treatment effectiveness. Treatment acceleration reduces treatment duration without compromising effectiveness. Translational Relevance The generated data help to optimize clinical PACK-CXL settings and direct future research efforts.
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Affiliation(s)
- Malwina Kowalska
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Switzerland
- Ophthalmology Section, Equine Department, Vetsuisse Faculty, University of Zurich, Switzerland
- Center for Clinical Studies, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Elisa Mischi
- Ophthalmology Section, Equine Department, Vetsuisse Faculty, University of Zurich, Switzerland
- Center for Clinical Studies, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Szymon Stoma
- Image and Data Analysis Group (IDA), Scientific Center for Optical Electron Microscopy (ScopeM), Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Simon F Nørrelykke
- Image and Data Analysis Group (IDA), Scientific Center for Optical Electron Microscopy (ScopeM), Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
- Department of Systems Biology, Harvard Medical School, Boston, MA, USA
| | - Sonja Hartnack
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Simon A Pot
- Ophthalmology Section, Equine Department, Vetsuisse Faculty, University of Zurich, Switzerland
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Lu NJ, Koliwer-Brandl H, Gilardoni F, Hafezi N, Knyazer B, Achiron A, Zbinden R, Egli A, Hafezi F. The Antibacterial Efficacy of High-Fluence PACK Cross-Linking Can Be Accelerated. Transl Vis Sci Technol 2023; 12:12. [PMID: 36757342 PMCID: PMC9924428 DOI: 10.1167/tvst.12.2.12] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
Purpose To determine whether high-fluence photoactivated chromophore for keratitis cross-linking (PACK-CXL) can be accelerated. Methods Solutions of Staphylococcus aureus and Pseudomonas aeruginosa with 0.1% riboflavin were prepared and exposed to 365 nm ultraviolet (UV)-A irradiation of intensities and fluences from 9 to 30 mW/cm2 and from 5.4 to 15.0 J/cm2, respectively, representing nine different accelerated PACK-CXL protocols. Irradiated solutions and unirradiated controls were diluted, plated, and inoculated on agar plates so that the bacterial killing ratios (BKR) could be calculated. Additionally, strains of Achromobacter xylosoxidans, Staphylococcus epidermidis, and Stenotrophomonas maltophilia were exposed to a single accelerated PACK-CXL protocol (intensity: 30 mW/cm2, total fluence: 15.0 J/cm2). Results With total fluences of 5.4, 10.0, and 15.0 J/cm2, the range of mean BKR for S. aureus was 45.78% to 50.91%, 84.13% to 88.16%, and 97.50% to 99.90%, respectively; the mean BKR for P. aeruginosa was 69.09% to 70.86%, 75.37% to 77.93%, and 82.27% to 91.44%, respectively. The mean BKR was 41.97% for A. xylosoxidans, 65.38% for S. epidermidis, and 78.04% for S. maltophilia for the accelerated PACK-CXL protocol (30 mW/cm2, 15 J/cm2). Conclusions The BKR of high-fluence PACK-CXL protocols can be accelerated while maintaining a high, but species-dependent, BKR. The Bunsen to Roscoe law is respected in fluences up to 10 J/cm2 in S. aureus and P. aeruginosa, whereas fluences above 10 J/cm2 show strain dependence. Translational Relevance The high-fluence PACK-CXL protocols can be accelerated in clinical practice while maintaining high levels of BKR.
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Affiliation(s)
- Nan-Ji Lu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China,School of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium,ELZA Institute, Dietikon, Zurich, Switzerland
| | | | | | - Nikki Hafezi
- School of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium,ELZA Institute, Dietikon, Zurich, Switzerland
| | - Boris Knyazer
- Department of Ophthalmology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Asaf Achiron
- Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Reinhard Zbinden
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Adrian Egli
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Farhad Hafezi
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China,ELZA Institute, Dietikon, Zurich, Switzerland,Ocular Cell Biology Group, Center for Applied Biotechnology and Molecular Medicine, University of Zurich, Zurich, Switzerland,USC Roski Eye Institute, University of Southern California, Los Angeles, CA, USA,Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Afrasiabi S, Chiniforush N. Antibacterial potential of riboflavin mediated blue diode laser photodynamic inactivation against Enterococcus faecalis: A laboratory investigation. Photodiagnosis Photodyn Ther 2023; 41:103291. [PMID: 36642284 DOI: 10.1016/j.pdpdt.2023.103291] [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: 10/12/2022] [Revised: 01/11/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVES This study aimed to evaluate the inactivation potency of riboflavin-mediated blue diode laser photodynamic inactivation (PDI) against Enterococcus faecalis at planktonic and biofilm stages and also investigated its effect on the tooth color change. MATERIALS AND METHODS The antibacterial and antibiofilm activities of riboflavin mediated PDI against E. faecalis were investigated. The numbers of colony-forming units (CFUs)/mL were calculated. Teeth discoloration were evaluated using the CIE L*a*b* based color difference (ΔE). RESULTS Antibacterial analysis indicated that the blue diode laser irradiation at 12, 18, 24, and 30 J/cm2 alone and different concentrations of riboflavin solution (6.25 to 100 μM) reduced the number of CFU/mL of E. faecalis, but the reduction was not statistically significant (P > 0.05). Depending on the riboflavin concentration and the light dose, there can be as much as a 1-log effect on CFU/mL. In addition, E. faecalis biofilm was more affected with 30 J/cm2 irradiation dosage and 100 μM riboflavin than other groups. Meanwhile, bacterial suspensions treated with 5.25% sodium hypochlorite (NaOCl) showed maximum biofilm inhibition and colony number reduction, compared with the control. The teeth exhibited clinically acceptable color change after riboflavin treatment at concentration ranging from 6.25 to 50 μM (ΔE < 3.7). CONCLUSIONS The riboflavin mediated PDI process is somewhat less effective than NaOCl but perhaps less toxic to tissues. It might be feasible to repeat the riboflavin + light treatment to further promote efficacy.
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Affiliation(s)
- Shima Afrasiabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Sharma A, Sharma R, Chander J, Nirankari V. In vitro antimicrobial efficacy of riboflavin, ultraviolet-A radiation, and combined riboflavin/ultraviolet-A radiation on ocular pathogens. Taiwan J Ophthalmol 2023; 13:21-27. [DOI: 10.4103/tjo.tjo_28_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/14/2021] [Indexed: 03/14/2023] Open
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Marković ZM, Kováčová M, Jeremić SR, Nagy Š, Milivojević DD, Kubat P, Kleinová A, Budimir MD, Mojsin MM, Stevanović MJ, Annušová A, Špitalský Z, Todorović Marković BM. Highly Efficient Antibacterial Polymer Composites Based on Hydrophobic Riboflavin Carbon Polymerized Dots. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:nano12224070. [PMID: 36432356 PMCID: PMC9699046 DOI: 10.3390/nano12224070] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/12/2022] [Accepted: 11/17/2022] [Indexed: 06/01/2023]
Abstract
Development of new types of antimicrobial coatings is of utmost importance due to increasing problems with pathogen transmission from various infectious surfaces to human beings. In this study, new types of highly potent antimicrobial polyurethane composite films encapsulated by hydrophobic riboflavin-based carbon polymer dots are presented. Detailed structural, optical, antimicrobial, and cytotoxic investigations of these composites were conducted. Low-power blue light triggered the composites to eradicate Escherichia coli in 30 min, whereas the same effect toward Staphylococcus aureus was reached after 60 min. These composites also show low toxicity against MRC-5 cells. In this way, RF-CPD composites can be used for sterilization of highly touched objects in the healthcare industry.
