All-in-one NIR-activated nanoplatforms for enhanced bacterial biofilm eradication

Antibiotic-free responsive biomaterials for specific and targeted Helicobacter pylori eradication

Gastric cancer is highly correlated with Helicobacter pylori (H. pylori) infection. Approximately 50 % of the population worldwide is infected with H. pylori. However, current treatment regimens face severe challenges including drug resistance and gut microbiota disruption. An integrative treatment with slight negative influences on intestinal flora, conforming with concepts of integrative prevention of gastric cancer, is urgently needed. Non-antibiotic responsive biomaterials can respond to different stimuli, including pH, enzymes, light, ultrasound and magnetism, under which biomaterials are specifically activated to perform antibacterial capabilities, while neutral intestinal microenvironments differ from gastric microenvironments or inflammatory sites and have no or minimal irradiation via precisely controlled exogenous stimuli, which may not only overcome antibiotic resistance but also avoid gut microbiota disorders. First, the latest progress in responsive biomaterials against H. pylori without gut microbiome disturbance and their anti-H. pylori performances are profoundly summarized. Second, the mechanisms against planktonic bacteria, biofilms and intracellular bacteria are discussed respectively. Finally, the strategies of specific and targeted H. pylori elimination by responsive biomaterials are introduced. Additionally, the challenges and the focus of future research on translation into clinical application are fully proposed. Antibiotic-free responsive biomaterials for specific and targeted H. pylori eradication represent an innovative approach.

2-D transition metal trichalcophosphogenide FePS3 against multi-drug resistant microbial infections

Antimicrobial resistance (AMR) is a significant concern to society as it threatens the effectiveness of antibiotics and leads to increased morbidity and mortality rates. Innovative approaches are urgently required to address this challenge. Among promising solutions, two dimensional (2-D) nanomaterials with layered crystal structures have emerged as potent antimicrobial agents owing to their unique physicochemical properties. This antimicrobial activity is largely attributed to their high surface area, which allows for efficient interaction with microbial cell membranes, leading to physical disruption or oxidative stress through the generation of reactive oxygen species (ROS). The latter mechanism is particularly noteworthy as it involves the degradation of these nanomaterials under specific conditions, releasing ROS that can effectively kill bacteria and other pathogens without harming human cells. This study explores the antimicrobial properties of a novel biodegradable nanomaterial based on 2-D transition metal trichalcogenides, FePS3, as a potential solution to drug-resistant microbes. Our findings indicate that FePS3 is an exceptionally effective antimicrobial agent with over 99.9% elimination of various bacterial strains. Crucially, it exhibits no cytotoxic effects on mammalian cells, underscoring the potential for safe biomedical application. The primary mechanism driving the antimicrobial efficacy of FePS3 is the release of ROS during biodegradation. ROS has a crucial role in neutralizing bacterial cells, conferring significant antipathogenic properties to this compound. The unique combination of high antimicrobial activity, biocompatibility, and biodegradability makes FePS3 a promising candidate for developing new antimicrobial strategies. This research contributes to the increasing body of evidence supporting the use of 2-D nanomaterials in addressing the global challenge of AMR, offering a potential pathway for the development of advanced, effective, and safe antimicrobial agents.

Nanomaterials at the forefront of antimicrobial therapy by photodynamic and photothermal strategies

In the face of the increasing resistance of microorganisms to traditional antibiotics, the development of innovative treatment methods is becoming increasingly urgent. Nanophototherapy technology can precisely target the infected area and achieve synergistic antibacterial effects in multiple modes. This phototherapy method has shown significant efficacy in treating diseases caused by drug-resistant bacteria, especially in the elimination of biofilms, where it has demonstrated strong dissolution capabilities. PTT utilizes photothermal agents to convert near-infrared light into heat, effectively killing bacteria and promoting tissue regeneration. Similarly, PDT utilizes photosensitizers, which produce reactive oxygen species (ROS) when activated by light, destroying the structure and function of bacterial cells. This review summarizes photothermal agents and photosensitizers used for antibacterial purposes. In conducting our literature review, we employed a systematic approach to ensure a comprehensive and representative selection of studies. Additionally, this article explores the potential of phototherapy in regulating wound microenvironments, promoting wound healing, and activating the immune system. Nanophototherapeutic materials show great potential for application in antibacterial treatment and are expected to provide innovative solutions for drug-resistant bacterial infections that traditional antibiotics are struggling to address.

Graphene Oxide/Black Phosphorus Functionalized Collagen Scaffolds with Enhanced Near-Infrared Controlled In Situ Biomineralization for Promoting Infectious Bone Defect Repair through PI3K/Akt Pathway

Infectious bone defects resulting from surgery, infection, or trauma are a prevalent clinical issue. Current treatments commonly used include systemic antibiotics and autografts or allografts. Nevertheless, therapies come with various disadvantages, including multidrug-resistant bacteria, complications arising from the donor site, and immune rejection, which makes artificial implants desirable. However, artificial implants can fail due to bacterial infections and inadequate bone fusion after implantation. Thus, the development of multifunctional bone substitutes that are biocompatible, antibacterial, osteoconductive, and osteoinductive would be of great clinical importance. This study designs and prepares 2D graphene oxide (GO) and black phosphorus (BP) reinforced porous collagen (Col) scaffolds as a viable strategy for treating infectious bone defects. The fabricated Col-GO@BP scaffold exhibited an efficient photothermal antibacterial effect under near-infrared (NIR) irradiation. A further benefit of the NIR-controlled degradation of BP was to promote biomineralization by phosphorus-driven and calcium-extracted phosphorus in situ. The abundant functional groups in GO could synergistically capture the ions and enhance the in situ biomineralization. The Col-GO@BP scaffold facilitated osteogenic differentiation of bone marrow-derived mesenchymal stem cells (BMSC) by leveraging its mild photothermal effect and biomineralization process, which upregulated heat shock proteins (HSPs) and activated PI3K/Akt pathways. Additionally, systematic in vivo experiments demonstrated that the Col-GO@BP scaffold obviously promotes infectious bone repair through admirable photothermal antibacterial performance and enhanced vascularization. As a result of this study, we provide new insights into the photothermal activity of GO@BP nanosheets, their degradation, and a new biological application for them.

Escaping the ESKAPE pathogens: A review on antibiofilm potential of nanoparticles

ESKAPE pathogens, a notorious consortium comprising Enterococcusfaecium, Staphylococcusaureus, Klebsiellapneumoniae, Acinetobacterbaumannii, Pseudomonasaeruginosa, and Enterobacter species, pose formidable challenges in healthcare settings due to their multidrug-resistant nature. The increasing global cases of antimicrobial-resistant ESKAPE pathogens are closely related to their remarkable ability to form biofilms. Thus, understanding the unique mechanisms of antimicrobial resistance of ESKAPE pathogens and the innate resilience of biofilms against traditional antimicrobial agents is important for developing innovative strategies to establish effective control methods against them. This review offers a thorough analysis of biofilm dynamics, with a focus on the general mechanisms of biofilm formation, the significant contribution of persister cells in the resistance mechanisms, and the recurrence of biofilms in comparison to planktonic cells. Additionally, this review highlights the potential strategies of nanoparticles for managing biofilms in the ESKAPE group of pathogens. Nanoparticles, with their unique physicochemical properties, provide promising opportunities for disrupting biofilm structures and improving antimicrobial effectiveness. The review has explored interactions between nanoparticles and biofilms, covering a range of nanoparticle types such as metal, metal-oxide, surface-modified, and functionalized nanoparticles, along with organic nanoparticles and nanomaterials. The additional focus of this review also encompasses green synthesis techniques of nanoparticles that involve plant extract and supernatants from bacterial and fungal cultures as reducing agents. Furthermore, the use of nanocomposites and nano emulsions in biofilm management of ESKAPE is also discussed. To conclude, the review addresses the current obstacles and future outlooks in nanoparticle-based biofilm management, stressing the necessity for further research and development to fully exploit the potential of nanoparticles in addressing biofilm-related challenges.

