Photodynamic Therapy for Colorectal Cancer: An Update and a Look to the Future

This review provides an update on the current state of photodynamic therapy (PDT) for colorectal cancer (CRC) and explores potential future directions in this field. PDT has emerged as a promising minimally invasive treatment modality that utilizes photosensitizers and specific light wavelengths to induce cell death in targeted tumor tissues. In recent years, significant progress has been made in understanding the underlying mechanisms, optimizing treatment protocols, and improving the efficacy of PDT for CRC. This article highlights key advancements in PDT techniques, including novel photosensitizers, light sources, and delivery methods. Furthermore, it discusses ongoing research efforts and potential future directions, such as combination therapies and nanotechnology-based approaches. By elucidating the current landscape and providing insights into future directions, this review aims to guide researchers and clinicians in harnessing the full potential of PDT for the effective management of CRC.

Antibacterial nanophotosensitizers in photodynamic therapy: An update

Bacterial infections constitute a major challenge of clinical medicine, particularly in specialties such as dermatology and dental medicine. Antiseptics and antibiotics are the main adjunctive therapies to anti-infective procedures in these specialties. However, antibacterial photodynamic therapy (PDT) has been introduced as a novel and promising alternative to conventional antibacterial approaches. PDT relies on the formation of reactive oxygen species (ROS) by a photosensitizer (PS) after activation by a specific light source. Nanotechnology was later introduced to enhance the antibacterial efficacy of PS during PDT. In this review, we describe the different nanoparticles (NPs) used in PDT and their properties. Recent in vivo data of NPs in antibacterial PDT in dermatology and dental medicine and their safety concerns are also reviewed.

Nanotherapeutic Intervention in Photodynamic Therapy for Cancer

The clinical need for photodynamic therapy (PDT) has been growing for several decades. Notably, PDT is often used in oncology to treat a variety of tumors since it is a low-risk therapy with excellent selectivity, does not conflict with other therapies, and may be repeated as necessary. The mechanism of action of PDT is the photoactivation of a particular photosensitizer (PS) in a tumor microenvironment in the presence of oxygen. During PDT, cancer cells produce singlet oxygen (¹O₂) and reactive oxygen species (ROS) upon activation of PSs by irradiation, which efficiently kills the tumor. However, PDT's effectiveness in curing a deep-seated malignancy is constrained by three key reasons: a tumor's inadequate PS accumulation in tumor tissues, a hypoxic core with low oxygen content in solid tumors, and limited depth of light penetration. PDTs are therefore restricted to the management of thin and superficial cancers. With the development of nanotechnology, PDT's ability to penetrate deep tumor tissues and exert desired therapeutic effects has become a reality. However, further advancement in this field of research is necessary to address the challenges with PDT and ameliorate the therapeutic outcome. This review presents an overview of PSs, the mechanism of loading of PSs, nanomedicine-based solutions for enhancing PDT, and their biological applications including chemodynamic therapy, chemo-photodynamic therapy, PDT-electroporation, photodynamic-photothermal (PDT-PTT) therapy, and PDT-immunotherapy. Furthermore, the review discusses the mechanism of ROS generation in PDT advantages and challenges of PSs in PDT.

Nanobiotics against antimicrobial resistance: harnessing the power of nanoscale materials and technologies

Given the spasmodic increment in antimicrobial resistance (AMR), world is on the verge of “post-antibiotic era”. It is anticipated that current SARS-CoV2 pandemic would worsen the situation in future, mainly due to the lack of new/next generation of antimicrobials. In this context, nanoscale materials with antimicrobial potential have a great promise to treat deadly pathogens. These functional materials are uniquely positioned to effectively interfere with the bacterial systems and augment biofilm penetration. Most importantly, the core substance, surface chemistry, shape, and size of nanomaterials define their efficacy while avoiding the development of AMR. Here, we review the mechanisms of AMR and emerging applications of nanoscale functional materials as an excellent substitute for conventional antibiotics. We discuss the potential, promises, challenges and prospects of nanobiotics to combat AMR.

