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

Polydopamine-curcumin coating of titanium for remarkable antibacterial activity via synergistic photodynamic and photothermal properties

Combined photothermal therapy (PTT) and photodynamic therapy (PDT) has emerged as a novel and effective antibacterial strategy. In order to endow titanium (Ti) with antibacterial properties, the Ti-PDA-Cur composite was prepared using the excellent adhesion properties of polydopamine (PDA) to load curcumin (Cur) on the surface of Ti. The Ti-PDA-Cur coating can produce singlet oxygen (1O2) and heat under 405 + 808 nm light irradiation, which can effectively kill Staphylococcus aureus and Escherichia coli. Moreover, the cytotoxicity and hemolysis rate of Ti-PDA-Cur were low, indicating its good biocompatibility. Therefore, this study provided a new strategy for the development of new Ti implants.

Photodynamic therapy alone or in combination to counteract bacterial infections

INTRODUCTION

Antibacterial photodynamic therapy presents a promising alternative to antibiotics, with potential against multidrug-resistant bacteria, offering broad-spectrum action, reduced resistance risk, and improved tissue selectivity.

AREAS COVERED

This manuscript reviews patent literature in the field of antibacterial photodynamic therapy through the period of 2019-2023. All data are from the US and European patent databases and SciFinder.

EXPERT OPINION

Antibacterial photodynamic therapy (PDT) is an appealing approach for treating bacterial infections, especially biofilm-related ones, by releasing reactive oxygen species (ROS) upon light activation. Its success is driven by a growing variety of photosensitizers (PSs) with tailored properties, like water solubility, controllable surface charge, and ROS generation efficiency. Among them, Aggregation Induced Emission (AIE)-type PSs are promising, demonstrating enhanced efficacy when aggregated in biological environments. However, the penetration of pristine PSs into bacterial biofilms within deep tissues or complex anatomical regions is limited, reducing their antibacterial effectiveness. To address this, nanotechnology has been integrated into antibacterial PDT to synthesize various nano-PSs. This adaptability allows seamless integration with other antimicrobial treatments, offering a comprehensive approach to combat localized infections, especially in dentistry and dermatology. By combining PSs with complementary therapies, antibacterial PDT offers a multifaceted strategy for effective microbial control and management.

Construction of gelatin/alginate hydrogels doped hemicyanine derivatives for photodynamic antibacterial application

Hydrogel systems based on natural polymer materials have provided alternative opportunities for preparing antimicrobial dressings. A composite antibacterial hydrogel system containing gelatin (Gel), alginate (Alg) and hemicyanine derivatives with different chain lengths (C3, C6 and C10) was constructed. The composite hydrogels have excellent swelling ability and low degradability due to the classical three-dimensional network structure. Because of the photosensitization ability of C3, C6 and C10, hydrogels containing these molecules can also effectively produce reactive oxygen species (ROS) under light. Importantly, the hydrogel containing C3 molecules that have higher spatial extension structure and shorter alkyl chain than C6 and C10 shows better photo-responsive antibacterial effect against drug-resistant Escherichia coli. The bacterial killing activity of the composite hydrogel system could be regulated by changing the alkyl chain length of the photosensitizers. This effective and photo-responsive composite hydrogel system is expected to be used for bacteria-infected wound repair and promoting wound healing.

Advances in Development of Novel Therapeutic Strategies against Multi-Drug Resistant Pseudomonas aeruginosa

Pseudomonas aeruginosa (P. aeruginosa) with multi-drug resistance (MDR) is a major cause of serious healthcare-associated infections, leading to high morbidity and mortality. This opportunistic pathogen is responsible for various infectious diseases, such as those seen in cystic fibrosis, ventilator-associated pneumonia, urinary tract infection, otitis externa, and burn and wound injuries. Due to its relatively large genome, P. aeruginosa has great diversity and can use various molecular mechanisms for antimicrobial resistance. For example, outer membrane permeability can contribute to antimicrobial resistance and is determined by lipopolysaccharide (LPS) and porin proteins. Recent findings on the regulatory interaction between peptidoglycan and LPS synthesis provide additional clues against pathogenic P. aeruginosa. This review focuses on recent advances in antimicrobial agents and inhibitors targeting LPS and porin proteins. In addition, we explore current and emerging treatment strategies for MDR P. aeruginosa, including phages, vaccines, nanoparticles, and their combinatorial therapies. Novel strategies and their corresponding therapeutic agents are urgently needed for combating MDR pathogens.

A comprehensive guide on screening and selection of a suitable AMP against biofilm-forming bacteria

Lately, antimicrobial resistance (AMR) is increasing at an exponential rate making it important to search alternatives to antibiotics in order to combat multi-drug resistant (MDR) bacterial infections. Out of the several antibacterial and antibiofilm strategies being tested, antimicrobial peptides (AMPs) have shown to give better hopes in terms of a long-lasting solution to the problem. To select a desired AMP, it is important to make right use of available tools and databases that aid in identification, classification, and analysis of the physiochemical properties of AMPs. To identify the targets of these AMPs, it becomes crucial to understand their mode-of-action. AMPs can also be used in combination with other antibacterial and antibiofilm agents so as to achieve enhanced efficacy against bacteria and their biofilms. Due to concerns regarding toxicity, stability, and bioavailability, strategizing drug formulation at an early-stage becomes crucial. Although there are few concerns regarding development of bacterial resistance to AMPs, the evolution of resistance to AMPs occurs extremely slowly. This comprehensive review gives a deep insight into the selection of the right AMP, deciding the right target and combination strategy along with the type of formulation needed, and the possible resistance that bacteria can develop to these AMPs.