Nano-Bio Interactions: Biofilm-Targeted Antibacterial Nanomaterials

Biofilm is a spatially organized community formed by the accumulation of both microorganisms and their secretions, leading to persistent and chronic infections because of high resistance toward conventional antibiotics. In view of the tunable physicochemical properties and the related unique biological behavior (e.g., size-, shape-, and surface charge-dependent penetration, protein corona endowed targeting, catalytic- and electronic-related oxidative stress, optical- and magnetic-associated hyperthermia, etc.), nanomaterials-based therapeutics are widely used for the treatment of biofilm-associated infections. In this review, the biological characteristics of biofilm are introduced. And the nanomaterials-based antibacterial strategies are further discussed via biofilm targeting, including preventing biofilm formation, enhancing biofilm penetration, disrupting the mature biofilm, and acting as drug delivery systems. In which, the interactions between biofilm and nanomaterials include mechanical disruption, electron transfer, enzymatic degradation, oxidative stress, and hyperthermia. Additionally, the current advances of nanomaterials for antibacterial nanomaterials by biofilm targeting are summarized. This review aims to present a complete vision of antibacterial nanomaterials-biofilm (nano-bio) interactions, paving the way for the future development and clinical translation of effective antibacterial nanomedicines.

Multifunctional hemostatic polysaccharide-based sponge enhanced by tunicate cellulose: A promising approach for photothermal antibacterial activity and accelerated wound healing

Fast and effective hemostasis and protection against wound infection play a crucial role in trauma care. In this study, a sponge scaffold with a self-expanding interpenetrating macropore structure was designed via two-step cross-linking method for hemostasis and photothermal antimicrobial activity. Oxidized Konjac glucomannan (OKGM) and chitosan (CS) were crosslinked once to form a dynamic covalent bonding network, and a basic three-dimensional fiber porous network framework was constructed by uniformly dispersing Tunicate nanocellulose (TCNCs). Secondary crosslinking introduced Polydopamine (PDA NPs) into the sponge, while dynamic hydrogen bonds were interleaved to stabilize the frame. PDA NPs enhanced the sponge's antibacterial and antioxidant properties due to its good photothermal conversion efficiency and oxygen radical scavenging ability. Compared to cotton gauze and gelatin sponges, the composite sponges showed superior blood cell adhesion and platelet activation. In tests on rat liver trauma models, composite sponges showed shorter hemostasis time (12 ± 2.17 s) and less blood loss (0.1 ± 0.052 g). Sponges can protect wound tissue through their adhesion properties. In the full-thickness wound model infected with S. aureus, the composite sponge accelerated wound healing. Overall, this composite sponge has great potential for clinical use as a wound dressing.

Photothermal effective CeO2NPs combined in thermosensitive hydrogels with enhanced antibacterial, antioxidant and vascularization performance to accelerate infected diabetic wound healing

Chronic diabetic wound healing remains a formidable challenge due to susceptibility to bacterial infection, excessive oxidative stress, and poor angiogenesis. To address these issues, a sodium alginate (SA) based photothermal hydrogel dressing with multifunction was fabricated to facilitate wound treatment. Ceria nanoparticles (CeO2NPs) was synthesized, and their antibacterial performance by near-infrared light triggered photothermal effects was first studied and verified in this work. In addition, to release CeO2NPs to achieve antioxidation and pro-vascularization, thermosensitive gelatin (Gel) was utilized to embed the nanoparticles in advance and then composited in SA hydrogel networks. SA network was finally strengthened by acid soaking to form partially crystalline regions to act as natural crosslinkers. Results showed that the Gel/SA/CeO2 hydrogel displayed temperature-responsive release of CeO2NPs, significant antibacterial and antioxidative activity, as well as the ability to remove without injury and promote infected diabetic wound healing with low cytotoxicity, according to antibacterial investigations, cell studies, and in vivo animal studies. This research offers not only a successful method for quickening the healing of diabetic wounds but also a fresh approach to the general use of CeO2NPs.

Positively Charged Semiconductor Conjugated Polymer Nanomaterials with Photothermal Activity for Antibacterial and Antibiofilm Activities In Vitro and In Vivo

Biofilm infections are associated with most human bacterial infections and are prone to bacterial multidrug resistance. There is an urgent need to develop an alternative approach to antibacterial and antibiofilm agents. Herein, two positively charged semiconductor conjugated polymer nanoparticles (SPPD and SPND) were prepared for additive antibacterial and antibiofilm activities with the aid of positive charge and photothermal therapy (PTT). The positive charge of SPPD and SPND was helpful in adhering to the surface of bacteria. With an 808 nm laser irradiation, the photothermal activity of SPPD and SPND could be effectively transferred to bacteria and biofilms. Under the additive effect of positive charge and PTT, the inhibition rate of Staphylococcus aureus (S. aureus) treated with SPPD and SPND (40 μg/mL) could reach more than 99.2%, and the antibacterial activities of SPPD and SPND against S. aureus biofilms were 93.5 and 95.8%. SPPD presented better biocompatibility than SPND and exhibited good antibiofilm properties in biofilm-infected mice. Overall, this additive treatment strategy of positive charge and PTT provided an optional approach to combat biofilms.

Photothermal/Photoacoustic Therapy Combined with Metal-Based Nanomaterials for the Treatment of Microbial Infections

The increased spread and persistence of bacterial drug-resistant phenotypes remains a public health concern and has contributed significantly to the challenge of combating antibiotic resistance. Nanotechnology is considered an encouraging strategy in the fight against antibiotic-resistant bacterial infections; this new strategy should improve therapeutic efficacy and minimize side effects. Evidence has shown that various nanomaterials with antibacterial performance, such as metal-based nanoparticles (i.e., silver, gold, copper, and zinc oxide) have intrinsic antibacterial properties. These antibacterial agents, such as those made of metal oxides, carbon nanomaterials, and polymers, have been used not only to improve antibacterial efficacy but also to reduce bacterial drug resistance due to their interaction with bacteria and their photophysical properties. These nanostructures have been used as effective agents for photothermal therapy (PTT) and photodynamic therapy (PDT) to kill bacteria locally by heating or the controlled production of reactive oxygen species. Additionally, PTT or PDT therapies have also been combined with photoacoustic (PA) imaging to simultaneously improve treatment efficacy, safety, and accuracy. In this present review, we present, on the one hand, a summary of research highlighting the use of PTT-sensitive metallic nanomaterials for the treatment of bacterial and fungal infections, and, on the other hand, an overview of studies showing the PA-mediated theranostic functionality of metal-based nanomaterials.

