Sonodynamic inactivation of methicillin-resistant Staphylococcus aureus in planktonic condition by curcumin under ultrasound sonication

A narrative review: Ultrasound-Assisted drug delivery: Improving treatments via multiple mechanisms

Safe and efficient drug delivery is as important as drug development. Biological barriers, such as cell membranes, present significant challenges in drug delivery, especially for newly developed protein-, nucleic acid-, and cell-based drugs. Ultrasound-mediated drug delivery systems offer a promising strategy to overcome these challenges. Ultrasound, a mechanical wave with energy, produces thermal effects, cavitation, acoustic radiation, and other biophysical effects. Used alone or in combination with microbubbles or sonosensitizers, it breaks biological barriers, enhances targeted drug delivery, reduces adverse reactions, controls drug release, switches on/off drug functions, and ultimately improves therapeutic efficiency. Various ultrasound-mediated drug delivery methods, including transdermal drug delivery, nebulization, targeted microbubble destruction, and sonodynamic therapy, are being actively explored for the treatment of various diseases. This review article introduces the principles, advantages, and applications of ultrasound-mediated drug delivery methods for improved therapeutic outcomes and discusses future prospects in this field.

Co-crystallization of curcumin with tyramine resulted disparate impacts on the activities of photodynamic and sonodynamic treatments

Curcumin, a plant-derived phenolic compound, has emerged as a promising photo/sonosensitizer within food industry. However, the low aqueous solubility greatly restricts its practical application. Here, we utilized co-crystallization strategy to develop a curcumin-tyramine cocrystal with enhanced solubility (98.53-fold increase over curcumin) and characterized its physicochemical properties using FT-IR, SEM, and XRD. Moreover, the results also showed curcumin-tyramine cocrystal maintained comparable antimicrobial photodynamic activity to that of curcumin (2.44 ± 0.36 vs 3.24 ± 0.42-log decrease in CFU/mL); however, its sonodynamic inactivation efficacy was marked diminished (only exhibiting a 0.46 ± 0.11-log reduction in CFU/mL), suggesting co-crystallization may resulted disparate impacts on activities of photodynamic and sonodynamic treatments. Considering high penetrative ability of ultrasound to activate sensitizers within foods often gives sono/photodynamic treatment an edge over photodynamic treatment alone in food sterilization, our findings suggested the potential imbalanced influence of modification process on photodynamic and sonodynamic activities of sensitizers should not be overlooked when modifying the sensitizers.

A curcumin-based HDACs inhibitor for targeted sonodynamic therapy of breast cancer

Histone Deacetylases (HDACs) have emerged as key therapeutic targets in cancer treatment. In this study, we designed CURSAHA, a multifunctional anticancer agent, through the pharmacophore fusion of Vorinostat and curcumin. CURSAHA demonstrates broad-spectrum inhibitory activity against HDACs, effectively suppressing tumor cells with overexpressed HDACs. Notably, CURSAHA generates reactive oxygen species (ROS) under ultrasonic conditions, exhibiting sonodynamic therapeutic activity. Additionally, CURSAHA downregulates HDACs through redox reactions involving ROS. These properties enable CURSAHA to exhibit robust antitumor activity in both in vitro and in vivo models, highlighting its potential as a promising candidate for further development in cancer therapy.

An In vitro Study on the Antibacterial Effect of a Combined Photodynamic and Sonodynamic Therapy Using IR780 Iodide-loaded Mesoporous Silica Nanoparticles Against P. aeruginosa and Multi-Drug Resistant P. aeruginosa

BACKGROUND

The aim of this study was to investigate the antimicrobial photodynamic, sonodynamic, and combined photodynamic and sonodynamic potentials of IR780 iodide loaded mesoporous silica nanoparticles against gram-negative Pseudomonas aeruginosa (P. aeruginosa) and multi drug resistant Pseudomonas aeruginosa (MDR P. aeruginosa).

METHODS

IR780 iodide loaded mesoporous silica nanoparticles were synthesized, and their antimicrobial photodynamic and sonodynamic potentials against one P. aeruginosa strain, and one MDR P. aeruginosa strain were investigated. Laser irradiation was achieved via a 785 nm diode laser (500 mW/cm2, 5 min). Ultrasound irradiation was achieved via a 1-MHz ultrasound unit (1.5 W/cm2, 50% duty cycle, 3 min). Viable bacterial cells were counted by serial dilution method. Data were analyzed by ANOVA followed by Tukey's test (p ≤ 0.05).

RESULTS

The results revealed that for P. aeruginosa, the combined photodynamic therapy (PDT) and sonodynamic therapy (SDT) showed a 44% reduction in bacterial cell viability as compared to 18% and 31% when exposed to SDT alone and PDT alone, respectively. For MDR. P. aeruginosa, the combined treatment resulted in a 45% reduction in bacterial cell viability, as compared to 14% and 30% when exposed to SDT alone and PDT alone, respectively. The killing effect was mainly due to the photodynamic and sonodynamic effects of the nanoparticles, mainly caused by singlet oxygen. No photothermal effect was involved in the killing.

CONCLUSION

The results of this study demonstrated that IR780 iodide-loaded mesoporous silica nanoparticles have the potential to be utilized as photo/sono therapeutic agents for the inactivation of drug-resistant bacteria.

Physicochemical properties of active films of rose essential oil produced using soy protein isolate-polyphenol conjugates for cherry tomato preservation

Soy protein isolate (SPI)-polyphenol conjugates were produced by grafting SPI individually with curcumin, naringenin, and catechin. The resulting conjugates showed better emulsifying properties and were used to develop active films containing rose essential oil. The effect of conjugation on the physicochemical and mechanical properties of these emulsion-based films was evaluated. The results showed that the barrier and mechanical properties of the films were improved when the SPI-polyphenol conjugates were used to emulsify the essential oil; in particular, the SPI-curcumin conjugate showed significant improvement. The improvements on the water vapor and oxygen barrier properties in the films were attributed to the formation of compact structure. Emulsion-based films stabilized by SPI-polyphenol conjugates showed antioxidant and antibacterial activities. They also demonstrated an ability to extend the shelf life of cherry tomatoes, as indicated by better preservation of weight, firmness, and ascorbic acid content.