Modulating the antibacterial activity of gold nanoparticles by balancing their monodispersity and aggregation

Aggregation is a key factor influencing the function of nanoparticles. Thioproline-modified gold nanoparticles show potent antibacterial activity, which is compromised by thioproline-mediated particle aggregation. By tuning the balance between the exposure and shielding of thioproline, a maximal antibacterial property of the gold nanoparticles is achieved.

Water-soluble chlorin e6-hydroxypropyl chitosan as a high-efficiency photoantimicrobial agent against Staphylococcus aureus

The development of new antimicrobial agents is important to combat infections caused by pathogenic bacteria. Herein, Hydroxypropyl chitosan (HPCS), a hydrophilic modified product of chitosan (CS), was employed as a carrier of the photosensitizer chlorin e6 (Ce6) through an amide bond to obtain the products (HPCS-Ce6 conjugates) with a degree of substitution (DS) ranging from 2.95% to 5.25%. The UV-vis absorption spectra and 1H NMR spectra confirmed the successful synthesis of the products. The products have a better and more stable reactive oxygen species (ROS) generation capacity and higher bacterial affinity than Ce6. At a very low dose (1.8 μg/mL), the highest DS product (HPCS-Ce6-3) can effectively kill Staphylococcus aureus (S. aureus) under 660 nm irradiation. In addition, the HPCS-Ce6 conjugates showed high biocompatibility in the CCK-8 test. The HPCS-Ce6 conjugates could be a photodynamic antibacterial agent with good water solubility, high biocompatibility, and antibacterial activity.

Nanomaterials enabling clinical translation of antimicrobial photodynamic therapy

Antimicrobial photodynamic therapy (aPDT) has emerged as a promising approach to aid the fight against looming antibiotic resistance. aPDT harnesses the energy of light through photosenstizers to generate highly reactive oxygen species that can inactivate bacteria and fungi with no resistance. To date aPDT has shown great efficacy against microbes causing localized infections in the skin and the oral cavity. However, its wide application in clinical settings has been limited due to both physicochemical and biological challenges. Over the past decade nanomaterials have contributed to promoting photosensitizer performance and aPDT efficiency, yet further developments are required to establish accredited treatment options. In this review we discuss the challenges facing the clinical application of aPDT and the opportunities that nanotechnology may offer to promote the safety and efficiency of aPDT.

Photodynamic chitosan functionalized MoS2 nanocomposite with enhanced and broad-spectrum antibacterial activity

Bacterial infection accompanied by antibiotic resistance leads to the lack of effective antibacterial agents, which has become an imminent problem afflicting people. Therefore, development of highly effective and broad-spectrum disinfecting alternatives to tackle this challenge is of great necessity. In view of the different cell wall structures of bacteria, we designed photodynamic antibacterial system based on chlorin e6 (Ce6) loaded chitosan functionalized molybdenum sulfide (MoS₂) nanocomposites (M-CS-Ce6). The nanocomposite can not only allow Ce6 to enter the cells of Gram-positive bacteria, but also destroy the cell wall permeability of Gram-negative bacteria and enhance the photo-antibacterial effect. 10 μg/mL of M-CS-Ce6 irradiated by 660 nm laser for 5 min, completely killed the target pathogens, exhibiting significantly enhanced photo-antibacterial performance against both Gram-positive and Gram-negative bacteria. Compared with other cationic photodynamic composites, M-CS-Ce6 had stronger and broad-spectrum photo-antibacterial effect. Taken together, M-CS-Ce6 could be a promising and safe broad-spectrum antibacterial agent.

Chlorin e6 conjugated chitosan as an efficient photoantimicrobial agent

The development of antibacterial agents with high bacteria-binding capability and antibacterial efficiency is highly desirable. Herein, cationic polysaccharide chitosan (CS) was combined with photosensitizer Chlorin e6 (Ce6) to construct a novel photodynamic antibacterial agent (CS-Ce6 conjugates) for combating gram-positive bacteria Staphylococcus aureus (S. aureus) and gram-negative bacteria Escherichia coli (E. coli). CS-Ce6 conjugates with different degrees of substitution (DS) were synthesized and characterized by a spectroscopic method and organic elemental analysis to understand the relationship between structure and antibacterial effect. CS-Ce6 conjugates revealed good reactive oxygen species (ROS) generation ability and photodynamic antibacterial effect. Meanwhile, they both were positively correlated with DS in the range of 4.81% ~ 11.56% resulting in stronger photodynamic antibacterial ability. These findings highlight that CS-Ce6 conjugates have the potential as an effective photodynamic bactericidal agent in the antibacterial field.