Bacteria-Targeted Combined with Photothermal/NO Nanoparticles for the Treatment and Diagnosis of MRSA Infection In Vivo

Currently, undeveloped diagnosis and delayed treatment of bacteria-infected sites in vivo not only expand the risk of tissue infection but are also a major clinical cause of multiple drug-resistant bacterial infections. Herein, an efficient nanoplatform for near-infrared (NIR)-light-controlled release and bacteria-targeted delivery of nitric oxide (NO) combined with photothermal therapy (PTT) is presented. Using maltotriose-decorated mesoporous polydopamine (MPDA-Mal) and BNN6, a smart antibacterial (B@MPDA-Mal) is developed to combine bacterial targeting, gas-controlled release, and PTT. Utilizing bacteria's unique maltodextrin transport system, B@MPDA-Mal can accurately distinguish bacterial infection from sterile inflammation and target the bacteria-infected sites for efficient drug enrichment. Moreover, NIR-light causes MPDA to generate heat, which not only effectively induces BNN6 to produce NO, but also raises the temperature to harm the bacteria further. NO/photothermal combination therapy effectively eliminates biofilm and drug-resistant bacteria. The myositis model of methicillin-resistant Staphylococcus aureus infection is established and indicates that B@MPDA-Mal can successfully eradicate inflammation and abscesses in mice. Meanwhile, magnetic resonance imaging technology is used to monitor the treatment procedure and healing outcomes. Given the aforementioned advantages, the smart antibacterial nanoplatform B@MPDA-Mal can be used as a potential therapeutic tool in the biomedical field against drug-resistant bacterial infections.

Green synthesis of nano silver-embedded carboxymethyl starch waste/poly vinyl alcohol hydrogel with photothermal sterilization and pH-responsive behavior

Bacterial wound infections remain a significant health issue of great concern. Hence, there is a need to develop a novel material with antibacterial properties and smart functions. In this study, the effects of silver nanoparticles content (AgNPs) on properties of photothermal and pH-responsive nanocomposite hydrogels were investigated. The nanocomposite hydrogel samples were prepared using cassava starch waste modified by carboxymethylation (CMS), and mixed with poly vinly alcohol (PVA) and tannic acid (TA). The presence of AgNPs in the hydrogel samples enhanced antibacterial activities and photothermal conversion ability. The use of as-prepared hydrogel using 200 mM silver nitrate (H-AgNPs-200) combined with near infrared (NIR) radiation produced 100 % antibacterial efficiency for Escherichia coli (E.coli) and 98.2 % for Staphylococcus aureus (S.aureus). Furthermore, the H-AgNPs-200 also provided the highest storage modulus at 87.9 kPa. The obtained nanocomposite hydrogel was shown to exhibit pH-responsive release of TA. Under NIR radiation, higher release of TA at different pH was observed. The cytotoxicity study indicated that the nanocomposite hydrogels had good biocompatibility. Hence, the development of nanocomposite hydrogel-based CMS from cassava starch waste/PVA/AgNPs is a promising and sustainable approach where agro-waste product is used as the base material for medical application in wound dressing.

Trends in Photothermal Nanostructures for Antimicrobial Applications

The rapid development of antimicrobial resistance due to broad antibiotic utilisation in the healthcare and food industries and the non-availability of novel antibiotics represents one of the most critical public health issues worldwide. Current advances in nanotechnology allow new materials to address drug-resistant bacterial infections in specific, focused, and biologically safe ways. The unique physicochemical properties, biocompatibility, and wide range of adaptability of nanomaterials that exhibit photothermal capability can be employed to develop the next generation of photothermally induced controllable hyperthermia as antibacterial nanoplatforms. Here, we review the current state of the art in different functional classes of photothermal antibacterial nanomaterials and strategies to optimise antimicrobial efficiency. The recent achievements and trends in developing photothermally active nanostructures, including plasmonic metals, semiconductors, and carbon-based and organic photothermal polymers, and antibacterial mechanisms of action, including anti-multidrug-resistant bacteria and biofilm removal, will be discussed. Insights into the mechanisms of the photothermal effect and various factors influencing photothermal antimicrobial performance, emphasising the structure-performance relationship, are discussed. We will examine the photothermal agents' functionalisation for specific bacteria, the effects of the near-infrared light irradiation spectrum, and active photothermal materials for multimodal synergistic-based therapies to minimise side effects and maintain low costs. The most relevant applications are presented, such as antibiofilm formation, biofilm penetration or ablation, and nanomaterial-based infected wound therapy. Practical antibacterial applications employing photothermal antimicrobial agents, alone or in synergistic combination with other nanomaterials, are considered. Existing challenges and limitations in photothermal antimicrobial therapy and future perspectives are presented from the structural, functional, safety, and clinical potential points of view.

Friends against the Foe: Synergistic Photothermal and Photodynamic Therapy against Bacterial Infections

Multidrug-resistant (MDR) bacteria are rapidly emerging, coupled with the failure of current antibiotic therapy; thus, new alternatives for effectively treating infections caused by MDR bacteria are required. Hyperthermia-mediated photothermal therapy (PTT) and reactive oxygen species (ROS)-mediated photodynamic therapy (PDT) have attracted extensive attention as antibacterial therapies owing to advantages such as low invasiveness, low toxicity, and low likelihood of causing bacterial resistance. However, both strategies have notable drawbacks, including the high temperature requirements of PTT and the weak ability of PDT-derived ROS to penetrate target cells. To overcome these limitations, a combination of PTT and PDT has been used against MDR bacteria. In this review, we discuss the unique benefits and limitations of PTT and PDT against MDR bacteria. The mechanisms underlying the synergistic effects of the PTT-PDT combination are also discussed. Furthermore, we introduced advancements in antibacterial methods using nano-based PTT and PDT agents to treat infections caused by MDR bacteria. Finally, we highlight the existing challenges and future perspectives of synergistic PTT-PDT combination therapy against infections caused by MDR bacteria. We believe that this review will encourage synergistic PTT- and PDT-based antibacterial research and can be referenced for future clinical applications.

Advances in image-guided drug delivery for antibacterial therapy

The emergence of antibiotic-resistant bacterial strains is seriously endangering the global healthcare system. There is an urgent need for combining imaging with therapies to realize the real-time monitoring of pathological condition and treatment progress. It also provides guidance on exploring new medicines and enhance treatment strategies to overcome the antibiotic resistance of existing conventional antibiotics. In this review, we provide a thorough overview of the most advanced image-guided approaches for bacterial diagnosis (e.g., computed tomography imaging, magnetic resonance imaging, photoacoustic imaging, ultrasound imaging, fluorescence imaging, positron emission tomography, single photon emission computed tomography imaging, and multiple imaging), and therapies (e.g., photothermal therapy, photodynamic therapy, chemodynamic therapy, sonodynamic therapy, immunotherapy, and multiple therapies). This review focuses on how to design and fabricate photo-responsive materials for improved image-guided bacterial theranostics applications. We present a potential application of different image-guided modalities for both bacterial diagnosis and therapies with representative examples. Finally, we highlighted the current challenges and future perspectives image-guided approaches for future clinical translation of nano-theranostics in bacterial infections therapies. We envision that this review will provide for future development in image-guided systems for bacterial theranostics applications.

Carbon nanomaterials for phototherapy

Phototherapy attracts increasing interest for broad bio-applications due to its noninvasive and highly selective nature. Owing to their good biocompatibility, unique optoelectronic properties and size/surface effects, carbon nanomaterials show great promise for phototherapy. Various carbon nanomaterials have been demonstrated as efficient phototherapy agents for a large variety of phototherapeutic applications, including cancer treatment, anti-bacteria, and Alzheimer's disease. This review summarizes the recent progress of carbon nanomaterials for phototherapy. Current challenges and future perspectives are also discussed.