The synergistic effect of photodynamic and sonodynamic inactivation against Candida albicans biofilm

Candida albicans biofilm can cause diseases that are resistant to conventional antifungal agents. Photodynamic (PDI), sonodynamic (SDI), and sonophotodynamic (SPDI) inactivation have arisen as promising antimicrobial strategies. This study evaluated these treatments mediated by curcumin against C. albicans biofilms. For this, C. albicans biofilms were submitted to PDI, SDI, or SPDI with different light and ultrasound doses, then, the viability assay was performed to measure the effectiveness. Finally, a mathematical model was suggested to fit acquired experimental data and understand the synergistic effect of light and ultrasound in different conditions. The results showed that SPDI, PDI, and SDI reduced the viability in 6 ± 1; 1 ± 1; and 2 ± 1 log, respectively, using light at 60 J/cm2, ultrasound at 3 W/cm2, and 80 μM of curcumin. The viability reduction was proportional to the ultrasound and light doses delivered. These results encourage the use of SPDI for the control of microbial biofilm.

Conjugated polymer nanoparticles as sonosensitizers in sono-inactivation of a broad spectrum of pathogens

Sonodynamic inactivation (SDI) of pathogens has an important advantage when compared to optical excitation-based protocols due to the deeper penetration of ultrasound (US) excitation in biological media or animal tissue. Sonosensitizers (SS) are compounds or systems that upon US stimulation in the therapeutic window (frequency = 0.8-3 MHz and intensity < 3 W/cm2) can induce damage to vital components of pathogenic microorganisms. Herein, we report the synthesis and application of conjugated polymer nanoparticles (CPNs) as an efficient SS in SDI of methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae and Candida tropicalis. A frequent problem in the design and testing of new SS for SDI is the lack of proper sonoreactor characterization which leads to reproducibility concerns. To address this issue, we performed dosimetry experiments in our setup. This enables the validation of our results by other researchers and facilitates meaningful comparisons with different SDI systems in future studies. On a different note, it is generally accepted that the mechanisms of action underlying SS-mediated SDI involve the production of reactive oxygen species (ROS). In an attempt to establish the nature of the cytotoxic species involved in our CPNs-based SDI protocol, we demonstrated that singlet oxygen (1O2) does not play a major role in the observed sonoinduced killing effect. SDI experiments in planktonic cultures of optimally growing pathogens using CPNs result in a germicide effect on the studied pathogenic microorganisms. The implementation of SDI protocols using CPNs was further tested in mature biofilms of a MRSA resulting in ∼40 % reduction of biomass and ∼70 % reduction of cellular viability. Overall, these results highlight the unique and unexplored capacity of CPNs to act as sonosensitizers opening new possibilities in the design and application of novel inactivation protocols against morbific microbes.

Sonophotodynamic inactivation of Pseudomonas aeruginosa biofilm mediated by curcumin

The inactivation of Pseudomonas aeruginosa biofilm is a major challenge, as biofilms are less responsive to conventional treatments and responsible for persistent infections. This has led to the investigation of alternative approaches for biofilm control such as photodynamic (PDI) and sonodynamic (SDI) inactivation. The combination of them, known as Sonophotodynamic Inactivation (SPDI), has improved the effectiveness of the process. Curcumin, a well-established photosensitizer, has been identified as a potential sonosensitizer. This study evaluated the most effective combination for SPDI against P. aeruginosa biofilms in vitro, varying curcumin concentrations and ultrasound intensities. The results indicated that the inactivation was directly proportional to the curcumin concentration. Using curcumin 120 µM and 3.0 W.cm-2 of ultrasound intensity, SPDI demonstrated the highest and the best synergistic results, equivalent to 6.9 ± 2.1 logs of reduction. PDI reduced 0.7 ± 0.9 log and SDI had no effect. In conclusion, SPDI with curcumin is a promising approach for biofilm inactivation.

Antibacterial activity of curcumin and its essential nanoformulations against some clinically important bacterial pathogens: A comprehensive review

Multidrug-resistant bacterial infections can kill 700,000 individuals globally each year and is considered among the top 10 global health threats faced by humanity as the arsenal of antibiotics is becoming dry and alternate antibacterial molecule is in demand. Nanoparticles of curcumin exhibit appreciable broad-spectrum antibacterial activity using unique and novel mechanisms and thus the process deserves to be reviewed and further researched to clearly understand the mechanisms. Based on the antibiotic resistance, infection, and virulence potential, a list of clinically important bacteria was prepared after extensive literature survey and all recent reports on the antibacterial activity of curcumin and its nanoformulations as well as their mechanism of antibacterial action have been reviewed. Curcumin, nanocurcumin, and its nanocomposites with improved aqueous solubility and bioavailability are very potential, reliable, safe, and sustainable antibacterial molecule against clinically important bacterial species that uses multitarget mechanism such as inactivation of antioxidant enzyme, reactive oxygen species-mediated cellular damage, and inhibition of acyl-homoserine-lactone synthase necessary for quorum sensing and biofilm formation, thereby bypassing the mechanisms of bacterial antibiotic resistance. Nanoformulations of curcumin can thus be considered as a potential and sustainable antibacterial drug candidate to address the issue of antibiotic resistance.

Triarylboron-Doped Acenethiophenes as Organic Sonosensitizers for Highly Efficient Sonodynamic Therapy with Low Phototoxicity

The development of efficient organic sonosensitizers is crucial for sonodynamic therapy (SDT) in the field of cancer treatment. Herein, a new strategy for the development of efficient organic sonosensitizers based on triarylboron-doped acenethiophene scaffolds is presented. The attachment of boron to the linear acenethiophenes lowers the lowest unoccupied molecular orbital (LUMO) energy, resulting in redshifted absorptions and emissions. After encapsulation with the amphiphilic polymer DSPE-mPEG₂₀₀₀ , it is found that the nanostructured BAnTh-NPs and BTeTh-NPs (nanoparticles of BAnTh and BTeTh) shows efficient hydroxyl radical (^• OH) generation under ultrasound (US) irradiation in aqueous solution with almost no phototoxicity, which can overcome the shortcomings of O₂ -dependent SDT and avoid the potential cutaneous phototoxicity issue. In vitro and in vivo therapeutic results validate that boron-doped acenethiophenes as sonosensitizers enable high SDT efficiency with low phototoxicity and good biocompatibility, indicating that boron-functionalization of acenes is a promising strategy toward organic sonosensitizers for SDT.