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Affiliation(s)
- Zoran M. Marković
- Vinča Institute of Nuclear Sciences—National Institute of the Republic of Serbia, University of Belgrade, 11000 Belgrade, Serbia
| | - Mária Kováčová
- Polymer Institute, Slovak Academy of Sciences, Dúbravská Cestá 9, 84541 Bratislava, Slovakia
- Department of Physical Electronics, Faculty of Science, Masaryk University, Kotlářská 2, 611 37 Brno, Czech Republic
| | - Sanja R. Jeremić
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11042 Belgrade, Serbia
| | - Štefan Nagy
- Institute of Materials and Machine Mechanics, Slovak Academy of Sciences, Dúbravská Cestá 9/6319, 84513 Bratislava, Slovakia
| | - Dušan D. Milivojević
- Vinča Institute of Nuclear Sciences—National Institute of the Republic of Serbia, University of Belgrade, 11000 Belgrade, Serbia
| | - Pavel Kubat
- J. Heyrovsky Institute of Physical Chemistry, Academy of Sciences of the Czech Republic, Dolejškova 3, 182 23 Praha, Czech Republic
| | - Angela Kleinová
- Polymer Institute, Slovak Academy of Sciences, Dúbravská Cestá 9, 84541 Bratislava, Slovakia
| | - Milica D. Budimir
- Vinča Institute of Nuclear Sciences—National Institute of the Republic of Serbia, University of Belgrade, 11000 Belgrade, Serbia
| | - Marija M. Mojsin
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11042 Belgrade, Serbia
| | - Milena J. Stevanović
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11042 Belgrade, Serbia
- Faculty of Biology, University of Belgrade, Studentski trg 16, 11000 Belgrade, Serbia
- Serbian Academy of Sciences and Arts, Knez Mihailova 35, 11000 Belgrade, Serbia
| | - Adriana Annušová
- Department of Multilayers and Nanostructures, Institute of Physics, Slovak Academy of Sciences, Dúbravská Cestá 9, 84541 Bratislava, Slovakia
- Centre for Advanced Materials Application, Slovak Academy of Sciences, Dúbravská Cesta 9, 84511 Bratislava, Slovakia
| | - Zdeno Špitalský
- Polymer Institute, Slovak Academy of Sciences, Dúbravská Cestá 9, 84541 Bratislava, Slovakia
| | - Biljana M. Todorović Marković
- Vinča Institute of Nuclear Sciences—National Institute of the Republic of Serbia, University of Belgrade, 11000 Belgrade, Serbia
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Tarff A, Drew-Bear LE, Yee R, Cano M, Zhang Y, Behrens A. Bactericidal Efficacy of High Irradiance Ultraviolet A Photoactivation of Riboflavin Versus Standard Corneal Cross-Linking Protocol In Vitro. Cornea 2022; 41:1166-1170. [PMID: 35849757 DOI: 10.1097/ico.0000000000003031] [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: 10/22/2021] [Accepted: 02/11/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to compare the efficacy of high ultraviolet A (UVA) irradiance photoactivation of riboflavin (vitamin B2) versus the standard corneal cross-linking protocol on bacterial viability. METHODS Methicillin-sensitive Staphylococcus aureus (MSSA) Newman strain and methicillin-resistant multidrug-resistant S. aureus (MDR-MRSA) USA300, CA409, CA127, GA656, and NY315 strains were exposed to a UVA energy dose of 5.4 to 6 J/cm 2 by 2 high irradiance regimens: A) 30 mW/cm 2 for 3 minutes and B) 10 mW/cm 2 for 10 minutes with B2 0.1%. Control groups included B2/UVA alone, CA409 exposed to standard B2 0.1% + UVA (3 mW/cm 2 for 30 minutes), and an untreated sample. Cell viability was assessed. Triplicate values were obtained. The Mann-Whitney test and Student t test were used for statistical analysis. RESULTS There was no difference comparing the median bacterial load (log CFU/mL) of the untreated samples versus regimen A: Newman P = 0.7, CA409 P = 0.3, USA300 P = 0.5, CA127 P = 0.6, GA656 P = 0.1, and NY315 P = 0.2 ( P ≥ 0.1); and B: Newman P = 0.1, CA409 P = 0.3, USA300 P = 0.4, CA127 P = 0.6, GA656 P = 0.1, and NY315 P = 0.3 ( P ≥ 0.1). Standard regimen killed 100% of CA409. CONCLUSIONS Photoactivation of B2 by high UVA irradiance does not seem to be effective for bacterial eradication in this study.
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Affiliation(s)
- Andreina Tarff
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD. Dr. Tarff is now with the Department of Graduate Medical Education, Louis A. Weiss Memorial Hospital, Chicago, IL; and
| | - Laura E Drew-Bear
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD. Dr. Tarff is now with the Department of Graduate Medical Education, Louis A. Weiss Memorial Hospital, Chicago, IL; and
| | - Rebecca Yee
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Dr. Yee is now with the Department of Pathology, The George Washington University School of Medicine and Health Sciences, Washington DC. Dr. Zhang is now with the State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Marisol Cano
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD. Dr. Tarff is now with the Department of Graduate Medical Education, Louis A. Weiss Memorial Hospital, Chicago, IL; and
| | - Ying Zhang
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Dr. Yee is now with the Department of Pathology, The George Washington University School of Medicine and Health Sciences, Washington DC. Dr. Zhang is now with the State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ashley Behrens
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD. Dr. Tarff is now with the Department of Graduate Medical Education, Louis A. Weiss Memorial Hospital, Chicago, IL; and
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13
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Suter A, Schmitt S, Hübschke E, Kowalska M, Hartnack S, Pot S. The bactericidal effect of two photoactivated chromophore for keratitis-corneal crosslinking protocols (standard vs. accelerated) on bacterial isolates associated with infectious keratitis in companion animals. BMC Vet Res 2022; 18:317. [PMID: 35978428 PMCID: PMC9386977 DOI: 10.1186/s12917-022-03397-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background Bacterial corneal infections are common and potentially blinding diseases in all species. As antibiotic resistance is a growing concern, alternative treatment methods are an important focus of research. Photoactivated chromophore for keratitis-corneal crosslinking (PACK-CXL) is a promising oxygen radical-mediated alternative to antibiotic treatment. The main goal of this study was to assess the anti-bactericidal efficacy on clinical bacterial isolates of the current standard and an accelerated PACK-CXL treatment protocol delivering the same energy dose (5.4 J/cm2). Methods Clinical bacterial isolates from 11 dogs, five horses, one cat and one guinea pig were cultured, brought into suspension with 0.1% riboflavin and subsequently irradiated. Irradiation was performed with a 365 nm UVA light source for 30 min at 3mW/cm2 (standard protocol) or for 5 min at 18mW/cm2 (accelerated protocol), respectively. After treatment, the samples were cultured and colony forming units (CFU’s) were counted and the weighted average mean of CFU’s per μl was calculated. Results were statistically compared between treated and control samples using a linear mixed effects model. Results Both PACK-CXL protocols demonstrated a significant bactericidal effect on all tested isolates when compared to untreated controls. No efficacy difference between the two PACK-CXL protocols was observed. Conclusion The accelerated PACK-CXL protocol can be recommended for empirical use in the treatment of bacterial corneal infections in veterinary patients while awaiting culture results. This will facilitate immediate treatment, the delivery of higher fluence PACK-CXL treatment within a reasonable time, and minimize the required anesthetic time or even obviate the need for general anesthesia.
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Affiliation(s)
- Anja Suter
- Ophthalmology Section, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
| | - Sarah Schmitt
- Veterinary Bacteriology Section, Institute for Food Safety and Hygiene, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Ella Hübschke
- Veterinary Bacteriology Section, Institute for Food Safety and Hygiene, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Malwina Kowalska
- Epidemiology Section, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Sonja Hartnack
- Epidemiology Section, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Simon Pot
- Ophthalmology Section, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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14
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Cheng J, Wei A, Hong J, Xu J. Clinical Investigation of the Safety and Efficacy of Low-temperature Plasma as an Adjuvant Treatment for Mild to Moderate Fungal Keratitis: A Pilot Study. Ocul Immunol Inflamm 2022:1-10. [PMID: 35522197 DOI: 10.1080/09273948.2022.2060839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE This pilot study assessed the safety and efficacy of low-temperature plasma (LTP) as an adjuvant treatment for mild to moderate fungal keratitis (FK). METHODS Thirty FK patients were randomized into LTP (n = 15) and control (n = 15) groups. Patients were followed up for 3 months. The best-corrected visual acuity (BCVA), ulcer size, and hypopyon height were measured; healing time or complications were documented and compared. RESULTS More patients in the LTP group healed completely (11/15 in 48 days) compared with the control group (4/15 in 59.5 days), and those patients had a deeper initial ulcer depth and exhibited better BCVA improvements. Four patients failed after LTP treatment due to perforation, increased inflammatory infiltration, or hypopyon; those with more hypopyon were more likely to fail. CONCLUSIONS LTP could be a promising adjuvant therapy to topical antifungal drugs for mild to moderate FK.
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Affiliation(s)
- Jingyi Cheng
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Ministry of Health (Fudan University), Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, (Fudan University), Shanghai, China
| | - Anji Wei
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Ministry of Health (Fudan University), Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, (Fudan University), Shanghai, China
| | - Jiaxu Hong
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Ministry of Health (Fudan University), Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, (Fudan University), Shanghai, China.,Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Jianjiang Xu
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Ministry of Health (Fudan University), Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, (Fudan University), Shanghai, China
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15
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Advances in photodynamic antimicrobial chemotherapy. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY C: PHOTOCHEMISTRY REVIEWS 2021. [DOI: 10.1016/j.jphotochemrev.2021.100452] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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16
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Photophysical properties and therapeutic use of natural photosensitizers. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY 2021. [DOI: 10.1016/j.jpap.2021.100052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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17
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ToF-SIMS Analysis of Demineralized Dentin Biomodified with Calcium Phosphate and Collagen Crosslinking: Effect on Marginal Adaptation of Class V Adhesive Restorations. MATERIALS 2021; 14:ma14164535. [PMID: 34443059 PMCID: PMC8398264 DOI: 10.3390/ma14164535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 12/05/2022]
Abstract
This study aimed to assess the effect of biomodification before adhesive procedures on the tooth-restoration interface of class V restorations located in caries-simulated vs. sound dentin, and the quality of dentin surface by time-of-flight secondary ion mass spectrometry (ToF-SIMS). Class V cavities located on cervical dentin were prepared on the buccal surfaces of extracted human molars under the simulation of intratubular fluid flow. Two dentin types, i.e., sound and demineralized by formic-acid, were biomodified with 1% riboflavin and calcium phosphate (CaP) prior to the application of a universal adhesive (Clearfil Universal Bond) in etch and rinse or self-etch mode, and a conventional micro hybrid composite (Clearfil APX). Restorations were subjected to thermo mechanical fatigue test and percentages of continuous margins (% CM) before/after fatigue were compared. Bio modification of dentin surfaces at the molecular level was analyzed by Time-of-Flight Secondary Mass Spectometry (ToF-SIMS). % CM were still significantly higher in tooth-restoration interfaces on sound dentin. Meanwhile, biomodification with riboflavin and CaP had no detrimental effect on adhesion and in carious dentin, it improved the % CM both before and after loading. Etching carious dentin with phosphoric acid provided with the lowest results, leading even to restoration loss. The presence of molecule fragments of riboflavin and CaP were detected by ToF-SIMS, evidencing dentin biomodification. The adhesive interface involving carious dentin could be improved by the use of a collagen crosslinker and CaP prior to adhesive procedures.
