Antimicrobial photodynamic therapy fighting polymicrobial infections - a journey from in vitro to in vivo

Photochem Photobiol Sci. 2020 Oct 1;19(10):1332-1343. doi: 10.1039/d0pp00108b. Epub 2020 Sep 30.

Abstract

Rapidly evolving multidrug resistance renders conventional antimicrobial strategies increasingly inefficient. This urges the exploration of alternative strategies with a lower potential of resistance development to control microbial infections. A promising option is antimicrobial photodynamic therapy (aPDT), especially in the setting of wound infections. In this study its effectiveness was tested as a treatment option for polymicrobially infected wounds in both in vitro and in vivo models. First, aPDT was applied to wound-relevant Gram-positive and Gram-negative bacteria in planktonic culture as the standard in vitro test system and compared different media to show a possible dependency of the therapy on the surrounding environment. In a second step, aPDT was investigated in an in vitro model mimicking the wound bed conditions using fibrin-coated culture plates. Finally, we tested aPDT in vivo in a polymicrobial infected wound healing model in immunocompromised BALB/c mice. In vitro, it was shown that the bactericidal effectiveness of aPDT was strongly dependent on the surrounding environment of the phototoxic reaction. In vivo, the significant delay in wound healing induced by polymicrobial infection was drastically diminished by a two-times application of aPDT using 100 μM methylene blue (generally regarded as safe for topical application on human skin) and 24 J cm-2 pulsed red LED light. Our experiments suggest that aPDT is capable of significantly improving wound healing also in complicated polymicrobially infected wound situations.

MeSH terms

  • Animals
  • Anti-Bacterial Agents / chemistry
  • Anti-Bacterial Agents / pharmacology*
  • Coinfection / drug therapy*
  • Coinfection / microbiology*
  • Disease Models, Animal*
  • Escherichia coli K12 / drug effects*
  • Female
  • In Vitro Techniques
  • Mice
  • Mice, Inbred BALB C
  • Microbial Sensitivity Tests
  • Photochemotherapy*
  • Photosensitizing Agents / chemical synthesis
  • Photosensitizing Agents / pharmacology*
  • Staphylococcus capitis / drug effects*
  • Wound Healing / drug effects

Substances

  • Anti-Bacterial Agents
  • Photosensitizing Agents