Ex vivo efficacy of sonodynamic antimicrobial chemotherapy for inhibition of Enterococcus faecalis and Candida albicans biofilm

BACKGROUND

This study aimed to assess the ex vivo efficacy of sonodynamic antimicrobial chemotherapy (SACT) also known as antimicrobial sonodynamic therapy for inhibition of Enterococcus faecalis and Candida albicans biofilm.

MATERIALS AND METHODS

This study was conducted on 80 extracted single-canal maxillary anterior teeth. After instrumentation, the root canals were inoculated with E. faecalis and C. albicans suspensions, and the teeth were assigned to 5 groups of control (no antimicrobial therapy), nano-curcumin, ultrasound waves, 5.25% sodium hypochlorite (NaOCl), and SACT (nano-curcumin plus ultrasound waves). The mean biofilm thickness and number of colonies were then counted.

RESULTS

The E. faecalis colony count in nano-curcumin, ultrasound waves, and SACT groups was significantly lower than that in the control group (P<0.05). The C. albicans colony count in SACT group was significantly lower than that in the control and ultrasound waves groups (P<0.05). The mean biofilm thickness in NaOCl and SACT groups was significantly thinner than other groups (P<0.05). The mean biofilm thickness in SACT group was significantly thinner than that in ultrasound waves group (P<0.001).

CONCLUSION

In summary, SACT using nano-curcumin had an almost comparable efficacy to NaOCl, but was more effective than ultrasound waves and nano-curcumin for reduction of C. albicans and E. faecalis biofilm.

Multi-Modal Imaging Monitored M2 Macrophage Targeting Sono-Responsive Nanoparticles to Combat MRSA Deep Infections

BACKGROUND

MRSA with high morbidity and mortality is prone to cause serious infection, SDT has become a new antibiotic-free modality for bacterial infection treatment. Switching from proinflammatory M1 macrophages to anti-inflammatory M2 macrophages dominant could activate the immune system to generate an anti-infection immune response.

METHODS

Herein, we developed M2 macrophages derived cell membranes coated PLGA nanoparticles with IR780 encapsulation (M2/IR780@PLGA) for antibacterial SDT and subsequent M2 macrophage polarization to enhance the therapeutic efficacy of MRSA myositis. For in situ visualization of antibacterial SDT, both diagnostic high-frequency US and magnetic resonance imaging (MRI) were introduced to monitor the sono-therapeutic progression of M2/IR780@PLGA nanoparticles in mice with bacterial myositis.

RESULTS

Our developed M2/IR780@PLGA nanoparticles exhibited excellent antibacterial effects due to the IR780 under low-frequency US irradiation in vitro. In an MRSA-infected mice model, a great deal of M2/IR780@PLGA nanoparticles accumulated at the site of inflammation due to M2 macrophage coating. The infected legs in the M2/IR780@PLGA nanoparticles-based SDT group were significantly smaller, fewer blood flow signals, a slight muscular edema without obvious intermuscular abscesses under high-frequency US and MR images guidance. Histopathology proved the infected legs in the M2/IR780@PLGA nanoparticles-mediated SDT group had less clumped bacteria infiltration, more M2 macrophage expression and less M1 macrophage expression. The percentage of mature dendritic cells in spleens was much higher in the group of mice with M2/IR780@PLGA nanoparticles-based SDT.

CONCLUSION

This study provides a promising nanoparticles-based SDT anti-bacterial strategy, which could effectively enhance the antibacterial SDT and subsequent promote M2 macrophage polarization to boost the therapeutic efficacy of MRSA myositis.

Recent developments of sonodynamic therapy in antibacterial application

The rapid emergence of pathogenic bacteria poses a serious threat to global health. Notably, traditional antibiotic therapies suffer from the risk of strengthening bacterial drug resistance. Sonodynamic therapy (SDT) combining sonosensitizers and low-intensity ultrasound (US) has broadened the way towards treating drug-resistant bacteria. The allure of this therapy emerges from the capacity to focus the US energy on bacterial infection sites buried deep in tissues, locally activating the sonosensitizers to produce cytotoxic reactive oxygen species (ROS) with the ability to induce bacterial death. The past decade has witnessed the rapid development of antibacterial SDT owing to their excellent penetration, favorable biocompatibility and specific targeting ability. This review summarizes available sonosensitizers for antibacterial SDT, and digs into innovative biotechnologies to improve SDT efficiency, such as enhancing the targeting ability of sonosensitizers, image-guided assisted SDT, improvement of hypoxia and combination of SDT with other therapies. Finally, we conclude with the present challenges and provide insights into the future research of antibacterial SDT.

Application of sonodynamic technology and sonosensitizers in food sterilization: a review of developments, trends and challenges

Food safety and food waste have always been hot topics of discussion in recent years. However, the infection of human pathogenic bacteria and the waste of food resources caused by microbial-contaminated food remains common. Although traditional sterilization technology has been very mature, it causes changes in food flavor and excessive energy consumption to a certain extent. Moreover, the widespread bacterial resistance has also sounded a warning for researchers and finding a new alternative to antibiotics is urgently needed. The application of sonodynamic sterilization technology in medical treatment has aroused the interest of researchers. It provides ideas for new food sterilization technology. As a new non-thermal sterilization technology, sonodynamic sterilization technology has strong penetration, safety, less residue and by-products, and will less change the quality of the food itself. Therefore, sonodynamic sterilization technology has great potential applied in food sterilization technology. This review describes the concept of sonodynamic sterilization technology, the sterilization mechanism of sonodynamic sterilization and the inactivation mechanism of various pathogens, the classification and application of sonosensitizers, and the ultrasonic technology in sonodynamic sterilization in the application over the recent years. It provides a scientific reference for the application of sonodynamic sterilization technology in the field of food sterilization.