Rough Carbon-Iron Oxide Nanohybrids for Near-Infrared-II Light-Responsive Synergistic Antibacterial Therapy

Infections caused by multidrug resistant bacteria are still a serious threat to human health. It is of great significance to explore effective alternative antibacterial strategies. Herein, carbon-iron oxide nanohybrids with rough surfaces (RCF) are developed for NIR-II light-responsive synergistic antibacterial therapy. RCF with excellent photothermal property and peroxidase-like activity could realize synergistic photothermal therapy (PTT)/chemodynamic therapy (CDT) in the NIR-II biowindow with improved penetration depth and low power density. More importantly, RCF with rough surfaces shows increased bacterial adhesion, thereby benefiting both CDT and PTT through effective interaction between RCF and bacteria. In vitro antibacterial experiments demonstrate a broad-spectrum synergistic antibacterial effect of RCF against Gram-negative Escherichia coli (E. coli), Gram-positive Staphylococcus aureus (S. aureus), and methicillin-resistant Staphylococcus aureus (MRSA). In addition, satisfactory biocompatibility makes RCF a promising antibacterial agent. Notably, the synergistic antibacterial performances in vivo could be achieved employing the rat wound model with MRSA infection. The current study proposes a facile strategy to construct antibacterial agents for practical antibacterial applications by the rational design of both composition and morphology. RCF with low power density NIR-II light responsive synergistic activity holds great potential in the effective treatment of drug-resistant bacterial infections.

Exploring the potential of highly charged Ru(II)- and heteronuclear Ru(II)/Cu(II)-polypyridyl complexes as antimicrobial agents

The antimicrobial potential of two ruthenium(II) polypyridyl complexes, [Ru(phen)₂L1]²⁺ and [Ru(phen)₂L2]²⁺ (phen = 1,10-phenanthroline) containing the 4,4'-(2,5,8,11,14-pentaaza[15])-2,2'-bipyridilophane (L1) and the 4,4'-bis-[methylen-(1,4,7,10-tetraazacyclododecane)]-2,2' bipyridine (L2) units, is herein investigated. These peculiar polyamine frameworks afford the formation of highly charged species in solution, influence the DNA-binding and cleavage properties of compounds, but they do not undermine their singlet oxygen sensitizing capacities, thus making these complexes attractive ¹O₂ generators in aqueous solution. L1 and L2 also permit to stably host Fenton -active Cu²⁺ ion/s, leading to the formation of mixed Ru²⁺/Cu²⁺ forms capable to further strengthen the oxidative damages to biological targets. Herein, following a characterization of the Cu²⁺ binding ability by [Ru(phen)₂L2]²⁺, the water-octanol distribution coefficients, the DNA binding, cleavage and ¹O₂ sensitizing properties of [Ru(phen)₂L2]²⁺ and [Cu₂Ru(phen)₂L2]⁶⁺ were analysed and compared with those of [Ru(phen)₂L1]²⁺ and [CuRu(phen)₂L1]⁴⁺. The antimicrobial activity of all compounds was evaluated against B. subtilis, chosen as a model for gram-positive bacteria, both under dark and upon light-activation. Our results unveil a notable phototoxicity of [Ru(phen)₂L2]²⁺ and [Cu₂Ru(phen)₂L2]⁶⁺, with MIC (minimal inhibitory concentrations) values of 3.12 μM. This study highlights that the structural characteristics of polyamine ligands gathered on highly charged Ru(II)-polypyridyl complexes are versatile tools that can be exploited to achieve enhanced antibacterial strategies.