Visible light-regulated cationic polymer coupled with photodynamic inactivation as an effective tool for pathogen and biofilm elimination

Background

Pathogenic microorganism pollution has been a challenging public safety issue, attracting considerable scientific interest. A more problematic aspect of this phenomenon is that planktonic bacteria exacerbate biofilm formation. There is an overwhelming demand for developing ultra-efficient, anti-drug resistance, and biocompatibility alternatives to eliminate stubborn pathogenic strains and biofilms.

Results

The present work aims to construct a visible light-induced anti-pathogen agents to ablate biofilms using the complementary merits of ROS and cationic polymers. The photosensitizer chlorin e6-loaded polyethyleneimine-based micelle (Ce6-TPP-PEI) was constructed by an amphiphilic dendritic polymer (TPP-PEI) and physically loaded with photosensitizer chlorin e6. Cationic polymers can promote the interaction between photosensitizer and Gram-negative bacteria, resulting in enhanced targeting of PS and lethality of photodynamic therapy, and remain active for a longer duration to prevent bacterial re-growth when the light is turned off. As expected, an eminent antibacterial effect was observed on the Gram-negative Escherichia coli, which is usually insensitive to photosensitizers. Surprisingly, the cationic polymer and photodynamic combination also exert significant inhibitory and ablative effects on fungi and biofilms. Subsequently, cell hemolysis assessments suggested its good biocompatibility.

Conclusions

Given the above results, the platform developed in this work is an efficient and safe tool for public healthcare and environmental remediation.

A multifunctional Fe2O3@MoS2@SDS Z-scheme nanocomposite: NIR enhanced bacterial inactivation, degradation antibiotics and inhibiting ARGs dissemination

To fight the flourishment of drug-resistant bacteria caused by antibiotics and the dissemination of antibiotic resistance genes (ARGs), it is of great urgency to develop multifunctional non-antibiotic agents with residual antibiotics elimination, and ARGs dissemination inhibition properties. Herein, sodium dodecyl sulfate (SDS) was modified onto the surface of Fe2O3 @MoS2 by ultrasonic method to obtain the Z-scheme, multifunctional Fe2O3 @MoS2 @SDS nanocomposites. The Fe2O3 @MoS2 @SDS (weight ratio of Fe2O3 @MoS2 and SDS was 1:1) was selected as the optimal agent. Under NIR irradiation, the Fe2O3 @MoS2 @SDS had a photothermal conversion efficiency of 45.96%, and could generate plenty of reactive oxygen species (ROS) at the same time. Under the synergy of photothermal and photodynamic, the antibacterial efficiency of Fe2O3 @MoS2 @SDS to E. coli, MRSA and P. aeruginosa could reach 99.95%, 99.97% and 99.58%, respectively, indicating excellent photothermal-photodynamic therapy (PPT) effect. The Fe2O3 @MoS2 @SDS also displayed photocatalytic activity in degradation of tetracycline (TC). The degradation rate of TC could reach 92.3% after 2 h of visible light irradiation. The obtained results indicated that a promising Fe2O3 @MoS2 @SDS composite based multifunctional nanoplatform could be constructed for NIR induced bacterial inactivation, antibiotics degradation and ARGs dissemination inhibition.

The photosensitizer-based therapies enhance the repairing of skin wounds

Wound repair remains a clinical challenge and bacterial infection is a common complication that may significantly delay healing. Therefore, proper and effective wound management is essential. The photosensitizer-based therapies mainly stimulate the photosensitizer to generate reactive oxygen species through appropriate excitation source irradiation, thereby killing pathogenic microorganisms. Moreover, they initiate local immune responses by inducing the recruitment of immune cells as well as the production of proinflammatory cytokines. In addition, these therapies can stimulate the proliferation, migration and differentiation of skin resident cells, and improve the deposition of extracellular matrix; subsequently, they promote the re-epithelialization, angiogenesis, and tissue remodeling. Studies in multiple animal models and human skin wounds have proved that the superior sterilization property and biological effects of photosensitizer-based therapies during different stages of wound repair. In this review, we summarize the recent advances in photosensitizer-based therapies for enhancing tissue regeneration, and suggest more effective therapeutics for patients with skin wounds.

Near-infrared laser-controlled nitric oxide-releasing gold nanostar/hollow polydopamine Janus nanoparticles for synergistic elimination of methicillin-resistant Staphylococcus aureus and wound healing

Recently, nitric oxide (NO) has received increasing interest in combat against bacteria-induced infections because of its ability to sensitize and enhance the antibacterial effectiveness of many therapeutic approaches such as antibiotics. However, high-efficient loading and controlled release of NO remain a big challenge. In the present work, a type of gold nanostar/hollow polydopamine Janus nanostructure (GNS/HPDA JNPs) with precise near infrared (NIR)-controlled NO release property was fabricated using a facile seed-mediated method. Upon NIR laser irradiation, the NO-releasing GNS/HPDA JNPs (GNS/HPDA-BNN6) exhibited a synergistic photothermal and NO antibacterial effect by significantly inhibiting the growth and biofilm formation of both Gram-negative and Gram-positive bacterial strains, including methicillin-resistant Staphylococcus aureus (MRSA). An in-depth mechanism study revealed that two pathways were mainly involved in the synergistic photothermal and NO antibacterial effect. In one pathway, the synergistic effect severely destroyed the bacterial membrane by causing leakage of intracellular components such as DNA. In another pathway, the synergistic effect largely disturbed bacterial metabolism by regulating relative metabolic genes, followed by enhancing ROS generation to cause intracellular GSH depletion and DNA damage. More importantly, the synergistic effect significantly diminished the drug resistance of MRSA by downregulating the expression of the drug-resistant gene mecA and some relative multidrug efflux pumps (e.g., SepA and Tet38). An in vivo evaluation using a rat model with MRSA-infected wounds indicated that the synergistic photothermal and NO effect of GNS/HPDA-BNN6 can effectively eliminate MRSA from wounds, thereby alleviating inflammation and promoting wound healing. STATEMENT OF SIGNIFICANCE: Multidrug-resistant (MDR) bacteria have become a big threat to mankind, and therefore, the development of innovative antibacterial agents with high antibacterial efficiency is urgently required. Nanomaterial-mediated nitric oxide (NO) therapy is a promising strategy to effectively combat MDR bacteria through a synergistic antibacterial effect. Here, a gold nanostar/hollow polydopamine Janus nanostructure with precise near infrared (NIR) light-controlled NO release property (GNS/HPDA-BNN6) was developed. Both in vitro and in vivo evaluations demonstrated that GNS/HPDA-BNN6 could effectively eliminate methicillin-resistant Staphylococcus aureus (MRSA) from infected wounds and promote wound healing through a synergistic photothermal and NO therapeutic effect. Remarkably, the synergistic effect significantly diminished the drug resistance of MRSA by downregulating the expression of some drug-resistant genes and multidrug efflux pumps.