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18
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Koudouna E, Huertas-Bello M, Rodriguez CN, Consuelo Henao S, Navarrete ML, Avila MY. Genipin in an Ex Vivo Corneal Model of Bacterial and Fungal Keratitis. Transl Vis Sci Technol 2021; 10:31. [PMID: 34436544 PMCID: PMC8399543 DOI: 10.1167/tvst.10.9.31] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 07/06/2021] [Indexed: 01/04/2023] Open
Abstract
Purpose To determine whether genipin (a natural crosslinker) could reduce the colonization and proliferation of bacteria and fungi in an ex vivo model of corneal infection. Methods This study, using an ex vivo model of bacterial and fungal keratitis, investigated the antimicrobial efficacy of genipin crosslinking. Excised corneoscleral buttons were wounded by scalpel incision and subsequently infected with Staphylococcus aureus, Pseudomonas aeruginosa, or Candida albicans. After inoculation, corneas were treated with genipin for 24 hours at 37°C. Histologic examinations were carried out, and the number of viable colony-forming units (CFU)/cornea was determined. Results Genipin exerts bactericidal action against S. aureus and P. aeruginosa, as well as fungicidal action against C. albicans and significantly reduced the CFU compared to contralateral eyes that received saline treatment (P < 0.05). Conclusions These data identify genipin as a novel ocular antimicrobial agent that has the potential to be incorporated into the therapeutic armamentarium against microbial keratitis. Translational Relevance This study provided evidence for the antimicrobial and antifungal properties of genipin as an alternative crosslinker that could be used in the management of infectious keratitis.
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Affiliation(s)
- Elena Koudouna
- Department of Ophthalmology, Faculty of Medicine, Bogota DC, Universidad Nacional de Colombia, Bogota Colombia
- Structural Biophysics Group, School of Optometry and Vision Sciences, Cardiff University, Cardiff, Wales, UK
| | - Marcela Huertas-Bello
- Department of Ophthalmology, Faculty of Medicine, Bogota DC, Universidad Nacional de Colombia, Bogota Colombia
| | - Cristian Nicolas Rodriguez
- Department of Microbiology, Faculty of Medicine, Bogota DC, Universidad Nacional de Colombia, Bogota Colombia
| | - Sandra Consuelo Henao
- Department of Microbiology, Faculty of Medicine, Bogota DC, Universidad Nacional de Colombia, Bogota Colombia
| | - Myriam Lucia Navarrete
- Department of Microbiology, Faculty of Medicine, Bogota DC, Universidad Nacional de Colombia, Bogota Colombia
| | - Marcel Yecid Avila
- Department of Ophthalmology, Faculty of Medicine, Bogota DC, Universidad Nacional de Colombia, Bogota Colombia
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19
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Feizi S, Karimian F, Esfandiari H. Corneal crosslinking for the treatment of infectious keratitis: a review. EXPERT REVIEW OF OPHTHALMOLOGY 2021. [DOI: 10.1080/17469899.2021.1933440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Sepehr Feizi
- Ophthalmic Research Center, Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid Karimian
- Ophthalmic Research Center, Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Esfandiari
- Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
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20
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Marasini S, Zhang AC, Dean SJ, Swift S, Craig JP. Safety and efficacy of UV application for superficial infections in humans: A systematic review and meta-analysis. Ocul Surf 2021; 21:331-344. [PMID: 33812086 DOI: 10.1016/j.jtos.2021.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Ultraviolet (UV) light is naturally antimicrobial, but risks associated with UV overexposure have limited its clinical application. This systematic review evaluates the safety and efficacy of UV light treatment of superficial human infections. METHODS MEDLINE, Embase, Cochrane CENTRAL, ANZCTR and US National Library of Medicine were searched (March 25, 2020). Clinical studies applying UV light (200-400 nm) for superficial infections and non-clinical studies evaluating the antimicrobial effects of UV light on human samples were included. Randomised controlled trials (RCTs) and non- RCTs were appraised using the Cochrane risk of bias and the ROBINS-I tools, respectively. RESULTS Eleven RCTs, seven non-RCTs, 24 case studies, and 11 in vitro studies were included. Most clinical studies (34/42) evaluated UVA treatment for microbial keratitis (MK) using cross-linking (UVA-CXL) methods. Six clinical studies assessed UVC; one, UVB; and one, broadband UV for chronic skin infections. Pooled data analysis showed no difference in the time to wound resolution with UVA-CXL relative to standard treatment (mean difference [MD]: -18.20 [95% CI: -39.04 to 2.65] days; p = 0.09). Adverse event incidence was similar to control for UVA-CXL in MK (RR: 0.70 [95%CI: 0.32-1.79]; 5 RCTs) and UVC in skin infections (RR: 0.63 [95%CI: 0.25-1.54]; 2 RCTs). CONCLUSION Alone or as an adjunct to standard therapy, UV light shows promise as a safe and effective treatment for a wide range of infections. Applications of UV light as an anti-infective agent are deserving of further evaluation, especially in the context of growing antibiotic resistance. REGISTRATION PROSPERO registration number CRD42020176510.
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Affiliation(s)
- Sanjay Marasini
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Alexis Ceecee Zhang
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, Australia
| | - Simon J Dean
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Simon Swift
- Department of Molecular Medicine and Pathology, The University of Auckland, Auckland, New Zealand
| | - Jennifer P Craig
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand.
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21
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Wu F, He P, Chang X, Jiao W, Liu L, Si Y, Yu J, Ding B. Visible-Light-Driven and Self-Hydrogen-Donated Nanofibers Enable Rapid-Deployable Antimicrobial Bioprotection. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2021; 17:e2100139. [PMID: 33656273 DOI: 10.1002/smll.202100139] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 01/21/2021] [Indexed: 06/12/2023]
Abstract
The novel coronavirus SARS-CoV-2 has prompted a worldwide pandemic and poses a great threat to public safety and global economies. Most present personal protective equipment (PPE) used to intercept pathogenic microorganisms is deficient in biocidal properties. Herein, we present green nanofibers with effective antibacterial and antiviral activities that can provide sustainable bioprotection by continuously producing reactive oxygen species (ROS). The superiority of the design is that the nanofibers can absorb and store visible light energy and maintain the activity under light or dark environment. Moreover, the nanofibers can uninterruptedly release ROS in the absence of an external hydrogen donor, acting as a biocide under all weather conditions. A facile spraying method is proposed to rapidly deploy the functional nanofibers to existing PPE, such as protective suits and masks. The modified PPE exhibit stable ROS production, excellent capacity for storing activity potential, long-term durability, and high bactericidal (>99.9%) and viricidal (>99.999%) efficacies.
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Affiliation(s)
- Fan Wu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials College of Textiles, Donghua University, Shanghai, 201620, China
| | - Peiwen He
- College of Materials Science and Engineering, Donghua University, Shanghai, 201620, China
| | - Xinyi Chang
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials College of Textiles, Donghua University, Shanghai, 201620, China
| | - Wenling Jiao
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials College of Textiles, Donghua University, Shanghai, 201620, China
| | - Lifang Liu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials College of Textiles, Donghua University, Shanghai, 201620, China
| | - Yang Si
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials College of Textiles, Donghua University, Shanghai, 201620, China
- College of Materials Science and Engineering, Donghua University, Shanghai, 201620, China
- Innovation Center for Textile Science and Technology, Donghua University, Shanghai, 200051, China
| | - Jianyong Yu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials College of Textiles, Donghua University, Shanghai, 201620, China
- Innovation Center for Textile Science and Technology, Donghua University, Shanghai, 200051, China
| | - Bin Ding
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials College of Textiles, Donghua University, Shanghai, 201620, China
- College of Materials Science and Engineering, Donghua University, Shanghai, 201620, China
- Innovation Center for Textile Science and Technology, Donghua University, Shanghai, 200051, China
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22
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Kasparova EA, Yang B, Bocharova YA, Novikov IA. [Application of visible longwave radiation for inactivation of microorganisms]. Vestn Oftalmol 2020; 136:42-49. [PMID: 33084278 DOI: 10.17116/oftalma202013606142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To perform a comparative assessment of the bactericidal and fungicidal effects of various parts of the radiation spectrum (Ultraviolet A, red, green and blue). MATERIAL AND METHODS The study included strains of the most clinically significant microorganisms, which are the most common causes of purulent keratitis - S. aureus, P. aeruginosa and fungi C. albicans. After populating the surface of Petri dishes uniformly with microorganisms of each culture, on four out of the five specimens the central zone of the surface with a diameter of 1 cm was irradiated with light of different spectrum - from ultraviolet to red, with a total radiation energy density of 5.4 J/cm2. One specimen remained as the control subject. After irradiation, scanning electron microscopy with lanthanides contrasting (SEMLC) was used to evaluate the total metabolic activity, the activity of the efflux systems and the morphological characteristics of the microorganisms. RESULTS The damaging effect of visible spectrum light and UVA radiation on S. aureus, P. aeruginosa and C. albicans cultures was proved by SEMLC. Green spectrum emission with a wavelength of 500 nm had the highest antimicrobial activity. It was manifested by a decrease in the overall level of metabolic activity (from 40-63 c.u. to 26-37 c.u. (S. aureus (p<0.01), P. aeruginosa (p<0.01) and C. albicans (p<0.05)), as well as a 2-fold increase in the proportion of S. aureus cells with active efflux systems. CONCLUSION SEMLC allows evaluation of parameters of the microorganisms` state: morphological (form and size) and functional (general metabolic activity, activation of efflux systems). Investigation of S. aureus, P. aeruginosa and C. albicans cultures using SEMLC demonstrated the antimicrobial activity of green spectrum radiation of 500 nm wavelength. This will serve as a basis for further research and development of a method of treating infectious keratitis using green light.
