Antimicrobial photodynamic therapy: assessment of genotoxic effects on keratinocytes in vitro

Zeina, B.; Greenman, John; Corry, David; Purcell, Wendy M.

doi:10.1046/j.1365-2133.2003.05091.x

Cited by 76 publications

(52 citation statements)

References 13 publications

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“…The potential for topical application to affected areas in mucocutaneous candidiasis and application of light only to affected areas makes these infections particularly amenable to approach by PDT. Zeina et al have demonstrated that PDT with methylene blue under conditions that lead to effective killing of typical skin microbes, including C. albicans cause neither cytotoxicity (24) nor DNA damage to keratinocytes in vitro (23). These observations lend support to the notion that selectivity for the microbe may be possible for mucocutaneous candidiasis, but gathering in vivo data will also be important.…”

Section: Discussionmentioning

confidence: 48%

Susceptibility of Candida Species to Photodynamic Effects of Photofrin

Bliss¹,

Bigelow

Foster

et al. 2004

Antimicrob Agents Chemother

149

126

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The in vitro susceptibility of pathogenic Candida species to the photodynamic effects of the clinically approved photosensitizing agent Photofrin was examined. Internalization of Photofrin by Candida was confirmed by confocal fluorescence microscopy, and the degree of uptake was dependent on incubation concentration. Uptake of Photofrin by Candida and subsequent sensitivity to irradiation was influenced by culture conditions. Photofrin uptake was poor in C. albicans blastoconidia grown in nutrient broth. However, conversion of blastoconidia to filamentous forms by incubation in defined tissue culture medium resulted in substantial Photofrin uptake. Under conditions where Photofrin was effectively taken up by Candida, irradiated organisms were damaged in a drug dose-and light-dependent manner. Uptake of Photofrin was not inhibited by azide, indicating that the mechanism of uptake was not dependent on energy provided via electron transport. Fungal damage induced by Photofrin-mediated photodynamic therapy (PDT) was determined by evaluation of metabolic activity after irradiation. A strain of C. glabrata took up Photofrin poorly and was resistant to killing after irradiation. In contrast, two different strains of C. albicans displayed comparable levels of sensitivity to PDT. Furthermore, a reference strain of C. krusei that is relatively resistant to fluconazole compared to C. albicans was equally sensitive to C. albicans at Photofrin concentrations of >3 g/ml. The results indicate that photodynamic therapy may be a useful adjunct or alternative to current anti-Candida therapeutic modalities, particularly for superficial infections on surfaces amenable to illumination.Photodynamic therapy (PDT) is a process in which cells are treated with an agent that makes them susceptible to killing by exposure to light. These agents, called photosensitizers, are generally macrocyclic compounds that exhibit no or minimal inherent toxicity but result in the generation of cytotoxic reactive oxygen species when excitation occurs with light of the appropriate wavelength. PDT has been applied most extensively in the treatment of neoplasms and shows promise as a novel therapy for some non-neoplastic disorders (4, 11). Photofrin is a photosensitizer that has been the subject of intensive investigation (4). Derived from acid treatment of hematoporphyrin, this compound has been approved by the U.S. Food and Drug Administration for the treatment of endobronchial and esophageal tumors (11) and is currently in clinical trials for several other indications.Although PDT is becoming established as a treatment modality to augment conventional chemotherapy and radiation in the oncologic literature, much less is known about the effects of photosensitizers on fungi of medical importance. Candida species have become increasingly prevalent as causes of both mucocutaneous and systemic infection in immunocompromised patients (3). Moreover, resistance of Candida to traditional antifungals such as fluconazole is increasing, with some species such as Cand...

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Section: Discussionmentioning

confidence: 48%

Susceptibility of Candida Species to Photodynamic Effects of Photofrin

Bliss¹,

Bigelow

Foster

et al. 2004

Antimicrob Agents Chemother

149

126

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“…According to some authors, it seems to be part of the normal skin flora, and therefore it would be responsible for infectious and inflammatory processes in very few cases [65] . Conversely, other authors have dealt with PDT for the treatment of S. epidermidis as an infection rather than as a mere colonizer [65] . Many studies showed the efficacy of PDT against this bacterial component, with different types of methods and photosensitizers.…”