Carboxymethyl chitosan-based multifunctional hydrogels incorporated with photothermal therapy against drug-resistant bacterial wound infection

Wound infection especially that induced by drug resistant bacteria has been considered an increasing medical crisis. Herein a biocompatible wound dressing is conveniently constructed by incorporating (Sr_0.6Bi_0.305)₂Bi₂O₇ (denoted as SBO) with excellent photothermal performance into a facile antibacterial hydrogel (gel) obtained from multiple physical crosslinks among Ag⁺, carboxymethyl chitosan and polyacrylic acid. The prepared SBO gel features excellent bactericidal activities, hemostasis, adequate mechanical properties, adhesiveness and adsorption capacities to bacterial cells and toxin. The gel can disperse SBO homogeneously in the network and SBO effectively convert visible light energy into localized heat for synergistic sterilization. In vitro assays confirm the potent broad-spectrum bactericidal activities of SBO gel to some common pathogens and drug resistant strains such as MRSA and CAPA. Mice model of MRSA-induced wound infections verified the practical efficacy of SBO gel in combating bacterial infections and accelerating wound healing. Moreover, this is the first report of SBO as a photothermal agent applied in anti-infection treatment. All of these results highlight the potential application of SBO gel in drug-resistant bacteria associated wound management.

Stabilizing Enzymes in Plasmonic Silk Film for Synergistic Therapy of In Situ SERS Identified Bacteria

Increasing antibiotic resistance becomes a serious threat to public health. Photothermal therapy (PTT) and antibacterial enzyme-based therapy are promising nonresistant strategies for efficiently killing drug-resistant bacteria. However, the poor thermostability of enzymes in PTT hinders their synergistic therapy. Herein, antibacterial glucose oxidase (GOx) is embedded in a Ag graphitic nanocapsule (Ag@G) arrayed silk film to fabricate a GOx-synergistic PTT system (named silk-GOx-Ag@G, SGA). The SGA system can stabilize GOx by a vitrification process through the restriction of hydrogen bond and rigid β-sheet, and keep the antibacterial activity in the hyperthermal PTT environment. Moreover, the arrayed Ag@G possesses excellent chemical stability due to the protection of graphitic shell, providing stable plasmonic effect for integrating PTT and surface enhanced Raman scattering (SERS) analysis even in the GOx-produced H2 O2 environment. With in situ SERS identification of bacterial intrinsic signals in the mouse wound model, such SGA realizes superior synergistic antibacterial effect on the infected Escherichia coli, Staphylococcus aureus, and methicillin-resistant Staphylococcus aureus in vivo, while without causing significant biotoxicity. This system provides a therapeutic method with low resistance and in situ diagnosis capability for efficiently eliminating bacteria.

Bacteria-Triggered Multifunctional Hydrogel for Localized Chemodynamic and Low-Temperature Photothermal Sterilization

Pathogenic infections seriously threaten public health and have been considered as one of the most critical challenges in clinical therapy. Construction of a safe and efficient photothermal antibacterial platform is a promising strategy for treatment of bacterial infections. Considering that high temperature does harm to the normal tissues and cells, herein, a bacteria-triggered multifunctional hydrogel is constructed for low-temperature photothermal sterilization with high efficiency by integrating localized chemodynamic therapy (L-CDT). The hydrogel is constructed by incorporating copper sulfide nanoparticles (CuS_NPs ) with photothermal profile into the network of hyaluronic acid (HA) and Fe³⁺ -EDTA complexes, named as CHFH (CuS_NPs -HA-Fe³⁺ -EDTA hydrogel). Bacteria can be accumulated on the surface of CHFH, which secretes hyaluronidase to decompose the HA and release Fe³⁺ . The Fe³⁺ is reduced into Fe²⁺ in microenvironment of bacteria to trigger Fenton reaction. The generated hydroxyl radicals result in sterilization based on L-CDT within short range. By integrating with photothermal property of CuS_NPs , low-temperature photothermal therapy (LT-PTT) for sterilization is realized, which improves the antibacterial efficiency while minimizes damage to normal tissues. The CHFH is further used to prepare Band aid which effectively promotes the Staphylococcus aureus-infected wound healing process in vivo, confirming the great potential for clinical application.

A biodegradable and near-infrared light-activatable photothermal nanoconvertor for bacterial inactivation

The development of biodegradable nanomaterials for near-infrared photothermal antibacterial is of great significance to improve the biosafety of nano-antibacterial strategies in clinical application. In this study, a new nano-antibacterial strategy was developed, in which a biodegradable charge-transfer nanocomplex acted as a high-efficiency near-infrared light-activatable photothermal nanoconvertor. The charge-transfer nanocomplex was synthesized through oxidation-induced self-assembly of 3,3',5,5'-tetramethylbenzidine molecules. This nanocomplex can efficiently convert light energy around 900 nm into heat energy, with a photothermal conversion efficiency of up to 30%. More importantly, the nanocomplex can spontaneously degrade under physiological conditions within 12 hours. Utilizing the photothermal effect of this nanocomplex, both Gram-positive bacteria and Gram-negative bacteria can be inactivated within 2 minutes. In addition, the inactivation mechanism was systematically discussed and the results indicated that the photothermal effect induced bacterial cell membrane damage was probably responsible for the antibacterial effect.

Two-dimensional biomaterials: material science, biological effect and biomedical engineering applications

To date, nanotechnology has increasingly been identified as a promising and efficient means to address a number of challenges associated with public health. In the past decade, two-dimensional (2D) biomaterials, as a unique nanoplatform with planar topology, have attracted explosive interest in various fields such as biomedicine due to their unique morphology, physicochemical properties and biological effect. Motivated by the progress of graphene in biomedicine, dozens of types of ultrathin 2D biomaterials have found versatile bio-applications, including biosensing, biomedical imaging, delivery of therapeutic agents, cancer theranostics, tissue engineering, as well as others. The effective utilization of 2D biomaterials stems from the in-depth knowledge of structure-property-bioactivity-biosafety-application-performance relationships. A comprehensive summary of 2D biomaterials for biomedicine is still lacking. In this comprehensive review, we aim to concentrate on the state-of-the-art 2D biomaterials with a particular focus on their versatile biomedical applications. In particular, we discuss the design, fabrication and functionalization of 2D biomaterials used for diverse biomedical applications based on the up-to-date progress. Furthermore, the interactions between 2D biomaterials and biological systems on the spatial-temporal scale are highlighted, which will deepen the understanding of the underlying action mechanism of 2D biomaterials aiding their design with improved functionalities. Finally, taking the bench-to-bedside as a focus, we conclude this review by proposing the current crucial issues/challenges and presenting the future development directions to advance the clinical translation of these emerging 2D biomaterials.

Combating Biofilms by a Self-Adapting Drug Loading Hydrogel

A bacterial biofilm is one of the main reasons that many diseases are difficult to cure. Herein, a teicoplanin (TPN)-loaded self-adapting chitosan-based hydrogel (CPH) system, called TPN-CPH, was prepared by encapsulating antibacterial TPN into CPH. This TPN-CPH can effectively combat preformed biofilms in vitro of Staphylococcus aureus (S. aureus). It has a good therapeutic effect on full-thickness cutaneous wounds in vivo of mice infected with biofilms. In addition, TPN-CPH can accelerate wound healing by self-adapting the wound and providing a moist environment. The operation process of TPN-CPH is simple, and no external stimulation such as light and heat is needed in the treatment process, making it more convenient for clinical application. Furthermore, this is a challenge to use self-adapting hydrogels to adapt the micro-size channels of biofilms. TPN-CPH provides a chitosan-based self-adapting hydrogel system for loading drugs to kill bacteria in biofilms, and thus it is promising for infection control.