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Affiliation(s)
| | - Biao Yang
- Research Institute of Eye Diseases, Moscow, Russia
| | - Yu A Bocharova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - I A Novikov
- Research Institute of Eye Diseases, Moscow, Russia
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23
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Simões JCS, Sarpaki S, Papadimitroulas P, Therrien B, Loudos G. Conjugated Photosensitizers for Imaging and PDT in Cancer Research. J Med Chem 2020; 63:14119-14150. [PMID: 32990442 DOI: 10.1021/acs.jmedchem.0c00047] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Early cancer detection and perfect understanding of the disease are imperative toward efficient treatments. It is straightforward that, for choosing a specific cancer treatment methodology, diagnostic agents undertake a critical role. Imaging is an extremely intriguing tool since it assumes a follow up to treatments to survey the accomplishment of the treatment and to recognize any conceivable repeating injuries. It also permits analysis of the disease, as well as to pursue treatment and monitor the possible changes that happen on the tumor. Likewise, it allows screening the adequacy of treatment and visualizing the state of the tumor. Additionally, when the treatment is finished, observing the patient is imperative to evaluate the treatment methodology and adjust the treatment if necessary. The goal of this review is to present an overview of conjugated photosensitizers for imaging and therapy.
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Affiliation(s)
- João C S Simões
- Institute of Chemistry, University of Neuchatel, Avenue de Bellevaux 51, CH-2000 Neuchatel, Switzerland.,BioEmission Technology Solutions, Alexandras Avenue 116, 11472 Athens, Greece
| | - Sophia Sarpaki
- BioEmission Technology Solutions, Alexandras Avenue 116, 11472 Athens, Greece
| | | | - Bruno Therrien
- Institute of Chemistry, University of Neuchatel, Avenue de Bellevaux 51, CH-2000 Neuchatel, Switzerland
| | - George Loudos
- BioEmission Technology Solutions, Alexandras Avenue 116, 11472 Athens, Greece
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24
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Antimicrobial Photoinactivation Approach Based on Natural Agents for Control of Bacteria Biofilms in Spacecraft. Int J Mol Sci 2020; 21:ijms21186932. [PMID: 32967302 PMCID: PMC7554952 DOI: 10.3390/ijms21186932] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 01/08/2023] Open
Abstract
A spacecraft is a confined system that is inhabited by a changing microbial consortium, mostly originating from life-supporting devices, equipment collected in pre-flight conditions, and crewmembers. Continuous monitoring of the spacecraft’s bioburden employing culture-based and molecular methods has shown the prevalence of various taxa, with human skin-associated microorganisms making a substantial contribution to the spacecraft microbiome. Microorganisms in spacecraft can prosper not only in planktonic growth mode but can also form more resilient biofilms that pose a higher risk to crewmembers’ health and the material integrity of the spacecraft’s equipment. Moreover, bacterial biofilms in space conditions are characterized by faster formation and acquisition of resistance to chemical and physical effects than under the same conditions on Earth, making most decontamination methods unsafe. There is currently no reported method available to combat biofilm formation in space effectively and safely. However, antibacterial photodynamic inactivation based on natural photosensitizers, which is reviewed in this work, seems to be a promising method.
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25
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Leanse LG, Goh XS, Cheng JX, Hooper DC, Dai T. Dual-wavelength photo-killing of methicillin-resistant Staphylococcus aureus. JCI Insight 2020; 5:134343. [PMID: 32493838 DOI: 10.1172/jci.insight.134343] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 04/23/2020] [Indexed: 12/20/2022] Open
Abstract
With the effectiveness of antimicrobials declining as antimicrobial resistance continues to threaten public health, we must look to alternative strategies for the treatment of infections. In this study, we investigated an innovative, drug-free, dual-wavelength irradiation approach that combines 2 wavelengths of light, 460 nm and 405 nm, against methicillin-resistant Staphylococcus aureus (MRSA). MRSA was initially irradiated with 460-nm light (90-360 J/cm2) and subsequently irradiated with aliquots of 405-nm light (54-324 J/cm2). For in vivo studies, mouse skin was abraded and infected with approximately 107 CFUs of MRSA and incubated for 3 hours before irradiating with 460 nm (360 J/cm2) and 405 nm (342 J/cm2). Naive mouse skin was also irradiated to investigate apoptosis. We found that staphyloxanthin, the carotenoid pigment in MRSA cells, promoted resistance to the antimicrobial effects of 405-nm light. In addition, we found that the photolytic effect of 460-nm light on staphyloxanthin attenuated resistance of MRSA to 405-nm light killing. Irradiation of 460 nm alone did not elicit any antimicrobial effect on MRSA. In a proof-of-principle mouse skin abrasion infection model, we observed significant killing of MRSA using the dual-wavelength irradiation approach. However, when either wavelength of light was administered alone, no significant decrease in bacterial viability was observed. Moreover, exposure of the dual-wavelength irradiation to naive mouse skin did not result in any visible apoptosis. In conclusion, a dual-wavelength irradiation strategy may offer an innovative, effective, and safe approach for the treatment of skin infections caused by MRSA.
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Affiliation(s)
- Leon G Leanse
- Wellman Center for Photomedicine.,Vaccine and Immunotherapy Center, and
| | | | - Ji-Xin Cheng
- Department of Chemistry, Boston University, Boston, Massachusetts, USA
| | - David C Hooper
- Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Tianhong Dai
- Wellman Center for Photomedicine.,Vaccine and Immunotherapy Center, and
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Kvam E, Benner K. Mechanistic insights into UV-A mediated bacterial disinfection via endogenous photosensitizers. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2020; 209:111899. [PMID: 32485344 DOI: 10.1016/j.jphotobiol.2020.111899] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 01/09/2023]
Abstract
UV-A and visible light are thought to excite endogenous photosensitizers in microbes, thereby initiating complex chemical interactions that ultimately kill cells. Natural solar-based disinfection methods have been adapted into commercial lighting technologies with varying degrees of reported efficacy and associated safety hazards for human exposure. Here we utilize a narrow-spectrum UV-A LED prototype (currently in development for health care applications) to investigate the mechanism of bacterial photoinactivation using 365 nm light. Using a combination of reverse genetics and biochemical investigation, we report mechanistic evidence that 365nm light initiates a chain-reaction of superoxide-mediated damage via auto-excitation of vitamin-based electron carriers, specifically vitamin K2 menaquinones and the FAD flavoprotein in Complex II in the electron transport chain. We observe that photoinactivation is modifiable through supplementation of the environment to bypass cell damage. Lastly, we observe that bacteria forced into metabolic dormancy by desiccation become hypersensitized to the effects of UV-A light, thereby permitting photoinactivation at fluences that are significantly lower than the industry threshold for safe human exposure. In total, these results substantiate the mechanism and potential application of narrow- spectrum UV-A light for bacterial disinfection purposes.
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Affiliation(s)
- Erik Kvam
- GE Research, One Research Circle, Niskayuna, NY 12309, USA.
| | - Kevin Benner
- GE Current, a Daintree Company, East Cleveland, OH 44112, USA
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27
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Hellander Edman A, Ström L, Ekesten B. Corneal cross-linking (CXL)-A clinical study to evaluate CXL as a treatment in comparison with medical treatment for ulcerative keratitis in horses. Vet Ophthalmol 2019; 22:552-562. [PMID: 31012258 DOI: 10.1111/vop.12662] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/17/2019] [Accepted: 02/20/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Compare CXL treatment with medical treatment alone in horses with stromal, ulcerative keratitis. ANIMALS STUDIED 24 horses (24 eyes) with stromal, ulcerative keratitis were included. PROCEDURE 12 horses were initially treated with CXL, and 12 horses were given conventional medical treatment. Topical medical treatment was added to horses in the CXL group if necessary. Parameters including cytology, microbial growth, time to fluorescein negativity, and time to inhibition of stromal melting were evaluated. RESULTS After the first day of treatments, a decrease in inflammatory signs and pain from the eye was observed in both groups. Stromal melting ceased within 24 hours regardless of treatment. CXL treatment alone was sufficient in 3 horses with noninfectious, superficial stromal ulcerations. Clinical signs of impaired wound healing were seen after 3-14 days in corneas with suspected or proven bacterial infection treated with CXL only, most likely because of insufficient elimination of bacteria deeper in the corneal stroma or because of re-infection from bacteria in the conjunctiva. The average decrease in stromal ulcer area per day after onset of treatment was almost identical between the groups, and no significant difference in time to fluorescein negativity was found. CONCLUSIONS We consider CXL a possible useful adjunct treatment of corneal stromal ulcers in horses, especially for melting ulcers and as a potential alternative to prophylactic antibiotic treatment for noninfected stromal ulcers. However, CXL should not be used alone for infected or suspected infected stromal ulcers, because topical antibiotics were required in all horses with proven infectious keratitis.