Fibrous testing papers for fluorescence trace sensing and photodynamic destruction of antibiotic-resistant bacteria

The increasing prevalence of antibiotic-resistant bacteria needs rapid identification and efficient destruction routes. This study proposes testing paper derived from electrospun fibrous mats and aggregation-induced emission (AIE) probes for trace sensing and simultaneous destruction of antibiotic-resistant E. coli. Aptamers are conjugated on fibers for selective capture of E. coli, and the capture capability can be regenerated via rinsing with salt solution. Hydroxyl tetraphenylethene (TPE) is linked with two cephalosporin molecules to construct TPE-Cep probes, and the fluorescence emission is turned on specifically in the presence of β-lactamase, which is a critical marker for screening resistant bacteria. Fibrous mats are lit up only in the presence of antibiotic-resistant bacteria, and the fluorescence intensity changes could be statistically fitted into an equation for quantitative analysis. Fibrous strips display apparent color changes from blue to green for a visual readout of bacterial levels, and the limit of detection (LOD) is much lower than those of previous paper substrates. In addition, the TPE-Cep probes could produce reactive oxygen species (ROS) under room light illumination to kill the captured bacteria. Thus, the integration of aptamer-grafted electrospun fibers and functional AIE probes provides potential for selective capture, trace imaging and photodynamic destruction of antibiotic-resistant bacteria.

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.

A versatile nanocomposite based on nanoceria for antibacterial enhancement and protection from aPDT-aggravated inflammation via modulation of macrophage polarization

Antibacterial photodynamic therapy (aPDT) is of vital importance for the treatment of periodontal diseases due to its great potential on effective elimination of pathogenic bacteria via overwhelming reactive oxygen species (ROS) generation. However, the excessive ROS after the therapeutic process may impose an oxidative stress within periodontal pockets, consequently leading to an irreversible destroy in surrounding tissue and severely limit its biomedical applications. In this study, considering the contradiction between ROS in bacteriostasis and inflammation, the role of ROS in different temporal and spatial states has been fully studied. Accordingly, we have designed composite nanomaterials that can play ROS based aPDT and anti-inflammatory effect by eliminating ROS, taking account of different ratio of photosensitizer/ROS scavenger to realize a time-sequential manner. Herein, a simple multifunctional nanocomposite was fabricated by coating red light-excited photosensitizer chlorin e6 (Ce6) onto nanoceria, achieving simultaneous sterilization and inflammation elimination via a dual directional regulation effect. This nano-based platform could utilize the aPDT for antibacterial purpose in the first stage with red-light irradiation, and subsequently scavenge the residual ROS via nanoceria to modulate host immunity by down-regulating the M1 polarization (pro-inflammatory) of macrophages and up-regulating the M2 polarization (anti-inflammatory and regenerative) of macrophages. Moreover, the local ROS level induced by activated inflammation pathway can be adjusted in a very long time because of the charge conversion effect of CeO₂. The regenerative potential of inflammatory surrounding tissues was improved in the animal model. Our strategy will open a new inspiration to fight against the defects of aPDT in the treatment of periodontal disease, even in the anti-infection therapy for the future clinical application.

β-FeOOH/Fe-TiO2 heterojunctions on Ti for bacteria inactivation under light irradiation and biosealing

Intraosseous transcutaneous implants transferring mechanical stress directly from the skeleton to a prosthesis are an area of biological mechanics. However, bacterial invasion and weak biosealing with skin tissue usually induce implant failure. In this paper, composite coatings consisting of β-FeOOH as an outer layer and Fe-TiO₂ as an inner layer were prepared on Ti via micro-arc oxidation and hydrothermal treatment (HT). The surface microstructures and optical absorption properties of the coatings were observed, the production of reactive oxygen species (ROS) was measured, Staphylococcus aureus (S. aureus) and fibroblast behaviors were studied in vitro, and bacteria inactivation and skin tissue responses on different surfaces were evaluated in vivo. The results show that Fe³⁺ was doped into TiO₂ and β-FeOOH nanoparticles were gradually deposited on TiO₂ during HT treatment, forming β-FeOOH/Fe-TiO₂ heterojunctions. The light absorption of the composite coatings shifted to the longer wavelength region because of a narrowed TiO₂ bandgap and the formation of heterojunctions. Under light irradiation, photoinduced electrons and holes on the heterojunctions were separated efficiently. Via optimizing the amount of Fe³⁺ in TiO₂, ROS that formed at the heterojunctions after light irradiation for 10 min could kill 80% of S. aureus compared with pure Ti in vitro, but they did not affect fibroblast behavior, including proliferation and phenotyping. In vivo, the optimized β-FeOOH/Fe-TiO₂ heterojunctions, upon light irradiation, could inhibit bacterial infection, suppress an inflammatory response, and promote integration with skin tissue. Such results provide a new perspective suggesting the potential application of β-FeOOH/Fe-TiO₂ heterojunctions in percutaneous Ti implants, especially in infected cases.