Magnetically Guided Nanoworms for Precise Delivery to Enhance In Situ Production of Nitric Oxide to Combat Focal Bacterial Infection In Vivo

Overexploitation of antibiotics increases the emergence of multidrug-resistant agents (MDRAs), which may potentially cause a global crisis with severe health consequences. Hence, there is great demand for next-generation antibacterial platforms based on antibiotic-free strategies or targeted therapies to mitigate the emergence of MDRAs. Herein, an all-in-one hollow nanoworm (A-Fe/AuAg@PDA) is developed with a core comprising citrate-capped Au-Ag nanoparticles (Cit-AuAg NPs) loaded with Fe₂O₃ and an l-arginine (L-Arg)-modified polydopamine (PDA) outer shell, possessing exceptional magnetic-targeting ability and a photothermal therapeutic effect. Following intravenous injection, A-Fe/AuAg@PDA can be precisely delivered to the targeted infection sites by an externally applied magnetic field. The in situ produced NO, together with Ag ions and reactive oxygen species, synergistically results in the highly effective elimination of in vivo bacterial infection. With the aid of functional worm-like A-Fe/AuAg@PDA nanocarriers possessing superior biocompatibility, the combination of magnetic guidance therapy and near-infrared-triggered in situ generation of NO may provide a novel approach for eradicating abscesses in the body. To our knowledge, this is the first study highlighting the magnetically guided delivery of worm-like nanocarriers for the antibiotic-free therapy of bacterial infections using in situ generated NO gas, which demonstrates high potential for application in clinical gas therapy.

A bifunctional nanoplatform based on copper manganate nanoflakes for bacterial elimination via a catalytic and photothermal synergistic effect

Bacterial infection has been recognized as one of the greatest threats to public health. In view of the continuous increase of bacterial resistance, constructing a collaborative bactericidal platform is a promising strategy to enhance the efficiency of antimicrobial agents. Herein, we report a facile, biocompatible and versatile nano-platform based on positively charged copper manganate nanoflakes (CuMnO2 NFs), which exhibits intrinsic peroxidase-like catalytic activity and excellent photothermal properties. The CuMnO2 NFs can bind with negatively charged bacteria via electrostatic interactions, and generate hydroxyl radicals (˙OH) through catalysis involving hydrogen peroxide (H2O2) to make bacteria more susceptible to temperature. Introducing near-infrared light generates hyperthermia to fight against bacteria and enhances the peroxidase-like catalytic activity of the CuMnO2 NFs, thus producing more ˙OH to combat bacteria. The PTT-enhanced ˙OH synergistic antibacterial strategy exerts desirable antibacterial efficiencies of 98.78% and 99.92% against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) at a controlled low temperature (below 50 °C), without damage to healthy tissues. Animal experiments indicate that this synergistic treatment has a better therapeutic effect on S. aureus-infected wounds in mice, compared with either treatment by itself. Therefore, this work holds great promise for developing new synergistic antimicrobial strategies to treat bacterial infections.

PEGylated Phthalocyanine-Functionalized Graphene Oxide with Ultrahigh-Efficient Photothermal Performance for Triple-Mode Antibacterial Therapy

This study proposes a novel multifunctional synergistic antibacterial phototherapy technique for the rapid healing of bacteria-infected wounds. By binding PEGylated phthalocyanines to the surface of graphene oxide via noncovalent functionalization, the photothermal conversion efficiency of the obtained nanocomposites can be significantly increased, which shows that the sample temperature can achieve nearly 100 °C after only 10 min of 450 nm light illumination at a concentration ≥25 μg/mL. Moreover, the nanocomposites can rapidly generate singlet oxygen under 680 nm light irradiation and physically cut bacterial cell membranes. The triple effects are expected to obtain a synergistic antibacterial efficiency and reduce the emergence of bacterial resistance. After dual-light irradiation for 10 min, the generation of hyperthermia and singlet oxygen can cause the death of Gram-positive and Gram-negative bacteria. The results of an in vivo experiment revealed that the as-prepared nanocomposites combined with dual-light-triggered antibacterial therapy can effectively restrain the inflammatory reaction and accelerate the healing of bacteria-infected wounds. These were confirmed by the examination of pathological tissue sections and inflammatory factors in rats with bacteria-infected wounds. This nanotherapeutic platform is a potential photoactivated antimicrobial strategy for the prevention and treatment of bacterial infection.

Titanium carbide/zeolite imidazole framework-8/polylactic acid electrospun membrane for near-infrared regulated photothermal/photodynamic therapy of drug-resistant bacterial infections

Bacteria induced wound infection has become fatal healthcare issues needed to be resolved urgently. It is of vital importance to develop multifunctional therapeutic platforms to fight against increased bacterial antibiotic resistance. Herein, a titanium carbide (MXene)/zeolite imidazole framework-8 (ZIF-8)/polylactic acid (PLA) composite membrane (MZ-8/PLA) was fabricated through in-situ growth of ZIF-8 on MXene and the subsequent electrospinning process. It indicated MZ-8 can generate singlet oxygen and hyperthermia at photothermal (PTT) convention efficiency of 80.5% with bactericidal rate of more than 99.0%. In addition, MZ-8 showed remarkable antitumor efficiency in vitro and in vivo based on the combined photodynamic/photothermal therapy. Theoretical calculation illustrated MZ-8 could improve the laser activation process by acceleration of intermolecular charge transfer, reducing excitation energy, stabilizing excited states and increasing intersystem crossing rate. After incorporated into electrospun scaffolds, MZ-8/PLA exhibited potent PTT and photodynamic therapy (PDT) properties under 808 nm laser irradiation. The antibacterial rates of MZ-8/PLA were up to 99.9% and 99.8% against Escherichia coli and Methicillin-resistant staphylococcus aureus, respectively. In-vivo experimental results further confirmed that MZ-8/PLA can accelerate bacteria infected wound healing without observable resistance. This work opens a new avenue to design promising platforms for fighting against extremely drug resistant bacterial infection.

Epithelium-Penetrable Nanoplatform with Enhanced Antibiotic Internalization for Management of Bacterial Keratitis

A standardized regimen for addressing the adverse effects of bacterial keratitis on vision remains an intractable challenge due to poor epithelial penetration and a short corneal retention time. In this study, a new strategy is proposed to implement the direct transport of antibiotics to bacteria-infected corneas via topical administration of an epithelium-penetrable biodriven nanoplatform, thereby enabling the efficacious treatment of bacterial keratitis. The nanoplatforms were composed of amphiphilic glycopolymers containing boron dipyrromethene and boronic acid moieties with stable fluorescence characteristics and the ability to potentiate epithelial penetration deep into the cornea. The boronic acid-derived nanoplatforms enabled efficient cellular internalization through the high affinity of boric acid groups for the diol-containing bacterial cell wall, resulting in enhanced drug penetration and retention inside the pathogenic bacteria. The bacterial cells formed agglomerations after incorporating the nanoplatforms along with a special mechanism to release the encapsulated cargo in response to in situ bacteria. Compared with the drug alone, this smart system achieved enhanced bacterial mortality and attenuated inflammation associated with Staphylococcus aureus-induced keratitis in rats, demonstrating a paradigm for targeted ocular drug delivery and an alternative strategy for managing bacterial keratitis or other bacterial infections by heightening corneal permeability and transcorneal bioavailability.