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Affiliation(s)
- Anna Hellander Edman
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Lena Ström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Björn Ekesten
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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28
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Novel LDPE-riboflavin composite film with dual function of broad-spectrum light barrier and antimicrobial activity. Food Control 2019. [DOI: 10.1016/j.foodcont.2019.01.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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29
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Martinez JD, Arboleda A, Naranjo A, Aguilar MC, Durkee H, Monsalve P, Dubovy SR, Donaldson KE, Miller D, Amescua G, Parel JM. Long-term outcomes of riboflavin photodynamic antimicrobial therapy as a treatment for infectious keratitis. Am J Ophthalmol Case Rep 2019; 15:100481. [PMID: 31198886 PMCID: PMC6556526 DOI: 10.1016/j.ajoc.2019.100481] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 01/25/2019] [Accepted: 05/29/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose To report the long-term outcomes of three patients with infectious keratitis treated with riboflavin photodynamic antimicrobial therapy (PDAT). Observations Case series reporting three patients with infectious keratitis unresponsive to standard medical treatment who underwent riboflavin photodynamic antimicrobial therapy (PDAT) as an adjunct therapy. One male and two female patients were treated, the median age of presentation was 58 years (range, 29-79 years). The organisms isolated and treated were Pseudomonas aeruginosa, Mycobacterium chenolae, and Curvularia spp. Different risk factors to develop corneal infection ulcers were identified, including corneal abrasion in a contact lens user, history of penetrating keratoplasty with chronic use of topical corticosteroids, and organic trauma. The median follow-up was 47 months (range 37-54 months), and there were no complications secondary to riboflavin PDAT treatment. Two cases underwent optical penetrating keratoplasty after infection was resolved and ocular surface was quiet for at least 3 years. Conclusions and importance Riboflavin PDAT can be used as an adjunct treatment in infectious keratitis to strengthen the corneal collagen fibers, delay keratolysis, and allow more time for antimicrobials to work and this way prevent a corneal perforation.
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Affiliation(s)
- Jaime D Martinez
- Anne Bates Leach Eye Hospital, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alejandro Arboleda
- Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Andrea Naranjo
- Anne Bates Leach Eye Hospital, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mariela C Aguilar
- Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Heather Durkee
- Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Pedro Monsalve
- Anne Bates Leach Eye Hospital, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Pathology, University of Miami, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sander R Dubovy
- Anne Bates Leach Eye Hospital, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA.,Department of Pathology, University of Miami, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kendall E Donaldson
- Anne Bates Leach Eye Hospital, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Darlene Miller
- Anne Bates Leach Eye Hospital, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Ocular Microbiology Laboratory, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Guillermo Amescua
- Anne Bates Leach Eye Hospital, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jean-Marie Parel
- Anne Bates Leach Eye Hospital, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,University of Liege Sart-Tillman CHU Dept. of Ophthalmology, Liege, Belgium
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Makdoumi K, Hedin M, Bäckman A. Different photodynamic effects of blue light with and without riboflavin on methicillin-resistant Staphylococcus aureus (MRSA) and human keratinocytes in vitro. Lasers Med Sci 2019; 34:1799-1805. [PMID: 30929100 DOI: 10.1007/s10103-019-02774-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/07/2019] [Indexed: 02/07/2023]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of infections in humans. Photodynamic therapy using blue light (450 nm) could possibly be used to reduce MRSA on different human tissue surfaces without killing the human cells. It could be less harmful than 300-400 nm light or common disinfectants. We applied blue light ± riboflavin (RF) to MRSA and keratinocytes, in an in vitro liquid layer model, and compared the effect to elimination using common disinfection fluids. MRSA dilutions (8 × 105/mL) in wells were exposed to blue light (450 nm) ± RF at four separate doses (15, 30, 56, and 84 J/cm2). Treated samples were cultivated on blood agar plates and the colony forming units (CFU) determined. Adherent human cells were cultivated (1 × 104/mL) and treated in the same way. The cell activity was then measured by Cell Titer Blue assay after 24- and 48-h growth. The tested disinfectants were chlorhexidine and hydrogen peroxide. Blue light alone (84 J/cm2) eliminated 70% of MRSA. This dose and riboflavin eradicated 99-100% of MRSA. Keratinocytes were not affected by blue light alone at any dose. A dose of 30 J/cm2 in riboflavin solution inactivated keratinocytes completely. Disinfectants inactivated all cells. Blue light alone at 450 nm can eliminate MRSA without inactivation of human keratinocytes. Hence, a high dose of blue light could perhaps be used to treat bacterial infections without loss of human skin cells. Photodynamic therapy using riboflavin and blue light should be explored further as it may perhaps be possible to exploit in treatment of skin diseases associated with keratinocyte hyperproliferation.
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Affiliation(s)
- Karim Makdoumi
- Department of Ophthalmology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. .,Department of Ophthalmology, Örebro University Hospital, SE-701 85, Örebro, Sweden.
| | - Marie Hedin
- Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Anders Bäckman
- Department of Clinical Research Laboratory, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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31
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Özdemir HB, Kalkancı A, Bilgihan K, Göçün PU, Öğüt B, Karakurt F, Erdoğan M. Comparison of corneal collagen cross-linking (PACK-CXL) and voriconazole treatments in experimental fungal keratitis. Acta Ophthalmol 2019; 97:e91-e96. [PMID: 29862655 DOI: 10.1111/aos.13829] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 04/22/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the antifungal efficacy of corneal collagen cross-linking with photoactivated riboflavin (PACK-CXL) and voriconazole in experimental Fusarium solani and Candida albicans keratitis models. METHODS Sixty-four corneas of 32 New Zealand rabbits were included and divided into two main groups. Intrastromal injection of Fusarium and Candida suspensions was performed, and it was observed that keratitis was formed on the third day. Both groups were randomly separated into the following four groups: control, PACK-CXL, voriconazole and PACK-CXL combined with voriconazole. PACK-CXL was applied using 0.25% riboflavin in an accelerated Dresden protocol (total ultraviolet A dose 5.4 J/cm²). Voriconazole was applied topically as 7x1/day with a dose of 1% (10 mg/ml). Corneal buttons were excised on the tenth day, and microbiological and pathological examinations were performed. RESULTS The PACK-CXL and PACK-CXL combined with voriconazole groups each had 100 colony-forming unit (CFU/ml) of reproduced micro-organisms compared with 500 CFU/ml in the voriconazole group and 1500 CFU/ml in the control group (p < 0.001) in the Fusarium keratitis model. The PACK-CXL combined with voriconazole group had 100 CFU/ml, the PACK-CXL group had 150 CFU/ml, and the voriconazole group had 200 CFU/ml of reproduced micro-organisms compared with 4000 CFU/ml in the control group (p < 0.002) in the Candida keratitis model. (p < 0.001). Fewer hyphae and non-specific stromal changes were observed in the pathological cross sections examined in subgroups that used CXL. CONCLUSION There was less fungus reproduction and a lower keratitis score for Fusarium solani and Candida albicans in the treatment groups compared to the control groups, especially in groups that used PACK-CXL. These results suggest that it is useful to combine PACK-CXL treatment with medical treatment in the fungal keratitis algorithm at the early stage of the disease.
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Affiliation(s)
- Hüseyin Baran Özdemir
- Ulucanlar Eye Training and Research Hospital; University of Health Sciences; Ankara Turkey
| | - Ayşe Kalkancı
- Department of Medical Microbiology; Gazi University Faculty of Medicine; Ankara Turkey
| | - Kamil Bilgihan
- Department of Ophthalmology; Gazi University Faculty of Medicine; Ankara Turkey
| | - Pınar Uyar Göçün
- Department of Pathology; Gazi University Faculty of Medicine; Ankara Turkey
| | - Betül Öğüt
- Department of Pathology; Gazi University Faculty of Medicine; Ankara Turkey
| | - Funda Karakurt
- Department of Medical Microbiology; Gazi University Faculty of Medicine; Ankara Turkey
| | - Merve Erdoğan
- Department of Medical Microbiology; Gazi University Faculty of Medicine; Ankara Turkey
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32
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Li X, Fu T, Li B, Yan P, Wu Y. Riboflavin-protected ultrasmall silver nanoclusters with enhanced antibacterial activity and the mechanisms. RSC Adv 2019; 9:13275-13282. [PMID: 35520764 PMCID: PMC9063772 DOI: 10.1039/c9ra02079a] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 04/18/2019] [Indexed: 11/26/2022] Open
Abstract
Developing silver nanomaterials with efficient antimicrobial properties is of importance for combating bacteria. Here, we report ultrasmall riboflavin-protected silver nanoclusters (RF@AgNCs) that can effectively kill or suppress the growth of Gram-positive S. aureus, Gram-negative E. coli, and fungi C. albicans. Riboflavin (RF) with intrinsic biocompatibility was used as a surface ligand to synthesize silver nanoclusters. TEM revealed that the synthesized RF@AgNCs were ultrasmall (2.4 ± 1.2 nm), spherical and well-dispersed. Antibacterial activity tests showed that RF@AgNCs possessed superior antibacterial efficacy in comparison with RF, AgNPs and mixed RF and AgNPs (RF + AgNPs). The mechanisms of antibacterial activity of RF@AgNCs were studied by fluorescence microscopy-based Live/Dead cell staining assays and ROS measurement. And the results illustrated that the integrity of the bacteria membrane was disrupted and intracellular high level ROS generation was induced by RF@AgNCs. The cytotoxic activities were also assessed and RF@AgNCs were found to be non-toxic to human red blood cells and mammalian cells. With the highly efficient antibacterial activity and acceptable biocompatibility, RF@AgNCs hold great promise in biomedical applications as well as in water sterilization and the textile industry. Riboflavin acted as a surface coating to synthesize ultrasmall silver nanoclusters and RF@AgNCs possessed highly efficient antibacterial activity and good biocompatibility.![]()
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Affiliation(s)
- Xizhe Li
- Key Laboratory of Biomedical Information Engineering of Ministry of Education
- School of Life Science and Technology
- Xi'an Jiaotong University
- Xi'an
- PR China
| | - Tao Fu
- Key Laboratory of Biomedical Information Engineering of Ministry of Education
- School of Life Science and Technology
- Xi'an Jiaotong University
- Xi'an
- PR China
| | - Bingyu Li
- Key Laboratory of Biomedical Information Engineering of Ministry of Education
- School of Life Science and Technology
- Xi'an Jiaotong University
- Xi'an
- PR China
| | - Peng Yan
- Key Laboratory of Biomedical Information Engineering of Ministry of Education
- School of Life Science and Technology
- Xi'an Jiaotong University
- Xi'an
- PR China
| | - Yayan Wu
- Key Laboratory of Biomedical Information Engineering of Ministry of Education
- School of Life Science and Technology
- Xi'an Jiaotong University
- Xi'an
- PR China
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Silva AF, Borges A, Giaouris E, Graton Mikcha JM, Simões M. Photodynamic inactivation as an emergent strategy against foodborne pathogenic bacteria in planktonic and sessile states. Crit Rev Microbiol 2018; 44:667-684. [PMID: 30318945 DOI: 10.1080/1040841x.2018.1491528] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Foodborne microbial diseases are still considered a growing public health problem worldwide despite the global continuous efforts to ensure food safety. The traditional chemical and thermal-based procedures applied for microbial growth control in the food industry can change the food matrix and lead to antimicrobial resistance. Moreover, currently applied disinfectants have limited efficiency against biofilms. Therefore, antimicrobial photodynamic therapy (aPDT) has become a novel alternative for controlling foodborne pathogenic bacteria in both planktonic and sessile states. The use of aPDT in the food sector is attractive as it is less likely to cause antimicrobial resistance and it does not promote undesirable nutritional and sensory changes in the food matrix. In this review, aspects on the antimicrobial photodynamic technology applied against foodborne pathogenic bacteria and studied in recent years are presented. The application of photodynamic inactivation as an antibiofilm strategy is also reviewed.