Photodynamic Suppression of Enterococcus Faecalis in Infected Root Canals with Indocyanine Green, TroloxTM and Near-Infrared Light

Recently, our group showed that additional supplementation of Trolox™ (vitamin E analogue) can significantly enhance the antimicrobial photodynamic effect of the photosensitizer Indocyanine green (ICG). Up to now, the combined effect has not yet been investigated on Enterococcus faecalis in dental root canals. In the present in vitro study, eighty human root canals were inoculated with E. faecalis and subsequently subjected to antimicrobial Photodynamic Therapy (aPDT) using ICG (250, 500, 1000 µg/mL) and near-infrared laser light (NIR, 808 nm, 100 Jcm-2). Trolox™ at concentrations of 6 mM was additionally applied. As a positive control, irrigation with 3% NaOCl was used. After aPDT, root canals were manually enlarged and the collected dentin debris was subjected to microbial culture analysis. Bacterial invasion into the dentinal tubules was verified for a distance of 300 µm. aPDT caused significant suppression of E. faecalis up to a maximum of 2.9 log counts (ICG 250 µg/mL). Additional application of TroloxTM resulted in increased antibacterial activity for aPDT with ICG 500 µg/mL. The efficiency of aPDT was comparable to NaOCl-irrigation inside the dentinal tubules. In conclusion, ICG significantly suppressed E. faecalis. Additional application of TroloxTM showed only minor enhancement. Future studies should also address the effects of TroloxTM on other photodynamic systems.

Construction of mPt/ICG-αA nanoparticles with enhanced phototherapeutic activities for multidrug-resistant bacterial eradication and wound healing

The emergence of multidrug-resistant (MDR) bacterial infections calls for novel strategies for effective bacterial inhibition and wound healing. Phototherapeutic approaches are promising in treating bacterial infection because of their high efficiency, noninvasiveness, and few side effects; however, their antibacterial effect is limited by the formation of biofilms in wounds. Herein, we report novel composite nanoparticles (mPt/ICG-αA NPs) combining mesoporous platinum (mPt) nanoparticles, indocyanine green (ICG) and α-amylase (αA) for combating MDR bacteria and treating wound infection, which integrates a triple bacterial inhibition mechanism arising from the combination of photodynamic therapy (PDT), photothermal therapy (PTT) and α-amylase enzymatic activities. The combination of mPt and ICG significantly enhances the effect of PTT and the temperature can be increased up to 80.8 °C to induce efficacious bacterial degeneration. Meanwhile, mPt/ICG-αA (mPIA) NPs with a low concentration of 25 μg mL-1 exhibited a remarkable catalase activity (CAT) and could continuously decompose endogenous H2O2 into O2 in a hypoxic microenvironment, thereby enhancing the PDT effect to achieve broad-spectrum bactericidal activity. mPIA NPs showed excellent MDR antibacterial efficiency against both Gram-positive Staphylococcus aureus (S. aureus) and Gram-negative Escherichia coli (E. coli), and the bactericidal rate reached up to 99.0% and 97.2% with single 808 nm near-infrared light irradiation, respectively. mPIA NPs also exhibited an excellent ability to destroy biofilms and biocompatibility. Animal experiments further suggested that mPIA NPs could achieve the successful repairment of wounds infected with S. aureus in living systems, while this platform demonstrated negligible toxicity towards mice. Considering the superior performances of mPIA NPs, the synergistic αA-CAT-PDT-PTT boosted therapeutic activity presented in the current work provides a promising method to effectively fight against biofilm-related infectious diseases and wound healing.

Recent Progress of Photothermal Therapy Based on Conjugated Nanomaterials in Combating Microbial Infections

Photothermal therapy has the advantages of non-invasiveness, low toxicity, simple operation, a broad spectrum of antibacterial ability, and non-proneness to developing drug resistance, which provide it with irreplaceable superiority in fighting against microbial infection. The effect of photothermal therapy is closely related to the choice of photothermal agent. Conjugated nanomaterials are potential candidates for photothermal agents because of their easy modification, excellent photothermal conversion efficiency, good photostability, and biodegradability. In this paper, the application of photothermal agents based on conjugated nanomaterials in photothermal antimicrobial treatment is reviewed, including conjugated small molecules, conjugated oligomers, conjugated polymers, and pseudo-conjugated polymers. At the same time, the application of conjugated nanomaterials in the combination of photothermal therapy (PTT) and photodynamic therapy (PDT) is briefly introduced. Finally, the research status, limitations, and prospects of photothermal therapy using conjugated nanomaterials as photothermal agents are discussed.