The Building Blocks of Antimicrobial Resistance in Pseudomonas aeruginosa: Implications for Current Resistance-Breaking Therapies

P. aeruginosa is classified as a priority one pathogen by the World Health Organisation, and new drugs are urgently needed, due to the emergence of multidrug-resistant (MDR) strains. Antimicrobial-resistant nosocomial pathogens such as P. aeruginosa pose unwavering and increasing threats. Antimicrobial stewardship has been a challenge during the COVID-19 pandemic, with a majority of those hospitalized with SARS-CoV2 infection given antibiotics as a safeguard against secondary bacterial infection. This increased usage, along with increased handling of sanitizers and disinfectants globally, may further accelerate the development and spread of cross-resistance to antibiotics. In addition, P. aeruginosa is the primary causative agent of morbidity and mortality in people with the life-shortening genetic disease cystic fibrosis (CF). Prolonged periods of selective pressure, associated with extended antibiotic treatment and the actions of host immune effectors, results in widespread adaptive and acquired resistance in P. aeruginosa found colonizing the lungs of people with CF. This review discusses the arsenal of resistance mechanisms utilized by P. aeruginosa, how these operate under high-stress environments such as the CF lung and how their interconnectedness can result in resistance to multiple antibiotic classes. Intrinsic, adaptive and acquired resistance mechanisms will be described, with a focus on how each layer of resistance can serve as a building block, contributing to multi-tiered resistance to antimicrobial activity. Recent progress in the development of anti-resistance adjuvant therapies, targeting one or more of these building blocks, should lead to novel strategies for combatting multidrug resistant P. aeruginosa. Anti-resistance adjuvant therapy holds great promise, not least because resistance against such therapeutics is predicted to be rare. The non-bactericidal nature of anti-resistance adjuvants reduce the selective pressures that drive resistance. Anti-resistance adjuvant therapy may also be advantageous in facilitating efficacious use of traditional antimicrobials, through enhanced penetration of the antibiotic into the bacterial cell. Promising anti-resistance adjuvant therapeutics and targets will be described, and key remaining challenges highlighted. As antimicrobial stewardship becomes more challenging in an era of emerging and re-emerging infectious diseases and global conflict, innovation in antibiotic adjuvant therapy can play an important role in extending the shelf-life of our existing antimicrobial therapeutic agents.

2D Nanomaterials for Tissue Engineering and Regenerative Nanomedicines: Recent Advances and Future Challenges

Regenerative medicine has become one of the hottest research topics in medical science that provides a promising way for repairing tissue defects in the human body. Due to their excellent physicochemical properties, the application of 2D nanomaterials in regenerative medicine has gradually developed and has been attracting a wide range of research interests in recent years. In particular, graphene and its derivatives, black phosphorus, and transition metal dichalcogenides are applied in all the aspects of tissue engineering to replace or restore tissues. This review focuses on the latest advances in the application of 2D-nanomaterial-based hydrogels, nanosheets, or scaffolds that are engineered to repair skin, bone, and cartilage tissues. Reviews on other applications, including cardiac muscle regeneration, skeletal muscle repair, nerve regeneration, brain disease treatment, and spinal cord healing are also provided. The challenges and prospects of applications of 2D nanomaterials in regenerative medicine are discussed.

The recent progress in photothermal-triggered bacterial eradication

Increasing evidence suggested that bacterial infection diseases posed a great threat to human health and became the leading cause of mortality. However, the abuse of antibiotics and their residues in the environment result in the emergence and prevalence of drug-resistant bacteria. Photothermal therapy (PTT) has received considerable attention owing to its noninvasiveness, and proved to be promising in preventing bacterial infection diseases. In this review, we first surveyed the recent progress of PTT-based responsive targeting strategies for bacterial killing. We then highlighted the PTT-based smart designs of bio-films, hydrogels and synergistic methods for treating bacterial infections. Existing challenges and perspectives are also discussed to inspire the future development of a PTT-based platform for the efficient therapy of bacterial infections.

Antibacterial and antibiofilm properties of graphene and its derivatives

Infections resulting from bacteria and biofilms have become a huge problem threatening human health. In recent years, the antibacterial and antibiofilm effects of graphene and its derivatives have been extensively studied. However, there continues to be some controversy over whether graphene and its derivatives can resist infection and biofilms. Moreover, the antibacterial mechanism and cytotoxicity of graphene and its derivatives are unclear. In the present review, antibacterial and antibiofilm abilities of graphene and its derivatives in solution, on the surface are reviewed, and their toxicity and possible mechanisms are also reviewed. Furthermore, we propose possible future development directions for graphene and its derivatives in antibacterial and antibiofilm applications.

Emerging photothermal-derived multimodal synergistic therapy in combating bacterial infections

Due to the emerging bacterial resistance and the protection of tenacious biofilms, it is hard for the single antibacterial modality to achieve satisfactory therapeutic effects nowadays. In recent years, photothermal therapy (PTT)-derived multimodal synergistic treatments have received wide attention and exhibited cooperatively enhanced bactericidal activity. PTT features spatiotemporally controllable generation of hyperthermia that could eradicate bacteria without inducing resistance. The synergy of it with other treatments, such as chemotherapy, photo-dynamic/catalytic therapy (PDT/PCT), immunotherapy, and sonodynamic therapy (SDT), could lower the introduced laser density in PTT and avoid undesired overheating injury of normal tissues. Simultaneously, by heat-induced improvement of the bacterial membrane permeability, PTT is conducive for accelerated intracellular permeation of chemotherapeutic drugs as well as reactive oxygen species (ROS) generated by photosensitizers/sonosensitizers, and could promote infiltration of immune cells. Thereby, it could solve the currently existing sterilization deficiencies of other combined therapeutic modes, for example, bacterial resistance for chemotherapy, low drug permeability for PDT/PCT/SDT, adverse immunoreactions for immunotherapy, etc. Admittedly, PTT-derived synergistic treatments are becoming essential in fighting bacterial infection, especially those caused by antibiotic-resistant strains. This review firstly presents the classical and newly reported photothermal agents (PTAs) in brief. Profoundly, through the introduction of delicately designed nanocomposite platforms, we systematically discuss the versatile photothermal-derived multimodal synergistic therapy with the purpose of sterilization application. At the end, challenges to PTT-derived combinational therapy are presented and promising synergistic bactericidal prospects are anticipated.

Fe3O4–Au–polydopamine hybrid microcapsules with photothermal–photodynamic synergistic anti-bacterial performance

A novel magnetic Fe3O4–Au–PDA hybrid microcapsule with both photothermal (PTT) and photodynamic (PDT) anti-bacterial functions has been developed, and the product exhibits higher antibacterial performance by the combined PTT/PDT treatment.

Antibacterial self-assembled nanodrugs composed of berberine derivatives and rhamnolipids against Helicobacter pylori

The prevalence of infections with Helicobacter pylori (H. pylori) has progressively increased worldwide, which demonstrated to be closely correlated to its biofilm formation. H. pylori biofilms protect the bacteria by significantly decreasing their sensitivity to antibiotics. Moreover, H. pylori colonizes on the gastrointestinal tract epithelium which is covered by mucus layer, acting as another barrier to prevent antibacterial agents from reaching the colonization sites. Herein, we prepared four types of versatile self-assembled nanodrugs (BD/RHL NDs) containing lipophilic alkyl berberine derivatives (BDs) and rhamnolipids (RHL) to overcome the dual obstructions of both mucus layer and biofilms. Molecular dynamics simulations estimated that the driving forces for self-assembly of BD/RHL NDs were electrostatic and hydrophobic interactions. BD/RHL NDs, characterized by appropriate size, negative charge and enhanced hydrophilicity, successfully penetrated through mucus layer without interacting with mucins. In in vitro experiments, BD/RHL NDs exhibited substantial ability to eradicate H. pylori biofilms by destroying their extracellular polymeric substances (EPS) and killing planktonic H. pylori. Furthermore, BD/RHL NDs inhibited the adherence of H. pylori on both biotic and abiotic surfaces, therefore cut off the critical step of the biofilm re-formation which was associated with the recrudescence of infections. In an H. pylori-infected mice model, C10-BD/RHL NDs group showed 40 folds less remnant H. pylori and greater mucosal protection compared with the conventional clinical triple therapy. In conclusion, BD/RHL NDs could penetrate through mucus layer and effectively eradicate H. pylori biofilms in vitro and in vivo, providing a novel strategy for clinical treatment of biofilm-related infections.