Excited state and reactive oxygen species against cancer and pathogens: a review on sonodynamic and sono-photodynamic therapy

Photodynamic and sonodynamic therapy are therapies having great potential in the treatment of bacterial infections and cancer. Their background is associated with photo- and sonosensitizers - substances that can be excited when exposed to light or ultrasound. These sensitizers belong to a variety of compounds groups, including porphyrins, porphyrazines, and phthalocyanines. Releasing the energy when returning to the ground state can occur in the manner of transferring it to oxygen molecules, leading to reactive oxygen species able to disrupt membranes of bacterial and cancer cells, leaving the organism's cells unaffected. In recent years, the number of reports on numerous sensitizers being effective has been constantly growing. Therefore, the development of this field may prove beneficial for dealing with cancer and microbes. This review describes the development of photodynamic and sonodynamic therapy, as well as their combination, with emphasize on sonodynamic therapy and its potential in the treatment of cancer and bacterial infections.

Recent advances in metal-organic framework-based materials for anti-staphylococcus aureus infection

The rapid spread of staphylococcus aureus (S. aureus) causes an increased morbidity and mortality, as well as great economic losses in the world. Anti-S. aureus infection becomes a major challenge for clinicians and nursing professionals to address drug resistance. Hence, it is urgent to explore high efficiency, low toxicity, and environmental-friendly methods against S. aureus. Metal-organic frameworks (MOFs) represent great potential in treating S. aureus infection due to the unique features of MOFs including tunable chemical constitute, open crystalline structure, and high specific surface area. Especially, these properties endow MOF-based materials outstanding antibacterial effect, which can be mainly attributed to the continuously released active components and the exerted catalytic activity to fight bacterial infection. Herein, the structural characteristics of MOFs and evaluation method of antimicrobial activity are briefly summarized. Then we systematically give an overview on their recent progress on antibacterial mechanisms, metal ion sustained-release system, controlled delivery system, catalytic system, and energy conversion system based on MOF materials. Finally, suggestions and direction for future research to develop and mechanism understand MOF-based materials are discussed in antibacterial application.

Antimicrobial Effect of Phytochemicals from Edible Plants

Current strategies of combating bacterial infections are limited and involve the use of antibiotics and preservatives. Each of these agents has generally inadequate efficacy and a number of serious adverse effects. Thus, there is an urgent need for new antimicrobial drugs and food preservatives with higher efficacy and lower toxicity. Edible plants have been used in medicine since ancient times and are well known for their successful antimicrobial activity. Often photosensitizers are present in many edible plants; they could be a promising source for a new generation of drugs and food preservatives. The use of photodynamic therapy allows enhancement of antimicrobial properties in plant photosensitizers. The purpose of this review is to present the verified data on the antimicrobial activities of photodynamic phytochemicals in edible species of the world’s flora, including the various mechanisms of their actions.

The promise of low-intensity ultrasound: A review on sonosensitizers and sonocatalysts by ultrasonic activation for bacterial killing

Antimicrobial resistance has become one of the main public health issues in modern society. Ultrasonicantimicrobial treatment (UAT) is expected to solve the problem of antimicrobial resistance since ultrasonic treatment does not cause drug resistance during inactivation. However, the ultrasonic application is hindered due to the high energy cost. To cast more lights on the ultrasound in tandem with catalysts as a superior strategy for bacterial inactivation, the present review focuses on the UAT with the assistant of continuous development of organic sonosensitizer and inorganic sonocatalyst. With the application of these nanomaterials, the ultrasonic parameters changed from low-frequency and high-power ultrasound to high-frequency and low-power ultrasound. The review also presents the composition of sonosensitizers/sonocatalysts including organic and inorganic nanoparticles and discusses the ultrasonic activation mechanisms triggered by these catalysts. Based on the synergistic effect of ultrasound and catalysts, we discuss the importance of extracellular oxidation and intracellular oxidation in the process of bacterial inactivation. Overall, UAT combined with catalysts appears to be an effective treatment strategy that can be successfully applied in the field of medicine, environmental treatment, and food industry.

Antibacterial Sonodynamic Therapy: Current Status and Future Perspectives

Multidrug-resistant bacteria have emerged in both community and hospital settings, partly due to the misuse of antibiotics. The inventory of viable antibiotics is rapidly declining, and efforts toward discovering newer antibiotics are not yielding the desired outcomes. Therefore, alternate antibacterial therapies based on physical mechanisms such as light and ultrasound are being explored. Sonodynamic therapy (SDT) is an emerging therapeutic approach that involves exposing target tissues to a nontoxic sensitizing chemical and low-intensity ultrasound. SDT can enable site-specific cytotoxicity by producing reactive oxygen species (ROS) in response to ultrasound, which can be harnessed for treating bacterial infections. This approach can potentially be used for both superficial and deep-seated microbial infections. The majority of the sonosensitizers reported are nonpolar, exhibiting limited bioavailability and a high clearance rate in the body. Therefore, targeted delivery agents such as nanoparticle composites, liposomes, and microbubbles are being investigated. This article reviews recent developments in antibacterial sonodynamic therapy, emphasizing biophysical and chemical mechanisms, novel delivery agents, ultrasound exposure and image guidance strategies, and the challenges in the pathway to clinical translation.