Section: Hidradenitis Suppurativamentioning

confidence: 99%

“…It is well known that PDT shows antibacterial effects [44,45] and that the role of a bacterial component could be considered in HS pathogenesis. PDT likely benefits HS because it disrupts the biofilm that is commonly created by Staphylococcus epidermidis and Staphylococcus aureus in HS lesions [65] . The effect of S. epidermidis on the human skin is controversial.…”

Section: Hidradenitis Suppurativamentioning

confidence: 99%

Photodynamic Therapy and Skin Appendage Disorders: A Review

Megna

Fabbrocini

Marasca

et al. 2016

Skin Appendage Disord

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Photodynamic therapy (PDT) is a noninvasive treatment that utilizes light treatment along with application of a photosensitizing agent. In dermatology, PDT is commonly used and approved for the treatment of oncological conditions such as actinic keratosis, Bowen disease and superficial basal cell carcinoma. In the last 2 decades however, PDT has also been used for the treatment of several nonneoplastic dermatological diseases. The present review summarizes published data on PDT application in skin appendage disorders. Our literature review shows that: (a) PDT may be a suitable treatment for acne, folliculitis decalvans, hidradenitis suppurativa, nail diseases, and sebaceous hyperplasia; (b) there is a lack of agreement on PDT features (type, concentrations and incubation period of used substances, number and frequency of PDT sessions, optimal parameters of light sources, and patient characteristics [e.g., failure to previous treatments, disease severity, body surface area involved, etc.] which should guide PDT use in these diseases); (c) further research is needed to establish international guidelines helping dermatologists to choose PDT for the right patient at the right time.

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“…Kömerik et al 15 observed complete inactivation of Porphyromonas gingivalis in the maxillary molar region of rats after PDT, with no adverse effects on the periodontal structures after 3 days and significant reductions in bone loss after 90 days. Moreover, Zeina et al 16 detected no genotoxicity (immediate and delayed effects) on skin cells after a PDT protocol that was effective for killing microbial species. These authors concluded that there is a wide safety margin for PDT between microbial elimination and damage to host cells.…”

mentioning

confidence: 99%

Susceptibility of Candida albicans to photodynamic therapy in a murine model of oral candidosis

Mima

Pavarina

Dovigo

et al. 2010

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, an

141

130

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Objective. In vivo studies of antimicrobial PDT in animal models of oral candidosis are scarce and the association of porphyrin and LED light has not been evaluated for in vivo photoinactivation of Candida. In this study the effectiveness of photodynamic therapy (PDT) on the inactivation of Candida albicans in vivo was evaluated. Study design. Seventy-one 6-week-old female Swiss mice were immunosuppressed, provided tetracycline to their drinking water, then orally swabbed with a suspension of C. albicans (10 7 CFU/mL). Four days after oral inoculation, PDT was performed on the dorsum of the tongue after topical administration of Photogem at 400, 500, or 1000 mg/L and followed 30 minutes later by illumination with LED light (305 J/cm 2 ) at 455 or 630 nm (n ϭ 5 each). After swabbing to recover yeast from the tongue, the number of surviving yeast cells was determined (CFU/mL) and analyzed by ANOVA and Holm-Sidak tests (P Ͻ .05). Animals were humanely killed, and the tongues surgically removed and processed for histological evaluation of presence of yeast and inflammatory reaction. Results. PDT resulted in a significant reduction in C. albicans recovered from the tongue (P Ͻ .001) when compared with mice from the positive control group. There was no difference between the concentrations of Photogem and LED light wavelengths used. Histological evaluation of the tongue revealed that PDT causes no significant adverse effects to the local mucosa. Conclusion. PDT promoted significant reduction in the viability of C. albicans biofilm without harming the tongue tissue.

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Antimicrobial photodynamic therapy: assessment of genotoxic effects on keratinocytes in vitro

Abstract: APDT sufficient to reduce microbes by seven log cycles showed no detectable genotoxic effects on keratinocytes. APDT applied in vivo may represent a useful low-risk alternative to conventional antimicrobial treatment in dermatology.

Cited by 76 publications

References 13 publications

Susceptibility of Candida Species to Photodynamic Effects of Photofrin

Susceptibility of Candida Species to Photodynamic Effects of Photofrin

Photodynamic Therapy and Skin Appendage Disorders: A Review

Susceptibility of Candida albicans to photodynamic therapy in a murine model of oral candidosis

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