Thermo-resistance of ESKAPE-panel pathogens, eradication and growth prevention of an infectious biofilm by photothermal, polydopamine-nanoparticles in vitro

Nanotechnology offers many novel infection-control strategies that may help prevent and treat antimicrobial-resistant bacterial infections. Here, we synthesized polydopamine, photothermal-nanoparticles (PDA-NPs) without further surface-functionalization to evaluate their potential with respect to biofilm-control. Most ESKAPE-panel pathogens in suspension with photothermal-nanoparticles showed three- to four-log-unit reductions upon Near-Infra-Red (NIR)-irradiation, but for enterococci only less than two-log unit reduction was observed. Exposure of existing Staphylococcus aureus biofilms to photothermal-nanoparticles followed by NIR-irradiation did not significantly kill biofilm-inhabitants. This indicates that the biofilm mode of growth poses a barrier to penetration of photothermal-nanoparticles, yielding dissipation of heat to the biofilm-surrounding rather than in its interior. Staphylococcal biofilm-growth in the presence of photothermal-nanoparticles could be significantly prevented after NIR-irradiation because PDA-NPs were incorporated in the biofilm and heat dissipated inside it. Thus, unmodified photothermal nanoparticles have potential for prophylactic infection-control, but data also constitute a warning for possible development of thermo-resistance in infectious pathogens.

Phototherapy-based combination strategies for bacterial infection treatment

The development of nanomedicine is expected to provide an innovative direction for addressing challenges associated with multidrug-resistant (MDR) bacteria. In the past decades, although nanotechnology-based phototherapy has been developed for antimicrobial treatment since it rarely causes bacterial resistance, the clinical application of single-mode phototherapy has been limited due to poor tissue penetration of light sources. Therefore, combinatorial strategies are being developed. In this review, we first summarized the current phototherapy agents, which were classified into two functional categories: organic phototherapy agents (e.g., small molecule photosensitizers, small molecule photosensitizer-loaded nanoparticles and polymer-based photosensitizers) and inorganic phototherapy agents (e.g., carbo-based nanomaterials, metal-based nanomaterials, composite nanomaterials and quantum dots). Then the development of emerging phototherapy-based combinatorial strategies, including combination with chemotherapy, combination with chemodynamic therapy, combination with gas therapy, and multiple combination therapy, are presented and future directions are further discussed. The purpose of this review is to highlight the potential of phototherapy to deal with bacterial infections and to propose that the combination therapy strategy is an effective way to solve the challenges of single-mode phototherapy.

Multivalent and synergistic chitosan oligosaccharide-Ag nanocomposites for therapy of bacterial infection

Chitosan oligosaccharide functionalized silver nanoparticles with synergistic bacterial activity were constructed as a multivalent inhibitor of bacteria. Placing the chitosan oligosaccharide on silver nanoparticles can dramatically enhance the adsorption to the bacterial membrane via multivalent binding. The multicomponent nanostructures can cooperate synergistically against gram-positive and gram-negative bacteria. The antibacterial activity was increased via orthogonal array design to optimize the synthesis condition. The synergistic bacterial activity was confirmed by fractional inhibitory concentration and zone of inhibition test. Through studies of antimicrobial action mechanism, it was found that the nanocomposites interacted with the bacteria by binding to Mg²⁺ ions of the bacterial surface. Then, the nanocomposites disrupted bacterial membrane by increasing the permeability of the outer membrane, resulting in leakage of cytoplasm. This strategy of chitosan oligosaccharide modification can increase the antibacterial activity of silver nanoparticles and accelerate wound healing at the same time. The nanomaterial without cytotoxicity has promising applications in bacteria-infected wound healing therapy.

Rapid and effective photodynamic treatment of biofilm infections using low doses of amoxicillin-coated gold nanoparticles

Bacterial biofilm are complex microbial communities covered by a matrix of extracellular polymeric substances, which develops when a community of microorganisms irreversibly adheres to a living or inert surface. This structure is considered an important virulence factor because it is difficult to eradicate and often responsible for treatment failures. This adherent community represents one of the greatest problems in public health due to the continued emergence of conventional antibiotic-therapy resistance. Photodynamic Antimicrobial Therapy (PACT) is a therapeutic alternative and promises to be an effective treatment against multiresistant bacteria biofilm, demonstrating a broad spectrum of action. This work demonstrates the reduction in biofilms of relevant clinical isolates (as Pseudomonas aeruginosa and Staphylococcus aureus) treated with PACT using low concentrations of amoxicillin-coated gold nanoparticles (amoxi@AuNP) as a photosensitizer. Moreover, the viability reduction of 60% in S. aureus biofilms and 70% in P. aeruginosa biofilms were obtained after three hours of irradiation with white light and amoxi@AuNP. Scanning electron microscopy analysis revealed that amoxi@AuNP could penetrate and cause damage to the biofilm matrix, and interact with bacteria cells. A strong biofilm production in P. aeruginosa was observed by confocal laser scanning microscopy using acridine orange as a probe, and a markedly decrease in live bacteria was appreciated when PACT was applied. The use of amoxi@AuNP for PACT allows the viability reduction of clinical Gram positive and Gram negative biofilms. This novel strategy needs shorter irradiation times and lower concentrations of nanoparticles than other reports described. This could be attributed to two major innovations: the selectivity for the bacterial wall given by the amoxicillin and the polydispersity of size and shapes with seems to contribute to the photo-antibacterial capacity.

Ultra-efficient Antibacterial System Based on Photodynamic Therapy and CO Gas Therapy for Synergistic Antibacterial and Ablation Biofilms

In recent years, with the emergence of various kinds of drug-resistant bacteria, existing antibiotics have become inefficient in killing these bacteria, and the formation of biofilms has further weakened the therapeutic effect. More problematically, the massive use and abuse of antibiotics have caused severe side effects. Thus, the development of ultra-efficient and safe antibacterial systems is urgently needed. Herein, a photodynamic therapy (PDT)-driven CO-controlled delivery system (Ce6&CO@FADP) is developed for synergistic antibacterial and ablation biofilms. Ce6&CO@FADP is constructed using a fluorinated amphiphilic dendritic peptide (FADP) and physically loaded with Ce6 and CORM-401. After efficiently entering the bacteria, Ce6&CO@FADP can rapidly release CO intracellularly by the massive consumption of the H₂O₂ generated during the PDT process, without affecting the generation of singlet oxygen (¹O₂). As such, the combination of CO and ¹O₂ exerts notable synergistic antibacterial and biofilm ablation effects both in vitro and in vivo (including subcutaneous bacterial infection and biofilm catheter models) experiments. More importantly, all biosafety assessments suggest the good biocompatibility of Ce6&CO@FADP. Together, these results reveal that Ce6&CO@FADP is an efficient and safe antibacterial system, which has essential application prospects for the treatment of bacterial infections and ablation of biofilms in vivo.