Curcumin-mediated sono/photodynamic treatment preserved the quality of shrimp surimi and influenced its microbial community changes during refrigerated storage

Shrimp surimi is widely acknowledged as a value-added shrimp product due to its delicious taste, rich flavor, and nutrition. However, the refrigerated shrimp surimi is prone to deterioration due to rapid microbial growth during storage. The present study sought to assess the effects of curcumin-mediated sono/photodynamic treatment on bacterial spoilage and shrimp surimi quality stored at 4 °C. The total viable count (TVC), microbiota composition, and quality parameters, including the total volatile basic nitrogen (TVB-N), thiobarbituric acid reactive substance (TBARs), and pH were investigated. The results showed that the spoilage bacteria in shrimp surimi rapidly increased with a surge on day 2 during refrigeration storage. The Psychrobacter and Brochothrix were identified as the Specific Spoilage Organisms (SSOs), which were also positively correlated with TVB-N and TBARs. The results further elucidated that the sono/photodynamic treatment could significantly inhibit the growth of SSOs on the surface and interior of shrimp surimi and delay shrimp surimi quality deterioration. In conclusion, the sono/photodynamic treatment as a non-thermal sterilization method could be a reliable and potential method for inactivating spoilage microorganisms and preserving shrimp surimi quality.

Sonodynamic antimicrobial chemotherapy: An emerging alternative strategy for microbial inactivation

Sonodynamic antimicrobial chemotherapy (SACT), which relies on a combination of low-intensity ultrasound and chemotherapeutic agents termed sonosensitizers, has been explored as a promising alternative for microbial inactivation. Such treatment has superior penetration ability, high target specificity, and can overcome resistance conferred by the local microenvironment. Taken of these advantages, SACT has been endowed with an extensive application prospect in the past decade and attracted more and more attention. This review focusses on the current understanding of the mechanism of SACT, the interaction of sonodynamic action on different microbes, the factors affecting the efficacy of SACT, discusses the findings of recent works on SACT, and explores further prospects for SACT. Thus, a better understanding of sonodynamic killing facilitates the scientific community and industry personnel to establish a novel strategy to combat microbial burden.

Synergistic inactivation of bacteria based on a combination of low frequency, low-intensity ultrasound and a food grade antioxidant

This study evaluated a synergistic antimicrobial treatment using a combination of low frequency and a low-intensity ultrasound (LFU) and a food-grade antioxidant, propyl gallate (PG), against a model gram-positive (Listeria innocua) and the gram-negative bacteria (Escherichia coli O157:H7). Bacterial inactivation kinetic measurements were complemented by characterization of biophysical changes in liposomes, changes in bacterial membrane permeability, morphological changes in bacterial cells, and intracellular oxidative stress upon treatment with PG, LFU, and a combination of PG + LFU. Combination of PG + LFU significantly (>4 log CFU/mL, P < 0.05) enhanced the inactivation of both L. innocua and E. coli O157:H7 compared to PG or LFU treatment. As expected, L. innocua had a significantly higher resistance to inactivation compared to E. coli using a combination of PG + LFU. Biophysical measurements in liposomes, bacterial permeability measurements, and scanning electron microscope (SEM)-based morphological measurements show rapid interactions of PG with membranes. Upon extended treatment of cells with PG + LFU, a significant increase in membrane damage was observed compared to PG or LFU alone. A lack of change in the intracellular thiol content following the combined treatment and limited effectiveness of exogenously added antioxidants in attenuating the synergistic antimicrobial action demonstrated that oxidative stress was not a leading mechanism responsible for the synergistic inactivation by PG + LFU. Overall, the study illustrates synergistic inactivation of bacteria using a combination of PG + LFU based on enhanced membrane damage and its potential for applications in the food and environmental systems.

The anti-biofilm capability of nano-emodin-mediated sonodynamic therapy on multi-species biofilms produced by burn wound bacterial strains

BACKGROUND

Management of burn wound infections (BWIs) is difficult due to the emergence of multidrug-resistant microorganisms. This study aimed to explore the anti-biofilm efficacy of sonodynamic therapy (SDT) using nano-emodin (N-EMO) against multi-species bacterial biofilms containing Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii.

METHODS

Following synthesis and confirmation of N-EMO as a sonosensitizer, the anti-biofilm efficacy of SDT against multi-species bacterial biofilms was determined using minimum inhibitory concentrations (MIC), minimum biofilm inhibitory concentration (MBIC), and minimal biofilm eradication concentration (MBEC) of N-EMO. The reduction of multi-species bacterial biofilms was then evaluated following the treatments using Log reduction and crystal violet (CV) assays. In addition, the expression profiling of abaI, agrA, and lasI genes using SDT with sub-MIC, sub-MBIC, and sub-MBEC of N-EMO was assessed.

RESULTS

Successful synthesis of N-EMO was confirmed through several characterization tests. As the results demonstrated, the MIC value of N-EMO for the multi-species bacterial suspension was 0.15 × 10^-4 g/L, as well as, the MBEC value of N-EMO was 2.5 × 10^-4 g/L, approximately 4-fold higher than that of MBIC (0.62 × 10^-4 g/L). According to the CV assay, there were 57.8 %, 71.0 %, and 81.5 % reduction in the biofilm of multi-species bacterial growth following SDT using 1/128 MBEC, 1/16 MBIC, and 1/2 MIC of N-EMO, respectively. Log reductions analysis demonstrated that 1/2 MIC of N-EMO was more potent in inhibiting the biofilm growth of multi-species test bacteria by 5.725 ± 0.12 (99.9993 %). In this study, N-EMO-mediated SDT could obviously downregulate the gene expression of virulence factors (P < 0.05). The gene expression of lasI, agrA, and abaI were downregulated about 2.5-, 3.6-, and 5.5-fold; and 3.0-, 5.2-, and 7.4-fold following SDT with sub-MBIC and sub-MBEC of N-EMO, respectively.

CONCLUSION

These results highlight the potential of N-EMO-mediated SDT in inhibition of biofilm formation, degradation of formed biofilms, and reduction of virulence factor associated with biofilms of multi-species bacterial biofilms in BWIs.