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Affiliation(s)
- Alex Fiori Silva
- a Postgraduate Program of Health Sciences , State University of Maringá , Maringá , Paraná , Brazil.,b LEPABE, Department of Chemical Engineering, Faculty of Engineering , University of Porto , Porto , Portugal
| | - Anabela Borges
- b LEPABE, Department of Chemical Engineering, Faculty of Engineering , University of Porto , Porto , Portugal
| | - Efstathios Giaouris
- c Department of Food Science and Nutrition, Faculty of the Environment , University of the Aegean , Lemnos , Greece
| | | | - Manuel Simões
- b LEPABE, Department of Chemical Engineering, Faculty of Engineering , University of Porto , Porto , Portugal
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McBrearty J, Barker D, Damavandi M, Wilson-Nieuwenhuis J, Pilkington LI, Dempsey-Hibbert N, Slate AJ, Whitehead KA. Antimicrobial synergy of cationic grafted poly( para-phenylene ethynylene) and poly( para-phenylene vinylene) compounds with UV or metal ions against Enterococcus faecium. RSC Adv 2018; 8:23433-23441. [PMID: 35540130 PMCID: PMC9081575 DOI: 10.1039/c8ra02673d] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/20/2018] [Indexed: 01/25/2023] Open
Abstract
The rise in multidrug resistant bacteria is an area of growing concern and it is essential to identify new biocidal agents. Cationic grafted compounds were investigated for their antimicrobial properties using minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) tests. Synergy testing was carried out using the compounds in the presence of ultraviolet (UV). Fractional inhibitory concentration (FIC) and fractional bactericidal concentration (FBC) tests were carried out using the cationic molecules in conjunction with metal ion solutions of gold, silver, palladium, platinum, rhodium, titanium, tin, vanadium and molybdenum. Individually, the cationic compounds containing quaternary amines, polyphenylene vinylene (PPV) with long polyacrylate grafts (PPV-g-PMETAC (HMw)), polyphenylene ethylene (PPE) with long polyacrylate grafts (PPE-g-PMETAC (HMw)), polyphenylene vinylene (PPV) with short polyacrylate grafts (PPV-g-PMETAC (LMw)) and polyphenylene ethylene (PPE) with short polyacrylate grafts (PPE-g-PMETAC (LMw)) were effective against Enterococcus faecium. The most successful compound under UV was PPV-g-PMETAC (HMw). Following the FICs, palladium and rhodium ion solutions caused a synergistic reaction with all four tested compounds. The presence of conjugated bonds in the cationic molecules increased its antimicrobial activity. These results suggest that the chemical backbone of the compounds, alongside the chain lengths and chain attachment affect the antimicrobial efficacy of a compound. These factors should be taken into consideration when formulating new biocidal combinations.
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Affiliation(s)
- Jordan McBrearty
- Microbiology at Interfaces Group, Faculty of Science and Engineering, Manchester Metropolitan University Manchester M1 5GD UK +44(0) 161 247 1157
| | - David Barker
- School of Chemical Sciences, University of Auckland Auckland 1010 New Zealand
| | - Mona Damavandi
- School of Chemical Sciences, University of Auckland Auckland 1010 New Zealand
| | - Joels Wilson-Nieuwenhuis
- Microbiology at Interfaces Group, Faculty of Science and Engineering, Manchester Metropolitan University Manchester M1 5GD UK +44(0) 161 247 1157
| | - Lisa I Pilkington
- School of Chemical Sciences, University of Auckland Auckland 1010 New Zealand
| | - Nina Dempsey-Hibbert
- Microbiology at Interfaces Group, Faculty of Science and Engineering, Manchester Metropolitan University Manchester M1 5GD UK +44(0) 161 247 1157
| | - Anthony J Slate
- Microbiology at Interfaces Group, Faculty of Science and Engineering, Manchester Metropolitan University Manchester M1 5GD UK +44(0) 161 247 1157
| | - Kathryn A Whitehead
- Microbiology at Interfaces Group, Faculty of Science and Engineering, Manchester Metropolitan University Manchester M1 5GD UK +44(0) 161 247 1157
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Zhu Z, Zhang H, Yue J, Liu S, Li Z, Wang L. Antimicrobial efficacy of corneal cross-linking in vitro and in vivo for Fusarium solani: a potential new treatment for fungal keratitis. BMC Ophthalmol 2018; 18:65. [PMID: 29499665 PMCID: PMC5833033 DOI: 10.1186/s12886-018-0727-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 02/21/2018] [Indexed: 11/20/2022] Open
Abstract
Background Fungal keratitis is one of the major causes of visual impairment worldwide. However, the effectiveness of corneal collagen cross-linking (CXL) for fungal keratitis remains controversial. In this study, we developed an in vitro and an in vivo models to assess the efficacy of CXL for Fusarium keratitis. Methods The effect of in vitro CXL fungicidal was evaluated on the cultures of Fusarium solani which were exposed to irradiation for different durations. Viability of fungal was appraised under four conditions: no treatment (control); CXL: UVA (365 nm)/riboflavin; riboflavin and UVA (365 nm). Each batch of sterile plate culture was irradiated for different CXL durations. The in vivo Therapeutic effect was studied on a mouse keratitis model. The animals were divided randomly into three groups: group A with no treatment (control); Group B with CXL treatment for two minutes and group C with CXL treatment for three minutes. The CXL procedure was performed 24 h post inoculation in each group. All mice with corneal involvement were scored daily for 7 days and 10 days after infection. Corneals were extracted at various time points for quantitative fungal recovery. Histological evaluations were conducted to calculate the number of polymorphonuclear cells. Results Viability of fungal decreased significantly in CXL group with 30-min irradiation compared with that in control, riboflavin and UVA groups (P < 0.01). The colony-forming units (CFUs) of fungal solutions in culture significantly decreased with CXL treatment (P < 0.05). Clinical scores, corneal lesion, corneal opacity, neovascularization and the depth of ulceration scores in group B and group C were remarkably lower than that in group A (P < 0.05, P = 0.001, P = 0.001, P = 0.034 and P = 0.025 respectively). Scores of group C were much lower than that in group B. Histological revealed that destruction of corneal collagen fibers and infiltration of inflammatory cells into corneal tissue in group B and group C were much lower than that in group A. Conclusions We believe that CXL treatment may be applied to fungal keratitis, therapeutic efficacy will improve with longer treatment duration.
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Affiliation(s)
- Ziqian Zhu
- People's Hospital of Zhengzhou University and Henan Provincial People's Hospital, Henan Eye Institute, Henan Eye Hospital, Zhengzhou, 450003, China
| | - Hongmin Zhang
- People's Hospital of Zhengzhou University and Henan Provincial People's Hospital, Henan Eye Institute, Henan Eye Hospital, Zhengzhou, 450003, China
| | - Juan Yue
- People's Hospital of Zhengzhou University and Henan Provincial People's Hospital, Henan Eye Institute, Henan Eye Hospital, Zhengzhou, 450003, China
| | - Susu Liu
- People's Hospital of Zhengzhou University and Henan Provincial People's Hospital, Henan Eye Institute, Henan Eye Hospital, Zhengzhou, 450003, China
| | - Zhijie Li
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Liya Wang
- People's Hospital of Zhengzhou University and Henan Provincial People's Hospital, Henan Eye Institute, Henan Eye Hospital, Zhengzhou, 450003, China.