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.

Layered double hydroxide nanostructures and nanocomposites for biomedical applications

Layered double hydroxide (LDH) nanostructures and related nanocomposites have attracted significant interest in biomedical applications including cancer therapy, bioimaging and antibacterial treatment. These materials hold great advantages including low cost and facile preparation, convenient drug loading, high drug incorporation capacity, good biocompatibility, efficient intracellular uptake and endosome/lysosome escape, and natural biodegradability in an acidic environment. In this review, we summarize the development of three types of LDH nanostructures including pristine LDH, surface modified LDH, and LDH nanocomposites for a range of biomedical applications. The advantages and disadvantages of LDH nanostructures and insights into the future development are also discussed.

Novel nanomaterial-based antibacterial photodynamic therapies to combat oral bacterial biofilms and infectious diseases

Oral diseases such as tooth caries, periodontal diseases, endodontic infections, etc., are prevalent worldwide. The heavy burden of oral infectious diseases and their consequences on the patients' quality of life indicates a strong need for developing effective therapies. Advanced understandings of such oral diseases, e.g., inflammatory periodontal lesions, have raised the demand for antibacterial therapeutic strategies, because these diseases are caused by viruses and bacteria. The application of antimicrobial photodynamic therapy (aPDT) on oral infectious diseases has attracted tremendous interest in the past decade. However, aPDT had a minimal effect on the viability of organized biofilms due to the hydrophobic nature of the majority of the photosensitizers (PSs). Therefore, novel nanotechnologies were rapidly developed to target the delivery of hydrophobic PSs into microorganisms for the antimicrobial performance improvement of aPDT. This review focuses on the state-of-the-art of nanomaterials applications in aPDT against oral infectious diseases. The first part of this article focuses on the cutting-edge research on the synthesis, toxicity, and therapeutic effects of various forms of nanomaterials serving as PS carriers for aPDT applications. The second part discusses nanomaterials applications for aPDT in treatments of oral diseases. These novel bioactive nanomaterials have demonstrated great potential to serve as carriers for PSs to substantially enhance the PDT therapeutic effects. Furthermore, the novel aPDT applications not only have exciting therapeutic potential to inhibit bacterial plaque-initiated oral diseases, but also have a wide applicability to other biomedical and tissue engineering applications.

Synthesis and biological evaluation of an epidermal growth factor receptor-targeted peptide-conjugated phthalocyanine-based photosensitiser

A peptide-conjugated zinc(ii) phthalocyanine containing the epidermal growth factor receptor-targeted heptapeptide QRHKPRE has been prepared. The conjugate labelled as ZnPc-QRH* can selectively bind to the cell membrane of HT29 human colorectal adenocarcinoma cells in 10 min followed by internalisation upon prolonged incubation via receptor-mediated endocytosis, leading to localisation in lysosomes eventually. By manipulating the incubation time, the subcellular localisation of the conjugate can be varied and the cell-death pathways induced upon irradiation can also be altered. It has been found that photosensitisation initiated at the cell membrane and in the lysosomes would trigger cell death mainly through necrosis and apoptosis respectively. Intravenous administration of the conjugate into HT29 tumour-bearing nude mice resulted in higher accumulation in the tumour than in most major organs. The selective binding of this conjugate to tumour has also been demonstrated by comparing the results with those of the analogue with a scrambled peptide sequence (EPRQRHK). The overall results indicate that ZnPc-QRH* is a promising EGFR-targeted photosensitiser for photodynamic therapy.

Outsmarting superbugs: bactericidal activity of nanostructured titanium surfaces against methicillin- and gentamicin-resistantStaphylococcus aureusATCC 33592

The colonisation of biomaterial surfaces by pathogenic bacteria is a significant issue of concern, particularly in light of the rapid rise of antibiotic resistance.