In Vitro Application of Sonodynamic Antimicrobial Chemotherapy as a Sonobactericidal Therapeutic Approach for Bacterial Infections: A Systematic Review and Meta-analysis

Introduction: This study aimed to perform a systematic review of the literature followed by a meta-analysis about the efficacy of sonodynamic antimicrobial chemotherapy (SACT) in bacterial infections. Methods: According to the PICOS (population, intervention, comparison and outcome) recommendations and PRISMA guidelines, an electronic search was conducted in PubMed, SCOPUS, Embase, and Cochrane Library based on the MeSH terms. All analyses were conducted using Biostat's Comprehensive Meta-Analysis version 2.0. The inter-study heterogeneity and publication bias assessments were carried out on the studies using I2 and the Egger's regression test. Results: Initially, 126 articles were identified in the electronic search, and 14 studies remained after analysis and exclusion of the duplicated studies and eligibility criteria. All results from the included studies displayed a significant reduction of microorganisms. The meta-analysis demonstrated a significant reduction in the bacterial load in all analyses (0.944% [95% CI, 0.901-0.969%; P=0.000]). Also, there was a low risk of bias for microbial load reduction without the evidence of publication bias. Conclusion: The results highlight that there is scientific evidence emphasizing the effectiveness of SACT in reducing the count of microorganisms in bacterial infections.

Recent Advances in Nanomaterial-Assisted Combinational Sonodynamic Cancer Therapy

Ultrasound (US)-triggered sonodynamic therapy (SDT), as a promising noninvasive therapeutic modality, has received ever-increasing attention in recent years. Its specialized chemical agents, named sonosensitizers, are activated by low-intensity US to produce lethal reactive oxygen species (ROS) for oncotherapy. Compared with phototherapeutic strategies, SDT provides many noteworthy opportunities and benefits, such as deeper penetration depth, absence of phototoxicity, and fewer side effects. Nevertheless, previous studies have also demonstrated its intrinsic limitations. Thanks to the facile engineering nature of nanotechnology, numerous novel nanoplatforms are being applied in this emerging field to tackle these intrinsic barriers and achieve continuous innovations. In particular, the combination of SDT with other treatment strategies has demonstrated a superior efficacy in improving anticancer activity relative to that of monotherapies alone. Therefore, it is necessary to summarize the nanomaterial-assisted combinational sonodynamic cancer therapy applications. Herein, the design principles in achieving synergistic therapeutic effects based on nanomaterial engineering methods are highlighted. The ultimate goals are to stimulate the design of better-quality combined sonodynamic treatment schemes and provide innovative ideas for the perspectives of SDT in promoting its future transformation to clinical application.

Enhancing Aqueous Solubility and Antibacterial Activity of Curcumin by Complexing with Cell-Penetrating Octaarginine

Bacterial resistance to antimicrobial drugs is one of the biggest threats to human health and novel drugs, and strategies are needed to obviate this resistance crisis. An innovative strategy for designing novel antimicrobial drugs is based on the hybridization of an antimicrobial agent with a second functional entity. Here, we use a cell-penetrating peptide-octaarginine (R8) as the second functional entity and develop a complex or hybrid of R8 and curcumin that possibly targets the bacterial cell membrane. Minimum inhibitory concentration assays show that the antibacterial activity of the complex is enhanced in a synergistic manner and rapid killing kinetics are obtained, emphasizing a bactericidal mode of action. In addition, electron microscopy images reveal bacterial membrane disruption by the complex. The R8-curcumin complex also displays activity against HeLa cells.

Sono-photodynamic inactivation of Escherichia coli and Staphylococcus aureus in orange juice

Efficiency of blue (462 ± 3 nm) light emitting diode (LED) illumination to inactivate Escherichia coli and Staphylococcus aureus in the presence of exogenous photosensitizer (curcumin) was studied in freshly squeezed orange juice. Further, the combinational effect of ultrasound (US), photosensitizer (PS) and blue light (BL) on inactivation of microbes was evaluated. The effect of process parameters such as concentration of PS, US and volume of the juice on E. coli and S. aureus inactivation was also investigated. The US alone and PS + BL treatments resulted in 3.02 ± 0.52 and 1.06 ± 0.13 log reduction of E. coli; 0.18 ± 0.14 and 2.34 ± 0.13 log reduction of S. aureus, respectively. The combination of PS + US + BL treatment at optimized conditions resulted in 2.35 ± 0.16 log reduction of S. aureus. An additive effect on the inactivation of E. coli (4.26 ± 0.32 log reduction) was observed with PS + US + BL combination treatment. The US treatment showed significant change in cloud value, colour and browning index of orange juice. The combinational non-thermal processes (PS + BL and PS + US + BL) did not have any significant effect on total phenolic content, total flavonoid content, and hesperidin content of the orange juice. However, these processes affected ascorbic acid content and antioxidant activity negatively. Thus, this study indicated that photodynamic inactivation of E. coli and S. aureus using LED-based photosensitization in fruit juices could be a potential method for microbial inactivation. Nevertheless, the effect on quality parameters needs to be considered while optimizing the process.

An Insight into Advanced Approaches for Photosensitizer Optimization in Endodontics-A Critical Review

Apical periodontitis is a biofilm-mediated disease; therefore, an antimicrobial approach is essential to cure or prevent its development. In the quest for efficient strategies to achieve this objective, antimicrobial photodynamic therapy (aPDT) has emerged as an alternative to classical endodontic irrigation solutions and antibiotics. The aim of the present critical review is to summarize the available evidence on photosensitizers (PSs) which has been confirmed in numerous studies from diverse areas combined with several antimicrobial strategies, as well as emerging options in order to optimize their properties and effects that might be translational and useful in the near future in basic endodontic research. Published data notably support the need for continuing the search for an ideal endodontic photosensitizer, that is, one which acts as an excellent antimicrobial agent without causing toxicity to the human host cells or presenting the risk of tooth discoloration. The current literature on experimental studies mainly relies on assessment of mixed disinfection protocols, combining approaches which are already available with aPDT as an adjunct therapy. In this review, several approaches concerning aPDT efficiency are appraised, such as the use of bacteriophages, biopolymers, drug and light delivery systems, efflux pump inhibitors, negative pressure systems, and peptides. The authors also analyzed their combination with other approaches for aPDT improvement, such as sonodynamic therapy. All of the aforementioned techniques have already been tested, and we highlight the biological challenges of each formulation, predicting that the collected information may encourage the development of other effective photoactive materials, in addition to being useful in endodontic basic research. Moreover, special attention is dedicated to studies on detailed conditions, aPDT features with a focus on PS enhancer strategies, and the respective final antimicrobial outcomes. From all the mentioned approaches, the two which are most widely discussed and which show the most promising outcomes for endodontic purposes are drug delivery systems (with strong development in nanoparticles) and PS solubilizers.