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Garg P, Das S, Roy A. Collagen Cross-linking for Microbial Keratitis. Middle East Afr J Ophthalmol 2017; 24:18-23. [PMID: 28546688 PMCID: PMC5433123 DOI: 10.4103/meajo.meajo_305_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Collagen cross-linking is gaining popularity not only for arresting the progression of keratoconus but also other indications including management of corneal infections. In this review article, we analyzed the published literature to understand the level of evidence for its use in corneal ulcer. Photoactivated riboflavin and ultraviolet A light are known to possess antimicrobial properties. The treatment also induces formation of inter- and intra-fibrillar bonds, thereby making the corneal collagen resistant to the action of proteases arresting stromal melt. Both properties are well documented in in vitro experiments. The antimicrobial action is seen against bacteria, fungi, and parasites. The animal experiments have documented its efficacy against bacterial and fungal keratitis models. The literature on its application in human corneal infection is highly variable and comprises case reports, case series, and comparative nonrandomized and randomized trials. The treatment has been used as primary treatment, adjunctive treatment along with antibiotics, as the first line of treatment as well as for failed medical treatment cases. Even the cases included are of variable severity caused by a variety of microorganisms including culture-negative cases. Furthermore, the treatment protocols are also variable. While most reports show beneficial effects for bacterial corneal ulcer cases, especially those with superficial infiltrate, the effect has been mixed for fungal and parasitic keratitis. In view of these characteristics, we infer that the level of evidence for its use in corneal ulcer is at most weak. We need well-characterized, high-quality, clinical trials of sufficient power to assess its true value.
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Affiliation(s)
- Prashant Garg
- Tej Kohli Cornea Institute, KAR Campus, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sujata Das
- Tej Kohli Cornea Institute, Bhubaneswar Campus, L. V. Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Aravind Roy
- Tej Kohli Cornea Institute, KVC Campus, L. V. Prasad Eye Institute, Vijayawada, Andhra Pradesh, India
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37
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Jiang LZ, Qiu SY, Li ZW, Zhang X, Tao XC, Mu GY. Therapeutic and inducing effect of corneal crosslinking on infectious keratitis. Int J Ophthalmol 2016; 9:1820-1823. [PMID: 28003986 DOI: 10.18240/ijo.2016.12.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 08/09/2016] [Indexed: 11/23/2022] Open
Abstract
The corneal crosslinking (CXL) with riboflavin and ultraviolet-A (UVA) is a new therapy method to successfully treat infectious keratitis in clinical practice. However, there are rare reports on the complications of CXL such as the secondary keratitis. The diverse clinical outcomes on keratitis have highlighted the necessity to further evaluate the efficacy and complications of CXL. We reviewed the positive and negative reports on UVA/riboflavin related with keratitis and provided our opinion on the therapeutic and side effect of UVA/riboflavin crosslinking on keratitis.
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Affiliation(s)
- Liang-Zhu Jiang
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250000, Shandong Province, China; Department of Ophthalmology, the People's Hospital of Linyi, Linyi 276000, Shandong Province, China
| | - Shi-Yan Qiu
- Department of Pediatrics, the People's Hospital of Linyi, Linyi 276000, Shandong Province, China
| | - Zhi-Wei Li
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250000, Shandong Province, China
| | - Xiao Zhang
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250000, Shandong Province, China
| | - Xiang-Chen Tao
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250000, Shandong Province, China
| | - Guo-Ying Mu
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250000, Shandong Province, China
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Erdem E, Yagmur M, Boral H, Ilkit M, Ersoz R, Seyedmousavi S. Aspergillus flavus Keratitis: Experience of a Tertiary Eye Clinic in Turkey. Mycopathologia 2016; 182:379-385. [DOI: 10.1007/s11046-016-0089-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 11/01/2016] [Indexed: 11/29/2022]
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Polat N, Gunduz A, Gunduz A, Cumurcu T, Gunduz G. The Influence of Corneal Collagen Crosslinking on Conjunctival Flora. Curr Eye Res 2016; 42:364-367. [DOI: 10.1080/02713683.2016.1196710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Nihat Polat
- Department of Ophthalmology, Medical Faculty, Inonu University, Malatya, Turkey
| | - Abuzer Gunduz
- Department of Ophthalmology, Medical Faculty, Inonu University, Malatya, Turkey
| | - Ayten Gunduz
- Department of Microbiology, Malatya State Hospital, Malatya, Turkey
| | - Tongabay Cumurcu
- Department of Ophthalmology, Medical Faculty, Inonu University, Malatya, Turkey
| | - Göksel Gunduz
- Department of Ophthalmology, Medical Faculty, Inonu University, Malatya, Turkey
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Abstract
Photodynamic therapy (PDT) was discovered more than 100 years ago, and has since become a well-studied therapy for cancer and various non-malignant diseases including infections. PDT uses photosensitizers (PSs, non-toxic dyes) that are activated by absorption of visible light to initially form the excited singlet state, followed by transition to the long-lived excited triplet state. This triplet state can undergo photochemical reactions in the presence of oxygen to form reactive oxygen species (including singlet oxygen) that can destroy cancer cells, pathogenic microbes and unwanted tissue. The dual-specificity of PDT relies on accumulation of the PS in diseased tissue and also on localized light delivery. Tetrapyrrole structures such as porphyrins, chlorins, bacteriochlorins and phthalocyanines with appropriate functionalization have been widely investigated in PDT, and several compounds have received clinical approval. Other molecular structures including the synthetic dyes classes as phenothiazinium, squaraine and BODIPY (boron-dipyrromethene), transition metal complexes, and natural products such as hypericin, riboflavin and curcumin have been investigated. Targeted PDT uses PSs conjugated to antibodies, peptides, proteins and other ligands with specific cellular receptors. Nanotechnology has made a significant contribution to PDT, giving rise to approaches such as nanoparticle delivery, fullerene-based PSs, titania photocatalysis, and the use of upconverting nanoparticles to increase light penetration into tissue. Future directions include photochemical internalization, genetically encoded protein PSs, theranostics, two-photon absorption PDT, and sonodynamic therapy using ultrasound.
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Rose Bengal- and Riboflavin-Mediated Photodynamic Therapy to Inhibit Methicillin-Resistant Staphylococcus aureus Keratitis Isolates. Am J Ophthalmol 2016; 166:194-202. [PMID: 27016125 DOI: 10.1016/j.ajo.2016.03.014] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 03/07/2016] [Accepted: 03/10/2016] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate the in vitro efficacy of rose bengal- and riboflavin-mediated photodynamic therapy for inhibition of methicillin-resistant Staphylococcus aureus (MRSA) isolates. DESIGN Experimental study. METHODS Two different multidrug-resistant, clinical MRSA isolates were grown on nutrient agar, prepared in suspension, and adjusted to concentrations of 1.5 × 10(4) colony-forming units per milliliter. Bacterial suspensions were mixed with rose bengal, riboflavin, or water according to experimental group. Tested in triplicate, groups included: Group I, MRSA control; Group II, MRSA with 0.1% rose bengal; Group III, MRSA with 0.03% rose bengal; and Group IV, MRSA with 0.1% riboflavin. All experimental groups were exposed to 3 lighting conditions: dark, ambient room light for 30 minutes, and 5.4 J/cm(2) with either green light-emitting diode (LED) or ultraviolet-A (UV-A) irradiation. Plates were photographed at 72 hours and custom software measured bacterial growth inhibition. RESULTS Complete growth inhibition of both MRSA strains was demonstrated (1) for both rose bengal concentrations under ambient and green LED irradiation, and (2) for the 0.1% rose bengal in the dark. The 0.03% rose bengal in dark conditions showed complete inhibition of strain 2 but incomplete inhibition of strain 1. Riboflavin showed almost complete inhibition with UV-A irradiation but demonstrated minimal inhibition for both strains in dark and ambient light conditions. CONCLUSIONS Rose bengal- and riboflavin-mediated photodynamic therapy demonstrated complete growth inhibition in vitro of 2 multidrug-resistant MRSA strains. Rose bengal was also effective in dark and ambient conditions. These results may have implications for in vivo therapy.
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Abbouda A, Abicca I, Alió JL. Current and Future Applications of Photoactivated Chromophore for Keratitis-Corneal Collagen Cross-Linking (PACK-CXL): An Overview of the Different Treatments Proposed. Semin Ophthalmol 2016; 33:293-299. [PMID: 27093581 DOI: 10.3109/08820538.2015.1123731] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To review the application of the PACK-CXL and to identify different treatment protocols according to the pathogens associated with keratitis. METHODS A systematic review of 21 articles. The primary outcome was the healing of a corneal ulcer, defined as epithelization, blocking corneal melting. The secondary end-point was the recovery of visual acuity. RESULTS We studied a total of 145 eyes. Infectious keratitis was associated with bacteria in 80 eyes (55.55%), fungus in 24 eyes (16.67%), and protozoa in 13 (8.97%). In 26 (18%), the microbiological culture was negative or not performed. The mean time of re-epithelization was 25.70±29.83days (1-180). A total of 27 patients needed corneal transplantation. The overall probability of blocking corneal melting was 84.13%. Three different protocols for each group of pathogens have been proposed. CONCLUSION PACK-CXL still has a limit in its spread. In the future, we hope that each pathogen will be treated with the most efficient and least invasive protocols available.
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Affiliation(s)
- A Abbouda
- a Department of Ophthalmology , University of Rome , Rome , Italy
| | - I Abicca
- a Department of Ophthalmology , University of Rome , Rome , Italy
| | - J L Alió
- b Vissum Corporacion Oftalmologica , Alicante , Spain
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Makdoumi K, Bäckman A. Photodynamic UVA-riboflavin bacterial elimination in antibiotic-resistant bacteria. Clin Exp Ophthalmol 2016; 44:582-586. [DOI: 10.1111/ceo.12723] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 02/03/2016] [Accepted: 02/06/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Karim Makdoumi
- Department of Ophthalmology, Faculty of Medicine and Health; Örebro University; Örebro Sweden
| | - Anders Bäckman
- Clinical Research Centre, Faculty of Medicine and Health; Örebro University; Örebro Sweden
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Efficacy of Primary Collagen Cross-Linking with Photoactivated Chromophore (PACK-CXL) for the Treatment of Staphylococcus aureus-Induced Corneal Ulcers. Cornea 2016; 34:1281-6. [PMID: 26252742 DOI: 10.1097/ico.0000000000000550] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the efficacy of corneal collagen cross-linking (CXL) with photoactivated riboflavin (PACK-CXL) as primary therapy for Staphylococcus aureus-induced corneal ulcers in a rabbit model. METHODS The right eye of 40 rabbits was inoculated with S. aureus to induce formation of central corneal ulcers (day 1). The ulcer was examined on day 5, and rabbits were randomly assigned to 4 groups-group A: no treatment (control); group B: topical antibiotic treatment (cefazolin 50 mg/mL, garamycin 14 mg/mL drops, chloramphenicol 5% ointment every 2 hours); group C: PACK-CXL; group D: PACK-CXL + topical antibiotics. Follow-up by biomicroscopy was performed on day 5 and then every week for 1 month. The main outcome measures included infiltrates or the scar diameter, time to healing, time to full epithelialization, and a change in corneal thickness. RESULTS After 1 month of treatment, group C ulcers had the smallest mean scar diameter (8.8 mm), followed by groups D (11.2 mm), B (13.0 mm), and A (24.5 mm) (P = 0.011). Group C had the shortest mean healing time (15.5 days), followed by groups D (17.2 days), B (19.7 days), and A (21.8 days). Analysis of relative reduction in the infiltrate size from day 5 yielded better results for groups C (P = 0.039) and D (P = 0.034) than those of group B. CONCLUSIONS We demonstrate a beneficial effect of PACK-CXL as primary treatment, either as stand-alone or as an adjuvant to antimicrobial therapy.
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Lamy R, Chan E, Good SD, Cevallos V, Porco TC, Stewart JM. Riboflavin and ultraviolet A as adjuvant treatment against Acanthamoeba cysts. Clin Exp Ophthalmol 2016; 44:181-7. [PMID: 26355273 DOI: 10.1111/ceo.12644] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 08/02/2015] [Accepted: 09/07/2015] [Indexed: 01/24/2023]
Abstract
BACKGROUND Experimental studies have shown that the standard dose of riboflavin (R) or R + ultraviolet-A (UVA) as solo treatment are not able to exterminate Acanthamoeba cysts or even trophozoites. The purpose of this study is to determine whether the application of R + UVA can enhance the cysticidal effects of cationic antiseptic agents in vitro. METHODS The log of either polyhexamethylene biguanide or chlorhexidine minimal cysticidal concentration in solutions containing riboflavin (concentrations 0.1, 0.05 and 0.025%) plus either Acanthamoeba castellanii cysts or Acanthamoeba polyphaga cysts was determined and compared in groups treated with UVA 30 mW/cm(2) for 30 min and in control groups (with no exposure to UVA). A permutation test was used to determine the P value associated with treatment. RESULTS Regardless of the riboflavin concentration and UVA treatment condition, no trophozoites were seen in plates where the cysts were previously exposed to cationic antiseptic agent concentrations ≥200 µg/mL for Acanthamoeba castellanii samples and ≥100 µg/mL for A. polyphaga samples. There was no statistical evidence that R + UVA treatment was associated with minimal cysticidal concentration (P = 0.82). CONCLUSION R + UVA in doses up to 10 times higher than recommended for corneal crosslinking does not enhance the cysticidal effect of either polyhexamethylene biguanide or chlorhexidine in vitro.
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Affiliation(s)
- Ricardo Lamy
- Department of Ophthalmology, University of California - San Francisco, San Francisco, California, USA
| | - Elliot Chan
- Department of Ophthalmology, University of California - San Francisco, San Francisco, California, USA
| | - Samuel D Good
- Department of Ophthalmology, University of California - San Francisco, San Francisco, California, USA
| | - Vicky Cevallos
- Francis I. Proctor Foundation, University of California - San Francisco, San Francisco, California, USA
| | - Travis C Porco
- Francis I. Proctor Foundation, University of California - San Francisco, San Francisco, California, USA
| | - Jay M Stewart
- Department of Ophthalmology, University of California - San Francisco, San Francisco, California, USA
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Chan TCY, Lau TWS, Lee JWY, Wong IYH, Jhanji V, Wong RLM. Corneal collagen cross-linking for infectious keratitis: an update of clinical studies. Acta Ophthalmol 2015; 93:689-96. [PMID: 25990098 DOI: 10.1111/aos.12754] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 03/30/2015] [Indexed: 11/30/2022]
Abstract
Collagen cross-linking (CXL) with ultraviolet light-activated riboflavin is a corneal surface procedure developed for the treatment of keratoconus and corneal ectasia. With the known microbicidal and corneal stiffening effects of ultraviolet irradiation and photoactivated riboflavin, it has recently been introduced for the management of infectious keratitis, especially for ulcers resistant to antimicrobial therapy or associated with corneal melting. Various authors have attempted to use CXL as an adjunctive, salvage or even as the sole treatment for infectious corneal ulcers. The aim of this review was to provide a summary of the clinical studies in the literature. It is worth noting that there is still no consensus on the treatment protocol of CXL against infectious keratitis. The disparities in outcome measures, treatment protocol and study design can confound the interpretation and hamper the generalization of the study results. Based on current evidence, the role of CXL in infectious keratitis remained unclear despite the reported success in some clinical cases. Further investigations are warranted concerning the efficacy and safety of treating infectious keratitis with CXL.
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Affiliation(s)
- Tommy C. Y. Chan
- Hong Kong Eye Hospital; Hong Kong SAR China
- Department of Ophthalmology and Visual Sciences; The Chinese University of Hong Kong; Hong Kong SAR China
| | - Tiffany W. S. Lau
- Hong Kong Eye Hospital; Hong Kong SAR China
- Department of Ophthalmology and Visual Sciences; The Chinese University of Hong Kong; Hong Kong SAR China
| | - Jacky W. Y. Lee
- Department of Ophthalmology; The University of Hong Kong; Hong Kong SAR China
| | - Ian Y. H. Wong
- Department of Ophthalmology; The University of Hong Kong; Hong Kong SAR China
| | - Vishal Jhanji
- Hong Kong Eye Hospital; Hong Kong SAR China
- Department of Ophthalmology and Visual Sciences; The Chinese University of Hong Kong; Hong Kong SAR China
| | - Raymond L. M. Wong
- Hong Kong Eye Hospital; Hong Kong SAR China
- Department of Ophthalmology and Visual Sciences; The Chinese University of Hong Kong; Hong Kong SAR China
- Department of Ophthalmology; The University of Hong Kong; Hong Kong SAR China
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Xu K, Chan TCY, Vajpayee RB, Jhanji V. Corneal Collagen Cross-linking: A Review of Clinical Applications. Asia Pac J Ophthalmol (Phila) 2015; 4:300-6. [PMID: 26381468 DOI: 10.1097/apo.0000000000000145] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Corneal collagen cross-linking (CXL) has been shown to slow down or stop the progression of keratoconus. In addition, CXL has been applied in cases of corneal ectasia. Recent reports of the use of CXL in cases of infectious keratitis have generated further interest in this treatment modality. This review discusses the principle, clinical uses, and complications associated with CXL.
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Affiliation(s)
- Kunyong Xu
- From the *Department of Ophthalmology, Queen's University, Kingston, Canada; †Department of Ophthalmology, Hotel Dieu and Kingston General Hospitals, Kingston, Canada; ‡Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; §Hong Kong Eye Hospital, Hong Kong; ¶Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia; ∥Vision Eye Institute, Royal Victorian Eye and Ear Hospital, North West Academic Centre University of Melbourne, Melbourne, Australia; and **Department of Ophthalmology, Prince of Wales Hospital, Hong Kong
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Uddaraju M, Mascarenhas J, Das MR, Radhakrishnan N, Keenan JD, Prajna L, Prajna VN. Corneal Cross-linking as an Adjuvant Therapy in the Management of Recalcitrant Deep Stromal Fungal Keratitis: A Randomized Trial. Am J Ophthalmol 2015; 160:131-4.e5. [PMID: 25841317 DOI: 10.1016/j.ajo.2015.03.024] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 03/27/2015] [Accepted: 03/29/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To assess the efficacy of corneal cross-linking (CXL) as an adjuvant to appropriate antifungal therapy in nonresolving deep stromal fungal keratitis. DESIGN Randomized clinical trial. METHODS Eyes with culture-positive deep stromal fungal keratitis not responding to appropriate medical therapy for a period of 2 weeks were randomized to receive either adjuvant CXL or no additional treatment. Antifungal medical therapy was continued in both groups. The prespecified primary outcome was treatment failure at 6 weeks after enrollment, defined as perforation and/or increase in ulcer size by ≥2 mm. RESULTS The trial was stopped before full enrollment because of a marked difference in the rate of perforation between the 2 groups. Of the 13 cases enrolled in the study, 6 were randomized to the CXL group and 7 to the non-CXL group. Five eyes in the CXL group and 3 eyes in the non-CXL group experienced treatment failure by 6 weeks (P = .56). In a secondary analysis, the CXL group experienced more perforations than the non-CXL group (4 vs 0, respectively; P = .02). CONCLUSION CXL used as adjuvant therapy for recalcitrant deep stromal fungal keratitis did not improve outcomes.
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