Bacteria-Responsive Nanoliposomes as Smart Sonotheranostics for Multidrug Resistant Bacterial Infections

Rapid emergence of multidrug resistant (MDR) "superbugs" poses a severe threat to global health. Notably, undeveloped diagnosis and concomitant treatment failure remain highly challenging. Herein, we report a sonotheranostic strategy to achieve bacteria-specific labeling and visualized sonodynamic therapy (SDT). Using maltohexaose-decorated cholesterol and bacteria-responsive lipid compositions, a smart nanoliposomes platform (MLP18) was developed for precise delivery of purpurin 18, a potent sonosensitizer proved in this study. Taking advantage of the bacteria-specific maltodextrin transport pathway, the prepared MLP18 can specifically target the bacterial infection site and accurately distinguish the foci from sterile inflammation or cancer with a highly selective fluorescence/photoacoustic signal on the bacteria-infected site of mice. Moreover, the bacteria-responsive feature of MLP18 activated an efficient release and internalization of high concentration sonosensitizer into bacterial cells, resulting in effective sonodynamic elimination of MDR bacteria. In situ MRI monitoring visualized such potent sonodynamic activity and indicated that MLP18-mediated SDT could successfully eradicate inflammation and abscess from mice with bacterial myositis. In view of the above advantages, the developed nanoliposomes may serve as a promising sonotheranostic platform against MDR bacteria in the areas of healthcare.

Target-oriented photofunctional nanoparticles (TOPFNs) for selective photodynamic inactivation of Methicillin-resistant Staphylococcus aureus (MRSA)

To inactivate methicillin-resistant Staphylococcus aureus (MRSA) with minimum damage to host cells and tissue, target-oriented photofunctional nanoparticles (TOPFNs) were fabricated and characterized. MRSA is a predominant infective pathogen even in hospital and non-hospital environments due to its ability to develop high levels of resistance to several classes of antibiotics through various pathways. To solve this major problem, photodynamic inactivation (PDI) method applies to treat antibiotic-resistant bacteria. PDI involves the photosensitizer (PS) and light with a specific wavelength to be able to apply for a non-invasive therapeutic procedure to treat pathogenic bacteria by inducing apoptosis or necrosis of microorganisms. However, most current PDI researches have suffered from the instability of PDI agents in the biological environment due to the lack of selectivity and low solubility of PDI agents, which leads to the low PDI efficiency. In this study, the TOPFNs were fabricated by an esterification reaction to introduce hematoporphyrin (HP) and MRSA antibody to the surface of Fe₃O₄ nanoparticles. The TOPFNs were designed as dispersible PDI agent in biological condition, which was effectively used for selectively capturing and killing of MRSA. The capture efficiency TOPFNs was compared with PFNs as a negative control. The results showed that the capture efficiency of TOPFNs and PFNs was 95.55% and 6.43% in MRSA and L-929 cell mixed condition, respectively. And TOPFNs have a selective killing ability for MRSA with minimum damage to L-929 cells. Furthermore, PDI effect of TOPFNs was evaluated on the mice in vivo condition in order to check the possibility of practical medical application.

Antimicrobial sonodynamic and photodynamic therapies against Candida albicans

Candida albicans biofilms exhibit unique characteristics and are highly resistant to antifungal agents. Antimicrobial photodynamic therapy (aPDT) is an alternative treatment limited to treating superficial infections due to the poor light penetration. In this manuscript, the antifungal properties of sonodynamic therapy (SDT) were assessed. SDT uses ultrasound instead of light, enabling the treatment of deeper infections. Planktonic cells and biofilms of C. albicans were treated with aPDT or SDT, in addition to combined aPDT/SDT, with cell survival determined using colony forming units. The total biomass and structural integrity of the biofilms were also investigated. The results demonstrated that while individual aPDT or SDT eradicated suspensions, they had little impact on biofilms. However, combined aPDT/SDT significantly reduced the viability and total biomass of biofilms. Microscopic images revealed that biofilms treated with aPDT/SDT were thinner and comprised mainly of dead cells. These results highlight the potential of combined aPDT/SDT for the inactivation of C. albicans biofilms.

Photodynamic antimicrobial chemotherapy with cationic phthalocyanines against Escherichia coli planktonic and biofilm cultures

Cationic phthalocyanines (Pcs) combine with photodynamic antimicrobial chemotherapy (PACT) presents excellent antibacterial activity to Gram-negative bacteriaE. coli.

Low-Intensity Ultrasound Combined with Hematoporphyrin Monomethyl Ether in the Treatment of Experimental Periodontitis in Rats

Objectives. This study aims to evaluate the efficacy of hematoporphyrin monomethyl ether- (HMME-) mediated sonodynamic therapy (SDT) on experimental periodontal disease in rats. Methods. Periodontal disease was induced by submerging ligatures at the first maxillary molar subgingival region in forty-eight male SD rats. After 30 days, the ligatures were removed. The rats were randomly allocated into four groups; the experimental SDT group was treated through hypodermic injection of 40 μg/mL HMME and 3 W/cm² low-intensity ultrasound irradiation (1 MHz, 600 s). Those in control groups received 40 μg/mL HMME alone (control 1 group) or 3 W/cm² ultrasound irradiation alone (control 2 group) or were subjected to neither HMME nor ultrasound (control 3 group). After 10 days of treatment, all rats were euthanized, the maxilla was obtained for histological examination, and the alveolar bone level was evaluated by histometric analysis. Results. The control groups showed more bone loss (P < 0.05) after 10 days of treatment than the SDT group. There is no significant difference among the control groups (P > 0.05). Conclusions. HMME mediated SDT was an effective therapy of experimental periodontal tissue in rats.

Sonodynamic action of hypocrellin B on methicillin-resistant Staphylococcus aureus

Methicillin-resistant Staphylococcus aureus (MRSA) commonly causes refractory infections and has recently become a serious public health concern. The present study was designed to investigate sonodynamic action of hypocrellin B on MRSA. A MRSA strain (ATCC BAA-43) was used in the present study. The dark toxicity of hypocrellin B on MRSA and its uptake in MRSA first were measured. And then bacteria were incubated with hypocrellin B and exposed to ultrasound. After sonodynamic treatment, colony forming unit assay and bacterial viability assay were conducted. Membrane permeability assay, DNA fragmentation assay, and DNA synthesis assay were also performed to examine the underlying mechanism. The results showed that hypocrellin B at concentrations of up to 500 μM had no toxicity to MRSA in the dark. After incubation for 50 min, hypocrellin B could be maximally absorbed by MRSA, and exhibited significant sonodynamic activity in a dose-dependent manner. The 5-log reduction in colony forming unit (CFU) was observed after hypocrellin B (40 μM) treatment at an intensity of 1.38 W/cm(2) ultrasound for 5 min. Compared to the control, hypocrellin B alone and ultrasound sonication alone group, more dead cells were found and bacterial membrane integrity was notably damaged after sonodynamic treatment of hypocrellin B. However, no remarkable DNA damage was found in MRSA after sonodynamic treatment of hypocrellin B. All the findings demonstrated that hypocrellin B could serve as a potential antibacterial sonosensitizer to significantly cause damage to the membrane integrity of MRSA and inhibit its growth under ultrasound sonication.

Nanoparticles in sonodynamic therapy: state of the art review

The different types and advantages of nanoparticles in sonodynamic therapy.

Sonodynamic action of chlorin e6 on Staphylococcus aureus and Escherichia coli

Bacteria remain a great threat to human health. In the present study, we examined whether sonodynamic action of chlorin e6 had antibacterial activity on gram-positive bacterial strain Staphylococcus aureus (S. aureus) and gram-negative bacterial strain Escherichia coli (E. coli). Colony forming unit (CFU) assay showed that sonodynamic treatment of chlorin e6 induced a 2-log reduction in CFU of E. coli cells, 7-log reduction in CFU of S. aureus. Fluorescent microscopy observed that dead cells remarkably increased whereas live cells decreased after sonodynamic treatment of chlorin e6 on S. aureus cells. We first demonstrated that sonodynamic action of chlorin e6 has antibacterial effect on both gram-positive and negative bacteria, more powerful on gram-positive bacteria.

Sonodynamic action of hypocrellin B on biofilm-producing Staphylococcus epidermidis in planktonic condition

Staphylococcus epidermidis is an opportunistic pathogen causing biofilm-associated infections. To investigate sonodynamic action of hypocrellin B on biofilm-producing Staphylococcus epidermidis in planktonic culture, a biofilm-producing strain Staphylococcus epidermidis (ATCC 35984) was incubated with hypocrellin B and then exposed to ultrasound at intensity (ISATA) of 1.56 W/cm(2) with a frequency of 1 MHz in continuous mode for 5 min. After sonodynamic treatment of hypocrellin B, the bacterial growth was measured using the colony counting method. Bacterial membrane integrity was investigated using a flow cytometry with propidium iodide staining. Intracellular reactive oxygen species (ROS) level was measured using a flow cytometry with DCFH-DA staining. The results showed that sonodynamic action of hypocrellin B significantly induced survival reduction of Staphylococcus epidermidis in a hypocrellin B dose-dependent manner, and a 4-log reduction was observed after the combined treatment of hypcorellin B (40 μM) and ultrasound sonication with the intensity of 1.56 W/cm(2) for 5 min. Bacterial membrane integrity was notably damaged and the level of intracellular ROS level was remarkably increased after sonodynamic treatment. The findings demonstrated that sonodynamic action of hypocrellin B had significant antibacterial activity on biofilm-producing Staphylococcus epidermidis in planktonic condition probably through increasing intracellular ROS level to cause damage to bacterial membrane integrity.

Sonodynamic action of curcumin on foodborne bacteria Bacillus cereus and Escherichia coli

Bacterial contamination is an important cause of foodborne diseases. The present study aimed to investigate sonodynamic action of curcumin on foodborne bacteria Bacillus cereus (B. cereus) and Escherichia coli (E. coli). The uptake of curcumin was measured for optimizing the concentration incubation time before ultrasound sonication, and colony forming units (CFU) were counted after ultrasound treatment. The chromosomal DNA fragmentation of bacteria was analyzed and the effect of hypoxic condition on the antibacterial efficacy of sonodynamic action of curcumin was also assessed in this study. The results showed that the maximum uptake of curcumin in B. cereus and E. coli occurred in 50min after curcumin incubation. Curcumin had sonodynamic bactericidal activity in a curcumin dose-dependent manner, and 5.6-log reduction in CFU of B. cereus was observed after curcumin treatment (2.0μM), however, only 2-log reduction in CFU of E. coli after 40μM curcumin treatment. No significant change in chromosomal DNA was found after the combined treatment of curcumin and ultrasound. The survival of B. cereus and E. coli after sonodynamic treatment in hypoxic group was significantly higher than that in normal oxygen group. These findings indicated that sonodynamic action of curcumin had significant inactivation effect on foodborne bacteria, and B. cereus was more sensitive to sonodynamic treatment of curcumin than E. coli. Sonodynamic antibacterial activity of curcumin might be dependent on the oxygen environment.

Sonodynamic antimicrobial chemotherapy: First steps towards a sound approach for microbe inactivation

Sonodynamic therapy (SDT) relies on the ability of ultrasound to activate sonosensitisers and trigger the generation of reactive oxygen species (ROS) to achieve cell death. SDT was explored as an anticancer approach until 6 years ago, when its potential application as an antimicrobial strategy was pointed out and the term "sonoantimicrobial chemotherapy" (SACT) was coined. The excellent penetration of ultrasound in liquid media make SACT a particularly promising approach for the non-invasive treatment of deep-seated infections, and for the reduction of bacterial load in turbid water. In this review we provide an account of the brief history of SACT, from its molecular bases to the current state of the art and perspective applications.